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Preview: Health Promotion International - current issue

Health Promotion International Current Issue





Published: Thu, 05 Oct 2017 00:00:00 GMT

Last Build Date: Thu, 05 Oct 2017 08:44:41 GMT

 



Strengthening public health capacity through a health promotion lens

2017-10-05

Public health systems across the world are under severe pressure. Although most health systems are still largely focused on treatment, cure, and care (Beaglehole and Dal Poz, 2003), the growing burden of non-communicable diseases, with a double burden of chronic and infectious diseases in low- and middle income countries, creates increasing and shifting demands on health care and public health services. At the same time, widening health inequalities, increasing antimicrobial resistance, and globalization are a threat to the very existence of the global public health system (Garrett, 2003). Rampant infectious disease such as the H1N1 influenza pandemic of 2009, the outbreaks of Ebola in West Africa and of the Zika virus in the Americas, and the recent cholera epidemics in Yemen and Cote d’Ivoire, bring out the shortcomings of the ability of health systems to prepare for and respond to public health emergencies.



The contribution of distance education to health promotion in Chile

2016-04-22

Abstract
The objective of this paper is to present the distance education's contribution to developing health promotion in Chile, through evaluation of a postgraduate certificate program for professionals, and a training course for nurse technicians working in primary healthcare, with an 8-month follow-up after program completion. The program methodology was participatory, interactive and reflective, with mentoring support, exercises, group work and discussions as well as content pertinent to the needs of practice. The evaluation was quali-quantitative with an analysis of the student profile, the implementation process, outcomes at the end of the training and impacts on workplace changes. The results showed a high rate of student approval (87 and 76%), good academic performance and a high level of satisfaction with the methodology and knowledge delivered. The participants' final projects were adapted to local work places realities and were implemented by 62.6% of technicians and 43% of professionals, in addition to changes in work practices that favor health promotion. The level of fulfillment of participants' expectations was very high and the most frequent barriers to implementing the final project were lack of time and personnel, along with minimal support from management and low prioritization of health promotion. This study shows the effectiveness of a distance training model for professionals and technicians that can reach the most remote parts of the country, where there is no access to presencial training, with an educational program centered on work activities and current health challenges.



Understanding exclusionary mechanisms at the individual level: a theoretical proposal

2016-04-20

Abstract
On the basis of the social exclusion framework put forth by the Social Exclusion Knowledge Network (SEKN), we propose a framework that conceives social exclusion as a mechanism that limits access to rights, resources and capabilities needed for a healthy life. While it is widely accepted that drivers of social exclusion are structural, the consequences are experienced by individuals in their everyday lives. This article proposes an adaptation of the SEKN framework, illustrating additional basic elements that should be considered in the study of exclusionary mechanisms. We argue that studying access to rights, resources and capabilities is one way to capture the relational aspect of exclusion mechanisms. In doing so, we shift the focus away from the individual and direct the analysis towards contextual conditions that cause the emergence of certain individual attributes. We use the example of food insecurity experienced by individuals to illustrate how a specific problem can be the manifestation of different structural exclusion mechanisms that limit access to the rights, resources and capabilities required for a healthy life.



Applying the Ottawa Charter to inform health promotion programme design

2016-04-20

Abstract
There is evidence of a correlation between adoption of the Ottawa Charter's framework of five action areas and health promotion programme effectiveness, but the Charter's framework has not been as fully implemented as hoped, nor is generally used by formal programme design models. In response, we aimed to translate the Charter's framework into a method to inform programme design. Our resulting design process uses detailed definitions of the Charter's action areas and evidence of predicted effectiveness to prompt greater consideration and use of the Charter's framework. We piloted the process by applying it to the design of four programmes of the Healthy Children's Initiative in New South Wales, Australia; refined the criteria via consensus; and made consensus decisions on the extent to which programme designs reflected the Charter's framework. The design process has broad potential applicability to health promotion programmes; facilitating greater use of the Ottawa Charter framework, which evidence indicates can increase programme effectiveness.



No sex for fish: empowering women to promote health and economic opportunity in a localized place in Kenya

2016-04-06

Abstract
A pervasive cultural practice called ‘jaboya’ or women trading sex for fish exists at Nyamware Beach, on Lake Victoria in Kenya, where the fishing industry is the primary source of income. This case study describes how an innovative market-based solution succeeded in changing the gender dynamics on Nyamware beach and empowering women with the means of production in the industry. Over the course of 6 months, three boats were built for women to own and manage, and 29 women and 20 men received business skills training while establishing local community savings and loans associations. This project succeeded in quickly adjusting the economic imbalance that previously left women few options but to exchange sex to purchase the best fish for food and for distribution. Participating women applied resulting increased income to school fees for children and toward their households and businesses. Women owning businesses, earning income and gaining a voice in the community has changed the gender dynamics of men working on the boats for women and has positively altered the perception of women in the community. Additionally, this project offers potential health benefits such as a reduction in the transmission of HIV/AIDS and other sexually transmitted infections due to reduced rates of transactional sex, and reduced rates of depression, alcohol abuse and post-traumatic stress disorder from transactional sex, which can be traumatic. The success of this project demonstrates that small and innovative approaches addressing root causes of economic and social inequality can improve health and promote sustainable economic development.



Organizational uncertainty and stress among teachers in Hong Kong: work characteristics and organizational justice

2016-03-30

Abstract
A growing literature now exists examining the relationship between organizational justice and employees' experience of stress. Despite the growth in this field of enquiry, there remain continued gaps in knowledge. In particular, the contribution of perceptions of justice to employees' stress within an organizational context of uncertainty and change, and in relation to the new and emerging concept of procedural-voice justice. The aim of the current study was to examine the main, interaction and additive effects of work characteristics and organizational justice perceptions to employees' experience of stress (as measured by their feelings of helplessness and perceived coping) during an acknowledged period of organizational uncertainty. Questionnaires were distributed among teachers in seven public primary schools in Hong Kong that were under threat of closure (n = 212). Work characteristics were measured using the demand–control–support model. Hierarchical regression analyses observed perceptions of job demands and procedural-voice justice to predict both teachers' feelings of helplessness and perceived coping ability. Furthermore, teacher's perceived coping was predicted by job control and a significant interaction between procedural-voice justice and distributive justice. The addition of organizational justice variables did account for unique variance, but only in relation to the measure of perceived coping. The study concludes that in addition to ‘traditional’ work characteristics, health promotion strategies should also address perceptions of organizational justice during times of organizational uncertainty; and, in particular, the value and importance of enhancing employee's perceived ‘voice’ in influencing and shaping justice-related decisions.



Implementation of web-based interventions by Dutch occupational health centers

2016-03-28

Abstract
The aim of this qualitative study was to identify barriers and facilitators to the adoption and particularly the implementation of a web-based computer-tailored obesity prevention intervention by occupational health centers. Participants were directors of Dutch occupational health centers who had adopted and implemented the intervention for the corresponding efficacy study (n = 8) as well as non-adopters (n = 12). Individual semi-structured interviews were carried out to study barriers and facilitators related to the intervention, the user, the organization, and the socio-political environment. All interviews were carried out by telephone, audio-recorded and transcribed verbatim. The transcripts were analyzed using a directed-content approach and coded by two persons. There were important differences in perceptions between adopters and non-adopters, particularly on barriers and facilitators related to the intervention and the personal beliefs of the implementer. The relative advantages of the intervention were considered to be most important. Participants also indicated that their personal attitudinal and self-efficacy beliefs influenced their implementation efforts. Regarding the organization, the possibilities to increase profits and integrate the intervention within the organization were considered to be important facilitators for the implementation. Participants mentioned few implementation barriers and facilitators related to the socio-political environment. Strategies to improve the implementation of web-based computer-tailored interventions by occupational health centers should be tailored to implementers' unique perceptions and particularly address the perceived advantages and disadvantages of the intervention, attitudinal and self-efficacy beliefs, and the potential to increase organizations' profits and competitiveness.



Association of social capital at the individual level with physical activity in communities with high mortality in Korea

2016-03-28

Abstract
The aim of this study was to investigate the association of various dimensions of social capital at the individual level with physical activity. We used data from community health interviews conducted in 40 sub-municipal-level administrative units with high mortality from August to October in 2010, 2011 or 2012 for health projects in South Korea. The 8800 study subjects included 220 adults from each administrative unit, who were sampled systematically using the resident registration database. The physical activity level was defined according to the intensity, duration and frequency of self-reported physical activity. Social capital indicators were assessed with measures used in other health surveys or studies. Adjusting for gender, age, marital status, educational level, occupation, food security (a proxy for socio-economic status), administrative unit and self-rated health, we calculated the adjusted odds ratio (AOR) with a 95% confidence interval (CI) of participating in physical activity based on various measures of social capital using multivariate logistic regression analysis. Social participation in both informal and formal organizations compared with no social participation, higher generalized trust compared with lower trust and higher perceived control at both the community and individual levels compared with lower perceived control at both levels increased the odds of being physically active [AOR = 1.25 (95% CI: 1.10–1.41), 1.36 (95% CI: 1.19–1.54) and 1.31 (95% CI: 1.17–1.48), respectively]. Various social capital measures at the individual level were found to be associated with physical activity independently of each other and of confounders in communities with high mortality in Korea.



Underage purchasing of alcohol from packaged liquor outlets: an Australian study

2016-03-22

Abstract
Access to the supply of alcohol is an important factor influencing adolescent alcohol consumption. Although alcohol sales outlets are prohibited from selling alcohol to underage youth, there has been limited research investigating compliance. The present study sought to estimate the extent to which adolescents that appeared underage were successfully able to purchase alcohol from packaged liquor outlets in Australia; and to identify store and sales characteristics associated with illegal purchasing. In 2012, purchase surveys were conducted (n= 310) at packaged liquor outlets in 28 urban and rural communities across three states of Australia: Western Australia, Queensland and Victoria. Confederates successfully purchased alcohol at 60% (95% CI: 55–66) of outlets. The density of general alcohol outlets in the surrounding area and the type of liquor outlet were predictors of successful alcohol purchases; however, this was moderated by the state in which the purchase was made. Regional geographical location was also found to predict underage alcohol purchase. The majority of alcohol sales outlets in Australia breach regulations prohibiting sales to underage youth. Consistent enforcement of policies across the states of Australia, and reducing the number of alcohol outlets, will help prevent alcohol outlets illegally selling alcohol to underage adolescents.



Exploring and revitalizing Indigenous food networks in Saskatchewan, Canada, as a way to improve food security

2016-03-22

Abstract
The project discussed in this paper was designed to expand research and instigate revitalization of Indigenous food networks in Saskatchewan, Canada, by exploring the current state of local Indigenous food networks, creating a Facebook page, organizing volunteer opportunities and surveying workshop participants regarding their knowledge and interest in Indigenous foods. The survey included Likert scale questions and qualitative questions. Project activities and survey results are discussed using statistical and qualitative analysis of the themes. Results indicate that participants are very interested in learning more about, and having greater access to, traditional foods and suggest that supporting Indigenous food networks may be an appropriate response to food insecurity in communities. Elders and community members are vital players in Indigenous foods exploration and revitalization in Saskatchewan by passing on traditional education.



Factors influencing workplace health promotion intervention: a qualitative systematic review

2016-03-22

Abstract
Although workplace health promotion (WHP) has evolved over the last 40 years, systematically collected knowledge on factors influencing the functioning of WHP is scarce. Therefore, a qualitative systematic literature review was carried out to systematically identify and synthesize factors influencing the phases of WHP interventions: needs assessment, planning, implementation and evaluation. Research evidence was identified by searching electronic databases (Scopus, PubMed, Social Sciences Citation Index, ASSIA, ERIC, IBBS and PsycINFO) from 1998 to 2013, as well as by cross-checking reference lists of included peer-reviewed articles. The inclusion criteria were: original empirical research, description of WHP, description of barriers to and/or facilitators of the planning, implementation and/or evaluation of WHP. Finally, 54 full texts were included. From these, influencing factors were extracted and summarized using thematic analysis. The majority of influencing factors referred to the implementation phase, few dealt with planning and/or evaluation and none with needs assessment. The influencing factors were condensed into topics with respect to factors at contextual level (e.g. economic crisis); factors at organizational level (e.g. management support); factors at intervention level (e.g. quality of intervention concept); factors at implementer level (e.g. resources); factors at participant level (e.g. commitment to intervention) and factors referring to methodological and data aspects (e.g. data-collection issues). Factors regarding contextual issues and organizational aspects were identified across three phases. Therefore, future research and practice should consider not only the influencing factors at different levels, but also at different phases of WHP interventions.



Awareness of nutrition problems among Vietnamese health and education professionals

2016-03-22

Abstract
Professionals who provide nutrition education and consulting to the public are encouraged to take into account the health, environmental and social contexts that influence health-related attitudes and behaviours in the population. This paper examined the awareness of shifts in population health outcomes associated with the nutrition transition in Vietnam among university nutrition lecturers, health professionals and school education professionals. Most of these professionals held accurate views of the current population health issues in Vietnam. However, they differed in their awareness of the seriousness of overweight and obesity. Although the majority indicated that the prevalence of obesity and non-communicable diseases (NCDs) had increased, nearly half believed that the government should complete its attempts to control undernutrition before trying to control obesity. More health professionals believed that food marketing was responsible for the growing prevalence of children's obesity, and more of them disapproved of the marketing of less healthy food to children. In contrast, the university nutrition lecturers were least aware of food marketing and the seriousness of obesity. Of the three groups, the university nutrition lecturers held less accurate perceptions of nutrition transition problems and their likely drivers. There is an urgent need for greater provision of public nutrition education for all three groups of professionals.



Political rhetoric from Canada can inform healthy public policy argumentation

2016-03-22

Abstract
Household food insecurity (HFI), insufficient income to obtain adequate food, is a growing problem in Canada and other Organisation of economic cooperation and development (OECD) countries. Government political orientations impact health policies and outcomes. We critically examined Canadian political rhetoric around HFI from 1995 to 2012 as a means to support effective healthy public policy argumentation. We analysed a data set comprised of Hansard extracts on HFI from the legislative debates of the Canadian federal and three provincial governments, using thematic coding guided by interpretivist theories of policy. Extracts were examined for content, jurisdiction, the political affiliation of the legislator speaking and governing status. Members of non-governing, or ‘opposition’ parties, dominated the rhetoric. A central hunger-as-poverty theme was used by legislators across the political spectrum, both in government and in opposition. Legislators differed in terms of policy approach around how income should flow to citizens facing HFI: income intervention on the left, pragmatism in the centre, reliance on markets on the right. This analysis is a case-example from Canada and caution must be exercised in terms of the generalizability of findings across jurisdictions. Despite this limitation, our findings can help healthy public policy advocates in designing and communicating HFI policy interventions in OECD countries with a similar left–right spectrum. First, even with a divisive health policy issue such as actions to address HFI, core themes around poverty are widely understood. Secondly, the non-polarizing centrist, pragmatist, approach may be strategically valuable. Thirdly, it is important to treat the rhetoric of opposition members differently from that of government members.



Intersectoriality in Danish municipalities: corrupting the social determinants of health?

2016-03-22

Abstract
Action on the social determinants of health (SDH) through intersectoral policymaking is often suggested to promote health and health equity. This paper argues that the process of intersectoral policymaking influences how the SDH are construed and acted upon in municipal policymaking. We discuss how the intersectoral policy process legitimates certain practices in the setting of Danish municipal health promotion and the potential impact this can have for long-term, sustainable healthy public policy. Based on ethnographic fieldwork, we show how the intention of intersectoriality produces a strong concern for integrating health into non-health sectors to ensure productive collaboration. To encourage this integration, health is often framed as a means to achieve the objectives of non-health sectors. In doing so, the intersectoral policy process tends to favor smaller-scale interventions that aim to introduce healthier practices into various settings, e.g. creating healthy school environments for increased physical activity and healthy eating. While other more overarching interventions on the health impacts of broader welfare policies (e.g. education policy) tend to be neglected. The interventions hereby neglect to address more fundamental SDH. Based on these findings, we argue that intersectoral policymaking to address the SDH may translate into a limited approach to action on so-called ‘intermediary determinants’ of health, and as such may end up corrupting the broader SDH. Further, we discuss how this corruption affects the intended role of non-health sectors in tackling the SDH, as it may impede the overall success and long-term sustainability of intersectoral efforts.



Libraries as ‘everyday’ settings: the Glasgow MCISS project

2016-03-22

Abstract
A settings-based approach is now well-established in health promotion, initially undertaken in conventional places like schools and workplaces, but more recently being expressed in a wider range of what Torp et al. call ‘everyday’ settings. In this context, libraries have emerged as another potential setting whose ubiquity and accessibility suggests that they may be particularly effective in addressing health inequalities. Drawing on a case study—the Glasgow Macmillan Cancer Information and Support Services Library project—this paper reports on the potential for seeing ‘libraries as settings’ and in the context of a set of associated theoretical resources, specifically scrutinizes the nature of initiative implementation. Data were drawn from multiple sources: semi-structured interviews and focus groups with strategic partners and stakeholders, operational staff, project volunteers, service users and members of the general public. Qualitative data were complemented by quantitative insights from surveys with members of the partnership, libraries staff and volunteers. Despite some concerns associated with potentially hostile cultural and financial contexts that might threaten longer term sustainability, insights suggested that in pragmatic terms, the project was attracting sizable ‘footfall’ and successfully addressing a range of needs. Additionally, the formal implementation processes associated with project implementation were considered to have been highly successful in embedding the model into the library culture. In summary, there is evidence that libraries have the potential to be considered as supportive settings and could act as a model for an emergent vision of what libraries do.



Social support and coping means: the lived experiences of Northeastern Thai women with breast cancer

2015-04-15

Abstract
Social support plays a critical role in how women living with breast cancer deal with their diagnosis and treatment. This article discusses the meanings of breast cancer and the experiences of social support among women living with breast cancer in Northeastern Thailand (Isan). In-depth interviews were conducted with 18 women with breast cancer. Data were analysed using the thematic analysis method. Being diagnosed with breast cancer can be a traumatic experience. However, many women with breast cancer managed to deal with their illnesses and treatments and this was based largely on social support they received. Available support from family members, friends, neighbours, religion and health care professionals was essential for them to deal with their breast cancer. Social support was an important component for the provision of good care for these women and women living with breast cancer. Although medical treatments were essential for breast cancer, social support could enhance the effectiveness of the treatments as it helped women to have positive perspectives about their health conditions and to better deal with their illnesses. Our findings are useful for sensitive health promotion for women with breast cancer in Thailand and elsewhere. Social support should be modified to meet the woman's individual needs. Health professionals are an important source of social support for women with breast cancer. Having an understanding and being sensitive to these women's experiences and challenges means that health care professionals can provide more individualised support and care to women during their vulnerable period of life.