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PubMed1989

Health promotion in context: the effects of significant others on health behavior change.

Maintenance of health behavior change over the long-term has been routinely difficult. One of the reasons for this difficulty is that only individuals' attitudes or behavior are changed, without concomitant support from the social environment. The purpose of this study was to explore several of the ways in which significant others--family members, friends, and coworkers--may affect changes in health behavior. Eighty-four participants in a work site health promotion program were the subjects of the study. Self-reports of health behaviors were gathered at baseline and at the end of the 7-week program; in addition, subjects reported the extent to which significant others generally supported health behavior changes, encouraged them to maintain changes they had made, and made changes in their own health behaviors. Results provide support for the general hypothesis that one individual attempting to change health behavior may be positively influenced by significant others during the course of the change process. Family members were particularly helpful, and overall supportiveness was more helpful than others' change in health habits or encouragement. Behaviors most influenced by others were exercise and fat consumption. Suggestions for future theoretical development, research, and intervention are discussed.

Attitude to Health↗
PubMedDate not supplied

Exploring nursing outcomes for health promotion.

The author examines nursing outcomes in relation to the aspect of nursing that deals with health promotion. The focus is on identifying factors that influence nursing outcomes and outcome selection, health promotion in the context of today's nursing practice, and the importance of nurses articulating their unique contribution to health promotion. The author also discusses measurement challenges inherent in outcome evaluation, and suggests future directions for enhancing outcome evaluation in health promotion.

Health Promotion↗
PubMed2002

Building a model of self-care for health promotion in aging.

PURPOSE: To synthesize knowledge about self-care in older community-dwelling people, identify essential dimensions of self-care related to health promotion and well-being in aging, and organize the findings into a literature-based, integrated model with applicability in practice, research, and education. ORGANIZING CONSTRUCT: Self-care and health promotion. Related concepts included self-concept, self-care ability, and self-care activity. METHODS: These terms were used to search Medline, CINAHL, and PsycINFO data bases. Theoretical and research articles from the last decade that related to self-care and health promotion in community-dwelling elders and that provided recommendations for education and practice were selected for inclusion in the analysis. FINDINGS: Self-care for health promotion in independent elders is multidimensional. Synthesis of literature findings resulted in development of the model of Self-care for Health Promotion in Aging, with five dimensions: internal and external environment, self-care ability, education, self-care activity, and outcomes. Examples of education plans that are developed in partnership with clients to promote better health and maximize quality of life are presented. CONCLUSIONS: Findings from current theoretical and empirical literature were synthesized to develop a model of self-care for health promotion in aging. Suggestions are made regarding application of the model in clinical practice and further theory building and hypothesis testing.

Aged↗
PubMed2002

[Involvement of Polish enterprises in workplace health promotion. Trends observed in years 1998-2001].

The author presents voluntary activities aimed at improving the workers' health in medium-sized and large enterprises in Poland, as well as the dynamic of changes in this area. The data were collected from enterprises chosen at random in 1998 (147 enterprises), 2000 (755) and 2001 (215). At present, over 60% of enterprises declare that they do more for their workers' health than it is required by legal regulations. Since 1998, the number of such declarations has been constantly growing. It is observed that the larger enterprise and the better economic situation, the more frequent health promotion activities. Two areas of activities are most commonly carried out: (1) medical services, e.g. vaccinations, extra diagnostic examinations and therapeutical services; and (2) investments in the work environment, e.g. ergonomics, improvement of interior designs. Unfortunately, promotion of healthy lifestyles, e.g. non-smoking campaigns or stress management are definitely less frequent. Although a growing number of enterprises becomes involved in health promotion, the range of their activities is diminishing. The programs aimed at promoting health conductive behaviors among workers are in particular given up. As far as smoking cessation is considered, the enterprises disseminate materials on the adverse effects of smoking or related ill-health and punish smokers for breaking smoking bans instead of helping their workers and teach them how to quit smoking or support those who want to give up this habit. In the years 2000 and 2001, the educational and supporting activities decreased whereas the punitive policy was on the rise.

Health Care Surveys↗
PubMed1996

Community health promotion: concepts and lessons from contemporary sociology.

The idealism on behalf of community interventions from The First International Conference on Health Promotion in 1986 today seems to be reduced. This article argues that there has been too little concern with what kind of social and spatial reality the community actually is among health promotion initiators and researchers. Contemporary sociological approaches to the community, emphasizing how collective and personal identities are developed in a situation with massive external and global influences, are introduced. The article advocates a stronger concern with particular local contexts and the inhabitants' self-interpretations, to learn more about whether and how local identities and cultures can be mobilized in health promotion initiatives. This focus contrasts that on education guiding most community health promotion projects. Inspired by contemporary methodological discussions centering around the concept of mechanism and contextual analysis in community studies, the article also criticizes the quasi-experimental research designs involved in many community health promotion projects.

Community Health Planning↗
PubMed2003

Development and testing of a framework for assessing the effectiveness of health promotion.

OBJECTIVES: The purpose was to develop and test a framework for assessing the overall effectiveness of health promotion in one Canadian province. METHODS: The project relied on expert opinion and consensus. A multidisciplinary team developed a Project Description Framework and a Health Promotion Evaluation Framework. Two sets of inclusion criteria were developed for selecting projects to be assessed using the Framework. The sampling frame was all health promotion projects starting in Alberta in January 1993 or later for which a written program evaluation could be obtained. Of 180 project reports, 91 met the first set and 35 met the remaining inclusion criteria. Two research associates independently used the Project Description Framework. Three associates independently applied the inclusion criteria. Consensus was reached in all cases. Research team members used the Health Promotion Evaluation Framework to assess the 35 projects and to comment on its utility and any gaps identified. RESULTS: A framework for assessing the effectiveness of health promotion was developed and tested. CONCLUSION: This framework is a useful tool as evidenced by the review that was obtained and subsequent applications.

Alberta↗
PubMed1989

Health status measurement in the evaluation of health promotion.

A step beyond treatment and even the prevention of disease is coming onto the health agenda. It is health promotion--"the advancement of well-being and the avoidance of health risks by achieving the optimal levels of the behavioral, societal, environmental and biomedical determinants of health." It differs from medical service in that the latter is directed largely toward overcoming poor health, disequilibrium with one's environment. Health promotion is aimed at maintaining the level of health and, insofar as possible, strengthening the potential (resources) for health. The emergence of health promotion raises an issue for those concerned with health status measurement: whether we consider health as having only biologic elements as traditionally understood in biomedical science, and role (performance) elements as traditionally understood in sociomedical science; or whether we add to these considerations a view of health as the dynamic equilibrium of individuals or groups of people with their environment, their capacity to live physically, mentally, and socially. The latter view entails measuring the health of people on a continuum extending from "perfect" harmony with one's environment and maximum potential for responding to adversities, on the one hand, to extreme invalidism and no reserves, i.e., the premorbid state, at the other extreme. That view also entails expanding attention to the whole population, not just the sick. It also means considering the relative emphasis to be given conceptual and methodologic work, individual versus community responsibilities for health, and the alleged medicalization of life.

Health Promotion↗
PubMedDate not supplied

Health promotion and disease prevention in HMOs: a survey of newly established IPAs in New York City.

Independent Practice Associations (IPAs) are the fastest growing segment of the Health Maintenance Organization (HMO) industry, but little is known about their provision of health promotion and disease prevention to subscribers. To examine the extent to which IPA policies encourage health promotion and disease prevention, we interviewed medical directors and other senior administrators of six newly developing IPA-HMOs in New York City. We also reviewed promotional literature to assess how extensively health promotion and disease prevention were marketed to the potential subscriber. Although medical protocols for preventive screening exist in most IPAs, compliance with guidelines is left largely to the individual physician's judgment for implementation. IPA respondents suggested that their physician panels are oriented toward prevention, but there is uncertain evidence in this regard, and incentive payments could discourage referrals for screening. Health education programs are sporadic. Health promotion and disease prevention do not appear to be a high priority among six newly established IPAs in New York City. We recommend several steps that would encourage IPA-HMOs to increase their health promotion activities.

Adult↗
PubMedDate not supplied

Impact of a comprehensive health promotion curriculum on physician behavior and attitudes.

Physician involvement with health promotion and disease prevention (HP/DP) is essential in the control of diseases in which behavioral risk factors are etiologically important. Yet physician involvement with health promotion is generally perceived as less than optimal. We report that an intensive, multifactorial curriculum introduced into a community hospital family medicine residency program increased physicians' use of preventive strategies with their patients and facilitated their use of specific, easy-to-follow protocols for the management of common problems amenable to health promotion.

Attitude of Health Personnel↗
PubMed2001

Soldier and family wellness across the life course: a developmental model of successful aging, spirituality, and health promotion, Part II.

As an alternative to the current Department of Defense approach to health promotion and related research, which is critiqued in Part I of this article, the authors present a new, integrative health promotion and wellness model. This age-graded model incorporates successful aging, targeted health promotion, and spirituality in the context of the developmental perspective provided by life course constructs. By using an age-graded, multidisciplinary system of assessment, intervention, and follow-up in the context of preparing military personnel and families for the next season of life, this model advocates the prevention of disease and disability, active engagement with life, the maximization of high cognitive and physical functioning, and positive spirituality. Preliminary, selected illustrations from a variation of this model at the U.S. Army War College are provided. Progressive extrapolation of the model to other military leadership schools is proposed as a more efficacious health promotion strategy for the Department of Defense.

Aging↗
PubMedDate not supplied

[Work site health promotion in Germany--1: Program availability and effect on occupational characteristics].

Worksite health promotion and disease prevention is becoming more and more established in Germany. This study investigates the state of the health programmes utilising a representative sample of 116 companies with company health insurance. 105 companies answered the detailed questions during phone interviews or using written questionnaires. 60% of the companies offer worksite health promotion and disease prevention programmes. The focus is mainly on behavioural aspects, while structural aspects play a minor role within the programmes. To a great extent the health promotion and disease prevention programmes are independent of structural characteristics of the company and the company location. At present, an evaluation of the health benefits and cost-effectiveness of the health programmes is only of secondary interest.

Forecasting↗
PubMedDate not supplied

A comparison of Omaha worksite health promotion activities to the 1992 national survey with a special perspective on program intervention.

PURPOSE: The purpose of this study was to compare the results from a survey of Omaha worksite health promotion activities with the results of a 1992 national survey. Comparisons were made on: (1) the kinds of health promotion activities offered, (2) progress toward the Healthy People 2000 worksite objectives, (3) types of program intervention offered, and (4) administrative factors. DESIGN: A one-time, written, mail-out/mail-back survey design was used. SETTING: The study took place in Omaha, Nebraska. SUBJECTS: All area public and private worksites with 250 or more employees were sent surveys. Individuals who were preselected and identified as the best qualified within the company completed the survey instrument. Of the 176 worksites surveyed, 86 completed the survey (49%). MEASURES: Descriptive statistics (percentages) were used to compare the two surveys on kinds of programs offered, progress toward Healthy People 2000 related to worksite health promotion, the types of program intervention offered, and administrative factors. RESULTS: Generally, a greater percentage of respondent worksites from the national survey are offering more health promotion activities and have made more progress toward the Healthy People 2000 worksite objectives than the Omaha worksites. Results from both surveys showed that low levels of intervention are more prevalent than high levels of intervention, and that health promotion activities in most worksites are coordinated by human resources departments and not by someone professionally prepared in health education. CONCLUSIONS: Traditionally, major goals of worksite health promotion programs have focused on important organizational outcomes such as improved productivity/morale, reduction in absenteeism, and health care cost-containment. It is important to recognize, however, that low levels of intervention have less impact than more intensive programs on these desired outcomes. Future goals for local and national worksite health promotion programs may need to encourage implementation of more intensive intervention programs.

Health Promotion↗
PubMed2003

[Why worry about evidence in health promotion?].

This paper, in a sociological and historical perspective, aims at positioning the main issues linked to the idea of utilizing evidence-based practices in health promotion. It begins to do so by looking at the international evolution of health promotion and evidence-based practices, and by providing definitions for these concepts. In a second section, the paper analyzes how the evidence based practices approach has confronted the field of health promotion, especially since the second half of the 1990s. It argues that this has occurred in the context of the evaluative concerns put forward by governments all over the world, in order to downsize their publicly funded health systems. The reaction, often negative, of the health promotion field to evidence-based practices is also documented. Finally, some methodological and political issues raised by the idea of utilizing evidence-based practices in health promotion are presented. The paper concludes that this approach is far from a panacea but has potential limited utilization for certain kinds of health promotion practices. Alternative suggestions on how to establish "best practices" in this field are also offered.

Cross-Cultural Comparison↗
PubMed2002

Health-promoting self-care in family caregivers.

Caregiving for family members with cognitive impairment is stressful and time consuming. Because of the attention needed to manage the memory and behavior problems of the care receiver, family caregivers have little time to attend to their own health needs. Most research related to the health of family caregivers has been conducted within a stress-illness framework. Fewer researchers have studied caregiver health from a health-promotion paradigm. The purpose of this study was to compare health-promoting self-care behavior infamily caregivers with demographically matched noncaregivers and to investigate the mediational effect of health-promoting self-care behavior on the relationship between stress and well-being. Findings revealed that family caregivers scored significantly lower on all measures of health promotion, with the exception of Nutrition and Number of Medications, and significantly higher on Barriers to Health-Promoting Actions. Health-promoting self-care behavior acted as a mediator to reduce the effect of caregiver stress on general well-being.

Caregivers↗
PubMed1992

The Heart Smart cardiovascular school health promotion: behavior correlates of risk factor change.

BACKGROUND: A growing awareness of health promotion and positive lifestyle change, coupled with the knowledge that cardiovascular risk has its origins in childhood, has led to the development of health promotion programs in the elementary school. While most school-based programs target specific behaviors or enlist singular intervention modalities, the Heart Smart cardiovascular school health promotion targeted the total school environment with a multidisciplinary approach to prompt the school's varied institutions to implement changes in curriculum, school lunch, and physical education. METHODS: Components of the Heart Smart environmental intervention included: (a) a school lunch program providing cardiovascular healthful food choices, reduced in fat by 30% and in sodium and sugar by 50%; (b) a physical education program promoting personal fitness and aerobic conditioning; and (c) cardiovascular risk factor screening, measuring fasting lipids and lipoproteins, anthropometrics, and blood pressure. Changes in cardiovascular risk factor status, school lunch selections, and exercise performance were compared. RESULTS: Screening participants showed greater improvement in health knowledge than nonparticipants. School lunch choices were successfully altered, and children whose lunch choices were cardiovascular healthful evidenced the greatest cholesterol reduction. Improvements in run/walk performance were related in predicted directions to the overall cardiovascular risk profile. Increases in high-density lipoprotein cholesterol were observed at intervention schools. CONCLUSION: Observations indicate a relationship between behavior change and physiologic changes achieved in a total school health promotion to reduce cardiovascular risk.

Anthropometry↗