The use of telemarketing in the community-wide prevention of heart disease: The Pawtucket Heart Health Program

The marketing of preventive health behaviors is typically accomplished through various broadcast, print, and other mass media channels. By making randomly-dialed telephone calls to 4,000 residents of Pawtucket, RI, volunteers of the Pawtucket Heart Health Program succeeded in registering nearly 400 individuals for risk factor reduction groups or self-help behavior change kits. Additionally, community awareness of the program was an indirect benefit of this telemarketing. Telemarketing is an interactive and inexpensive approach to marketing preventive health behaviors.Rick Schwertfeger, M.A.T. is the Director of the Education Department at Valley Regional Hospital, Claremont, NH 03743. John P. Elder, Ph.D., M.P.H. is an Assistant Professor at the Graduate School of Public Health, San Diego State University, San Diego, CA 92182. Robert Cooper, B.A. is a Health Promotion Specialist at the Pawtucket Heart Health Program, Pawtucket, RI 02860. Thomas M. Lasater, Ph.D. is the Co-Principal Investigator and Richard A. Carleton, M.D. is the Principal Investigator of the Pawtucket Heart Health Program The Memorial Hospital/Brown University Program in Medicine, Pawtucket, RI 02860. This research was supported by grant HL23629 from the National Heart, Lung and Blood Institute, DHHS. Correspondence should be sent to John P. Elder, Graduate School of Public Health, San Diego State University, San Diego, CA 92182.     

Public health re-energised: what the new White Paper will mean

The Coalition Government has set out its intended strategy for public health in England in the White Paper "Healthy Lives, Healthy People" (November 2010). This aims to tackle high levels of "lifestyle" health problems such as obesity, alcohol misuse and smoking, and to reduce health inequalities. Policies will be evidence-based and the emphasis will be on outcomes rather than targets. The focus will be local and will include wider dimensions of public health such as tobacco control and transport. Mental health will have greater prominence. Local government will play a major part, with Directors of Public Health and public health budgets transferring from Primary Care Trusts to Local Authorities. Public health funding will be ring-fenced. A dedicated public health service, Public Health England, will be established in the Department of Health, to provide disease control and support local innovation. There will be greater investment in the early years of life, and an increase in health visitor numbers and Family Nurse Partnerships. The public health role of school nurses is likely to increase under a forthcoming review of school nursing.     

A new approach to public health. Strategies for its implementation]

Public Health System accepts "New Public Health" only in a theoretical way, since in the practice essential modifications to get "Health For All-2000" aims are not implemented. It is necessary to look "bridge-heads" that permit to introduce changes gradually to reorganize Health Services. In the present article, different alternatives are analyzed, all of them giving priority to the programmes that consider Health as a natural resource. These programmes can be "Governmental Programmes" so Health policies coming from the Health Department can be assumed by the others Public Administration Departments.     

The Establishment of the School of Public Health at the State University of New York,Downstate Medical Center: The First Nationally Accredited School of Public Health in a Public University in New York City

The State University of New York (SUNY), Downstate Medical Center initiated a Master of Public Health (MPH) degree program in July 2001 following planning efforts that began in 1995. Twelve students entered the program in June 2002, and currently some 110 MPH students and 12 Doctor of Public Health (DrPH) students are enrolled. This article describes the long and complex process of transforming the original MPH degree program, with its single focus on urban and immigrant health, with a student enrollment of 12 and 8 full-time faculty, into a school of public health with a large student enrollment of 122 students, 25 full-time faculty, five MPH degree tracks, and four DrPH degree tracks. The process of establishing the SUNY Downstate School of Public Health in 2009 from its inception as an MPH program in 2001 spanned a period of 8 years. This process was guided by a commitment to two basic principles. The first was to maintain the original 2005 program accreditation by the Council on Education for Public Health (CEPH). The second was to sequentially secure accreditation for all subsequent four MPH and four DrPH degree tracks through CEPH’s procedure of substantive change approval. This policy assured continuous national CEPH accreditation of the original Urban and Immigrant Health MPH degree track and all added degree programs. The 5-year period following the initial CEPH accreditation of the MPH program in 2005 was one of intense development during which all of the essential elements for CEPH accreditation of a school of public health were put into place. This rapid development was made possible by the vision and full support of Downstate’s president, John C. LaRosa, MD, FACP, and the dedicated efforts of many. This included the students, faculty, staff, and administrators of the School of Public Health, the school’s Community Advisory Group, several external advisors, and many in the medical center’s Central Administration, College of Medicine, School of Graduate Studies, College of Nursing, College of Health Related Professions, and the University Hospital of Brooklyn. From the very beginning of the planning phase for an MPH program and through the ultimate accreditation of the School of Public Health in 2010, broad participation was solicited from all major units in the medical center. Thus, the MPH program became a center-wide initiative and not merely that of the College of Medicine’s Department of Preventive Medicine and Community Health. This broad participation has been continuously maintained through the involvement of leaders of other medical center academic units and the University Hospital of Brooklyn in the program’s and then the school’s standing and ad hoc committees, and in other activities as well. Similarly, community representation has been maintained, some through formal linkages relevant to the practical field experiences required of all students. In October 2010, the Board of Councilors of CEPH accredited the SUNY Downstate School of Public Health for a 5-year period through 31 December 2015. The accreditation of the school was a major milestone for Downstate, Brooklyn, and New York City. The SUNY Downstate School of Public Health is the first CEPH accredited school of public health in the history of Brooklyn, and only the second such school in New York City. It is also the first CEPH accredited school of public health at a publicly supported university in New York City. The school has already had a major impact on improving the health and well-being of the people of Brooklyn through its numerous collaborative community-based health promotion and disease prevention programs.     

„Human Trafficking,Public Health and the Law“ – eine interdisziplinäre „Spring School“

Background

Currently approximately 20.9 million human beings are victims of human trafficking worldwide—a modern form of slavery. The victims are mostly women and children and come from a variety of different countries. As part of an Erasmus Intensive Program a two-week spring school was held on “Human Trafficking, Public Health and the Law” focusing the issue of human trafficking, particularly from the perspectives of Law and Public Health.

Results

Students and teachers from five universities from different countries worked out the principles on the international fight against trafficking in human beings using the method of the “New Haven School of Jurisprudence”. These “Siena Principles on Human Trafficking and Public Health” focus on the three levels prevention, prosecution of traffickers and protection of victims.

Conclusion

The Spring School should set an sign to encourage the international, interdisciplinary discourse on the problem of trafficking in persons. In the future, in particular research in the field of Public Health should be intensified as the basis for development of targeted measures in the fight against human trafficking. In the following article the contents of the Spring School will be illuminated, including the methodology used, and the final result—the written principles—illustrated.     

2007年蓝田县中小学校和幼儿园食堂卫生状况调查

[目的]了解学校食堂卫生状况，为开展学校食品卫生专项整治提供依据。[方法]采用卫生部《餐饮业食品卫生量化分级评分表》嘲，以现况调查的方法对蓝田县61户学校食堂的食品卫生状况进行调查并进行相关项目的现况分析。[结果]蓝田县61户学校食堂，持有效卫生许可证的49户，持证率80．33％；从业人员268人，持有效健康证261人，从业人员体检培训合格率为97．38％；食（饮）具抽检488份，合格317份，合格率为64．96％。[结论]严格的监督检查，经营户的卫生法律意识提高有助于学校食堂食品卫生状况的改善。     

Research related to the status of "collaboration" among municipal public health nurses in Japan

PURPOSE: The two main goals of this research were: (1) To clarify the current state of collaboration among municipal public health nurses throughout Japan (referred to collectively as "Public Health Nurses"); and (2) To identify personal factors that separate Public Health Nurses who collaborate frequently from those who do not, and to clarify the characteristics of relevant interventions. The author believes that the results of this study should be valuable in demonstrating specific methodologies related to the ability of Public Health Nurses the ability to execute collaborative activities. OBJECTIVE: Before conducting the main survey, a preliminary survey was performed to determine the affiliate divisions for Public Health Nurses employed by all of the 3,190 municipalities in Japan. Based on this survey, we gained an understanding of factors such as the number of Public Health Nurses and their places of employment. Next, during December 2003 to August 2004, we carried out a questionnaire survey by post to the 21,631 Public Health Nurses in Japan who had been identified through the preliminary survey. METHODS: Survey items included: the Public Health Nurse's gender, age, position, most recent academic history, total years of work, number of years working with the current employer, affiliated division, types of tasks undertaken, status of execution of those tasks, and collaborative activities, as well as specialists institutions and organizations involved in such collaboration. RESULTS: Data were gathered from 13,024 Public Health Nurses, which represents roughly 80% of the Public Health Nurses in Japan. First, regarding collaboration, links with health and medical institutions, health centers, and other government institutions appeared active, but this was not the case for social welfare facilities for the physically or mentally disabled. Furthermore, although the subjects collaborated with Public Health Nurses from other institutions, as well as with government administrators and doctors, there was little collaboration with pharmacists or with mental health and welfare workers. When we analyzed data for individual specialists and specialized institutions, we found that the "collaborating" group had significantly higher scores for collaborative activities than the "not collaborating" group. These scores are believed to reflect actual conditions. When we analyzed the relationships between personal factors for Public Health Nurses and collaborative activity scores, we found that scores tended to be higher for older nurses and for those with more years of experience. Looking at the relationship between details of tasks undertaken and collaborative activity scores we found that the group developing new business or securing budgets to develop new business had significantly higher scores, and that in terms of the execution of day-to-day operations, the Public Health Nurses with higher scores were those undertaking tasks that required new knowledge, or tasks that demanded high-level skills. CONCLUSIONS: Municipal Public Health Nurses often collaborate with specialists or health-related divisions, but they do not collaborate closely with divisions related to welfare services for the physically or mentally disabled. The Public Health Nurses with the highest collaborative activity scores were those scores clearly indicated active collaboration, and whose personal factors included extensive experience in the field. These Public Health Nurses were also involved in tasks that demanded a high level of skill.     

Partnering essentials.

"The Management Moment" is a regular column within the Journal of Public Health Management and Practice. Janet Porter, PhD, and Edward Baker, MD, MPH, MSc, are serving as The Management Moment Editors. Dr. Porter is Associate Dean for Executive Education, The North Carolina Institute for Public Health, School of Public Health, at the University of North Carolina at Chapel Hill, and Dr. Baker is Director of the North Carolina Institute for Public Health, School of Public Health, at the University of North Carolina at Chapel Hill. This column provides commentary and guidance on timely management issues commonly encountered in public health practice.     

Management is a Team Sport.

"The Management Moment" is a regular column within the Journal of Public Health Management and Practice. Janet Porter, PhD, and Edward Baker, MD, MPH, MSc, are serving as The Management Moment Editors. Dr. Porter is Associate Dean for Executive Education, The North Carolina Institute for Public Health, School of Public Health, at the University of North Carolina at Chapel Hill, and Dr. Baker is Director of the North Carolina Institute for Public Health, School of Public Health, at the University of North Carolina at Chapel Hill. This column provides commentary and guidance on timely management issues commonly encountered in public health practice.     

Environmental medicine in public health service--a social responsibility and its consequences

The special committee for "Environmental Medicine" established by the Federal Association of Doctors in the German Public Health Service presents its paper entitled "Environmental Medicine in the Public Health Service--A Social Responsibility and its Consequences: Propositions with regard to the situation, aims, strategies, and opportunities for action". The paper includes core ideas and responsibilities in the public health service. It aims at providing a number of guidelines for implementing "Environment and Health" ("Umwelt und Gesundheit"), an action programme by the Federal Ministry of Environmental Protection and the Ministry of Health, as well as "Health 21" ("Gesundheit 21"), the framework concept "Health for all" for the WHO's European Region. The paper also aims at initiating and facilitating steps for joint action by the Public Health Service. These theses were passed on to Mrs. Andrea Fischer, the Federal Minister of Health, during a meeting with the Board of the Association. In Germany, environment-related public health protection is well established in the Public Health Departments and state institutes/departments within the scope of public health provision and disease prevention. Typical responsibilities include environmental hygiene and environment-related medical services which have increased in importance. The range of responsibilities and its current political importance are a result of environment-related public health risks, the social situation of the population, also with regard to health issues, and the scope of responsibilities and competencies by doctors and staff in the public health departments. With the people's demands for health, quality of life and life expectancy, this need for action increases. In this paper, judicial, professional, and personal consequence are presented which arise as public health authorities assume these responsibilities.     

REVIEWS OF BOOKS AND REPORTS

Book reviewed in this article:
Psychiatric Disorders in School Children
Initiating School Related Heart Programs
Vannier, Maryhelen, Teaching Health in Elementary Schools .
Annual Report 1961–62, Division of Medical Services, Philadelphia Public Schools     

Organizing public health nursing for the 1990s: generalist or specialist

Since the 1930s, Public Health Nurses (PHNs) have been deployed in most health units in Canada to provide community-based care for all people living in defined geographical areas. PHNs have provided nursing services for all ages and stages for a variety of health and illness states. A literature review and a systematic analysis of the internal and external factors affecting Public Health Nursing practice in this community led to a recommendation to assign nurses to specific target populations (e.g. parent-child, school, adolescent, adult, seniors) instead of assigning responsibility for all health problems in a geographic location. We describe the processes of assessment, analysis, planning and implementation of the change from geographic assignment to target population assignment for Public Health Nurses.     

Prevalence of cigarette smoking among secondary school students--Budapest, Hungary, 1995 and 1999

The average per capita cigarette consumption in Hungary is among the highest in the world (World Health Organization [WHO], unpublished data, 1997) (1). In 1999, the Metropolitan Institute of State Public Health and Public Health Officer Service, Budapest, Hungary, collaborating with CDC, conducted a survey of cigarette smoking among secondary school students aged 14-18 years in Budapest (1999 population of Budapest: approximately 2 million), similar to a survey conducted in 1995 (2). This report summarizes the survey findings, which indicate that current smoking among secondary school students in Budapest increased from 36% in 1995 to 46% in 1999.     

Primary prevention of cardiovascular diseases in childhood: changes in serum total cholesterol, high density lipoprotein, and body mass index after 2 years of intervention in Jerusalem schoolchildren age 7-9 years

A school health education and promotion program, the Israeli version of the American Health Foundation's "Know Your Body" program, was developed by the Department of Public Health of the Municipality of Jerusalem in 1983. Eight experimental and eight control schools participated in this cohort study of Arab and Jewish first-grade children. After the first 2 years of intervention, comparison of experimental and control groups showed a significant increase in serum high density lipoproteins among Jewish children and a decrease in serum total cholesterol and body mass index among both Jewish and Arab children. These results indicate that changes in cardiovascular disease risk factors such as blood total cholesterol, high density lipoproteins, and body mass index are possible after a health education program is introduced to first-grade students for a relatively short period of time.     

Hypertension control: meeting the 1990 objectives for the nation.

Hypertension (high blood pressure) is 1 of 15 health priorities of the Public Health Service set forth in the report, "Promoting Health/Preventing Disease: Objectives for the Nation." The nine objectives for hypertension include improved health status, reduced risk factors, increased public-professional awareness, improved services and protection, and improved surveillance-evaluation systems. A number of Federal agencies, coordinated by the National Heart, Lung, and Blood Institute, are working to reach the hypertension objectives in cooperation with State, local, and voluntary agencies and organizations. A great deal of progress has been made toward the objectives, as reflected by a variety of indicators. By 1980, for example, 34.1 percent of the population with hypertension had their blood pressure controlled at less than 160/95 mm Hg, but in 1972 only 16.5 percent were so controlled. Since 1972, the age-adjusted death rate has dropped 42 percent for stroke and 27 percent for coronary heart disease. Data indicate that the national goal for sodium ingestion (3-6 grams daily) may already have been met. Fifty-one percent of the population understand that hypertension may lead to stroke, meeting another objective. Public knowledge about hypertension as a "major likely cause of heart trouble" almost doubled in the 6-year period for which data are available. In 1982, 30 percent of processed food in grocery stores had sodium content labeling and almost 50 percent had calorie labeling, according to studies conducted by the Bureau of Foods of the Food and Drug Administration. Efforts are underway to develop a methodology for assessing incidence of hypertension and categories of hypertension control, a need spelled out in another objective.     

Practicing management and leadership: creating the information network for public health officials.

The Management Moment" is a regular column within the Journal of Public Health Management and Practice. Janet Porter, PhD, and Edward Baker, MD, MPH, MSc, are serving as The Management Moment Editors. Dr Porter is Associate Dean for Executive Education, The North Carolina Institute for Public Health, School of Public Health, at the University of North Carolina at Chapel Hill, and Dr Baker is Director of The North Carolina Institute for Public Health, School of Public Health, at the University of North Carolina at Chapel Hill. This column provides commentary and guidance on timely management issues commonly encountered in public health practice.     

Food and Nutrition in Public Health: constitution, contours and scientific status

This paper aims to examine the route on which Food and Nutrition in Public Health was build in the Brazilian context, from its fields of origin, identifying tensions and convergences, seeking to demarcate its boundaries and to characterize its status within the scientific field. We seek to evince the existence of a movement marked by the fruitful encounter between the field of "Public Health" and a portion of the field of "Food and Nutrition", or more precisely, one of their cores, starring actors oriented by knowledge distinguished from other nuclei in this field. Such phenomena, that we postulate as outcomes of the contact nuclei of knowledge that identify the Public Health with the field of "Food and Nutrition", led to a specific core of distinct knowledge and praxis in this context corresponds to what we call "Food and Nutrition in Public Health". This is a process marked from the outset by tensions between the biological and social paradigms, becoming the one hand, as a major challenge to be faced, and secondly, as a promising way for the approach between different fields of science, both the more practical, such as those targeted to conceptual reflection.     

Meetings, meetings, and more meetings.

The Management Moment" is a regular column within the Journal of Public Health Management and Practice. Janet Porter, PhD, and Edward L. Baker, MSc, MD, MPH, are serving as The Management Moment Editors. Dr Porter is Associate Dean for Executive Education, The North Carolina Institute for Public Health, School of Public Health, at the University of North Carolina at Chapel Hill, and Dr Baker is Director of The North Carolina Institute for Public Health, School of Public Health, at the University of North Carolina at Chapel Hill. This column provides commentary and guidance on timely management issues commonly encountered in public health practice.