Workplace health promotion in Shanghai: needs assessment in four diffement industries

A baseline study s made of knowledge/attitudes and preventivehealth behaviours among 1960 subjects in four selected factoriesin the People's Republic of China using randomization and stratifiedclusters.     

The results of a worksite health promotion programme in Kuala Lumpur, Malaysia

The worksite is one of the key channels for the delivery of interventions to reduce chronic diseases among adult populations. It provides easy and regular access to a relatively stable population and it encourages sustained peer support. This paper reports a 2-year follow-up of the impact of a worksite health promotion programme on serum cholesterol and dietary changes among employees in a city in Malaysia. A quasi-experimental study was conducted among Malay-Muslim male security guards, with those working in a public university in Kuala Lumpur comprising the intervention group, and those working in the teaching hospital of the same university as the comparison group. They were comparable in socio-demographic characteristics. The intervention group received intensive individual and group counselling on diet, physical activity and quitting smoking. The comparison group was given minimal education on the same lifestyle changes through mail and group counselling. The intervention group showed a statistically significant reduction in their mean total cholesterol levels as compared with the comparison group, with an intervention effect of -0.38 (95% CI = -0.63, -0.14) mmol/l. The intervention group also reported a reduction in the amount of cigarettes smoked. The worksite was shown to be an effective channel for health promotion. The adoption of the new lifestyle behaviours should be supported and sustained through modification of work policies.     

Researching the implementation of community mental health promotion programs

Understanding the process of program implementation plays a critical role in advancing research, practice and policy in mental health promotion. This paper focuses on the implementation of community mental health promotion and considers the challenges presented in implementing and evaluating complex, multifaceted interventions carried out in the context of dynamic community settings. The Rural Mental Health Project1–3 is presented as a case study to illustrate the practical and research challenges encountered in implementing and evaluating a community mental health promotion initiative. This case study highlights the factors that contributed to the successful implementation and evaluation of a community‐based intervention for rural communities on the border region in the Republic and Northern Ireland. Among the factors identified are: a partnership model of working; local co‐ordinating structures and consultation mechanisms; use of a structured planning model to guide program planning and implementation; mobilisation of cross‐community and inter‐agency support; and a comprehensive logic evaluation framework to assess the input, process, impact and outcomes of the project as it unfolded.     

Co-ordination, collaboration and health promotion: lessons and issues from an alcohol education programme

This article draws upon the evaluation of an alcohol educationprogramme in South West England to develop a discussion abouthow to improve co-ordination and collaboration in health promotionbetween different professionals. The importance of collaborationis frequently recognized but research evidence suggests thatit is very hard to achieve. Three main issues are addressed.First, the article considers how the national funders of regionalprogrammes can improve their relationship with local agencies.Second, the district co-ordination model of the South West programmeis assessed as a possible model for co-ordination across a rangeof health topics. Third, the tactics of professional networkdevelopment at the local level are explored.     

Worksite and communications-based promotion of a local walking path

Current research has shown relationships between the environment (eg, parks and trails) and levels of physical activity participation. This study was designed to implement and evaluate a communications based worksite campaign to promote awareness of an existing local walking path and to increase walking. Promotional materials were distributed for 1 month via flyers, email, website postings, and during bi-weekly information booths. Evaluations were conducted at baseline, during, and following the promotional campaign. Borderline statistically significant increases in walking activity from baseline were observed midway through the campaign (p = 0.069) and following the campaign (p = 0.075). Counts observed during the intervention were almost triple those at baseline and increased in the post-campaign phase to approximately three and a half times those at baseline. Sign recognition surveys revealed at baseline, 51% of the participants correctly identified the walking path signs, which increased to 65% during the campaign (p = .0674). Familiarity with physical activity messages around the workplace increased from 64.6% at baseline to 75.5% during the campaign (p = .097). This study shows initial promise of a theoretically based communications intervention to increase knowledge of physical activity and to promote walking.Melissa A. Napolitano is Assistant Professor of Psychiatry and Human Behavior and Staff Psychologist, Centers for Behavioral and Preventive Medicine, Brown Medical School and The Miriam Hospital, Providence, Rhode Island, Heather Lerch is a Health Promotion Specialist at MassMutual Benefits Management, Inc., Springfield, Massachusetts, George Papandonatos is Assistant Professor of Biostatistics, Brown University, Providence, Rhode Island, and Bess H. Marcus is Professor of Psychiatry and Human Behavior and Director, Centers for Behavioral and Preventive Medicine, Brown Medical School and The Miriam Hospital, Providence, Rhode Island     

Effectiveness of health promotion programs in moderating medical costs in the USA

Although evidence from scientific evaluations of health promotionprograms has demonstrated improvements in selected health outcomes,the relationship between participation in health programs anddefinitive economic returns in medical cost savings has beenmore difficult to establish. The purpose of this study is toevaluate the effect of employee participation in health promotionprograms with selected medical cost outcomes. Program participationwas operationalized as a summed participation score based onemployee program participation data. Increasing levels of programparticipation were associated with increasingly higher medicalcosts but not with higher numbers of health risks. A Cost ChangeModel was developed to investigate the relationship betweenprogram participation and changes in cost status (high cost/lowcost) over a 6-year time period. Program participation was highestamong the high-cost employees. Participation patterns may havereflected the appeal of most health promotion programming tohigh-risk/high-cost employees. Over time those employees whoparticipated in a comprehensive health promotion program, includingintervention programs, experienced moderation in medical costs.In contrast, for those employees with participation primarilyconcentrated in health risk awareness and identification programs,medical costs continued to increase. These findings provideevidence for the effectiveness of a comprehensive health promotionprogram in moderating medical care costs.     

Evaluation of a workplace cardiovascular health promotion programme in the Republic of Ireland

This paper describes a comprehensive evaluation of the organizational impact of a workplace health promotion programme, in the context of a framework devised by Nutbeam in 1998. The Happy Heart at Work programme, sponsored by the Irish Heart Foundation, has been in existence for 10 years and aims to promote a healthy lifestyle through specially devised modular materials. A postal census survey of 785 valid registered sites expressing any level of initial interest in the programme yielded a 40% response rate (n = 311). Of these, 194 (63%) were currently active and 114 were not. Active organizations were less likely to be Irish owned (54.5% versus 71.4%, p < 0.05), and more likely to operate in shifts (72.3% versus 51.1%, p < 0.05) or to have an occupational physician amongst the staff (36.9% versus 31%). Programme impact within active organizations, based on pre-defined Health Promoting Workplace parameters, was documented. There was agreement in the questionnaire responses that participating organizations promote a smoke-free environment (mean rating on five-point scale = 4.42), employee health and well-being (4.21) and good nutritional practice (4.11). Triangulation of research methods, including a telephone survey of gatekeepers from within organizations (n = 18), focus groups with participant employees (n = 42) and a review of the staff opinions of the facilitating organization on the programme, all showed strong concordance with respect to the strengths and weaknesses of Happy Heart at Work. The programme was felt to help improve employees' lifestyle habits and morale, as well as the company's public image. The main drawbacks of the programme were its relatively low profile, even in actively participating organizations, and the fact that it was not seen to be independently sustainable without intensive and ongoing support.     

Responsive evaluation in health promotion: its value for ambiguous contexts

Responsive evaluation offers a perspective in which evaluation is reframed from the assessment of program interventions on the basis of policymakers' goals to an engagement with all stakeholders about the value and meaning of their practice. This article argues for this perspective both generally and more particularly in relation to health promotion. Responsive evaluation is especially appropriate in health promotion contexts characterized by a high degree of ambiguity. Ambiguity refers to the absence of or contradictory interpretations about what needs to, can and should be done, when and where. Ambiguity is high in the case of non-routine programs, lack of knowledge about success indicators, collaborative and community based programs and the absence of consensus among stakeholders. In health promotion contexts marked by a low degree of ambiguity random controlled trials (RCTs) and quantitative methods are to be considered. This implies the evaluators should assess the degree of ambiguity of a situation before deciding about an appropriate design.     

The health promoting school: progress and future challenges in Welsh secondary schools

Data were obtained from a random sample of 87 secondary schoolsin Wales (UK) about the organization and provision of healtheducation teaching, the implementation of health related policies,and the involvement of outside agencies and professionals inthe planning and delivery of health education programmes. Theresults suggest that schools have made progress in curriculumdevelopment. However, if the concept of the health promotingschool is to be translated into practice, greater attentionwill need to be given us the development of broadly based policiesfor health covering both pupils and staff and the better integrationof school programmes with community resources. Greater understandingof the health promoting school concept by teaching staff andthe development of examples of good practice in embedding healtheducation into national curriculum subjects, are also advocated.     

Developing methodologies for evaluating community-wide health promotion

There has been growing recognition that health promotion programswhich target whole communities are more likely to be effectivein changing health behaviour. However, studies evaluating theimpact of community-wide health promotion programs rarely useadequate methodology. Randomised control trials where multiplewhole communities are randomly assigned to control and interventiongroups are optimum if evaluators hope to validly attribute changesin health behaviour to the intervention. However, such trialspresent a number of difficulties including cost and feasibilitylimitations and the evolving nature of statistical techniques.This paper proposes applying a fairly well-accepted phased evaluationapproach to the evaluation of community participation programs,using three defined phases. Phase 1 consists of small-scalestudies to develop the measures and assess acceptability andfeasibility of the intervention; Phase 2 consists of studiesin a small number of communities designed to trial the interventionin the real world; Phase 3 studies use an appropriate numberof entire communities to provide valid evidence of efficacyof the intervention. It is suggested that criteria be resolvedto identify adequate studies at each stage and that advantagesand limitations of Phase 1 and 2 studies be clearly identified.The paper describes the major design, sampling and analysisconsiderations for a Phase 3 study.     

缙云县农村学校健康教育与健康促进活动效果评估

目的：了解缙云县农村学校开展健康教育和健康促进活动的效果,为更好地开展农村学校健康教育和健康促进活动提供科学的依据。方法：按照整群随机抽样的方法,分别抽取大源镇中学初中生6个班256名学生,大源镇小学12个班482名学生作为调查对象,采用自行设计的问卷在干预前后进行调查。结果：中学生干预前为45.8%,干预后为71.4%,干预前后差别有统计学意义;小学生干预前为41.8%,干预后为65.7%;干预前后差别有统计学意义;不同年级学生干预前后差别有统计学意义。结论：学校健康教育和健康促进活动成效显著,高年级学生效果更显著,但健康相关知识知晓率总体偏低,今后必须要加强偏远山区学校的健康教育工作。     

Health promotion behaviors of Gujurati Asian Indian immigrants in the United States

The purpose of this paper was to examine the health promotion behaviors of Asian Indians, one of the fastest-growing immigrant groups in the United States. The sample consisted of 261 respondents randomly selected from the Charotar Patidar Samaj, a national Gujarati Association membership directory. Health promotion behaviors were obtained using the Health Promotion Lifestyle Profile II. Respondents demonstrated lower scores in physical activity and nutrition and higher scores in the areas of interpersonal skills and spiritual growth domain of the health promotion behaviors. Physical inactivity was the highest among adults of 25–50 years of age. A significant difference existed between males and females in the domain of health responsibility. Females were more responsible for their health and reported medical problems to a physician more often than their male counterparts. They also educated themselves about health promotion behaviors through reading and watching TV programs. Study results support previous research findings and make an important contribution to understanding the Asian Indian's health-promoting lifestyle behaviors.     

大庆油田员工心理健康促进方案构建的研究

目的探讨适用于油田企业的员工心理健康促进方案的运作模式及其内容,了解员工生活与心理压力的来源与类型,规划构建有关心理健康教育课程。方法采用问卷调查方法,自行设计调查问卷,在大庆油田有限责任公司员工内采用分层抽样方法抽取3 000人作为调查对象。收集调查对象对心理健康促进的看法及需求并对资料进行统计分析。结果有效问卷2 760份,全体研究对象都认为现代企业关注员工心理健康很重要;受调查对象压力总体感觉比较大及以上者占33.59%,员工压力来源的排序依次为经济压力、生活压力、人际关系压力、职业发展压力、婚姻情感压力及内部竞争压力;员工需要获得的专业帮助依次为情绪管理、压力管理、有效沟通技巧、适应技巧、子女教育与亲子关系、心理调整技巧及职业规划设计;大庆油田员工心理健康促进方案以员工心理健康评价、心理卫生教育训练为主,辅以员工个别心理咨询。结论对大庆石油员工进行心理卫生教育是必要的。     

Promoting healthy vision in students: progress and challenges in policy, programs, and research

Background:  An estimated 1 in 5 American children has a vision problem. Children living in poor urban environments have twice the normal rate of vision problems. Uncorrected vision problems can worsen over time and result in permanent vision loss. Early detection and treatment of vision problems is therefore essential in optimizing children's health and development. Federal-, state-, and school-based prevention efforts continue to evolve to identify and serve children with vision problems.
Methods:  Review of current literature on (1) major vision problems among children, (2) unique problems faced by low-income children with poor vision, and (3) the rise in health policy and program efforts to support the goal of healthy vision for each child. The preliminary relationship established between vision and academic performance is also discussed.
Results:  Low-income children have a disproportionate amount of vision problems and face several barriers to acquiring vision care. Varied actions among states include legislation requiring screening and follow-up before entry into elementary school.
Conclusions:  States and schools can take concrete steps to increase the number of children identified and treated for vision problems. Health policy and programs should also address common barriers to children receiving and wearing their glasses at home and in the classroom. Further research is necessary to assess the relationship between children's vision and educational outcomes. To the extent that vision is associated with academic success, policies and programs can be shaped to address the achievement gap that exists among our nation's youth and to support the goal of healthy vision for each child.     

Health promotion research: dilemmas and challenges

OBJECTIVE: To analyse dilemmas and challenges in health promotion research, and to generate ideas for future development. METHOD: The analysis is based on authors' experiences in working in the field of research and action in health promotion and on experiences of others as found in literature. RESULTS: The assumptions underlying scientific research as based in the biomedical design are difficult to meet in community-based health promotion research. Dilemmas are identified in relation to the possibility of defining the independent and dependent variables beforehand and the intermingling of these variables (the intervention and outcome dilemma), the difficulty in quantifying the desired outcomes (the number dilemma), and the problem of diffusion of the programme to the control group (the control group dilemma). CONCLUSION: Research in health promotion has specific reasons to reconsider the approach towards research, the selection of outcome variables, and research techniques. Strategies and methods to make activities and their outcomes clear are discussed and criteria to judge confidence and applicability of research findings are presented.