Global Health Promotion Research Articles

Culturally-relevant physical activity for public health promotion: global evidence synthesis

Abstract Background The WHO has noted the importance of cultural insights for health. Culturally-relevant physical activity has a growing evidence base in many regions and specific populations, but the scope and scale for global health promotion is underexplored. Methods A multinational expert team used a critical literature review method to: (1) define culturally-relevant physical activity; (2) delineate relevant characteristics supporting inclusion in population-level health promotion and surveillance; and (3) provide agenda setting in research, policy, and practice from a global public health promotion perspective. The critical review method, which evaluates rather than summarizes literature, was chosen as the research evidence is complex, broad, and has not been synthesized previously from this perspective. Results Culturally-relevant physical activity was defined as practices that include physical activity based on a population’s cultural customs. These can be Indigenous (e.g., hula, an Indigenous dance of Native Hawaiians) or regional (e.g., Shota (Shotë), an Albanian folk dance). Practices have shared characteristics that support multi-dimensional value for health, engagement, and healing. These include a collectivist, intergenerational component, passed from elders and shared forward with children as part of a community. Many have foundations in nature, a strength for health and wellbeing in green and blue spaces. Many include traditional art, clothing, accessories, and music with deep significance, including care for the tools and location of practice (e.g, drums, boats, land). Many practices would not be captured in harmonized public health surveillance systems despite their value. From this synthesis, research hypotheses were created and next steps proposed. Conclusions This evidence synthesis supports engagement, planning, uptake, policy, surveillance, and study of culturally-relevant physical activity for public health promotion locally and globally. Key messages • An important strength of culturally-relevant physical activity is that it is context and population specific. However, this may hide the scope and scale of the existing evidence supporting this work. • This evidence synthesis confirms how culturally-relevant physical activity is valuable globally across shared assets in research and practice, supporting next steps for public health promotion.

Clean-up actions as catalysts for sustainability and physical activity promotion

Abstract Issue The convergence of global sustainability and health promotion implies integrated policies and actions. Initiatives like the European Green Deal and the UN’s Sustainable Development Goals emphasize the urgent need to address climate change while promoting health through behaviours such as physical activity (PA). Description We explore the relationship between PA, sustainability, and health outcomes, highlighting the European Green Deal’s impact on PA promotion and the 2030 Agenda for Sustainable Development’s alignment with health behaviours. In addition, we further discuss the concept of “green exercise” and provide insights about how eco-friendly initiatives (e.g., plogging) may have dual benefits in both individual and environmental domains. Results Emerging eco-friendly activities, including plogging, plalking and pliking, directly benefit the environment, while holding the potential to contribute to PA accumulation. Walking while picking up litter (i.e., plalking) can represent up to 4-5 metabolic equivalents (METs), which corresponds to performing a moderate-intensity PA. If other activities - running or cycling - are performed while picking up litter, the number of METs (i.e., >6 METs) involved may correspond to performing a vigorous-intensity PA. Lessons The physiological impact of eco-friendly activities, such as litter picking, reveals their potential as moderate to vigorous-intensity PA, favouring compliance with WHO PA recommendations (i.e., 150 min/week). Integrated policies and actions are needed to address global challenges effectively, emphasizing the interconnectedness of PA promotion, sustainability efforts, and health outcomes. Key messages • Engaging in green initiatives fosters PA and supports the United Nations’ goals for health and sustainability. • Plogging and similar eco-activities offer dual benefits: cleaner environments and healthier lifestyles.

Health beyond borders: the future of health promotion.

This article situates the field of health promotion in its current cutting-edge agendas around health and wellbeing; social and other determinants of health; complexity and its associated sciences; planetary health; and inclusion and diversity. However, it is also proposed that there are emergent dimensions that should be placed more deliberately on the agendas of health promotion research and practice. The piece offers three dimensions for noting health promotion futures: a cognitive, spatial and temporal one. The first is a non-anthropocentric appreciation of the complex interactions between geosphere, biosphere and anthroposphere that can be framed through a lens of governance and cosmology; the second one is established by humankind's journeys beyond the atmosphere into outer space; and the third one argues we - that is, the global health (promotion) community - need to account for temporal determinants of health, more consciously and conscientiously. The gazes seem beyond current agendas of health - but the article demonstrates how they are to become mission-critical aspects of contemporary and future worlds.

Implementing the service-learning methodology in nursing education: A case study

IntroductionNurses play a crucial role in global health promotion, and innovative teaching strategies are vital to addressing modern educational challenges. Service-learning, a credit-based approach, integrates community service with academic learning, enhancing students' understanding of course content while fostering civic values. Although established in the United States of America and growing in Europe, most studies on service-learning focus on student learning outcomes, often overlooking its impact on the communities served. AimsThe purpose of this study is to test whether the service-learning practice of nursing students teaching a pharmacology curriculum topic to school children promotes knowledge of the topic in both the nursing students and the school children. DesignThis research involves two pretest-posttest quantitative analyses and two satisfaction surveys. ParticipantsSeventy-six nursing students participated during the 2022–2023 academic year, and 69 primary school pupils received the service-learning intervention. ResultsPost-test scores of nursing students were significantly higher than pre-test scores (p = 0.0009). The percentage of correct answers post-intervention was significantly higher than pre-intervention (p < 0.0001). Additionally, 98.7 % of nursing students found the service-learning experience beneficial for learning, and 94.7 % reported increased social awareness.For the school children, the percentage of correct responses after the service-learning experience was statistically significantly higher than before the activity (p < 0.0001). The percentage of correct answers from pupils in each primary grade (fourth, fifth, and sixth) was statistically significantly higher after the application of the learning experience compared to before (p < 0.0001, p < 0.0001, and p < 0.001, respectively). The satisfaction survey indicated high acceptance of the methodology among both nursing students and school pupils. ConclusionsService-learning enhances knowledge of the pharmacology topic in both nursing students and school children.

Reassessing Cervical Cancer Prevention: Evaluating the NHS Cervical Cancer Screening Programme Through the Health Belief Model and Global Health Promotion Strategies

Cervical cancer remains a significant public health issue in the United Kingdom, with disparities in screening coverage and outcomes persisting despite robust national programs. This critical analysis evaluates the NHS Cervical Screening Programme (CSP) through the lens of the Health Belief Model (HBM) and global health promotion strategies, such as those outlined in the Ottawa Charter. The analysis explores how individual beliefs about susceptibility, severity, benefits, and barriers influence participation in cervical screening, while also critiquing the CSP's reliance on these factors to the potential exclusion of broader social determinants of health. Key findings reveal that while the HBM provides a valuable framework for understanding individual health behaviors, its emphasis on personal responsibility may overlook significant socioeconomic and cultural barriers, leading to inequities in screening uptake. Furthermore, the CSP's approach, though well-intentioned, may inadvertently undermine patient autonomy by promoting a top-down model of health promotion. The analysis is supported by data from the 2022-2023 Cervical Screening Standards Data Report and other contemporary sources, highlighting the need for more culturally sensitive and equitable strategies. Recommendations for policymakers include the enhancement of targeted interventions for high-risk groups, improved communication strategies, and the integration of a social model of health that considers the broader determinants of health. Future studies are encouraged to explore the sociocultural factors influencing screening behaviors and to evaluate the effectiveness of new screening technologies and integrated HPV vaccination programs. This analysis underscores the importance of rethinking cervical cancer prevention strategies to ensure they are inclusive, equitable, and aligned with the principles of health promotion.

Campaign Governance and Playfulness: Unraveling Chinese HPV Immunization Promotion Efforts on Douyin.

(1) Background: Playful immunization promotion helps to approach persuasive efforts and raise vaccine acceptance. However, playful promotion in the field of HPV immunization has not been explored. (2) Methods: To address this gap, we analyzed data gleaned from 73 short videos posted by state media and from semi-structured interviews with 37 Chinese stakeholders using thematic analysis. (3) Results: The analysis revealed that state media promoted HPV immunization using celebrity endorsement, anthropomorphism techniques and entertainment performance strategies. Additionally, state media engaged in circle mobilization and livestreamed on Douyin to reach wider audiences. Although playful strategies increased the popularity of HPV vaccine promotion, insufficient multi-stakeholder partnerships and homogeneous message delivery decreased the efficiency of HPV immunization promotion campaigns. (4) Conclusions: The strengthening of multi-stakeholder partnerships and the optimization of the public service provision of HPV vaccination are expected. Our research will not only deepen the global audience's understanding of Chinese immunization promotion campaigns, but also offer insights for implementing future global health promotion.

Shaping global health promotion: a comprehensive analysis of the 10 Global Conferences on Health Promotion Conferences (1986‒2021)

ObjectiveThis study analyzed how the 10 Global Conferences on Health Promotion have played a significant role in shaping and promoting a worldwide consensus and actions on health promotion, effectively addressing diverse health challenges that evolved over different periods. MethodsThe textual analysis method was used in this study and text encoding was conducted to systematically examine the declarations and reports presented by the 10 Global Conferences on Health Promotion held during 1986‒2021. We summarized the themes and key achievements, and key vocabulary in the conference declarations was extracted and analyzed to construct the global health promotion consensus and actions. ResultsThe fundamental principles of the conferences are to foster consensus and initiate actions in the realm of health promotion on a global scale. The primary purpose and goal are to promote health from regional to global. Significantly, our findings highlight a transition in the primary actors driving health promotion. It underscores a shift in health promotion from being driven primarily by organizations like the World Health Organization, governments, and international bodies, to a more inclusive approach involving non-governmental organizations and the general public. This development implies that health promotion has evolved into a collective global endeavor, demanding the proactive involvement of various stakeholders, and forging new alliances in public health. Meanwhile, the coronavirus disease 2019 (COVID-19) pandemic has further shaped the landscape of health promotion, underscoring the need for intensified focus on areas including disease prevention, health education, and the integration of digital health technologies, and emphasizing the importance of a multidimensional, responsive approach in public health initiatives. ConclusionsSustained collaboration and innovative strategies are pivotal to advancing health promotion globally. Countries, together with public and private entities, should intensify cooperation. Multisectoral collaboration among partners such as healthcare, education, social security, and the industry is vital for health promotion and achieving global health goals.

Overview of the ten global conferences on health promotion and implications for future work

Since 1986, the WHO has held ten global health promotion conferences covering various health promotion issues and sustainable development worldwide. These sessions have formed a series of consensus and actions that guide promoting health globally. This study analyzed the declarations, reports, and news materials from the ten conferences that studied health promotion action areas, focal topics, actor networks, partnership relationships, and other significant outcomes. It also explored how these conferences contributed to the construction and advancement of global health promotion consensus and actions. The first Global Conference on Health Promotion identified the concept of health promotion and five key action areas, laying the foundation for subsequent conferences and health promotion actions. Over the years, the ten conferences continuously expanded the essence of health promotion, developed partnership relationships, formulated public health promotion policies, and called for health promotion actions. This process culminated in the formation of global consensus and collective actions. The latter conferences have gained significant attention and influence. The conferences offer valuable insights for future global health promotion endeavors and provide global perspectives and pathways for the development of Healthy China.

Decolonial framework for applying reflexivity and positionality in global health research.

Contemporary research practices link to colonial and imperialist knowledge creation and production and may promote harmful perspectives on marginalized and oppressed groups. We present a framework for a decolonial approach to research in global health and health promotion applicable across research settings. This framework is aimed at anticipating and alleviating potentially harmful practices inherent in dominant research methods. The framework focuses from a macro- and micro-level perspective on three critical dyads: 'context' and 'accountability'; 'researcher identity' and 'positionality'; and 'procedural ethics' and 'ethics in practice' considerations. We present guidance for how to consider reflexivity and positionality as they apply in this framework in global health and health promotion research practice.

Research journey of sports promotion: A bibliometric analysis

Background: Research on exercise and health promotion has grown significantly, indicating an increasing interest in physical fitness and healthy living among people. Purpose: This study aimed to to provide a comprehensive overview of research on health and sports promotion, identify the field, identify prominent papers and academics, and use keyword analysis to determine the thematic focus. This research hoped to contribute to understanding the emerging dynamics in this interdisciplinary sector. Methods: Bibliometric methods analyse data sets that include publication trends, author information, countries, and newly discovered keywords. This analysis used VOSviewer bibliometric analysis software. The data analysed was 1,850 documents. Results: The results showed a steady increase in publications on sports, physical exercise, and health promotion issues. The reputable publications are those in the “International Journal of Environmental Research and Public Health” and “BMC Public Health”. Key phrases, such as “physical activity” and “health promotion” dominate the themes, with the United States and the United Kingdom emerging as important contributors. Conclusion: This study highlighted notable researchers, important sources, and concentrations of subjects in health and exercised promotion research, which underscored its dynamic nature. The knowledge gathered from this bibliometric research contributed to a more complex understanding of this interdisciplinary field’s changing goals and trends. Implications: Thematic concentration and identifying important articles can inspire evidence-based strategies for global health and physical activity promotion, international collaboration, and future research orientation.

AI for Detection of Tuberculosis: Implications for Global Health.

Tuberculosis, which primarily affects developing countries, remains a significant global health concern. Since the 2010s, the role of chest radiography has expanded in tuberculosis triage and screening beyond its traditional complementary role in the diagnosis of tuberculosis. Computer-aided diagnosis (CAD) systems for tuberculosis detection on chest radiographs have recently made substantial progress in diagnostic performance, thanks to deep learning technologies. The current performance of CAD systems for tuberculosis has approximated that of human experts, presenting a potential solution to the shortage of human readers to interpret chest radiographs in low- or middle-income, high-tuberculosis-burden countries. This article provides a critical appraisal of developmental process reporting in extant CAD software for tuberculosis, based on the Checklist for Artificial Intelligence in Medical Imaging. It also explores several considerations to scale up CAD solutions, encompassing manufacturer-independent CAD validation, economic and political aspects, and ethical concerns, as well as the potential for broadening radiography-based diagnosis to other nontuberculosis diseases. Collectively, CAD for tuberculosis will emerge as a representative deep learning application, catalyzing advances in global health and health equity. Keywords: Computer-aided Diagnosis (CAD), Conventional Radiography, Thorax, Lung, Machine Learning Supplemental material is available for this article. © RSNA, 2024.

Campaign Governance and Partnerships: Unraveling COVID-19 Vaccine Promotion Efforts in China's Neighborhoods.

COVID-19 vaccine promotion helps counter vaccine hesitancy and raise vaccine acceptance. Therefore, the Chinese state created collaborative infrastructures of COVID-19 vaccine promotion programs to promote stakeholder engagement and unload the burden of policy practitioners. However, partnerships in COVID-19 vaccine promotion programs have been underrepresented. To address this lacuna, we qualitatively explored how partnerships in the COVID-19 vaccine promotion campaign (CVPC) were organized in China's neighborhoods. Specifically, we recruited participants via personal networks, referrals from acquaintances, and snowballing approaches, and conducted the qualitative thematic analysis following interviews with 62 Chinese stakeholders. This study indicates that to promote partnerships in CVPCs, neighborhood managers formed leadership in CVPCs, expanded the collaborative network, trained Health Promotion Practitioners (HPPs), and coordinated with HPPs to shape partnership agreements, produced COVID-19 vaccine promotional materials and advertised COVID-19 vaccines via diverse media tools. Although coproduction of CVPCs to a certain extent promoted state-society interaction in neighborhoods and state responsiveness to public demands, partners' disagreements on strategies applied by states for promoting COVID-19 vaccines eroded partnerships in CVPCs. To construct a robust partnership in CVPCs, depoliticizing CVPCs and creating shared values among stakeholders in CVPCs are expected. Our study will not only deepen global audiences' understanding of CVCPs in China but also offer potential neighborhood-level solutions for implementing local and global health promotion efforts.

Trickle-down policies: Utilizing strategic plans to facilitate local public health work

Abstract Background The main weight of health promotion strategies are outlined internationally, but carried out locally. More knowledge is needed about how municipalities and communities can be supported in building capacity for carrying out systematic, local Public Health Work. This study explores how strategic recommendations from national/international levels can contribute to the facilitation of systematic, local health promotion work through conscious utilization of juridical and strategic municipal documents. Methods An in-depth hierarchical document analysis was carried out in selected municipalities. A contextual content analysis of central terms was conducted the aim to understand how these were addressed across document-type and municipality. Findings Central aims and strategies from health promotion have “trickled-down” into national and municipal documents. Variations in how intentions are anchored and implemented in the municipal context occur: if and how they were addressed, linked to higher-level aims and operationalized in ways that enabled collaborative action (including the allocation of resources). Obligatory activities (e.g. establishing a local knowledge-base) were more likely to be implemented locally; however, variations occured regarding how these were followed-up subsequently. Discussion Global health promotion aims and strategies can contribute to facilitate for local public health work. Differences in how the planning literature was utilized might facilitate for different outcomes. To enable coherent approaches across sectors and actors, top-down approaches have to be combined with local competence-building and enable collaborative action. Framing spatial tasks in ways that highlight their contribution to achieve overarching goals can built competence across stakeholders, and enable systematic approaches over time. Key messages • Utilizing local strategic documents can facilitate for the realization of global and national health promotion intentions. • To enable coherent approaches across sectors and actors, top-down approaches have to be combined with local competence-building and enable collaborative action.

Changing the global obesity narrative to recognize and reduce weight stigma: A position statement from the World Obesity Federation.

Weight stigma, defined as pervasive misconceptions and stereotypes associated with higher body weight, is both a social determinant of health and a human rights issue. It is imperative to consider how weight stigma may be impeding health promotion efforts on a global scale. The World Obesity Federation (WOF) convened a global working group of practitioners, researchers, policymakers, youth advocates, and individuals with lived experience of obesity to consider the ways that global obesity narratives may contribute to weight stigma. Specifically, the working group focused on how overall obesity narratives, food and physical activity narratives, and scientific and public-facing language may contribute to weight stigma. The impact of weight stigma across the lifespan was also considered. Taking a global perspective, nine recommendations resulted from this work for global health research and health promotion efforts that can help to reduce harmful obesity narratives, both inside and outside health contexts.

A Pandemic Adaptation and Its Aftermath: Using AI and In-Person Facilitation for Community Health Education in Liberia and the United States.

Health promotion commonly focuses on supporting youth wellness, as health behaviors acquired in childhood and adolescence tend to have a significant impact on an individual's future. Adolescent health education is associated with positive health and educational outcomes, yet young people experience barriers to fully engaging in learning about health issues that are often unique to their social location. Barriers for successful engagement in health education for African diaspora youth in North American and European contexts may include school initiatives built around engagement models that do not center Black youth; for Black youth in majority-Black societies, barriers may include access to resources or exclusionary practices based on other social characteristics. Global health promotion has used a variety of multimodal educational tools from radio to more recently online engagement, especially in African contexts, to reach young people. This essay shares experiences using AI and in-person facilitation to engage in community health education with youth in Liberia and the United States. In our practice, we found that there are far more underlying systemic and structural similarities to the inequities experienced between African and Black American youth and that utilizing AI tools alongside of in-person discussion may contribute to better outcomes for youth health education.

The Mediterranean diet as a healthy dietary model and its impact on the immune system and intestinal microbiota

The relationship between nutrition and immunity is very complex, because each phase of the immune response can be affected by the lack of essential nutrients such as vitamins and minerals. In addition, it has been described that the most prevalent non-communicable diseases worldwide, such as metabolic syndrome, diabetes mellitus, cardiovascular diseases and cancer, underlie the activation of inflammatory mechanisms, which can compromise immune functions, often caused or accompanied by alterations in nutritional patterns and intestinal microbiota. In this context, it is clear that diet is a key modulator of the immune system and much interest is emerging in the area of nutrition as a means of treatment and prevention. The Mediterranean diet has been widely described as positively influencing and is proposed not only as a potential tool in the clinical management of different diseases, but also for global health promotion. Therefore, the aim of this review is to address the current knowledge on the regulatory role of the nutritional components present in the Mediterranean diet on the immune system and the intestinal microbiota.

Towards to an Integrative and Integrated Hospital Psychology: The Department of Health and Clinical Psychology of Hospital CUF Tejo

Psychology is recognized as an autonomous technical-scientific area, evidence-based, particularly involved in the promotion of global health, prevention and treatment of psychological disorders, aiming to increase health gains. Its integration into the different levels of care has been progressive, meeting standards of quality, effectiveness, equity, guaranteeing the safety of citizens and respect for human rights. Hospitals constitute one of the most important health care environments where clinical and health psychology has expanded as a specific career. This article reviews the historical path of Psychology integration in hospital care, its identity construction, and the specificity of its actions in several clinical domains, supporting a close articulation with medical and non-medical specialties and various fields of scientific knowledge. Some of the main future challenges in this area of knowledge are discussed, with a view of maximizing mental health protective factors and mitigating vulnerabilities in specific groups.

Mental Health as a Global Development Challenge: A Critical Analysis of the Case in Nepal

This paper builds on primary literature to provide a critical analysis investigating mental health as a global development challenge in the context of Nepal. First, the Nepalese mental healthcare context is introduced and reviewed. Second, challenges for mental healthcare progress in Nepal are examined, and solutions are suggested. Third, this analysis considers the critical role of Nepalese traditional healers in the solution to its mental healthcare challenge. Further, community development is discussed in the context of mental healthcare, and finally, suggestions are devised for global mental health promotion.

The Significance of Traditional and Complementary Medicine to Self-Care and Addressing Global Health Challenges: Advancing the Commitments of the Declaration of Astana Through a Strong Research Program.

The Declaration of Astana (DoA) developed at the Global Conference on Primary Health Care (PHC) in 2018 outlined a number of core commitments and aspirations that fall in line with the broader vision for advancing global health, addressing a number of health-related sustainable development goals and ultimately ensuring health for all. Two specific goals of the DoA that are of particular interest and concern to the argument posited here are as follows: "to build sustainable primary health care" and "to empower individuals and communities." Moreover, these specific goals and the broader declaration all point to and "highlight the importance of empowering individuals as self-carers." However, it would appear that the conception of PHC, the related health workforce and the types of self-care activities, practices and initiatives envisioned within the DoA fail to explicitly accommodate or fully acknowledge the importance of both traditional and complementary medicine (T&CM) and more specifically "T&CM self-care" in strengthening the health of all communities. The aim of this editorial is to help articulate the significance of T&CM to self-care and as a consequence to the success of the DoA and wider desired advances in global health.

School-based mental health promotion: A global policy review.

Schools are increasingly recognized as important settings for mental health promotion, but it is unclear what actions schools should prioritize to promote student mental health and wellbeing. We undertook a policy review of global school-based mental health promotion policy documents from United Nations (UN) agencies to understand the frameworks they use and the actions they recommend for schools. We searched for guidelines and manuals from UN agencies through the World Health Organization (WHO) library, the National Library of Australia and Google Scholar, from 2000 to 2021, using various combinations of search terms (e.g., mental health, wellbeing, psychosocial, health, school, framework, manual, and guidelines). Textual data synthesis was undertaken. Sixteen documents met inclusion criteria. UN policy documents commonly recommended a comprehensive school-health framework aimed at integrating actions to prevent, promote, and support mental health problems within the school community. The primary role of schools was framed around building enabling contexts for mental health and wellbeing. Terminology was relatively inconsistent across different guidelines and manuals, particularly around how comprehensive school health was conceptualized, which included aspects of scope, focus, and approach. United Nations policy documents are oriented toward comprehensive school-health frameworks for student mental health and wellbeing that include mental health within wider health-promoting approaches. There are expectations that schools have the capabilities to deliver actions to prevent, promote and support mental health problems. Effective implementation of school-based mental health promotion requires investments that facilitate specific actions from governments, schools, families, and communities.