Implementation Of Health Promotion Activities Research Articles

Qualitative evaluation of a complex intervention to implement health promotion activities according to healthcare attendees and health professionals: EIRA study (phase II)

ObjectiveTo evaluate the implementation and development of a complex intervention on health promotion and changes in health-promoting behaviours in primary healthcare according to healthcare attendees and health professionals.DesignDescriptive qualitative evaluation...

Global epidemiology, risk factors, and histological types of ovarian cancers in Trinidad.

Background:Ovarian cancer is the seventh most common cancer in women in the world and Trinidad and Tobago is ranked 18th in the world with respect to the rate of occurrence. About 68% cases are diagnosed at a late stage, resulting in low survival rates. Since there is very scanty literature available on the epidemiology of ovarian cancer in the Caribbean region, this study was undertaken to assess the most common risk factors, presenting symptoms and common histological varieties in Trinidad.Methods:A hospital-based, cross-sectional study was designed, and all the 23 diagnosed ovarian cancer cases registered during 2015–2017 were considered. Information on sociodemographics, presenting symptoms, and histological type of cancers were collected after getting the ethical approval. Of the total 23 cases, 17 cases were included in this study after ensuring completeness of data as detailed analysis of patient data was done using Microsoft Excel.Results:The common risk factors identified were previous pregnancies, previous surgeries, and irregularities in the menstrual cycle. The commonest histological variety was granulosa tumors and the most common associated symptoms were irregular menses and abdominal pain in premenstrual women, and abdominal distention in postmenopausal women.Conclusions:It would greatly enhance the detection rate if screening and testing for the CA-125 gene were a mandatory practice, for any patient found with more than three risk factors. The public health authorities should identify the modifiable risk factors and implement cancer reduction and health promotion activities to reduce the mortality related to ovarian cancers.

Implementing health promotion activities using community-engaged approaches in Asian American faith-based organizations in New York City and New Jersey.

Faith-based organizations (FBOs) (e.g., churches, mosques, and gurdwaras) can play a vital role in health promotion. The Racial and Ethnic Approaches to Community Health for Asian Americans (REACH FAR) Project is implementing a multi-level and evidence-based health promotion and hypertension (HTN) control program in faith-based organizations serving Asian American (AA) communities (Bangladeshi, Filipino, Korean, Asian Indian) across multiple denominations (Christian, Muslim, and Sikh) in New York/New Jersey (NY/NJ). This paper presents baseline results and describes the cultural adaptation and implementation process of the REACH FAR program across diverse FBOs and religious denominations serving AA subgroups. Working with 12 FBOs, informed by implementation research and guided by a cultural adaptation framework and community-engaged approaches, REACH FAR strategies included (1) implementing healthy food policies for communal meals and (2) delivering a culturally-linguistically adapted HTN management coaching program. Using the Ecological Validity Model (EVM), the program was culturally adapted across congregation and faith settings. Baseline measures include (i) Congregant surveys assessing social norms and diet (n=946), (ii) HTN participant program surveys (n=725), (iii) FBO environmental strategy checklists (n=13), and (iv) community partner in-depth interviews assessing project feasibility (n=5). We describe the adaptation process and baseline assessments of FBOs. In year 1, we reached 3790 (nutritional strategies) and 725 (HTN program) via AA FBO sites. Most AA FBOs lack nutrition policies and present prime opportunities for evidence-based multi-level interventions. REACH FAR presents a promising health promotion implementation program that may result in significant community reach.

Community-Informed Health Promotion to Improve Health Behaviors in Honduras.

Honduras is the second poorest country in Central America. The already high burden of disease is disproportionately worse among individuals with less education and limited access to health care. Community engagement is needed to bridge the gap in health care resources with the need for health promotion and education. Culturally relevant health promotion activities can foster transcultural partnerships. The purpose of this study was to partner nursing students with village leaders to assess a community's health needs and implement health promotion activities in Honduras. Participatory action research was used in the study. U.S. nursing students ( n = 4) partnered with a nonprofit organization and community partners in Villa Soleada to interview mothers in Villa Soleada, a Honduran village of 44 families, and implement health promotion activities targeted to the health priorities of their families. Structured interviews with 24 mothers identified gastrointestinal issues, health care access and quality, and malaria as the top three priorities. Ninety-two percent of respondents were interested in nurse-led health promotion. Activities engaged new community partners. This partnership and learning model was well received and sustainable. The U.S. nurses involved in the partnership gained exposure to Honduran health issues and led locally tailored health promotions in Villa Soleada. The community's response to health promotion were positive and future activities were planned. Nursing student's immersion experiences to support population-based health activities in low-resource settings are a replicable model that can help build healthier communities with a sustainable local infrastructure. Transcultural nursing experiences enhance students' perspectives, increase personal and professional development, strengthen nursing students' critical thinking skills, and for some students, confirm their desire to practice in an international arena.

Economic evaluation of health promotion for older people-methodological problems and challenges.

BackgroundThe support of health promotion activities for older people gains societal relevance in terms of enhancing the health and well-being of older people with a view to the efficient use of financial resources in the healthcare sector. Health economic evaluations have become an important instrument to support decision-making processes in many countries. Sound evidence on the cost-effectiveness of health promotion activities would encourage support for the implementation of health promotion activities for older people. This debate article discusses to what extent economic evaluation techniques are appropriate to support decision makers in the allocation of resources regarding health promotion activities for older people. We address the problem that the economic evaluation of these interventions is hampered by methodological obstacles that limit comparability, e.g. with economic evaluations of curative measures. Our central objective is to describe and discuss the specific problems and challenges entailed in the economic evaluation of health promotion activities especially for older people with regard to their usefulness for informing decision making processes.DiscussionBeyond general problems concerning the economic evaluation of health promotion, our discussion focusses on problems that pertain to the analysis of cost and outcomes of health promotion interventions for older people. With regard to costs these are general problems of economic evaluations, namely the actual implementation of a societal perspective, the appropriate measurement and valuation of informal caregiver time, the measurement and valuation of productivity costs and costs incurred in added years of life. The main problems concerning the identification and measurement of outcomes are related to the identification of outcome parameters that, firstly, adequately reflect the broad effects of health promotion interventions, especially social benefits that gain importance for older people, and secondly, ensure a comparability of effects across different age groups. In particular, the limitations of the widely used QALY for older people are discussed and recently developed alternatives are presented.ConclusionsThe key conclusion of the article is that a comparison of the effects of different health promotion initiatives between different age groups by means of economic evaluation is not recommendable. Taking into account the complex outcomes of health promotion interventions it has to be accepted that the outcomes of these interventions will often not be comparable with clinical interventions and have to be assessed differently.

Effectiveness of district health promotion model (Hoshiarpur Ambala model): An implementation experience from two districts from Northern part of India

Introduction: In India, implementation of Health Promotion activities follows a vertical approach at district level. A Health Promotion project was therefore implemented for 3 years in Hoshiarpur and Ambala districts of Northern India, with objectives to develop, implement, and assess the effectiveness of integrated health promotion model. Materials and Methods: Situation analysis in two districts was followed by a state level stakeholders workshop in which detailed layout of model and a health promotion manual (Hindi, English, and Punjabi) was developed for capacity building of workforce. The effectiveness of model was assessed using mix of quantitative as well as qualitative methods. Results: The key features of model included integration and convergence within National Health Programs, multitasking, multisectoral involvement, and community empowerment, using digital media and advocacy tools. The facility assessment survey revealed improvements in implementation of activities as per annual activity calendar of IEC/BCC activities, better display of IEC material, with improved reporting, monitoring, and supervision. At community level, the awareness levels of the community members regarding communicable/noncommunicable diseases and key Reproductive and Child Health issues improved significantly (P < 0.05). Similarly, the client exit survey showed that dissemination of health information by MO/ANM increased in 3 years from 8% to 80% and 7.3% to 75% in districts Hoshiarpur and Ambala, respectively (P < 0.05). In-depth interview with key stakeholders and focused group discussion with Village Health and Sanitation Committee/Village Level Core Committee has shown their active involvement and improvements in their functioning. Based on indicative costing, per capita costs of National Health Mission for IEC/BCC/Health promotion activities need to be increased from INR 0.7 (USD 0.01) to INR 4 (USD 0.06), which requires increase in budget allocation from 1% to minimum of 4%. Conclusion: Model was found to be effective and feasible on pilot implementation. District level human and financial resources, however, must be augmented to implement health promotion activities effectively.

The School as a setting: Health promotion in schools

UK Moksnes Center for Health Promotion Research, Sor Trondelag University College, Trondheim, Norway Contact: unni.karin.moksnes@hist.no Schools are an important setting for implementing health promotion activities (HPA). Center for Health Promotion Research are developing mental HPA for implementation in secondary high schools in Norway together with school nurses. Mental HPA has often in Norway been to target risk populations like young with depressive thoughts. Our HPAprograms are universal program, targeting the whole student population, and aiming at strengthen the resistance resources by teaching the students how to reveal both resources within themselves, which they have available, and in their environment; peers, teachers, family etc. An important resource is to learn more about the variance within normality, to develop their mental health literacy. To learn that all young goes through phases of mental hardship, and that this is normality. The lecture will focus on the development and content of the mental HPA, the theoretical foundation of and the implementation of the program. 8th European Public Health Conference: Parallel Sessions 81

Expanding a successful community-based obesity prevention approach into new communities: Challenges and achievements

A previously successful community-based obesity prevention intervention with a focus on school settings was expanded into new communities with varying contexts. In order to understand the complexities involved in implementing health promotion activities in schools, this study examined experiences of school staff and project officers including barriers, contextual factors and achievements. School environment assessments were conducted in schools across four Victorian communities with school staff (n=1-5 staff plus a trained researcher per group in 9 primary and 8 secondary schools) 12-18 months post-intervention. Process reports from project officers were also reviewed and analysed (n=4). School staff commonly reported time pressures as a barrier to implementation and project officers working within schools reported competing priorities and limited health promotion experience of staff; lack of stakeholder engagement; low participation in some activities and insufficient implementation time. Contextual factors included community socioeconomic status, student ethnicity and living rurally. Achievements included student and staff enjoyment from programme activities, staff capacity building, partnerships, embedding activities into existing infrastructure and programmes, and having consistent health-related messages repeated through a variety of strategies. Community-based interventions with a focus on school settings need to consider system level, organisational and contextual (i.e. socioeconomic, ethnicity, family and town characteristics) factors when expanding previously effective strategies into new communities. Implementation benefits may have added whole of school benefits in addition to child health. Focussing on overcoming the challenges experienced in this complex initiative is required for future interventions. ACTRN12609000892213.

Employers' paradoxical views about temporary foreign migrant workers' health: a qualitative study in rural farms in southern Ontario.

BackgroundThe province of Ontario hosts nearly a half of Canada’s temporary foreign migrant farm workers (MFWs). Despite the essential role played by MFWs in the economic prosperity of the region, a growing body of research suggests that the workers’ occupational safety and health are substandard, and often neglected by employers. This study thus explores farm owners’ perceptions about MFWs occupational safety and general health, and their attitudes towards health promotion for their employees.MethodsUsing modified grounded theory approach, we collected data through in-depth individual interviews with farm owners employing MFWs in southern Ontario, Canada. Data were analyzed following three steps (open, axial, and selective coding) to identify thematic patterns and relationships. Nine employers or their representatives were interviewed.ResultsFour major overarching categories were identified: employers’ dependence on MFWs; their fragmented view of occupational safety and health; their blurring of the boundaries between the work and personal lives of the MFWs on their farms; and their reluctance to implement health promotion programs. The interaction of these categories suggests the complex social processes through which employers come to hold these paradoxical attitudes towards workers’ safety and health. There is a fundamental contradiction between what employers considered public versus personal. Despite employers’ preference to separate MFWs’ workplace safety from personal health issues, due to the fact that workers live within their employers' property, workers' private life becomes public making their personal health a business-related concern. Farmers’ conflicting views, combined with a lack of support from governing bodies, hold back timely implementation of health promotion activities in the workplace.ConclusionsIn order to address the needs of MFWs in a more integrated manner, an ecological view of health, which includes the social and psychological determinants of health, by employers is necessary. Employers and other stakeholders should work collaboratively to find a common ground, harnessing expertise and resources to develop more community-based approaches. Further research and continuous dialogue are needed.

Worksite Health Promotion and Occupational Physicians: Interventional Effects of Exercises

Results of annual health checkups at workplaces revealed a steady increase in the incidence of cardiovascular risk factors such as dyslipidemia and hypertension in Japan. With the aging of the workforce, the incidence is expected to increase further. These risk factors are modifiable through a lifestyle modification program including mild exercise and nutritional guidance. In 1988, the Japanese government revised the Industrial Safety and Health Law to promote health in the workplace and implemented the Total Health Promotion Plan (THP). However, only 5.0% of workplaces were implementing THP programs according to a survey conducted in 2007. Therefore, we have recommended some measures for worksite health promotion, such as collaboration between community health and occupational health for implementing health promotion activities especially in small and medium scale enterprises, environmental improvement to promote occupational health, and an approach to increase physical activity that includes walking to work and using the stairs. Worksite health promotion should be considered an important company initiative in terms of work-related outcomes such as job satisfaction, work ability, and absenteeism in addition to cardiovascular risk factors.

Health promotion and young prisoners: a European perspective.

The purpose of this paper is to assess the health promotion needs of vulnerable young prisoners and the existing health promotion activities in custodial settings in seven European Union (EU) Member States. The research comprised two components: the first involved identifying existing health promotion practices. The second involved mapping out young offenders' health promotion needs by carrying out a needs assessment. Both quantitative and qualitative methods were adopted. The quantitative element comprised surveys among young prisoners and prison staff and focused on the availability and perceived importance of health promotion activities in prison. The qualitative element comprised focus groups with young offenders and individual interviews with prison staff, field experts and NGO members. The findings from the research have identified a number of similar, but also some diverse areas of unmet need for health promotion activities in prison settings across these diverse seven EU countries. There is no consistency of approach within and between countries regarding health promotion policy, guidance, resources and programmes for young prisoners. In order to improve the health of young prisoners and to establish and increase sustainability of existing health promotion programmes, there is a need for the establishment of National and EU standards. Providing health promotion activities for young prisoners while in custodial settings is key to addressing their unmet health and well-being needs and to facilitate their reintegration back into the community. Despite the barriers identified by this research, health promotion is to some extent being delivered in the partner countries and provides a foundation upon which further implementation of health promotion activities can be built especially when the benefits of health promotion activities, like dealing with the common problems of alcohol and drug addiction, mental health and communicable diseases are linked to successful reintegration.

Health promotion in mental health care: perceptions from patients and mental health nurses

To gain insight into the factors influencing the integration of physical activity and healthy eating into the daily care of individuals with mental disorders (MD) living in sheltered housing and to increase the understanding of the relationships between and complexities of these factors. Growing attention is given to the implementation of health promotion activities in mental health care. By improving the understanding of perceptions of patients and mental health nurses, health promotion programmes targeting physical activity and healthy eating can be developed that better meet the patients' needs. A descriptive qualitative study. Based on a purposive sampling strategy, three focus groups including 17 mental health nurses and individual interviews with 15 patients were conducted. Although physical and mental health benefits of physical activity and healthy eating were identified, several barriers to integrate healthy lifestyles into the daily life of patients were reported. Important barriers identified by the patients consisted of lack of energy and motivation as a result of the MD, side effects of psychotropic drug use, and hospitalisation. Lack of time and personal views and attitudes towards health promotion were reported by the mental health nurses as important elements influencing the way in which they integrate health promotion in the care provided. Support from the mental health nurse was considered important by the patients in changing their unhealthy lifestyle behaviour. The results of the study provide insight into important factors influencing the integration of health promotion activities targeting physical activity and healthy eating in individuals with MD living in sheltered housing. The information derived from this study is useful and relevant in the design and implementation of health promotion interventions targeting physical activity and healthy eating in people with MD living in sheltered housing.

HIA practices in Nigeria

Health impact assessment (HIA) provides useful information on existing health services, their capabilities and the health status of the local communities, which is otherwise often unavailable. In Nigeria, HIA is usually applied to projects and, by exposing existing health inequities in project communities, provides the necessary tool for development proponents to act to provide or improve health services and to implement health promotion activities. Based on HIA experience in Nigeria, this paper highlights the deficiencies in national legislation with regards to HIA/EIA (environmental impact assessment) integration and a number of learning points are discussed. First, a complete health baseline is critical to the understanding of project impacts; analysis must be broad-based, considering existing health determinants. Second, community stakeholders and proponents may modify the implementation of health mitigation measures and should be seen as collaborators in the assessment process. Third, strong HIA recommendations can influence project design. A greater participation of the health sector in EIA is required to enhance HIA utilization.

A comprehensive evaluation of intervention effects on workplace health promotion in a pharmaceutical company

To evaluate the comprehensive workplace health promotion intervention effect in a pharmaceutical company. The evaluation was conducted by using questionnaires, access to information, on-site surveys, satisfaction surveys and interviews. After the intervention, the awareness rate of the staff on "Occupational Disease Prevention Law", occupational disease prevention measures, the definition of hypertension, HIV transmission and high blood pressure, coronary heart disease preventive measures, have been raised from 72.4%, 13.8%, 67.5%, 45.8%, 51.7% to 97.8%, 19.9%, 82.3%, 94.7%, 53.1% respectively. The lifestyle of the staff has been improved, the improvement rate of smoking, drinking, having breakfast 4 times a week and above are 98.5%, 70.2% and 30.6% separately. Out of the 47 evaluation indicators, 41 meet the requirements, 5 basically meet the requirements. After implementing workplace health promotion activities, the level of occupational safety and health management of the pharmaceutical company has been enhanced, the physical and mental health of the staff have been promoted. The WHP comprehensive interventions are feasible and effective.

84 - Effectiveness of three overweight and obesity prevention strategies in high school adolescents: The PRALIMAP trial

| 163 Consortium for School Health was adopted to consider the following domains for HPS activities: social and physical environment, teaching and learning, healthy school policy, and partnerships and services. The rubric, a familiar assessment tool in educational settings, defines HPS best practices at different levels of implementation, and was developed in consultation with local stakeholders. The tool will be administered to all schools in Nova Scotia with Grade 5 students as part of a larger CIHR-funded research project (The Children’s Lifestyle and School Performance Study, CLASS II). A quantitative system will be developed to score schools according to their level of implementation. The findings will highlight the need to consider local policy contexts in the development and administration of tools, to accurately measure implementation of health promotion activities. Results will help advance future tool development and provide insight into what schools need to create a healthy school environment, thereby contributing to childhood obesity prevention.

The Worksite Health Promotion Capacity Instrument (WHPCI): development, validation and approaches for determining companies' levels of health promotion capacity

BackgroundThe Worksite Health Promotion Capacity Instrument (WHPCI) was developed to assess two key factors for effective worksite health promotion: collective willingness and the systematic implementation of health promotion activities in companies. This study evaluates the diagnostic qualities of the WHPCI based on its subscales Health Promotion Willingness and Health Promotion Management, which can be used to place companies into four different categories based on their level of health promotion capacity.MethodsPsychometric evaluation was conducted using exploratory factor and reliability analyses with data taken from a random sample of managers from n = 522 German information and communication technology (ICT) companies. Receiver operating characteristic (ROC) analyses were conducted to determine further diagnostic qualities of the instrument and to establish the cut-off scores used to determine each company's level of health promotion capacity.ResultsThe instrument's subscales, Health Promotion Willingness and Health Promotion Management, are based on one-dimensional constructs, each with very good reliability (Cronbach's alpha = 0.83/0.91). ROC analyses demonstrated satisfactory diagnostic accuracy with an area under the curve (AUC) of 0.76 (SE = 0.021; 95% CI 0.72-0.80) for the Health Promotion Willingness scale and 0.81 (SE = 0.021; 95% CI 0.77-0.86) for the Health Promotion Management scale. A cut-off score with good sensitivity (71%/76%) and specificity (69%/75%) was determined for each scale. Both scales were found to have good predictive power and exhibited good efficiency.ConclusionsOur findings indicate preliminary evidence for the validity and reliability of both subscales of the WHPCI. The goodness of each cut-off score suggests that the scales are appropriate for determining companies' levels of health promotion capacity. Support in implementing (systematic) worksite health promotion can then be tailored to each company's needs based on their current capacity level.

A Worksite Obesity Intervention: Results From a Group-Randomized Trial

We used a participatory process to develop an obesity intervention appropriate for elementary school personnel. A randomized controlled trial included 16 school worksites (8 intervention, 8 control). Intervention schools formed committees to develop and implement health promotion activities for employees. Anthropometric and self-report data were collected at baseline and postintervention (2 years later). The primary outcome measures were body mass index (BMI), waist-hip ratio, physical activity, and fruit and vegetable consumption. After adjustment for age, ethnicity, and job classification, employees in intervention schools reduced their BMI by an average of 0.04 kg/m2, and those in control schools increased their BMI by an average of 0.37 kg/m2. Comparisons for waist-hip ratio, weekly physical activity minutes, and fruit and vegetable consumption were not significant. The participatory process appeared to be an effective means for stimulating change. The intervention may have slowed and perhaps reversed the tendency of adults to gain weight progressively with age.

Financial health promotion in Japan and Mongolia

Introduction Health promotion is becoming a noticeable policy in both developed and developing countries facing a burden of both communicable and noncommunicable diseases. This paper discusses the focus of health promotion policy, financing arrangements and the perspectives of social health insurance to fund health promotion. The population health status in Japan is among the highest in the world despite an increasing incidence of cancer, heart, cardiovascular diseases and diabetes. Communicable diseases such as HIV/ AIDS and new types of influenza also pose threats to public health. In Mongolia, both communicable and noncommunicable diseases are a serious public health concern. Since 1995, cardiovascular diseases, cancer and injuries have been the leading causes of mortality. Tobacco and alcohol consumption, physical inactivity and unhealthy diet are common risk factors for many chronic diseases. Japan In 2000, Japan announced the National Health Promotion Movement in the 21st century, with the shortened name of Healthy Japan 21. This policy aims to encourage all citizens to be healthy and free of disease. It focuses on healthy dietary habits, promotion of physical activities, diagnostic tests and reduction of tobacco use. Traditionally, health promotion is regarded as a useful means to prevent disease and promote health among different social groups. Municipal governments, health centres and urban communities play a major role in implementing health promotion activities. Health promoting leaders have been identified and nominated by community members and trained to conduct health promoting activities in their communities. These include advocacy of healthy lifestyle, behaviour, attitudes, dietary habits, access to health-related information and improvement of health literacy and education at community level. Studies suggest that a community participation approach suited to the socioeconomic setting has been effective in improving health-related behaviour and promoting health in Japan. (1) Mongolia Since 2000, the government of Mongolia has approved 16 public health programmes with health promotion effects such tobacco control, health education, cancer and injury prevention, nutrition, population fitness activities, child and reproductive health. However, strong evidence is not available yet about whether these programmes have been successful in controlling and reducing risky behaviours among the population. Since 2002, there has been an increase in the reporting of unsafe sex practices. There is an increasing trend in tobacco consumption, especially among young people. It is estimated that about 65% of males and 20% of females consume tobacco, which is higher than the respective averages in developing countries. The 2006 STEP survey on the prevalence of noncommunicable disease risk factors estimated that 9 of every 10 people surveyed had at least one risk factor and I in 5 people had three or more risk factors for developing a disease. (2) Currently, the public health programmes in Mongolia are implemented at population level but other country experiences show that the effects of health promotion can be increased through action at the community and individual level. There is an acute lack of funding support for the public health programmes in Mongolia. Although the central government budget is referred to as the main funding source, no specific budgeting tools and guidelines are provided. The 2005 national health accounts estimated that the level of spending on public health services was less than 5% of total health expenditure. (3) Financing promotion schemes In Japan, local governments assumed the main responsibility for financing health promotion. In practice, the availability of local revenues to implement health promotion activities varied among the country's 47 prefectures. Therefore, the financial adjustment policy was implemented in the form of financial assistance from the national to local governments. …

Health-promoting hospitals in Estonia: what are they doing differently?

The health-promoting hospitals (HPH) movement in Estonia was initiated in 1999. This study aimed to compare the implementation of health-promoting and quality-related activities in HPH and those which have not joined the HPH network (non-HPH). In the beginning of 2005, a postal survey was conducted among the top managers of 54 Estonian hospitals. The questionnaire was based on the WHO standards for HPH and on the set of the national quality assurance (QA) requirements for health services. The study demonstrated some significant differences in the uptake of health promotion and QA activities between HPH and non-HPH. For example, regular patient satisfaction studies were conducted in 83% of HPH and 46% of non-HPH (P < 0.03) and 65% of HPH and 46% of non-HPH cooperated with various patient organizations (P < 0.03). Systems for reporting and analysis of complications were implemented in 71% of HPH and 33% of non-HPH (P < 0.03); also, the implementation of various guidelines was more developed in HPH. All HPH have carried out a risk analysis on the workplace and staff job satisfaction studies were conducted in 89% of HPH and 41% non-HPH (P < 0.05). This study indicates that the concepts of HPH and QA are closely related. Making progress in health promotion is accompanied with QA and vice versa. Implementation of health-promoting activities in hospitals will promote the well-being and health of patients and hospital staff, and creates a supportive environment to provide safe and high-quality health services.

Development of the Indicator “Policies to Prevent Childhood Obesity” to Monitor Childrenʼs Health

MAB1-PD-05 Introduction: The prevalence of childhood obesity and overweight is rising significantly with as many as 1 in 4 affected in some European regions. The CEHAPE Regional Priority Goal II aims to reduce the prevalence of overweight and obesity and to decrease the morbidity from lack of adequate physical activity by implementing health promotion activities in accordance with the WHO Global Strategy on Diet, Physical Activity and Health and the WHO Food and Nutrition Action Plan for the European Region for 2000 to 2005. The CEHAPE calls for the development of child-specific indicators to monitor the implementation of policies from this goal. Methods: Developing an indicator to monitor the implementation of policies and activities to prevent and reduce obesity was a priority in the RPGII work package of the ENHIS project coordinated by WHO/EURO Bonn Office. The indicator aims to evaluate a number of policies and actions resulting form the WHO Global Strategy and WHO European Action Plan. Policies and actions were identified by reviewing the mentioned WHO documents, and international experts were consulted on the appropriateness of the policies listed in the indicator. The questionnaire was sent then to participant country officials to undertake a feasibility testing. This testing included questions on the availability of each data element, as well as an evaluation of the usefulness of the indicator on the basis of its perceived understandability and policy relevance. Results: Data availability, understandability, and policy relevance were reported to be high and homogeneous among participating countries. Countries completed the questionnaire demostrating the feasibility and aplicabiltity of the indicator and reported lack of legislation on responsible food advertising and marketing, on minimum physical exercise requirements, and lack of a special administrative structure responsible for implementation of WHO strategies. Conclusions: Despite the limitations of comparisons between composite indexes, this indicator provides crucial information on the implementation of policies and activities recommended by WHO and is needed to evaluate the support given by countries to WHO initiatives. It shows which areas are well implemented and which ones are failing to be implemented. The high scoring obtained should be interpreted as an indication of increased capability, willingness, and commitment by countries. This indicator is under further pilot testing in the framework of ENHIS2 project and will be used to monitor the implementation progress of CEHAPE at the intergovernmental meeting in 2007. Acknowledgments: ENHIS partners, Ingrid Keller (WHO, Geneva), EC DGSanco Grant 2003112.