Health Promotion Framework Research Articles

Moving from local to global: The examples of the United Nations Sustainable Development Goals and the Okanagan Charter

The United Nations Sustainable Development Goals (SDGs) set forth 17 broad goals that we should pursue globally to ensure the health of the planet and of humankind. Within each goal, several targets are identified. This article explores the overarching framework of the SDGs as a guide to ensuring human and planetary health. The one goal, Goal #3: Global Health and Wellbeing was described in more detail. Simultaneous to the development of the SDGs, a health promotion framework, the Okanagan Charter, was launched. The Okanagan Charter similarly identifies the calls to action and principles that are the foundation of the work. This article explores briefly the origins of the Okanagan Charter and describes the study that was conducted to explore the implementation of the Charter at the first 10 campuses to sign on to the Charter. The findings identify that systems approaches require leadership and engaged champions, effective communication structures, dedicated resources, work across silos, and development of targets and measures to gauge progress; these structures are crucial for effective systems approaches to complex initiatives such as holistic health promotion strategies. The article concludes with a discussion about future directions for the crucial health promotion agenda.

Work and Environmental Factors on Job Burnout: A Cross-Sectional Study for Sustainable Work

In the context of sustainable development, the occupational sphere must be integrally considered within health promotion frameworks, ensuring an equitable work–life balance while recognizing and amplifying the capabilities of every employee. Concurrently, there is a notable trend of physicians transitioning from public to private healthcare sectors, with burnout frequently cited in scholarly discourse as a primary catalyst for this shift. The objective of our study was to examine the vulnerability of medical staff to burnout. To achieve this, we conducted a cross-sectional analysis involving 1084 physicians from various specialties, employed in urban hospital settings. This research was executed via the distribution of an anonymous questionnaire, utilizing the Google Forms platform during work hours. The questionnaire was based on the Maslach Burnout Inventory (MBI) scale, specifically adapted for medical professionals, requiring respondents to provide insights into their experiences. Analysis of the collected data from a total of 614 respondents indicated a moderate predisposition towards burnout among the sample. These findings underscore the necessity for interventions targeting organizational flexibility and, notably, the restructuring of remuneration practices. Salaries often do not reflect the terms of employment contracts across numerous EU jurisdictions, necessitating urgent reforms. In conclusion, the reinforcement of interpersonal dynamics within medical teams and between healthcare institutions and their practitioners emerges as a critical strategy. Enhancing these relationships is essential for revitalizing the healthcare delivery system, ensuring that medical professionals are adequately compensated in alignment with the principles of sustainable employment.

Your Body Is Your Home: The feasibility of an intuitive eating intervention for early adolescents.

Intuitive eating (IE) is an emerging health promotion framework which has shown promise in the prevention and early intervention of disordered eating (DE) behavior in adults. This study sought to extend this work by assessing the feasibility and preliminary efficacy of a 5-week IE intervention, "Your Body is Your Home," delivered in school classrooms for early adolescents aged 11-13. The present study utilized a quasi-experimental design. Eligibility criteria were defined a priori and published in a registered protocol. Four classrooms (n = 128 student participants) were recruited into two streams, and self-report questionnaires were administered at pre-test, post-test, and 4-week follow-up. The questionnaires included the Intuitive Eating Scale for Early Adolescents (IES-2-EA), the Body Appreciation Scale (BAS-2), and the WHO Wellbeing Index (WHO-5). Linear mixed models were used to conduct preliminary efficacy testing. The results indicate that a brief classroom-based IE intervention is feasible and acceptable for both students and teaching staff; retention, fidelity, and attendance targets were achieved. Students and teachers rated all five sessions of the intervention as a highly feasible method of health promotion. Further, preliminary efficacy data suggest IE interventions aimed at early adolescents may be a feasible way of improving certain aspects of IE (p < .001) in male and female participants, and body appreciation (p < .001) in male participants. The study provides preliminary support for the implementation and evaluation of an IE intervention as part of school-based health promotion and offers preliminary effect size estimates for a larger-scale randomized trial. Existing evidence suggests that IE may be a useful framework through which relationships with food and the body can be improved. The present study seeks to extend this work by adapting the framework for early adolescents (among whom the framework is not well understood) and examining feasibility, acceptability, and preliminary changes to several health and well-being metrics following a 5-week school-based intervention.

Interventions based on salutogenesis for older adults: An integrative review.

To synthesize the evidence of interventions based on salutogenesis for older adults. With the increasing tendency of global ageing and the progression of 'healthy ageing', salutogenesis has been adopted as a framework of health promotion for older adults. An integrative review following PRISMA guidelines. Seven databases including PubMed, Cochrane Library, Web of Science, Embase, Scopus, PsycINFO and CINAHL Plus were systematically searched on 29 September 2022 and updated on 18 July 2023. Eighteen eligible studies were included in this review. Salutogenic-based interventions fell into three main categories: dialogue-based, health education courses based, and goal setting and achievement based. The intervention doses: length ranged from 4 weeks to 2 years, with most (n = 12) within 12 weeks; the duration of each session ranged from 30 to 150 min, with the majority (n = 7) within 1 h; the frequency ranged from five times weekly to three times in 10 months, and in six studies was once a week. Intervention providers were mostly multidisciplinary teams, while in four studies were nurses only. Most of the studies reported that salutogenic-based interventions could improve older adults' sense of coherence, quality of life, self-efficacy, self-management, meaning of life and mental health. This review synthesized the interventions based on salutogenesis for older adults, including salutogenesis application, intervention and its doses, intervention settings and providers, and intervention effects. Future research on the effectiveness of the intervention, the optimal dose of the intervention and the underlying mechanisms are still necessary to understand salutogenic-based interventions. Not apply as it's a review paper. Salutogenic-based intervention is effective for older adults in different scenarios to improve their health outcomes. Nurses play a key role in salutogenic-based interventional programs and thus should be essential personnel as the intervention provider.

A framework for faith-based maternal and child health promotion in the USA

A framework for faith-based maternal and child health promotion in the USA

The International Framework for School Health Promotion: Supporting Young People Through and After the COVID-19 Pandemic.

The worldwide COVID-19 government restrictions imposed on young people to limit virus spread have precipitated a growing and long-term educational and health crisis. This novel study used Sen's Capabilities Approach as a theoretical framework to examine the current health and educational impacts of COVID-19 on youth, referencing emerging literature. The objective was to inform the design of an internationally relevant framework for school health promotion to support young people through and after the COVID-19 pandemic. Mapping of existing health resources, internal/external conversion factors and capabilities were used to identify classroom, school and system level strategies that will enable young people to flourish. Four central enablers were identified and used in the design of the International Framework for School Health Promotion (IFSHP). The IFSHP can be used by educational institutions, school leaders and teachers to innovate existing health promotion programs, policies and practices to support young people through and after the COVID-19 pandemic. School systems, schools and teachers are encouraged to utilize the IFSHP to review and innovate existing school health programs to ensure they meet the increased physical and mental health needs of young people.

Reframing Diabetes Prevention: From Body Shaming to Metabolic Reprogramming

This review integrates new developments in psychology with updated physiological insight on the complex relationships among chronic psychological stress (arising from weight stigmatization and body shaming), food composition, physical activity and metabolic health for the example of diabetes. We address how visual measures of health, such as body mass index (BMI) and waist-to-hip ratio, do not adequately capture metabolic health and can instead contribute to weight stigmatization, chronic stress, and system-wide impairment of metabolic health. We also emphasize the importance of food composition over calorie counting. We summarize how chronic stress interacts with nutritional deficiencies and physical inactivity to disrupt the stress response, immune response, gut microbiome, and function of fat depots. We specifically address how interactions among lifestyle factors and the gut microbiome regulate whether fat stored around the waist has a negative or positive effect on metabolic health. We aim to provide a resource and updated framework for diabetes prevention and health promotion by (i) highlighting metabolic imbalances triggered by lifestyle changes during the transition to industrialized society and (ii) detailing the potential to support metabolic health through access to modest, but comprehensive lifestyle adjustments.

The social ecology of health promotion within war-effected refugee preschool children

Health promotion frameworks that identify the risk and protective factors in promoting the health of war-affected preschool children living in refugee camps are limited. This study aimed to identify ecological factors in refugee camps affecting the health promotion of children in a vulnerable population using the storytelling method. Twenty Syrian refugee children aged between five and six years were interviewed individually. Data were analyzed in NVivo V.11 software using thematic content analysis. Four major themes derived from the data included the following; risk factors that cause illness, awareness of the illness, strategies for coping with illness, and protecting and promoting health. These results suggest that health promotion programs targeting refugee children should be considered as a bio-socio-ecological approach.

The insurance role in workplace health promotion: a comparative analysis of the United States and the Philippines.

There is a void in the health promotion literature concerning the role of health insurance. This study offers a comparative analysis of employee health insurance in the United States and the Philippines. As the first study of its kind, it examines insurance as an instrument of health promotion policy for improving population health and reducing healthcare costs. The following questions guide this study: (i) How has insurance coverage of employee healthcare in these two countries evolved and changed over time, and why? (ii) What factors incentivize payers (employers and insurers) to incorporate health promotion into their health plans, even if health promotion does not fall within the traditional ambit of insurance? and (iii) How does health promotion through the insurance vehicle operate cost-efficiently and within the Global Health Promotion framework of the World Health Organization (WHO)? US and Philippine public-use datasets were gathered and disaggregated to address these questions. The Affordable Care Act (ACA) in the US and universal healthcare legislation leading to the Universal Healthcare Act (UHC) in the Philippines initiated major paradigmatic shifts in insurance coverage. Health literacy, behavioral change and social equity are objectives pursued in both countries by mandating and/or nudging payers to offer health screenings, wellness and fitness programs and primary preventive and diagnostic services. By providing a means to finance access to promotive health and encourage individual responsibility for risk prevention ('healthism'), insurance influences social attitudes about health. However, our findings indicate that outcomes and relative success vary depending on a country's insurance environment, its regulation and the economic, political and socio-cultural forces that affect or shape it (e.g. private markets vs. multi-payer system). Contextual realities also drive incentives and rewards to payers and users of promotive health benefits against the backdrop of financial risk or exposure.

Our Healthy Community Conceptual Framework and Intervention Model for Health Promotion and Disease Prevention in Municipalities.

This paper introduces the conceptual framework and intervention model of Our Healthy Community (OHC), a new, coordinated, and integrated approach towards health promotion and disease prevention in municipalities. The model is inspired by systems-based approaches and employs a supersetting approach for engaging stakeholders across sectors in the development and implementation of interventions to increase health and well-being among citizens. The conceptual model includes a combination of a bottom-up approach emphasizing involvement of citizens and other community-based stakeholders combined with a top-down approach emphasizing political, legal, administrative, and technical support from a variety of councils and departments in local municipality government. The model operates bidirectionally: (1) by pushing political and administrative processes to promote the establishment of conducive structural environments for making healthy choices, and (2) by involving citizens and professional stakeholders at all levels in co-creating processes of shaping their own community and municipality. An operational intervention model was further developed by the OHC project while working with the OHC in two Danish municipalities. The operational intervention model of OHC comprises three main phases and key actions to be implemented at the levels of local government and community: (1) Local government: Situational analysis, dialogue, and political priorities; (2) Community: Thematic co-creation among professional stakeholders; and (3) Target area: Intervention development and implementation. The OHC model will provide municipalities with new tools to improve the citizens' health and well-being with available resources. Health promotion and disease prevention interventions are developed, implemented, and anchored in the local community by citizens and local stakeholders at municipal and local community levels using collaboration and partnerships as leverage points.

Exploring a faith-based approach to puberty education in Tanzania.

Many adolescents in Tanzania do not receive timely and comprehensive puberty education. This study explored faith-based organizations a site for puberty education. Two puberty books, each developed through participatory research with Tanzanian adolescents and stakeholders, were promoted to 177 Christian denomination churches in Dar es Salaam, Tanzania to understand the factors that faith leaders considered in their decision to purchase puberty books, or share information about the intervention to their peers and congregants. Data collection included routine monitoring via weekly reports and ethnographic observation. Data were analyzed using the Ecological Framework for Health Promotion to capture how individual, interpersonal, and institutional factors influenced leaders' decisions to purchase or promote puberty books. At the individual level, leaders cited their personal experiences in their support for the intervention, but leaders' time and confidence in their ability to effectively promote books to others were barriers to participation. Interpersonally, the diffusion of information between church leaders, particularly when information came from well-known or respected leaders, emerged as an important factor in leaders' willingness to promote books. At the institutional level, leaders' decisions were impacted by resources, institutional culture, and institutional hierarchy. Importantly, twelve churches in the sample purchased books. Limited financial resources and the need to receive approval from denominational leaders were discussed by leaders as barriers to purchasing books. Despite research showing high religiosity in Tanzania, the role of religious institutions in providing puberty education has remained unexplored. Our results inform future research and practice by providing an articulation of the socioecological factors that played a role in faith leaders' decisions related to puberty education interventions in Tanzania.

PRÁTICAS DE PROMOÇÃO DA SAÚDE NA ATENÇÃO PRIMÁRIA: COMPARATIVO ENTRE FLORIANÓPOLIS-BRASIL E GIRONA-ESPANHA

ABSTRACT Objective: to understand the health promotion practices developed by nurses in the Primary Care context in Florianópolis and Girona. Method: this is a comparative study with a qualitative approach and of the descriptive exploratory type, carried out with eight nurses between June 2021 and April 2022 in health units that developed health promotion practices. The data, collected by means of semi-structured interviews, were analyzed through thematic analysis based on the health promotion framework. Results: four categories related to health promotion practices emerged from the data, namely: Training actions for health professionals in health promotion; Health promotion activities in individual consultations; Health education group activities; and Community health promotion actions. Conclusion: it is concluded that, in both municipalities, nurses develop individual and collective health promotion practices through groups and community actions, focusing on lifestyle changes. In Florianópolis they are grounded on the National Health Promotion Policy and, in Girona, health promotion actions are based on actions involving specific groups aimed at preventing diseases.

Habitação, saúde e meio ambiente em conflito no Distrito Federal: a Vila Santa Luzia em perspectiva

Abstract The article discusses the correlations between housing, environment and health in the Vila Santa Luzia community, Federal District, Brazil. It purports to investigate the perceptions, interpretations and representations of residents and community leaders about such correlations based on health promotion and healthy housing theoretical framework. Data were collected by means of interviews. Results point to a willingness between the parties to reach a satisfactory, reasonable and republican resolution for the conflict in question. In conclusion, the socio-environmental and health experience of Vila Santa Luzia is relevant and significant, both in empirical and analytical (public policies) terms.

Concepts of dementia prevention in the health promotion among older adults: A narrative review

The number of older adults with dementia is predicted to markedly increase in the coming decades. A person suffers from dementia every 3 seconds globally, and one out of every 7 people suffers from dementia in Taiwan. The purpose of this narrative review is to integrate existing concepts of dementia prevention into health promotion and improve older adults' quality of life. This narrative review was performed using the PubMed database by searching for basic research and systematic reviews on dementia prevention and health promotion among older adults. We established a framework for dementia prevention and health promotion with regard to the physical, mental, spiritual, and social health aspects. We identified the following strategies related to older adults towards dementia prevention and health promotion in follows: Physical health promotion: cognitive activities, physical activities, body mass index, balanced diet, rainbow diet, Mediterranean diet, dietary approaches to stop hypertension diet, mind diet, no smoking and drinking, avoiding the "three highs" (i.e., hyperglycemia, hyperlipidemia, and hypertension), and head trauma; Mental health promotion: Positive thinking, Brief Symptom Rating Scale (BSRS-5), depression scale, and ascertained dementia 8 questionnaire (AD8) screening; Spiritual health promotion: religious beliefs, spiritual music, meditative activities, mindfulness, yoga, Qi-gong, Tai-chi, and Baduanjin; and Social health promotion: A supportive family system, socialization, social support, social networks, social interaction, and social participation. The conclusion of this narrative review was to integrate the concepts of dementia prevention and health promotion among older adults.

Early Detection Of Heart Attack After Cardiac Catheterization In Health Promotion Perspective: A Case Study

Heart attack cases among cardiovascular disease continue increasing every year and ranking as the highest cause of death in Indonesia. The objective of this research was to provide a framework for health promotion nurses to prevent heart attacks after cardiac catheterization. This research used a case study with the Case Management Society of America (CMSA) model. The case was selected from a patient with Coronary artery disease (CAD), 58 years old, retired of a civil servant, ex-chronic smoker, controlled hypertension, and a family history of CAD. The stages of CMSA data processing include Assessment, Preparation Pre-Catheterization, Recovery Phase, Planning and Intervention, and Evaluation. Objective data was taken from the physical examination results. Subjective data were obtained from interviews according to the CMSA standard, reputed journals, and other official documents. Analysis of the case study was conducted by coding, categorizing, comparing, and organizing. This case study revealed that health promotion nurses need to know the potential complications of post-heart catheterization i.e. shortness of breath, chest pain, lack of activity that is not known by family members, assumptions about uncontrolled nutrition, irregular medication, and heart attacks. The research recommended to prevent heart attacks post catheterization, health promotion nurses have to provide daily notes as patient progress reports and set a regular follow-ups.

Programa Saúde na Escola: potencialidades e limites da articulação intersetorial para promoção da saúde infantil

ABSTRACT The study aimed to understand the potential and limits of the intersectoral articulation of the School Health Program for the promotion of children’s health from the perspective of primary care professionals. This research had a qualitative, descriptive-exploratory approach, carried out with 20 health professionals from different professional categories, in four municipalities in the Greater Florianópolis. Data collection was carried out through interviews from November 2020 to March 2021. The data underwent content analysis and discussed according to the theoretical framework of health promotion. It stood out as potential: monitoring the health conditions of schoolchildren, expanding access to health information, partnership with other sectors, and the creation of links with the school community. The limits highlighted were the partial coverage of the school network, the lack of knowledge about the program, the overload of activities, the lack of human resources and infrastructure, and the impacts caused by the COVID-19 pandemic. It is concluded that there is a need to strengthen the School Health Program as a public policy with the purpose of implementing articulated actions between health and education so that they can actually improve schoolchildren’s quality of life and act on their social determinants.

Minding environment, minding workers: environmental workers' mental health and wellbeing.

Climate change and environmental degradation caused by human activities are having an irrefutable impact on human health, particularly mental health. People working in the environment sector are confronted with these impacts daily. This exploratory study was conducted as a response to concern in the sector about rising levels of worry and distress, and a need for organizational knowledge about effective workplace mental health strategies. Using evidenced-based frameworks for workplace mental health and wellbeing, the study focused on the relationship between climate change, environmental degradation and mental health issues for this sector. This Australian-based exploratory qualitative study was guided by participatory research approaches. Maximum variation and criterion sampling strategies were applied to engage environmental sector senior managers (n = 8) in individual/paired interviews, followed by online focus group sessions with frontline employees (n = 9). Qualitative thematic analysis techniques were used in an iterative process, combining inductive and deductive strategies. Data was triangulated and interpretation was finalized with reference to literature and a workplace mental health promotion framework. Interview data provided new perspectives on the interconnectivity between risk and protective factors for mental health. Workers were motivated by commitment and values to continue their work despite experiencing increasing levels of trauma, ecological grief, and stress due to overwork and ecological and climate change crises. The findings highlight the need for integrated health promotion approaches that acknowledge the complex interactions between risk and supportive factors that influence mental health in this sector.

Advances in Gender-Transformative Approaches to Health Promotion.

Gender is an important determinant of health, but explicit attention to gender is often missing in health promotion. We build on Pederson and colleagues' gender-transformative framework for health promotion to propose four guiding principles for gender-transformative health promotion. First, health promotion must address gender norms directly if it is to improve health outcomes. Second, it should move beyond individual change to engage explicitly with structural and social determinants of health. Third, it should address underlying gender-related determinants in order to influence health outcomes. And fourth, it requires complexity-informed design, implementation, and evaluation. We provide background on key concepts that are essential for designing, implementing, and evaluating gender-transformative health promotion: gender norms, socioecological approaches, and the gender system. We give examples of the four principles in practice, using the case of postnatal mental health promotion in Australia and sexuality education in Mexico. These four principles can be applied to health promotion efforts across contexts and outcomes to address the harmful gender norms that contribute to poor health as a part of broader efforts to improve health and well-being.

Evaluation of Social Impact Within Primary School Health Promotion: A Systematic Review

ABSTRACTBACKGROUNDHealth promotion programs and interventions are designed to encourage behavioral changes in children, encouraging them to make safe and healthy life choices. This systematic review seeks to examine how social impact is measured in primary school health promotion interventions.METHODA systematic search and review process was used to identify and examine primary school health promotion interventions. The PRISMA guidelines were followed to source articles from 6 electronic databases reporting school health promotion programs or interventions in Australia, Canada, New Zealand, or the United Kingdom.RESULTSA total of 77 studies were located, representing 55 health promotion interventions delivered in primary school settings. Of these interventions, only 8 (15%) measured or attempted to measure social impact, whereas another 8 (15%) alluded to social impact. The predominant theories reported were social based theories (theories which examine the social influences on people, environments, and behaviors) (n = 17, 59%), with almost a third not informed by an overt health promotion framework or model (n = 34, 59%). A systematic rating system identified some level of stakeholder engagement (n = 30, 53%).CONCLUSIONSThis systematic review highlights the need for social impact measurement within health promotion to illuminate the role of school programs in delivering lasting change.

Wellbeing as a policy framework for health promotion and sustainable development.

For years Gross Domestic Product (GDP) has served as a key indicator of human progress and “successful” societies. Unfortunately, GDP has failed to robustly capture the human experience or predict resilience through crises; and obscures the presence of inequity -- a key determinant of suffering. It is clear the global community needs a new organizing principle: one that envisions and measures progress by focusing on the conditions that support health, resilience, and overall wellbeing. This paper examines key health promotion concepts and approaches, juxtaposed with philosophical underpinnings of the concept of wellbeing, alternative measurement strategies, and examples of wellbeing policy initiatives. In doing so, the paper highlights the relevance of wellbeing policy frameworks to health promotion, the utility of health promotion strategies for implementing wellbeing policy frameworks, and controversies and pitfalls that require consideration. The paper concludes by outlining how health promotion is uniquely poised to contribute to wellbeing policy frameworks that promote the sources of human and planetary thriving through sustainable development, and that promoting a wellbeing agenda can strengthen efforts to promote health by addressing social determinants and ensuring universal access to resources that support coping with emerging challenges and strengthen resilience.