A pilot study of Aboriginal health promotion from an ecological perspective

BackgroundAboriginal Community Controlled Organisations (ACCOs) provide community-focussed and culturally safe services for First Peoples in Australia, including crisis intervention and health promotion activities, in a holistic manner. The ecological model of health promotion goes some way towards describing the complexity of such health programs. The aims of this project were to: 1) identify the aims and purpose of existing health promotion programs conducted by an alliance of ACCOs in northern Victoria, Australia; and 2) evaluate the extent to which these programs are consistent with an ecological model of health promotion, addressing both individual and environmental determinants of health.MethodsThe project arose from a long history of collaborative research. Three ACCOs and a university formed the Health Promotion Alliance to evaluate their health promotion programs. Local community members were trained in, and contributed to developing culturally sensitive methods for, data collection. Information on the aims and design of 88 health promotion activities making up 12 different programs across the ACCOs was systematically and prospectively collected.ResultsThere was a wide range of activities addressing environmental and social determinants of health, as well as physical activity, nutrition and weight loss. The design of the great majority of activities had a minimal Western influence and were designed within a local Aboriginal cultural framework. The most common focus of the activities was social connectedness (76 %). Physical activity was represented in two thirds of the activities, and nutrition, weight loss and culture were each a focus of about half of the activities. A modified coding procedure designed to assess the ecological nature of these programs showed that they recruited from multiple settings; targeted a range of individual, social and environmental determinants; and used numerous and innovative strategies to achieve change.ConclusionFirst Peoples’ health promotion in the Goulburn-Murray Rivers region encompasses a broad range of social, cultural, lifestyle and community development activities, including reclaiming and strengthening cultural identity and social connectedness as a response to colonisation.

Best practice principles for research with Aboriginal and Torres Strait Islander communities in action: Case study of a safe infant sleep strategy

Traditionally, health protection and health promotion activities have operated independently of each other in the workplace. Health protection has usually been viewed as encompassing the activities that protect workers from occupational injury and illness ranging from basic safety training to the us

The dichotomy of commissioning Indigenous health and wellbeing program evaluations: What the Funder wants vs what the Community needs.

During the past 20 years there has been a dramatic increase in societal interest in preventing disability and death in the United States by changing individual behaviors linked to the risk of contracting chronic diseases. This renewed interest in health promotion and disease prevention has not been without its critics. Some critics have accused proponents of life-style interventions of promoting a victim-blaming ideology by neglecting the importance of social influences on health and disease. This article proposes an ecological model for health promotion which focuses attention on both individual and social environmental factors as targets for health promotion interventions. It addresses the importance of interventions directed at changing interpersonal, organizational, community, and public policy, factors which support and maintain unhealthy behaviors. The model assumes that appropriate changes in the social environment will produce changes in individuals, and that the support of individuals in the population is essential for implementing environmental changes.

The Australian Journal of Primary Health is published by CSIRO PUBLISHING on behalf of the Australian Institute for Primary Care and School of Public Health, La Trobe University in association with the Primary and Community Health Network. The Journal is a refereed, international journal designed to publish articles on a range of issues influencing community health services and primary health care. The focus of the Australian Journal of Primary Health is on the integration of theory and practice in primary health utilising perspectives from a range of disciplines. The Journal publishes research articles, policy reports and analyses, book reviews, case reports, the views of practitioners, consumers, carers, students, and special interest groups, and descriptions of professional practice initiatives in the field of primary health care

In an era characterised by the adverse impacts of climate change and environmental degradation, health promotion programmes are beginning to actively link human health with environmental sustainability imperatives. This paper draws on a study of health promotion and sustainability programmes in Australia, providing insights to evaluation approaches being used and barriers and enablers to these evaluations. The study was based on a multi-strategy research involving both quantitative and qualitative methods. Health promotion practitioners explained through surveys and semi-structured interviews that they focused on five overarching health and sustainability programme types (healthy and sustainable food, active transport, energy efficiency, contact with nature, and capacity building). Various evaluation methods and indicators (health, social, environmental, economic and demographic) were identified as being valuable for monitoring and evaluating health and sustainability programmes. Findings identified several evaluation enablers such as successful community engagement, knowledge of health and sustainability issues and programme champions, whereas barriers included resource constraints and competing interests. This paper highlights the need for ecological models and evaluation tools to support the design and monitoring of health promotion and sustainability programmes.

Health promotion in sport: An analysis of peak sporting organisations’ health policies

Objective: Policy development is the biggest gap for health-promoting sports clubs. The present study aims to identify Irish sports club’s involvement in health promotion (HP) policy development. Design: Mixed methods concurrent survey design, with quantitative data providing insights into priorities, activities and documentation and qualitative data documenting stakeholders’ perceived needs. Setting: Two hundred and thirty-nine sports clubs in Ireland. Method: The survey measured perceptions of HP, the importance of promoting 10 health topics (e.g. suicide prevention, healthy eating, addictive behaviours) and corresponding actions relevant to HP in club policy documents and future needs. Quantitative data were analysed using multivariate statistics. The policy cycle was used to conduct a deductive analysis of qualitative data on sports clubs’ perceived needs. Results: A high importance score (>70%) was found for the 10 health topics. Sports clubs reported their greatest investment was in physical activity promotion, and the lowest investment was in supporting the participation of disabled people. Up to two thirds of sports clubs had no HP policy. Irish sports clubs’ perceptions of HP showed higher but similar patterns of response relative to sports clubs in other countries. Conclusion: Findings suggest that sports clubs consider HP to be an important part of their remit, but up to 66% have no policy in this regard. The policy cycle analysis helped identify the key tools needed to promote sports clubs’ HP policy development. Practical implications include fostering the inclusion of HP in sports clubs’ development plans by establishing templates and receiving support from sports federations.

Health promotion for Australian Aboriginal and Torres Strait Islander communities and their people has generally had limited efficacy and poor sustainability. It has largely failed to recognise and appreciate the importance of local cultures and continues to have minimal emphasis on capacity building, community empowerment and local ownership. Culturally Appropriate Health Promotion is a framework of principles developed in 2008 with the World Health Organization and the Global Alliance for Health Promotion. It serves as a guide for community-focused health promotion practice to be built on and shaped by the respect for understanding and utilisation of local knowledge and culture. Culturally Appropriate Health Promotion is not about targeting, intervening or responding. Rather, it encourages health programme planners and policymakers to have a greater understanding, respect, a sense of empowerment and collaboration with communities, and their sociocultural environment to improve health. This commentary aims to examine and apply the eight principles of Culturally Appropriate Health Promotion to the Australian Aboriginal and Torres Strait Islander context. It proposes a widespread adoption of the framework for a more respectful, collaborative, locally suitable and therefore appropriate approach to Australian Aboriginal and Torres Strait Islander health promotion.

PurposeThe concepts of public health, health and health promotion have been used for decades in relation to sport in policy, research and practice. That sport has some kind of significance for and connection to public health is clear. But how can we understand the relationships between sport and public health?The aim of this presentation is to argue that what is regarded as knowledge about the relationship between sport and public health largely depends on how the concepts of public health, health, health promotion and sport are framed.MethodsIn this presentation, we theorize the relationship between sport and public health as different patterns and give examples of how sports clubs can thus act as a health-promoting setting for different target groups.ResultsA first attempt to categorize the patterns in the four categories (i) health promotion as an outcome of sport, (ii) health promotion through sport, (iii) health promotion in sport, and (iv) health promoting sport. In these four categories we reveal research, that because of how they define health promotion and sport, are quite different. The different categories also use the concept of sport differently, as something that will always be healthy because it contains physical activity, as a mean, as an arena where you reach people or in a more integrated way.ConclusionsWe argue that it is not enough to recognize that physical activity and sport are good for people's physical health. By using a more inclusive conceptualization of how health can be promoted in, through and as health-promoting sport, health promotion studies can feed into the conclusions of other studies, i.e. what can be done about the how-question. What we propose and provide empirical examples of in this presentation can be seen as a theoretical basis for discussing the relationship or relationships between sport and public health that can be used in policy, research and practice. It is therefore possible to broaden the issue, to make it more complex, to go beyond compartmentalized thinking and to contribute to sustainable change in sport. Because, sustainable sport can be a question of how!Support/Funding SourceNone

Review Question/Objectives The objective of this systematic review is to examine the best available qualitative evidence about the influences on, and perceptions toward, coronary artery disease (CAD) prevention strategies in Asian Indians (AI). Additionally this review will help in identifying barriers to preventive measures, such as deeply- held cultural beliefs. The anticipated outcome is an in-depth understanding of Asian Indians’ perceptions and knowledge of CAD, which can be used to develop more effective, culturally sensitive health promotion services for AI communities. Specifically, the review seeks answers to the following questions: 1. What are the perceptions of AI about CAD? 2. What are the beliefs of AI regarding CAD? 3. What are the barriers or challenges to improving lifestyle for prevention of CAD among AI? 4. What is the knowledge of AI regarding risk factors of CAD? 5. What is the knowledge of AI regarding preventive strategies for CAD? 6. What is the AI attitude towards overcoming the risk factors? Inclusion Criteria Types of Participants This review will consider studies that include Asian Indians who have CAD and their family members or who are at risk of developing CAD. For this review “Asian Indians” will include people who trace their origin to the country of India. The participants to be studied are both AI male and female adults, 18 years or older. Studies with a primary focus only on participants from other countries in South Asia (Pakistan, Bangladesh and Srilanka) other than India would be excluded. Studies on AI children would not be included for this review. Studies on cerebrovascular disease such as stroke, transient ischemic attack (TIA) and peripheral vascular disease (PVD) will be excluded. Studies on AIs with congestive heart failure (CHF) and cardiac arrhythmias such as atrial fibrillation will be excluded. . Studies on AIs with ischemic heart disease, angina and myocardial infarction will be included. Types of Interventions/Phenomenon of interest The review will consider studies that have examined perceptions, attitudes, beliefs, knowledge, and meaning of CAD and its prevention among Asian Indians. TRUNCATED AT 350 WORDS

To assess the impact of health promotion programs and microcredit programs on three communities in the Dominican Republic. One community had only the health promotion program, one community had only the microcredit program, and one community had both a health promotion program and a microcredit program. This pilot project examined the hypothesis that the largest changes in 11 health indicators that were studied would be in the community with both a health promotion program and a microcredit program, that there would be intermediate changes in the community with only a health promotion program, and that the smallest changes would be in the community with only a microcredit program. The health promotion programs used community volunteers to address two major concerns: (1) the prevalent causes of mortality among children under 5 years of age and (2) women's health (specifically breast and cervical cancer screening). The microcredit program made small loans to individuals to start or expand small businesses. Outcome measures were based on comparisons for 11 health indicators from baseline community surveys (27 households surveyed in each of the three communities, done in December 2000 and January 2001) and from follow-up surveys (also 27 households surveyed in each of the three communities, in June and July 2002, after the health promotion program had been operating for about 13 months). Households were randomly chosen during both the baseline and follow-up surveys, without regard to their involvement in the microcredit or health promotion programs. The health indicators improved in all three communities. However, the degree of change was different among the communities (P < 0.001). The community with parallel microcredit and health promotion programs had the largest changes for 10 of the 11 health indicators. Multisector development is known to be important on a macroeconomic scale. The results of this pilot project support the view that multisector development is also important on a microeconomic level, given that the parallel microcredit and health promotion programs resulted in greater change in the measured health indicators than either program alone. As far as we authors know, this is the first published study to quantify changes in health indicators related to parallel health promotion and microcredit programs as compared to control communities with only a health promotion program or a microcredit program.

Although sports clubs' potential for health promotion is acknowledged, research on whether they promote healthy eating is limited. We aimed to evaluate Finnish youth sports clubs' health promotion orientation, as well as associations between sports clubs' health promotion orientation, coaches' nutritional discussions and sports club participants' (SPs') fruit and/or vegetable consumption. The cross-sectional study included 554 SPs aged 14-16 years, 275 club officials and 311 coaches. Participants replied to questionnaires about sports clubs' health promotion and their own health behaviours, including dietary habits. Health promotion orientation was estimated using a Health Promoting Sports Club (HPSC) index (range 0-22) and nutritional discussions and fruit and/or vegetable consumption as frequencies. A mixed-effects multivariable logistic regression was used to analyse the associations. Most sports clubs (69%) had a high health promotion orientation, but the variation between the clubs was wide (HPSC index range 5-21). SPs' daily fruit and/or vegetable consumption was associated with female gender [odds ratio (OR) 3.48, 95% confidence interval (CI) 2.23-5.42, P < 0.001], better self-rated health (OR 3.26, 95% CI 1.13-9.41, P = 0.03), higher average school grades (OR 1.67, 95% CI 1.04-2.67, P = 0.03), and SPs' responses that their coach had often discussed nutrition (OR 2.11, 95% CI 1.41-3.14, P < 0.001). Although sports clubs' orientation towards health promotion was mostly high, it seems not to be enough to promote healthy eating among adolescent participants. Instead, coaches' nutritional discussions were associated with adolescents' fruit and/or vegetable consumption.

<h3>Introduction</h3> Providing sexual and reproductive health services for Aboriginal communities in regional Victoria can be a challenge. High rates of Chlamydia, Hepatitis C and unplanned pregnancies are a concern for communities. Victorian Aboriginal Health Services (AHS) partner with state based specialist organisations to assist with clinical education of the AHS workforce and the communities' health promotion needs. A partnership between the Dhauwurd Wurrung Elderly and Community Health Service (DWECH) in Portland, Victorian Aboriginal Community Controlled Health Organisation (VACCHO), Wulumperi Unit Melbourne Sexual Health Centre (MSHC) and Family Planning Victoria (FPV) strives to address these ongoing needs in 2015. <h3>Methods</h3> Clinical education was organised by DWECH for four AHS in the region and was delivered by MSHC and FPV at DWECH. Participants were Nurses and Aboriginal Health Workers from DWECH (Portland), Gunditjmara Aboriginal Cooperative (Warrnambool), Kirrae Community Health Service (Framlingham) and Windamara Aboriginal Cooperative (Heywood). The aim of the education was to increase workforce capacity by educating local AHS staff about clinical sexual and reproductive health topics and available health promotion resources. <h3>Results</h3> The Deadly Sexy Heath Kit (health promotion resource for AHS staff) developed by VACCHO and health promotion programs developed by MSHC (Young Peoples Sexual and Reproductive Health, Sacred Sistas, Deadly Dudes) were delivered in the region to Aboriginal Communities. The individual AHS in the region will monitor their client attendance and service delivery over the 2015 period. It is expected that the AHS will see an increase in screening for Chlamydia and Hepatitis C and sexual and reproductive health awareness as a result of the health promotion activities delivered to the communities. <h3>Conclusion</h3> Ongoing clinical sexual and reproductive health education and support of the AHS workforce and targeted health promotion programs will improve the sexual and reproductive health needs of the Aboriginal communities living in the western district of Victoria. <h3>Disclosure of interest statement</h3> Nil.