Health Promotion Goals Research Articles

“Round Peg in a Square Hole”: Lessons from Community Health Promotion Practice on Dynamics of Accountability, Reporting and Evaluation, and Governance

This paper presents results from a small-scale institutional ethnography study of reporting requirements and evaluation practices in two urban community health centers (CHCs), as a sample of community-based nonprofit organizations that focus on social justice and health equity. The study illuminated complex relationships among accountability, reporting and evaluation, and governance. Among the CHCs, reporting and evaluation practices consistent with goals of obtaining social justice and health equity were undermined by an imbalance toward funder-oriented functional accountability. Analysis of accountability and reporting practices as systemic factors shaping knowledge production, decision-making, and action revealed notable consequences for CHCs’ health promotion practice. This paper proposes a wholistic accountability model to encourage equitable power relations in evaluation, enable participatory methods, and better align CHC knowledge production and governance systems with their health promotion goals. This study further adds to the growing literature supporting critical attention to nonprofit accountability in the context of systems change work.

Physical literacy-based intervention for older adults: a cluster randomized controlled trial study protocol.

The ageing population creates concerns and challenges worldwide. The large number of older adults (aged over 65) in Hong Kong continues to rise as people live longer. This may result in heavy burdens on public services and problems such as a shortage of medical resources. The purpose of this study is to implement a physical literacy-based intervention among older adults in Hong Kong in order to achieve the goal of health promotion. A two-arm cluster randomized controlled trial will be employed in this proposed study. Ten daycare centers for the older adults in Hong Kong will be invited to participate in this study. The intervention group will receive functional fitness training and mastering physical literacy class twice a week with buddy peer support, and they will be asked to keep a reflective writing journal on a daily basis for 12 weeks in total. Participants will be evaluated at baseline (week 0), post-intervention (week 12), and at 6-week follow-up (week 18). This will consist of objective and self-reported measures covering elements within physical literacy (i.e., physical competence, motivation and confidence, knowledge and understanding) and also physical activity levels on an individual basis. The study intends to introduce a conceptual framework of physical literacy for the older adults through an intervention that allows older people to develop daily behaviour habits, which should promote active ageing for the older adults and greater self-esteem in later life. After this study, participants may share their positive experiences, and encourage their peers in the community to become physically literate in the future. In the long run, due to the feasibility and sustainability of these potential programs, this proposed study has the potential to connect seniors through social engagement and contribute to healthy living. Clinical trial approval from the National Library of Medicine (Reference number: NCT06137859).

Getting Precise about Gender and Sex Measurement: A Primer for Epidemiologists

Abstract Accurately measuring gender and sex is crucial in public health and epidemiology. Iteratively reexamining how variables—including gender and sex—are conceptualized and operationalized is necessary to achieve impactful research. Reexamining gender and sex advances epidemiology toward its goals of health promotion and disease elimination. While we cannot reduce the complexities of sex and gender to simply an issue of measurement, striving to capture these concepts and experiences accurately must be an ongoing dialogue and practice—to the benefit of the field and population health. We assert that epidemiology must counteract misconceptions and accurately measure gender and sex in epidemiology. We aim to summarize existing critiques and guiding principles in measuring gender and sex that can be applied in practice.

Developing an Online Health Community Platform for Facilitating Empowerment in Chronic Disease Prevention and Health Promotion.

This study aimed to develop an online health community platform for facilitating the empowerment of people with chronic diseases dwelling in the community regarding disease prevention and health promotion. The user-centered design approach included four main steps: (1) identifying the health problems and needs of target users, (2) developing the content of the platform, (3) constructing the platform, and (4) pilot testing, refinement, and finalization. An online health community platform available both in a mobile application and a Web-enabled application has been launched to facilitate empowerment and self-management by people with chronic conditions. The main components of the application comprised (1) screening for chronic diseases and health problems, (2) setting personal goals for health promotion and action planning to achieve the goals themselves, (3) offering an online health community with shared group goals that help users engage with their peers to attain their goals, and (4) creating one's own online health community and inviting others to participate. The platform has the potential to encourage people with chronic conditions to proactively engage in their own health promotion. Future studies are needed to determine the impact of the application on self-management and empowerment for its users.

Mental health promotion and the positive concept of health: Navigating dilemmas

A prevailing view holds that the main goal of mental health promotion is to maintain and improve positive mental health, which is not merely defined by the absence of mental disorders, but by the presence of certain abilities. There are, however, challenges associated with this view that this paper aims to identify and explore. We start by highlighting three requirements for an ethically and politically justified mental health promotion scheme: (i) using a positive concept of mental health that (ii) respects the neutrality principle while (iii) not being overly permissive. Then, we argue that the WHO's positive concept of health violates (ii), and continue by exploring three philosophical accounts (i.e., Nordenfelt, 1995, 2017; Graham 2010; Wren-Lewis & Alexandrova, 2021) that could potentially provide a solution. We show that these face a dilemma of their own: they either violate (ii) or (iii), and they can rectify one issue only by violating the other. Considering the problems linked to the positive notion of health, the final section explores the alternate route of rejecting proposition (i) and instead embracing a negative concept of health. We argue that this option does not present a more advantageous solution. We conclude by highlighting the necessity for additional research to tackle the challenges we identified.

Floristic changes and environmental drivers of soil fungi and archaea in different salt-tolerant plant communities in the intertidal habitat of coastal wetlands.

Microorganisms are crucial elements of terrestrial ecosystems, which play significant roles in improving soil physicochemical properties, providing plant growth nutrients, degrading toxic and harmful chemicals, and biogeochemical cycling. Variations in the types and quantities of root exudates among different plants greatly alter soil physicochemical properties and result in variations in the diversity, structure, and function of soil microorganisms. Not much is understood about the differences of soil fungi and archaea communities for different plant communities in coastal wetlands, and their response mechanisms to environmental changes. In this study, fungal and archaea communities in soils of Suaeda salsa, Phragmites australis, and Spartina alterniflora in the intertidal habitat of coastal wetlands were selected for research. Soil fungi and archaea were analyzed for diversity, community structure, and function using high throughput ITS and 16S rRNA gene sequencing. The study revealed significant differences in fungi and archaea's diversity and community structure in the rhizosphere soil of three plant communities. At the same time, there is no significant difference in the functional groups. SOM, TP, AP, MC, EC and SOM, TN, TP, AP, MC, EC are the primary environmental determinants affecting changes in soil fungal and archaeal communities, respectively. Variations in the diversity, community structure, and ecological functions of fungi and archaea can be used as indicators characterizing the impact of external disturbances on the soil environment, providing a theoretical foundation for the effective utilization of soil microbial resources, thereby achieving the goal of environmental protection and health promotion.

Nature of the work correlated to overweight and obesity for nurses: A 10-year hospital-based cohort study.

Nurses are a high-risk group for overweight and obesity due to high stress, low-labor medical work, irregular diet, and lack of exercise. There is scarce information on relationship between job characteristics and overweight and obesity among nurses. This study aimed to answer the question. Does the nature of the work including job position, seniority relate to overweight and obesity among nurses? Their incidence was also investigated. We conducted a retrospective cohort study of nurses who underwent annual checkups during 2007 to 2016 in a medical center. Overweight was defined as a body mass index between 24 and 27 kg/m 2 . Obesity was defined as a body mass index higher than 27 kg/m 2 . We calculated the prevalence and incidence of overweight and obesity and estimated relative risks using logistic regression. Overall, 4253 participants were enrolled for the incidence of overweight and obesity. We found that junior staff, administrative directors, working in intensive care units, and old age had a high possibility of overweight. Junior staff, administrative directors, old age, and male sex tend to be obesity. Overweight and obesity occurred rapidly in the first 2 years of their career. Our findings suggest that policies should be set up to achieve the goal of workplace health promotion. Health plans focusing on these factors may help nurses avoid obesity and overweight. The director of the hospital should keep track of the health checkup database to confirm the benefits of its long-term implementation.

Revised Contemplative Landscape Model (CLM): A reliable and valid evaluation tool for mental health-promoting urban green spaces

Due to rapid urbanization and an increase in mental health issues in urban populations, urban green spaces (UGS) design needs to be optimized to meet mental health and well-being promotion goals. However, existing frameworks and tools that aim to address this pressing need are often not adequately validated against health measures. The Contemplative Landscape Model (CLM), developed in 2016, is the first instrument that measures the quality of UGS and informs landscape design with regard to the mental health and well-being of people passively exposed to them. Recent studies with this tool and developments in UGS literature prompted the development and validation of a revised version of CLM presented here. The reliability and validity of CLM were tested with a panel of independent experts and showed better reliability/internal consistency (ω = .893; α = .890) than the original CLM. This time, validity was tested in two ways: (1) against neuropsychological data (electroencephalogram, EEG, and self-reported valence and arousal ratings), acquired during passive exposure to UGS scenes and (2) through factor analysis of experts’ UGS assessments. Validity testing showed that (1) CLM predicts brain activity patterns associated with mindfulness, relaxation, and positive mood, and (2) contemplativeness of landscapes is a valid construct undergird by two parallel factors both predicting beneficial EEG responses. In conclusion, CLM is an effective and robust instrument for assessing the visual quality of UGS predictive of mental health and well-being benefits in urban residents.

Correction: Health-Related Goals of Digital Prevention and Health Promotion in Families

Correction: Health-Related Goals of Digital Prevention and Health Promotion in Families

Patient navigation for colorectal cancer screening in deprived areas: the COLONAV cluster randomized controlled trial

BackgroundThe objective of this study was to assess the effectiveness of a Patient Navigation Intervention targeting deprived patients for Colo-Rectal Cancer (CRC) screening participation.MethodsA cluster randomized controlled trial was conducted in 5 districts. Peer Lay Patient Navigators were recruited to operate in deprived areas. Eligible participants had to be between 50 and 74 years old, live in these deprived areas and receive an invitation to the nationally organized Colo-Rectal Cancer (CRC) screening during the study period. The theory-driven navigation intervention was deployed for 18 months. A population Health Intervention Research assessment method was used to assess effectiveness and context interaction. The primary criterion was screening participation at 12 months.ResultsTwenty-four thousand two hundred eighty-one individuals were included inside 40 clusters. The increase in participation in the intervention group was estimated at 23%, (ORa = 1.23, CI95% [1.07–1.41], p = 0.003). For the subgroup of individuals who participated, the time delay to participating was reduced by 26% (ORa = 0.74, CI95% [0.57–0.96], p = 0.021). Main factors modulating the effect of the intervention were: closeness of navigator profiles to the targeted population, navigators’ abilities to adapt their modus operandi, and facilitating attachment structure.ConclusionThe ColoNav Intervention succeeded in demonstrating its effectiveness, for CRC screening. Patient Navigation should be disseminate with broader health promotion goals in order to achieve equity in health care.Trial registrationclinicaltrials.gov NCT02369757 24/02/2015.

Kształtowanie prozdrowotnego stylu życia w regulacjach prawnych

Health is a strictly personal property, belonging to every human being, on the other hand, it is a socially valued value. Health is closely related to the person, the human body and its physical integrity, the violation or deprivation of which will result in a deviation from the norm provided for by law. Health as one of the inalienable attributes of a human being is included in the catalog of rights subject to special internal – national and external – international protection, therefore it is a global, basic, natural concept and every human being is entitled to it. Health is a sine qua non. Health is an inseparable condition - an attribute of broadly understood social well-being in all areas of life. The task, the goal of health promotion – a healthy lifestyle is public participation in defining problems, topics related to health and taking up solutions related to the improvement or change of the factors conditioning them.

Development of Virtual Reality Application for Oral and Dental Health Promotion on Early Childhood

Oral health is a condition that cannot be separated from the life of a child because poor of dental health will affect the other bodies. Education of oral health can improving oral health status, because the good education will be improved an effort to maintenance oral health. Improving health knowledge for early childhood can optimizing health promotion because the information will adhere effectively for them. It is important to develop appropriate media for health education in early childhood so the goals of health promotion can be achieved. This study was aim to develop oral health promotion media using virtual reality and to obtain the effectifeness of that media.This study was consist of development research and experimental research that develop virtual reality media and obtain the effectiveness of that media for improving oral health knowledge. This study conducted at SD Negeri 150/IV Jambi City. The stages of development research was done based on the ADDIE method. The method of experimental research was quasi experimental. Validation by expert was involved six expert that covering about design and material. There were eighty eight students to be subjects of this study, fourty for development research and fourty eight for experimental research. The data collected in this study were in the form of qualitative data and quantitative data. The study shown that virtual reality media was decent to use for oral health promotion and it was proven can improving oral health knowledge.

Role of primary care physician in health promotion and education

Undisputedly, healthy behaviours and lifestyles have a positive impact on health outcomes, and its individual, social, environmental, and cultural determinants are well understood. Primary care physicians can effectively intervene with patients to encourage healthy behaviour through numerous chances. Regular clinical practice includes health promotion as a necessary element. Health systems can support a person's health requirements through primary health care, including illness prevention, treatment, palliative care, and more. This approach also guarantees that the delivery of healthcare is centred on patients' needs and supports their preferences. Regular care must incorporate health promotion strategies if the healthcare system is to be effective. Giving individuals the information, they need to improve and take better control of their health is the goal of health promotion. Primary care physicians are the immediate contact with the community which makes them the ideal candidates for health promotion and education. The purpose of this research is to review the available information about the role of primary care physician in health promotion and education. Health promotion and education is necessary for the prevention of diseases as it aids in educating population regarding diseases and risk factors. Also, because of its accessibility to care and continuity of treatment, primary healthcare is in a prime position to potentially intervene to modify unhealthy habits. Primary care physicians being first line of contact plays a key role in this regard. Although further research is needed for the implementation of health promotion and education strategies by primary care physicians.

Pilihan Media Promosi Kesehatan Berdasarkan Kategori Generasi di Rumah Sakit Islam Ibnu Sina Pekanbaru

Health promotion is an effort to spread health information or messages to all levels of society. Achieving health promotion goals generally requires media or tools so that health promotion can be more effective and efficient. The delivery and media of health promotion must be adapted to the characteristics of the target to be achieved. This article discusses the choice of health promotion media by generation category at Ibnu Sina Islamic Hospital Pekanbaru. This study involved 200 patients seeking treatment at the Outpatient Polyclinic from October 1 to 5, 2021. Patients were asked to fill out a questionnaire on Googleform, then the results of the questionnaire were analyzed using the Chi Square or Fisher Exact test, where p < 0.05 was considered significant. This study was dominated by Generation Y (44.0%), college education (54.5%) and male gender (53.5%). Respondents of this study generally chose Instagram as an online health promotion media (61.0%), while leaflets were the media of choice for offline health promotion media (37.5%). Fisher's exact test for the difference between Generasi and health promotion media both online and offline was significant based on statistical tests (p-value = 0.000). There is a difference between the age generation and the choice of health promotion media.

MENTAL HEALTH PROMOTION

Background: Having the person at the center of health, both in person-centered clinical care and people-centered public health [1] are a guiding principle in health promotion. Mental health is an integral part of each person’s health and well-being. This is an absolute necessity always and more so during the years of the coronavirus pandemic and the post-pandemic “new normal”.
 Objective: To discuss the basic concepts of health, mental health, health promotion and mental health promotion, focusing on peace and justice, two key target areas and goals of mental health promotion [2,3].
 Method: The holistic approach, the need to reduce stigma and discrimination, and the person- and people-centered approach in mental health promotion were reviewed.
 Results: The importance of identifying target populations and using paradigms of mental health promotion initiatives, like the Athens Mental Health Promotion Initiative, was noted, as well as the positive role played by celebrities who have excelled despite their mental disorders (“recovery”). The relevance of mental health promotion guidance and effectiveness of existing mental health promotion strategies have to be updated by further research in order to meet the need for intensification of mental health promotion efforts during the COVID pandemic.
 Conclusion: In the post-COVID era a “new normal” requires an update of policies for an intensified and different person-centered approach delivered by different providers to different recipients of services.

P10-03 Developing online health community platform for enhancing physical activity in the community

Virtual communities are emerging in many aspects of health activities and widespread in health management. Online health communities offer a virtual system where people with common interest, specific health needs can exchange information and experiences with other people with the same condition as well as getting support from peer and professionals. The objective of this study is to develop an ICT platform enhancing community resident participation involving in the chronic disease prevention and physical activities. The aim of this platform is to promote physical activity of community residents for health promotion and disease prevention goal attainment. Health promotion goals for enhancing physical activity were set by health care professionals based on scientific evidence. Instead of individual plan to set the goal by themselves, the platform offered them tailored goal with their conditions and then suggested them to participate in group shared their physical activity goals. The platform encouraged the active participation of community residents though adherence physical activity of health communities in which they were members.The ICT platform provides a place where community residents with chronic conditions or even healthy people who want to promote their health be able to find an appropriate group for together prevent disease and enhancing physical activity. The platform in the study allowed community residents to develop their own communities and invite other members to participate with them. This online community intended to empower community residents to increase their involvement in their self-management and pushing the active participation in phycial activities. Function such as reminder of activity participating was added. Future study will be conducted to evaluate changes in health promotion self-efficacy, health goal fulfillment, health-related quality of life, and shared decision-making after using the Health Community Platform among community residents. Extensive research initiatives are needed to determine the impact of virtual health communities on patient outcome, the overall process as well as quality and access of care.

The road from discovery to healing: What does it take?

Education and career choices are two major life decisions.1 One who considers a degree in Medicine may ask: “am I up to the challenge,” “am I curious about how medicine improves life,” and “do I care profusely about human life?” Practicing clinical medicine is the most common path; but, not all those with a career in Medicine are physicians. There are researchers in the basic sciences, and there are inventors and innovators of biomedical devices. All those working in Medicine start with valuing and pursuing the improvement of life.
 The ideal medical school integrates disciplines for a complete understanding of medicine.2 Two of the articles in this edition describe challenges facing Philippine medical schools. The first article re-evaluates the adjustment factor used in the admission process. The second article highlights flexibility and innovation in the sudden shift to online learning.
 The MD-PhD Program connects scientific research with clinical practice. In the US, this program started in the 1950s and expanded through the Medical Scientist Training Program to more than 90 active MD-PhD programs in 2016.3 The country’s first MD-PhD Program started in 2010 at the University of the Philippines College of Medicine (UPCM). One of our physician-scientist graduates authored an article on the pharmacologic potential of locally harvested edible mushrooms.
 Many other UPCM graduates do research at the Philippine General Hospital. As an academic medical center, it houses “a large and diverse sample of patients, experienced and interested investigators, with organizational support.”4 In this edition, physician trainees and faculty authored or mentored seven studies. They study various disease and systems processes with the goal of health promotion.
 Three articles studied hospital processes related to health service delivery. Radiation oncologists explored delays in repeated CT simulation for the radiation of head and neck cancer patients. Ophthalmologists formed a time quality management team to reduce the total consultation time at their outpatient clinic. OB-GYN sonologists looked at methods of manual disinfection of transvaginal probes to keep patients safe while undergoing such procedures.
 Two articles studied the epidemiology of cerebrovascular diseases and neoplasms (periampullary malignancies), two of the top causes of mortality in the country. Two other studies looked at diseases that affect the quality of life: visual impairment in the young, and the use of a modified approach to hip arthroplasty.
 Case reports remain valuable sources of unusual information and new ideas.5 This edition also features a case report on a rare childhood malignancy found in an elderly patient who was successfully treated.
 The road from discovery to healing can take many forms as exemplified by the 11 articles in this edition of Acta Medica Philippina. Publication is a step on the road from discovery to healing. To complete the journey is to implement their findings in clinical practice. Many implementation challenges exist due to differing approaches.6
 The road from discovery to healing is not an easy one. We hope to close the gap between evidence and practice; we contribute to an ever-evolving and growing body of knowledge; and we offer the best treatment to our patients, the lives we value the most.
 
 Jean Anne B. Toral, MD, MSc Department of Obstetrics and Gynecology College of Medicine and Philippine General Hospital University of the Philippines Manila Coordinator for Research and Chief of the Expanded Hospital Research Office, Philippine General Hospital
 
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 Camilleri AR. What are life’s biggest decisions? [Internet]. 2021 [cited June 2022]. Available from: https://www.psychologytoday.com/us/ blog/life-s-biggest-decisions/202101/what-are-lifes-biggest-decisions
 Napier S. Rapid response: the characteristics of an ideal medical school. BMJ. 2019; 323:1437.
 Harding CV, Kahn JR, Akabas MH, Andersen OS. History and outcomes of fifty years of physician-scientists training in medical scientist training programs. Acad Med. 2017 Oct; 92(10):1390-8.
 Pinsky WW. The roles of research in an academic medical center. The Ochsner Journal. 2000 Oct; 2(4):201-2.
 Loubon CO, Culquichicon C, Correa R. The importance of writing and publishing case reports during medical training. Cureus. 2017 Dec;9(12):e1964.
 Kristensen N, Nymann C, Konradsen H. Implementing research results in clinical practice – the experiences of healthcare professionals. BMC Health Sciences Research. 2016; 16:48.

Network Analysis for a Community-Based School- and Family-Based Obesity Prevention Program.

Rising childhood obesity with its detrimental health consequences poses a challenge to the health care system. Community-based, multi-setting interventions with the participatory involvement of relevant stakeholders are emerging as promising. To gain insights into the structural and processual characteristics of stakeholder networks, conducting a network analysis (NA) is advisable. Within the program “Family+—Healthy Living Together in Families and Schools”, a network analysis was conducted in two rural model regions and one urban model region. Relevant stakeholders were identified in 2020–2021 through expert interviews and interviewed by telephone to elicit key variables such as frequency of contact and intensity of collaboration. Throughout the NA, characteristics such as density, centrality, and connectedness were analyzed and are presented graphically. Due to the differences in the number of inhabitants and the rural or urban structure of the model regions, the three networks (network#1, network#2, and network#3) included 20, 14, and 12 stakeholders, respectively. All networks had similar densities (network#1, 48%; network#2, 52%; network#3, 42%), whereas the degree centrality of network#1 (0.57) and network#3 (0.58) was one-third higher compared with network#2 (0.39). All three networks differed in the distribution of stakeholders in terms of field of expertise and structural orientation. On average, stakeholders exchanged information quarterly and were connected on an informal level. Based on the results of the NA, it appears to be useful to initialize a community health facilitator to involve relevant stakeholders from the education, sports, and health systems in projects and to strive for the goal of sustainable health promotion, regardless of the rural or urban structure of the region. Participatory involvement of relevant stakeholders can have a positive influence on the effective dissemination of information and networking with other stakeholders.

Intersectoral violence prevention: the potential of public health-criminal justice partnerships.

Building successful intersectoral partnerships to address health is critical to reaching health promotion goals. With the confluence of the COVID-19 pandemic, the increase in violence during the pandemic and the heightened demand for racial justice resulting from police killings of people of color, particularly young, black males, intersectoral public health–criminal justice partnerships must be more thoroughly examined. Violence prevention is both a public health and criminal justice issue, with public health systems emphasizing primary prevention and criminal justice systems addressing violence prevention at secondary and tertiary levels. Public health–criminal justice collaborations can provide an opportunity to seize upon unrealized violence reduction goals across the spectrum of prevention. At the same time, issues remain that are at odds across field boundaries as exemplified through community violence prevention. While there have been successful examples of such collaborations, past public health–criminal justice partnerships also demonstrate the challenges of working together. These challenges have yet to be systematically described and rooted in the larger literature on partnerships. In this paper, collaborative challenges are enumerated and evidence-informed strategies to overcome those barriers to achieve violence reduction goals are identified as a way to ground further intersectoral partnership work between public health and criminal justice.

Efficacy of Sin Tax and Recommendations for Implementation of Tobacco Tax Regimen in Pakistan

Behavioural economics is a comparatively recent topic that challenges the mainstream economics’ basic assumptions. It emphasizes that humans aren't always rational, aren't always self-interested, and don't always have time-consistent preferences. A sin tax is a type of sumptuary tax that is imposed on some typically socially prohibited items and services, like liquor, cigarettes, SSBs, and gambling. Sumptuary taxes, which are a type of sumptuary regulation, are presumably meant to reduce transactions involving something that society finds undesirable. Tobacco usage continues to be one of Pakistan's most pressing development concerns. Tobacco products usage is the foremost reason of death from non-communicable diseases (NCDs), such as cancer, lingering breathing illnesses, and cardio vascular diseases (CVDs). Tobacco taxation, which is widely recognized as a fundamental component of tobacco regulating policy, is utilized in Pakistan to combat tobacco use with the dual goals of public health promotion and income collection. Behind the scenes, the tobacco industry's success is based on a lack of understanding of real economics. Despite the fact that tobacco usage is linked to a number of negative health outcomes, higher health costs, and overworked health systems, the tax incomes it creates often encourage policy inertia in low-income countries like Pakistan. It is important that while taxing the sin of tobacco consumption the basic goal should be discouraging the behaviour and not income generation.