Sustainable Health Promotion Research Articles

Perspectives of sustainable global school health promotion in Asia and Africa

Perspectives of sustainable global school health promotion in Asia and Africa

Cost-effectiveness and return on investment of school-based health promotion programmes for chronic disease prevention.

BackgroundWhile school-based health prevention programmes are effective in addressing unhealthy diet and physical inactivity, little is known about their economic implications. We conducted an economic evaluation of the programmes that were previously identified as feasible, acceptable, and sustainable in the Canadian context.MethodsThis study builds on a meta-analysis of the effectiveness of feasible, acceptable, and sustainable school-based health promotion programmes. A micro-simulation model incorporated intervention effects on multiple risk factors to estimate incremental cost-effectiveness and return on investment (ROI) of comprehensive school health (CSH), multicomponent, and physical education (PE) curriculum modification programmes. Cost-effectiveness was expressed as the programme costs below which the programme would be cost-effective at a CA$50 000 threshold level.ResultsThe estimated costs below which interventions were cost-effective per quality-adjusted life year gained were CA$682, CA$444, and CA$416 per student for CSH, multicomponent, and PE curriculum modification programmes, respectively. CSH programmes remained cost-effective per year of chronic disease prevented for costs of up to CA$3384 per student, compared to CA$1911 and CA$1987 for multicomponent and PE curriculum modification interventions, respectively. If the interventions were implemented at total discounted intervention costs of CA$100 per student, ROI through the avoidance of direct healthcare costs related to the treatment and management of chronic diseases would be 824% for CSH, 465% for multicomponent interventions, and 484% for PE curriculum modification interventions.ConclusionsWhereas each examined intervention types showed favourable economic benefits, CSH programmes appeared to be the most cost-effective and to have the highest ROI.

Current Knowledge of Medicinal Mushrooms Related to Anti-Oxidant Properties

Background: A renewed focus on medicinal mushrooms has brought forth a sustainable health dimension. Conventional health strategies are insufficiently integrated with sustainable health promotion. The health-promoting outcome of mushrooms has fascinated many groups during the past few years because of various primary and secondary metabolites in different cellular components. They contain many bioactive metabolites, including proteins (cytokines, ergothioneine), fibers, moisture, carbohydrates (uronic acid), folate, thiamine, ascorbic acid, vitamin D, calcium, potassium, polysaccharides (G. lucidum polysaccharides, alpha and beta glucans, and lentinan) polyketides, polyphenols (Protocatechuic acid, inonoblins A–vanillic acid, phelligridins D, E, and G, hydroxybenzoic acid, gallic acid, tannic acid, hispidine, gentisic acid, and tocopherol), nucleotides (adenosine, cordycepin), lovastatin, steroids, alkaloids, and sesquiterpenes. Objective: This study was conducted to gather information on the current knowledge of medicinal mushrooms, with respect to their antioxidant properties. Conclusions: The results indicated that mushrooms are a promising source of natural antioxidants. Of all mushrooms, the Ganoderma tsugae Murill exhibited an excellent antioxidant potential of 93.7–100% at 20 mg/mL.

Occupational choices of school-going adolescents: a study in the Pitseng Area, Leribe District, Lesotho

Adolescents require opportunities to engage in occupations and need to have the requisite aptitude and agency to choose the occupations they want or need to engage in. Occupations are defined as the everyday activities that people choose to engage in individually or as groups that bring meaning and purpose to their lives. These occupations can be chosen or enforced. There is a paucity of literature around the occupations that adolescents in rural contexts choose and the meaning underlying their choices. This study explored the occupations of school-going adolescents of Pitseng, Lesotho, to gain insight into adolescent behaviour, and the strategies needed to develop sustainable health promotion programs for adolescents in this area. A descriptive qualitative research design was used. Purposive sampling was used to recruit 47 adolescents aged between 13 and 15 years from three high schools in Pitseng, Leribe district, Lesotho. Data was collected using focus group interviews after consent was obtained from the parents or caregivers and assent from the adolescents. Data were analysed thematically using Braun and Clarke's method. Three main themes emerged from the study: realities of customary rural life, facilitators of occupational engagement, and wellbeing versus risky behaviour. Participation in daily routine occupations, cultural norming, resource scarcity, school milieu and leisure engagement were subthemes derived under the first theme. The subthemes identified under the theme facilitators of occupational engagement were intrinsic motivation, and vicarious modelling and peer support. The third theme encompassed the conceptualisation of wellbeing and risky behaviour as subthemes. The adolescents were found to engage in risky behaviour to escape the monotony in their daily lives. This could be attributed to them having fewer choices for recreational activities during their free time. Some adolescents were able to improvise and attempted to enjoy their lives with fewer occupational choices. The natural environment, coupled with creativity, facilitated the engagement of adolescents in fun activities. The dominant influences relating to the adolescents' occupational choices and participation in activities were the impoverished rural context and the traditional inherited practices. The protracted timeframes for completing basic activities and household responsibilities and the scarcity of resources for leisure led to a restricted range of leisure activities. The traditional cultural context influenced gender-based differences in the manifestation of occupations. Despite the challenges, the adolescents showed resilience, creativity and a strong desire to improve their futures. Moreover, in this culturally steeped environment, the school and the community chief may be the two best entry points for organisations planning to facilitate health promotion programs. They are recognised and sanctioned power bases in rural communities. Recommendations for education, leisure, health promotion and further study were made for Pitseng.

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.

Yuva spandana - A youth mental health promotion model in India - Design, methods and progress.

A unique youth mental health promotion program called Yuva Spandana is implemented and functional across all districts within Karnataka. Trained guidance providers named Yuva Parivarthakas (YPs) and Yuva Samalochakas (YS) provide support to youth having issues at Yuva Spandana Kendras (YSKs). We highlight the process of development of the program "Yuva Spandana" into a sustainable community-based youth mental health promotion model addressing youth issues across Karnataka and describe the profile of beneficiaries attending YSKs in Karnataka between 2017 and 2019. Yuva Spandana has evolved over time and got established in local-self-governments and communities.

Lyrics and artistic improvisations in health promotion for the COVID-19 pandemic control in East Africa.

News about the outbreak of coronavirus disease 2019 (COVID-19) in Wuhan City, Hubei Province, China in December 2019 diffused gradually to East Africa through mainstream media and social media. The general public construed the pandemic threat as being ‘far away’ and associated it with foreign practices and behaviours. Social media discourse was initially replete with indifference about the perceived risk. Conflicting views about the possibility of the pandemic spreading to Africa and the complexity of explaining its causes delayed the desired understanding of the reality of the global public health concern. The popular public response to the COVID-19 control discourse is therefore characterised by ambivalence about embracing the pandemic control protocols. Drawing on content and discourse analysis of musical and poetic compositions on COVID-19 by artists in East Africa and shared among WhatsApp users in Kenya, this article describes local perspectives on COVID-19 risk and their health promotion implications. It explores local construction of the meaning of the COVID-19 pandemic and its consequences for effective health promotion. The article considers the spontaneous musical and poetic performances by experienced and amateur artists as local attempts to enhance compliance with the global COVID-19 control protocols and popular participation in local health promotion. The basic premise is that artists’ creation and sharing of digital COVID-19 lyrics denote their attempt to go beyond the medical logic of health promotion by including broad aspects of a cultural logic of care. This approach would establish an integrated and sustainable health promotion framework to prevent the spread of COVID-19 and its impact on local societal wellbeing.

Building health-promoting sports clubs: a participative concept mapping approach

ObjectivesThe potential of sports clubs to promote health beyond physical activity has been acknowledged by researchers and policy-makers. This study gathered stakeholder ideas on support sports clubs need to increase health promotion efforts and prioritize them based on importance and feasibility. Study designThe study design used in this study is a mixed-methods concept mapping approach. MethodsFrench sports and public health stakeholders (n = 45) were invited to participate. Steps included are as follows: (1) formulating a focus prompt, (2) brainstorming statements in response to the focus prompt, (3) sorting statements into themed piles, and (4) rating statements based on indicators. Multidimensional scaling and hierarchical cluster analysis were used to produce visual cluster maps, and descriptive statistics generated Go-Zone graphs based on mean importance and feasible ratings. ResultsParticipants generated 62 statements from the focus prompt: ‘What assistance would benefit sports clubs to become a health-promoting setting?‘. Final sorting produced 9 clusters: Tools for health promotion, Communication tools, Stakeholder training courses, Diagnostic and Financing, Awareness and Mobilization, Advocacy, Policies and Methods, Sharing and Networking, as well as Communication and Dissemination. Participant ratings produced 34 statements within the Go-Zone graphs. ConclusionUnderstanding stakeholders’ needs to increase health promotion activities in sports clubs is crucial to planning and implementing sustainable health promotion policies and practice. Priority areas include increasing awareness of health promotion benefits, mobilizing actors, advocating for support, and educating sports club actors.

Physical Activity as Part of an Intramural Health Promotion Programme for People with and without Chronic Diseases. A New Tool in Health Care Run by a Public Social Health Insurance.

Background: Regular physical activity is a corner stone for healthy living, and preventing the onset or progression of diseases. The Social Insurance Fund for Public Service, Railway and Mining Industries is building an intramural health promotion facility in Austria with the aim to provide a comprehensive evidence-based health promotion programme for their insured. The target group are all people who, regardless of their health status and the presence of diseases, are ready to make their lifestyle more health-oriented. The health promotion facility offers health promotion measures in five areas: promoting physical training, optimizing nutritional patterns, managing everyday stress, increasing social capital, and improving health literacy. The focus is on increasing resources and on overcoming barriers. Depending on age, previous illnesses, range of motion, stress level, body weight and personal aims and expectations, the measures are individually tailored. The stay is divided into a two-week initial stay and a follow-up week. A comprehensive scientific evaluation concept of all measures and the entire stay is an integral part of the design. Conclusion: This project combines the advantages of comprehensive active health promotion, and an intramural stay. It is a pioneering social insurance project for sustainable health promotion and integrated care.

Health Promotion Programs to Reduce Noncommunicable Diseases: A Call for Action in Kuwait.

Most public health issues in Kuwait are related to unhealthy behaviours. Research shows that behaviours are the result not only exclusively of personal choices but also of myriads of other social and environmental factors. Kuwait is one of the leading countries in obesity and tobacco use in the world. Cardiovascular diseases stemming from complications related to these and other risk factors are important health issues based on their morbidity and mortality implications. These risks are spread across society and affect the old as well as young boys. The serious gaps between Kuwait’s health-related needs and the existing policies to reduce public health risks in Kuwait create a significant obstacle to healthy behaviour change. Kuwait requires adequate laws, policies, regulations, activities, and programs to promote people’s health. The Socio-Ecological Model (SEM) has been used successfully in health promotion in various behavioural settings, including obesity, physical inactivity, and smoking. We propose the use of SEM as a planning framework in building sustainable health promotion programs in Kuwait while paying attention to other concepts such as systems thinking, authentic community participation, community capacity, policy development, public health infrastructure enhancement, health coaching, and equity.

Identifying the facilitators, constraints and barriers of community indoor walking programmes: protocol for a realist synthesis

IntroductionPhysical inactivity is a costly and leading health risk factor. Engaging in moderate or more intense regular physical activity reduces premature mortality at the population level. Walking is a viable...

The perceptions of community-based organizations collaborating with nursing faculty to promote students’ public health nursing competencies

Collaborative community-based organizations (CBOs) and academic partnerships are a prerequisite for the creation of quality learning environments for undergraduate nursing students. However, the explicit nature of the relationship between academic and CBO partners is not as well-defined as the one between hospitals and their clinical settings. The aim of this study was to describe and evaluate the implementation and impact of a 3-year-long partnership between a nursing school and 20 different CBOs. Semi-structured individual interviews were conducted with 11 CBO partners throughout June and July of 2018. Interview questions explored the collaborative process, its benefits, and areas for improvement. Study participants reported that the partnerships brought several benefits, including familiarizing students with marginalized populations, demystifying the health care system for the populations served by the CBOs, and the students’ development of sustainable health promotion tools that contributed positively to the CBOs’ overall mission. Challenges identified by the CBOs included finding resources to provide adequate student supervision and population access, and some students’ challenges with adapting to the CBOs’ client population or community environment. Collaborative partnerships were mutually beneficial for populations, students and the community organizations. These results support the establishment and long-term development of these types of partnerships.

Managing Dengue Disaster: Uncovering Paramount Community Elements for DNA Sensory Tool Accessibility in Malaysia

In this study, communities’ psychosocial judgements (relationship, awareness, responsibility, and attitude) were evaluated in relation to DNA-based dengue kit accessibility. It was carried out by handing out 100 structured questionnaires (Kajang Housing (KjH): 40, Kajang Industrial (KjI): 40, Kuala Selangor (KuS): 20). From our descriptive analyses, KuS respondents exhibited a closer relationship with their neighbours (100%) compared to other respondents. KjH, KjI and KuS respondents know very little about dengue vector species. While KjH is leading the other two study areas, KjI and KuS in terms of knowing all symptoms associated with dengue fever (DF), KuS shows more interest to participate in dengue campaigns and/or prevention and control programs compared to KjH and KjI. Not more than 25% of total respondents are willing to offer transportation or nurturing their neighbours back to health. While KjI is more confident to use DNA biosensor when outside of their community, not more than 35% of total respondents are confident enough to use it within their neighbourhood. All communities, especially the affected ones, should take a proactive step by making use of DNA biosensor as an early warning tool, in conjunction with good psychosocial behaviours towards dengue, to achieve sustainable health promotion in managing dengue disaster.

Sustainable health promotion for the seniors during COVID-19 outbreak: a lesson from Tokyo.

The COVID-19 pandemic is novel corona virus infection outbreak that has gone global in 2020. Current prevention policies consist of hand hygiene and social distancing. Emergencies overloaded health services and shocked the logistics chains in many countries, especially Italy and China. Having more than a quarter of its population being elderly, Japan is at high risk for COVID-19 induced morbidity and mortality. This situation cancelled schedules of all routine group exercise activities for the seniors in Japan. While the outbreak is ongoing, staying at home is safe. However, successive days of being house-ridden and limited movement can lead to excessive physical inactivity. Some elderly who are not moving much can lose a significant amount of muscle strength, flexibility and aerobic capacity. It can accelerate the frailty and dependency of the seniors, and subsequently, claiming of care and health services. Moreover, existing and new evidences showed that physical activity can promote antiviral immunity. An alternative to usual group exercise activities is crucial to keep seniors active without affecting social distancing. While staying at home for long, functional exercises maintaining basic level of physical activity and movements are urgently required to be introduced to the seniors in Tokyo and around the world to prevent functional decline. Home exercise is a practical option. Therefore, we made a home-version of the functional training exercise video with different sets of 10-minutes exercise for 7 days a week. This breakthrough alternative may sustain health promotion for the elderly persons to preserve their active aging and maintain optimal health.

Sustainability of and Adherence to Preschool Health Promotion Among Children 9 to 13 Years Old

BackgroundLong-term evaluations of child health promotion programs are required to assess their sustainability and the need for reintervention. ObjectivesThis study sought to explore the long-term impact of a preschool health promotion intervention delivered in an urban low-income area of Colombia (phase 1) and to assess the effect of a new community-based intervention (phase 2). MethodsIn phase 1, a cross-sectional analysis of knowledge, attitudes, and habits (KAH) toward a healthy lifestyle and ideal cardiovascular health (ICH) scores of 1,216 children 9 to 13 years old was performed. Of the total, 596 had previously received a preschool health promotion intervention at 3 to 5 years old, whereas the remaining 620 were not previously intervened (intervention-naive group). In phase 2, all children were cluster randomized 1:1 to receive either a 4-month educational intervention (the SI! Program) to instill healthy behaviors in community centers (24 clusters, 616 children) or to control (24 clusters, 600 children). Previously intervened and intervention-naive children were not mixed in the same cluster. The primary outcomes were the change from baseline in KAH and ICH scores. Intervention effects were tested for with linear mixed-effects models. ResultsIn phase 1, ∼85% of children had nonideal cardiovascular health, and those who previously received a preschool intervention showed a negligible residual effect compared with intervention-naive children. In phase 2, the between-group (control vs. intervention) differences in the change of the overall KAH and ICH scores were 0.92 points (95% confidence interval [CI]: −0.28 to 2.13; p = 0.133) and −0.20 points (95% CI: −0.43 to 0.03; p = 0.089), respectively. No booster effect was detected. However, a dose-response effect was observed, with maximal benefit in children attending >75% of the scheduled intervention; the difference in the change of KAH between the high- and low-adherence groups was 3.72 points (95% CI: 1.71 to 5.73; p < 0.001). ConclusionsAlthough overall significant differences between the intervention and control groups were not observed, high adherence rates to health promotion interventions may improve effectiveness and outcomes in children. Reintervention strategies may be required at multiple stages to induce sustained health promotion effects (Salud Integral Colombia [SI! Colombia II]; NCT03119792)

Promoting cervical screening among women experiencing homelessness and socio-economic disadvantage in Sydney.

Australia's national cervical screening program has reduced rates of cervical cancer morbidity and mortality. However, these benefits have not been experienced by all women. A Cervical Cancer Screening Project was implemented with lay health educators to address inequitable screening access by women experiencing socio-economic disadvantage. Resources and a training program were developed and piloted with the specialist homelessness services workforce in Sydney, NSW. Data was collected to inform their development and evaluation through interviews, focus groups, self-administered surveys and analysis of NSW Pap Test Register data. Women reported low familiarity with the term 'cervical screening'. They identified a good patient-doctor relationship, and seeing a female practitioner, as screening enablers. While the majority reported having cervical screening before, NSW Pap Test Register data showed only 74% had screened previously and of those, 69% were overdue. Homelessness service workers expressed interest in talking with clients about cervical screening, and reported increased knowledge and confidence following training. The homelessness sector is an appropriate venue to access women who are disadvantaged and under-screened. However, increasing workforce capacity to discuss screening does not lead to increased screening for women accessing these services. Further efforts are required. SO WHAT?: Access to cervical screening by women experiencing disadvantage remains a challenge. Sustained multi-faceted health promotion efforts are required to increase access. These should be informed by additional research exploring barriers and enablers for this group of women.

How Health Promoters Can Assess Capacity Building Processes in Setting-Based Approaches-Development and Testing of a Monitoring Instrument.

Background: Health promoters often use stakeholder groups to jointly plan and implement local interventions. Stakeholder groups should take over responsibility to later run the health promotion program independently. Monitoring this process of capacity building can help health promoters improve the quality of the process. Instruments for the systematic assessment of capacity building among stakeholder groups are scarce. The goal of this study was to develop, and pilot test a generic assessment instrument for setting-based capacity building. Methods: We drafted a semi-standardized monitoring instrument to be used in stakeholder groups in various settings. This “EVA-protocol” (short for evaluation protocol) was based on capacity building domains e.g., leadership, resource mobilization. It was pilot implemented in a research network on increasing an active lifestyle in various settings. The respective health promoters documented 78 meetings of 15 different stakeholder groups. We performed feedback interviews and member checking among the facilitating health promoters, asking for comprehensibility, length, usability and perceived benefits of the instrument. Findings: Data collected in the “EVA-protocol” helped the facilitating health promoters understand the development of competences and capacities in the stakeholder groups and identify factors that favor or hinder the capacity building process. The instrument was rated as user friendly, but it was remarked that it is best filled out by two persons and reflected upon by those to offer the greatest benefit. Not all projects could afford this procedure due to lack of time/staff resources. Conclusions: The drafted instrument can serve as quality management tool for health promoters who facilitate participatory stakeholder groups in different settings and intend to build capacities for sustainable health promotion structures.

Selling health and happiness how influencers communicate on Instagram about dieting and exercise: mixed methods research

BackgroundEating disorders among adolescents are an ongoing public health concern. Sustainable health promotion programmes require a thorough understanding of the social context in which minors engage. Initial studies show that young people make extensive use of social networks in order to exchange experiences and gather information. During this process their (buying) behaviour is significantly affected by so-called influencers.MethodsThe exploratory research studies non-campaign driven health communication on dieting and exercise by influencers in social networks with a focus on content, techniques and visible impact. In a mixed methods approach, we initially analysed 1000 posts from influencers on Instagram quantitatively. Subsequently we conducted an in-depth content analysis of 9 extreme and 27 typical communication threads.ResultsInfluencers gain the trust and friendship of their followers by designing body-shape focused visual content and targeted communication techniques. They identify and define diet and exercise as factors to be controlled for body perfection. By consuming dietary supplements and wearing tight-fitting branded sportswear, influencers promise a simplified way of optimizing one’s appearance as the key to happiness. Direct and surreptitious advertising of industry-specific products constitutes the communicative focus. At the same time, minors identify with the roles and ideals demonstrated by influencers and their needs are satisfied on several different levels. This creates a relationship of dependency between influencers and their followers.ConclusionsThe dynamics in the field of health communication by influencers on social networks will become increasingly important in the coming years. This is largely due to the targeted demand on the part of (mainly) underage users and the high attractiveness of influencer marketing on the part of companies. Influencers suggest a dependence on happiness, well-being, health and beauty. Only those who create a body shaped through control and discipline are healthy and beautiful - and can be happy. The indirectly communicated conclusions, which can be considered as extremely critical, illustrate the need for action in order to protect and positively accompany young people in their psychological and physical development. The shift of authority figures within Generation Z, as well as identified communication techniques, can be considered and may be harnessed by targeted, group-oriented campaign designs.

Family Nutrition Improvement Efforts Through Nutrition Management of Pokea Clam Based on Environmental Health

The coastal communities of the Pohara river, Sampara Subdistrict, where the habitat for endemic pokea clam growth, has a habit of consuming pokea clam meat which can affect the nutritional status of the family. Pokea clam meat (Batissa violacea celebensis von Marten 1897) contains fatty acids, which can reduce the risk of cardiovascular disease. The purpose of this community service, to identify patterns of consumption of pokea clam and nutritional status. The method used through interviews, counseling and examination of nutritional status. The number of respondents identified was 72 respondents. Data were collected by questionnaire regarding the consumption pattern of pokea clam, measurement of height, weight and waist circumference. The results of the identification of consumption patterns of pokea clam meat showed 58% of respondents, consuming average pokea clam 1-3 times a day. As many as 78%, processing directly the pokea clam meat. The types of preparations consumed are pokea satay (39%) and boiled pokea (8%). The results of examination of Body Mass Index (BMI) obtained 50.0% normal nutritional status, 16.7% excess and 30.6% obesity. Waist circumference measurement results, 47.2% are normal, and 52.8% are not normal. Integrated and sustainable health promotion, need to improve the nutritional status of coastal communities.

Creative Learning and Teaching Activities in a School-Based Program Promoting Adolescent Health.

Designing educational activities that engage health profession students' interest in community-based learning is challenging. University faculty channeled concerns about regional trends in cardiovascular disease among adolescents into activities that linked students' foundational knowledge to critical application experiences. Between 2013 and 2017, university faculty partnered with a local health system and a public high school to develop a sustainable health promotion plan for the school. The university component involved activities that students implemented as part of their community clinical experiences. Participant results and feedback were overwhelmingly positive and affirmed that linking learning to real-world concerns made preventive health care concepts interesting and easier to grasp. Educational activities that involve neighboring stakeholders is a creative and meaningful way to provide engaging learning experiences for future health professionals while contributing to authentic solutions within a community-based partnership. [J Nurs Educ. 2019;58(8):485-487.].