Health Promotion Counseling Research Articles

The The Effect of Counseling Using Video Health Promotion Media on Increasing Knowledge and Attitudes of Pregnant Women about The First 1000 Days of Life in Meukek District

The first 1000 days of life is a sensitive period that determines the child's future life, where the impact of this period on the baby will last a long time and cannot be overcome. Improved nutrition is implemented through a holistic care strategy that focuses on the first 1000 days of life starting from the pregnancy period until the child is 2 years old. This research aims to determine the impact of increasing the knowledge and attitudes of pregnant women through the use of video health promotion media. This research uses a quasi-experimental design with a two-group pre-test and post-test. The sample was allocated into two intervention groups: the first group received an education intervention with video health promotion media, and the other group received an education intervention without video media. The research sample consisted of 126 pregnant women who received antenatal care at Posyandu. Statistical analysis of the data was carried out using Mann Whitney and Wilcoxon analysis. The results showed that the level of knowledge and attitudes of pregnant women regarding the first 1000 days of life had a significant effect after receiving counseling intervention using video health promotion media (P < 0.001). In conclusion, counseling using video health promotion media and counseling without video media about the first 1000 days of life can increase the knowledge and attitudes of pregnant women in Meukek District.

Peningkatan Pengetahuan Masyarakat Melalui Edukasi Dalam Pencegahan ISPA Di Desa Cinta Rakyat Kecamatan Percut Sei Tuan

<table width="598" border="1" cellspacing="0" cellpadding="0"><tbody><tr><td valign="top" width="371"><p><strong><em>Abstract </em></strong></p><p align="center"> </p><p><em>Acute respiratory infections are a major cause of infectious disease morbidity and mortality worldwide. According to the World Health Organization, about 4 million people died from acute respiratory infections, 98% of which were caused by lower respiratory tract infections. Infant, child and elderly mortality rates are very high, especially in low- and middle-income countries. efforts to control ARI through health promotion education activities or counseling. Education is carried out with the aim of increasing knowledge and even the community is expected to be able to improve health status. The method in this service activity uses educational methods or counseling based on lecture discussions about ARI. The targets in this activity are mothers who have babies and children. Health problem factors, namely the habit of burning garbage can cause air pollution that comes from burning smoke in the environment and smoking habits.</em><em></em></p></td></tr></tbody></table>

Peningkatan Pengetahuan mengenai PHBS sebagai Program Promosi Kesehatan pada Tatanan Sekolah di SMPN 4 Sungguminasa Kabupaten Gowa

PHBS in schools is a set of efforts implemented by school members on the basis of awareness to prevent disease, create a clean and healthy environment, and improve health. The 2015 Indonesia Health Profile presents data that there are 68% of those who have a clean and healthy lifestyle in the school environment. Based on the results of observations at SMPN 4 Sungguminasa, problems related to the school were found with scattered trash, the condition of the toilets that were not clean, the sinks for washing hands were unhygienic and some were not proper, drainage conditions for handwashing did not flow so that water for washing hands accommodated, and many of the posters about health impact messages have been damaged. The purpose of community service is to increase the knowledge of SMPN 4 Sungguminasa students about PHBS. The method used in carrying out health promotion activities is conducting education by using the method of sticking posters in places that are easily seen and followed by conducting counseling and ending with a discussion/question and answer between the instructor and the audience (participants). The target participants for the service were representatives of grade 7 and 8 students, Osis administrators, and PMR administrators totaling 50 people. According to the results of the data from this activity the average result of the level of knowledge of students (i) in the very good category after being given education related to PHBS at SMPN 4 Sungguminasa was obtained 98.4% and the average result of the level of student knowledge (i) in the very good category after being given education related to drugs, it obtained 100%. In conclusion, community service activities through health promotion counseling methods and posters can very well increase the knowledge of SMPN 4 Sungguminasa students by 98.4%, so that all students, teachers and school educators are required to routinely implement PHBS at school.

Community paediatric clinics and their role in supporting developmental outcomes and services for children living in disadvantaged communities.

Children living in disadvantaged communities have substantially increased risk for deleterious health and developmental outcomes. A considerable proportion of developmental delay is avoidable; however if children do not receive appropriate treatment within this critical period, damage can be irreparable. Community paediatric clinics provide medical and developmental assessment; deliver health promotion services, counselling, and advice to caregivers; and referral to services. The aim of this study was to systematically search, appraise, and synthesise the literature exploring the role of community paediatric clinics in supporting developmental outcomes and services for children living in disadvantaged communities. Electronic databases were searched using a carefully developed search strategy. Validated tools and appropriate guidelines assessed quality and confidence in evidence. Data analysis and mixed-methods synthesis was guided by the Segregated Framework for Mixed-Method Systematic Reviews. Eighteen studies were selected for inclusion. Areas of emphasis in the literature include the identification and monitoring of developmental delay; engagement of vulnerable families; relational working with children, families, and local services; referral to early intervention services; parental empowerment, practitioner capacity building; and tackling barriers to healthcare access. Through use of a child and family-centred model of care, community paediatric clinics can better meet the needs of vulnerable populations.

Health-promotion Counseling And Offers For Parents Of Children With Disabilities. A Public Health Pilot Project

PURPOSE: Due to the psychological and physical stress, family caregivers are less healthy than people without private care tasks. Studies confirm the benefits of physical activity, relaxation, and healthy nutrition as primary and secondary preventive measures for older relatives who are caring for life partners or their own parents. In Germany, interventions or intervention studies addressing the health promotion of caregiving parents are scarce. The project aims to establish preventive health counseling and health promotion offers/courses for this group. For this reason, we assessed their preferences and needs. METHODS: The caregiving parents were informed about the project through several social institutions (by e-mail and personal addressing) in the area of Frankfurt/Main, Germany and invited to fill out our online-based questionnaires (preferred characteristics of preventive health counseling and offers). The survey was anonymous. Descriptive analyses were performed. RESULTS: 82 participants took part in the survey. After checking for completeness and plausibility, data of 56 participants (age: 45 + - 6 years; females: n = 48) were considered for analysis. Out of the 56 participants the majority (n = 45 / 80%) is interested in preventive health counseling (90% physical activity and relaxation, 60% nutrition) and nearly all of them (n = 53 / 95%) would like to attend in health promotion offers (77% physical activity, like back training or hiking, and 74% relaxation, like yoga or meditation, 49% healthy nutrition) mediated via both presence (near to home) and online formats. 72% prefer group and 38% individual offers. 47% would like care/support offers for their child during the presence offers, and 30% would like to have a group only for caregiving parents. CONCLUSION: The majority of the interviewed caregiving parents are interested in preventive health counseling and offers (presence and online formats). An accompanying on site care/support offer for the child may favour the parents' participation in presence offers. Health promotion offers exclusively for caregiving parents are requested. This may help to promote social interaction and networking between them, which may be an important need for the target group.

Evidence and consensus-based clinical practice guidelines for management of overweight and obesity in midlife women: An AIIMS-DST initiative.

Evidence and consensus-based clinical practice guidelines for management of overweight and obesity in midlife women: An AIIMS-DST initiative.

Development and Reliability of the Physical Therapy Healthy Lifestyle Appraisal: A New Assessment Tool to Guide Behavior Change

Purpose: Physical therapists are well positioned to encourage their patients to live a healthy lifestyle. Physical therapists report barriers that limit their ability to practice health promotion counseling with their patients including the availability of a brief tool to gather information about their patient's current level of activity related to specific health behaviors. The purpose of this study was to describe the development and testing of the Physical Therapy Healthy Lifestyle Appraisal (PTHLA). Methods: The PTHLA is a patient self-report questionnaire that assesses stage of change, importance of changing, and confidence in engaging in 6 health behaviors. Physical Therapy Healthy Lifestyle Appraisal version 1 (106 items) was designed to compare different constructs for measuring stage of change and confidence in engaging in health behaviors. After pilot testing, 3 versions were tested to arrive at the 18 item PTHLA-version 3. Physical therapy patients in outpatient clinics in Michigan, Minnesota, and Texas were recruited for this multiphase study (version 1 n = 60, version 2 n = 65, and version 3 n = 28). Results: Physical Therapy Healthy Lifestyle Appraisal version 3 consists of 3 questions for each of 6 health behavior domains; a 3-option ordinal question for assessing stage of change and 11-point rulers for assessing importance of engaging in the behavior and confidence in engaging in the behavior. Unique items from version 1 and version 2 were retained in PTHLA-version 3, whereas those items that were somewhat redundant were excluded. Behavioral definitions for the “sleep” and “stress” domains were the only changes made from the first to the second versions. Across samples and behavioral domains, scores for the 18 items generally displayed satisfactory-to-high test–retest reliabilities (Cohen κ w = 0.56–1.00, mean = 0.76; Spearman ρ = 0.53–1.00, mean = 0.77; intraclass correlation coefficient = 0.39–1.00, mean = 0.74). Confidence in behavior ruler scores displayed satisfactory-to-high convergent correlations with scores from lengthier multiple-item confidence in behavior measures (Pearson r validity coefficients = 0.33–0.90, mean = 0.63). The three-option stage of change items demonstrated satisfactory convergent validity with scores on the stage of change ruler (Pearson r validity coefficients = 0.16–0.86, mean = 0.61). Conclusions: The PTHLA-version 3 is a reliable and efficient tool for PT practice developed by physical therapists with expertise in prevention, health promotion, and wellness. Physical therapists can use the information provided from the PTHLA to initiate conversations about behavior change with their patients. Understanding the patient's current stage of change, level of interest in changing the behavior, and confidence for changing the behavior is important information for the PT to ensure a productive and respectful conversation about behavior change.

HUBUNGAN PENGETAHUAN DENGAN TINGKAT KONTROL PENYAKIT ASMA DI POLI PARU RS. TK. III DR. REKSODIWIRYO PADANG

Asthma in Indonesia has increased cases from the year 2016 (1,256 cases) to the year 2017 (2,148 cases). The number of asthma patients in pulmonary polyclinic RS.TK.III dr. Reksodiwiryo Padang Hospital as many as 515 peoples in 2018, in 2019 found as much as 521 people with an average asthma patient who visited 35 peoples for a week. This research aims to know the relationship between knowledge with the level of asthma control in the pulmonary clinic of TK. III Dr. Reksodiwiryo Padang Hospital. This research is descriptive analytic with cross sectional study approach conducted in Juni until October 2021. The population in this study were all asthma patients who came to pulmonary polyclinic as much as 35 peoples. Data collection tools in the from of questionnaires and processed by computerized using chi-square. The results of the study were obtained largely (80%) Patients with asthma control levels are not controlled and more than half (57,1%) Patients with less good knowledge. There is a link between knowledge with the degree of asthma control in pulmonary polyclinic in TK. III Dr. Reksodiwiryo Padang Hospital with the value P (0.027). through the head of TK. III Dr. Reksodiwiryo Padang Hospital to nurses in pulmonary clinic to further enhance health promotion or health counseling efforts to improve the knowledge of patients in asthma controllers.

The Role of Chiropractic Care in Providing Health Promotion and Clinical Preventive Services for Adult Patients with Musculoskeletal Pain: A Clinical Practice Guideline.

Objective: To develop evidence-based recommendations on best practices for delivery of clinical preventive services by chiropractors and to offer practical resources to empower provider applications in practice. Design: Clinical practice guideline based on evidence-based recommendations of a panel of practitioners and experts on clinical preventive services. Methods: Synthesizing the results of a literature search for relevant clinical practice guidelines and systematic reviews, a multidisciplinary steering committee with training and experience in health promotion, clinical prevention, and/or evidence-based chiropractic practice drafted a set of recommendations. A Delphi panel of experienced practitioners and faculty, primarily but not exclusively chiropractors, rated the recommendations by using the formal consensus methodology established by the RAND Corporation/University of California. Results: The Delphi consensus process was conducted during January-February 2021. The 65-member Delphi panel reached a high level of consensus on appropriate application of clinical preventive services for screening and health promotion counseling within the chiropractic scope of practice. Interprofessional collaboration for the successful delivery of clinical preventive services was emphasized. Recommendations were made on primary, secondary, tertiary, and quaternary prevention of musculoskeletal pain. Conclusions: Application of this guideline in chiropractic practice may facilitate consistent and appropriate use of screening and preventive services and foster interprofessional collaboration to promote clinical preventive services and contribute to improved public health.

The Relationship between the Attitudes towards Menopause and Sexual Functions among Women in the Climacteric Period, Turkey

Background & aim: An investigation of the attitudes towards menopause is considered to help to understand the menopausal period better in order to plan more comprehensive health promotion approaches. This study aimed to investigate the relationship between the attitudes towards menopause and sexual functions among women in the climacteric period. Methods: This cross-sectional study was conducted between the 1st May 2019 and the 1st January 2020 in Turkey. The study was completed with 153 women in climadteric period, who were selected using the simple random sampling method. Data were collected through the socio-demographic questionnaire, the Attitude towards Menopause Questionnaire (ATMQ), and the Female Sexual Function Index (FSFI). Data analysis was done using descriptive statistics, independent t-test, and Pearson correlation test. Results: Themean scores of ATMQ and FSFI were found 34.39±12.30 and 20.05±9.18, respectively. The ATMQ indicated positive, and significant relationship with all FSFI sub-scales and total scores (p 0.05). Conclusion: The results showed that two-thirds of the participating women had negative attitudes towards menopause, and increased negative attitudes of women affected their sexual functions, negatively. It is recommended to design health promotion programs and counseling services to promote positive attitude towards menopause in women in the climacteric period.

Promotional Strategies to Increase Iron–Folic Acid Supplementation Compliance among Pregnant Women in the Philippines

Anemia in pregnancy is a risk factor for maternal and neonatal mortality and morbidity. Iron deficiency anemia (IDA), the most common type of anemia in pregnancy, adversely affects the wellbeing of both the mother and the child. Iron–folic acid supplementation (IFAS), a cost-effective public health intervention of IDA in pregnancy recommended by the World Health Organization (WHO), is implemented globally with the Philippines included. However, only 19% of Filipino pregnant women take the recommended number of 180 IFAS tablets. This is considered a factor in the prevalence of anemia in pregnancy. Very low IFAS uptake was due to the behaviors and practices of both pregnant women and healthcare providers. Limited awareness on the impact of anemia in pregnancy and the significance of IFAS, late and less frequent antenatal care (ANC) visits, experience of side effects and unpleasant taste of the supplement, and not receiving or purchasing supplements were the identified factors to low IFAS compliance. Among healthcare providers, a low level of IFAS compliance was found to be related to the late reporting of pregnant women to the antenatal facility, and inability to motivate and provide appropriate counseling regarding the supplementation’s use and significance. Behaviors and practices of pregnant mothers toward IFAS compliance appear to be a result of healthcare providers’ inadequate healthcare services. Therefore, healthcare providers need to improve their ANC program and revisit their approaches on existing health and nutrition promotion programs, health education and counseling techniques, follow-up and monitoring strategies, and ANC visits promotion efforts. These efforts were found effective in well-informed and empowered pregnant women to IFAS compliance and other significant ANC access. Improved IFAS compliance will eventually contribute to lower the prevalence of anemia in pregnancy for better maternal and neonatal outcomes.

Using Information Technology to Assess Patient Risk Factors in Primary Care Clinics: Pragmatic Evaluation

BackgroundTobacco use, physical inactivity, and poor diet are associated with morbidity and premature death. Health promotion and primary prevention counseling, advice, and support by a primary care provider lead to behavior change attempts among patients. However, although physicians consider preventative health important, there is often a larger focus on symptom presentation, acute care, and medication review.ObjectiveThis study evaluated the feasibility, adoption, and integration of the tablet-based Risk Factor Identification Tool (RFIT) that uses algorithmic information technology to support obtainment of patient risk factor information in primary care clinics.MethodsThis is a pragmatic developmental evaluation. Each clinic developed a site-specific implementation plan adapted to their workflow. The RFIT was implemented in 2 primary care clinics located in Manitoba. Perceptions of 10 clinic staff and 8 primary care clinicians informed this evaluation.ResultsClinicians reported a smooth and fast transfer of RFIT responses to an electronic medical record encounter note. The RFIT was used by 207 patients, with a completion rate of 86%. Clinic staff reported that approximately 3%-5% of patients declined the use of the RFIT or required assistance to use the tablet. Among the 207 patients that used the RFIT, 22 (12.1%) smoked, 39 (21.2%) felt their diet could be improved, 20 (12.0%) reported high alcohol consumption, 103 (56.9%) reported less than 150 minutes of physical activity a week, and 6 (8.2%) patients lived in poverty. Clinicians suggested that although a wide variety of patients were able to use the tablet-based RFIT, implemented surveys should be tailored to patient subgroups.ConclusionsClinicians and clinic staff positively reviewed the use of information technology in primary care. Algorithmic information technology can collect, organize, and synthesize individual health information to inform and tailor primary care counseling to the patients’ context and readiness to change. The RFIT is a user-friendly tool that provides an effective method for obtaining risk factor information from patients. It is particularly useful for subsets of patients lacking continuity in the care they receive. When implemented within a context that can support practical interventions to address identified risk factors, the RFIT can inform brief interventions within primary care.

Effectiveness of a Female Community Health Volunteer–Delivered Intervention in Reducing Blood Glucose Among Adults With Type 2 Diabetes

Female community health volunteers (FCHVs) are frontline community health workers who have been a valuable resource in improving public health outcomes in Nepal, but their value is understudied in diabetes care. To assess whether an FCHV-delivered intervention is associated with reduced blood glucose levels among adults with type 2 diabetes. This community-based, open-label, 2-group, cluster randomized clinical trial with a 12-month delayed control group design was conducted in 14 clusters of a semiurban setting in Western Nepal. A total of 244 adults with type 2 diabetes were recruited between November 2016 and April 2017. The follow-up assessment was conducted at 12 months after enrollment. Data analysis was performed from January to February 2019. Seven clusters were randomized to the FCHV-delivered intervention in which 20 FCHVs provided home visits 3 times a year (once every 4 months) for health promotion counseling and blood glucose monitoring. If participants had blood glucose levels of 126 mg/dL or higher, the FCHVs referred them to the nearest health facility, and if participants were taking antihyperglycemic medication, they were followed up by the FCHVs for adherence to their medication. Seven clusters were randomized to usual care (control group). The primary outcome was the change in mean fasting blood glucose from baseline to 12-month follow-up. Secondary outcomes included changes in mean systolic blood pressure, mean diastolic blood pressure, mean body mass index, percentage change in the proportion of low physical activity, harmful alcohol consumption, current smoking, low fruit and vegetable intake, and antihyperglycemic medication status. Of 244 participants, 120 women (56.6%) and 92 men (43.4%) completed the trial. At baseline, the mean (SD) age was 51.71 (8.77) years; 127 participants were in the intervention group, and 117 participants were in the control group (usual care). At baseline, the mean (SD) fasting blood glucose level was 156.06 (44.48) mg/dL (158.48 [45.50] mg/dL in the intervention group and 153.43 [43.39] mg/dL in the control group). At 12-month follow-up, the mean fasting blood glucose decreased by 22.86 mg/dL in the intervention group, whereas it increased by 7.38 mg/dL in the control group. The mean reduction was 27.90 mg/dL greater with the intervention (95% CI, -37.62 to -18.18 mg/dL; P < .001). In secondary outcome analyses, there was a greater decline in mean systolic blood pressure in the intervention group than in the control group (-5.40 mm Hg; 95% CI, -8.88 to -1.92 mm Hg; P = .002). There was detectable difference in the intake of antihyperglycemic medication between the groups (relative risk, 1.35; 95% CI, 1.1 to 1.74; P = .02). These findings suggest that an FCHV-delivered intervention is associated with reduced blood glucose levels among adults with type 2 diabetes in a low-resource setting in Nepal. ClinicalTrials.gov Identifier: NCT03304158.

Bahasa Indonesia

Maternal Mortality increased every year in Banyumas, in pregnant women who experience obstetric complications that young age pregnancy in adolescents. One strategy to prevent pregnancy young age through a comprehensive multi-dimensional empowerment. This study used qualitative research methods. Data collection techniques used were interviews with key informants, namely 17 pregnant women aged under 20 years and informants supporting 17 families of pregnant women, 9 peers pregnant women, 9 families peers pregnant women, 3 religious leaders, three community leaders and 3 the clinic. The location of this research is Puskesmas I Cilongok, health center and health center II Donates Jatilawang. Instrument is a human instrument of this research, in-depth interview guidelines, recorders and stationery. Key informants had known phenomenon of young age pregnancies that occur in the environment. The role of parents still felt less and peers have run a good role in this issue. The role of community leaders, religious and health workers still can not be felt directly by the informant. The desired form of regulation is a collection with lectures, discussions and counseling. Media used audiovisual and print media such as books, leaflets and posters. Culture associated with younger age pregnancy is not there and there are community organizations that are still active. Community empowerment model they want is the collection method of health promotion lectures, discussions and counseling and media in the form of audiovisual and print media

Exploring Health Behaviors in Ugandan Adolescents Living in Rural Fishing Communities.

Adolescents in rural Uganda face unique opportunities and challenges to their health. The primary goal of this exploratory cross-sectional survey study was to describe the health behaviors of adolescents of age 13-19 living in four Ugandan fishing communities as a foundation for developing programs to reduce risky health behaviors and HIV/AIDS transmission. The majority of boys (59.6%) and one third of girls reported lifetime sexual intercourse; girls reported earlier sexual debut than boys, as well as higher rates of sexual assault, rape, and/or coerced intercourse. Sexually active youth were more likely to have viewed pornography, be tested for other sexually transmitted infections, and attend boarding schools. Alcohol use was prevalent among both sexes; however, the use of other substances was infrequently reported. Since the majority of adolescents in Uganda attend boarding school, there is an opportunity to expand the school nurse scope of care to include health promotion education and counseling.

Congenital infections in Hong Kong: beyond TORCH

Congenital infections refer to a group of perinatal infections that are caused by pathogens transmitted from mother to child during pregnancy (transplacentally) or delivery (peripartum) which may have similar clinical presentations, including rash and ocular findings. TORCH is the acronym that covers these infections (toxoplasmosis, other [syphilis], rubella, cytomegalovirus, herpes simplex virus). Other important causes of intrauterine/perinatal infection include human immunodeficiency virus, varicella-zoster virus, Treponema pallidum, Zika virus, and parvovirus B19. This overview aims to describe various congenital infections beyond TORCH with a Hong Kong perspective. Intrauterine and perinatal infections are a major cause of in utero death and neonatal mortality, and an important contributor to childhood morbidity. A high index of suspicion for congenital infections and awareness of the prominent features of the most common congenital infections can help to facilitate early diagnosis, tailor appropriate diagnostic evaluation, and initiate appropriate early treatment. Intrauterine infections should be suspected in newborns with clinical features including microcephaly, seizures, cataract, hearing loss, congenital heart disease, hepatosplenomegaly, small for gestational age, and/or rash. Primary prevention of maternal infections during pregnancy is key to the prevention of congenital infection, and resources (if available) should focus on public health promotion and pre-marital counselling.

The most common health care services needed by university students and employee

Objectives: The identification of the health needs of university students and staff may be the first step in improving public health approaches. The aim of this study was to investigate the most needed health care services by the university students and employees.&#x0D; Materials and Methods: A cross-sectional study was carried out with 864 representative individuals on Marmara University Göztepe Campus, Istanbul, Turkey. All participants were given a questionnaire including questions about the sociodemographic characteristics and health status, healthy lifestyle behaviours and health needs. Results: The mean age of the participants was 24±7.9 years. The number of participants who had periodic health maintenance/ check-up was 11.4%. Smoking and alcohol use prevalence was similar for students and employees (30.9% and 30.2%). Depression screening was found to be positive in 67.4% of the participants (58.7% of the employees, 69.7% of the students).The most commonly requested information was on healthy nutrition (42.4%), followed by screening for diseases (32.3%), emergency situations/first aid (31.2%), exercise counselling (28.6%) and prevention of chronic diseases (27.8%). &#x0D; Conclusion: Our findings show that the most needed health care services are psychological counselling, periodic health controls, health promotion counselling and first aid training.

Telemedicine: A new survivorship visit model.

89 Background: The number of cancer survivors in the United States is expected to approach 22 million by the year 2029. With an annual Survivorship Program visit volume exceeding 16,000, this comprehensive cancer center developed an innovative approach to delivering survivorship care to meet the growing demand for comprehensive follow up care. Institutional space, patient convenience and visit compliance are also factors in considering alternatives to traditional ‘brick and mortar’ visits. Methods: Patients are seen in our Autologous Bone Marrow Transplant (BMT) Survivorship Clinic at 6, 12- and 24-months post-transplant. A pilot was developed targeting patients scheduled for a 6-month visit, where patients are often struggling with treatment sequelae, managing other medical appointments, and returning to work and life after transplant. Patients were offered a telemedicine visit instead of an in-person clinic visit with the survivorship advanced practice provider (APP). The Survivorship APP and administrative staff were trained on the use of monitors and technologic means to connect patient to provider. Eligible patients had to have an institutional portal account and speak English. They were contacted by phone to assess interest, and if they agreed, instructions were provided via secure institutional portal reviewing device and connectivity requirements. Results: The telemedicine visit components included: review of home medication list, interval history and review of systems, screen for late treatment effects, lab result review, treatment summary and care plan review including risk of secondary cancer and screening recommendations, health promotion counseling, primary care physician recommendations and immunization status. Of 26 visits scheduled, 22 were successfully completed. Challenges to completing the visit will be described and include poor connectivity and patient location at the time of the scheduled visit. Conclusions: Despite some minor challenges, patients described good satisfaction with telemedicine citing visit comprehensiveness and convenience. As a result of the successful pilot, telemedicine visits are being expanded to include survivorship patients who are 24 months post BMT.

The Effectiveness of Health Promotion in Reducing of Skabies In The Islamic Boarding School

Background: The results of interviews with the School Health Unit in 3 Islamic boarding schools (pesantren) in Blora City District showed that 75% -90% of santri had been exposed to scabies.Purpose: This study aims to analyze the effectiveness of health promotion in reducing the incidence of scabies.Methods: Interventions in the form of health promotion (counseling, and community development). Independent health promotion variables, the dependent variable is the incidence of scabies, the variable between knowledge, attitude, and behavior. The research design is quasi-experimental one group (pretest-posttest). Place of research for Islamic boarding schools in Blora City District. The research population of the santri was a sample of students in grades 8 and 9. Proportional random sampling sampling technique. The intervention is carried out on August, 26, 2018 until October, 23, 2018.Result: Mean knowledge, attitude, and behavior before intervention 69.76; 69.86; 54.65. After intervention 87,18; 88.06; 63.35. P Value of knowledge, attitudes, and behavior = 0.00; meaning that there are differences in knowledge, attitudes, and behaviors before and after the intervention. Before the intervention students were exposed to 128 scabies (75.29%) and after intervention 5 people (2.94%). There is a difference in the proportion of scabies before and after the intervention with P Value = 0.00.Conclusion: Health promotion is effective in reducing the incidence of scabies in Islamic boarding schools in Blora City

Physicians' perspectives on medication adherence and health promotion among cancer survivors.

Cancer survivors face an increased risk of cardiovascular events compared with the general population. Adopting a healthy lifestyle may reduce these risks, and guidelines encourage health-promotion counseling for cancer survivors, but the extent of physician adherence is unclear. This mixed-method study surveyed 91 physicians, including 30 primary care physicians (PCPs), 30 oncologists, and 31 specialists (urologists, dermatologists, and gynecologists). Interviews also were conducted with 12 oncologists. Most PCPs (90%) reported recommending health promotion (eg, weight loss, smoking cessation) to at least some cancer survivors, whereas few oncologists (26.7%) and specialists (9.7%) said they ever did so (P<.001). Although most physicians believed that at least 50% of cancer survivors would be adherent to medication regimens to prevent cancer recurrence, they also believed that, if patients were trying to lose weight, they would not remain medication-adherent. In interviews, oncologists expressed fear that providing health-promotion advice would distress or overwhelm patients. Additional health-promotion barriers identified by thematic analysis included: identifying cancer as oncologists' focal concern, time pressure, insufficient behavior change training, and care coordination challenges. Facilitators included perceiving a patient benefit and having health-promotion resources integrated into the cancer care system. Physicians often do not have the time, expertise, or resources to address health promotion with cancer survivors. Research is needed to evaluate whether health-promotion efforts compromise medical regimen adherence, as physicians' responses suggest.