Impact Of Health Promotion Interventions Research Articles

Quantitative methods used to evaluate impact of health promotion interventions to prevent HIV infections: a methodological systematic review protocol.

BackgroundCombination prevention is currently considered the best approach to combat HIV epidemic. It is based upon the combination of structural, behavioral, and biomedical interventions. Such interventions are frequently implemented in a health-promoting manner due to their aims, the approach that was adopted, and their complexity. The impact evaluation of these interventions often relies on methods inherited from the biomedical field. However, these methods have limitations and should be adapted to be relevant for these complex interventions. This systematic review aims to map the evidence-based methods used to quantify the impact of these interventions and analyze how these methods are implemented.MethodsThree databases (Web of Science, Scopus, PubMed) will be used to identify impact evaluation studies of health promotion interventions that aimed at reducing the incidence or prevalence of HIV infection. Only studies based on quantitative design assessing intervention impact on HIV prevalence or incidence will be included. Two reviewers will independently screen studies based on titles and abstracts and then on the full text. The information about study characteristics will be extracted to understand the context in which the interventions are implemented. The information specific to quantitative methods of impact evaluation will be extracted using items from the Mixed Methods Appraisal Tool (MMAT), the guidelines for reporting Statistical Analyses and Methods in the Published Literature (SAMPL), and the guidelines for Strengthening The Reporting of Empirical Simulation Studies (STRESS). This review will be conducted according to the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) statement.DiscussionThe impact evaluation of HIV prevention interventions is a matter of substantial importance given the growing need for evidence of the effectiveness of these interventions, whereas they are increasingly complex. These evaluations allow to identify the most effective strategies to be implemented to fight the epidemic. It is therefore relevant to map the methods to better implement them and adapt them according to the type of intervention to be evaluated.Systematic review registrationPROSPERO CRD42020210825Supplementary InformationThe online version contains supplementary material available at 10.1186/s13643-022-01970-z.

Impact of Health Promotion Intervention on Perception and Knowledge on Cervical Cancer and Screening among Women in Kirinyaga County, Kenya

Cervical cancer is a major cause of death among women in the world with majority of the deaths occurring in developing countries like Kenya. Developed countries have organized screening that has helped in the early detection and screening of cervical cancer, in turn reducing mortality from the disease. There is a need to assist the women at risk to enroll into a routine cervical cancer screening program. This study assessed the impact of health promotion on individual perception and knowledge on uptake cervical cancer and screening among women at risk in Kirinyaga Central sub-county in Kirinyaga County, Kenya. The study adopted a randomized control study design with a sample size of 206 women aged between 25- 69 years were proportionately distributed in in the 4 wards. Respondents were randomized into control and intervention arms. Both qualitative and quantitative data was collected. Analysis was done using, thematic content for qualitative data; descriptive statistics was used to summarize categorical variables. Bivariate analysis using the Fisher exact and Chi-square was also applied. Factors with a p<0.05 were further analyzed in multivariate analysis. Respondents who had a high perception of being susceptible to cervical cancer were 4.26 times most likely to attend cervical cancer screening than those who did not. Respondents who had a high perception of cervical cancer being a serious disease were 3.46 times more likely to adhere to cervical cancer screening compared to those who did not. This study recommends to the management of Kirinyaga County and Kerugoya County Referral Hospital to provide health education through provider initiated calls through the mobile phone technology with the aim of bringing positive perception on importance of cervical cancer screening.

The Impact of Health Promotion Interventions on Telomere Length: A Systematic Review.

The aim of this study was to evaluate the effectiveness of health promotion interventions in delaying telomere shortening (a biomarker for aging). PubMed, PsychINFO, EMBASE, CINAHL, and Cochrane Library databases. Inclusion criteria: (1) empirical studies involving human subjects; (2) health promotion intervention studies including both randomized control trials (RCTs) and non-RCTs.; (3) measured telomere length as an intervention outcome; and (4) were written in English. Exclusion criteria: (1) observational studies without any health promotion intervention practices and (2) did not report intervention effects. Data extraction was performed by two reviewers following the preferred reporting items for systematic reviews and meta-analysis guidelines. Substantial heterogeneity in intervention type and study design in the included studies precluded a meta-analysis. We conducted a narrative synthesis instead. Thirty studies were included in the review, of which 16 were RCTs. One-third of the included studies reported significant intervention impacts in delaying telomere shortening, with relatively consistent significant results emerged from weight-loss interventions and interventions involving multiple lifestyle modification components (eg, diet and exercise). Most of supplement intervention studies observed null effects in telomere length. Weight-loss and comprehensive lifestyle intervention strategies show encouraging impacts in delaying telomere shortening. More rigorous studies targeting populations at different age stages through life span are needed.

Impact of Health Promotion Interventions on Early Childhood Caries Prevention in Children Aged 2-5 Years Receiving Dental Treatment Under General Anesthesia.

Aim: This study was conducted to evaluate the impact of health promotion interventions on early childhood caries prevention in 2–5 year-olds receiving dental treatment under general anesthesia.Materials and Methods: Thirty-seven mother-child couples presenting to the clinic of the Dental School of Tehran University of Medical Sciences for treatment under general anesthesia were randomly divided to two groups: 19 couples in the pamphlet and fluoride varnish four times a year, and 18 couples in the pamphlet plus six phone call reminders and fluoride varnish four times a year. A standard questionnaire on demographics and children oral health-related practice of parents was completed by respondents. On children's oral examination, the Simplified Oral Hygiene Index (OHI-S), dmft, and the presence of new white spot lesions (WS) were recorded in both phases. At the final stage, Early Childhood Oral Health Impact Scale (ECOHIS) was completed by parents. The length of follow-up was 24 months.Results: In both groups, there was an increase in the number of mothers who knew how to brush their children's teeth as well as the number of mothers who brushed their children's teeth (P < 0.05). In the reminder group, an improvement occurred in the mothers' perception of their perceived ability to make their children brush their teeth twice a day (P = 0.03). Clinical examination revealed a significant decrease in the OHI-S (from 1.9 ± 0.8 to 1.15 ± 0.5) and the number of WS (from 8.5 ± 5.5 to 0.08 ± 0.5) in both groups on the follow-up visit. The mean dmft was 11.0 ± 4.0 with a mean d component of 10.56 ± 4 at the baseline, which decreased significantly to 1.44 ± 1.96 after dental treatment. No significant increase was seen in new caries in the intervention groups. There was no significant difference in the ECOHIS score between the two groups.Conclusion: The similar impact of both interventions suggests the possibility of applying the simpler one, i.e., the educational pamphlet, fluoride varnish and frequent follow-ups. However, in the reminder group, the mothers' perception of their perceived ability to make children brush their teeth twice a day was improved.

Reducing social isolation and loneliness in older people: a systematic review protocol

IntroductionSocial isolation and loneliness affect approximately one-third to one-half of the elderly population and have a negative impact on their physical and mental health. Group-based interventions where facilitators are well...

Improving workers’ health in project-based work: job security considerations

Purpose – The purpose of this paper is to investigate the impact of health promotion interventions in Queensland, Australia. During the research period, the workers’ employing organization, a large contracting organization, was engaged in a competitive tender to renew their service contract. The research therefore provided an opportunity to examine the impact of health promotion interventions in project-based work environments under conditions of job insecurity. Design/methodology/approach – The sample comprised of workers contracted to provide facility maintenance and management services for a power station. Data were collected using a longitudinal survey of workers’ health, weekly logs recording health behaviour, and a post-intervention evaluation workshop. Health interventions implemented sought to encourage workers to eat more fruit and participate in a physical exercise programme. Findings – Findings revealed that workers’ health was generally lower than the Queensland male population when measured using a standardized norm-based tool. The log data revealed that health behaviour fluctuated over time but did not show significant or sustained improvement with the introduction of the health interventions. The evaluation workshop revealed that workers’ concerns about their job security during the research period impacted their health behaviours. Originality/value – The need to address the structural and organizational factors that influence the health of project-based workers is highlighted. In particular, concerns about continuity of work may otherwise reduce the beneficial effect of health promotion programmes.

Process evaluation of a multifaceted health program aiming to improve physical activity levels and dietary patterns among construction workers.

To evaluate the process of a health promotion program, aiming to improve physical activity levels and diet among construction workers. The process evaluation was conducted after the RE-AIM framework for the evaluation of the public health impact of health promotion interventions. Effectiveness was assessed on motivational stage-of-change, self-efficacy, and decisional balance for physical activity and dietary behavior. The external validity of the trial was satisfactory with representative reach of workers and adoption of workplace units in the participating construction company. The extent to which the program was implemented as intended was modest. The intervention was effective on participants' progress through stages of behavior change. Based on the RE-AIM dimensions, it is concluded that for construction workers, the program is feasible and potentially effective, but adjustments are required before widespread implementation.

Applying the RE-AIM framework to assess the public health impact of policy change

Planning and evaluation models have been developed to assess the public health impact of health promotion interventions. However, few have been applied to health policies. There is an important need for models to help design and evaluate health policies. This article applies the RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) planning and evaluation framework to health policies. We provide definitions and application examples for different policies. As demonstrated by a case study, the RE-AIM dimensions and definitions can also apply to policies. Considerations regarding compliance and enforcement are presented to clarify the complex implementation dimension. The RE-AIM framework can be useful in estimating public health impact, comparing different health policies, planning policies designed for increased likelihood of success, and identifying areas for integration of policies with other health promotion strategies.

Using epidemiological models to estimate the health effects of diet behaviour change: the example of tailored fruit and vegetable promotion

To explore the use of epidemiological modelling for the estimation of health effects of behaviour change interventions, using the example of computer-tailored nutrition education aimed at fruit and vegetable consumption in The Netherlands. The effects of the intervention on changes in consumption were obtained from an earlier evaluation study. The effect on health outcomes was estimated using an epidemiological multi-state life table model. Input data for the model consisted of relative risk estimates for cardiovascular disease and cancers, data on disease occurrence and mortality, and survey data on the consumption of fruits and vegetables. If the computer-tailored nutrition education reached the entire adult population and the effects were sustained, it could result in a mortality decrease of 0.4 to 0.7% and save 72 to 115 life-years per 100,000 persons aged 25 years or older. Healthy life expectancy is estimated to increase by 32.7 days for men and 25.3 days for women. The true effect is likely to lie between this theoretical maximum and zero effect, depending mostly on durability of behaviour change and reach of the intervention. Epidemiological models can be used to estimate the health impact of health promotion interventions.

Process evaluations of the 5-a-day projects.

Process evaluation is an important, but infrequently conducted, component of evaluating the impact of health promotion interventions. The process evaluation results from the nine 5-a-Day projects were overviewed. Process evaluation helped explain some of the weaker aspects of program performance, process indicators occasionally declined over time and varied by demographic characteristics, and some process measures were related to mediating variables and program outcomes. Future development of process evaluation must include further development of concepts, more consistent and thorough conduct of process evaluation, appropriate methodological work, and assessment of the relations among the process evaluation components and the program mediators and outcomes. Further development in this area promises refinement in understanding how and why interventions achieve their effects, how best to conduct intervention programs to maximize effects, and enhancement of the internal and external validity of the studies.

Evaluating the public health impact of health promotion interventions: the RE-AIM framework.

Progress in public health and community-based interventions has been hampered by the lack of a comprehensive evaluation framework appropriate to such programs. Multilevel interventions that incorporate policy, environmental, and individual components should be evaluated with measurements suited to their settings, goals, and purpose. In this commentary, the authors propose a model (termed the RE-AIM model) for evaluating public health interventions that assesses 5 dimensions: reach, efficacy, adoption, implementation, and maintenance. These dimensions occur at multiple levels (e.g., individual, clinic or organization, community) and interact to determine the public health or population-based impact of a program or policy. The authors discuss issues in evaluating each of these dimensions and combining them to determine overall public health impact. Failure to adequately evaluate programs on all 5 dimensions can lead to a waste of resources, discontinuities between stages of research, and failure to improve public health to the limits of our capacity. The authors summarize strengths and limitations of the RE-AIM model and recommend areas for future research and application.

Health promotion and older people: a qualitative study of general practitioners' views.

To explore general practitioners' (GPs') beliefs about health promotion for older people and attitudes towards educational strategies likely to improve practice in this area. Four discussion groups, each lasting one and a half hours, completed in Melbourne, Australia in August and September 1995. Interviews were transcribed verbatim and analysed for major themes. A convenience sample of 20 GPs took part; 11 university affiliates, four participant contacts and five GPs from telephone book listings. GPs' perceptions of their health promotion practice varied from "integrated into all medical care", to "something separate from usual practice". Positive views of older people contrasted with ageist views, with a few GPs expressing a nihilistic approach to medical care of older people. Regardless of the GPs' attitudes, lack of time and reimbursement disincentives were perceived to limit preventive practice and the potential impact of health promotion interventions. GPs felt overwhelmed with their workloads, and initial reactions to the idea of any "new" program were negative. Reactions to educational strategies varied, with choice and relevance to ease of practice being important for GP participation. GPs differ in their views of health promotion and in their approaches to its delivery for older people. Educational programs are often viewed negatively, but if they offer the opportunity to save time, increased participation may be more likely.

The Effectiveness and Efficiency of Health Promotion in Specialty Clinic Care

Chronic illnesses make up the majority of health problems in North America. Many chronically ill persons adjust over time to their illnesses; however, there remains a small but important group of those less adjusted, who are concentrated in specialty clinics and are high users of health care resources. This randomized clinical trial investigated the impact of health promotion interventions in the form of problem-solving counseling or phone support that augmented conventional clinic medical care. Chronically ill, poorly adjusted outpatients (n = 293) attending clinics were randomly assigned to receive additional problem-solving counseling, phone call support, or neither. Psychosocial adjustment to illness, utilization, and expenditures of health services were the main outcomes measured. There were no overall significant differences between groups in their change in psychosocial adjustment and expenditures for health and social care. However, interaction analyses (P < 0.05) gave an indication of who might benefit from these interventions. Those who lived alone and infrequently used problem-solving behaviors to cope with their illness significantly improved their adjustment to illness and had fewer health service expenditures if they received problem-solving counseling. Supportive telephone calls were most effective for those who lived with someone and frequently used problem-solving coping behaviors. These findings suggest that health promotion services should be targeted to outpatients described by specific social support and coping characteristics.