Conceptual Framework Of Health Research Articles

The hallmarks of aging as a conceptual framework for health and longevity research.

The inexorability of the aging process has sparked the curiosity of human beings since ancient times. However, despite this interest and the extraordinary scientific advances in the field, the complexity of the process has hampered its comprehension. In this context, The Hallmarks of Aging were defined in 2013 with the aim of establishing an organized, systematic and integrative view of this topic, which would serve as a conceptual framework for aging research. Ten years later and promoted by the progress in the area, an updated version included three new hallmarks while maintaining the original scope. The aim of this review is to determine to what extent The Hallmarks of Aging achieved the purpose that gave rise to them. For this aim, we have reviewed the literature citing any of the two versions of The Hallmarks of Aging and conclude that they have served as a conceptual framework not only for aging research but also for related areas of knowledge. Finally, this review discusses the new candidates to become part of the Hallmarks list, analyzing the evidence that supports whether they should or should not be incorporated.

Toward a conceptual framework of health and its operational definition: an application in the 1958 British birth cohort

BackgroundDefining and measuring Health presents a challenge, partly due to its conceptual pluralism. To measure Health as an ability to adapt and self-manage, we developed an approach within the theoretical framework of resources and reserves over the life course, recently proposed in the literature. We aimed to (i) use the conceptual framework developed to identify indicators of deteriorating health reserves, (ii) construct an overall health measure from these indicators, (iii) evaluate the association between the overall health measure and subsequent health outcomes and (iv) assess the robustness of our method.MethodsWe used data from 7,043 individuals born in 1958 in Great Britain included in the National Child Development Study. An overall health measure was constructed via the sum of three selected indicators of deteriorating health reserves in mid-life: chronic widespread pain (CWP), Clinical Interview Schedule - revised (CIS-r), and allostatic load (AL). A three-category variable was defined: impaired/medium/optimal overall health. We explored criterion validity by modelling the relationships between the overall health measure, or each reserve taken separately at 44–45 years, and self-rated health at 46 years and mortality up to 58 years, corresponding to 14 years of follow up, using Cox and logistic regressions respectively. We performed comparative analyses to assess the robustness of the method.ResultsHaving an impaired overall health measure was significantly associated with all-cause premature mortality (HRimpaired = 2.74 [1.86; 4.05]) and an increased risk of later fair/poor/very poor self-rated health (ORimpaired = 7.50 [6.29; 8.95]). The overall health measure had a greater effect on the self-rated health estimates than each indicator of deteriorating health reserves considered separately (ORAL medium = 1.82 [1.59; 2.09]; ORAL high = 2.74 [2.37; 3.16]; ORCIS-r = 5.20 [4.45; 6.08]; ORCWP = 2.85 [2.53; 3.21]). CIS-r and allostatic load were also associated with premature mortality contrary to chronic widespread pain (HRAL medium1.82 [1.27; 2.61]; HRAL high = 3.10 [2.19; 4.40]; HRCIS-r = 1.77 [1.22; 2.56]; HRCWP = 1.32 [0.98; 1.76]). The multiple comparative analyses conducted allowed us to assess the robustness of our method within this cohort.ConclusionsWe proposed a method for measuring Health in mid-life in line with the concept of Health as the ability to adapt and self-manage and the concept of health reserves. This method may be applied and further developed within the field of social and positive epidemiology.

Conditions for the success and the feasibility of health mediation for healthcare use by underserved populations: a scoping review

ObjectiveThis article aims to analyse the conditions under which health mediation for healthcare use is successful and feasible for underserved populations.MethodWe conducted a scoping review on the conditions for effective...

First Nations Peoples' Eating and Physical Activity Behaviors in Urban Areas: A Mixed-Methods Approach.

The dietary transition from traditional to commercial foods and a decrease in physical activity (PA) have impacted the health of the First Nations people of Quebec (Canada), resulting in many suffering from multiple chronic diseases. This study had two objectives: (1) to examine eating and PA behaviors among First Nations peoples in urban areas and (2) to explore the associated health representations. To achieve these objectives, a mixed-methods approach, including a questionnaire (n = 32) and a semi-structured interview (n = 14), was used to explore the participants’ lifestyle profiles and health experiences. The questionnaire focused on the eating and PA behaviors of First Nations people and their underlying motivations. At the same time, the interviews investigated their health views on diet and PA behaviors based on the conceptual framework of health and its determinants. According to the participants, health is the autonomy to live without pain by maintaining a balance between physical and psychological aspects, eating healthy and exercising. Family and work influence participants’ PA and eating behaviors. Exploring First Nations people’s beliefs and perceptions and the motivations underlying their health behaviors could help encourage the maintenance of a healthy lifestyle despite multiple chronic health conditions.

LGBTQI + Migrants: A Systematic Review and Conceptual Framework of Health, Safety and Wellbeing during Migration.

The health and safety of LGBTQI+ migrants or migrants who are of diverse sexual orientation, gender identity or expression (SOGIE) remains an under-studied area, particularly for the period during transit from their place of origin to destination. This systematic review aims to describe the literature on the health risks and consequences among SOGIE migrants during transit and examine their access and use of services. Six peer-reviewed databases and websites of nine large migration organisations were searched to identify the literature on forced migrants and sexual and gender minorities. Twenty English-language studies from 2000–2021 were included and analysed drawing on a conceptual framework. Studies emerged from six regions and the majority of research participants identified as gay men. In general, quality appraisal demonstrated studies as either medium or high quality. Findings suggested five common themes associated with SOGIE health and well-being, including: daily exposure to discrimination, harassment and violence; coping, social support and resilience; access to services; mental health; and physical and sexual health. Depression, anxiety and post-traumatic stress disorder (PTSD) were prevalent amongst SOGIE migrants, particularly when associated with detention or camp environments, and were exacerbated by social isolation. Barriers to accessing healthcare were identified and specific sexual health services were often found lacking, especially for trans persons. Unsurprisingly, during transit, SOGIE migrants are very likely to experience the double marginalisation of their migrant or minority status and their gender identity. Results indicate that services for SOGIE migrants need to tailor service access and support approaches to respond to the particular health and protection needs of SOGIE individuals in each setting.

Conceptual Framework of Health and Safety Management Practices Affecting Safety Performance of Malaysian Bumiputera SMEs

The aim of this study is to identify safety performance practices affecting safety performance of Bumiputera SMEs and to develop a conceptual framework explaining the relationship of health and safety management among Bumiputera small and medium enterprise (SME) entrepreneurs in Malaysia. The study brings understanding on health and safety management and broader safety performance issues within Malaysia context by analysing the comprehensive literature. SMEs are in dire needs to implement health and safety management properly as it is estimated around 60% of workplace accidents that occurred are accounted to SME. Bumiputera SMEs can rely on health and safety management practices such as entrepreneur’s commitment, safety training, worker’s involvement in safety, safety communication, safety rules and procedures, and safety promotion policies to increase safety performance in the organization. A safety management system reflects the organization’s commitment to safety which will result in improved safety performance; thus, it is worth investigating. This study reveals that there is a need for further research to discover new insights on health and safety management and enhance safety performance among Bumiputera SME entrepreneurs in Malaysia.

Identificación de un conjunto de categorías CIF representativas del funcionamiento al egreso hospitalario de personas adultas tratadas por cáncer: consenso nacional de expertos

IntroductionThe International Classification of Functioning, Disability and Health (ICF) provides a standardised language and conceptual framework for health and health-related conditions, aiming to unify communication between different disciplines. ObjectiveTo describe the process of selecting (through national expert consensus) ICF categories representative of functioning problems in cancer patients at hospital discharge. MethodWe conducted a descriptive qualitative and quantitative study that used the expert consensus method to design a clinical instrument. The study included 21 experts, consisting of 2 patients and 19 health professionals from different disciplines. A total of 208 ICF categories obtained in a previous stage through a systematic review and linking process were evaluated in 3 rounds. Participants evaluated each code and classified it as: highly relevant, relevant, slightly relevant, and not relevant at all. Only those codes assessed as «highly relevant» by more than 50% of the experts were included (cut off). In addition, another 143 ICF categories were evaluated in the second round. ResultsIn all, 24 ICF categories were obtained: 10 corresponded to the body function component, 11 to activities and participation, and 3 to environmental factors. ConclusionsConsensus using the common language of the ICF resulted in the selection of 24 representative categories of the main health problems related to functioning at hospital discharge in adults treated for cancer.

Examining Indigenous food sovereignty as a conceptual framework for health in two urban communities in Northern Ontario, Canada.

While land is a nexus for culture, identity, governance, and health, as a concept land is rarely addressed in conversations and policy decisions about Indigenous health and well-being. Indigenous food sovereignty, a concept which embodies Indigenous peoples' ability to control their food systems, including markets, production modes, cultures and environments, has received little attention as a framework to approach Indigenous health especially for Indigenous people living in urban spaces. Instead, discussions about Indigenous food sovereignty have largely focused on global and remote and rural communities. Addressing this gap in the literature, this article presents exploratory work conducted with Waasegiizhig Nanaandawe'iyewigamig and Shkagamik-Kwe Health Centre, two Indigenous-led Aboriginal Health Access Centres in urban service centers located in Northern Ontario, Canada.

Will the Meikirch Model, a New Framework for Health, Induce a Paradigm Shift in Healthcare?

Over the past decades, scientific medicine has realized tremendous advances. Yet, it is felt that the quality, costs, and equity of medicine and public health have not improved correspondingly and, both inside and outside the USA, may even have changed for the worse. An initiative for improving this situation is value-based healthcare, in which value is defined as health outcomes relative to the cost of achieving them. Value-based healthcare was advocated in order to stimulate competition among healthcare providers and thereby reduce costs. The approach may be well grounded economically, but in the care of patients, “value” has ethical and philosophical connotations. The restriction of value to an economic meaning ignores the importance of health and, thus, leads to misunderstandings.We postulate that a new understanding of the nature of health is necessary. We present the Meikirch model, a conceptual framework for health and disease that views health as a complex adaptive system. We describe this model and analyze some important consequences of its application to healthcare.The resources each person needs to meet the demands of life are both biological and personal, and both function together. While scientific advances in healthcare are hailed, these advances focus mainly on the biologically given potential (BGP) and tend to neglect the personally acquired potential (PAP) of an individual person. Personal growth to improve the PAP strongly contributes to meeting the demands of life. Therefore, in individual and public health care, personal growth deserves as much attention as the BGP. The conceptual framework of the Meikirch model supports a unified understanding of healthcare and serves to develop common goals, thereby rendering interprofessional and intersectoral cooperation more successful. The Meikirch model can be used as an effective tool to stimulate health literacy and improve health-supporting behavior. If individuals and groups of people involved in healthcare interact based on the model, mutual understanding of and adherence to treatments and preventive measures will improve. In healthcare, the Meikirch model also makes it plain that neither pay-for-performance nor value-based payment is an adequate response to improve person-centered healthcare.The Meikirch model is not only a unifying theoretical framework for health and disease but also a scaffold for the practice of medicine and public health. It is fully in line with the theory and practice of evidence-based medicine, person-centered healthcare, and integrative medicine. The model offers opportunities to self-motivate people to improve their health-supporting behavior, thereby making preventive approaches and overall healthcare more effective.We believe that the Meikirch model could induce a paradigm shift in healthcare. The healthcare community is hereby invited to acquaint themselves with this model and to consider its potential ramifications.

Trends in health care reform

Ageing is a phenomenon which is becoming one of the leading priorities of Europe and of the European Commission. The ageing of the population of Europe is a fact which is evident given the trend towards healthier, more active and longer lives. There are four main demographic trends (EC, 2006), specifically the average number of children per woman is below the population replacement number of 2.1 per woman for industrialised countries, and this rate is falling further; the decline in fertility in recent decades followed the post-war baby boom which is today causing the bulge in the size of the population aged 45 to 65 years; the dramatic increase in life expectancy since 1960; and the fact that immigration, although primarily of working age, will not compensate for the joint effect of low fertility and increased life expectancy. More generally, ageing, as emphasized by EC communication on Disability Action Plan (2005), is strongly correlated with disability prevalence: nearly 30% of people belonging to the age group of 5564 report a disability and 63% of people with disabilities are older than 45. This is the so-called phenomenon of compression of morbidity. There is a need to measure these elements independently and against the background of the clear conceptual framework of health provided by WHO's International Classification of Functioning, Disability and Health ICF (WHO, 2001; Leonardi et al., 2006). Based on a theoretical framework that defines disability as the interaction of a health condition with contextual factors, ICF has been tested since its approval in 2001 in several projects, such as the EU project MHADIE (www.mhadie.it). Taking all this into account, including the notion that the UN Convention on the Rights of Persons with Disabilities that mandates the need for clear data as an essential precondition for rights-based policy (Art 31), the Collaborative Research on Ageing in Europe (COURAGE in Europewww.courageineurope.eu) attempts to respond to this need by developing an ICF-based instrument for measuring health, health-related outcomes and determinants of disability for an ageing population.

The Development of ICF Core Sets for Hearing Loss

The International Classification of Functioning, Disability and Health (ICF), adopted by the World Health Organization (WHO) in 2001, offers a framework for a comprehensive understanding of health. One of the main goals of the ICF is to provide a conceptual framework of health that can be applied both for research purposes and in clinical settings. In order to promote the use of the ICF in clinical settings, the WHO initiated the Core Sets project. Core Sets, targeting a specific health condition, consist of a set of ICF categories that can serve as minimal standards (Brief ICF Core Set) or as standards for comprehensive assessment (Comprehensive ICF Core Set). In 2009, a process of developing ICF Core Sets for Hearing Loss was initiated. This process involves three phases of development. In the first phase, four scientific studies are conducted to collect evidence for relevant ICF categories to be used in the Core Sets. In phase two, a consensus conference is held to establish relevant ICF categories, and in the third phase, the Core Sets that are retained are tested and validated. This paper describes the process of developing ICF Core Sets for Hearing Loss as well as an invitation to participate in the project.

Strategies for gender-equitable HIV services in rural India

The emergence of HIV in rural India has the potential to heighten gender inequity in a context where women already suffer significant health disparities. Recent Indian health policies provide new opportunities to identify and implement gender-equitable rural HIV services. In this review, we adapt Mosley and Chen's conceptual framework of health to outline determinants for HIV health services utilization and outcomes. Examining the framework through a gender lens, we conduct a comprehensive literature review for gender-related gaps in HIV clinical services in rural India, focusing on patient access and outcomes, provider practices, and institutional partnerships. Contextualizing findings from rural India in the broader international literature, we describe potential strategies for gender-equitable HIV services in rural India, as responses to the following three questions: (1) What gender-specific patient needs should be addressed for gender-equitable HIV testing and care? (2) What do health care providers need to deliver HIV services with gender equity? (3) How should institutions enforce and sustain gender-equitable HIV services? Data at this early stage indicate substantial gender-related differences in HIV services in rural India, reflecting prevailing gender norms. Strategies including gender-specific HIV testing and care services would directly address current gender-specific patient needs. Rural care providers urgently need training in gender sensitivity and HIV-related communication and clinical skills. To enforce and sustain gender equity, multi-sectoral institutions must establish gender-equitable medical workplaces, interdisciplinary HIV services partnerships, and oversight methods, including analysis of gender-disaggregated data. A gender-equitable approach to rural India's rapidly evolving HIV services programmes could serve as a foundation for gender equity in the overall health care system.

Social Class Gradients and Health in Childhood

To determine if there are social class gradients in health in children aged 6 to 11 years. Self and parent reports of health of children in 5 sites across the United States were assessed using the Child Health and Illness Profile-Child Edition. Distribution of scores in 4 domains: satisfaction (with health); comfort; resilience; and risk avoidance were used to create profiles of health. Social class was defined as a composite of parental education and work participation. Social class gradients were found for all but the satisfaction domain and for most subdomains in the parent version; the most notable gradient was in the risk avoidance domain, with better health the higher the social class. Apparent gradients did not reach statistical significance in the child reports. Children from a higher social class were more likely to be in excellent/average health and less likely to be in poor health profiles than were lower class children. The findings generally mirror those from a prior study of adolescents, using the same conceptual framework for health and the same measure of social class, and are consistent with a cumulative effect for most aspects of health, and with a critical-period effect for risky behaviors.