Provide Health Promotion Services Research Articles

Rethinking organizational culture in intersectoral coordination: theperspective of boundary work.

The purpose of this paper is to rethink the concept of organizational culture as something that emerges bottom-up by using the sociological concepts of boundary object and boundary work as an analytical lens and to show how this approach can help understand and facilitate intersectoral coordination. We used observations and qualitative interviews to develop "deep" knowledge about processes of intersectoral coordination. The study draws on a conceptual framework of "boundary work" and "boundary objects" to show how a bottom-up perspective on organizational culture can produce better understanding of and pave the way for intersectoral coordination. We use a case of health professionals engaged in two Danish intersectoral programs developing and providing health promotion services for women with gestational diabetes mellitus (GDM). The study showed how boundary work revolves around negotiations on how to define, understand and act on the diagnosis of GDM. This diagnosis has the characteristics of a "boundary object", being more loosely structured in general terms, but strongly structured in local settings. Boundary objects help connect different professionals and facilitate coordination. The analysis showed how the introduction of time and the concept of "lifelong health promotion" helped to transgress existing organizational and professional boundaries. The findings contribute to the literature on organizational culture and intersectoral coordination. We highlight the benefits of a practice-oriented, bottom-up perspective for a better understanding of how shared meaning is produced in cross professional coordination and collaboration. While the theoretical implications will be general applicable when studying organizational culture, the implications for practice are sensitive to context and the processes we have described as the outcomes of boundary work are generated from cases that were most likely to provide deep insight into our research topic. For practice this can build bridges between organizational and professional boundaries. The findings contribute to the literature on organizational culture and intersectoral coordination. We highlight the benefits of a practice-oriented, bottom-up perspective for a better understanding of how shared meaning is produced in cross professional coordination. This may build bridges between organizational and professional boundaries in practice settings.

DEVELOPMENT OF SELF-ASSESSMENT TOOLS FOR ORGANIZATIONS: PREVENTION AND DELAY OF DISABILITY PROGRAMS IN TAIWAN

Abstract This study aimed to develop a tool for service organizations to self-assess their characteristics and abilities of providing better disability prevention and function maintenance services. The development of the tool involved two stages. In the first stage, a self-assessment tool with 40 items was developed through literature based on Dunn’s policy evaluation framework. The tool was then subjected to two rounds of Delphi method, and pilot test. Six experts were invited, and the Delphi method results showed high consensus. Pilot test invited 170 service organizations to complete the survey and the results showed good internal consistency and validity with 20 items and six dimensions, including internal efficacy, responsiveness, professional, community collaboration, environmental factors, and sustainability (χ2[df=171, N = 170] = 282.88; p < 0.001; CFI = 0.923; RMSEA = .071; SRMR=.055). The sustainability (mean:4.20, SD: 0.61) and responsiveness (mean:4.20, SD: 0.59) showed the highest self-assess ratings. Combining internal resources and efficacy as internal efficacy showed good validity. and together with a new domain “internal efficacy” showed strong association with other domains. This tool could provide the program agencies to self-assess their ability to provide better disability prevention and function maintenance services. There were two new concepts, internal efficacy and sustainability, identified through the process which may indicate both of these two concepts are important to organization that provide health promotion services and culture-sensitive in Taiwanese society. Promoting these two concepts for future organizations is recommended.

Pharmacists’ involvements and barriers in the provision of health promotion services towards noncommunicable diseases: Community-based cross-sectional study in Northwest Ethiopia

BackgroundCommunity drug retail outlets (CDROs) are among the initial healthcare facilities where pharmacists play a crucial role in preventing and managing noncommunicable diseases (NCDs). Therefore, this study assessed pharmacists’ level of involvement and barriers in the provision of health promotion for noncommunicable diseases at CDROs in Northwest Ethiopia.MethodsA community-based multicenter cross-sectional study was conducted among community pharmacists in Northwest Ethiopia from April to June 2022. Data was collected using a self-administered structured questionnaire, and analyzed using the Statistical Package for Social Science (SPSS) version 26. The level of involvement mean score difference among pharmacists was investigated using an independent samples t-test and a one-way ANOVA. Logistic regression analysis was used to examine the association between pharmacists’ level of involvement and other variables. A p-value < 0.05 at a 95% confidence interval (CI) was considered statistically significant.ResultsA total of 285 (94.4%) participants participated in the study out of 302 approached samples. Overall, more than half (58.9%) of the participants showed a high level of involvement in health promotion. Pharmacists who had a degree and/or above (AOR = 0.03, 95% CI: 0.01–0.63; p < 0.001) and served a lower number of clients per day (AOR = 0.19, 95% CI: 0.04–94; p = 0.042) were less likely to have low involvement in health promotion services. Pharmacists who worked fewer hours per day (AOR = 3.65, 95% CI: 1.79–7.48; p = 0.005) were more likely to have low involvement. Lack of an appropriate area in the CDROs (52.1%) and lack of coordination with other healthcare providers (43.6%) were the most reported barriers to the provision of health promotion.ConclusionMost pharmacists were found to have a high level of involvement in health promotion activities. A lack of an appropriate area in the CDROs and a lack of coordination with other healthcare providers were among the most reported barriers. Pharmacists might benefit from training to increase their educational backgrounds, and barriers could be addressed to enhance the pharmacist involvement.

Relationships Between Lifestyle, Quality of Life, Organizational Culture and Job Satisfaction Among Nurses Related to Health Promoting Hospital (HPH) Standards.

Providing quality healthcare services through health promotion activities to patients, hospital-based professionals and the wider community is the goal of the health promoting hospital (HPH). There is, however, no formal structured pathway for "universally" providing health promotion services in hospitals. Accordingly, this study was conducted with the aim of presenting a model designed to promote and increase health-related satisfaction of hospital-professionals in health-promoting hospitals (HPHs) in Iran-as a potential tool to guide international HPH standards. Lifestyle, quality of life, organizational culture, and job satisfaction were measured using standardized questionnaires in specialized hospitals in Hamadan, Iran. A structural equation model (SEM) using partial least squares (PLS) software (version 2) was used to determine the validity and fit of the conceptual framework/model. The study revealed that several factors were identified as strong predictors of job satisfaction and wellbeing, including various dimensions of lifestyle such as spiritual health, physical activity, stress management, and interpersonal communication, dimensions of quality of life including physical and mental aspects, and organizational culture. The values of predictive relevance (Q2) for physical and psychological dimension of life quality, organizational culture, and job satisfaction were estimated to be 0.101, 0.250, and 0.040 and 0.251, respectively. Conclusively, the study found a goodness of fit (GOF) value of 0.415, indicating that the model had a high predictive power and fit well. Based on these results, it is suggested that implementing HPH interventions that focus on the outcomes of this model could lead to increased job satisfaction and wellbeing in hospitals. Additionally, the model could serve as a useful indicator of HPHs.

Osvrt na multidisciplinarne timove za promociju zdravlja

The success of modern health promotion programs, which have been brought about by political decision at the local, national, and international levels, depend on the effectiveness of health promotion teams. In this article, the multidisciplinary approach is reviewed as a modern approach to teamwork for health promotion, which is a prerequisite for effective health promotion. The multidisciplinary approach includes a wide range of experts in public health, with different knowledge, qualifications, and skills, brought together to contribute to the provision of health promotion services from their own perspective.

Assessment of community pharmacy professionals’ willingness, involvement, beliefs, and barriers to offer health promotion services: a cross-sectional study

IntroductionThe role of community pharmacy professionals has been expanded to patient care and health promotion service globally. However, in Ethiopia, there is a scanty of data on the issue, although the country is dealing with a double burden of non-communicable and communicable diseases.ObjectivesThis study aimed to assess community pharmacy professionals’ willingness, involvement, beliefs, and barriers to offer extended services for health promotion in Injibara town, Amhara, Ethiopia.MethodsA cross-sectional study was conducted among licensed and registered community pharmacy professionals working in Injibara town from June 25 to July 10, 2022. A structured self-administered questionnaire was used to collect data. The data were presented using descriptive statistics. The data were analyzed using STATA version 16 software.ResultsA total of 24 community pharmacy professionals were involved in the study, with a response rate of 92.3%. Approximately 91.7% of them were involved in health promotional services. Of them, 54.1% were willing and strongly believed that their involvement in health promotion services would have a positive impact on promoting health. A total of 60.9% of the community pharmacy professionals reported that they were very involved in family planning and alcohol consumption counseling. Different barriers to not providing health promotion services were also cited.ConclusionsMajority of community pharmacy professionals in this study is involved in health promotional services but there are also barriers on their involvement. Therefore, governmental strategies to overcome the barriers that hamper their involvement should be designed.

Attitudes, perceptions, and barriers of community pharmacists in Rwanda towards health promotion: a cross sectional study

BackgroundThe practice of Pharmacists has changed worldwide over the past years. Today, health promotion is better known as an important part of modern pharmacy practice. Involving Community Pharmacists in health promotion is thus considered a valuable option in addressing public health issues. However, the literature on this practice remains unsubstantiated in African countries. In Rwanda, Community Pharmacists are believed to be solely involved in dispensing and very little has been studied about their role in health promotion. Thus, this study aimed to evaluate attitudes, perceptions, and barriers of Community Pharmacists in Rwanda towards their involvement in health promotion.MethodsA cross-sectional study was conducted among 236 licensed Community Pharmacists in Rwanda from 23rd January to 23rd June, 2021. A list of all respondents was obtained from Rwanda Food and Drugs Authority. All participants were randomly enrolled. Each community pharmacy was represented by one Pharmacist. We collected data from community pharmacy settings using a self-administered questionnaire made of close and open-ended questions. Statistical analyses were performed using Statistical Packages for Social Sciences (SPSS) version 25.ResultsOf the 236 respondents, (n = 149, 63.1%) were male and (n = 87,37%) were female. The average age was 38.1 years (SD = 4.3). More than half confirmed that professional curriculum is adequate for offering health promotion services (n = 152, 64.4%).Majority responded that health promotion is part of their responsibility, and they are willing to provide health promotion services (n = 233,98.7%).The statement that “Pharmacists should not be involved in public health activities “was opposed by many (n=174,73.7%).The most sought-after service provided was education to drug misuse (n=211, 89.4%).Three major barriers to provision of health promotion were: lack of coordination with other healthcare professionals(n=106,69%),structure of healthcare system (n=157,67%),and lack of equipment (n=144,61%).Most Pharmacists disagreed with the statement that “patients are not interested in getting health promotion services”(n = 134,57%).ConclusionThough Community Pharmacists faced several challenges that hindered their participation in health promotion, they had positive attitudes towards promoting public health messages. There are several barriers like lack of structure to provide health promotion services that need to be addressed to boost more active participation of Pharmacists in health promotion.

Chairside Screening for Undiagnosed Diabetes and Prediabetes in Patients with Periodontitis.

Introduction Globally, it is estimated that half of all people with diabetes are undiagnosed. Because of the well-documented bidirectional link between diabetes and periodontitis, dentists and dental hygienists may have the possibility to screen a targeted population for diabetes during routine dental visits. The aim of the present study is to investigate the effectiveness of one device for diagnosis of diabetes/prediabetes used in one private dental practice and investigate the correlation between the levels of HbA1c and periodontal parameters. Methods Periodontal patients that were never diagnosed with diabetes were asked to fill a risk assessment questionnaire for type 2 diabetes mellitus. PD, CAL, FMBS%, FMPS%, and HbA1c through a prick-finger test were measured before and after periodontal therapy or only once in patients following supportive periodontal therapy. Results A total of 98 subjects were screened, and among them, one had diabetes and 30 had prediabetes. The mean value of HbA1c was 5.62% for patients with untreated periodontitis and 5.42% for periodontally treated patients. The diagnosis of diabetes resulted to be correlated to FMBS% and FMPS%, while HbA1c levels were correlated to FMBS%, FMPS%, and periodontitis grade. Conclusion The present chairside diabetes-screening protocol allowed a consistent proportion of patients to become aware of their pathological or prepathological condition and to seek proper and timely medical care. Thus, dentists and dental hygienists could provide health promotion services and preventive measures.

An assessment of nurses' participation in Health Promotion: a knowledge, perception, and practice perspective.

SummaryBackgroundHealth promotion (HP) at the population level serves to improve health inequalities, enhance the quality of life, and ensures the provision of healthcare and related services. Nurses at all levels are charged with the task of ensuring that patients receive HP services. However, their competence in addressing this challenge needs further exploration. This study assessed the influence of HP knowledge and perceptions in nurses’ HP practice.MethodsThe study was conducted using a self-administered questionnaire among 184 nurses randomly sampled from a tertiary hospital. Questions bordered on respondents’ demographics, knowledge, perception, and practice of HP. Responses were retrieved and analysed using IBM SPSS Statistics, Version 26.0. Armonk, NY: IBM Corp, 2019.ResultsAnalysis showed a statistically significant relationship between participants demographics and possessing adequate knowledge to provide HP services. Statistically significant relationships were found amongst the following variables: ‘A holistic knowledge of disease pathology and processes are vital for effective care of patients’ and ‘education of patients on medication’ p = 0.001, ‘awareness of importance of educating patients about their condition’ and ‘patients encouraged to engage in healthy lifestyle’ p < 0.001.ConclusionData showed that nurses’ knowledge regarding HP had a strong influence on their perception of HP. Their perception of HP in turn strongly influenced their practice of the same. Therefore, rigorous efforts must be made by governmental agencies, and organizations involved in healthcare worker training and nursing accreditation, to ensure the HP curriculum is well incorporated in nursing undergraduate training and sustained in service.

UPAYA PENINGKATAN KEGIATAN PROMOSI KESEHATAN MELALUI MEDIA DIGITAL DI PUSKESMAS PAKEL TULUNGAGUNG

The Indonesian government has declared a health development paradigm based on a healthy paradigm, which means that health development must prioritize promotive and preventive efforts, without neglecting curative and rehabilitative efforts. The purpose of this residency is to find out how the process of providing health promotion services is, the types of communication media used in the process of disseminating health promotion information and the community's use of the communication media used. Problem identification using fishbone analysis. Then look for alternative solutions to existing problems with ultrasound. Next, problem solving analysis is carried out based on a SWOT analysis. The results of the study stated that the problem that needs to be prioritized for completion is that the team needs web-design and content creator training. The strategy that can be applied to this residency activity is to conduct web-design and content creator training. After the training, it was found that the participants' evaluations were very good (86%) good (14%), very in accordance with the theme (80%) appropriate (20%), the delivery of the resource persons was very good (60%) good (40%), considered this training was very useful (86%) and useful (14%).

Users' Experiences With the NoHoW Web-Based Toolkit With Weight and Activity Tracking in Weight Loss Maintenance: Long-term Randomized Controlled Trial.

BackgroundDigital behavior change interventions (DBCIs) offer a promising channel for providing health promotion services. However, user experience largely determines whether they are used, which is a precondition for effectiveness.ObjectiveThe primary aim of this study is to evaluate user experiences with the NoHoW Toolkit (TK)—a DBCI that targets weight loss maintenance—over a 12-month period by using a mixed methods approach and to identify the main strengths and weaknesses of the TK and the external factors affecting its adoption. The secondary aim is to objectively describe the measured use of the TK and its association with user experience.MethodsAn 18-month, 2×2 factorial randomized controlled trial was conducted. The trial included 3 intervention arms receiving an 18-week active intervention and a control arm. The user experience of the TK was assessed quantitatively through electronic questionnaires after 1, 3, 6, and 12 months of use. The questionnaires also included open-ended items that were thematically analyzed. Focus group interviews were conducted after 6 months of use and thematically analyzed to gain deeper insight into the user experience. Log files of the TK were used to evaluate the number of visits to the TK, the total duration of time spent in the TK, and information on intervention completion.ResultsThe usability level of the TK was rated as satisfactory. User acceptance was rated as modest; this declined during the trial in all the arms, as did the objectively measured use of the TK. The most appreciated features were weekly emails, graphs, goal setting, and interactive exercises. The following 4 themes were identified in the qualitative data: engagement with features, decline in use, external factors affecting user experience, and suggestions for improvements.ConclusionsThe long-term user experience of the TK highlighted the need to optimize the technical functioning, appearance, and content of the DBCI before and during the trial, similar to how a commercial app would be optimized. In a trial setting, the users should be made aware of how to use the intervention and what its requirements are, especially when there is more intensive intervention content.Trial RegistrationISRCTN Registry ISRCTN88405328; https://www.isrctn.com/ISRCTN88405328International Registered Report Identifier (IRRID)RR2-10.1136/bmjopen-2019-029425

The health coaching competency gap - Analysis of pharmacist competency frameworks from Australia, Canada, New Zealand the United Kingdom and the United States of America.

The traditional competency frameworks for coaches, the International Coaching Federation (ICF) and the European Mentoring and Coaching Council (EMCC) disregard the differences in expertise required among the diverse professions that may provide coaching. A recent systematic review has identified competencies specific to health professionals who health coach. There are increasing workload pressures in primary care; pharmacists can potentially shift to the greater provision of health promotion services, such as health coaching. The provision of such services needs to be underpinned by competency frameworks, which support the role of pharmacists as health coaches. This analysis identifies the competency gaps for pharmacists if they are to take on the role of health coaching. The enabling competencies of health coaches were compared to the competency frameworks of pharmacists from Australia (AUS), Canada (CAN), New Zealand (NZ), the United Kingdom (UK) and the United States of America (USA). Correlations between the international pharmacist competency frameworks and the competencies enabling health coaching showed that entry to practice pharmacists from AUS, CAN and NZ all require training enabling the health coaching competency 'demonstrates confidence', whereas competency frameworks for pharmacists from both the UK and the USA included all competencies required to health coach. Although pharmacists from the countries examined had most of the competencies required to health coach, gaps within the international pharmacist competency frameworks were apparent, university curricula addressing these gaps would equip entry to practice pharmacists with the knowledge and understanding to confidently provide emerging professional pharmacy services such as health coaching.

Assessing Managers’ Attitudes Toward Health Promoting Hospitals at a Teaching Hospital in Tehran, Iran

Background: Hospitals are the most important and largest providers of health services in the health system. Objectives: This study aimed to examine hospital managers’ attitudes toward health promotion policies at a teaching hospital in Tehran, Iran. Methods: This research was a descriptive-analytical study. The study population consisted of 75 senior and middle managers of a teaching hospital in Tehran, Iran in 2018. Sampling was conducted through a census. The study instrument was a researcher-made questionnaire assessing managers’ attitudes toward health promotion. The questionnaire was validated. Data were collected and then analyzed using SPSS 20 software. Results: Total score of health promotion policies was estimated to be 84.5 ± 10.6 out of 100. The highest scores of the components associated with health promotion policies were 94.9 ± 9.34 and 93.8 ± 10.36 of 100 belonging to “Awareness of hospital staff of health promotion policies” and “Enjoyment of a written health promotion policy” items, respectively; while the lowest score was 75.4 ± 20.68 out of 100 belonging to “Informing patients, their companions, and staff about factors associated with the disease whose health is supported by the hospital”. The highest score of components associated with health promotion activities was 94.1 ± 9.74 out of 100 belonging to “Increasing patients’ trust by providing health promotion services” item and the lowest was 72.2 ± 19.4 out of 100 belonging to “Assessment of patient’s needs for health promotion” item. Conclusion: Hospital managers’ attitudes score was high toward health promotion policies and activities, but there are still problems with health promotion activities, the most important of which is a therapeutic-centered perspective.

Development and Evaluation of Health Promotion Training Program for Community Pharmacists in Oyo State, Nigeria

Background. Community pharmacists have considered training in health promotion services to improve their practice, but no published study in Nigeria has provided such training to improve practice change. Objectives. The study aims to develop and evaluate the appropriateness and applicability of health promotion training provided for community pharmacists after identifying the gaps in the provision of health promotion services in community pharmacies in Oyo State, Nigeria. Materials and Methods. A 2-day training was developed, conducted, and evaluated on a 5-point Likert-type scale, semistructured questionnaire administered to randomly sampled 80 respondents. It rated participants’ opinions on the training content, resource persons, and perceived sufficiency of the training. Data were analyzed using IBM SPSS Version 21 with descriptive statistics while open-ended responses were analyzed thematically. Results. Response rate was 72.5%. Total mean score of participants’ opinions on the training program was 45.67 ± 5.802 (range of 10–50; midpoint 30). An average score ranged from 3.97 to 4.61 out of the total score of 5 was obtained for good presentation abilities of the resource persons. Respondents (93.1%) strongly agreed and agreed that the training was sufficient to deliver the health promotion services (4.36 ± 0.765). They suggested the need to organize the training periodically (15.5%), training to cover other areas like use of diagnostic test kit and immunization (13.8%) and allowance of more time for interaction and sharing of experiences by participants (10.3%). Conclusion. The training was adequate for use by community pharmacists and fit for the purpose it was designed for.

Advancing health promotion through massage therapy practice: A cross-sectional survey study.

The human resources needed to provide health promotion services to improve health behaviors in populations are currently limited. Health promotion and education is included in the definition of massage therapy, and many within the massage therapy profession understand that health promotion and education are a part of massage therapy practice. However, the amounts and types of health promotion activities in massage therapy practice have not been thoroughly explored. The objective of this study was to investigate the current attitudes, practices, and barriers toward providing health promotion in a national sample of practicing massage therapists. A descriptive cross-sectional survey disseminated May to August 2016 to practicing massage therapists in the United States. The majority (90.2%) of the 182 participants agree or strongly agree that it is important for massage therapists to provide health promotion. Therapists with less favorable attitudes about providing health promotion reported more barriers to providing the messages to their patients. Barriers to providing health promotion included a lack of guidelines, knowledge, and skills. Training and guidelines for massage therapists regarding health promotion would be a reasonable next step for future research development. Utilizing massage therapists as health promoters may provide opportunities to deliver more prevention messages to patients which may impact public health.

The science of peer support as applied to behavioral medicine and the care of individuals surviving with cancer: a commentary on "Peer mentors delivering a physical activity intervention for cancer survivors: effects among mentors by Pinto et al."

There is a critical gap between the resources available to promote health and wellness after cancer and services that address these public health goals. Researchers, policy makers, healthcare providers, and community stakeholders increasingly recognize the benefits of filling this gap with trained peer mentors who can provide health-promotion services to fellow cancer survivors. This commentary addresses a mixed-method study by Pinto and colleagues that investigated the responses and experiences of trained peer mentors who delivered their telephone-based physical activity intervention for breast cancer survivors. Their findings suggested that peer mentors did not experience harms from their role while revealing that peer mentors reported benefits related to helping themselves and helping others. Drawing on our expertise in peer support provision and peer mentoring, we address the significant opportunity offered by training peer mentors to deliver behavioral interventions, draw connections to relevant literatures and theoretical perspectives on potential benefits for peer mentors, and highlight the need for rigorous, theory-based research to determine the circumstances under which peer mentoring benefits mentors and the mechanisms underlying these benefits.

Trends in US Hospital Provision of Health Promotion Services, 1996-2014.

Hospitals have long played important roles in the provision of health promotion services (HPS) in local communities, defined as activities that enable people to increase control over and improve their health, including programs such as disease prevention and wellness. Nearly 2 decades ago, researchers cross-sectionally documented the provision of HPS by hospitals, but little research has been done to update this work or document how HPS have changed over time. This study assessed changes in the provision of HPS among US hospitals between 1996 and 2014. Relationships were assessed using random effects Poisson regression models. The overall number of HPS reported by hospitals was relatively modest (approximately half of all possible services, on average). The number of services increased modestly over time, although the rate of increase became less positive over time. The findings highlight a number of opportunities to improve hospital provision of HPS.

The Implementation and Evaluation of Health Promotion Services and Programs to Improve Cultural Competency: A Systematic Scoping Review.

Cultural competency is a multifaceted intervention approach, which needs to be implemented at various levels of health-care systems to improve quality of care for culturally and ethnically diverse populations. One level of health care where cultural competency is required is in the provision of health promotion services and programs targeted to diverse patient groups who experience health-care and health inequalities. To inform the implementation and evaluation of health promotion programs and services to improve cultural competency, research must assess both intervention strategies and intervention outcomes. This scoping review was completed as part of a larger systematic literature search conducted on evaluations of cultural competence interventions in health care in Canada, the United States, Australia, and New Zealand. Seventeen peer-reviewed databases, 13 websites and clearinghouses, and 11 literature reviews were searched. Overall, 64 studies on cultural competency interventions were found, with 22 being health promotion programs and services. A process of thematic analysis was utilized to identify key intervention strategies and outcomes reported in the literature. The review identified three overarching strategies utilized in health promotion services and programs to improve cultural competency: community-focused strategies, culturally focused strategies, and language-focused strategies. Studies took different approaches to delivering culturally competent health interventions, with the majority incorporating multiple strategies from each overarching category. There were various intermediate health-care and health outcomes reported across the included studies. Most commonly reported were positive reports of patient satisfaction, patient/participant service access, and program/study retention rates. The health outcome results indicate positive potential of health promotion services and programs to improve cultural competency to impact cardiovascular disease and mental health outcomes. However, due to measurement and study quality issues, it is difficult to determine the extent of the impacts. Examined together, these intervention strategies and outcomes provide a framework that can be used by service providers and researchers in the implementation and evaluation of health promotion services and programs to improve cultural competency. While there is evidence indicating the effectiveness of such health promotion interventions in improving intermediate and health outcomes, further attention is needed to issues of measurement and study quality.

Practice and Barriers towards Provision of Health Promotion Services among Community Pharmacists in Gondar, Northwest Ethiopia.

Background Health promotion is now becoming an integral part of community pharmacy practice worldwide. Objectives This study was intended to determine the level of involvement of community pharmacists in providing health promotion service and to identify the barriers to the practice. Methods A cross-sectional study was conducted on 48 community pharmacists working in Gondar town, Northwest Ethiopia. Data on sociodemographic factors, practice, and barriers to health promotion service were collected and analyzed using SPSS version 20. Results The majority of respondents were B.Pharm holders (n = 27, 56.3%). Almost all respondents (n = 45, 95.8%) were willing and claimed to be well involved in health promotion services. The top 5 services were related to drug misuse, asthma, diabetes, family planning, and cardiovascular diseases. However, involvement in some types of health promotion services significantly differed based on sex, educational level, and pharmacy ownership of respondents. The main barrier reported was lack of training. Conclusion The community pharmacists in Gondar, Northwest Ethiopia, are engaged in health promotion activities. However lack of training has limited their level of involvement and practice differences were noted based on sex, educational level, and pharmacy ownership status of the respondents.

Barriers to promote cardiovascular health in community pharmacies: a systematic review.

Community pharmacists play an important role in the provision of health promotion services, and community pharmacies are considered as a potentially ideal site for cardiovascular health promotion. Information based on a systematic review of barriers to promoting cardiovascular health in community pharmacy is currently lacking. We have sought to identify the most important barriers to cardiovascular health promotion in the community pharmacy. We have systematically searched PubMed and International Pharmaceutical Abstracts for a period of 15 years from 1 April 1998 to 1 April 2013, contacted subject experts and hand-searched bibliographies. We have included peer-reviewed articles, with English abstracts in the analysis, if they reported community pharmacists' perceptions of the barriers to cardiovascular health promotion activities in a community pharmacy setting. Two reviewers have independently extracted study characteristics and data. We identified 24 studies that satisfy the eligibility criteria. The main barriers to cardiovascular health promotion in the community pharmacy included pharmacist-related factors; practice site factors; financial factors; legal factors; and patient-related factors. This review will help to provide reliable evidence for health promotion practitioners of the barriers to promoting cardiovascular health in the community pharmacy setting. This knowledge is valuable for the improvement of cardiovascular health promotion in this setting and guiding future research.