Health Promotion Issues Research Articles

Influence of personality traits on gingival health

Background:The maintenance of good oral hygiene is considered a salient issue in dental health promotion. Personality is the combination of characteristics or qualities that form an individual's distinctive character. Various personality traits have been proposed to influence the oral health. The purpose of the present study was to assess the influence of personality characteristics using questionnaire on oral hygiene performance and gingival health.Materials and Methods:In total, 155 patients were subjected to personality questionnaire using Eysenck Personality Questionnaire. Clinical parameters such as Patient oral hygiene performance index and gingival index were recorded. Based on Eysenck Personality Questionnaire, the subjects were divided into three groups: Psychoticism, extroversion, and neuroticism.Results:Data analysis showed that subjects in psychoticism and neuroticism groups displayed moderate gingivitis, whereas subjects in extroversion group had severe gingivitis. Subjects in all the three groups demonstrated poor oral hygiene status. No statistically significant relation was found.Conclusions:A considerable clinical correlation was observed between the different personality traits and gingival health status of the subjects. It was not statistically significant. Further trials need to be conducted so as to ascertain this association so that psychological interventions may be undertaken to improve the oral hygiene condition of the population.

The Rural Restaurant Healthy Options Program

Local media should be used to raise awareness of health promotion programs. In rural areas, local newspapers provide an opportunity to reach large numbers of residents. Although there are expert guidelines describing the process for successfully engaging local media, little has been documented regarding the range of responses that local, rural newspapers might have when approached about covering health promotion programs. This study describes the response of rural, local newspapers to a press release about a health promotion program taking place in 28 restaurants in different rural towns. The most common reason for not publishing a story was that it would constitute free advertising for the restaurant. Twenty-two stories were analyzed using descriptive statistics. The majority of the responding newspapers were weeklies, and 16 published the full press release verbatim. Three stories included photos, and five included quotes. Headlines typically included the name of the restaurant and the university partner. The overall response rate is encouraging; however, there is considerable room for improvement in terms of personalizing the story with photos or quotes. Greater efforts may be required to obtain this depth of coverage, including training for local journalists to increase their interest and confidence in covering health promotion issues.

Opportunities to Enhance Prevention-Related Competencies in Graduate Medical Education in Psychiatry: A Position Statement of the Prevention Committee of the Group for the Advancement of Psychiatry

The field of psychiatry has adopted a renewed emphasis on applying a public health approach to mental health care. A fundamental principle in public health is to focus on the prevention of illnesses and the promotion of well-being. Psychiatry has long stressed the importance of prevention and mental health promotion with every significant stride that is made in research and policy arenas, particularly in the areas of national and international policy, but also in everyday psychiatric practice (1). The recent passage of the Patient Protection and Affordable Care Act has the potential to attract even greater attention to issues of prevention and mental health promotion in psychiatry and throughout medicine. However, even with an increased understanding of the importance of these interventions, few psychiatrists are properly equipped with a foundation of knowledge in the prevention of mental illnesses and the promotion of mental health (2). Currently, the timing is ideal for reframing the importance of wellness and prevention in residency training programs, preparing psychiatrists with the necessary skills to practice prevention- and health promotion-minded psychiatry. The Group for the Advancement of Psychiatry (GAP) Prevention Committee recommends expanded training in the prevention of mental illnesses and the promotion of mental health in psychiatry residency training through three specific interventions: 1) creating a patient care-based preventive psychiatry rotation; 2) adding didactic curricula that address specific topics in mental illness prevention and mental health promotion; and 3) providing specialized training in systems-based practice aspects of mental health promotion and mental illness prevention. Psychiatrists can effectively highlight prevention of mental disorders and promotion of mental wellness by serving as advocates, technical advisors, program directors, researchers, and preventive care providers in various settings (3). Residency training is an ideal starting point to move forward in the dissemination of prevention and mental health promotion principles. The Accreditation Council for Graduate Medical Education (ACGME) Program Requirements for graduate medical education in psychiatry set the training standards by which all U.S. psychiatrists become proficient practitioners. The Council clearly defines the specialty of psychiatry as “a medical specialty focused on the prevention, diagnosis, and treatment of mental, addictive, and emotional disorders” (4). As the Prevention Committee of GAP, we are indeed pleased and encouraged to see that the specialty is defined first and foremost by an emphasis on prevention. However, we believe that even more specific, well-defined competencies will increase the relevant knowledge and experience base for all psychiatrists. Among the six ACGME competencies (patient care, medical knowledge, practice-based learning and improvement, interpersonal and communication skills, professionalism, and systems-based practice) prevention is mentioned in two competency areas. There is a focus on prevention when describing components of medical knowledge within the didactic curriculum, and an expectation that residents “advocate for the promotion of mental health and the prevention of disease” from a systems-based practice perspective (4). We believe that additional competency domains would benefit from more clearly defined prevention- and promotion-related training goals. In particular, we will outline our position on the expansion of training (and the expansion of actual program requirements) with regard to three competency domains: patient care, medical knowledge, and systems-based practice.

Exploring the relationship between premarital sex and cigarette/alcohol use among college students in Taiwan: a cohort study

BackgroundCigarette/alcohol use and premarital sex, and their subsequent consequences on the well-being of college students, are international health promotion issues. However, little is known about the temporal relationship of these risk behaviors among Taiwanese college students.MethodsThis study utilizes data from the Taiwan Youth Project, a cohort sample of 20-year-olds (N = 2,119) with a 2-year follow-up, to explore the relationship between adolescent cigarette/alcohol use, and subsequent premarital sex. To incorporate the Taiwanese context where the normative value of abstinence until marriage remains strong, multivariate logistic regression models included data on premarital sex attitudes, stressful life events, peer influence, as well as family and individual factors which might influence this relationship.ResultsThe sample consists of 49% male and 51% female college students. About 16% of the sample report having had premarital sex by age 20. After excluding sexually active youth, 20% of males and 13% of females report engaging in premarital sex in the 2-year follow-up interview. Multivariate logistic regression analyses reveal adolescent alcohol use is significantly associated with a higher likelihood of engaging in premarital sex for both genders; adolescent smoking is significantly associated with premarital sexual activity among males, but not females. Our results indicate liberal premarital sexual attitudes and stressful personal events are also significantly associated with premarital sexual activity.ConclusionsThese findings suggest health promotion programs for college students need to take developmental and gender perspectives into account. Future research to incorporate a broader, multi-cultural context into risk reduction materials is recommended.

Dialectical thinking and health behaviors: The effects of theory of planned behavior

The primary purpose of this study was to investigate whether the theory of planned behavior (TPB) mediated the relationship between dialectical thinking and health behaviors. A sample of 285 undergraduates was tested with a dialectical thinking styles scale, health promoting lifestyle profiles, and TPB questionnaires. Structural equation modeling was used for data analysis. Results indicated that all the three dimensions of thinking styles (belief in the connection, acceptance of change, and acceptance of contradiction) exerted significant effects on TPB constructs. Specifically, the connection and the change dimensions had positive effects on health behaviors mediated by TPB, whereas the contradiction dimension had a negative effect. Model 2 showed a satisfactory fit, demonstrating the influential pathways between dialectical thinking and health behaviors. Implications in issues of health promotion and future research are discussed.

Relationship between health literacy, health status, and healthy behaviors among older adults in Isfahan, Iran

Background:Health literacy is a measure of an individual's ability to read, comprehend, and act on medical instructions. Limited health literacy can reduce the adults’ ability to comprehend and use basic health-related materials, such as prescription, food labels, health education pamphlets, articles, appointment slips, and health insurance plans, which can affect their ability to take appropriate and timely health care action. Nowadays, low health literacy is considered a worldwide health threat. So, the purpose of this study was to assess health literacy level in older adults and to investigate the relationships between health literacy and health status, health care utilization, and health preventive behaviors.Materials and Methods:A cross-sectional survey of 354 older adults was conducted in Isfahan. The method of sampling was clustering. Health literacy was measured using the Test of Functional Health Literacy in Adults (TOFHLA). Data were collected using home interviewing. Health status was measured based on self-rated general health. Health care utilization was measured based on self-reported outpatient clinic visits, emergency room visits, and hospitalizations, and health preventive behaviors were measured based on self-reported preventive health services use.Results:Approximately 79.6% of adults were found to have inadequate health literacy. They tended to be older, had fewer years of schooling, lower household income, and were females. Inadequate health literacy was associated with poorer general health (P < 0.001). Health literacy level was negatively associated with outpatient visits (P = 0.003) and hospitalization (P = 0.01). No significant association was found between health literacy level and emergency room utilization. Self-reported lack of PSA (Prostate-Specific Antigen) test (P < 0.001) and fecal occult blood test (FOBT; P = 0.003) was higher among individuals with inadequate health literacy than those with adequate health literacy. No significant association was found between health literacy level and mammogram in the last 2 years.Conclusion:Low health literacy is more prevalent in older adults. It indicates the importance of health literacy issue in health promotion. So, with simple educational materials and effective interventions for low health literacy group, we can improve health promotion in the society and mitigate the adverse health effects of low health literacy.

Child abuse prevention and health promotion issues

Child abuse prevention and health promotion issues

‘I don't know anyone that has two drinks a day’: Young people, alcohol and the government of pleasure

Problematic alcohol consumption is a major public health, health education and health promotion issue in Australia and internationally. In an effort to better understand young people's drinking patterns and motivations we investigated the cultural drivers of drinking in 14–24 year-old Australians. We interviewed 60 young people in the state of Victoria aged 20–24 about their drinking biographies. At the time of interviewing, the draft guidelines on low-risk drinking were released by the National Health and Medical Research Council, Australia, and we asked our participants what they knew about them and if they thought they would affect their drinking patterns. Their responses indicate that pleasure and sociability are central to young people's drinking cultures which is supported by a range of research. However, O’Malley and Valverde claim that pleasure is silenced and/or deployed strategically in neo-liberal governance discourses about drugs and alcohol such as these guidelines which raises questions about the limits of such discourses to affect changes in drinking patterns.

Review of Occupational health psychology.

Occupational Health Psychology, by Stavroula Leka and Jonathon Houdmont (Editors). Oxford, UK: Wiley-Blackwell, 2010, 368 pages (ISBN 978-1-4051-6809115-9, CA$71.95, Paperback) Reviewed by E. KEVIN KELLOWAY DOI: 10.1037/a0023317 Although a relatively young subfield in psychology, occupational health psychology (OHP) is at point of consolidating a diverse research literature. Journals devoted to field (e.g., Work & Stress, Journal of Occupational Health Psychology) have emerged and there are several collections devoted to summarising research literature for researchers and graduate students. Leka and Houdmont offer a further contribution with this volume which they describe as textbook devoted to occupational health psychology intended for undergraduate instruction in field. Certainly there is a growing need for such a text. Undergraduate courses in occupational health psychology are beginning to emerge and, at present, instructors must either adapt texts from other areas (e.g., health psychology or occupational health and safety) or rely on collections of research articles. Despite this need, creating the first textbook in field is a daunting task as such a venture is likely to be scrutinized by others in field who may have themselves contemplated writing such a volume. Leka and Houdmont have chosen an interesting strategy in creating an edited textbook with individual chapters written by estabUshed experts in field. In doing so, they have in many cases gotten the best people in a particular area to write chapters in their area of expertise. Despite their reliance on multiple authors, editors have maintained a consistent style throughout volume ? each chapter begins with a chapter outline and ends with a chapter summary. Textboxes throughout are used to highlight individuals prominent in field (e.g., Tom Cox) or to highlight applications and research issues and to provide definitions of key terms. I would expect that students will appreciate such pedagogical features in addition to depth of expertise that underlies each chapter. Although not divided into sections, one can intuit a structure to book that begins with a broad perspective on occupational health psychology and then progressively adopts a narrower focus. As one would expect, volume begins with an introduction to occupational health psychology authored by Leka and Houdmont. They offer a definition of field as well as a brief history. Although based in United Kingdom, they also incorporate emergence of OHP as a field in North America. The major of chapters deals with issues of work stress. Cox and Griffiths (Chapter 2) provide a theoretical view of work stress ? they focus on major theories that have dominated much of recent research in area. O'DriscoU and Brough (Chapter 3) review effects of work organisation on health with a specific focus on psychosocial risk factors. In fourth chapter, Randall and Nielsen review interventions designed to e?minate or mitigate effects of workplace stressors. In Chapter 5, Leka and Cox review management of psychosocial risk factors in organisations. This is an approach to stress management that is well established in U.K. and has considerable potential for application in organisations. In contrast to this narrowing focus on workplace stress, next set of chapters deals with a variety of issues related to occupational health psychology. Noblet and Rodwell consider issues of workplace health promotion. Bakker and Derks review implications of positive organisational scholarship for occupational health psychology. In Chapter 8, Leather Zarola and Santos consider effect of physical workplace ? an issue often overlooked by psychologists. Zwetsloot and Leka focus on issues of corporate culture with implications for health and well-being. …

Systems Thinking and Health Promotion

The launch of the American Journal of Health Promotion blessed the field with a broad conceptual framework, now refined to include physical, emotional, social, spiritual, and intellectual dimensions of health. Throughout the years, this framework has become increasingly nuanced as research and practice have woven the rich fabric of what we know as health promotion today. However, although the multidimensionality of health promotion is firmly established, we still have lacked a shared understanding of the realities of multilevel influence and the value in multilevel intervention. The basic concept is well accepted, as illustrated, for example, by the Stokol’ social ecological model or the Bronfenbrenner developmental ecology model. Recently, there has been growing interest in systems thinking as a framework to guide science and strategy for a more comprehensive, integrated way of addressing individual, group, organization, community, and societal factors that influence health behavior. A serious shift to systems thinking for health promotion would require fundamental reworking of our usual ways of thinking, working, and evaluating. In 2001, the Institute of Medicine (IOM) produced a landmark report called Crossing the Quality Chasm, in which it endorsed the idea that health care systems are complex adaptive systems (CAS). As health promotion shifts to greater attention to multilevel influences and systems change strategy, CAS principles must be considered. The IOM report followed an important publication in 1998 and was accompanied by a series of publications in the British Medical Journal, which advocated the same emphasis on adopting the CAS lens to better understand how to improve and transform health systems. The IOM report was very important, as it was the first high-level consensus report that endorsed the CAS lens. What all of these publications emphasized is the dual nature of CAS: that they are at one and the same time complex and unpredictable, yet amenable to guided transformation by applying simple rules, as long as these rules are applied with the requisite flexibility to allow for adaptation processes. Health promotion issues are increasingly described as complex problems, deeply embedded within the fabric of society; consider, for example, obesity and chronic disease. Complex problems require intervention at many different system levels and the engagement of actors and organizations across levels ranging from the home, school, and work environments to communities, regions, and entire countries. This multi-level, multi-actor view is at the heart of systems thinking. Key features of complex systems that need to be taken into account in health promotion intervention and evaluation include the following: they are self-organizing and constantly adapting to change; they are driven by interactions between systems components and governed by feedback; and they are nonlinear and often unpredictable, with changes on one part of the system producing unexpected changes in other parts. As a consequence of these features, they often are program and policy resistant. This is not the way most of us in health promotion think about the needs and design of our interventions. A fundamental mind shift is needed, as well as major investments in theory, research methods, practice, and policy. Areas of particular importance for further development include interorganizational partnerships, networks, leadership, and integrated strategic communications. To summarize, the health promotion field during the past 25 years has developed a mosaic of research results and intervention strategies, richly colored by a broad, integrative view of key dimension of individual health. What is most needed now is a complementary view of how best to foster and support systems thinking for a more comprehensive, integrated, and dynamic framework for population approaches to health for all.

Herausforderungen bei der Gesundheitsförderung im frühen Kindesalter

The issue of health promotion during the early childhood years is primarily geared towards parents. They should be assisted while developing their health care and educational skills so that they can promote the healthy development of their children. It is also important to strengthen communicators in their work with families. Most children nowadays are physically healthy, but certain health-related risks have increased. Children from families with a low social status are affected the most. Furthermore, early childhood intervention programs have been set up which are aimed at the early and long-term improvement of development opportunities for children and families. These also contribute to ensuring that children enjoy a healthy upbringing and safeguard their rights to protection, support, and participation. Health promotion offers range from education to counseling and extend to outreach work. Among the challenges are the widespread education of parents, promotion of participation, the advancement of key player networking, and improved quality assurance.

Finding self: A qualitative study of transgender, transitioning, and adulterated silicone

Objective: To describe the development and testing of a theory-based interview guide. To increase awareness of adulterated silicone use among Transgender. Design: A qualitative study based on semi-structured interviews. Setting: Interviews were conducted in Chicago, Illinois, USA. Method: Seven transgender adults aged 18 and over were interviewed using grounded theory method and an interview guide created for this study. Results: Participants perceived that adulterated injection liquid silicone is used widely among transgender as a cheaper means to augment physical appearance. The prevalence of illicit silicone is widespread among vulnerable, minority populations and is associated with health complications. Conclusions: Several health-promotion issues were discovered. These included the need for safer transition options, the need for more cost effective transition options, the need to collect surveillance data, and the need for health promotion and action research.

Case Study on Nutrition Labelling Policy-making in Canada

In order to understand policy-making capacities, we conducted an in-depth examination of three stages of the policy cycle (agenda-setting, formulation, and decision-making) leading to mandatory nutrition labelling, nutrient content claims, and health claims regulations in Canada. Data were collected through document review and key informant interviews (n=24) conducted with government, industry, health organizations, professional associations, academia, and consumer advocacy groups. The policy-making processes were complex, unpredictable, and often chaotic. In the early stages, progress was hampered by a shortage of resources and negatively affected by policy silos. In spite of formidable barriers, a high degree of stakeholder convergence was achieved, which facilitated ground-breaking policy formulation. Success factors included a common health promotion issue frame that participants adopted early in the consultative process, "champions" within the federal government's health sector, strong advocates within a broad stakeholder community, and an innovative policy-formulation process overseen by an intersectoral advisory committee. Authentic partnerships among government, industry, and key stakeholders strengthened policy-making processes while helping to overcome policy silos at the organizational level. Barriers were reduced through effective change management practices and collaborative advisory and communication processes. Future research should involve an examination of the population health outcomes associated with this policy initiative.

Preventing non-communicable diseases in sub-Saharan Africa

Non-communicable diseases (NCDs) are the leading causes of death worldwide, accounting for almost 60% of all deaths and 43% of the global burden of disease (1). Moreover 80% of the NCD deaths occur in low and middle income countries (1). As African countries make the transition from a sole focus on infectious diseases to a dual focus on both infectious and NCDs there are key lessons to be learned related to the prevention and control of NCDs. In this supplement issue of Global Health Promotion, the 12 papers that follow provide concrete examples of how public health practitioners are effectively implementing strategies to prevent and control NCDs. There are a number of key themes that cut across these articles and commentaries: the important role of data and surveillance in describing the burden, creating the political will, and mobilizing leadership in the area of NCDs; the need to work across multiple governmental agencies including the Ministries of Health, Commerce, Education, Housing and Labor; the vitally important role that policies play, particularly in the areas of tobacco, nutrition and physical activity, in creating healthy environments; and finally the importance of engaging community members and non-governmental organizations in the planning, implementation and evaluation of NCD prevention and control efforts. Strengthening the capacity for health promotion in sub-Saharan Africa continues to be a challenge. Van den Broucke and colleagues (2) describe their work in two provincial areas of South Africa. They outline a process by which there was active participation of the community in the planning, implementation and evaluation of health promotion activities. By linking all relevant agencies including local authorities, community groups, non-governmental organizations, donor agencies and the private sector they were able to create a broad-based network for health promotion and NCD prevention. They note that creating these broad-based coalitions helps to increase community capacity and sustain health promotion efforts. The effective screening, treatment and control of hypertension and diabetes are extremely important components of NCD control efforts. Debussche et al. (3) describe their efforts in Burundi to mobilize a network of community health practitioners related to the screening and treatment of diabetes and cardiovascular disease. Likewise Mbeh and colleagues (4) in Cameroon depict the role that traditional healers can play in the screening and treatment of diabetes. The collaboration between traditional medicine and biomedicine is possible when it is understood that both traditional healers and biomedical personnel are on the same side of health issues, and are working against a common enemy – disease/illness – and for one goal – the health of the patient. They conclude that with careful selection and close educational supervision, traditional healers can do a good job at identifying potential diabetes patients, referring them to health facilities, and educating their peers, patients and the population about diabetes. Villalon and colleagues (5) conducted a nutrition education program among 47 pregnant women in Benin. Noting improvements in healthy weight gain and Apgar scores in the intervention group. Lins and colleagues (6) in their commentary describe the growing burden ofNCDs in sub-Saharan Africa. They discuss the links between heart disease, cancer, chronic obstructive pulmonary disease and type 2 diabetes with the risk factors: high blood pressure, high blood cholesterol, overweight/obesity,

Quacks and Clerks: Historical and Contemporary Perspectives on the Structure and Function of the British Medical Civil Service

The British government's requirement for expert medical advice from the 1850s led to the development of a medical civil service, which reached its peak in size and authority in the 1970s. By this time the Chief Medical Officer (CMO) had direct management of a staff of over 170 medically qualified civil servants, who provided expertise on the development and implementation of new medical treatments as well as on broader health protection and promotion issues. The successive Whitehall efficiency reviews from 1979 onwards culminated in 1994 in the merger of the parallel medical and civil service reporting hierarchies in the Department of Health, effectively reducing the CMO's ability to call upon the support of medical civil servants, at a time of increasing new health threats such as AIDS and MRSA. This article uses government reports to chart the rise and fall of the British medical civil service. It discusses how, in the last ten years, the British government has become more imaginative in its use of temporary specialist medical advisers (tsars) brought in from the NHS, in relaxing the formal civil service hierarchies, and quietly abandoning the statutory Standing Medical Advisory Committee (SMAC). This article suggests that when the government has failed to give adequate support to its CMOs, the medical civil service has suffered from poor morale, experienced recruitment difficulties, and the ability to respond to health crises has been compromised. It highlights the chronic lack of historical awareness in the development of health policy in Britain.

Smoking Cessation Efforts in One New York City HIV Clinic

In recent years, the medical management of HIV infection has become well-delineated, with established regularly updated standards of care that increasingly include health maintenance and promotion (Panel on Antiretroviral Guidelines for Adults and Adolescents, 2008). The management of HIV infection has progressed to the point that many experts consider it a chronic disease (Burkhalter, Springer, Chhabra, Ostroff, & Rapkin, 2005; Gritz, Vidrine, & Fingeret, 2007; Mamary, Bahrs, & Martinez, 2002; Niaura et al., 2000; Sackoff, Hanna, Pfeiffer, & Torian, 2006). The perception of HIV management has changed as people living with HIV infection (PLWH) live longer and their lives are less constrained by illness or illness-related activities. HIV should not be an acute terminal illness but rather a chronic, manageable disease, especially in well-resourced epicenters such as New York City, where HIV care and medications are readily available. Health maintenance and promotion issues such as diet and exercise may have once had secondary importance or even been considered unimportant components of HIV care. But now they have become increasingly relevant, even a priority, to an HIVinfected person’s immediate and long-term health status. Since 1997, mortality in PLWH from non-HIVrelated disease has risen to approximately 25%. The causes of these deaths include non-HIV-related cancers, heart disease, and non-HIV-related bacterial infections (Benard et al., 2007; Niaura et al., 2000;

Reflections on a falls prevention peer education project

There is an extensive body of research around ways to prevent falls in older people, however how to best engage older people with fall prevention advice is a complex health promotion issue with mes...

A summary of the guidance relating to four lifestyle risk factors for recurrent stroke

Background: Stroke is a major cause of mortality, disability and family disruption; yet prevalence continues to rise despite advances in prevention and treatment. Many risk factors for stroke are modifiable, including life style behaviours, i.e. tobacco and alcohol use, diet and physical activity. Patterns that influence lifestyle behaviour are believed to be embedded in family life. Primary and secondary prevention of stroke are important health promotion issues. Objective: To summarize government recommendations and contemporary evidence-based guidelines regarding four lifestyle risk factors for recurrent stroke. Methods: Structured review methods were used. Conclusions: Modifiable lifestyle risk factors for stroke and recurrent stroke have been identified and brief interventions are known to be cost effective health promotion tools. However, very few studies have tested the effectiveness of behavioural interventions designed to address lifestyle risk factors for recurrent stroke and none have tested the effectiveness of family-centred behavioural interventions. Recommendations for education, practice and research are presented.

Using ACHIS to Analyze Nursing Health Promotion Interventions for Vulnerable Populations in a Community Nursing Center: A Pilot Study

The purpose of the study was to describe the health promotion interventions of nurses serving a low-income urban population in an academic community nursing center (CNC) in Wisconsin. The Omaha System (OS) was used to code client problems and nursing interventions for 9,839 visits at the CNC. A dataset created by the Automated Community Health Information System (ACHIS), a computerized clinical information system, was used. A pilot testing was performed with the ACHIS data repository. Each intervention was linked to a nursing diagnosis coded with modifiers as either actual or potential problems or health promotion issues. The Lundeen's Comprehensive Community-based Primary Health Care Model (CCPHCM) which emphasizes primary prevention and health promotion activities served as the conceptual framework for this study. A total of 58,747 modifiers were documented for 58,747 nursing diagnoses where a total of 9,836 nursing interventions were provided to 9,839 community center visits at the CNC. Although a majority of the nursing diagnoses (61.8%) were coded as actual problems as might be expected for this vulnerable population, 38% of the client problems were documented as potential problems (20.6%) and health promotion issues (17.7%.) Health Teaching, Guidance and Counseling (38.9%) and Case Management (25.8%) were the most frequently coded interventions. This research adds to the understanding of the importance of nurses' interventions toward health promotion with the vulnerable population. This preliminary analysis suggests that the ACHIS provide a clinical information system for collecting, storing, processing, retrieving, and managing clinical data in a data repository. [Asian Nursing Research 2009;3(3):130-138].

The Right Tools for the Right Job: Social Work Students Learning Community Development

The place of community development within social work varies across nations and time. The tensions in the 1970s in the UK gave way to decades when social work has been dominated by issues relating to protecting and caring for individuals. We now have a resurgence of community development activity, bringing together varied disciplines such as urban planning and health promotion as well as social work. Within the UK there are now requirements for community development knowledge and skills within qualifying social work training. This paper reflects on experiences in promoting community development practice learning in social work qualifying placements within Health and Social Care Trusts in Northern Ireland. Issues are raised about the diversity and complexity of expectations on qualifying training, and the challenges that face universities, colleges and employing organisations in developing practice learning in this curriculum area. The prospects for improving community development learning within both qualifying and post qualifying education and training are considered particularly in the light of inter-professional and inter-organisational initiatives that put community development in the context of health promotion, housing, crime, poverty and other social issues that might be addressed at community level to improve the health and social well-being of citizens.