The effect of a health promotion campaign on mortality in children

Previous research has shown that in the Netherlands there is a certain degree of preventable mortality associated with long-distance travel, particularly among children of ethnic minority descent. In 1985 a health promotion campaign was launched in Amsterdam with the aim of reducing travel-related deaths by increasing knowledge in ethnic minority communities about the risks involved in travel. In the present study, two data sets are used to examine the possible effects of this health promotion campaign on travel-related mortality in children. The first data set, which was collected locally, indicates that the number of Amsterdam children dying abroad has dropped considerably since 1985. This is particularly true within one group which is highly likely to exhibit risky travel behavior. The second data set, which was collected nationally, shows that an upward trend in mortality among children aged 0-14 years before 1985 has in fact changed into a downward trend since 1985. A similar pattern is observed in the Netherlands as a whole, but to a significantly less pronounced degree than in Amsterdam. Although the influence of extraneous factors can never be fully dismissed, the analysis provides support for the conclusion that the health promotion campaign did in fact succeed in reducing the number of travel-related deaths.     

Turning health research into health promotion: a study of causality and 'critical insights' in a United Kingdom health campaign

This article examines how important decisions about health can alter between public health policy formulation and eventual marketing implementation. Specifically, the article traces the development and production of a major United Kingdom social marketing campaign named Change4Life, and examines how ideas about the causes of and solutions to the obesity epidemic are produced in differing ways throughout the health promotion process. This study examines a variety of United Kingdom health research, policy, marketing strategy and marketing messages between 2008 and 2011. This research demonstrates that claims about causality oscillate and alter throughout the research, policy and Change4Life marketing process. These oscillations are problematic, since the Department of Health described the original consumer research as 'critical'. Given both the importance of the health issues being addressed and the amount of funding dedicated to Change4Life, that 'critical' research was directly contradicted in the campaign requires urgent review. To conclude, the article discusses the utility of social marketing when considering causal claims in health promotion.     

From risk-based health surveillance to health promotion: an evidence-based experience in a health care setting

In the European countries the health surveillance may be provided as a part of the national health system intervention. In Italy, the legislative Decree (626/94) makes the health surveillance compulsory for all those workers who are exposed to occupational risks. The aim of this study was to describe the introduction of preventive and protective measures, according to the new regulations, in the teaching hospital of the University of Modena. The population examined in 2000 included 1523 workers. Specific health surveillance protocols were prepared on the grounds of the risk characteristics based on the scientific evidence and on the risk perception. The intervention was oriented towards health promotion. The subjects were classified into 10 groups according to the risk characteristics. The percentage of workers ranged from 4% to 42%, depending on the exposure-related health changes. Moreover, the study explored some of the health surveillance benefits: an improvement in worker's satisfaction, an improvement in relationship between stakeholders, an early detection of health changes and a sickness absence reduction after the influenza vaccination program.     

Team awareness, problem drinking, and drinking climate: workplace social health promotion in a policy context

PURPOSE: (1) To determine the effectiveness of classroom health promotion/prevention training designed to improve work climate and alcohol outcomes; (2) to assess whether such training contributes to improvements in problem drinking beyond standard workplace alcohol policies. DESIGN: A cross-sectional survey assessed employee problem drinking across three time periods. This was followed by a prevention intervention study; work groups were randomly assigned to an 8-hour training course in workplace social health promotion (Team Awareness), a 4-hour informational training course, or a control group. Surveys were administered 2 to 4 weeks before and after training and 6 months after posttest. SETTING AND SUBJECTS: Employees were surveyed from work departments in a large municipality of 3000 workers at three points in time (year, sample, and response rates are shown): (1) 1992, n = 1081, 95%; (2) 1995, n = 856, 97%; and (3) 1999, n = 587, 73%. Employees in the 1999 survey were recruited from safety-sensitive departments and were randomly assigned to receive the psychosocial (n = 201), informational (n = 192), or control (n = 194) condition. INTERVENTION: The psychosocial program (Team Awareness) provided skills training in peer referral, team building, and stress management. Informational training used a didactic review of policy, employee assistance, and drug testing. MEASURES: Self-reports measured alcohol use (frequency, drunkenness, hangovers, and problems) and work drinking climate (enabling, responsiveness, drinking norms, stigma, and drink with co-workers). RESULTS: Employees receiving Team Awareness reduced problem drinking from 20% to 11% and working with or missing work because of a hangover from 16% to 6%. Information-trained workers also reduced problem drinking from 18% to 10%. These rates of change contrast with changes in problem drinking seen from 1992 (24%) to 1999 (17%). Team Awareness improvements differed significantly from control subjects, which showed no change at 13%. Employees receiving Team Awareness also showed significant improvements in drinking climate. For example, scores on the measure of coworker enabling decreased from pretest (mean = 2.19) to posttest (mean = 2.05) and follow up (mean = 1.94). Posttest measures of drinking climate also predicted alcohol outcomes at 6 months. CONCLUSION: Employers should consider the use of prevention programming as an enhancement to standard drug-free workplace efforts. Team Awareness training targets work group social health, aligns with employee assistance efforts, and contributes to reductions in problem drinking.     

The marketing of empowerment and the construction of the health consumer: a critique of health promotion

Health promotion claims to be empowering. However, this claim is not without major problematic contradictions and inconsistencies. The way in which health promotion is also controlling is identified in this article. To understand why the discourse of health promotion is traversed by this empowering/controlling contradiction, the discourse is critically analyzed, revealing a parallel with the structure of the discourse of marketing. Health promotion, rather than fulfilling its promise of empowerment, effectively constructs the individual subject as a "health consumer" in accordance with the model of consumer capitalism.     

Impact of a 10-year nation-wide alcohol campaign on knowledge of sensible drinking limits in Denmark

In Great Britain and in Denmark, strong efforts have been made to influence knowledge on upper threshold for hazardous drinking. In Denmark, a campaign has been repeated every week 40 from 1990 to 2000 with information on the sensible drinking limits of 21 drinks per week for men and 14 drinks per week for women. The aim of this study was to examine the effect of this ongoing campaign on the level of knowledge of sensible drinking limits for men and women. Random representative samples of 1030 adult Danes were telephone interviewed each year during 1994–1999. Our main finding was that the level of knowledge of sensible drinking limits for own sex increased in all subsets of the population throughout the period. However, at the end of the study period (1999) a total of 80% of highly educated young (18–25 years) men knew sensible drinking limits for own sex, while only 35% of uneducated older (more than 65 years) men had knowledge on sensible drinking limits. The proportions were similar among women. Subjects admitting an intake higher than sensible for own sex, i.e. 21 and 14 drinks per week, respectively, had the highest knowledge of these drinking limits. We conclude that public health campaigns, such as the sensible drinking limit campaign, certainly has an impact on level of awareness in the general population. Furthermore, those drinking more than 21 and 14 drinks per week, respectively, are reached by these campaigns.     

江苏省射阳县创建健康促进学校的现状及对策

健康促进学校是世界卫生组织在全球范围内积极倡导的学生健康新策略。江苏省射阳县是全国首批“亿万农民健康促进行动示范县”,在学校健康教育与健康促进方面也有着良好的基础。近年来,射阳县选择6所中小学开展健康促进学校创建工作。     

当前进一步推广工作场所健康促进的必要性与迫切性

复旦大学公共卫生学院顾学箕教授,世界卫生组织职业合作中心主任、专家顾问组成员,系我国著名医学教育家、公共卫生学家、劳动卫生职业病学专家,是我国劳动卫生专业学科资深的老前辈之一,为我刊历届编委和学术顾问,其业绩与名望享誉国内外,是我国预防医学界所爱戴与敬重的楷模,顾学箕教授年事已高,但为事业仍孜孜不倦,认真耕耘,潜心科研,为我国预防医学事业的发展作出了很大的贡献。日前,本刊特约顾学箕教授专稿《当前进一步推广工作场所健康促进的必要性与迫切性》,本期全文刊载如下以飨读者。     

Health promotion: convergence between the principles of health surveillance and socially responsible schools

The authors discuss the convergence between health surveillance and socially responsible schools from a health promotion perspective in Porto Alegre, Rio Grande do Sul State, Brazil. The aim of health promotion strategies is to provide the population with the necessary means to improve their health. One of the explanatory paradigms for health surveillance is the social production of health, acknowledging the influence of living conditions on the population's health. The main thrust of schools that promote citizenship is social inclusion, achieved through education by recognizing the needs and possibilities of students and empowering citizens by raising awareness of their rights and duties. The convergence between health surveillance and socially responsible schools is demonstrated in four fields of health promotion: development of personal capacities by providing information and health education to empower people for healthier choices; strengthening of community action for better health; creation of health-friendly public and private environments; and construction of healthy public policies, involving both government and nongovernmental organizations.     

河北省矽肺监测哨点接尘工人职业健康检查结果

目的了解矽肺监测哨点接尘工人的发病状况和影响因素,分析其危害因素对特定人群健康影响及发病的热点、规律和趋势,制定矽肺防治策略和措施。方法按照国家有关法律、法规、规范、标准的要求,对河北省矽肺监测哨点接尘工人进行职业健康检查,并对检查结果进行分析。结果职业健康检查涉及38家哨点企业共3394人,检出疑似职业病89人,检出率2．62％;职业禁忌证56人,检出率1．65％;疑似职业病检出涉及21家企业,占总调查企业的55．3％。结论该省大部分矽肺监测哨点企业职业病危害比较严重,接尘工人的健康问题不容忽视,应加强职业病防治工作。     

The health benefits of moderate drinking revisited: alcohol use and self-reported health status

PURPOSE: To examine the association between alcohol use and self-reported health status. In particular, we sought to determine whether moderate drinkers are more likely to self-report above-average health status compared with other current drinkers, former drinkers, and lifetime abstainers. DESIGN: Cross-sectional survey. SETTING: Continental United States. SUBJECTS: The sample adult component of the 2002 U.S. National Health Interview Survey (n = 31,044), representative of the U.S. noninstitutionalized civilian household population. MEASURES: Dichotomous measure of above-average self-reported health status relative to all other health states. Several measures characterized alcohol use patterns (i.e., continuous and categorical measure of alcohol use, a proxy measure of problem drinking, former drinking, lifetime abstaining). Chronic health conditions and various demographic and lifestyle factors were included as covariates in all regression models. RESULTS: For both men and women, current moderate drinkers had the highest odds (OR = 1.27 for men, p < .01; OR = 2.03 for women, p < .01) of reporting above-average health status compared with other current drinkers, former drinkers, and lifetime abstainers. The odds dropped to 1.12 and 1.34, respectively, when all past-year drinkers were collapsed into a single group. CONCLUSION: Moderate alcohol consumption was associated with the highest odds of reporting above-average health status, even after controlling for chronic health conditions and demographic and lifestyle factors associated with health.     

Prevention of alcohol misuse: a review of health promotion efforts among American Indians

PURPOSE. The purpose of this review is to provide an overview of a wide range of potentially useful strategies to address the prevention of alcohol misuse among American Indians. This broad approach to the review is useful because the extreme heterogeneity of the American Indian population requires that health promotion professionals explore many options and tailor their activities to specific communities. SEARCH METHOD. A literature search was initiated through MEDLINE using the following key words: prevention, alcohol, substance abuse, American Indian, and Native American. The search yielded 29 articles from the years 1982 through 1994. These articles, along with 45 previously identified in three overview articles, form the basis of the review and discussion in this paper. SUMMARY OF FINDINGS. As a group, American Indians experience many health problems that are related to alcohol misuse. Comparison of Indians to non-Indians shows that the age of first involvement with alcohol is younger, the frequency and amount of drinking is greater, and negative consequences are more common. Health promotion programs that address these issues must take into account American Indian heterogeneity and should use a comprehensive approach that addresses both heavy drinking and the sequelae of problems related to alcohol misuse. MAJOR CONCLUSIONS. Important concepts for providing health promotion services to this population are: cultural relevance must be carefully planned and monitored; individuals in the local community must be involved; the drunken Indian stereotype must be addressed; and community empowerment should be an important goal.     

Evaluating the effectiveness of health promotion policy: changes in the law on drinking and driving in California

The purpose of the study was to determine the utility of general population health surveillance data for evaluating broad policy changes that relate to health promotion. Data were drawn from the United States (US) Behavioral Risk Factor Surveillance System (BRFSS) for one US state, California. Because these data are collected frequently and continually, a quasi-experimental approach to the evaluation was possible using a type of interrupted time series analysis or longitudinal impact analysis. A statistically significant decrease in the number of declared episodes of drinking and driving was found after enactment of new state policy. These findings were compared and found consistent with another study in California that examined the effect of changes in the law on alcohol-related traffic accidents. Our findings suggest that data from a behavioral surveillance system, in this case the BRFSS, are useful to evaluate the effect of a health promotion intervention. Further, the study demonstrates the utility of comparing different data sources when assessing a population-wide change in health promotion policy.     

Evidence in favour of a low dose for the tuberculin test

In an attempt to solve the problem of whether a high or a low dose should be used for tuberculin testing a new method of statistical analysis is presented. It consists in tabulating the frequency of tuberculin “positive” children in households where the adults are tuberculin “positive” and tuberculin “negative” respectively; these frequencies are compiled for a wide range of arbitrarily chosen limits between “positive” and “negative” reactions. Values for these statistics have been obtained from data collected in Kenya; they strongly suggest that the reactors to the low-dose test are those infected with tubercle bacilli and the non-reactors to this test are the uninfected. However, a more detailed analysis is possible and this paper demonstrates that statistics of the type described may be used for testing the plausibility of a specific hypothesis about the patterns of tuberculin reactions among infected and uninfected persons. By testing a number of different hypotheses, the most plausible was found to be that the tuberculin sensitivities of infected and uninfected persons correspond to those of the reactors and the non-reactors to the low-dose test respectively. On the basis of the data presented it thus appears that the low-dose test is better suited than the high-dose test for distinguishing between infected and uninfected persons.     

Evaluation of a community bicycle helmet promotion campaign: what works and why

PURPOSE. This study identifies effective components of a bicycle helmet promotion campaign, and mechanisms by which these components affect child helmet ownership. DESIGN. A random telephone survey identified parents whose children did not own helmets prior to an educational campaign. A follow-up survey was conducted six months later. Regression analysis estimated the effects of four campaign components on child helmet ownership and tested for mediation by cognitive variables. SETTING. Study participants were residents of a suburban community which undertook a citywide educational campaign to increase child helmet ownership. SUBJECTS. Subjects were 210 parents with at least one school-aged child, none of whom owned helmets. INTERVENTION. A multicomponent campaign was implemented by a community coalition. In addition, random subsamples of the study participants received direct mail or direct telephone communications. RESULTS. Of the eligible respondents identified in the baseline sample, 39% completed the follow-up survey. Regression analysis showed that children whose parents received either helmet advice from a physician or direct telephone communications were 2.6 and 2.2 times more likely, respectively, to own helmets as children whose parents did not experience similar communication. Parental worry mediated the association, but parental beliefs about the effectiveness of helmets did not. CONCLUSION. Future helmet campaigns should use interpersonal strategies to increase parental worry about their children being involved in a bicycle accident. Generalization of these findings is limited by the high socioeconomic status of the study participants, and by the outcome measure, which is helmet ownership, not helmet use.     

Trends in health concepts and health promotion: a discussion paper.

Much misunderstanding and confusion exist about the meaning and nature of activities in health promotion. This article examines how our evolving beliefs and concepts about health have led to a new public health, namely health promotion. Health promotion is operationalized using Achieving Health for All: A Framework for Health Promotion.     

Social support: a critical factor in women's health and health promotion

Social networks and social support have been found to be beneficial to the health of individuals in a variety of ways--reducing mortality rates, improving recovery from serious illness, and increasing use of preventive health practices. Social relationships appear to be particularly important to women. Suggestions for health promotion and disease prevention activities include the use of buddy systems, feminist pedagogical techniques, group activities, and linkage to natural supports. Health promotion with women is an underdeveloped area of social work practice with great potential to increase the health of client populations.