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Preview: Health Promotion International - current issue

Health Promotion International Current Issue





Published: Thu, 30 Nov 2017 00:00:00 GMT

Last Build Date: Fri, 08 Dec 2017 14:51:06 GMT

 






Promoting health by addressing living conditions in Norwegian municipalities

Sun, 10 Jul 2016 00:00:00 GMT

Abstract
Worldwide, inequalities in health are increasing, even in well-developed welfare states such as Norway, which in 2012, saw a new public health act take effect that enshrined equity in health as national policy and devolved to municipalities’ responsibility to act on the social determinants of health. The act deems governance structures and “Health in All Policies” approaches as important steering mechanisms for local health promotion. The aim of this study is to investigate whether Norway’s municipalities address living conditions – economic circumstances, housing, employment and educational factors – in local health promotion, and what factors are associated with doing so. All Norway’s municipalities (n= 428) were included in this cross-sectional study, and both register and survey data were used and were subjected to descriptive and bi- and multivariate regression analyses. Eighty-two percent of the municipalities reported that they were capable of reducing inequalities in health. Forty percent of the municipalities defined living conditions as a main challenge in their local public health promotion, while 48% cited it as a main health promotion priority. Our study shows that defining living conditions as a main challenge is positively associated with size of municipality, and also its assessment of its own capability in reducing inequalities in health. The latter factor was also associated with actually prioritizing living conditions in health promotion, as was having established cross-sectorial working groups or inter-municipal collaboration related to local health promotion. This study underlines the importance of inter-sectoral collaboration to promote health and well-being.



Seeing the community’s perspective through multiple emic and etic vistas

Tue, 21 Jun 2016 00:00:00 GMT

Abstract
Health impact assessment (HIA) researchers regularly use community input in their investigations to help them better understand local health issues. Community data is commonly associated with the lived experiences of local impacted residents known as ‘emic’ data. It is becoming more common practice for HIA researchers to access outside experts and stakeholders (‘etic’ data) during the community input phase of their investigations. Utilizing published international HIA data, I look at who HIA researchers invite when they seek to get ‘community input’ in their HIA investigations. The HIA database was generated from an internet investigation of published HIAs (in English) from 1999 to 2011 and focused particularly on single authored assessments that were conducted by governments, non-governmental organizations (NGOs) or universities. HIA researchers access a wide range of emic and etic community perspectives in their search for the ‘community’s view’. Government, NGO and university investigators access community perspectives differently, with university HIA researchers inviting more emic-oriented community vistas than both government and NGO researchers. University and government HIA investigators are more likely to invite multiple emic and etic community perspectives during their community participation projects than NGO researchers. NGO HIA investigators tend to either invite emic perspectives or etic perspectives for their community input with less mixing of the two views in a single project. The paper concludes with a discussion on how HIA researchers can frame the ‘community’s perspective’ in their HIA investigations through a combination of both ‘insider’ and ‘outsider’ community input sampling strategies.



Toward consensus on self-management support: the international chronic condition self-management support framework†

Mon, 30 May 2016 00:00:00 GMT

Abstract
Self-management support (SMS) initiatives have been hampered by insufficient attention to underserved and disadvantaged populations, a lack of integration between health, personal and social domains, over emphasis on individual responsibility and insufficient attention to ethical issues. This paper describes a SMS framework that provides guidance in developing comprehensive and coordinated approaches to SMS that may address these gaps and provides direction for decision makers in developing and implementing SMS initiatives in key areas at local levels. The framework was developed by researchers, policy-makers, practitioners and consumers from 5 English-speaking countries and reviewed by 203 individuals in 16 countries using an e-survey process. While developments in SMS will inevitably reflect local and regional contexts and needs, the strategic framework provides an emerging consensus on how we need to move SMS conceptualization, planning and development forward. The framework provides definitions of self-management (SM) and SMS, a collective vision, eight guiding principles and seven strategic directions. The framework combines important and relevant SM issues into a strategic document that provides potential value to the SMS field by helping decision-makers plan SMS initiatives that reflect local and regional needs and by catalyzing and expanding our thinking about the SMS field in relation to system thinking; shared responsibility; health equity and ethical issues. The framework was developed with the understanding that our knowledge and experience of SMS is continually evolving and that it should be modified and adapted as more evidence is available, and approaches in SMS advance.



Development of health literacy scale among Brazilian mothers in Japan

Sat, 21 May 2016 00:00:00 GMT

Abstract
Japanese-Brazilians were the third largest immigrant group in Japan in 2011. Their health issues have caused concern, as their limited language made them vulnerable by hindering access to health services. Upon considering child health, mothers' health literacy (HL) is very important. This study aimed to develop a health literacy scale among Brazilian mothers (HLSBM) in Japan. Questionnaires in Portuguese were distributed to 1474 mothers from December 2011 to March 2012. Among 698 collected, 558 questionnaires were analyzed. We prepared 29 candidate items for HLSBM based on Nutbeam's concept of functional, interactive and critical literacy. The dimensional structure was determined statistically using confirmatory factor analysis. Validity was also analyzed by Pearson's correlation with Ishikawa's scale and Kendall's coefficient of concordance among researchers. Cronbach's α coefficients were calculated to examine internal consistency. The confirmatory factor analysis revealed a two-factor model (five items for basic literacy and five items for critical literacy) with sufficient goodness of fit (GFI 969, AGFI 945, NFI 959, CFI 972, RMSEA 060). The internal consistency values of the total score, basic and critical literacy sub-scales were 0.819, 0.889 and 0.667, respectively. Kendall's coefficient of concordance showed good agreement of researchers (p < 0.001). Pearson's correlation coefficients with Ishikawa's scale were 0.554 for total score, 0.446 for basic literacy and 0.472 for critical literacy. The HLSBM consisting of two factors was confirmed to be valid and reliable. The HLSBM must be useful for understanding this vulnerable group's health literacy and its associated factors.



Benefits of walking and solo experiences in UK wild places

Tue, 17 May 2016 00:00:00 GMT

Abstract
This paper examines human–nature interaction and how therapeutic this relationship is by investigating the efficacy of structured outdoor experience. Two walking and solo experience (WSEs) explored university students' (aged 20–43 years) perceptions of walking through and being with nature. The first was a 5-day journey (n = 4; 3 females and 1 male) and the second (n = 5; 3 females and 2 males) took place over two weekends, with a 2-week interval in-between. Pre- and post-experience interviews, journal writing, group discussions and a 9-month follow-up interviews were used to collect data and thematic analysis [Braun and Clarke (Using thematic analysis in psychology. Qual Res Psychol 2006;3:77–101.)] was applied. Both WSEs were considered together during analysis, as well as comparisons made between the two, in order to evaluate implications for practice. Benefits of the WSE that contributed to a general sense of well-being were: (i) gaining a sense of freedom and escape; (ii) gaining a sense of awareness and sensitivity to one's environment and its influence (iii) gaining confidence in being able to cope and take action; (iv) gaining a sense of perspective on and appreciation for life. Furthermore, the meaning participants formed in relation to their environment before, during and after the WSE, and the activity within that environment, played a role in their sense of well-being and in their motivations to re-access nature in other places. Findings suggest that WSEs are a cost effective way to give rise to beneficial and durable experiences, but a more holistic approach to policy is needed.



Adapting the capacities and vulnerabilities approach: a gender analysis tool

Sat, 07 May 2016 00:00:00 GMT

Abstract
Gender analysis methodology is increasingly being considered as essential to health research because ‘women's social, economic and political status undermine their ability to protect and promote their own physical, emotional and mental health, including their effective use of health information and services’ {World Health Organization [Gender Analysis in Health: a review of selected tools. 2003; www.who.int/gender/documents/en/Gender.analysis.pdf (20 February 2008, date last accessed)]}. By examining gendered roles, responsibilities and norms through the lens of gender analysis, we can develop an in-depth understanding of social power differentials, and be better able to address gender inequalities and inequities within institutions and between men and women. When conducting gender analysis, tools and frameworks may help to aid community engagement and to provide a framework to ensure that relevant gendered nuances are assessed. The capacities and vulnerabilities approach (CVA) is one such gender analysis framework that critically considers gender and its associated roles, responsibilities and power dynamics in a particular community and seeks to meet a social need of that particular community. Although the original intent of the CVA was to guide humanitarian intervention and disaster preparedness, we adapted this framework to a different context, which focuses on identifying and addressing emerging problems and social issues in a particular community or area that affect their specific needs, such as an infectious disease outbreak or difficulty accessing health information and resources. We provide an example of our CVA adaptation, which served to facilitate a better understanding of how health-related disparities affect Maasai women in a remote, resource-poor setting in Northern Tanzania.



Intersectoral action on SDH and equity in Australian health policy

Sat, 07 May 2016 00:00:00 GMT

Abstract
Intersectoral action between public agencies across policy sectors, and between levels of government, is seen as essential for effective action by governments to address social determinants of health (SDH) and to reduce health inequities. The health sector has been identified as having a crucial stewardship role, to engage other policy sectors in action to address the impacts of their policies on health. This article reports on research to investigate intersectoral action on SDH and health inequities in Australian health policy. We gathered and individually analysed 266 policy documents, being all of the published, strategic health policies of the national Australian government and eight State/Territory governments, current at the time of sampling in late 2012—early 2013. Our analysis showed that strategies for intersectoral action were common in Australian health policy, but predominantly concerned with extending access to individualized medical or behavioural interventions to client groups in other policy sectors. Where intersectoral strategies did propose action on SDH (other than access to health-care), they were mostly limited to addressing proximal factors, rather than policy settings affecting the distribution of socioeconomic resources. There was little evidence of engagement between the health sector and those policy sectors most able to influence systemic socioeconomic inequalities in Australia.



Early 20th century conceptualization of health promotion

Fri, 06 May 2016 00:00:00 GMT

Abstract
This historical analysis of the term ‘health promotion’ during the early 20th century in North American journal articles revealed concepts that strongly resonate with those of the 21st century. However, the lineage between these two time periods is not clear, and indeed, this paper supports contentions health promotion has a disrupted history. This paper traces the conceptualizations of health promotion during the 1920s, attempts to operationalize health promotion in the 1930s resulting in a narrowing of the concept to one of health education, and the disappearance of the term from the 1940s. In doing so, it argues a number of factors influenced the changing conceptualization and utilization of health promotion during the first half of the 20th century, many of which continue to present times, including issues around what health promotion is and what it means, ongoing tensions between individual and collective actions, tensions between specific and general causes of health and ill health, and between expert and societal contributions. The paper concludes the lack of clarity around these issues contributed to health promotion disappearing in the mid-20th century and thus resolution of these would be worthwhile for the continuation and development of health promotion as a discipline into the 21st century.



Applying lessons from behavioral economics to increase flu vaccination rates

Fri, 06 May 2016 00:00:00 GMT

Abstract
Seasonal influenza imposes an enormous burden on society every year, yet many people refuse to obtain flu shots due to misconceptions of the flu vaccine. We argue that recent research in psychology and behavioral economics may provide the answers to why people hold mistaken beliefs about flu shots, how we can correct these misconceptions, and what policy-makers can do to increase flu vaccination rates.



Stress and adolescent well-being: the need for an interdisciplinary framework

Fri, 06 May 2016 00:00:00 GMT

Abstract
Stress and strain among adolescents have been investigated and discussed largely within three separate disciplines: mental health, where the focus has been on the negative effects of stress on emotional health; criminology, where the emphasis has been on the effects of strain on delinquency; and biology, where the focus has been to understand the effects of stress on physiology. Recently, scholars have called for increased multilevel developmental analyses of the bio-psychosocial nature of risk and protection for behaviors of individuals. This paper draws on several different but converging theoretical perspectives in an attempt to provide an overview of research relevant to stress in adolescence and puts forth a new framework that aims to provide both a common language and consilience by which future research can analyze the effects of multiple biological, social and environmental factors experienced during specific developmental periods, and cumulatively over time, on harmful behavior during adolescence. We present a framework to examine the effects of stress on diverse behavioral outcomes among adolescents, including substance use, suicidal behavior, self-inflicted harm, and delinquency.



Partnering Healthy@Work: an Australian university—government partnership facilitating policy-relevant research

Fri, 06 May 2016 00:00:00 GMT

Abstract
Research funding is increasingly supporting collaborations between knowledge users and researchers. Partnering Healthy@Work (pH@W), an inaugural recipient of funding through Australia's Partnership for Better Health Grants scheme, was a 5-year partnership between the Menzies Institute for Medical Research, University of Tasmania and the Tasmanian State Service (TSS). The partnerships purpose was to evaluate a comprehensive workplace health promotion programme (Healthy@Work) targeting 30 000 public sector employees; generating new knowledge and influencing workplace health promotion policy and decision-making. This mixed methods study evaluates the partnership between policy-makers and academics and identifies strategies that enabled pH@W to deliver key project outcomes. A pH@W document review was conducted, two partnership assessment tools completed and semi-structured interviews conducted with key policy-makers and academics. Analysis of the partnership assessment tools and interviews found that pH@W had reached a strong level of collaboration. Policy-relevant knowledge was generated about the health of TSS employees and their engagement with workplace health promotion. Knowledge exchange of a conceptual and instrumental nature occurred and was facilitated by the shared grant application, clear governance structures, joint planning, regular information exchange between researchers and policy-makers and research student placements in the TSS. Flexibility and acknowledgement of different priorities and perspectives of partner organizations were identified as critical factors for enabling effective partnership working and research relevance. Academic-policy-maker partnerships can be a powerful mechanism for improving policy relevance of research, but need to incorporate strategies that facilitate regular input from researchers and policy-makers in order to achieve this.



Best practices for community gardening in a US–Mexico border community

Fri, 22 Apr 2016 00:00:00 GMT

Abstract
Minority communities such as those on the US–Mexico border are placed at disproportionate high risk for child and adult obesity, diabetes and cardiovascular diseases. A built environment characterized by an arid desert climate, lack of access to healthy foods, barriers to increasing physical activity, cultural and community norms which deter healthy eating and sustainable food production, shape obesity-related health disparities in these communities. Three pilot community gardens (implemented by two local governmental organizations and one community-based organization) were funded through the local Healthy Eating Active Living (HEAL) initiative in El Paso, Texas, and Las Cruces and Anthony, New Mexico (US–MX border communities with high obesity rates) in order to encourage healthy lifestyles among families in the region. A mixed-methods evaluation (n = 223) examined the implementation process, immediate outcomes and best practices of implementing and sustaining community gardens in these minority binational communities. In addition to nutrition-related outcomes, the potential for psychosocial outcomes from participating in community and school garden projects were observed. The best practices in relation to (i) assessing community norms related to growing food, (ii) increasing access to land and water for community/school gardening and (iii) enhancing social support for gardening are discussed. The implications of these best practices for obesity prevention and implementing community gardens in a minority US–MX border community characterized by cultural, geographical and socioeconomic barriers are examined.



Evidence for the value of health promotion interventions in natural disaster management

Wed, 20 Apr 2016 00:00:00 GMT

Abstract
A rapid review of literature was conducted to identify effective health promotion (HP) intervention strategies that relate to the management of disasters from natural hazards, including prevention, preparedness, response and recovery measures. Searches were conducted in formal literature from 2000 to 2011 and then updated to 2013. Out of 719 relevant abstracts, 57 studies were selected for more detailed review. In total, 16 studies were annotated for the narrative synthesis; these articles all reported an outcome-oriented evaluation of an HP-related intervention in a natural disaster situation in low- and middle-income countries (LMIC) or vulnerable populations in high-income countries (HIC). These 16 studies were also assessed for quality of their evaluation design. Although it was not possible to select only strong study designs, LMIC weak designs were matched with stronger designs in HIC most of the time. A narrative synthesis was conducted to report the results. In the preparedness and mitigation stages, there were six articles referring to four HP strategies. In the response and recovery phases, there were 10 articles referring to an additional four HP strategies. HP plays a role in regaining a sense of control after disaster through: engaging victims of disaster in group decisions (including children), collaboration and networking, recognition of local strengths and assets, conducting community needs assessments, respecting local knowledge, training local resources as part of an ongoing system and use of pre-existing community focal points or organizations as trusted locations for community services and reconnections.



Accelerating the health literacy agenda in Europe

Wed, 20 Apr 2016 00:00:00 GMT

Abstract
Health literacy can be defined as the knowledge, motivation and competence to access, understand, appraise and apply information to make decisions in terms of healthcare, disease prevention and health promotion. Health literacy is a European public health challenge that has to be taken seriously by policy-makers. It constitutes an emerging field for policy, research and practice. However, recent research has shown that health literacy advancement is still at its infancy in Europe, as reflected in the scarce scientific health literacy literature published by European authors. From a total of 569 articles published until 2011 on this subject, the first author of only 15% of them is from Europe. This article conveys recommendations of different European stakeholders on how to accelerate the health literacy agenda in Europe. A general introduction on the current status of health literacy is provided, followed by two cases applying health literacy in the areas of prevention of communicable diseases and promotion of digital health. The current EU strategies integrating health literacy are listed, followed by examples of challenges threatening the further development of health literacy in Europe. Recommendations as to how European stakeholders involved in research, policy, practice and education can promote health literacy are given. It is vital that the European Commission as well as European Union Member States take the necessary steps to increase health literacy at individual, organizational, community, regional and national levels.



Parents' perspectives of a universal early attachment programme in Scotland

Tue, 12 Apr 2016 00:00:00 GMT

Abstract
The ‘A Good Start’ programme is a universal early attachment programme for parents and babies aged 8 weeks and over, run by a charitable organization in one Scottish local authority. The programme offers non-stigmatizing support and parents are encouraged to access other community resources on completing it. At a family level, the programme aims are that parents (i) have an increased feeling of well-being; (ii) are more attuned to their babies and (iii) are more aware of services and confident in becoming involved with them. The collaborative research study was undertaken by a small research team between March 2014 and January 2015. It had two strands—a collaborative element which involved developing and supporting the use of the outcomes frameworks together with project staff and direct evaluation work, namely collation of the ‘A Good Start Web’ outcome measurement tool results and conducting interviews and focus groups with parents, staff and volunteer instructors who delivered the programme. The objectives of the evaluation were to evaluate the extent to which the programme were met, using the ‘A Good Start Web’ outcome measurement tool, augmented by qualitative data. It was clear from the qualitative evaluation data that most parents who participated in the programme felt that they benefited from it in many ways. Parents valued the opportunity to meet with other parents for peer support, to undertake a practical activity to enhance the bond with their baby which relaxed them both and to reduce their anxiety about caring for an infant.



A model for (re)building consumer trust in the food system

Tue, 12 Apr 2016 00:00:00 GMT

Abstract
The article presents a best practice model that can be utilized by food system actors to assist with (re)building trust in the food system, before, during and after a food incident defined as ‘any situation within the food supply chain where there is a risk or potential risk of illness or confirmed illness or injury associated with the consumption of a food or foods’ (Commonwealth of Australia. National Food Incident Response Protocol. Commonwealth of Australia, Canberra, 2012). Interviews were undertaken with 105 actors working within the media, food industry and food regulatory settings across Australia, New Zealand (NZ) and the United Kingdom (UK). Interview data produced strategy statements, which indicated participant views on how to (re)build consumer trust in the food system. These included: (i) be transparent, (ii) have protocols and procedures in place, (iii) be credible, (iv) be proactive, (v) put consumers first, (vi) collaborate with stakeholders, (vii) be consistent, (viii) educate stakeholders and consumers, (ix) build your reputation and (x) keep your promises. A survey was designed to enable participants to indicate their agreement/disagreement with the ideas, rate their importance and provide further comment. The five strategies considered key to (re)building consumer trust were used to develop a model demonstrating best practice strategies for (re)building consumer trust in the food system before, during and after a food incident. In a world where the food system is increasingly complex, strategies for (re)building and fostering consumer trust are important. This study offers a model to do so which is derived from the views and experiences of actors working across the food industry, food regulation and the media.