Health-promoting Factors Research Articles

Bridging gaps: A closer look at the health of sexual and gender minorities in Austria

Abstract Austria has long lacked comprehensive data on the health and well-being of sexual and gender minorities (SGMs). The 2022 LGBTIQ+ Health Report addresses this gap by presenting a comprehensive overview of the health status of SGMs in Austria. To contextualize SGM health issues, a review of the literature, health surveys, and action plans across Europe was conducted in the initial project phase. Then a questionnaire was developed in collaboration with an expert group for quantitative data collection. A total of 1,047 individuals participated in the survey; analyses of the quantitative data were enriched by insights from ten qualitative interviews. Detailed findings cover SGMs’ health status and experiences of discrimination as well as access to healthcare and health-promoting factors. Participants rated their health status lower than the average in Austria. A high number reported encountering discrimination in healthcare, especially among intersex and trans participants. While approximately half of the respondents were satisfied with healthcare provision, around 16% expressed dissatisfaction. Finally, a significant proportion of participants reported having foregone healthcare services at least once despite having health issues. Our work underscores the importance of recognizing the diverse needs of distinct groups within the SGM spectrum. It is crucial to avoid oversimplification by grouping them into a single SGM category as this obscures the unique challenges and inequalities faced by each subgroup. The rapid evolution of terms adds complexity to this work. Moreover, attention should be directed towards intersectionality within these groups as some are hard to reach with an online survey. Navigating the seas of public health innovation, our exploration of SGM health in Austria reveals not only the challenges but also the imperative for inclusive and tailored healthcare strategies. Key messages • The 2022 LGBTIQ+ Health Report Austria reveils SGM health realities: lower health status, discrimination, and unmet healthcare needs, urging targeted interventions. • Acknowledging diverse SGM groups and evolving terminologies, our study underscores the need for nuanced, intersectional healthcare approaches.

Physical activity promotion as intersectoral planning in Milan Health Protection Agency

Abstract Issue/problem Physical activity is a protective factor for preventing Noncommunicable diseases (NCDs) and, for this reason, it plays an important role in all the different guidelines for prevention and health promotion. The Italian Regional Prevention Plans and in particular the Lombardy one promote physical activity with a systemic approach, through both upstream and downstream actions to encourage the role of communities. Description of the problem Based on the regional plan, the Health Protection Agency (HPA) of the Metropolitan City of Milan developed locally validated actions and best practices for the promotion of physical activity, through the cross-sectoral involvement of different stakeholders (health system, companies, universities, local authorities, sports associations, etc.). Results Physical activity is embedded in all lines of health promotion activities in local planning documents. Sustainable and active mobility activities have been implemented in companies and schools with a comprehensive approach. Validated regional programs (Pedibus, Walking Groups, ecc.) have been implemented in the local community, along with the construction of permanent local laboratories for physical activity, structured through the development of specific territorial networks and providing for integration with the socio-sanitary setting. Lessons Promoting physical activity becomes an opportunity to both consolidate territorial networks and to develop evidence-based health promotion actions able to meet the different health needs of the population and to produce a structural change in living contexts. Key messages • Physical activity is both a protective factor for health promotion and a tool for implementing intersectoral and equity-oriented system actions from a life-course perspective. • Promoting physical activity becomes an opportunity to consolidate territorial networks.

Health beliefs model to explore older adults' dementia prevention and health promotion from 2021 to 2022 in Taiwan: A cross-sectional survey study.

One person suffers from dementia every 3 seconds globally. Thirteen older adults aged 65 and older will have dementia, and 1 in 5 older adults over the age of 80 years will have dementia in Taiwan. Older adults should be equipped with demonstrated health beliefs regarding dementia prevention and health promotion about Ascertain Dementia 8-item Questionnaire (AD8), cues to action, health beliefs, self-efficacy, and behavioral intention in daily life. The purpose of this study was to survey older adults' demographic background, AD8, cues to action, health beliefs, self-efficacy, and behavioral intention for dementia prevention and health promotion. A cross-sectional survey design was used. Convenience sampling was performed. A total of 330 older adults participated in the study. The questionnaire used in this study included questions on older adults' demographic background, AD8, cues to action, health beliefs, self-efficacy, and behavioral intention. The researcher collected complete data by receiving the sampling on paper or by interview from October 8, 2021, to February 12, 2022. The SPSS 23.0 statistical package was employed for quantitative analysis. Data analysis included frequency, percentage, mean, standard deviation (SD), Spearman's rho correlation, and simple regression analysis. The findings showed that older adults had the following mean scores on health beliefs (perceived susceptibility 13.45 ± SD 2.34, perceived severity 13.54 ± SD 2.69, perceived benefits 16.57 ± SD 2.84, perceived barriers 8.20 ± SD 3.69), self-efficacy 16.96 ± SD3.52, and behavioral intention 19.56 ± SD 3.51. Older adults' demographic background, perceived susceptibility, perceived severity, perceived benefits, perceived barriers, and self-efficacy explained 56.1% of the variance in behavioral intention. The conclusions of the study indicated that older adults' demographic background, AD8, cues to action, health beliefs, self-efficacy, and behavioral intention constituted the main factors for effective dementia prevention and health promotion. In the future, the research team will continue to explore older adults' dementia prevention and develop many strategies on health promotion, as well as slowing the aging brain process.

Physical activity and diabetes: Where, when, how and with whom?

Today, physical activity is one of the most effective preventive and health-promoting factors for people with diabetes. Understanding the issues involved and how to implement it will help you to support patients in maintaining this practice.

Single Leg Hop Performance After Anterior Cruciate Ligament Reconstruction: Ready for Landing but Cleared for Take-Off?

Understanding former professional football players engagement with health promoting behaviors (physical exercise, high quality diet, and good sleep hygiene) will be helpful for developing lifestyle interventions to improve their feelings of well-being, a relatively understudied facet of health among this population. Examine associations among health-promoting behaviors and subjective outcomes related to well-being among former National Football League (NFL) players. Cross-sectional. Online or hard-copy survey. Former NFL players. Self-reported health-promoting behaviors (exercise frequency, diet quality, sleep duration and disturbance) and factors related to well-being (PROMIS ® Meaning and Purpose [MP], Self-Efficacy [SE], Ability to Participate in Social Roles and Activities [SRA]). Multivariable linear regression models were fit for each well-being-related factor with health-promoting behaviors as explanatory variables alongside select demographic, behavioral, and functional covariates. Models were fit for the full sample and separately for individual age groups: <30 years; 30-39 years; 40-49 years; 50-59 years; 60-69 years; and 70+ years. A total of 1,784 former NFL players (aged 52.3±16.3 years) completed the survey. Lower sleep disturbance was associated with better MP (β[standard error]=-0.196[0.024]), SE (β[standard error]=-0.185[0.024]), and SRA (β[standard error]=-0.137[0.017]) in the full sample and almost all the individual age groups. More frequent moderate-to-vigorous exercise was associated with higher MP (β[standard error]=0.068[0.025]) and SRA (β[standard error]=0.151[0.065]) in the full sample, and with better MP, SE, and SRA among select middle-aged groups (between 40-69 years old). Diet quality, resistance training exercise frequency, other wellness activity frequency, and sleep duration were not associated with well-being-related factors in the full-group and sparse significant associations were observed in individual age group models. Lower sleep disturbance and more frequent moderate-to-vigorous exercise frequency may be important targets for improving overall health and well-being among former NFL players.

Socio-Ecological Factors in Building a Healthy Community: A Comparative Study of Healthy Community Assessment Standards

Healthy community assessment standards significantly influence community design and planning and are an important measure of a community’s ability to support health and well-being. Previous studies have mostly focused on built-environment indicators. However, building a healthy community is a complex issue involving multiple dimensions and factors. The consideration of the full range of health promotion factors is the key to determining their potential impact on individuals’ health. It is necessary to consider multiple perspectives to deepen the understanding of community health influences and enhance the effectiveness of the implementation of the assessment standards. The socio-ecological model (SEM) provides a critical framework for understanding the multiple influences on individual health. In this study, a two-dimensional interdisciplinary analytical framework of “socio-ecological factors–development goals” is developed by integrating development goals that summarize building considerations in assessment standards. Contextual analysis is used to examine the provisions of the following assessment standards: Assessment Standard for Healthy Community (ASHC), Assessment Standard for Healthy Retrofitting of Existing Residential Area (ASHRERA), WELL Community Standard (WELL), and Fitwel Certification System of Community (Fitwel). The results show that community and organization factors are used more than interpersonal and policy factors among the four standards. Humanistic constructions lack attention in the ASHC and ASHRERA standards compared with the other standards. The differences between the four standards indicate that there is a need to focus on regional features and develop locally adapted interventions. This study offers a novel exploration of the potential effectiveness of healthy community assessment standards from a multidisciplinary perspective. The results of this study support standard-setters and planners in the development of interventions to improve building healthy communities using intersectionality frameworks.

Socio-economic inequalities in the use of flu vaccination in Europe: a multilevel approach

BackgroundThe European-wide statistics show that the use of flu vaccination remains low and the differences between countries are significant, as are those between different population groups within each country. Considerable research has focused on explaining vaccination uptake in relation to socio-economic and demographic characteristics, health promotion and health behavior factors. Nevertheless, few studies have aimed to analyze between-country differences in the use of flu vaccination for the EU population. To address this gap, this study examines the socio-economic inequalities in the use of influenza vaccination for the population aged 15 years and over in all 27 EU Member States and two other non-EU countries (Iceland and Norway).MethodsUsing data from the third wave of European Health Interview Survey (EHIS) 2019, we employed a multilevel logistic model with a random intercept for country, which allows controlling simultaneously the variations in individuals’ characteristics and macro-contextual factors which could influence the use of flu vaccination. In addition, the analysis considers the population stratified into four age groups, namely adolescents, young adults, adults and elderly, to better capture heterogeneities in flu vaccination uptake.ResultsThe main findings confirm the existence of socio-economic inequalities between individuals in different age groups, but also of significant variation between European countries, particularly for older people, in the use of influenza vaccination. In this respect, income and education are strong proxy of socio-economic status associated with flu vaccination uptake. Moreover, these disparities within each population group are also explained by area of residence and occupational status. Particularly for the elderly, the differences between individuals in vaccine utilization are also explained by country-level factors, such as the type of healthcare system adopted in each country, public funding, personal health expenditure burden, or the availability of generalist practitioners.ConclusionsOverall, our findings reveal that vaccination against seasonal influenza remains a critical public health intervention and bring attention to the relevance of conceiving and implementing context-specific strategies to ensure equitable access to vaccines for all EU citizens.

Exploring the interconnections of anxiety, depression, sleep problems and health-promoting lifestyles among Chinese university students: a comprehensive network approach.

Anxiety, depression, and sleep problems are prevalent comorbid mental disorders among university students. The World Health Organization (WHO) emphasized a mental health promotion objective, recommending the consideration of protective health-promoting factors in strategies aimed at preventing mental disorders. Integrating theoretically significant constructs (such as protective factors) enhances our comprehension of the intricate mechanisms that underpin mental disorders. This study employed network analysis to first identify core and bridge symptoms within comorbid mental disorders and then explore how health-promoting lifestyles (HPLs) were associated with these disorders. The ultimate goal is to offer health promotion recommendations to enhance students' quality of life. A total of 3,896 qualified university students participated in this study. Anxiety, depression, sleep problems, and HPLs were assessed using the GAD-7, PHQ-9, PSQI, and HPLP-II scales. A Gaussian Graphical Model was used to construct the networks. The Network Comparison Test was applied to determine whether the associations between HPLs and comorbid symptoms vary by gender, educational level, family sibling, and mental health status. Low energy (PHQ4) had the highest strength centrality, followed by Daytime dysfunction (PSQI7) and Trouble relaxing (GAD4). Five bridge symptoms were identified: Daytime dysfunction (PSQI7), Self-harm even suicide (PHQ9), Sad mood (PHQ2), Low energy (PHQ4), and Feeling afraid (GAD7). Regarding protective HPLs, Physical activity, Spiritual growth, and Stress management generally emerged as the top three central mental health-promoting behaviors. Targeting core and bridge symptoms with timely and appropriate interventions can alleviate anxiety, depression, and sleep problems in this population. Moreover, promoting physical activity, fostering spiritual growth, and managing stress are likely to significantly enhance the overall mental health of university students.

Linalool as a key component in strawberry volatile organic compounds (VOCs) modulates gut microbiota, systemic inflammation, and glucolipid metabolism

Strawberries are rich in volatile organic compounds (VOCs), which are increasingly recognized as potential health-promoting factors. This study explored the health effects of intaking strawberry VOC extract and its dominant terpene, linalool. The results indicated that linalool and strawberry VOC extract significantly increased the abundance of beneficial bacteria like Lactobacillus, Bacillus, and Alistipes in mice. Moreover, mice treated with linalool and strawberry VOC extract exhibited notable reductions in serum pro-inflammatory cytokines; interleukin IL-6 decreased by 14.5% and 21.8%, respectively, while IL-1β levels decreased by 9.6% and 13.4%, respectively. Triglyceride levels in the treated groups were reduced by 38.3% and 58.1%, respectively. Spearman's correlation analysis revealed that Bacillus negatively correlated with glucolipid indices, and Bifidobacterium and Dubosiella negatively correlated with inflammatory factors, indicating that alterations in glucolipid metabolism might be associated with the regulation of gut microbiota and systemic inflammation.

Health policy activities during the COVID-19 epidemic in the context of public health, including health security

The aim of this article is to evaluate the health policies implemented in Poland during the SARS-CoV-2 virus epidemic and their impact on the functioning of the health care system and on public health. Quarantine and isolation of infected persons or those in contact with the source of infection, hospitalization of symptomatic persons and promotion of vaccines became the priority of the anti-epidemic measures taken. The reorganization of the health care system and the focus on the "covid" problem affected the availability of health care services and thus reduce health security. The type and nature of the introduced restrictions in social life reduced the potential of health-promoting factors related to lifestyle, living environment, health care. The negative effect of the health policy became not only the so-called "health debt," but above all an increase in the number of deaths mainly unrelated to COVID-19 disease, i.e. so-called excess deaths.

Effect of regular winter swimming on blood morphological, rheological, and biochemical indicators and activity of antioxidant enzymes in males

BackgroundExposure of the human body to cold water triggers numerous beneficial physiological changes. The study aimed to assess the impact of regular winter swimming on blood morphological, rheological, and biochemical indicators and activity of antioxidant enzymes in males.MethodsThe study involved 10 male winter swimmers (the same participants examined before the season and after the season) and 13 males (not winter swimming, leading a sedentary lifestyle) in the control group. Fasting blood was collected twice: in November and in March of the following year. Basic blood morphological indicators, red cell elongation index (EI) and aggregation index (AI), concentrations of testosterone, cortisol, urea, and creatinine, as well as plasma activity of antioxidant enzymes of catalase (CAT), superoxide dismutase (SOD), and glutathione peroxidase (GPx) were determined.ResultsThe data were collected from the same winter swimmers at the beginning and end of the season. Winter swimming resulted in a significant increase of EI values at a shear stress of 0.30 (p = 0.40), 0.58 (p < 0.001), 4.24 (p = 0.021), 8.23 (p = 0.001), 15.59 (p = 0.001), 30.94 (p = 0.004), and 60.00 Pa (p = 0.043); haemoglobin was lower than before the season (p < 0.027). No significant changes were observed in AI, AMP, T1/2, the levels of urea, creatinine, eGFR, testosterone, cortisol, or the activity of CAT or SOD. There was a statistically significant increase in GPx activity (p = 0.014) and increase in testosterone concentration (p = 0.035) in the group of winter swimmers examined before the season as compared with the control group. No statistically significant differences were found for the mean values of blood morphological indicators and other parameters.ConclusionsWinter swimming can prove to be a health-promoting factor in males, as indicated by a rise in the deformability of red blood cells in the blood vessel system after a full season of winter swimming, leading to better body oxygenation, and improves the antioxidant defence and testosterone concentration (within standard limits) in the group of winter swimmers examined before the season as compared with the control group. Winter swimming helps maintain appropriate levels of blood rheological indicators, urea, creatinine, eGFR, cortisol, testosterone, and activity of antioxidant enzymes.Trial registrationClinicalTrials.gov identifier NCT06223087, 15.01.2024.

Psychosocial resources and psychopathology among persons with neuromuscular disorders during the COVID-19 pandemic.

The COVID-19 pandemic substantially affected the lives of persons with inherited neuromuscular disorders (INMD), causing disruption in clinical and support services. While several studies have investigated mental health, distress and psychosocial resources in the general population during the pandemic, little is known about the experience of persons with INMD. This study was aimed to fill this gap by jointly investigating both psychopathological symptoms and psychosocial resources - specifically, resilience and perceived social support - among persons with INMD during the pandemic, taking into account demographic and clinical factors. Between April and December 2020, 59 participants with INMD (aged 15-59, 71.2% M) completed a questionnaire collecting demographic and clinical data, the Multidimensional Scale of Perceived Social Support, the Resilience Scale for Adults, and the Achenbach System of Empirically Based Assessment. Overall, participants showed good levels of resilience and perceived social support. A minority of participants reported clinically relevant psychopathological symptoms, 28.81% for anxiety and depression. Most psychopathological symptoms were negatively correlated with resilience (-0.347 < r < - .420), but not significantly associated with social support. Consistent with previous studies, regression analyses highlighted that participants with Duchenne muscular dystrophy were more prone to report anxious and depressive symptoms (B = 1.748, p = .028, OR = 5.744), and participants with myotonic dystrophy, attention problems (B = 2.339, p = .006, OR = 10.376). Resilience emerged as a potential predictor of lower anxious-depressive symptoms (B=-1.264, p = .012, OR = 0.283). The findings suggest the importance to investigate psychosocial resources in addition to psychopathology among persons with INMD, and to design interventions supporting resilience as a protective factor for mental health promotion.

The clustering effects of current smoking status, overweight/obesity, and physical inactivity with all-cause and cause-specific mortality risks in U.S. adults

ObjectiveTo estimate the associations of smoking, weight status and physical inactivity with all-cause and cause-specific deaths, and the advanced rate period (RAP) to determine how early death was advanced among United States (U.S.) adults aged 18 years or older. MethodsWe used data from the third National Health and Nutrition Examination Survey (NHANES III) and the 2019 Linked Mortality File (LMF) with a follow-up period of 21.6 years (n = 16,612, including 7,278 deaths). Smoking, weight status, and physical inactivity were obtained from NHANES III and mortality outcomes from the 2019 LMF. Cox regression was used to estimate hazard ratios, RAPs and their corresponding confidence intervals. ResultsFor adults who currently smoke, were obese and physically inactive, the rate of dying from all-cause, CVD, and cancer was at least 231 % greater than for those who never smoked, were normal weight and physically active. The RAPs associated with the clustering of these risk factors for all cause, CVD- and cancer-specific cause of deaths were 13.0, 12.1 and 18.9 years older, respectively. ConclusionsOur findings underscore the need to focus on modifiable risk factors for illness prevention and health promotion and call attention to the increasing clustering of unhealthy risk factors in the U.S. population.

Factors associated with high and low mental well-being in Spanish university students

BackgroundPrevious studies conducted in various nationally representative samples of the general population show that positive mental health is related to social prosperity. However, specific studies in university populations are scarce. In this study, we set out to explore factors associated with mental well-being (MWB) in a representative sample of first-year university students in Spain. MethodsMWB was assessed with the short version of the Warwick-Edinburgh Mental Well-Being Scale. Multinomial logistic regressions were performed to explore the association between different blocks of factors, including relational, adversity, stress, lifestyle, spiritual, health, and self-perceived health variables with high and low MWB, controlling for sociodemographic and university-related variables. ResultsData from 2082 students (18.6 ± 1.2 years; 56.6 % females) were analysed. Being male, being born in a foreign country, “high” self-perceived support, and “high” self-perceived mental health increased the odds of high MWB. Growing up in the suburbs, stressful experiences, and anxiety disorders reduced the odds of high MWB. Mood and anxiety disorders increased the odds of low MWB. “Middle” self-perceived support, sleeping ≥8 h per day, and “high” self-perceived mental health reduced the odds of low MWB. LimitationsThe cross-sectional design precludes establishing causal relationships. Data were collected in the 2014–15 academic year using self-reported online surveys. ConclusionThe factors associated with high and low MWB do not always mirror each other, so specific plans are needed to successfully address each of the two poles. Interventions and policies targeting these factors for health promotion and disease prevention would improve the MWB of university students.

Enfermedad crónica transmisible y no transmisible, y enfermedad cutánea del paciente migrante

The care of migrant patients includes initial screening and lifelong monitoring, highlighting the importance of preventing and tracking chronic, communicable and non-communicable diseases.The prevalence of hypertension, diabetes mellitus, dyslipidemia, and obesity varies by ethnicity, influenced by genetic factors, lifestyle, and socio-economic status. Preventive measures, health promotion, and risk factor identification are crucial.Chronic communicable diseases may manifest years after transmission, underscoring the necessity of primary care screening, especially for populations from endemic or high-risk areas.Imported skin lesions are a common reason for consultation among migrant and traveller patients. Their ethiology is varied, ranging from common conditions such as scabies, mycoses, and urticaria to tropical dermatoses like filariasis and leprosy.

Moving toward a Healthy Eating Pattern: Exploring the Interrelationship of Knowledge, Attitudes, and Behavior in Young Adults

Purpose of the study: The main aim of this research is to evaluate the relationship between knowledge, attitudes and dietary behavior in young adults in the area around the Pondok Tinggi health center..&#x0D; Methodology: Correlational type quantitative methods were used in this research. The sampling technique in this research used simple random sampling. The collecting technique in this research used a questionnaire on knowledge, attitudes and dietary behavior. Data analysis in this research uses correlation hypothesis testing with prerequisite tests for normality and linearity.&#x0D; Main Findings: The results of the analysis show that there is a significant relationship between people's knowledge and attitudes and dietary behavior. These findings indicate that better knowledge about healthy eating patterns and positive attitudes towards healthy eating patterns significantly contribute to the adoption of better eating behavior in young adults. Thus, this research provides evidence that education and increasing awareness about the importance of healthy eating patterns can be an effective strategy in improving public health.&#x0D; Novelty/Originality of this study: This research offers a holistic approach in evaluating the relationship between knowledge, attitudes and dietary behavior in adults aged 20-44 years around the Pondok Tinggi Community Health Center, Sungai Banyak City, Jambi province, highlighting the importance of these factors in community health promotion.

Use of Community Health Workers Among U.S. Male Latino Population: A Scoping Review.

Community Health Workers (CHWs) are an effective strategy to address the health needs of specified communities. The purpose of this scoping review was to explore the use of CHWs to address the health needs of the Latino male population. This project used specific search terms to identify relevant articles from PubMed, PsycINFO, and Google Scholar. Eligible articles included studies, conducted in the U.S. and in English from 2010 to 2022, that assessed the use of CHWs among a predominantly male (≥ 50%) Latino population. Twenty articles consisting of 13 interventions were identified for review and were further categorized into male-only participant samples (n = 10) and mixed-gender but predominantly-male participant samples (n = 10) for synthesis. Male-only participant samples focused on occupational health and participant's social support and networks. Predominantly-male, mixed-gender participant sample interventions were disease-centered and emphasized the longitudinal support of CHWs as well as social networks. Of the 13 interventions reviewed, almost all (n = 10) utilized existing social networks for engagement and nearly half (n = 6) employed community-based participatory research (CBPR) principles. Findings suggest that recruiting CHWs from within existing social networks and using CBPR are important factors for successful health promotion among male Latinos.

Some young adults can maintain good oral health despite socioeconomic challenges.

The association between dental caries experience and socioeconomic status, as reflected in income and educational level, is well known. However, some individuals maintain good health despite socioeconomic disadvantage. The aim of this qualitative study was to explore salutogenic (health-promoting) factors among healthy caries-free young adults of low socioeconomic status. Seventeen participants (11 women), 19-23 years of age, who were caries-free and of low socioeconomic status were interviewed in-depth. The interviews were transcribed verbatim and analysed using qualitative content analysis with an inductive approach. The theme revealed was 'Building trust and shifting responsibility from parent to child throughout children's development lays the salutogenic foundation for oral health', comprising three categories: (i) a basis for health; (ii) creating one's own path by testing wings; and (iii) developing resources for health. A feeling of trust was expressed, participants were confident in the unconditional support of their caregivers, and caregivers were trusting participants to be able to take control over their own oral health. Health-promotive factors were established not only by instilling healthy habits during childhood, but also by parental guidance through adolescence, enabling young adults to develop resources and assets to take control over their own health independently.

PHYSICAL ACTIVITY AND FITNESS LEVEL OF HEALTHCARE WORKERS IN A TERTIARY TEACHING HOSPITAL

Introduction: Physical activity (PA) and health-related fitness (HRF) level are currently considered key factors in public health promotion, and as such, is healthcare workers need to be well because they are not only responsible for themselves, but of their clients as well. To determine the PA and HRF levels of healthcare workers in a tertiary hospital, disaggregated to age, sex, work assignments, and job tenure. Methods: A cross-sectional research design was utilized to assess healthcare employees from the administrative, medical, nursing, and paramedical cohorts. ALPHA-FIT Test Battery was used to determine PA levels and assess cardiorespiratory fitness, muscular strength, lower extremity power and strength, upper body muscle endurance, balance, and body composition. Results: A total of 282 participants were tested, with mean age 37.4 years, 62.54% females, 52.13% perceives average health status, and the following fitness scores (One-Legged Stance: 2.67/3; Figure-of-8 run: 2.45/3; Shoulder-neck mobility: 4.58/5; Modified push-up: 2.05/4; Hand grip strength: 2.5/5; Jump and Reach: 2.82/4; Dynamic sit-up: 2.62/3; Six-minute walk test: 475.38 meters distance covered). Physical activity levels of HCWs are generally light (at least once a week). There were no significant differences in PA and HRF levels across cohorts. The results show significant inverse correlation between balance and shoulder-neck mobility and age. Discussion: Physical activity levels of HCW on average did not meet the World Health Organization’s recommended PA levels. Healthcare professionals who are expected to be well aware of benefits of PA and HRF have shown low to mid-fit levels of grip strength, upper extremity endurance, core strength, and cardiorespiratory endurance. Significance: Information on PA and HRF may aid in policy making on employee wellness such as appropriate workload and wellness facilities, which could highly impact health service delivery to the clients.

Integrated Care Model by the Village Health Volunteers to Prevent and Slow down Progression of Chronic Kidney Disease in a Rural Community, Thailand.

Chronic kidney disease (CKD) is a major health problem in Thailand and health behaviors are central to its risk and progression. Because of the shortage of healthcare personnel, village health volunteers (VHVs) have been collaborating in the primary health care system. However, the contribution of VHVs to CKD reduction has not been evaluated yet. This study aimed to evaluate the efficacy of the VHV-integrated model in preventing and slowing down CKD and its risk factors. The population-based cohort study was conducted in a rural community of Thailand between 2017 and 2019. Baseline clinical and behavioral characteristics including CKD, diabetes, hypertension, and other high-risk factors of the participants were collected. The integrated care model was initiated by the multidisciplinary care team that facilitated, empowered, and trained VHVs targeting risk factors of CKD, health literacy, and health promotion. Then the participants were educated and trained for lifestyle modification and were monitored continuously for 18 months by VHVs. Changes in the CKD risk factors, and kidney functions before and after the application of integrated care model were compared. A total of 831 subjects participated in the study with an average age of 57.5 years, and 69.5% were female. Among them, 222 participants (26.7%) were diagnosed as having CKD, the vast majority (95%) of which were in the early stages (G1-G3 and A1-A2). CKD risk factors such as high salt intake, smoking, alcohol consumption, self-NSAID (non-steroidal anti-inflammatory drugs) use were significantly decreased after application of the care model. Also, hemoglobin A1c was significantly reduced in diabetic patients, and blood pressure was controlled better than before in the hypertensive patients. Most importantly, a decline of estimated glomerular filtration rate of the CKD group was improved and lower than the non-CKD group. The integrated care model through VHV significantly attenuated the risk factors associated with CKD in the general and high-risk population and effectively slowed down the progression of CKD.