Hospital-based Health Promotion Research Articles

The effect of hospital-based health promotion on the health practices of full-time hospital nurses: a cross-sectional study

Many studies have reported positive contributions of health promotion on the health behavior of nursing staff working in hospitals, including the maintenance of a regular healthy diet, engagement in physical activity, performance of routine screening practices, and participation in a health examination. Despite being considered a role model for healthy lifestyles, little is known about the effect of health-promoting hospital settings on nursing staff. The aim of this study was to perform a nationwide, hospital-based, cross-sectional, survey comparing health practices between full-time nurses of health-promoting hospitals and those of non-health-promoting hospitals in Taiwan. We conducted a nationwide, hospital-based, cross-sectional, survey in 100 hospitals from May to July 2011 using a questionnaire as the measurement tool. Nurses aged between 18 and 65 years from certified health-promoting hospitals (n = 14,769) were compared with nurses in non-health-promoting hospitals (n = 11,242). A multiple logistic regression model was conducted to estimate the effect of certified HPH status on the likelihood of performing health behavior, receiving general physical examination, undergoing cancer screening, and participating in hospital-based health-promoting activities. All nurses of HPH hospitals were more likely to perform physical activity, practice cancer screening, receive at least one general physical examination in the past 3 years, and had a higher chance of participating in at least one hospital-based health-promoting activity in the past year (particularly weight-control groups and sports-related clubs) than those of non-HPH hospitals. This study suggests the effectiveness of implementing health promotion on the health behavior of full-time nursing staff in hospitals.

Case of 38 Years old Nulligravida with Primary Infertility with a Known Case of Diabetes Mellitus Came for in vitro Fertilization

Introduction: The term “Primary infertility” refers to a couple’s inability to conceive a child. Endometriosis: affects mostly women in their 30s and 40s, with roughly 40%of women suffering from endometriosis. This occurs when the uterine lining is discovered outside of the uterus. Endometriosis will make it difficult to conceive. Not everyone aspires to be a parent, but for those who do, the inability to produce a child is a heart-breaking reality. Many of us spend a significant portion of our lives trying to avoid unintended pregnancies, assuming that when we are ready to have a family, it will have happened naturally. We tend to believe that transiting from preventing pregnancy to planning conception and childbirth will be relatively painless and orderly. As a result, the inability to conceive is a major life stressor that can wreak havoc on otherwise happy couples. Case Presentation: She is a case of 48 yr. Primary Infertility nulligravida comes with DM. For 20 Year diagnostic hysteroscopy done. Ultrasonography done. A complete blood investigation is done. She is a history of Hypertension for 1 month and insulin-dependent diabetes for one 1year. Conclusion: This study emphasized the opportunity of strengthening public health and hospital-based health promotion programs (e.g., smoking, obesity STIs, etc.). Furthermore, detecting, avoiding, and controlling modifiable risk factors through increased awareness, screening, and early management of chronic diseases may help to reduce the incidence and severity of chronic diseases.

Risk profile of Qatari women treated for infertility in a tertiary hospital: a case-control study

BackgroundFemale infertility is a multifactorial condition constituting a worldwide public health problem. The ability to reproduce is an important product of any marriage, hence infertility may exert a negative impact on physical, financial, social and emotional wellbeing of affected couples. The cornerstone to the management of any disease, including infertility, is prevention. Identifying the modifiable risk factors of female infertility will aid at prevention, early detection, and treatment of medical conditions that can threaten fertility as well as promoting healthy behaviours that can preserve it.AimTo explore the risk profile of infertility among Qatari women and compare risk factors distribution among primary vs. secondary infertility.MethodologyA hospital-based case control study was conducted from September 17th, 2017- February 10th, 2018. Cases (n = 136) were enrolled from infertility clinic and controls (pregnant women, n = 272), were enrolled from antenatal clinic, Women Hospital, Hamad Medical Corporation (HMC). Interview questionnaire was utilized to collect data about sociodemographic, risk factors related to infertility and patient health Questionnaire (PHQ)-2. Body Mass Index (BMI) was calculated. Logistic regression was used to identify the associated factors to infertility. Statistical significance was set at 0.05.ResultsForty three primary and ninety three secondary infertility cases were included. Risk factors were age > 35 years (OR = 3.7, 95% CI: 1.41–9.83), second-hand smoking (OR = 2.44, 95% CI:1.26–4.73), steady weight gain (OR = 4.65,, 95% CI: 2.43–8.91), recent weight gain (OR = 4.87, 95% CI: 2.54–9.32), menstrual cycle irregularities (OR = 4.20, 95% CI:1.14–15.49), fallopian tube blockage (OR = 5.45, 95% CI: 1.75–16.95), and symptoms suggestive of sexually transmitted infections (STIs) including chronic lower abdominal/pelvic pain (OR = 3.46, 95% CI: 1.57–7.63), abnormal vaginal discharge (OR = 3.32, 95% CI:1.22–9.03) and dyspareunia (OR = 7.04, 95% CI: 2.76–17.95). Predictive factors for secondary infertility were; longer time from previous conception (OR = 5.8, 95% CI: 3.28–10.21), history of stillbirth (OR = 2.63, 95% CI: 1.04–6.67) or miscarriage (OR = 2.11, 95% CI: 1.21–3.68) and postpartum infection (OR = 3.75, 95% CI: 1.27–11.06). Protective factors were higher education level (OR = 0.44, 95% CI: 0.25–0.78), higher income (OR = 0.17, 95% CI: 0.06–0.49), and awareness/loyalty to fertility window (OR = 0.33, 95% CI: 0.21–0.52 and OR = 0.29, 95% CI: 0.19–0.44, consequently).ConclusionThis study highlighted the opportunities to strengthen public health as well as hospital-based health promotion programs importantly toward behavioural-related risk factors (e.g. smoking, obesity, STIs etc.). Moreover, detecting, preventing, and managing modifiable risk factors through awareness, screening and early management of chronic diseases, may contribute at reduction of incidence and severity of infertility. Such interventions can be delivered at premarital, family planning, post-natal and antenatal clinics at primary health care with early referral to secondary care if required.

Understanding the Use of Smartphone Apps for Health Information Among Pregnant Chinese Women: Mixed Methods Study.

BackgroundHospital-based health promotion resources to assist pregnant women in adopting a healthy lifestyle and optimizing gestational weight gain are important, but with limited effects. Increasingly, women are using mobile apps to access health information during the antenatal period.ObjectiveThe aims of the study were to investigate app-usage by Chinese women during pregnancy and to gain a better understanding of their views and attitudes toward apps containing health information.MethodsA mixed methods study design was applied. Study participants were recruited from 2 maternity hospitals in Shanghai, China, between March and July 2018. A self-administered Web-based survey was conducted with 535 pregnant Chinese women on their sources of health information and reasons for using apps during pregnancy. A total of 4 semistructured focus groups were also conducted with the pregnant women (n=28).ResultsThe use of pregnancy-related apps and the internet was common among the respondents. Almost half of the women had used pregnancy-related apps. Specifically, the use of apps for health information declined as pregnancy progressed from 70% (35/50) in the first trimester to 41.3% (143/346) in the third trimester. The main reason for using an app was to monitor fetal development (436/535, 81.5%), followed by learning about nutrition and recording diet in pregnancy (140/535, 26.2%). The women found that the apps were useful and convenient and can support lifestyle modifications during pregnancy. However, some apps also contained misinformation or incorrect information that could cause anxiety as reported by the participants. Many women expressed the need for developing an app containing evidence-based, well-informed, and tailored health information to support them during pregnancy.ConclusionsThe study suggests that apps were widely used by many Chinese women during pregnancy to monitor fetal development, to obtain diet and physical activity information, and to track their body changes. The women highly appreciated the evidence-based information, expert opinions, and tailored advice available on apps. Smartphone apps have the potential to deliver health information for pregnant women.

At what scale should proportionate universalism be applied to ensure health equity? Towards a contextualised approach to prevention and health promotion actions

Reduction of social inequalities in health has been one of the main political pillars of Regional Health Agencies in France since their creation in 2009. This paper presents a contextual analysis of the effects on social inequalities in health of a hospital-based health promotion and disease prevention programme in terms of overall health policy and scope. Qualitative analysis was used to describe the impact on social inequalities in health according to the classification proposed by Diderichsen et al. Carey's framework was used to apply proportionate universalism in order to analyse its action on these inequalities, adopting a contextualised and holistic approach with regard to regional and national public policy. The results showed that the intervention focused on targeted actions, but may have broader applications. The intervention strategy shifts between closing the inequality gap and levelling up the social gradient. However, analysis of this type of intervention using the proportionate universalism framework may lead to a revised view of the effects of the intervention on social inequalities in health. Implementing health-equity focused interventions remains a challenge for each institution, including Regional Health Agencies. However, research on hospital-based preventive interventions highlights contrasting results in terms of social gradient, depending on whether the intervention is considered in isolation or in its broader context. This article advocates a contextualised approach to analysing local interventions and their effects on social inequalities in health.

Self-Reported Changes in the Implementation of Hospital-Based Health Promotion in Taiwan

To evaluate the pattern of perceived changes in the implementation of the Health Promoting Hospital (HPH) Initiative. This was a cross-sectional study with a self-administered questionnaire, asking the correspondents what changes they perceived before and after adopting the HPH initiative. This study was conducted with 55 hospitals committed to the HPH in Taiwan, and 52 completed the questionnaire. One coordinator in each of the 55 hospitals served as subject. HPH seeks to improve health gains for its stakeholders by developing structure, cultures, decisions, and process conducive to health promotion. Perceived changes were measured in the areas of more resource inputs, changing work models, realigned implementation strategies, more programs, higher service volume, and improved quality control. Regarding realigned strategies, emphasizing the impact of healthy public policies, supportive environments, staff participation, individual knowledge and skills, and reorienting health services were measured. Descriptive analysis was used to examine the pattern of "prevalence of changes." Changes were more prevalent in the domains of patients and community (both with averaged ranks = 1.8); "realigning strategies" was the area in which more changes were perceived (average rank = 1). Emphases on healthy public policies and reorienting health services were the leading changes (both averaged ranks = 2.4) regarding realigning strategies. The HPH initiative appeared to be an effective approach to build organizational capacity for health promotion.

Health behaviors and participation in health promotion activities among hospital staff: which occupational group performs better?

BackgroundStaff health behaviors affect not only their own health but also their provision of health promotion services to their patients. Although different occupational groups work in hospitals, few studies have compared health behaviors among them. The objectives of this study were to examine health behaviors, including physical activity, eating 5 portions of fruits and vegetables per day (5 a day), and stress adaptation, and participation in hospital-based health promotion activities by occupational groups in hospitals.MethodsThis cross-sectional survey was conducted among full-time employees in 100 hospitals across Taiwan. This analysis included 4202 physicians, 31639 nurses, 2315 pharmacists, 8161 other health professionals, and 13079 administrative personnel.ResultsAdministrative personnel attended more health promotion lectures and clubs/groups than other health professionals, pharmacists and physicians, and those workers participated more than nurses. Participation in health promotion activities provided by hospitals was associated with better practice of health behaviors. After adjustment for socio-demographics and participation in health promotion activities, physicians, pharmacists, and other health professionals reported more 5 a day than administrative staff. Other health professionals reported more physical activity than administrative staff, and they reported more than physicians. Nurses reported the lowest level of physical activity, 5 a day, and stress adaptation of all occupational groups.ConclusionsNurses had worse health behaviors and less participation in health promotion activities than other groups. Workplace health promotion program for health professionals is needed, with special emphasis on nurses. Hospital-based health promotion programs could take the differences of occupational groups into consideration to tailor programs to the needs of different occupational groups.

The Impact of State Community Benefit Laws on the Community Health Orientation and Health Promotion Services of Hospitals

This study examined the effect of state community benefit laws and guidelines on the community health orientation and the provision of hospital-based health promotion services in hospitals. The sample included all not-for-profit and investor-owned acute-care hospitals in the United States during the year 2000. Multiple regression procedures were used to test the effect of community benefit laws and type of ownership while controlling for organizational and environmental variables. The results of these procedures indicated that, on average, not-for-profit hospitals in the ten states with community benefit laws/guidelines reported significantly more community health orientation activities than did not-for-profit hospitals in the forty other states. The results of the multiple regression procedures also indicated that, on average, the investor-owned hospitals in the ten states with laws/guidelines reported significantly more community health orientation activities than did the investor-owned hospitals in the forty other states. The study found that community benefit laws had the effect of decreasing ownership-related differences in reported community health orientation activities. Further, Levene's test of equality of variance showed that the not-for-profit hospitals in community benefit states exhibited significantly lower variance in the community health orientation activities when compared with the not-for-profit hospitals in non-community benefit states. However, none of the statistical tests supported the hypotheses that community benefit laws compelled or induced hospitals to offer significantly more health promotion services. The study concluded that coercive measures such as community benefit laws were effective in compelling not-for-profit hospitals to report increased community orientation activities, and it also concluded that the mimetic pressures associated with these laws were effective in inducing investor-owned hospitals to report increased community orientation activities.

Community Health Orientation, Community-based Quality Improvement, and Health Promotion Services in Hospitals

The objective of the study presented in this article was to examine the relationship between hospital community orientation and the provision of health promotion services. The study used data from the 2000 American Hospital Association survey and the 2000 Area Resource File to examine acute care hospitals throughout the United States. The study was a cross-sectional multiple regression analysis. Hospital community orientation was measured by two independent variables: (1) community health orientation and (2) community-based quality orientation. Health promotion services were represented by two dependent variables: (1) hospital-based health promotion services and (2) collaborative health promotion services. Organizational control variables included bed-size code, not-for-profit ownership, network participation, and joint venture/alliance membership. Environmental control variables included the proportion of population over age 65, the percentage of population below the poverty level, the square root of the proportion of Medicaid inpatient revenue, the presence of state community benefit laws/guidelines, a Herfindahl-Hirschman Index of level of competition, and an index of managed care influence. Results of regression analyses showed that community health and community-based quality orientations were positively and significantly related to both the direct provision of health promotion services by hospitals and the collaborative provision of health promotion services through systems, joint ventures, and networks. The study concludes that a community health orientation and a community-based quality orientation lead to greater provision of health promotion services.

The number of times attended as a factor in the success of a comprehensive hospital-based approach to health promotion.

This study assesses the relationship between a perceived change in a health-related behavior or attitude and the number of times an individual participates in a weekly hospital-based health promotion program. A survey was distributed to participants in April 1995. A univariate probit evaluation shows that the number of times attended and age have positive effects on the likelihood of change. As the number of times an individual attends increases, the more likely the person is to change, possibly revealing a reinforcement mechanism. It is important to learn the most effective way to raise attendance so the reinforcement process reaches more individuals.

Payment for cancer prevention. Community and government perspectives.

The development of a stronger interest in cancer prevention and early detection programs has led to the opportunity for mechanisms to provide adequate financial support at the individual, practitioner, and community levels. This discussion draws on the experiences of public health systems and emerging models for personal care to describe a framework for consideration of prevention and early detection funding, and to discuss the prospects of funding. Some prevention and early detection services are financed appropriately through individual payment mechanisms and can be covered in indemnity and capitated insurance plans. Population-based approaches to prevention do not fit this model, however, and need to be financed at the community level, through taxes or other shared financing schemes. Lack of public understanding of the differences between individual- and population-based prevention makes resource development difficult. Practitioners interested in such approaches need to join with others in the community to gain support. Long-term support of community efforts currently remains unclear. Although the actions identified are essential, they are not sufficient to support a comprehensive cancer prevention and detection program fully. The concerned clinician should become a part of the community-wide effort. This may be done individually, through participation on a local board of health or a hospital-based health promotion coalition. This also may be achieved through associations such as the local medical society or the local American Cancer Society.

The impact of cancer screening promotion by rural hospitals on cancer detection.

Hospitals almost universally provide health promotion programs for community residents. There is a lack of evidence regarding these programs' impact on the detection or prevention of disease. The purpose of the present study was to determine whether rural hospital-based health promotion programs for cancer screening were associated with detection of greater numbers of cancer cases in the communities served by the hospitals over the years that the promotion programs were offered. Data were collected from a survey of 95 rural Iowa hospitals and from state health registry data on 1985-1990 cancer occurrence. Breast and colon cancer screening promotion programs were related to detection of greater numbers of cases, after controlling for population, age and sex. These findings often held for both less advanced and more advanced cancer stages. Promotion of cervical cancer screening was not related to number of cervical cancers detected. The finding that the relationship between screening promotion and cancer detection persists irrespective of stage may have important policy and programmatic implications.

The rural hospital as a provider of health promotion programs.

Although patient education has always been recognized as an essential function of a hospital, it was not until the health concerns of the nation focused on prevention that hospitals began to develop activities aimed at primarily healthy individuals. Hospital health promotion evolved from patient education about specific diseases to programs focused on modifying of lifestyle practices to prevent future debilitating conditions. Studies conducted in the early 1980s show hospital-based health promotion programs increasing in number and including such target populations as senior citizens, children, business people, and hospital employees. However, the extent of involvement of the rural hospital in offering health promotion programs has not been clearly established. The current study was conducted to determine the status of health promotion programs in rural North Carolina hospitals. Elements considered were types of programs, target audiences, methods of financing, staff use, and availability of specialized facilities for health promotion programs. The results indicate rural hospitals do offer health promotion programs, but their primary focus is on hospital employees. Most programs are offered at low or no cost, making those offered for the community readily accessible. If input from the community is used and programming is aimed at specific health needs of rural populations, the rural hospital could make a significant contribution to an overall primary prevention strategy, lowering community health care costs.

Hospital-Based Health Promotion Programs for Children and Youth: An Idea Generator and Guide for Marketing Services to a Growing Community

Hospital-Based Health Promotion Programs for Children and Youth: An Idea Generator and Guide for Marketing Services to a Growing Community

Hospital-based Health Promotion Programs for Children and Youth, 1986

Hospital-based Health Promotion Programs for Children and Youth, 1986

A review of hospital-based health promotion programs in Michigan non-governmental hospitals

In 1983, the 217 hospitals of the Michigan Hospital Association (MHA) were surveyed to learn more about their efforts in health promotion programming. Eighty percent (174 hospitals) responded to the survey, with 48% reporting on 532 programs. Those programs included 216 in health promotion as defined by the survey instructions, 110 in disease management, 66 in first aid and safety, 87 screening, and 53 miscellaneous education programs. Further particulars about the programs are presented, including information regarding program audience, times offered per year, median enrollment, median participant hours, program age, number and type of educational methods used, follow-up methods, and fees charged. Hospital administrators' perceptions regarding health promotion programs were also surveyed. They indicated a higher level of interest in providing such programs because they viewed them as a needed community service. Conversely, they did not see them as a revenue generator. Seventy-two percent of the responding administrators indicated they currently offered health promotion programs, although only 48% submitted information regarding them. Seventy percent said they planned to begin new health promotion programs within the next 12 months, while only 6% planned to discontinue programs in the new year.