Implementation Of Health Promotion Programs Research Articles

Facilitators for the development and implementation of health promoting policy and programs - a scoping review at the local community level.

BackgroundHealth promotion, with a focus on multidimensional upstream factors and an ecological, life-course approach, is establishing itself as the guiding philosophy for addressing public health. Action at the political and programmatic level on the Social Determinants of Health has proven effective for promoting and building public health at all levels but has been particularly evident at the national and international levels – due in large part to available documents and guidelines. Although research and experience establish that health promotion is most effective when settings-based, the development of health promoting policies and programs at the local level is still difficult. This study intended to investigate available knowledge on the development and implementation of health promoting policies and programs at the local level and identify factors most important for facilitating capacity building and outcome achievement.MethodsWe used a scoping review in order to review the current literature on local policy development and program implementation. Keywords were chosen based on results of a previous literature review. A total of 53 articles were divided into two categories: policy and implementation. Critical analysis was conducted for each article and a summary assembled. Data was charted with specific focus on the aims of the study, data acquisition, key theories/concepts/frameworks used, outcome measures, results, and conclusions.ResultsThe articles included in this study primarily focused on discussing factors that facilitate the development of health promoting policy and the implementation of health promotion programs. Most significant facilitators included: collaborative decision-making, agreement of objectives and goals, local planning and action, effective leadership, building and maintaining trust, availability of resources, a dynamic approach, a realistic time-frame, and trained and knowledgeable staff. Within each of these important facilitating factors, various elements supporting implementation were discussed and highlighted in this study.ConclusionOur results indicate that clear and consistent facilitators exist for supporting health promoting policy development and program implementation at the local level. These results offer a starting point for local action on the Social Determinants of Health and have the potential to contribute to the development of a framework for improving action at the local level.

How a Population Health Approach Improves Health and Reduces Disparities: The Case of Head Start.

How a Population Health Approach Improves Health and Reduces Disparities: The Case of Head Start.

Digital technologies to generate health awareness

Digital technologies to generate health awareness

Implementing health promotion programmes in schools: a realist systematic review of research and experience in the United Kingdom.

BackgroundSchools have long been viewed as a good setting in which to encourage healthy lifestyles amongst children, and schools in many countries aspire to more comprehensive, integrated approaches to health promotion. Recent reviews have identified evidence of the effects of school health promotion on children’s and young people’s health. However, understanding of how such programmes can be implemented in schools is more limited.MethodsWe conducted a realist review to identify the conditions and actions which lead to the successful implementation of health promotion programmes in schools. We used the international literature to develop programme theories which were then tested using evaluations of school health promotion programmes conducted in the United Kingdom (UK). Iterative searching and screening was conducted to identify sources and clear criteria applied for appraisal of included sources. A review advisory group comprising educational and public health practitioners, commissioners, and academics was established at the outset.ResultsIn consultation with the review advisory group, we developed four programme theories (preparing for implementation, initial implementation, embedding into routine practice, adaptation and evolution); these were then refined using the UK evaluations in the review. This enabled us to identify transferable mechanisms and enabling and constraining contexts and investigate how the operation of mechanisms differed in different contexts. We also identified steps that should be taken at a senior level in relation to preparing for implementation (which revolved around negotiation about programme delivery) and initial implementation (which centred on facilitation, support, and reciprocity—the latter for both programme deliverers and pupils). However, the depth and rigour of evidence concerning embedding into routine practice and adaptation and evolution was limited.ConclusionsOur findings provide guidance for the design, implementation, and evaluation of health promotion in schools and identify the areas where further research is needed.Electronic supplementary materialThe online version of this article (doi:10.1186/s13012-015-0338-6) contains supplementary material, which is available to authorized users.

Health behaviour of miners.

What significantly affects the health of an individual health behaviour. It is of particular importance in the case of people working in very harsh environmental conditions. The aim of this study is to examine health behaviour among miners. The research data was collected with the use of the diagnostic survey method based on the Health Behaviour Inventory questionnaire developed by Juczyński. Two hundred coal miners were surveyed. The results obtained were subjected to a statistical analysis. A significance level of p < 0.05 was assumed, which indicates the occurrence of statistically significant differences or relations. The level of health behaviour among miners may be determined as medium and low. The research group obtained the best results with regard to their mental attitude, while their preventive behaviour received the worst evaluation. The research confirms the necessity of implementing health promotion programmes among miners, which would be focusing particularly on health behaviour.

Factors Facilitating the Implementation of Church-Based Heart Health Promotion Programs for Older Adults: A Qualitative Study Guided by the Precede-Proceed Model.

To describe the factors facilitating the implementation of heart health promotion programs for older adults in Anglican, United, and Catholic churches. The study used qualitative methods comprising semistructured interviews and focus groups. The interviews and focus groups were conducted in Anglican, Catholic, and United churches located in the Canadian cities of Toronto and Hamilton, Ontario. Twelve ordained pastors and 21 older parishioners who attended church regularly and who had no health conditions were recruited to best explain how churches could be suitable locations for health promotion activities targeting older adults. Twelve semistructured interviews with the pastors and three focus groups with the 21 parishioners were undertaken. A component of the Precede-Proceed model (a model for planning health education and health promotion programs and policies) was applied to the findings after direct content analysis of the data. Participants identified pastor leadership, funding for a parish nurse, community-focused interventions, secured infrastructure, and social support from congregation members as pertinent factors required for implementing health promotion programs in Anglican, United, and Catholic churches. The findings have particular relevance for health promotion and public health because they suggest factors that would be necessary to design church-based heart health promotion programs for older adults at risk of chronic diseases.

Workers of CEASA: factors associated with fatigue and work ability.

to investigate the socio-demographic characteristics, lifestyle and health conditions related to fatigue and the work ability. a cross-sectional study was conducted in 2011 and the sample was composed by 90 workers from the supply center of Campinas. Three questionnaires were used: Fatigue; Work ability index; and socio-demographic characteristics. in the univariate regression analysis, the variables associated with work ability were: education, use of medicine, stress, pain in the last six months and pain in the last week. In univariate regression analysis the variables associated with fatigue were: education, stress, sleepiness, pain in the last six months, pain in the last week and health problems. these results indicate the need for health promotion program implementation among these workers.

Sustainable Implementation of Evidence-Based Programmes in Health Promotion: A Theoretical Framework and Concept of Interactive Knowledge to Action

This article discusses 2 current issues in the field of public health research: (i) transfer of scientific knowledge into practice and (ii) sustainable implementation of good practice projects. It also supports integration of scientific and practice-based evidence production. Furthermore, it supports utilisation of interactive models that transcend deductive approaches to the process of knowledge transfer. Existing theoretical approaches, pilot studies and thoughtful conceptual considerations are incorporated into a framework showing the interplay of science, politics and prevention practice, which fosters a more sustainable implementation of health promotion programmes. The framework depicts 4 key processes of interaction between science and prevention practice: interactive knowledge to action, capacity building, programme adaptation and adaptation of the implementation context. Ensuring sustainability of health promotion programmes requires a concentrated process of integrating scientific and practice-based evidence production in the context of implementation. Central to the integration process is the approach of interactive knowledge to action, which especially benefits from capacity building processes that facilitate participation and systematic interaction between relevant stakeholders. Intense cooperation also induces a dynamic interaction between multiple actors and components such as health promotion programmes, target groups, relevant organisations and social, cultural and political contexts. The reciprocal adaptation of programmes and key components of the implementation context can foster effectiveness and sustainability of programmes. Sustainable implementation of evidence-based health promotion programmes requires alternatives to recent deductive models of knowledge transfer. Interactive approaches prove to be promising alternatives. Simultaneously, they change the responsibilities of science, policy and public health practice. Existing boundaries within disciplines and sectors are overcome by arranging transdisciplinary teams as well as by developing common agendas and procedures. Such approaches also require adaptations of the structure of research projects such as extending the length of funding.

Knowledge on Health Promotion Approach among Public Health Midwives in a District in Sri Lanka

Background The Ottawa Charter defines Health Promotion as the ‘process of enabling people to increase control over, and to improve, their health’. The National Health Promotion Policy recognizes health promotion as an efficient and cost effective approach to promote health in Sri Lanka. The Public Health Midwife (PHM) is the grass root level health worker responsible for promoting the health of communities in Sri Lanka. Their knowledge regarding health promotion has not been assessed. The main aim of this study was to describe their knowledge on health promotion and associated factors. Methods A cross sectional descriptive study was conducted among all PHMM (N=364) in the Kandy District who were eligible, using a self-administered questionnaire. Level of knowledge was based on scores obtained for responses to close ended questions and case scenarios. Results Knowledge on health promotion was ‘poor’ among 238 (65.4%). Incorrect labeling of other activities as activities using a health promotion approach was common 257(70.6%). Training programmes 285(73.9%) were the commonest source of knowledge while 95(26%) were never trained on health promotion approach during their career. The factors that were significantly associated with a level of ‘good’ knowledge on health promotion in multivariate analysis were; experience in the public health field less than 20 years (p=0.012), participating in training programmes on health promotion (p=0.03) and experience in implementing health promotion programmes (p=0.04).

The CDC Healthy Aging Research Network: Advancing Science toward Action and Policy for the Evidence-Based Health Promotion Movement.

Despite recent progress in the uptake of evidence-based health promotion (EBHP) programs within communities, many factors contribute to the need to focus on dissemination. These include the growth in the aging population, health care resource limitations, and interests in preserving community-based opportunities for maintaining independence and maximizing quality of life. For these reasons, The Prevention Research Centers’ Healthy Aging Research Network (HAN), funded by the Centers for Disease Control and Prevention’s (CDC’s) Healthy Aging Program, has as its core mission, to translate effective healthy aging interventions into sustainable community-based programs. Researchers and community-based stakeholders collaborate across HAN’s seven member center and two affiliate universities (Figure ​(Figure1)1) to develop and implement health promotion programs for older adults at individual, organizational, environmental, and policy levels (1–3). This commentary highlights selected HAN contributions to the EBHP movement from 2001 to 2014. These contributions serve as examples of potential models for future partnership efforts to enhance implementation, dissemination, and sustainability of EBHP programs. Figure 1 CDC Healthy Aging Research Network (HAN) member centers and affiliates (FY 2009-2014).

Challenges to establishing successful partnerships in community health promotion programs: local experiences from the national implementation of healthy eating activity and lifestyle (HEAL™) program.

Community-based programs to address physical activity and diet are seen as a valuable strategy to reduce risk factors for chronic disease. Community partnerships are important for successful local implementation of these programs but little is published to describe the challenges of developing partnerships to implement health promotion programs. The aim of this study was to explore the experiences and opinions of key stakeholders on the development and maintenance of partnerships during their implementation of the HEAL™ program. Semi-structured interviews with key stakeholders involved in implementation of HEAL™ in four local government areas. The interviews were transcribed verbatim and analysed thematically. Partnerships were vital to the success of the local implementation. Successful partnerships occurred where the program met the needs of the partnering organisation, or could be adapted to do so. Partnerships took time to develop and were often dependent on key people. Partnering with organisations that had a strong influence in the community could strengthen existing relationships and success. In remote areas partnerships took longer to develop because of fewer opportunities to meet face to face and workforce shortages and this has implications for program funding in these areas. Partnerships are important for the successful implementation of community preventive health programs. They take time to develop, are dependent on the needs of the stakeholders and are facilitated by stable leadership. SO WHAT?: An understanding of the role of partnerships in the implementation of community health programs is important to inform several aspects of program delivery, including flexibility in funding arrangements to allow effective and mutually beneficial partnerships to develop before the implementation phase of the program. It is important that policy makers have an understanding of the time it takes for partnerships to develop and to take this into consideration when programs are funded and implemented in the community.

Motives for the implementation of health promotion programmes in schools

Hintergrund Schulische Gesundheitsforderung hat zum Ziel, die am Schulleben beteiligten Personen in einem gesunden Lebensstil zu unterstutzen. Die Beweggrunde der wichtigsten Akteure hinsichtlich der Entscheidung fur Gesundheitsforderung in Schulen sollen – als ein forderlicher Faktor fur deren Gelingen – untersucht werden.

Screening for noncommunicable disease risk factors at a workplace in India: A physiotherapy initiative in a healthcare setting

Abstract Background Noncommunicable diseases (NCDs) account for two-thirds of all deaths globally. Physiotherapists have the requisite expertise to initiate and lead NCD risk factor screening and prevention programmes. The workplace can provide an ideal setting for physiotherapists to screen for risk factors and implement prevention programmes. Objective This study was designed to identify the common modifiable risk factors for NCD among employees of a healthcare institution. Methods A cross-sectional study of NCD risk factors was conducted in a large healthcare teaching institution. Employees from four of the seven constituent institutes of the healthcare institution were evaluated using the World Health Organisation STEPS Instrument (Steps I and II). Continuous variables were expressed as mean ± standard deviation. Categorical variables and the prevalence of risk factors were expressed as frequencies and percentages. Results A total of 247 employees (response rate 68.2%) participated in the study. Poor dietary habits, suboptimal blood pressure, and physical inactivity were identified as the most common modifiable NCD risk factors in this population. Conclusion Knowledge of NCD risk factors can be used by physiotherapists to implement health promotion programmes in the workplace as a means of reducing NCD-related economic and social burdens in India.

Worksite health promotion programs in college settings

The purpose of this paper is to describe the multifaceted nature and benefits of worksite health promotion programs (WHPPs), with emphasis on the college setting. An assessment of the peer-reviewed literature was conducted of articles published since 2000. Several search engines were accessed and selected key words were used. Most studies examining WHPPs have focused on return on investment and productivity. Research that targets the softer side-benefits of health promotion programs in the workplace is less available. Although the college setting offers some advantages for implementing health promotion programs. They may also have unique challenges due to their large and diverse employee population. There is little research to show the effectiveness and unique challenges of college-based health promotion programs.

Comparação dos hábitos pessoais e conhecimento basal de promoção de saúde entre alunos do primeiro ano do Curso de Especialização de Medicina do Trabalho (Turma 2011), alunos residentes e internos do quinto ano da Faculdade de Medicina da USP

During the years of the undergraduate medical course little emphasis is given to the importance of health promotion and prevention in the lives of doctors and patients. Typically, the teaching is based on a curative medicine. But, nowadays, the implementing health promotion programs are important to generate significant positive results for society and especially for businesses, employees and the financial market. This study aims to increase the sample size of a monograph made in 2011 and evaluate health promotion knowledge of first year’s students of specialization in Occupational Medicine, correlating it with the knowledge of the second year’s students of specialization in Occupational Medicine of Medicine College of Sao Paulo University, after Health Promotion module, and evaluate their own health habits. We’ll do a literature review from 1997 to 2014 on the topic in the online databases. A cross-sectional study will be done with two questionnaires that had been used in previous studies by Ferreira Junior 2011. Questionnaires are called 1) “Survey of attitudes and behavior” and 2) “Questionnaire of knowledge will be held in promoting health.” Then, statistical analysis will be made with data obtained by questionnaires and through the evaluation of results we’ll conclude the study.

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.

0292 Comparison of personal habits and baseline knowledge of health promotion among students of the Faculdade de Medicina da Universidade de São Paulo

ObjectivesBecause of the importance given to the implementation of health promotion programs nowadays generating positive outcomes important to society and especially to businesses, employees and the financial market this study...

Adolescents’ view of health concept and its risk factors: a literature review

Adolescence is the important period in human life. It is an essential prerequisite for playing social roles. The current study conducted a review on the concept, dimensions, and influential factors on health and risk taking, instruments and measurements of high-risk behaviors, risk factors, and high-risk behavior protective factors through adolescent perspectives. This literature review was conducted by electronic searching and library study on health and adolescents using Wiley Interscience, ScienceDirect, ProQuest, and Springer (1990-2012). The keywords for searching data collection sources included health, youth, young, adolescents, risk behaviors, risk taking, related factors, protective factors, risk factors, adolescent perspectives, quantitative study, qualitative study, measurement, and instrument. This literature review led to the arrangement of subjects in nine general categories titled definition of health concept and its dimensions, adolescents and health in adolescence, risk taking in adolescence and its measuring tools, gender differences in adolescence health and risk taking, adolescents' health and relationships, socioeconomic conditions and health, adolescents and psychiatric health, religion, and health, educational facilities and health, non-governmental organizations and their role in adolescents' health. What has been achieved from a review of these articles is that several personal, social, and family factors are associated with health and risk taking in adolescents. Generally, adolescents cared more about the psychosocial aspects of health than the physical dimensions. They also considered factors such as independence, communication, socioeconomic conditions, mental health, religion, and educational facilities synonymous with the concept of health. Therefore, in formulation and implementation of health promotion programs for adolescents, the concept of health and its various dimensions must be considered from adolescent perspectives.

Evaluation of cardiovascular risk factors among university students in Turkey: a cross-sectional survey

Background — Recent data indicate increasing rates of mortality from cardiovascular (CV) disease in Turkey. This study aimed to evaluate CV disease risk factors among university students in Northern Turkey. Methods — In this cross sectional descriptive study, 302 students were randomly recruited (171 females (57%) and 131 males (43%), mean age of 20±2.1 years). Blood glucose, cholesterol profile (total, high density lipoprotein (HDL) and low density lipoprotein (LDL) cholesterols), triglyceride, glycosylated haemoglobin, resting blood pressure, and body mass index were measured using standard protocols. All participants were asked to complete a questionnaire including questions on lifestyle, genetic predisposition, smoking habit, and psychosocial factors. Results — The mean systolic and diastolic blood pressure of students were 127.1±13.5 mmHg and 78.3±12.4 mmHg. The mean values were 98.4±14.2 mg/dL for fasting blood glucose value, 5.4±0.4 for HbA1C, 80.0±10.3 beats/min for heart rate, for total cholesterol 199.1±24.6 mg/dL, 43.8±9.9 mg/dL for HDL, 114.7±24.1 mg/dL for LDL, 199.1±24.6 mg/dL for trygliceride, 24.8±3.6 kg/m 2 for body mass index, 97.6±17.9 cm for waist circumference. No significant difference was observed between gender according to CV risk factors' values statistically. It was observed that 111 (36.8%) students were overweight, 32 (10.6%) were obes. About 135 (44.0%) of students had abnormally unacceptable WC value. Smoking habit was seen in 130 (43.0%) students (73 (24.2%) male and 57 (18.9%) female). Conclusion — A substantial proportion of Turkish students were overweight or obese, and had smoking habit. Our results underscore the need to implement health promotion programmes and perform large-scale epidemiological studies within the general Turkish young adult population.

On the Front Lines But Not Engaged in the Battle

Physical inactivity and its related health conditions have reached pandemic proportions.1 Because of its greater prevalence, inactivity in the general population now may account for more disease burden and mortality than smoking.2,3 In persons with neurologic health conditions, physical inactivity and its inherent risks are often compounded by physical and/or cognitive impairments that limit balance and mobility. Indeed, the statistics are alarming regarding the extent of inactivity and the sequelae of immobility in persons with neurologic deficits.4–7 In 2005, the US Department of Health and Human Services issued “The Surgeon General's Call to Action to Improve Health and Wellness in Persons with Disabilities.” This call to action challenges health care providers to forge partnerships to provide more effective treatment, better education of future providers, and the implementation of health promotion programs.8,9 Although barriers to implementing such programs certainly exist, the neurologic physical therapy community has been too passive on this issue. Ironically, neurologic physical therapists are on the front lines of the battle to promote physical activity and exercise. Physical therapists are trained to understand that sedentary behavior is not an inevitable consequence of most neurologic conditions.10 Physical therapists are uniquely positioned to intervene at the primary and secondary prevention levels in those living with neurologic conditions.11 Unfortunately, the majority of our care is delivered in response to the onset of disability rather than in an effort to prevent it. Many of our clients are discharged from insurance-reimbursed care and left to fend for themselves in search for health, reduction of disability, and options for physical activity and exercise. Rather than leading the charge to answer the Surgeon General's call, the physical therapy community appears willing to tacitly accept as inevitable the pervasiveness of the sedentary lifestyle due to neurologic dysfunction and its deleterious consequences. Our commitment to these individuals is incomplete unless we directly provide or advocate for access to prevention and wellness care. This special topic issue of the Journal of Neurologic Physical Therapy was designed to illustrate ongoing efforts to raise our standard of prevention and wellness care. Rimmer and Yamamato outline a plan for the prevention of postrehabilitation health decline in acquired neurologic conditions (cerebrovascular accident, traumatic brain injury, or spinal cord injury) through efforts to minimize extrinsic barriers to prevention and wellness programs. To provide an explicit example of the implementation of such a wellness program poststroke, Rose and colleagues outline their partnership with the community in delivering secondary prevention services. Ellis and Motl use Parkinson disease and Multiple Sclerosis as the context for addressing intrinsic barriers to participation, such as self-efficacy and outcomes expectations. As part of this discussion, they outline novel ways of encouraging participation through virtual coaches and online support. Mulligan and colleagues provide an explicit example of partnership with persons with Multiple Sclerosis to deliver interventions designed to minimize barriers to physical activity. The remaining two articles provide explicit examples of clinical application. Rather than focus just on mobility outcomes, in a case series of persons with Parkinson disease, Tabak and colleagues outline the potential cognitive benefits of consistent exercise. Finally, Sasso and colleagues provide an example of the successful application of efficacious interventions to a home program for an individual with a long-standing spinal cord injury. It is our hope that this special topic issue will motivate readers to consider their role in prevention and wellness in neurologic physical therapy. As stated previously, there are substantial barriers to the regular provision of prevention and wellness services to our clients. However, these barriers also represent a spectrum of opportunities for contributing to the solution. Physical therapists should be engaged in determining policy, in community advocacy with stakeholders, and in the provision of resources, infrastructure, and expertise to persons with neurologic disability in the community.11