Health Promotion Training Research Articles

Perspectives on Latino Lay Health Promoter Programs: Maryland, 2009

We examined common barriers and best practices in the design, implementation, monitoring, and evaluation of Latino lay health promoter programs. Ten lay health promoter program coordinators serving Maryland Latinos were recruited in 2009 through snowball sampling for in-depth semistructured interviews with a bilingual and bicultural researcher. Program coordinators were asked about recruitment, selection, training, and supervision; key program elements; and evaluation. Analyses were conducted to identify common themes. Respondents had worked up to 13 years in programs focused on such areas as awareness of healthy lifestyles and reducing risk of illness. Coordinators looked for Latino leaders with team-building skills and a desire to help the community. Six programs compensated promoters with stipends; 4 paid an hourly wage. Promoters were usually trained in monthly meetings that actively engaged them. Most programs conducted site visits, practice sessions, and performance evaluations. Our findings indicate that successful health promoter programs require needs assessments, formation of a target population advisory board, identification of appropriate promoters, and a significant amount of training. These findings can be used to guide future programs in the identification, recruitment, and training of health promoters as well as in program monitoring.

Evaluating postgraduate courses in Health Promotion

Background  Evaluation of short training/postgraduate courses, with focus on measuring acquisition of new knowledge, is often limited. Therefore, the aim of this study was to develop a Multiple Choice test for evaluating how well participating staff in the clinical prevention and health promotion training course had acquired knowledge. Methods  11 participants from a spring course and nine control persons took a pilot test, and 12 participants and 21 control persons took the final Autumn-test. A MC test was developed with 17 questions with three possible answers for each question. The participants answered the MC test as a pre-test and a post-test. Results  The pilot test showed that the number of correct answers in both groups resulted in a median of 13 ranging from 10-15 and 10-16 (p = 0.42), respectively. The Autumn testing showed a significant difference in number of correct answers between the pre-test and the post-test, 10.5 (6-13) versus 12 (11-13) (p = 0.016). Furthermore, there was a significant difference between the post-test of the participants and the answers of the control persons, 11 (8-14) (p = 0.02). In addition, the study found that the participants were positive towards answering the MC test, and that the test could be completed within the allocated period of time. Conclusion  A MC test can be easily developed to evaluate whether the participants acquire knowledge by participating in a training/postgraduate course in clinical health promotion. However, the MC test does not measure acquisition of new clinical skills and effect for the individual patients.

Between crossfire…: graduate degree level, policy on higher education and training in health promotion

Over the past 20 years, there has been a significant transformation within Latin American subcontinent in the organizational culture of public universities, as well as a change in the status, identity and practices of the academic profession. Higher education institutions are faced with the need to complement government funding with external funds including, but not limited to, the industrial sector. These institutions are also faced with requirements to become publicly accountable for their performance and results. This situation has led some authors (1) to claim that higher education has gone from being a public asset to an economics-centered model in which many institutions are evaluated by their ability to secure funding and not actually to provide the system with feedback. In Latin America and in some universities in Spain (2) the process of accountability has been linked with a growing tension placed on these institutions, dominated by conflicts between groups and individuals, both in terms of the struggle to successfully obtain financial subsidies and of meeting external demands to certify the academic quality of the teaching staff and the teaching programs. Since the early 1990s, several economic incentive programs linked with attaining indicators (as defined by externally developed standards) have been designed, thus creating a highly fragmented evaluation system, with very diverse criteria and characteristics. Within this highly complex context, a small number of health promotion (HP) graduate programs have emerged in some higher education institutions in Central and South America. With regards to health education (HE), in a scientific study published in the late 1980s, Maria Antonia Modolo (3) stressed the co-existence of two HE staff training models. The first (particularly common in some English-speaking countries) aimed to train specific personnel in this field at graduate level. Therefore, a number of high school diplomas and graduate degrees in HE exist in the educational institutions of these countries. The second training model adopted the principle that HE responsibilities should be shared by all members of the health team, and that they represent just another component (such as basic science, clinical science and epidemiology) of the curriculum of future professionals. It is this latter model that has guided (whether deliberately or not) education in both HE and HP in most Latin American countries. One student who was nearing the end of an HP graduate program complained:

Wiltshire pharmacy health promotion training initiative: a telephone survey

Abstract A telephone survey of 40 pharmacists before and after attendance on a health promotion course in Wiltshire, conducted using semi-structured questionnaires, indicated that training led to changes in knowledge and perceived changes in attitude and practice. The value of the increased knowledge was recognised by participants, in particular when talking to patients and other health professionals. The change in attitude, towards a more holistic view of health, is seen by the authors as a positive benefit of training, as it may be of value to the pharmacists. Changes in practice were evident despite recognised constraints. Recommendations for future health promotion training schemes are: training should be ongoing; joint working with other health care professionals is needed fully to achieve training objectives; the role of the pharmacist should be promoted; and this currently unremunerated role should be recognised by Wiltshire health authority for its potential contribution towards the health care of the population, and receive appropriate funding.

Health-promoting organization and organizational effectiveness of health promotion in hospitals: a national cross-sectional survey in Taiwan

To assess the organizational health-promotion (HP) status and its effect on the organizational effectiveness of HP in a national cross-sectional survey of all hospitals above the local community hospital level in Taiwan's hospitals, questionnaires were sent to 474 hospitals, of which 162 (34.18%) hospitals returned them and were rendered valid. The results of the organizational HP status reveal that the standardized overall score achieved is 76.26, suggesting that there is considerable room for improvement. The results of correlation analysis partially support the proposition of this study, suggesting that the higher the organizational HP status, the better the self-evaluated overall organizational and administrative effectiveness of its HP. When hierarchical multiple regression was performed, support for ownership (private hospitals), hospital accreditation grades (academic medical centers) and overall score of the Organizational Health of Hospital Assessment Scale were significant predicators of self-evaluated overall organizational effectiveness (F = 11.097, p < 0.01, R(2) = 0.369). Moreover, drafted annually, HP policies and plans and the number of staff HP training activities were found to partially mediate the relation between the organizational HP status, hospital characteristics and self-evaluated overall organizational effectiveness. The results contribute to clarify the conception of health-promoting hospital organizations and to identify a number of dimensions of health-promoting organizations related to the organizational effectiveness of HP in hospitals, which could allow hospitals to establish a healthier organization and more effective HP programs. This study also supplies the research field with important data and insights that can be used in future research.

Proposal for Subspecialty Physician Fellowship Training in Nutrition and Health Promotion

Subspecialty fellowship training programs in nutrition and health promotion (NHP) are necessary for any comprehensive solution to address physician shortages in this discipline. After a careful needs and resource assessment, current or future program directors can decide on 1 of 3 potential NHP training models: dedicated continuous, dedicated carve-out, or concurrent continuous. Each of these models will need to provide complete elements of core curricula and a sufficient amount of specialized modular NHP training. At the conclusion of the training program, NHP fellows should have fulfilled board certification eligibility requirements so that they may later become NHP experts and mentors to perpetuate this subspecialty.

Gesundheitswirkungen von Prävention: Erprobung des Evaluationssystems der Krankenkassen im Individualansatz und erste Befunde aus 212 Gesundheitskursen

The purpose of this study was to develop a measurement system for the evaluation of health promotion training courses offered by German statutory health insurance companies. In a field test, N=1 671 participants from 212 youth and adult courses for the promotion of either physical activity, coping with stress or nutritional improvement were included. 80% were female. Participants were questioned in a pre-post-design with a three month follow-up. The questionnaires covered health behaviour and health status. Participants' compliance and psychometric quality of the measurement instruments were good. On average, the health insurance companies assigned participants to different interventions adequately according to the participant's individual health problems. The health promotion courses triggered improvements of high effect sizes for health behaviour patterns, of moderate effect sizes for physical complaints, subjective health ratings, and health-related quality of life. Effects decreased after the end of the intervention but remained significantly above the initial values. BMI values continued their improvement after the end of the training courses. Thus, health promotion training courses generated stable health improvements of practically relevant effect sizes. The interventions provided good support and health improvements for all subgroups of participants, regardless of age, gender and educational background. Thus, the health promotion curricula of the health insurance companies offer a ubiquitous and easily accessible but effective intervention for health promotion in Germany, although men are clearly underrepresented among the participants. The trainings may be recommended and used by other health-care suppliers. The evaluation toolkit provides practical and valid instruments for a routine evaluation of health promotion trainings. It should be applied within random sampling designs.

The SeniorWISE Study: Improving Everyday Memory in Older Adults

We tested whether at-risk older adults receiving memory training showed better memory self-efficacy, metamemory, memory performance, and function in instrumental activities of daily living than participants receiving a health promotion training comparison condition. We followed participants for 26 months. The sample was mostly female (79%) and Caucasian (71%), with 17% Hispanics and 12% African Americans; average age was 75 years, and average education was 13 years. The memory training group made greater gains on global cognition and had fewer memory complaints, but both groups generally maintained their performance on the other cognitive measures and instrumental activities of daily living (IADLs) throughout the 24-month study period. Black and Hispanic participants made greater gains than Whites did on some memory performance measures but not on memory self-efficacy. The unexpected finding that minority elders made the largest gains merits further study. This study contributed to the knowledge base of geropsychiatric nursing by providing evidence for an effective psychosocial intervention that could be delivered by advanced practice nurses.

Radical Remedies:

As states weaken and public health care deteriorates throughout the developing world, new spaces are opening for civil society groups to fill the gaps of declining health systems. In Mexico, popular health groups have responded to health care decline by building community clinics, establishing health promoter training programs, and opening natural medicine pharmacies. Lower- and working-class women are the primary participants in these groups that use a self-help approach to find practical solutions to local health care problems. However, little is known about participants' circumstances, motivations, or the ideals they embrace. Drawing from women's narratives, I explore the "micropolitics" of women's participation in local health groups. I examine their efforts to reclaim control over the health process as a metaphor for claiming control over their lives. Highlighting the "instrumental effects" of participants' medical encounters and healing relationships, this case illuminates some unintended consequences of health care decline.

La formación de recursos humanos y el desarrollo de competencias para la capacitación en promoción de la salud en América Latina

The subject of health promotion professional training has raised a lot of interest in academic spheres, in professional organizations and in the health services sector at global and regional levels. Some of the topics that have stimulated regional dialogue and actions have been the following: developing curriculum and professional competencies for health promotion and health education academic programs; defining competencies and know-how in order to reorient health promotion capacity building initiatives for public health personnel; strengthening and increasing the academic and professional health promotion networks in Latin America; and organizing meetings and academic events and publications around the subject. During the academic years 2006-8, the Inter-American Coalition of Universities and Training Centers for Health Education and Health Promotion Personnel (www.ciueps.org) has been studying the different foci, competencies and characteristics of health promotion and health education professional training programs in the Latin American region. As part of this study, they have observed differences in curriculum foci between undergraduate, postgraduate and other levels of academic training and certifications. The Coalition as well as other Latin American entities has reiterated the challenges in the field of health promotion of professional training in the region. These include: maintaining an active forum to constantly refine professional competencies;expanding offerings at the different levels of health promotion training; developing courses on health-promotion-related disciplines; increasing the networks and academic exchanges between institutions in Latin America; encouraging the development of international courses on health promotion; increasing the production of theory and concepts on health promotion, health education and related practices in the Latin American context; improving dissemination of experiences in publications, at conferences and in electronic exchange forums.

HIV prevention for people with serious mental illness: a survey of mental health workers’ attitudes, knowledge and practice

The aim of this survey was to investigate the attitudes, knowledge and reported practice (capabilities) of mental health workers concerning human immunodeficiency virus (HIV) and other sexually transmitted diseases in people with serious mental illness. People with serious mental illness are at increased risk of HIV and other sexually transmitted infections. Mental health workers have a key role to play in promoting sexual health in this population, but it is unclear how they perceive their role in this work and whether they have the capabilities to deliver sexual health promotion. Cross sectional survey. A questionnaire was devised and distributed to 650 mental health workers working in a London (UK) NHS mental health service. A response rate of 44% was achieved. Overall, workers reported positive attitudes to sexual health promotion and were knowledgeable about risk behaviours and risk factors for HIV infection. Adherence to glove wearing was good. However, participants' knowledge about HIV/AIDS in people with schizophrenia was poor and most reported they were not engaged in sexual health promotion activities with people with serious mental illness. Glove wearing was predicted by those who had drug and alcohol training and clinical experience and knowledge of risk factors was predicted by previous health promotion training. No other demographic factors predicted any of the other subscales. Mental health workers require training to provide skills for health promotion regarding sexual health and HIV in people with serious mental health problems. In addition, there needs to be more research on risk behaviours. The development of effective interventions to reduce this behaviour.

The future of health promotion in schools goes through the strengthening of teacher training at a global level

Schools are considered to be settings for both health education and health promotion. But the core business of schools is actually focused on educational outcomes, not reducing health problems. In most countries, schools give low priority to health promotion, and school staffs, mainly teachers, are not aware of their role in health promotion. Studies show that teachers who have received health promotion training tend to be involved more frequently in health promotion projects and have a more comprehensive approach to health education. Pre-service and in-service staff training is then a main challenge. This is the reason why we have launched an initiative to join international forces to strengthen and advocate for teacher training in health promotion. The main goals are to develop research, affirm and reinforce the work done in teacher training in health promotion, support the institutes/colleges/universities in the provision of pre-service and in-service teacher training and stimulate international partnership work.

Making sustainable water and sanitation in the Peruvian Andes: an intervention model

Sustainability of water supplies in remote rural communities is problematic and resource consuming. CARE has a long history of working hand in hand with remote rural communities and devising programs tailored to their needs. We present here an intervention that integrates development of water supplies and sanitation, with operation and maintenance skills development and training of health promoters that can educate from within the community that ensures the sustainability of drinking water supply systems in rural communities. The training used is innovative in that it uses a series of video-workshops which are found to be particularly useful in communities with high illiteracy rates.

Higher education in health promotion in Europe: a comparative analysis of master's level training programmes using HP-Source.net

This report summarises opportunities in Europe for master's degree level training in health promotion. Using data available at www.HP-Source.net, 105 study programmes at 71 institutions, spread over 20 European countries, were identified that include health promotion as a main subject. The programmes were analysed along a number of dimensions, including title, learning objectives, curricula, learning and teaching methods, entry requirements, duration, accreditation, language(s) of instruction and participation in European educational structures. The present analysis reveals great diversity along all these dimensions, but also several clusters of programmes that offer quite similar education in health promotion. Of special interest is the range of options available in Europe for length of study, ranging from one to two years, with part-time as well as full-time options.

Drug use in prisons in Kyrgyzstan: a study about the effect of health promotion among prisoners

In Kyrgyzstan the prevalence of injecting drug behaviour is among the highest found throughout the world. Health promotion training, improved health care and needle/syringe exchange (NSE) programmes have been shown to decrease risk behaviour among injecting drug users. In Kyrgyzstan, an intervention study with training of prison staff and prisoners was performed in one prison. Before and after the training, a random selection of the prisoners answered a questionnaire about drug use, risk behaviour and health care. The survey was carried out in both the intervention prison and in a reference prison. The number of drug users, the use of drugs and risk behaviour were improved significantly within half a year and, especially, the injection and use of drugs decreased in the intervention group. The study clearly shows that increased focus, improved healthcare and training of prisoners and staff on drug use and harm reduction can reduce both use of drugs and risk behaviour.

The Health Specialist Initiative

The health specialist initiative aimed to develop closer working practices between health and social care practitioners by providing health input into assessments for child safeguarding and child protection. As part of this initiative, health visitors were transferred to work within social work child welfare teams, where they were renamed `health specialists' (health visitors are registered nurses or midwives, with additional specialized training and experience in child health, health promotion, and education, usually located in primary health care settings). This initiative aimed to develop closer working practices between health and social care and to provide comprehensive health input into assessments for child safeguarding and child protection. This evaluation found that the health specialist initiative is an example of a successful collaboration between health and social care in terms of both processes and outcomes. The health specialist was influential in improving communication and informationow between these two sets of professionals, increasing social worker knowledge of child health and development and strengthening assessments undertaken within social care. However, consideration needs to be given to the clinical health super- vision needs of the health workers based within a host organization. The health specialist initiative has important lessons and experiences for establishing partner- ship initiatives in practice settings for other children's services.

The concept of spirituality: its role within health promotion practice in the Republic of Ireland

AbstractSpirituality is increasingly recognized as a key determinant of health, and it has been adopted by the World Health Organization as part of its seven principles of health promotion. However, little is known about the extent to which it is incorporated into health promotion practice. This paper reports on a survey on spirituality and its perceived role in health and well‐being among Health Promotion Officers within Health Promotion Services in the Republic of Ireland. Although the importance of spiritual health promotion was recognized, it was discussed within health promotion practice relatively infrequently. The need for training in spiritual health promotion, a working definition of spirituality, and a set of guidelines for engagement with client groups were highlighted. Copyright © 2008 John Wiley &amp; Sons, Ltd.

The status of health-promoting schools in Hong Kong and implications for further development

An evaluation framework, called the Hong Kong Healthy Schools Award, has been developed to enable comprehensive collection and analysis of data reflecting the status of health-promoting schools (HPS) in Hong Kong. The key findings revealed a high prevalence of emotional problems, unhealthy eating habits, physical inactivity and risk-taking behaviours, leading to both intentional and unintentional injuries among students with higher prevalence among secondary school students. The results indicated a substantial lack of health policies in schools; it also indicated health services in schools not readily accessible to students and staff, and insufficient staff training in health promotion and education. However, most schools have made initiatives in environmental protection, established safety guidelines and strategies for managing students with emotional problems. The success of HPS depends largely on teachers' understanding of its building blocks. Evidence from the comprehensive mapping of the status of HPS in Hong Kong and from student surveys does show encouraging outcomes as well as identifying priority issues to be addressed in the next 5 years.

Enhancing the effectiveness of the International Union for Health Promotion and Education to move health promotion forward

The success in recent years of many IUHPE initiatives provides cause for celebration, but also reminds us of the challenges that lie ahead. The Global Programme for Health Promotion Effectiveness provides a blueprint for how the IUHPE can effectively participate in, and lead, global networks for health. Health promotion research is well organized and productive in most of the Northern hemisphere, but important wells of health promotion knowledge in the Southern hemisphere are not widely-enough disseminated. The IUHPE needs to help liberate knowledge producers everywhere from unnecessary structures, and find innovative ways to illuminate knowledge for all to see. We have developed and proven the effectiveness of a range of technologies such as settings-based health promotion. However, the vast majority of communities are untouched, and the IUHPE needs to be a leader in finding ways to better disseminate effective health promotion practice. The IUHPE is a vigorous and effective advocate for health promotion training, practice and research. Now we need to expand our advocacy for equity in health, building on our effective work on social clauses in trade agreements and on tobacco control.

Early Intervention and Information Use by Mental Health Social Workers

Previous research into the use of information by social care workers has revealed low levels of information usage due to factors such as lack of time, high case loads and a history of limited information use. This study examines the role and level/types of information used by mental health social workers in Leeds and Wakefield with particular relation to the early intervention approach in psychosis. A postal questionnaire was sent to mental health social workers in social services departments in Wakefield and Leeds to determine awareness of the early intervention approach, information use and attitudes towards mental health promotion and information literacy training. The results indicate a high level of awareness of mental health promotion, the early intervention approach and the importance of information as a support tool within this approach. However awareness is restricted by limited access to information sources due to time constraints, poor information and communication technology provision, and a lack of information culture in the parent organisations. The conclusions identify further areas for study and make recommendations for improving information literacy training in this professional area.