International Health Promotion Research Articles

A critical review of the reporting of reflexive thematic analysis in Health Promotion International.

Using the concept of methodological congruence-where the different elements of a study 'fit' together-we explore both problematic and good practice in (reflexive) thematic analysis (TA) as reported in Health Promotion International (HPI). Aligning with the importance we place on 'owning your perspectives' we situate this exploration in relation to our understanding of the variation in approaches to TA and qualitative research more broadly. This contextualization is necessary for highlighting why we judge practices to be in/congruent, and to facilitate more knowing congruence in future research. We critically reviewed a 'sample' of 31 papers published in HPI between 2010 and 2023 citing Braun and Clarke as reference for TA. We overview a range of problematic and good features of the use of TA in HPI, before focusing on two domains that seemed to present key challenges: theory and themes. Methodological incongruence can occur when postpositivist values and practices unwittingly creep into ostensibly non-positivist TA; we encourage thoughtfully and what we term 'knowing' consideration of theory, and quality practices and criteria. Methodological incongruence can also occur through mismatched conceptualizations of themes-notably, the use of 'topic summaries' as themes for reflexive TA (and fragmented thematic structures with 'thin' themes). We provide examples from the reviewed papers to demonstrate good practice in researcher reflexivity, articulation of theoretical and methodological frameworks and congruent themes. However, mindful of power dynamics, we only discuss problematic practice in general terms, to protect author anonymity. To facilitate thoughtful, quality TA-of all kinds-we provide eight pointers for researchers (and reviewers) to guide quality practice, and facilitate the use of concepts, procedures and criteria that promote knowing methodological congruence.

Second Wind: Understanding How Academics from the Philippines Adjust to Retirement

Second Wind: Understanding How Academics from the Philippines Adjust to Retirement

Socially active neighborhoods: construct operationalization for aging in place, health promotion and psychometric testing.

From the year 2003 when the first walkability scale was published to date, person-environment fit models and empirical research, some of which was published in Health Promotion International, have encapsulated healthy communities in 'neighborhood walkability'. While there is no doubt that neighborhood walkability positively influences health-seeking behaviors and health, recent models suggest that their measurement and conceptualization have not emphasized the role played by psychosocial and personal factors in aging in place. Thus, the development of scales measuring human ecosystem factors has not recognized all critical factors suited for older adults. In this paper, we aim to draw on relevant literature to frame a more holistic construct, hereby referred to as Socially Active Neighborhoods (SAN), that would better support aging in place in older populations. Through a narrative review based on a systematic search of the literature, we define the scope of SAN and delineate some contextual implications for gerontology, health promotion and psychometric testing. SAN, unlike neighborhood walkability in its current measurement and conceptualization, incorporates critical theory-informed psychosocial factors (i.e. safety and disability friendliness of neighborhood infrastructure) that can encourage older adults with physiological and cognitive limitations to maintain physical and social activities as well as health in later life. The SAN is the result of our adaptation of key person-environment models, including the Context Dynamics in Aging (CODA) framework, that recognizes the role of context in healthy aging.

Persian Translation and Determining the Validity of 2020 Standards for Health-Promoting Hospitals and Health Services Affiliated with the World Health Organization.

Since the establishment of the International Health Promotion Hospitals (HPH) in 2006, standards have been designed to evaluate this network. Based on the request of the General Assembly of HPH, the new standards have been revised in 2020 to be in harmony with the new global strategy of HPH for the years 2021-2025. The present study was conducted to translate the original version of the self-evaluation form of HPH and to determine its validity and reliability in Iranian society. The standard process of forward and backward translation was followed after that to determine the face validity of the Persian version of HPH standards, fifteen experts from ten hospitals in five major cities in Iran (Tehran, Mashhad, Isfahan, Shiraz and Hamadan) gave their opinions about 86 standard statements based on a five-point Likert scale, and the impact score was calculated. For determining content validity, both the content validity ratio (CVR) and content validity index (CVI) were used. All 86 standard statements of the five main standards had an impact score higher than 1.5. Also, regarding CVR, all 86 standard statements had a score higher than 0.49 (the minimum plausible score based on Lawshe's table). Finally, after calculating the CVI, all the standard statements had a CVI higher than 0.8, which indicated a very good content validity index for all the items. According to the results of this study, the Persian form of the 2020 HPH standards is valid enough to be used in Iranian hospitals and health services.

Sustainable practices of selected publiclylisted higher educational institutions in ensuring good health and well-being

Sustainable practices of selected publiclylisted higher educational institutions in ensuring good health and well-being

Retrospective analysis of the Special Olympics Health Promotion database for nutrition-specific variables

BackgroundStudies have shown that individuals with intellectual disabilities (ID) exhibit a high prevalence of obesity and poor-quality diet. The population of individuals with ID include athletes that participate in Special Olympics. AimIn order to develop appropriate educational programs for the Special Olympics Athletes in Connecticut, a baseline of the various health and nutrition variables needed to be established by examining the existing data in the Special Olympics International's Health Promotion database. MethodsA retrospective analysis was performed using data from the Special Olympics International (SOI) Health Promotion database. The study population included athletes at least 20 years of age (n = 47,932) and divided into sub-groups of non-USA, USA and Connecticut (CT). The data was provided by SOI to the research team in a de-identified form covering the time frame of 2014–2019. The existing data was originally collected by trained SO volunteers and included age, height, weight, bone mineral density (BMD), blood pressure (BP) variables and a health habits questionnaire. In addition to basic descriptive statistics, analysis was performed using Chi Squared Analysis and ANOVA with post-hoc. A significance level of p value ≤ 0.05 was used for all analyses. ResultsResults show a high prevalence of obesity, high blood pressure, low bone mineral density and a poor-quality diet across all groups. CT athletes were older and had a more even distribution by gender compared to the non-USA and USA groups. CT athletes had a high prevalence of obesity, HTN, and low BMD, as well as, a poor quality diet reflected by high frequency of consumption of sweetened beverages, fast food and snack food. CT athletes also did not consume the recommended daily servings of calcium containing foods or fruits and vegetables. ConclusionThis data will be used to develop educational programs that will help to improve the overall health of Special Olympics Athletes in Connecticut.

A bibliometric analysis of Health Promotion International content regarding unions, unionization and collective agreements

A recent article brought together the health benefits of unionization and working under collective agreements. It was noted how Canadian health promotion texts, reports and statements made no mention of unionization and working under collective agreements as promoting health. This was seen as a significant omission and reasons for this were considered. In this article this analysis is extended to consider how contributors to the flagship health promotion journal Health Promotion International (HPI) conceptualize unions, unionization and working under collective agreements as promoting health. Of 2443 articles published in HPI since its inception, 87 or 3.6% make mention of unions, unionization, collective agreements or collective bargaining, with most saying little about their promoting health. Instead, 20 make cursory references to unions or merely see them as providing support and engagement opportunities for individuals. Forty-five depict unions or union members as involved in a health promotion programme or activity carried out by the authors or by government agencies. Only 33 articles explicitly mention unions, unionization or collective agreements as potentially health promoting, representing 1.3% of total HPI content since 1986. We conclude that the health promoting possibilities of unionization and working under collective agreements is a neglected area amongst HPI contributors. Reasons for this are explored and an Organisation for Economic Cooperation and Development report on the importance of collective bargaining is drawn upon to identify areas for health promotion research and action.

유럽건강도시 발전과 국내적 함의

Objectives: To learn how sustainable health promotion was performed in European Healthy Cities based on relevant experiences during the 30 years and to identify relevant implications for Healthy Cities in Korea. Methods: This is a literature review of relevant studies found on Google Scholar (as of September 10, 2020), Research Information Sharing Service (as of September 20, 2020), European Healthy Cities Network (as of August 30, 2020). Health Promotion International (as of September 1, 2020) and Korea Healthy Cities Partnerships (as of September 20, 2020), via snowball sampling. Key words included “healthy cities”, “Korea”, and “European Healthy Cities Network”. Results: The European Healthy Cities Network has been the central vehicle for Health for All goal at the local level. Historically, the European Healthy Cities have helped establish the appropriate key focus, concepts, philosophy, and strategies for health promotion through quality improvement for accreditation and building a strong network. Conclusion: An adequately working mechanism for quality improvement in the Korea Healthy Cities Partnerships would guarantee the maturation of Healthy Cities in Korea. Therefore, now seems to be an appropriate time for tapping into the multilayer Healthy Cities network of WHO as well as the central and local governments.

Understanding Parental Health Literacy for Clean and Healthy Behavior in Early Childhood During the Covid-19 Pandemic

In the COVID-19 pandemic scenario, parents need to be familiar with health literacy by applying clean and healthy living habits to their family members, especially those with early childhood. This study aims to explain parents' perceptions of health literacy for a clean and healthy behavior in their children during the COVID-19 pandemic. The method used in this study is a cross-sectional study involving 22 men and 62 female respondents. Respondent requirements were used in data analysis to determine parents' perceptions of health literacy and the efforts they have made to practice clean and healthy lifestyle in their children. The research findings show that knowing the health awareness of parents has an impact on a child's balanced lifestyle. Based on six measures of clean and healthy behavior for children, three indicators were determined in the category of discipline and high discipline: using clean water, using the toilet, and doing physical activity. The act of washing children's hands with soap indicators has a high discipline score and the use of masks in children has low discipline. If the use of masks is not disciplined by parents, exposure to COVID-19 in early childhood can be disrupted.
 Keywords: Early Childhood, Parental health literacy, Clean and healthy behaviors

Pedagogical practices in health promotion: health-related bodily practices for adults and older people

ABSTRACT Background: It is well established in the literature how exercise prevents chronic diseases. Nevertheless, we still lack knowledge about the ways in which health-related bodily practices might contribute to health promotion. Less is known about pedagogies in public health directed at adult and older-age groups, within non-formal educational settings. Considering a lack of tailored and attractive approaches to health-related bodily practices for adults and older people [Pettigrew et al. 2019. “Encouraging Older People to Engage in Resistance Training: A Multi-Stakeholder Perspective.” Ageing & Society 39 (8): 1806–1825; Van Dyck, D., L. Mertens, G. Cardon, K. De Cocker, and I. De Bourdeaudhuij. 2017. “Opinions Toward PhysicalActivity, Sedentary Behavior, and Interventions to Stimulate Active Living During Early Retirement: Qualitative Study in Recently Retired Adults.” Journal of Aging and Physical Activity 25 (2): 277–286], we argue that there is a need to explore pedagogical practices that might further health promotion with this target group. Purpose: Drawing on Antonovsky’s theory of salutogenesis [1996. “The Salutogenic Model as a Theory to Guide Health Promotion.” Health Promotion International 11 (1): 11–18], the purpose of the study was to investigate how health and physical education (HPE) professionals delivered health-related bodily practices for adults and older people in community-based programmes. Data collection and analysis: A qualitative and grounded theory study design was employed. Participants included six HPE professionals, three health centre coordinators and thirty-four adults and older people enrolled in four community-based programmes from Brazil. Condensed fieldwork was adopted to generate data through three-days visits to each programme. Multiple data sources comprised semi-structured interviews, non-participant observation of health-related bodily practices sessions and documents/materials produced by participants. Data were analysed through open, axial and selective coding, using the constant comparative method [Charmaz 2006. Constructing Grounded Theory: A Practical Guide Through Qualitative Analysis. Book. Vol. 10. London: Sage Publications]. Findings: Three themes were generated to explain the ways HPE professionals worked with adults and older people in health promotion: adopting a holistic view of health, serving as a health resource and nurturing further health resources. These practices included caring attitudes, such as listening carefully to adults and older people, showing attentiveness and responsiveness to them. Moreover, a key finding indicated that the HPE professionals served in their pedagogical practices as health resources, which the adults and older people learned to draw on to cope with life situations and experience health development. Conclusion: The HPE professionals in the four programmes demonstrated they were capable of moving beyond a solely biomedical approach to health and focus on the salutary factors that enable health promotion through the development of a combination of pedagogical practices that were consistent with salutogenesis.

Correlation of Resilience with Good Relations with Neighbors

Correlation of Resilience with Good Relations with Neighbors

Appropriate approaches for improving health promotion literacy in adolescents – a systematic review

Abstract Background Adolescents are exposed to various risks for their health: substance use, Internet overuse, video game addiction, unhealthy diet (reduced intake of fruits and vegetables, fast food culture), low physical activity, overweight, stress, violence, unsafe sexual behaviours, self-medication. Health literacy is defined as the knowledge, motivation and competence to access, understand, appraise and apply right information to make decisions in terms of healthcare, disease prevention and health promotion. Despite the advancement of theoretical models, many national and international health promotion programs, the percentage of unhealthy behaviours still persist in young age. Objective: Current review proposes to assess the implementation and effectiveness of various interventions in order to identify possible success or failure factors. Methods Comprehensive Systematic review was performed. After three steps data searching (in PubMed, SCOPUS, Cochrane, PsycINFO, Google Scholar) and critical appraisal, 63 studies out of 739 were fully retrieved. Results Implementation aspects as intervention types (single or combined targeted risk factors), type of audience (students, parents, school staff, communities), settings (home, school or outdoor), type of organization (face to face, groups, online), professional or peer-led, communication type (written materials as brochures, posters or videoconferencing) or effectiveness measures were extracted and synthesized. Important features of context such as funding, European or government programs were used for clustering the studies. Conclusions Health literacy interventions in adolescents need the involvement of education staff and parents participation. Health literacy for adolescents has to take into account cultural context, language, psychological features of each age; either digital or non-digital interventions cannot elude face to face communication between adolescents and their parents, academics or peers. Key messages Health literacy school-based interventions are effective but the content for adolescents audience should rely on guidelines provided by interdisciplinary teams of experts. Health Literacy interventions in adolescents should be age-appropriate and do-not-harm precautions must always be taken in order to avoid prejudices, body-image or self-esteem concerns.

‘Because it’s fun’: English and American girls’ counter-hegemonic stories of alcohol and marijuana use

ABSTRACTGirls’ alcohol and other drug (AOD) use are depicted culturally as problematic. In this comparative, qualitative, study the voices of 59 English and American justice-involved girls give a counter-hegemonic portrayal of their alcohol and marijuana use. In their stories, we see how their AOD use is pleasurable and boundaried. AOD use involves negotiated risk within the situated context of shared experience and friendship networks that heighten and promote pleasure and fun. The findings offer the opportunity to address the ‘credibility gap’ in international health promotion policy. Our aim is to promote the adoption of policy approaches that recognize the complexity of girls’ lives and draw on strategies they have devised.

More than a Conversation: the Power of Bringing Scientists and the Community Together to Change Perceptions About Cancer.

According to the Centers for Disease Control and Prevention, up to 40% of annual deaths are due to preventable, modifiable risk factors (Centers for Disease Control and Prevention 2014). Evidence in the literature suggests that increased knowledge and engagement is a critical step in preventing disease and improving health behaviors (Health Promotion International 15(3):259-267, 2000; Risk Manag Healthc Policy 3:61-72, 2010; Urology 61(2):308-313, 2003). Educational seminars, titled Conversations with Scientists, are offered twice per year by the Advancing a Healthier Wisconsin Endowment with the goal of helping community members, patients, and families inform themselves and others about science and health. In the first series, Cancer: Past, Present, and Future, the goals of increasing (1) knowledge, (2) intent to improve health behaviors, and (3) intent to disseminate information to friends and family were evaluated. Additionally, focus groups and interviews were conducted with speakers and audience members to explore strengths of the existing program format and opportunities to improve. The World Health Organization estimates that between 30 and 50% of all cancer cases are preventable, and has called for efforts to raise public awareness of cancer risks (World Health Organization 2017). Findings indicate that the existing seminar format achieved its intended goals, and provided additional value that can be leveraged to improve health outcomes for participants and their families.

Milestones in Nordic Health Promotion research.

Based on the storytelling tradition and analyses of conference material, this article provides an overview of the evolving Nordic Health Promotion Research Network (NHPRN) and its conferences over the last 20 years. The story goes from the planning of the first conference in Bergen, Norway, back in 1996 to the eighth conference in Jyväskylä, Finland, in 2016. There have been three phases of development. During the first phase, 1996-2007, the five first conferences were initiated and implemented by departments of public health in the Nordic countries. The World Health Organization (WHO) collaborative centres of Health Promotion in Bergen University and a group at Karolinska Institute, Department of Social Medicine, creating supportive environments for health in Stockholm played key roles in initiating and supporting NHPRN. During the second phase, 2007-2014, the network was strengthened and supported by the Nordic School of Public Health (NHV) in Gothenburg. The third phase started when NHV closed down in 2015 and networking activities were transferred to the European Office of WHO in Copenhagen. The Nordic Health Promotion Research Conference series has served several purposes and will continue to do so. They are important Nordic meeting places, stimulating Health Promotion research, as well as explicitly managing ongoing concerns in the international Health Promotion community. This is reflected in the shift of foci over time. The content of the conferences has been highly responsive to whatever challenges are particularly relevant at different points in time, while also contributing to developing Health Promotion as a discipline, given that every conference has built on the previous ones.

A community approach as a lever for integrated health & social care

As a worldwide trend in health care and social care, new organizational arrangements and care perspectives focus more on a socio-ecological perspective towards integrated forms of health and social care (1,2,3). Based upon principles of social equity, sustainability and collective responsibility, a community-oriented Integrated Care Model is developed within health and social care (IC-model). This framework is acknowledged in both scientific papers (4) and international policy documents, including WHO-declarations (5). The community-oriented Integrated Care Model is developed as an alternative for the actual highly fragmented care delivery, the recently growing interplay between social care and health care and the access problem to health care and social care for the most socially vulnerable citizens (6,7). This framework is characterized by a community orientation, where integrated primary health care and social care can contribute to more positive health outcomes and social equity (8). In this exploratory study, an interdisciplinary research team (i.e. welfare and health academics) examine how a community (health) approach can be a lever for integrated health care and social care, and which roles community (health) workers can play in this approach. In this study the community-oriented (health) approach is scrutinized in the context of primary health care in Flanders (Belgium). Based on ethnographic research methodology, namely a combination of literature review, fieldwork (participant observation and document analyses) and interviews with (health and welfare) professionals, patients and informal caregivers (n=40), this research question is studied in three particular community health centres in Ghent (Flanders). The results will be available at the conference 2017. References : 1- Bentley M. An ecological public health approach to understanding the relationships between sustainable urban environments, public health and social equity. Health Promotion International, 2014;29(3): 528–37. 2- Conill EM. The socio-ecological and primary care approach to the creation of universal health systems in the work of Hernan san Martin. Cienc. saude coletiva. 2016;21(1):173-178. 3- De Maeseneer J, et al., Together we change. Eerstelijnsgezondheidszorg: nu meer dan ooit! Brussel. 2014 4- Lloyd J. and Wait S. Integrated Care: A guide for policymakers. London: Alliance for Health and the Future. 2005 5- World Health Organization (WHO). The World Health Report 2008: Primary Health Care – Now More Than Ever. 2008, Geneva. 6- Enthoven AC. Integrated delivery systems: the cure for fragmentation. Am J Manag Care. 2009;15(10):284-90. 7- Xyrichis A., & Lowton K. What fosters or prevents interprofessional teamworking in primary and community care? A literature review. International Journal of Nursing Studies, 2008;45: 140-153. 8- Shi L, The Impact of Primary Care: A Focused Review. Scientifica, 2012: 22.

Body mass index and waist circumference of Latin American adult athletes with intellectual disability.

To examine both body mass index (BMI) status and waist circunference (WC) in a large international sample of adult Special Olympics participants from Latin America. It also explored the association of age and sex with obesity in this population. BMI and WC records from a total of 4174 (2683 male and 1491 female) participant records from the Special Olympics International Health Promotion database were examined. The prevalence of overweight and obesity was quite high (i.e. > 40%), but generally lower than studies involving adults with intellectual disabilities from Europe and the USA. Chi-square analyses revealed that both increasing age and being female significantly predicted levels of overweight, obesity, and WC. These results suggest that efforts need to be made to prevent and reduce rates of overweight and obesity among Latin American Special Olympics participants, particularly women.

Association of poverty and social exclusion with body mass index among Special Olympics athletes in Europe.

To examine the association of a risk of poverty and social exclusion (AROPE), age, and gender with the body mass index (BMI) status of European Special Olympics athletes. BMI records were available for 1905 children and youth and 5517 adults from the Special Olympics International (SOI) Health Promotion database. AROPE was extracted from EU Eurostat statistics. Logistic regression analyses were used to predict BMI status. For children/youth and adults, respectively, 9.4 and 6.3% were underweight and 25.3 and 44.6% were overweight/obese. Being underweight was significantly associated with higher AROPE rates. Being female and lower AROPE rates were significantly associated with overweight/obesity for both children/youth (OR 1.27; 95% CI 1.07-1.50 and OR 0.97; 95% CI 0.96-0.98) and adults (OR 1.55; 95% CI 1.39-1.72 and OR 0.96; 95% CI 0.95-0.98). The Europe 2020 "platform against poverty" strategy aims to ensure that those experiencing poverty and social exclusion share the benefits of economic growth. These findings suggest that SOI health promotion efforts to foster healthy BMI are needed and should be tailored to specific social and economic circumstances in Europe.

Multidisciplinarity in health promotion: a bibliometric analysis of current research.

Health promotion (HP) is a relatively recent field that stems from, notably, public health, sociology, political science, psychology and education. This multidisciplinarity has contributed to HP's challenged institutionalization. Scholars have so far predominately explored HP's multidisciplinarity using anecdotal approaches, limiting our understanding of the breadth and interplay of the disciplines constituting HP research. The overall aim of this paper is to contribute to a better understanding of HP's multidisciplinarity using a bibliometric approach. We developed a three-pronged approach: (i) we examined the most cited journals within Health Promotion International; (ii) we asked an international panel of HP scholars (n = 27) to vote on the journals most relevant to their work; (iii) we examined the most common words in article abstracts among journals which received the highest number of votes. We used multiple correspondence analyses to examine similarities between HPI references, scholars' votes and abstracts' words. We found evidence that HP research reached across numerous disciplines but segregated into distinct subgroups with conflicting perspectives. We found that HPI was the only journal that was identified as relevant by a majority (81% of participants). Multidisciplinarity is a key feature of HP. It can strengthen HP by enriching our understanding of health and social issues from a variety of perspectives, but it may also divide experts into disciplinary silos. This may ultimately weaken its institutional pathways and its contribution to public health. More academic venues and institutions should be developed to facilitate collaboration among HP scholars and practitioners.

Health Promotion International

Health Promotion International