Effective Health Promotion Programs Research Articles

The Effects of Health Promotion Program on Healthy Aging, Wellbeing and Health Promoting Behaviour among Community Dwelling Older Adults

The Effects of Health Promotion Program on Healthy Aging, Wellbeing and Health Promoting Behaviour among Community Dwelling Older Adults

Effects of combined dietary intervention and physical-cognitive exercise on cognitive function and cardiometabolic health of postmenopausal women with obesity: a randomized controlled trial

BackgroundPostmenopausal women with obesity are markedly at risk of cognitive impairment and several health issues. Emerging evidence demonstrated that both diet and exercise, particularly physical-cognitive exercise are involved in cognitive and health benefits. However, the comparative effect of diet, exercise, and combined interventions in postmenopausal women with obesity on cognition and cardiometabolic health is still lacking. Identifying the effective health promotion program and understanding changes in cardiometabolic health linking these interventions to cognition would have important medical implications. This RCT aimed to examine the effect of single and combined interventions of diet and exercise on cognitive function and cardiometabolic health in postmenopausal women with obesity.MethodsNinety-two postmenopausal women with obesity were randomly assigned to diet group (intermittent fasting 2 days/week, 3 months), exercise group (physical-cognitive exercise 3 days/week, 3 months), combined group, or control group (n = 23/group). All cognitive outcomes and cardiometabolic outcomes were measured at baseline and post-3 months. Primary outcomes were executive functions, memory, and plasma BDNF levels. Secondary outcomes were global cognition, attention, language domain, plasma adiponectin levels, IL-6 levels, metabolic parameters, and physical function.ResultsAt the end of the 3-month intervention, the exercise and combined group demonstrated significant memory improvement which was accompanied by significant improvements in plasma BDNF level, insulin levels, HOMA-IR, %body fat, and muscle strength when compared to controls (p < 0.05). Only the combined intervention group demonstrated a significant improvement in executive function and increased plasma adiponectin levels when compared to control (p < 0.05). Surprisingly, no cognitive improvement was observed in the diet group (p > 0.05). Significant reduction in cholesterol levels was shown in the diet and combined groups when compared to controls (p < 0.05). Among the three intervention groups, there were no significant differences in all cognitive outcomes and cardiometabolic outcomes (p > 0.05). However, all three intervention groups showed significant improvements in plasma BDNF levels, weight, BMI, WHR, fat mass, and predicted VO2 max, when compared to control (p < 0.05).ConclusionThese findings suggest that combined physical-cognitive exercise and dietary intervention are promising interventions to improve cognition and obesity-related complications of postmenopausal women with obesity.Trial registrationNCT04768725 (https://clinicaltrials.gov) 24th February 2021.

Effectiveness of a Nursing Student-led Comprehensive Health Promotion Program for Rural Older Adults: Toward Community-based Learning

Objectives This study investigates the effects of a nursing student-led comprehensive health-promotion program for rural older adults on perceived health, depression, cognitive function, and life satisfaction.&#x0D; Methods A non-equivalent control group pre-post study design was adopted, and rural older adults aged 65 years and over were divided into the experimental (n=41) and control group (n=31). The experimental group underwent a comprehensive health-promotion program once-a-week for six weeks. Data analysis was performed using SPSS 26.0 statistical program, and the differences in subjective health, depression, cognitive function, and life satisfaction between the experimental and control groups after the program were tested by independent t-test, and reliability was analyzed by Cronbach's α.&#x0D; Results There were no significant differences in perceived health, depression, cognitive function, and life satisfaction at baseline between the two groups. After the program, there was a significant difference in life satisfaction between the control and experimental groups, and no significant difference in subjective health, depression, or cognitive function; however, the pre-post paired t-test for life satisfaction in the experimental group was not statistically significant.&#x0D; Conclusions A comprehensive program developed based on the needs of rural elders was an partially effective nursing intervention in increasing life satisfaction. The findings of this study may be useful in developing effective nursing student-led health promotion programs and interventions for rural older adults. In addition, this study suggests the possibility of nursing student-led health promotion programs centered on community-based learning as an alternative health service.&#x0D;

Mental Disorders and Mental Health Promotion in Police Officers.

The number of police officers suffering from mental illnesses is becoming a significant public health concern. Police officers are more likely to experience mental health problems than the general population. The use of effective mental health promotion programs can assist in reducing police officers' psychological problems. In this paper author reviews existing literature on mental disorders and mental health promotion among police officers. This review emphasizes the importance of mental health promotion and programs in improving police officers' well-being and decreasing mental disorders. The prevalence of mental disorders, risk factors, and negative consequences are explained. Furthermore, examples of programs or interventions to promote mental health, and recommendations for further study are presented. Therefore, this review could be useful in developing intervention program to support police officers' health.

Designing Intersectoral Environments to Address Isolation/Loneliness as a Risk Factor for Dementia: A Mixed Methods Health Promotion Program

AbstractBackgroundIntersectoral partnerships are critical for effective and sustainable health promotion programs. The aim of our Public Health Agency of Canada Dementia Community Investment project, What Connects Us∼Ce Qui Nous Lie (2020‐2023) was to collaboratively cultivate sociocultural environments worth living in using shared activities and events. In this paper, we present initial results on the effectiveness of using shared activities and events to link academic, arts/culture, mental health, and community‐based organizations and generate a sustainable web of resources for, while positively impacting on, the quality of life and connectivity as a protective factor for persons living with Alzheimer’s and related disorders (PLWA) and their carers.MethodWe used a mixed methods ethnographic approach to describe and measure the impact of shared activities and events on the intersectoral networks by fielding pre‐/post‐partner social network surveys distributed across four social sectors using standard intersectoral network metrics such as density, clustering, centralization, and average path length; as well as measures of centrality and bridging among partners. We measured the impact of this intervention se with pre‐/post‐activity participant surveys using the UCLA Loneliness scale and the CDC health quality of life instrument. All partners and participants answered demographic questions.ResultNetwork measures showed an increase from the initial number of organizations who submitted letters of support for the project (N = 16), as well as increases in network density at the intersectoral level. Patterns of centrality and bridging in the partner data are still emerging, with arts/cultural organizations being the most engaged in facilitating activities and events. For the participants in activities who completed surveys, emerging data demonstrate that those who participated in multiple activities had lower loneliness scores (N = 117 of the 370). Descriptions of context across the project support its upscaling, including the mechanisms that supported the continued growth in number, variety, and modifications of activities despite the impact of Covid‐19 on social distancing.ConclusionCommunity‐based efforts to create environments to reduce loneliness are possible but require effort to create sustainable intersectoral networks amidst structural and other leadership changes.

Designing Attitudinal Environments to Address Stigma: Virtual Film Screenings and Panel Discussions on Dementia in a Health Promotion Program

AbstractBackgroundIntersectoral partnerships are critical for effective and sustainable health promotion programs. Yet stigma and misperception continue to interfere with public engagement in dementia prevention programs, outreach, and willingness to access to dementia and‐or mental health related services for persons living with Alzheimer’s and‐or related disorders and personal carers. The aim of our Public Health Agency of Canada Dementia Community Investment project, What Connects Us∼Ce Qui Nous Lie (2020‐2023), was to collaboratively cultivate sociocultural environments worth living in using shared activities and events to address stigma at the intersection of dementia, aging and mental health. In this paper, we present initial results on the effectiveness of using on‐line, community screenings of short films featuring stories about living with dementia, followed by curated panel discussions with the film directors, arts/culture partners, policy makers and other stakeholders.MethodWe employed a mixed methods ethnographic approach to describe and measure the impact of six film screenings with pre/post‐film and then later post‐discussion measures of semantic sentiment. All discussions were simultaneously interpreted, and based on open‐ended qualitative questions that had been developed with panelists prior to the screening. The qualitative questions asked for one word/phrase responses to generate word clouds in French and English. Three researchers then assessed the words/phrases until agreement on positive or negative value was reached. French words were back‐translated into English prior to analysis using suzy‐net, a natural language processor, to confirm positive/negative valence and to measure changes within each film screening and across all film screenings.ResultThere was a significant change in sentiment from negative (e.g., frustration, lies, loss, confusion) to positive sentiment (e.g., humanity, empathy, compassion, understanding) across all waves within and across the six screenings, with the most change occurring post‐discussion. In addition, partners and project‐related team members were removed from the analysis to test for partner participation confounding with the overall shift in valence remaining the same.ConclusionFilms about living with dementia, and curated questions developed in collaboration with panelists and directors of 1st person experiences can positively impact changes in sentiment about dementia.

Analisis Efektifitas Program Promosi Kesehatan dalam Mencegah Diare pada Balita Diwilayah Kerja Puskesmas Miran

Diarrhea is defecation with liquid stools or: half liquid (half solid), water content greater than 200 grams or 200m1/24 hours Another definition of diarrhea is feces with a thinner consistency and more frequent frequency (&gt;2x in one day).The purpose of this study was to analyze the effectiveness of health promotion programs in preventing diarrhea in toddlers in the work area of the Miran Health Center The research method used by this researcher is a type of qualitative research Desaín this research is field research (feld re.search) this research uses key informants, namely the head of the miran health center, the main informant is the mother of a toddler who has diarrhea and supporting informants, namely the diarrhea program holder at the miran health center. Data collection procedures are carried out through interviews (interviews). The implementation of diarrhea programs in the work area of the miran health center has been well implemented The results of the evaluation obtained the number of toddlers with diarrhea in the work area of the miran health center is 12 toddlers and there are further assistance and intervention measures for diarrhea cases with the hope that it can reduce the rate of diarrhea in the work area of the miran health center.

Obesity and lifestyle behaviours among in-school children in Oman.

Many countries are experiencing an increasing prevalence of childhood obesity and this needs to be carefully addressed. To determine the prevalence of overweight and obesity and the sociodemographic factors and lifestyle risk behaviours associated with obesity among in-school children in Al Buraimi Governorate, Oman. We conducted a cross-sectional study among 714 male and female in-school children aged 6-17 years in 14 government schools in Al Buraimi Governorate, Oman, from April to July 2019. Data were collected on the sociodemographic characteristics and lifestyle of the students using a self-administered questionnaire. The students' height, weight and waist circumference were also measured. The BMI-for-age growth charts cutoff reference standards of the WHO were used to determine weight category. Central obesity was assessed by calculating the waist-to-height ratio, and the waist-toheight ratio cutoff of 0.50 was used to identify central obesity in both boys and girls. Data analysis was conducted using SPSS version 21, involving both descriptive and inferential statistics. A total of 714 students were included. The prevalence of overweight and obesity was 12.3% and 16.3% respectively, and 21.4% of the students had central obesity. Lifestyle risk behaviours were significantly associated with student's age, sex and mother's education (P < 0.05). Predictors of obesity were: unhealthy eating habits (adjusted odds ratio (AOR) = 5.20; 95% confidence interval (CI): 2.50-10.70), sedentary screen-based activities (AOR = 1.54; 95% CI: 1.05-2.26), inadequate night-time sleep duration (AOR = 0.60; 95% CI: 0.34-1.00), sibling obesity (AOR = 2.24; 95% CI: 1.55-3.25), paternal obesity (AOR = 1.66; 95% CI: 1.10-2.50) and maternal obesity (AOR = 1.64; 95% CI: 1.10-2.45). There is a need for effective health promotion programmes targeting in-school children in Oman, as well as regular monitoring of lifestyle behaviours associated with overweight and obesity among the younger populations. Larger studies are needed to understand the predictors of overweight and obesity among in-school children in Oman and to design relevant school-based interventions to prevent obesity among young Omanis.

Effect of Health Promotion Program Regarding Environmental Literacy and Climate Change Health Risks among Newly Nursing Students

Effect of Health Promotion Program Regarding Environmental Literacy and Climate Change Health Risks among Newly Nursing Students

The Efficacy of Health Promotion Program Among Parents Who Had Children With Attention-Deficit/Hyperactivity-Disorder

Objectives: To explore the effect of health promotion program (HPP) on stress, quality of life, health-promoting lifestyles, and children’s attention-deficit/hyperactivity disorder (ADHD) symptoms in parents of children with ADHD. Methods: Sixty parents of children with ADHD were equally randomized into the intervention (health promotion program) and control (usual care) groups. Outcomes included parents’ stress, quality of life, health-promoting lifestyles, and children’s ADHD symptoms before, immediately after, and 1, 3, and 6 months after the intervention. The GEE was used to evaluate the effectiveness. Results: The intervention group reported significant improvement in the children’s hyperactivity/impulse and opposition at the 6- and 3-month, respectively. Parental overall stress significantly improved at 3 and 6 months. Parents’ quality of life had significant effects at the immediate, 3-month, and 6-month. Self-actualization behavior for health-promoting lifestyles had significant effects at the immediate follow-up. Conclusion: HPP can promote the mental well-being of parents of children with ADHD.

Determinants of self-rated health among elderly patients with hypertension: a cross-sectional analysis based on the Chinese longitudinal healthy longevity survey

ABSTRACT Background The total number of elderly patients with hypertension in China has been increasing year by year, it is necessary to adopt simple and valid measures to evaluate the health status of elderly patients with hypertension to reduce the heavy burden faced by this group. Method This study is a cross-sectional analysis. Participants aged at least 65 years were included. Self-Rated Health (SRH) assessment of respondents was classified into two groups: participants who responded as “very good” and “good” were considered as having good SRH, and participants who answered as “average,” “poor,” and “very poor” were considered as having poor SRH. Chi-square tests were used to determine differences in patient characteristics between the two groups. Binary logistic regression models were used to identify factors associated with SRH. Results The results of the logistic regression analysis indicated that having a spouse, better economic status, exercise, eating fruits and vegetables, nighttime sleep of 7 to 9 hours, good living environment, interaction with friends, and hypertension with comorbidity such as diabetes mellitus, heart disease, stroke or hyperlipidemia were influencing factors of SRH (P < .05). Another finding was that alcohol use significantly affected SRH (P < .05). Depression, anxiety, and community nursing services did not figure as determinants of health in this group. Conclusion The findings of this study provide evidence for the need to develop effective health promotion programs for the well-being of hypertensive patients.

Oral and craniofacial research in the Generation R study: an executive summary

ObjectivesOral conditions are of high prevalence and chronic character within the general population. Identifying the risk factors and determinants of oral disease is important, not only to reduce the burden of oral diseases, but also to improve (equal access to) oral health care systems, and to develop effective oral health promotion programs. Longitudinal population-based (birth-)cohort studies are very suitable to study risk factors on common oral diseases and have the potential to emphasize the importance of a healthy start for oral health. In this paper, we provide an overview of the comprehensive oral and craniofacial dataset that has been collected in the Generation R study: a population-based prospective birth cohort in the Netherlands that was designed to identify causes of health from fetal life until adulthood.MethodsWithin the multidisciplinary context of the Generation R study, oral and craniofacial data has been collected from the age of 3 years onwards, and continued at the age of six, nine, and thirteen. Data collection is continuing in 17-year-old participants.Research outcomesIn total, the cohort population comprised 9749 children at birth, and 7405 eligible participants at the age of seventeen. Based on questionnaires, the dataset contains information on oral hygiene, dental visits, oral habits, oral health–related quality of life, orthodontic treatment, and obstructive sleep apnea. Based on direct measurements, the dataset contains information on dental caries, developmental defects of enamel, objective orthodontic treatment need, dental development, craniofacial characteristics, mandibular cortical thickness, and 3D facial measurements.ConclusionsSeveral research lines have been set up using the oral and craniofacial data linked with the extensive data collection that exists within the Generation R study.Clinical relevanceBeing embedded in a multidisciplinary and longitudinal birth cohort study allows researchers to study several determinants of oral and craniofacial health, and to provide answers and insight into unknown etiologies and oral health problems in the general population.

Perceived Health Needs of Church Leaders and Members: A Secondary Data Analysis of the Mid-South Congregational Health Survey.

Needs assessments have been successful in helping communities and congregations focus their health ministry efforts; however, most have used leader perceptions of congregational health needs. The purpose of this study was to examine and compare the self-reported needs of both church leaders and members to be addressed by their congregation. Church leaders (n = 369) and members (n = 459) from 92 congregations completed the 2019 Mid-South Congregational Health Survey. Frequencies and generalized linear mixed models (GLMM) were performed to examine the top 10 self-reported needs and associations by church role, respectively. Of the top 10 congregational needs, anxiety or depression, high blood pressure, stress, and healthy foods were ranked identically regardless of church role. Church leaders perceived obesity and diabetes to be important congregational health needs, whereas members perceived affordable health care and heart disease to be important congregational health needs. GLMM, controlling for within-church clustering and covariates, revealed church leaders were more likely than members to report obesity (odds ratio [OR]: 1.93, 95% confidence interval [CI] = [1.39, 2.67], p < .0001) and diabetes (OR: 1.73, 95% CI = [1.24, 2.41], p = .001) as congregational needs. Findings display similarities and differences in needs reported by church role. Including many perspectives when conducting congregational health needs assessments will assist the development of effective faith-based health promotion programs.

Using the Ophelia (Optimising Health Literacy and Access to Health Services) process as a practical tool for health promotion program delivery in various Philippine communities.

The Ophelia (Optimising Health Literacy and Access to Health Services) process can be used as a practical tool for effective health promotion program delivery because of its multi-sector and pragmatic approach to designing health interventions. An initial case study showed how its first phase was successfully adapted in a pilot community in Leyte, Philippines. In this study, the three phases of the Ophelia process were implemented in Leyte, along with additional communities in Mindoro and Surigao. After conducting needs assessment and community profiling in phase 1, the results were transformed into vignettes, hypothetical personas representing the health needs of the community. These were used in phase 2, which involved focus group discussions and workshops to cocreate intervention ideas with government organisations, practitioners, and community representatives. A rapid realist review was conducted in phase 3 to check for the feasibility of interventions. Through this, the top evidence-based health interventions for each life stage were listed and presented for prioritisation. Program implementation and impact evaluation plans were created for the top health intervention prior to implementation. The Ophelia process ensured that health promotion interventions addressed community needs and were designed using community resources and the wisdom of health practitioners that have been immersed in the local health system. SO WHAT?: The study demonstrated the usefulness of vignettes in presenting data to lay people and how the rapid realist review approach is a practical tool for policy-makers to ensure that program plans designed by the communities and health practitioners are evidence-based without sacrificing the timeliness of implementation.

Special Considerations for Management of Diabetes in Adult Patients with Intellectual and Developmental Disabilities.

Diabetes mellitus (DM) is a chronic health condition that is very prevalent worldwide. It has been demonstrated that individuals with intellectual and developmental disabilities (IDDs) are at a disproportionately high risk for developing diabetes. Persons with IDDs are estimated to be 2-3 times more likely to develop DM compared to the general population. The elevated risk of developing diabetes within the population of adults with IDDs is multifactorial and includes contributions from genetics, lifestyle, medication use and misuse, boundaries to appropriate medical care, a higher incidence of comorbid mental health disorders, and others. Further, inadequate screening for and management of diabetes for these patients results in heightened risk for adverse cardiovascular events and inferior health care outcomes. To improve patient outcomes for this unique patient population, health care providers need to be well trained in the optimal modalities of screening, diagnosis, and management of diabetes in adults with IDDs. This requires the development of effective diabetes intervention and health promotion programs aimed at patients with IDDs, utilizing a patient-centered approach to screening and management, and conducting further research to assess the impact of these interventions.

Prevalence of Ideal Cardiovascular Health Metrics among Young Asian Adults over 5 Years of Follow-Up.

Ideal cardiovascular health (CVH) metrics play an important role in preventing cardiovascular disease (CVD). However, there is a lack of cohort studies on CVH metrics among young Asian adults. The aims of this study were to describe early changes in CVH among young Asian adults and to investigate the association between CVH metrics and sociodemographic variables. A total of 10,000 young adults (aged 21-30 years) were recruited between 2000 and 2016. There were two CVH measurements taken from these participants over the study period. One measurement was taken at the beginning, and the other was taken five years later. Subgroup analysis of the changes in CVH metrics was divided by education level and marital status. The mean age of the participants was 26.8 years. The initial prevalence of ideal CVH metrics was 52.3% and 86.8% and decreased to 43.8% and 81.2% after five years for males and females, respectively. In the subgroup analysis, males with less than a university education had a smaller ideal CVH metric decrease (6.2%) than males with more than a university education (8.9%), while females with more than a university education had a smaller ideal CVH metric decrease (5.4%) than females with less than a university education (7.3%). Married males had a smaller ideal CVH metric decrease (6.1%) than single males (9.1%), while single females had a smaller ideal CVH metric decrease (5.3%) than married females (6.2%). The prevalence of ideal CVH metrics among young adults gradually decreased as age increased. Higher educational attainment and unmarried status were associated with a greater prevalence of ideal CVH metrics regardless of sex, but early CVH changes differed by sex, education level, and marital status. The prevalence of CVH changes found early among young adults can be used to monitor CVH changes quickly. Effective health promotion programs are needed to maintain CVH metrics among young adults.

Understanding COVID-19 vaccine hesitancy: A cross-sectional study in Malang District, Indonesia.

Vaccine hesitancy could undermine efforts to reduce incidence of coronavirus disease 2019 (COVID-19). Understanding COVID-19 vaccine hesitancy is crucial to tailoring strategies to increase vaccination acceptance. This study aims to investigate the prevalence of and the reasons for COVID-19 vaccine hesitancy in Malang District, Indonesia. Data come from a cross-sectional study among individuals aged 17-85 years old (N = 3,014). Multivariate ordered logistic regression was used to identify factors associated with postponing or refusing COVID-19 vaccines. The Oxford COVID-19 vaccine hesitancy scale was used to measure vaccine hesitancy. A wide range of reasons for hesitancy, including coronavirus vaccine confidence and complacency, vaccination knowledge, trust and attitude in health workers and health providers, coronavirus conspiracy, anger reaction and need for chaos, populist views, lifestyle, and religious influence, was examined. The results show that 60.2% of the respondents were hesitant to receive the COVID-19 vaccine. Low confidence and complacency beliefs about the vaccine (OR = 1.229, 95% CI = 1.195-1.264) and more general sources of mistrust within the community, particularly regarding health providers (OR = 1.064, 95% CI = 1.026-1.102) and vaccine developers (OR = 1.054, 95% CI = 1.027-1.082), are associated with higher levels of COVID-19 vaccine hesitancy. Vaccine hesitancy is also associated with anger reactions (OR = 1.019, 95% CI = 0.998-1.040), need for chaos (OR = 1.044, 95% CI = 1.022-1.067), and populist views (OR = 1.028, 95% CI = 1.00-1.056). The findings were adjusted for socio-demographic factors, including age, sex, education, marital status, working status, type of family, household income, religious beliefs, and residency. The results suggest the need for an effective health promotion program to improve community knowledge of the COVID-19 vaccine, while effective strategies to tackle "infodemics" are needed to address hesitancy during a new vaccine introduction program.

Study Protocol of a Mixed-Methods Study to Develop and Validate the Malaysian Anti-Hypertensive Agents Non-Adherence Scale in Hypertensive Patients

Introduction: Domains of adherence and non-adherence to hypertensive medications have not been extensively documented in Malaysia due to the absence of theoretically driven and culturally appropriate measurement tools, leading to a poor understanding of the adherence and underlying factors. We aim to identify these domains in Malaysian hypertensive patients and subsequently apply the findings to develop and validate the Malaysian Anti-Hypertensive Agents Non-Adherence Scale (MAANS). Methods: This study has an exploratory mixed-methods design. In Phase 1, we will recruit hypertensive patients from two health clinics to participate in a semi-structured interview. Recruitment of participants will terminate once thematic saturation is achieved. Coding and thematic analyses will be performed to identify the domains of adherence and non-adherence to anti-hypertensive medications. In Phase 2, based on the domains generated from Phase 1, we will develop the Malaysian Anti-Hypertensive Agents Non-Adherence Scale (MAANS). Four hundred hypertensive patients will be randomly selected. Data from 200 participants (serving as the calibration sample) will be subjected to exploratory factor analysis while data from additional 200 participants (serving as the validation sample) will be subjected to confirmatory factor analysis. Factor structure, predictive validity, and reliability of the MAANS will be statistically tested. Discussion: With the presence of the MAANS, health care providers can gather crucial information regarding barriers and facilitators to hypertensive treatment adherence and design effective health promotion programmes to reduce complications of uncontrolled hypertension. Trial registration: Ethical approval is granted by the Medical Research Ethics Committee, Ministry of Health, Malaysia (NMRR-18-3251-44694).

Perceptions of health and illness among older Hispanic adults.

Understanding perceptions of health and illness among older Hispanic adults is vital for nurses when designing effective health promotion programs. The purpose of this study was to explore the perceptions of health and illness and how health was maintained during times of illness. This inductive qualitative descriptive study used a single focus group with interviews over three sessions. All eight members of the focus group were Spanish-speaking, older adults living in the community. Immersion/crystallization and editing analytic styles were used to analyze the data. Participants were parishioners at a local church and knew each other from participating in community events. Perceptions of health mainly focused on both the absence of illness and physical limitations. Maintaining health included a healthy lifestyle and being physically active; however, food was central to maintaining health. Perceptions of illness were described as "feelings of sickness" such as sadness and worry. Dealing with illness was equated with physical limitations, with strategies suggested, including going to the doctor, preparing natural and folk remedies, spirituality, and support from family and friends. Nurses have an important role in assessing the health management strategies of older Hispanic adults and need to incorporate the older adults' understanding of health and illness into their plan of care.

Health Status and Self-Perception of Health in Czech Roma Community

Abstract Background The Roma population is reported to have a lower life expectancy in several European countries. The reasons for this are not well described, which limits the development of effective health promotion programs. This report investigates some possible reasons: self-perception of health risks and discrimination in a sample of Czech Roma. The study is a part of a complex health awareness program. Methods This is a pilot descriptive, cross-sectional survey conducted in Brno, Czech Republic in March 2022. Respondents were identified by community gatekeepers using quotas of gender and education. Data on disease incidence, lifestyle, attitudes to health care and risk perception were collected. Results In the sample of 30 participants, 60% were female, average age 42±5, 60% primary education. 57% daily smokers, with an average 17 cigarettes daily during 18 years. 35% had 1 chronic disease, another 38% had 2 and more. The most prevalent diseases were hypertension (43%) and obesity (41%). 60% of respondents with hypertension as compared to 23% without hypertension considered their stroke risk as medium. 43% smokers as compared to 21% non-smokers consider their risk of COPD as medium (for lung cancer 41% vs. 0%). Roma report not visiting a doctor due to a lack of time (33%), expecting the problem to resolve itself (33%), long waiting time (33%), but not discrimination (0%). Conclusions The Roma with risk factors correctly identify their risk of stroke, COPD, lung cancer as higher. None of them feel discriminated from physicians, but they limit contact with them due to other reasons. It appears that the prevalence of risk factors is higher in the Roma when compared to Caucasians based on the European Health Interview Survey (16% female, 31% male hypertension; 14% female, 29% male obesity). Self-perception of health and feeling of discrimination in Roma communities should be taken into account when designing health interventions. Key messages