1
|
Sweeting H, Thomson H, Wells V, Flowers P. Evolution of 'whole institution' approaches to improving health in tertiary education settings: a critical scoping review. RESEARCH PAPERS IN EDUCATION 2023; 38:661-689. [PMID: 37424522 PMCID: PMC7614732 DOI: 10.1080/02671522.2021.1961302] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 07/02/2021] [Indexed: 07/11/2023]
Abstract
In recent decades, 'whole school' approaches to improving health have gained traction, based on settings-based health promotion understandings which view a setting, its actors and processes as an integrated 'whole' system with multiple intervention opportunities. Much less is known about 'whole institution' approaches to improving health in tertiary education settings. We conducted a scoping review to describe both empirical and non-empirical (e.g. websites) publications relating to 'whole settings', 'complex systems' and 'participatory'/'action' approaches to improving the health of students and staff within tertiary education settings. English-language publications were identified by searching five academic and four grey literature databases and via the reference lists of studies read for eligibility. We identified 101 publications with marked UK overrepresentation. Since the 1970s, publications have increased, spanning a gradual shift in focus from 'aspirational' to 'conceptual' to 'evaluative'. Terminology is geographically siloed (e.g., 'healthy university' (UK), 'healthy campus' (USA)). Publications tend to focus on 'health' generally rather than specific health dimensions (e.g. diet). Policies, arguably crucial for cascading systemic change, were not the most frequently implemented intervention elements. We conclude that, despite the field's evolution, key questions (e.g., insights into who needs to do what, with whom, where and when; or efficacy) remain unanswered.
Collapse
Affiliation(s)
- Helen Sweeting
- Institute of Health & Wellbeing, University of Glasgow, Glasgow, UK
| | - Hilary Thomson
- Institute of Health & Wellbeing, University of Glasgow, Glasgow, UK
| | - Valerie Wells
- Institute of Health & Wellbeing, University of Glasgow, Glasgow, UK
| | - Paul Flowers
- School of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK
| |
Collapse
|
2
|
Jenkins CL, Wills J, Sykes S. Settings for the development of health literacy: A conceptual review. Front Public Health 2023; 11:1105640. [PMID: 36875396 PMCID: PMC9978221 DOI: 10.3389/fpubh.2023.1105640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 01/31/2023] [Indexed: 02/18/2023] Open
Abstract
Advances in conceptualizing settings in health promotion include understanding settings as complex and interlinked systems with a core commitment to health and related outcomes such as health literacy. Traditional settings for the development of health literacy include health care environments and schools. There is a need to identify and conceptualize non-traditional and emerging settings of twenty-first-century everyday life. The aim of this conceptual review is to inform a conceptual model of a "non-traditional" setting for the development of health literacy. The model uses the example of the public library to propose four equity-focused antecedents required in a setting for the development of health literacy: the setting acknowledges the wider determinants of health, is open access, involves local communities in how it is run, and facilitates informed action for health. The review concludes that a settings approach to the development of health literacy can be conceptualized as part of a coordinated "supersetting approach," where multiple settings work in synergy with each other.
Collapse
Affiliation(s)
- Catherine L Jenkins
- Institute of Health and Social Care, London South Bank University, London, United Kingdom
| | - Jane Wills
- Institute of Health and Social Care, London South Bank University, London, United Kingdom
| | - Susie Sykes
- Institute of Health and Social Care, London South Bank University, London, United Kingdom
| |
Collapse
|
3
|
Myre M, Glenn NM, Berry TR. Experiences of Size Inclusive Physical Activity Settings Among Women With Larger Bodies. RESEARCH QUARTERLY FOR EXERCISE AND SPORT 2022:1-10. [PMID: 35344473 DOI: 10.1080/02701367.2021.1983515] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 09/17/2021] [Indexed: 06/14/2023]
Abstract
Purpose: Size inclusive physical activity settings may help mitigate the impact of physical activity-related weight stigma. In this interpretive description study, we aimed to understand how women with larger bodies experienced size inclusive physical activity settings. The study was informed by a settings-based approach to health promotion. Method: We interviewed nine women with larger bodies who participated in size inclusive physical activity and used an inductive approach to analyze the data. Findings: At the individual level, size inclusion was experienced as an enhancement of well-being, self-worth, and belonging. This was closely tied to the interpersonal level, whereby weight-neutral practices used by fitness instructors and lack of judgment from other exercisers contributed to experiences of size inclusion. At the organizational level, the organization's culture, marketing, programs, and physical spaces could enhance or limit inclusion and participation. However, weight stigma was prevalent in women's experiences outside the physical activity setting. Conclusion: We provide recommendations to improve size inclusion in physical activity settings.
Collapse
|
4
|
Alexander SA, Shareck M. Widening the gap? Unintended consequences of health promotion measures for young people during COVID-19 lockdown. Health Promot Int 2021; 36:1783-1794. [PMID: 33604653 PMCID: PMC7928856 DOI: 10.1093/heapro/daab015] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
During the first wave of the COVID-19 pandemic, global measures preventing the spread of the new coronavirus required most of the population to lockdown at home. This sudden halt to collective life meant that non-essential services were closed and many health promoting activities (i.e. physical activity, school) were stopped in their tracks. To curb the negative health impacts of lockdown measures, activities adapting to this new reality were urgently developed. One form of activity promoted indoor physical activity to prevent the adverse physical and psychological effects of the lockdown. Another form of activity included the rapid development of online learning tools to keep children and youth engaged academically while not attending school. While these health promoting efforts were meant to benefit the general population, we argue that these interventions may have unintended consequences and inadvertently increase health inequalities affecting marginalized youth in particular, as they may not reap the same benefits, both social and physical, from the interventions promoting at-home physical activities or distance learning measures. We elaborate on several interventions and their possible unintended consequences for marginalized youth and suggest several strategies that may mitigate their impact.
Collapse
Affiliation(s)
- Stephanie A Alexander
- Fondation d’entreprise MGEN pour la santé publique, 3 square Max Hymans, 75748 Paris Cedex 15
| | - Martine Shareck
- Département des Sciences de la Santé Communautaire, Faculté de Médecine et des Sciences de la Santé, Université de Sherbrooke, 3001 12e Avenue Nord Sherbrooke, J1H 5N4 Québec, Canada
| |
Collapse
|
5
|
Hall J, Bingham DD, Seims A, Dogra SA, Burkhardt J, Nobles J, McKenna J, Bryant M, Barber SE, Daly-Smith A. A whole system approach to increasing children's physical activity in a multi-ethnic UK city: a process evaluation protocol. BMC Public Health 2021; 21:2296. [PMID: 34922508 PMCID: PMC8684063 DOI: 10.1186/s12889-021-12255-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 11/17/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Engaging in regular physical activity requires continued complex decision-making in varied and dynamic individual, social and structural contexts. Widespread shortfalls of physical activity interventions suggests the complex underlying mechanisms of change are not yet fully understood. More insightful process evaluations are needed to design and implement more effective approaches. This paper describes the protocol for a process evaluation of the JU:MP programme, a whole systems approach to increasing physical activity in children and young people aged 5-14 years in North Bradford, UK. METHODS This process evaluation, underpinned by realist philosophy, aims to understand the development and implementation of the JU:MP programme and the mechanisms by which JU:MP influences physical activity in children and young people. It also aims to explore behaviour change across wider policy, strategy and neighbourhood systems. A mixed method data collection approach will include semi-structured interview, observation, documentary analysis, surveys, and participatory evaluation methods including reflections and ripple effect mapping. DISCUSSION This protocol offers an innovative approach on the use of process evaluation feeding into an iterative programme intended to generate evidence-based practice and deliver practice-based evidence. This paper advances knowledge regarding the development of process evaluations for evaluating systems interventions, and emphasises the importance of process evaluation.
Collapse
Affiliation(s)
- Jennifer Hall
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford Royal Infirmary, Duckworth Lane, Bradford, BD9 6RJ, UK. .,Faculties of Life Sciences and Health Studies, University of Bradford, Richmond Road, Bradford, BD7 1DP, UK.
| | - Daniel D Bingham
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford Royal Infirmary, Duckworth Lane, Bradford, BD9 6RJ, UK.,Faculties of Life Sciences and Health Studies, University of Bradford, Richmond Road, Bradford, BD7 1DP, UK
| | - Amanda Seims
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford Royal Infirmary, Duckworth Lane, Bradford, BD9 6RJ, UK.,Faculties of Life Sciences and Health Studies, University of Bradford, Richmond Road, Bradford, BD7 1DP, UK
| | - Sufyan Abid Dogra
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford Royal Infirmary, Duckworth Lane, Bradford, BD9 6RJ, UK.,Faculties of Life Sciences and Health Studies, University of Bradford, Richmond Road, Bradford, BD7 1DP, UK
| | - Jan Burkhardt
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford Royal Infirmary, Duckworth Lane, Bradford, BD9 6RJ, UK
| | - James Nobles
- The National Institute for Health Research Applied Research Collaboration West (NIHR ARC West) at University Hospitals Bristol National Health Service Foundation Trust, Bristol, UK.,Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Jim McKenna
- School of Sport, Carnegie, Leeds Beckett University, Leeds, LS6 3QT, UK
| | - Maria Bryant
- Department of Health Sciences, Seebohm Rowntree Building, University of York, Heslington, York, YO10 5DD, UK.,The Hull York Medical School, University of York, York, YO10 5DD, UK
| | - Sally E Barber
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford Royal Infirmary, Duckworth Lane, Bradford, BD9 6RJ, UK.,Faculties of Life Sciences and Health Studies, University of Bradford, Richmond Road, Bradford, BD7 1DP, UK
| | - Andy Daly-Smith
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford Royal Infirmary, Duckworth Lane, Bradford, BD9 6RJ, UK.,Faculties of Life Sciences and Health Studies, University of Bradford, Richmond Road, Bradford, BD7 1DP, UK.,Centre for Applied Education Research, Wolfson Centre for Applied Health Research, Bradford Royal Infirmary, Bradford, West Yorkshire, UK
| |
Collapse
|
6
|
French M, Keegan T, Anestis E, Preston N. Exploring socioeconomic inequities in access to palliative and end-of-life care in the UK: a narrative synthesis. BMC Palliat Care 2021; 20:179. [PMID: 34802450 PMCID: PMC8606060 DOI: 10.1186/s12904-021-00878-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 11/05/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Efforts inequities in access to palliative and end-of-life care require comprehensive understanding about the extent of and reasons for inequities. Most research on this topic examines differences in receipt of care. There is a need, particularly in the UK, for theoretically driven research that considers both receipt of care and the wider factors influencing the relationship between socioeconomic position and access to palliative and end-of-life care. METHODS This is a mixed studies narrative synthesis on socioeconomic position and access to palliative and end-of-life care in the UK. Study searches were conducted in databases AMED, Medline, Embase, CINAHL, SocIndex, and Academic Literature Search, as well as grey literature sources, in July 2020. The candidacy model of access, which describes access as a seven-stage negotiation between patients and providers, guided study searches and provided a theoretical lens through which data were synthesised. RESULTS Searches retrieved 5303 studies (after de-duplication), 29 of which were included. The synthesis generated four overarching themes, within which concepts of candidacy were evident: identifying needs; taking action; local conditions; and receiving care. CONCLUSION There is not a consistent or clear narrative regarding the relationship between socioeconomic position and receipt of palliative and end-of-life care in the UK. Attempts to address any inequities in access will require knowledge and action across many different areas. Key evidence gaps in the UK literature concern the relationship between socioeconomic position, organisational context, and assessing need for care.
Collapse
Affiliation(s)
- Maddy French
- Division of Health Research, Lancaster University, Lancaster, UK.
| | - Thomas Keegan
- Lancaster Medical School, Lancaster University, Lancaster, UK
| | | | - Nancy Preston
- Division of Health Research, Lancaster University, Lancaster, UK
| |
Collapse
|
7
|
Lafrenière D, Kekewich M, Lukich N, Bearnes RD. A principle-based framework for improving health equity in the Champlain region of Ontario, Canada. Healthc Manage Forum 2021; 34:297-301. [PMID: 34396830 DOI: 10.1177/08404704211036211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
The purpose of this column is to present an action-oriented health equity framework derived from Beauchamp and Childress' four ethical principles (ie, autonomy, beneficence, nonmaleficence, and justice) and centred around the specific needs of marginalized and excluded communities of the Champlain region of Ontario. It describes the conceptual underpinnings of the framework, defines its components, and demonstrates how it can be applied. The principle-based health equity framework is a useful tool to reduce health disparities within healthcare organizations; it is designed to promote the incorporation of health equity objectives, strategies, principles, and measurements into healthcare organizations' strategic planning processes and operations.
Collapse
Affiliation(s)
- Darquise Lafrenière
- The Champlain Centre for Health Care Ethics, The Ottawa Hospital, Ottawa, Ontario, Canada
| | - Michael Kekewich
- Department of Clinical and Organizational Ethics, The Ottawa Hospital, Ottawa, Ontario, Canada
| | - Nikolija Lukich
- The Champlain Centre for Health Care Ethics, The Ottawa Hospital, Ottawa, Ontario, Canada
| | - Reece D Bearnes
- Ambulatory and Virtual Care, The Ottawa Hospital, Ottawa, Ontario, Canada
| |
Collapse
|
8
|
Sigblad F, Savela M, Okenwa Emegwa L. Managers' Perceptions of Factors Affecting Employees' Uptake of Workplace Health Promotion (WHP) Offers. Front Public Health 2020; 8:145. [PMID: 32432071 PMCID: PMC7214614 DOI: 10.3389/fpubh.2020.00145] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Accepted: 04/07/2020] [Indexed: 11/22/2022] Open
Abstract
Managers are often charged with the responsibility of overseeing Workplace health promotion (WHP) for which significant amounts of resources are laid aside yearly. While there is increasing interest by employers to include WHP policies, studies show that WHP implementation and uptake by employees still need to be improved upon. Given that managers are part of organizational decision-making and implementation of new policies, they serve as the bridge between workers and management. The aim of this study is to investigate managers' perceptions of employees' WHP uptake as well as challenges encountered by managers in the execution of their WHP-related tasks. Method: This study is based on a qualitative method using semi-structured interviews. Participants in the study were managers at medium and large-scale private companies in Northcentral Sweden. To ensure that participating companies are comparable in terms of structure and policy, only companies within the private sector were eligible to participate. Furthermore, only one manager per company was interviewed. A total of nineteen managers participated and the data generated were analyzed using content analysis. Results: A total of three themes and nine subthemes emerged. The first theme deals with factors at the individual level, subthemes include awareness of WHP, work-life balance, and attitudes. The second theme comprises of factors related to the WHP offer, subthemes were design of the WHP, supportive collaborators and financing of WHP. The third theme deals with organizational factors, subthemes were the nature of the organization's operations, management as role models and resources and support for managers. Results show that most of the challenges encountered by managers in executing WHP were mostly at the organizational level. Conclusion: Addressing modifiable factors at the individual and organizational levels and those related to the WHP may improve WHP uptake among employees.
Collapse
Affiliation(s)
- Fanny Sigblad
- The Swedish Work Environment Authority, Stockholm, Sweden
| | - Maria Savela
- Department of Public Health and Sport Science, Faculty of Health and Occupational Science, University of Gävle, Gävle, Sweden
| | - Leah Okenwa Emegwa
- Department of Public Health and Sport Science, Faculty of Health and Occupational Science, University of Gävle, Gävle, Sweden
- Swedish Red Cross University College, Huddinge, Sweden
| |
Collapse
|
9
|
Alexander SA, Jones CM, Tremblay MC, Beaudet N, Rod MH, Wright MT. Reflexivity in Health Promotion: A Typology for Training. Health Promot Pract 2020; 21:499-509. [PMID: 32285696 PMCID: PMC7298350 DOI: 10.1177/1524839920912407] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
Reflexivity has emerged as a key concept in the field of health promotion
(HP). Yet it remains unclear how diverse forms of reflexivity are
specifically relevant to HP concerns, and how these “reflexivities”
are interconnected. We argue that frameworks are needed to support
more systematic integration of reflexivity in HP training and
practice. In this article, we propose a typology of reflexivity in HP
to facilitate the understanding of reflexivity in professional
training. Drawing from key theories and models of reflexivity, this
typology proposes three reflexive positions (ideal-types) with
specific purposes for HP: reflexivity in, on, and underlying action.
This article illustrates our typology’s ideal-types with vignettes
collected from HP actors working with reflexivity in North America and
Europe. We suggest that our typology constitutes a conceptual device
to organize and discuss a variety of experiences of engaging with
reflexivity for HP. We propose the typology may support integrating
reflexivity as a key feature in training a future cadre of health
promoters and as a means for building a responsible HP practice.
Collapse
Affiliation(s)
| | | | | | - Nicole Beaudet
- Montreal Health and Social Services Agency, Montreal, Canada
| | | | | |
Collapse
|
10
|
Plamondon KM, Caxaj CS, Graham ID, Bottorff JL. Connecting knowledge with action for health equity: a critical interpretive synthesis of promising practices. Int J Equity Health 2019; 18:202. [PMID: 31878940 PMCID: PMC6933619 DOI: 10.1186/s12939-019-1108-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Accepted: 12/10/2019] [Indexed: 11/12/2022] Open
Abstract
Connecting knowledge with action (KWA) for health equity involves interventions that can redistribute power and resources at local, national, and global levels. Although there is ample and compelling evidence on the nature, distribution, and impact of health inequities, advancing health equity is inhibited by policy arenas shaped by colonial legacies and neoliberal ideology. Effective progress toward health equity requires attention to evidence that can promote the kind of socio-political restructuring needed to address root causes of health inequities. In this critical interpretive synthesis, results of a recent scoping review were broadened to identify evidence-informed promising practices for KWA for health equity. Following screening procedures, 10 literature reviews and 22 research studies were included in the synthesis. Analysis involved repeated readings of these 32 articles to extract descriptive data, assess clarity and quality, and identify promising practices. Four distinct kinds of promising practices for connecting KWA for health equity were identified and included: ways of structuring systems, ways of working together, and ways of doing research and ways of doing knowledge translation. Our synthesis reveals that advancing health equity requires greater awareness, dialogue, and action that aligns with the what is known about the causes of health inequities. By critically reflecting on dominant discourses and assumptions, and mobilizing political will from a more informed and transparent democratic exercise, knowledge to action for health equity can be achieved.
Collapse
Affiliation(s)
- Katrina M Plamondon
- School of Nursing, The University of British Columbia, 1147 Research Rd., ART 360, Kelowna, BC, V1V 1V7, Canada.
| | | | - Ian D Graham
- School of Epidemiology & Public Health, University of Ottawa, Ottawa, Canada
| | - Joan L Bottorff
- School of Nursing, The University of British Columbia, 1147 Research Rd., ART 360, Kelowna, BC, V1V 1V7, Canada
| |
Collapse
|
11
|
D'Innocenzo S, Biagi C, Lanari M. Obesity and the Mediterranean Diet: A Review of Evidence of the Role and Sustainability of the Mediterranean Diet. Nutrients 2019; 11:E1306. [PMID: 31181836 PMCID: PMC6627690 DOI: 10.3390/nu11061306] [Citation(s) in RCA: 114] [Impact Index Per Article: 22.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2019] [Revised: 05/27/2019] [Accepted: 05/30/2019] [Indexed: 02/07/2023] Open
Abstract
Several different socio-economic factors have caused a large portion of the population to adopt unhealthy eating habits that can undermine healthcare systems, unless current trends are inverted towards more sustainable lifestyle models. Even though a dietary plan inspired by the principles of the Mediterranean Diet is associated with numerous health benefits and has been demonstrated to exert a preventive effect towards numerous pathologies, including obesity, its use is decreasing and it is now being supplanted by different nutritional models that are often generated by cultural and social changes. Directing governments' political actions towards spreading adherence to the Mediterranean Diet's principles as much as possible among the population could help to tackle the obesity epidemic, especially in childhood. This document intends to reiterate the importance of acting in certain age groups to stop the spread of obesity and proceeds with a critical review of the regulatory instruments used so far, bearing in mind the importance of the scientific evidence that led to the consideration of the Mediterranean Diet as not just a food model, but also as the most appropriate regime for disease prevention, a sort of complete lifestyle plan for the pursuit of healthcare sustainability.
Collapse
Affiliation(s)
- Santa D'Innocenzo
- Prochild Project, Department of Medical and Surgical Sciences (DIMEC), St. Orsola-Malpighi Hospital, University of Bologna, 40138 Bologna, Italy.
| | - Carlotta Biagi
- Pediatric Emergency Unit, Department of Medical and Surgical Sciences (DIMEC), St. Orsola-Malpighi Hospital, University of Bologna, 40138 Bologna, Italy.
| | - Marcello Lanari
- Pediatric Emergency Unit, Department of Medical and Surgical Sciences (DIMEC), St. Orsola-Malpighi Hospital, University of Bologna, 40138 Bologna, Italy.
| |
Collapse
|
12
|
Madsen W, Ambrens M, Ohl M. Enhancing Resilience in Community-Dwelling Older Adults: A Rapid Review of the Evidence and Implications for Public Health Practitioners. Front Public Health 2019; 7:14. [PMID: 30792974 PMCID: PMC6374312 DOI: 10.3389/fpubh.2019.00014] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Accepted: 01/17/2019] [Indexed: 11/25/2022] Open
Abstract
Background: Resilience is a valuable platform for strengthening individuals and communities in the face of disaster. This review sought to evaluate the current literature related to individual and community resilience in community-dwelling older adults to understand the status of resilience in this population, identify gaps, and make recommendations about effective interventions that promote improved individual and community level capacity. Recognizing the concept of resilience is contested, the review conceptualized resilience as a collective concept that is multi-level and interdependent across those levels, cumulative, and contingent on context. Methods: The rapid review located 29 relevant peer review journal articles and industry reports related to research or evaluations of interventions aimed at increasing resilience at either a personal or community level. The results of these papers were thematically analyzed. Results: This review found personal resilience relates to those personal capacities and resources one has and uses to deal with individual stresses and change. We identified several recurring themes within those studies focused on personal resilience, including: (1) positive reframing and agency; (2) personal meaning and purpose; (3) acceptance and belonging. At a community level, we identified the following themes influence collective capacity and resources: (1) empowerment and shared decision making; (2) collective agency; and (3) collective leadership and engagement. Conclusions: The review highlighted the need to reframe how communities view older adults and shift the narrative away from focusing on age-related deficits toward acknowledging the economic and social contribution older adults make to the community through activities such as volunteering and the sharing of knowledge of history, culture and skills. Demonstrating the interdependence across levels, these activities illustrate personal-level capacities promoting collective action and participation as important for increasing community resilience. The review argues resilience is developed in everyday circumstances, therefore active involvement within communities needs to be encouraged within community-dwelling older adults. Developing active involvement will not only contribute to both personal and community level resilience but will enable communities to prosper and flourish through adversity.
Collapse
Affiliation(s)
- Wendy Madsen
- School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton, QLD, Australia
| | - Meghan Ambrens
- School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton, QLD, Australia
| | - Melanie Ohl
- School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton, QLD, Australia
| |
Collapse
|
13
|
Dooris M, Farrier A, Doherty S, Holt M, Monk R, Powell S. The UK Healthy Universities Self-Review Tool: Whole System Impact. Health Promot Int 2018; 33:448-457. [PMID: 28011661 PMCID: PMC6160901 DOI: 10.1093/heapro/daw099] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Over recent years, there has been growing interest in Healthy Universities, evidenced by an increased number of national networks and the participation of 375 participants from over 30 countries in the 2015 International Conference on Health Promoting Universities and Colleges, which also saw the launch of the Okanagan Charter. This paper reports on research exploring the use and impact of the UK Healthy Universities Network’s self review tool, specifically examining whether this has supported universities to understand and embed a whole system approach. The research study comprised two stages, the first using an online questionnaire and the second using focus groups. The findings revealed a wide range of perspectives under five overarching themes: motivations; process; outcomes/benefits; challenges/suggested improvements; and future use. In summary, the self review tool was extremely valuable and, when engaged with fully, offered significant benefits to universities seeking to improve the health and wellbeing of their communities. These benefits were felt by institutions at different stages in the journey and spanned outcome and process dimensions: not only did the tool offer an engaging and user-friendly means of undertaking internal benchmarking, generating an easy-to-understand report summarizing strengths and weaknesses; it also proved useful in building understanding of the whole system Healthy Universities approach and served as a catalyst to effective cross-university and cross-sectoral partnership working. Additionally, areas for potential enhancement were identified, offering opportunities to increase the tool’s utility further whilst engaging actively in the development of a global movement for Healthy Universities.
Collapse
Affiliation(s)
- Mark Dooris
- Healthy and Sustainable Settings Unit, University of Central Lancashire, Brook Building, Victoria Street, Preston PR12HE, UK
| | - Alan Farrier
- Healthy and Sustainable Settings Unit, University of Central Lancashire, Brook Building, Victoria Street, Preston PR12HE, UK
- Corresponding author: E-mail:
| | - Sharon Doherty
- Healthy and Sustainable Settings Unit, University of Central Lancashire, Brook Building, Victoria Street, Preston PR12HE, UK
| | - Maxine Holt
- Faculty of Health, Psychology & Social Care, Manchester Metropolitan University, Brooks Building, 53 Bonsall Street, Manchester M156GX, UK
| | - Robert Monk
- Faculty of Health, Psychology & Social Care, Manchester Metropolitan University, Brooks Building, 53 Bonsall Street, Manchester M156GX, UK
| | - Susan Powell
- Faculty of Health, Psychology & Social Care, Manchester Metropolitan University, Brooks Building, 53 Bonsall Street, Manchester M156GX, UK
| |
Collapse
|
14
|
Douthit NT, Biswas S. Global Health Education and Advocacy: Using BMJ Case Reports to Tackle the Social Determinants of Health. Front Public Health 2018; 6:114. [PMID: 29868534 PMCID: PMC5949558 DOI: 10.3389/fpubh.2018.00114] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Accepted: 04/04/2018] [Indexed: 12/15/2022] Open
Abstract
Since 2013, BMJ Case Reports (http://casereports.bmj.com/) has published over 70 global health case reports from five continents, written by doctors, nurses, students, and allied health professionals. These cases, a burgeoning repository of evidence of how real patients are affected by disease, trauma, violence, sexual assault, conflict, migration, adverse living and working conditions, and poor access to health care, discuss, in addition to clinicopathological findings, the global health problems affecting each patient. The global health problem analysis examines the problems of individual patients, critically appraises the literature, and describes actual and potential solutions for the patient, the local community, and patients affected by similar issues across the world. At present global health literature and learning materials lack a patient focus and real-life context in the analysis of global health problems. BMJ Case Reports global health case reports are a unique and important tool to learn about and advocate for change in the social, political, cultural, and financial determinants of health as they affect real patients. This growing evidence base brings together clinicians, local service providers, policy makers, and government and non-governmental institutions to effect real change in patients' lives toward improving health. Each global health case report is an excellent resource for learning, and together, these case reports provide essential reading for anyone embarking on a career in global health, and writing their own case report. The online course (http://casereports.bmj.com/site/misc/GHMA_Mar_2017.pptx) at BMJ Case Reports uses these cases and is free to access.
Collapse
Affiliation(s)
- Nathan T. Douthit
- BMJ Case Reports, London, United Kingdom
- Graduate Medical Education, Brookwood Baptist Health, Birmingham, AL, United States
| | | |
Collapse
|
15
|
El-Shafei DA, Abdelsalam AE, Hammam RAM, Elgohary H. Professional quality of life, wellness education, and coping strategies among emergency physicians. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2018; 25:9040-9050. [PMID: 29333570 DOI: 10.1007/s11356-018-1240-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Accepted: 01/08/2018] [Indexed: 06/07/2023]
Abstract
Professional quality of life (ProQOL) is affected by and affects professional well-being and performance. The objectives of this study are to identify risk factors of ProQOL among EM physicians in Zagazig University hospitals (ZUHs), to detect the relationship between ProQOL and coping strategies, and to measure the implication of the Worksite Wellness Education (WWE) program on improving knowledge skills, ProQOL, and coping. An intervention study was conducted among 108 EM physicians at ZUHs through two stages: assessing ProQOL subscales (CS, BO, and STS) and coping strategies and conducting the WWE program. A pre-post-test design was used in the evaluation. CS was higher among the older age group, smokers, nighttime sleepers, and hobbies' practitioners. Coping strategies carried out by EM physicians to overcome stress and their ProQOL scores were improved significantly post program. ProQOL has multiple factors that affect it. Applying the WWE program will address this concept and may raise awareness about how to cope with work stressors.
Collapse
Affiliation(s)
- Dalia A El-Shafei
- Department of Community, Environmental and Occupational Medicine, Faculty of Medicine, Zagazig University, Zagazig, Egypt.
| | - Amira E Abdelsalam
- Department of Public Health and Preventive Medicine, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Rehab A M Hammam
- Department of Community, Environmental and Occupational Medicine, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Hayam Elgohary
- Department of Psychiatry, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| |
Collapse
|
16
|
Evaluation of a Tai Chi Intervention to Promote Well-Being in Healthcare Staff: A Pilot Study. RELIGIONS 2018. [DOI: 10.3390/rel9020035] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
17
|
Darlington EJ, Violon N, Jourdan D. Implementation of health promotion programmes in schools: an approach to understand the influence of contextual factors on the process? BMC Public Health 2018; 18:163. [PMID: 29357922 PMCID: PMC5776776 DOI: 10.1186/s12889-017-5011-3] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Accepted: 12/20/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Implementing complex and multi-level public health programmes is challenging in school settings. Discrepancies between expected and actual programme outcomes are often reported. Such discrepancies are due to complex interactions between contextual factors. Contextual factors relate to the setting, the community, in which implementation occurs, the stakeholders involved, and the characteristics of the programme itself. This work uses realist evaluation to understand how contextual factors influence the implementation process, to result in variable programme outcomes. This study focuses on identifying contextual factors, pinpointing combinations of contextual factors, and understanding interactions and effects of such factors and combinations on programme outcomes on different levels of the implementation process. METHODS Schools which had participated in a school-based health promotion programme between 2012 and 2015 were included. Two sets of qualitative data were collected: semi-structured interviews with school staff and programme coordinators; and written documents about the actions implemented in a selection of four schools. Quantitative data included 1553 questionnaires targeting pupils aged 8 to 11 in 14 schools to describe the different school contexts. RESULTS The comparison between what was expected from the programme (programme theory) and the outcomes identified in the field data, showed that some of the mechanisms expected to support the implementation of the programme, did not operate as anticipated (e.g. inclusion of training, initiation by decision-maker). Key factors which influenced the implementation process included, amongst other factors, the mode of introduction of the programme, home/school relationship, leadership of the management team, and the level of delegated power. Five types of interactions between contextual factors were put forward: enabling, hindering, neutral, counterbalancing and moderating effects. Recurrent combinations of factors were identified. Implementation was more challenging in vulnerable schools where school climate was poor. CONCLUSION A single programme cannot be suited or introduced in the same manner in every context. However, key recurrent combinations of contextual factors could contribute to the design of implementation patterns, which could provide guidelines and recommendation for grass-root programme implementation.
Collapse
|
18
|
Integrating activity spaces in health research: Comparing the VERITAS activity space questionnaire with 7-day GPS tracking and prompted recall. Spat Spatiotemporal Epidemiol 2018; 25:1-9. [PMID: 29751887 DOI: 10.1016/j.sste.2017.12.003] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2016] [Revised: 12/06/2017] [Accepted: 12/22/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND Accounting for daily mobility allows assessment of multiple exposure to environments. This study compares spatial data obtained (i) from an interactive map-based questionnaire on regular activity locations (VERITAS) and (ii) from GPS tracking. METHODS 234 participants of the RECORD GPS Study completed the VERITAS questionnaire and wore a GPS tracker for 7 days. Analyses illustrate the spatial match between both datasets. RESULTS For half of the sample, 85.5% of GPS data fell within 500 m of a VERITAS location. The median minimum distance between a VERITAS location and a GPS coordinate ranged from 0.4 m for home to slightly over 100 m for a recreational destination. CONCLUSIONS There is a spatial correspondence between destinations collected through VERITAS and 7-day GPS tracking. Both collection methods offer complementary ways to assess daily mobilities, useful to study environmental determinants of health and health inequities.
Collapse
|
19
|
Pauly BM, Shahram SZ, Dang PTH, Marcellus L, MacDonald M. Health Equity Talk: Understandings of Health Equity among Health Leaders. AIMS Public Health 2017; 4:490-512. [PMID: 30155500 PMCID: PMC6111274 DOI: 10.3934/publichealth.2017.5.490] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Accepted: 11/08/2017] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Reducing health inequities is a stated goal of health systems worldwide. There is widespread commitment to health equity among public health leaders and calls for reorientation of health systems towards health equity. As part of the Equity Lens in Public Health (ELPH) program of research, public health decision makers and researchers in British Columbia collaborated to study the application of a health equity lens in a time of health system renewal. We drew on intersectionality, complexity and critical social justice theories to understand how participants construct health equity and apply a health equity lens as part of public health renewal. METHODS 15 focus groups and 16 individual semi-structured qualitative interviews were conducted with 55 health system leaders. Data were analyzed using constant comparative analysis to explore how health equity was constructed in relation to understandings and actions. RESULTS Four main themes were identified in terms of how health care leaders construct health equity and actions to reduce health inequities: (1) population health, (2) determinants of health, and (3) accessibility and (4) challenges of health equity talk. The first three aspects of health equity talk reflect different understandings of health equity rooted in vulnerability (individual versus structural), determinants of health (material versus social determinants), and appropriate health system responses (targeted versus universal responses). Participants identified that talking about health equity in the health care system, either inside or outside of public health, is a 'challenging conversation' because health equity is understood in diverse ways and there is little guidance available to apply a health equity lens. CONCLUSIONS These findings reflect the importance of creating a shared understanding of health equity within public health systems, and providing guidance and clarity as to the meaning and application of a health equity lens. A health equity lens for public health should capture both the production and distribution of health inequities and link to social justice to inform action.
Collapse
Affiliation(s)
- Bernadette M. Pauly
- Centre for Addictions Research of BC, University of Victoria, PO Box 1700 STN CSC, Victoria, BC, Canada
- School of Nursing, University of Victoria, PO Box 1700 STN CSC, Victoria, BC, Canada
| | - Sana Z. Shahram
- Centre for Addictions Research of BC, University of Victoria, PO Box 1700 STN CSC, Victoria, BC, Canada
| | - Phuc T. H. Dang
- Centre for Addictions Research of BC, University of Victoria, PO Box 1700 STN CSC, Victoria, BC, Canada
| | - Lenora Marcellus
- School of Nursing, University of Victoria, PO Box 1700 STN CSC, Victoria, BC, Canada
| | - Marjorie MacDonald
- Centre for Addictions Research of BC, University of Victoria, PO Box 1700 STN CSC, Victoria, BC, Canada
- School of Nursing, University of Victoria, PO Box 1700 STN CSC, Victoria, BC, Canada
| |
Collapse
|
20
|
Canadian policy perspectives on promoting physical activity across age-friendly communities: lessons for advocacy and action. AGEING & SOCIETY 2017. [DOI: 10.1017/s0144686x17000939] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
ABSTRACTPopulation ageing combined with physical inactivity has critical implications for the public health of communities in the twenty-first century. In the last decade, the World Health Organization launched the age-friendly cities agenda, aiming to address population ageing through whole-systems, rights-based, health equity-focused approaches. An important intervention for age-friendly communities is modifying built environments to support population-level physical activity. Physical activity can help mitigate impacts of chronic diseases and social isolation on older adults. Need for advocacy and action in this area raises questions of how to develop supportive environments for physical activity across age-friendly community types. In Canada, a substantial proportion of older adults live outside large urban municipalities, for which scant research exists on fostering age-friendly built environments. To this end, we conducted qualitative research involving semi-structured interviews with 21 municipal policy influencers in Alberta, Canada to gather perspectives on development and early implementation of an age-friendly policy framework in the small urban and rural context. Our findings are organised by three main themes providing key lessons for advocacy and action, namelypursuing comprehensive planning,promoting public engagementandprioritising the needs of older adults. This research informs advocacy and action priorities in promoting built environment modification for routine physical activity as part of an age-friendliness agenda for small urban and rural regions of Canada and other countries.
Collapse
|
21
|
Community Capacity Building for Physical Activity Promotion among Older Adults-A Literature Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14091058. [PMID: 28902146 PMCID: PMC5615595 DOI: 10.3390/ijerph14091058] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Revised: 09/07/2017] [Accepted: 09/11/2017] [Indexed: 02/08/2023]
Abstract
Community-based interventions to promote physical activity (PA) among older adults are of high interest in health promotion since they promise to be effective strategies to reach this population group. Community capacity building, that is, the local promotion of knowledge, skills, commitment, structures, and leadership, is among the recommended core strategies. However, little guidance is provided on how to achieve a high degree of community capacity. This study aims to identify practical strategies to enhance community capacities for PA promotion among older adults (50 years or older) and to evaluate their success. A literature review was conducted using scientific databases (PsycInfo and Web of Sciences) and grey literature (national and international project databases), and 14 studies (16 articles) were identified. Five groups of capacity building strategies emerged from the literature: (1) building community coalitions and networks, (2) training of professionals, (3) training of laypersons, (4) strengthening competence and awareness in the target population, and (5) allocation of financial resources. All studies used more than one strategy. Coalition building and strengthening competence and awareness were most frequently used. Feasibility and acceptability of the capacity building strategies were demonstrated. However, intervention effects on PA behavior and other relevant outcomes were inconsistent. The one study that systematically compared different capacity building approaches did not find any evidence for beneficial effects of intensified capacity building. More rigorous research evaluating the efficacy of specific strategies to enhance community capacities for PA promotion is needed.
Collapse
|
22
|
Abstract
Purpose
Implementing health promotion programmes in schools is key to improving children’s health and well-being but difficulties in achieving expected results are often reported in the research literature. Discrepancies between expected and achieved outcomes can originate from differences in contexts. Understanding how interactions between contexts and programmes generate variable outcomes is, therefore, critical. The purpose of this paper is to explore the outputs of a programme implemented in different school contexts. The focus is to pinpoint outputs, understand the involvement of combinations of contextual factors and identify recurrences in these combinations.
Design/methodology/approach
This retrospective study covers a period from 2006 to 2016. Data collection includes two sets of data in eight high schools in the Rhône-Alpes Region in France: written documents and interviews with school staff. Realist evaluation is used to attempt to pinpoint outputs and relating contextual factors.
Findings
Results highlight the limited outputs of the programme. Differences between schools appear to originate from existing school policy prior to participation, existence of a project team, identification of the issue as priority and staff turnover. Analysis of contextual factors led to considering the implementation process as enabling health capacity building and enhanced the capacity of settings and communities to promote health.
Research limitations/implications
The data provided remain partial as there was high staff turnover, reluctance to participate due to failure to implement the project, and schools being over burdened with other requests.
Originality/value
Previous research suggests that top-down implementation of a standard programme is not an efficient strategy for all schools to engage in the development of suitable health promotion policies. A potential way forward is to base support for the local development of health promotion in schools on a better understanding of the contexts in which implementation occurs.
Collapse
|
23
|
Del Fabbro L, Rowe Minniss F, Ehrlich C, Kendall E. Political Challenges in Complex Place-Based Health Promotion Partnerships: Lessons From an Exploratory Case Study in a Disadvantaged Area of Queensland, Australia. INTERNATIONAL QUARTERLY OF COMMUNITY HEALTH EDUCATION 2017; 37:51-60. [PMID: 28038500 DOI: 10.1177/0272684x16685259] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Settings-based health promotion involving multiple strategies and partners is complex, especially in disadvantaged areas. Partnership development and organizational integration are examined in the literature; however, there is more to learn from the examination of practice stakeholders' experience of intersectoral partnership processes. This case study examines stakeholder experiences of challenges in new partnership work in the context of a culturally diverse and socioeconomically disadvantaged region in Queensland, Australia. Health promotion staff and community representatives participated in interviews and focus groups, and the thematic analysis included observations and documentary analyses. Our findings highlight the retrogressive influence of broader system dynamics, including policy reform and funding changes, upon partnership working. Partnership enablers are disrupted by external political influences and the internal politics (individual and organizational) of health promotion practice. We point to the need for organization level commitment to a consistent agreed vision specifically accounting for place, as a cornerstone of intersectoral health promotion partnership resilience. If organizations from diverse sectors can embed a vision for health that accounts for place, complex health promotion initiatives may be less vulnerable to broader system reforms, and health in all policy approaches more readily sustained.
Collapse
Affiliation(s)
- Letitia Del Fabbro
- 1 Menzies Health Institute Queensland, Griffith University-Logan Campus, Brisbane, QLD, Australia
| | - Fiona Rowe Minniss
- 1 Menzies Health Institute Queensland, Griffith University-Logan Campus, Brisbane, QLD, Australia
| | - Carolyn Ehrlich
- 1 Menzies Health Institute Queensland, Griffith University-Logan Campus, Brisbane, QLD, Australia
| | - Elizabeth Kendall
- 1 Menzies Health Institute Queensland, Griffith University-Logan Campus, Brisbane, QLD, Australia
| |
Collapse
|
24
|
Blake H, Gartshore E. Workplace wellness using online learning tools in a healthcare setting. Nurse Educ Pract 2016; 20:70-5. [PMID: 27486706 DOI: 10.1016/j.nepr.2016.07.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Revised: 06/30/2016] [Accepted: 07/04/2016] [Indexed: 10/21/2022]
Abstract
The aim was to develop and evaluate an online learning tool for use with UK healthcare employees, healthcare educators and healthcare students, to increase knowledge of workplace wellness as an important public health issue. A 'Workplace Wellness' e-learning tool was developed and peer-reviewed by 14 topic experts. This focused on six key areas relating to workplace wellness: work-related stress, musculoskeletal disorders, diet and nutrition, physical activity, smoking and alcohol consumption. Each key area provided current evidence-based information on causes and consequences, access to UK government reports and national statistics, and guidance on actions that could be taken to improve health within a workplace setting. 188 users (93.1% female, age 18-60) completed online knowledge questionnaires before (n = 188) and after (n = 88) exposure to the online learning tool. Baseline knowledge of workplace wellness was poor (n = 188; mean accuracy 47.6%, s.d. 11.94). Knowledge significantly improved from baseline to post-intervention (mean accuracy = 77.5%, s.d. 13.71) (t(75) = -14.801, p < 0.0005) with knowledge increases evident for all included topics areas. Usability evaluation showed that participants perceived the tool to be useful (96.4%), engaging (73.8%) and would recommend it to others (86.9%). Healthcare professionals, healthcare educators and pre-registered healthcare students held positive attitudes towards online learning, indicating scope for development of further online packages relating to other important health parameters.
Collapse
Affiliation(s)
- Holly Blake
- School of Health Sciences, University of Nottingham, Queen's Medical Centre, Nottingham, UK.
| | | |
Collapse
|
25
|
Rock MJ, Degeling C, Graham TM, Toohey AM, Rault D, McCormack GR. Public engagement and community participation in governing urban parks: a case study in changing and implementing a policy addressing off-leash dogs. CRITICAL PUBLIC HEALTH 2016. [DOI: 10.1080/09581596.2016.1177635] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
26
|
Whitelaw S, Coburn J, Lacey M, McKee MJ, Hill C. Libraries as ‘everyday’ settings: the Glasgow MCISSproject. Health Promot Int 2016; 32:891-900. [DOI: 10.1093/heapro/daw021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
27
|
Weiss D, Lillefjell M, Magnus E. Facilitators for the development and implementation of health promoting policy and programs - a scoping review at the local community level. BMC Public Health 2016; 16:140. [PMID: 26869177 PMCID: PMC4751684 DOI: 10.1186/s12889-016-2811-9] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2015] [Accepted: 02/02/2016] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Health promotion, with a focus on multidimensional upstream factors and an ecological, life-course approach, is establishing itself as the guiding philosophy for addressing public health. Action at the political and programmatic level on the Social Determinants of Health has proven effective for promoting and building public health at all levels but has been particularly evident at the national and international levels - due in large part to available documents and guidelines. Although research and experience establish that health promotion is most effective when settings-based, the development of health promoting policies and programs at the local level is still difficult. This study intended to investigate available knowledge on the development and implementation of health promoting policies and programs at the local level and identify factors most important for facilitating capacity building and outcome achievement. METHODS We used a scoping review in order to review the current literature on local policy development and program implementation. Keywords were chosen based on results of a previous literature review. A total of 53 articles were divided into two categories: policy and implementation. Critical analysis was conducted for each article and a summary assembled. Data was charted with specific focus on the aims of the study, data acquisition, key theories/concepts/frameworks used, outcome measures, results, and conclusions. RESULTS The articles included in this study primarily focused on discussing factors that facilitate the development of health promoting policy and the implementation of health promotion programs. Most significant facilitators included: collaborative decision-making, agreement of objectives and goals, local planning and action, effective leadership, building and maintaining trust, availability of resources, a dynamic approach, a realistic time-frame, and trained and knowledgeable staff. Within each of these important facilitating factors, various elements supporting implementation were discussed and highlighted in this study. CONCLUSION Our results indicate that clear and consistent facilitators exist for supporting health promoting policy development and program implementation at the local level. These results offer a starting point for local action on the Social Determinants of Health and have the potential to contribute to the development of a framework for improving action at the local level.
Collapse
Affiliation(s)
- Daniel Weiss
- Department of Occupational Therapy, Norwegian University of Science and Technology, Faculty of Health and Social Science, NO-7491, Trondheim, Norway.
| | - Monica Lillefjell
- Department of Occupational Therapy, Norwegian University of Science and Technology, Faculty of Health and Social Science, NO-7491, Trondheim, Norway.
| | - Eva Magnus
- Department of Occupational Therapy, Norwegian University of Science and Technology, Faculty of Health and Social Science, NO-7491, Trondheim, Norway.
| |
Collapse
|
28
|
Shoveller J, Viehbeck S, Di Ruggiero E, Greyson D, Thomson K, Knight R. A critical examination of representations of context within research on population health interventions. CRITICAL PUBLIC HEALTH 2015. [DOI: 10.1080/09581596.2015.1117577] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
29
|
Lee JGL, Henriksen L, Rose SW, Moreland-Russell S, Ribisl KM. A Systematic Review of Neighborhood Disparities in Point-of-Sale Tobacco Marketing. Am J Public Health 2015; 105:e8-18. [PMID: 26180986 PMCID: PMC4529779 DOI: 10.2105/ajph.2015.302777] [Citation(s) in RCA: 230] [Impact Index Per Article: 25.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/14/2015] [Indexed: 11/04/2022]
Abstract
We systematically reviewed evidence of disparities in tobacco marketing at tobacco retailers by sociodemographic neighborhood characteristics. We identified 43 relevant articles from 893 results of a systematic search in 10 databases updated May 28, 2014. We found 148 associations of marketing (price, placement, promotion, or product availability) with a neighborhood demographic of interest (socioeconomic disadvantage, race, ethnicity, and urbanicity). Neighborhoods with lower income have more tobacco marketing. There is more menthol marketing targeting urban neighborhoods and neighborhoods with more Black residents. Smokeless tobacco products are targeted more toward rural neighborhoods and neighborhoods with more White residents. Differences in store type partially explain these disparities. There are more inducements to start and continue smoking in lower-income neighborhoods and in neighborhoods with more Black residents. Retailer marketing may contribute to disparities in tobacco use. Clinicians should be aware of the pervasiveness of these environmental cues.
Collapse
Affiliation(s)
- Joseph G L Lee
- At the time of this study, Joseph G. L. Lee, Shyanika W. Rose, and Kurt M. Ribisl were with the Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill. Lisa Henriksen is with the Stanford Prevention Research Center, Stanford University School of Medicine, Palo Alto, CA. Shyanika W. Rose was also with the Lineberger Comprehensive Cancer Center, School of Medicine, University of North Carolina and the Schroeder Institute for Tobacco Research and Policy Studies, Legacy, Washington, DC. Sarah Moreland-Russell is with the Center for Public Health Systems Science, Washington University, St. Louis, MO. Kurt M. Ribisl is also with the Lineberger Comprehensive Cancer Center
| | - Lisa Henriksen
- At the time of this study, Joseph G. L. Lee, Shyanika W. Rose, and Kurt M. Ribisl were with the Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill. Lisa Henriksen is with the Stanford Prevention Research Center, Stanford University School of Medicine, Palo Alto, CA. Shyanika W. Rose was also with the Lineberger Comprehensive Cancer Center, School of Medicine, University of North Carolina and the Schroeder Institute for Tobacco Research and Policy Studies, Legacy, Washington, DC. Sarah Moreland-Russell is with the Center for Public Health Systems Science, Washington University, St. Louis, MO. Kurt M. Ribisl is also with the Lineberger Comprehensive Cancer Center
| | - Shyanika W Rose
- At the time of this study, Joseph G. L. Lee, Shyanika W. Rose, and Kurt M. Ribisl were with the Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill. Lisa Henriksen is with the Stanford Prevention Research Center, Stanford University School of Medicine, Palo Alto, CA. Shyanika W. Rose was also with the Lineberger Comprehensive Cancer Center, School of Medicine, University of North Carolina and the Schroeder Institute for Tobacco Research and Policy Studies, Legacy, Washington, DC. Sarah Moreland-Russell is with the Center for Public Health Systems Science, Washington University, St. Louis, MO. Kurt M. Ribisl is also with the Lineberger Comprehensive Cancer Center
| | - Sarah Moreland-Russell
- At the time of this study, Joseph G. L. Lee, Shyanika W. Rose, and Kurt M. Ribisl were with the Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill. Lisa Henriksen is with the Stanford Prevention Research Center, Stanford University School of Medicine, Palo Alto, CA. Shyanika W. Rose was also with the Lineberger Comprehensive Cancer Center, School of Medicine, University of North Carolina and the Schroeder Institute for Tobacco Research and Policy Studies, Legacy, Washington, DC. Sarah Moreland-Russell is with the Center for Public Health Systems Science, Washington University, St. Louis, MO. Kurt M. Ribisl is also with the Lineberger Comprehensive Cancer Center
| | - Kurt M Ribisl
- At the time of this study, Joseph G. L. Lee, Shyanika W. Rose, and Kurt M. Ribisl were with the Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill. Lisa Henriksen is with the Stanford Prevention Research Center, Stanford University School of Medicine, Palo Alto, CA. Shyanika W. Rose was also with the Lineberger Comprehensive Cancer Center, School of Medicine, University of North Carolina and the Schroeder Institute for Tobacco Research and Policy Studies, Legacy, Washington, DC. Sarah Moreland-Russell is with the Center for Public Health Systems Science, Washington University, St. Louis, MO. Kurt M. Ribisl is also with the Lineberger Comprehensive Cancer Center
| |
Collapse
|
30
|
Abstract
The settings-based approach to health promotion (HP) employs a social ecological (SE) framework to integrate HP into the usual activities of the setting and to increase the setting’s support for healthy choices. The SE approach calls for systems thinking to account for the inextricable relationship between people, their behaviour and their environment. Knowledge about a setting can be used to mobilise people to participate in HP, to optimise success by taking into account the local context, and to anticipate and avoid barriers to success. In other words, the SE approach aims to help HP reach its goals for better health, established in concert with community needs and wishes. Yet, the focus on HP goals may detract attention from how intervention may have unanticipated, and even untoward effects on the setting. There is much evidence from classical ecological research that well-meaning interventions have unintended effects. Biology is so tuned to the possibility that the study of unintended effects is integral to the field. There is some evidence – but much less - that HP also has unexpected, deleterious effects. The evidence is limited because of neglect; the subject of unintended effects is only of peripheral interest in HP. This is a call for a more robust SE approach, in which frameworks used to guide settings-based HP are augmented so as to be concerned with planned effects, and also unplanned effects. What can be done to more responsibly monitor, document and report the full panoply of our effects, including detecting and preventing untoward effects?
Collapse
Affiliation(s)
- Maurice B. Mittelmark
- Department of Health Promotion and Development, Faculty of Psychology, University of Bergen, Norway
| |
Collapse
|
31
|
Dooris M, Wills J, Newton J. Theorizing healthy settings: a critical discussion with reference to Healthy Universities. Scand J Public Health 2014; 42:7-16. [DOI: 10.1177/1403494814544495] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The settings approach appreciates that health determinants operate in settings of everyday life. Whilst subject to conceptual development, we argue that the approach lacks a clear and coherent theoretical framework to steer policy, practice and research. Aims: To identify what theories and conceptual models have been used in relation to the implementation and evaluation of Healthy Universities. Methods: A scoping literature review was undertaken between 2010 and 2013, identifying 26 papers that met inclusion criteria. Findings: Seven theoretical perspectives or conceptual frameworks were identified: the Ottawa Charter; a socio-ecological approach (which implicitly drew on sociological theories concerning structure and agency); salutogenesis; systems thinking; whole system change; organizational development; and a framework proposed by Dooris. These were used to address interrelated questions on the nature of a setting, how health is created in a setting, why the settings approach is a useful means of promoting health, and how health promotion can be introduced into and embedded within a setting. Conclusions: Although distinctive, the example of Healthy Universities drew on common theoretical perspectives that have infused the settings discourse more generally. This engagement with theory was at times well-developed and at other times a passing reference. The paper concludes by pointing to other theories that offer value to healthy settings practice and research and by arguing that theorization has a key role to play in understanding the complexity of settings and guiding the planning, implementation and evaluation of programmes.
Collapse
Affiliation(s)
- Mark Dooris
- University of Central Lancashire, Preston, UK
| | - Jane Wills
- London South Bank University, London, UK
| | | |
Collapse
|
32
|
Social change or business as usual at city hall? Examining an urban municipal government's response to neighbourhood-level health inequities. Soc Sci Med 2014; 133:366-73. [PMID: 25245453 DOI: 10.1016/j.socscimed.2014.09.022] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2014] [Revised: 07/26/2014] [Accepted: 09/11/2014] [Indexed: 11/22/2022]
Abstract
There is a renewed interest in the potential of municipal governments working collaboratively with local communities to address health inequities. A growing body of literature has also highlighted the benefits and limitations of participatory approaches in neighbourhood interventions initiated by municipal governments. However, few studies have investigated how neighbourhood interventions tackling health inequities work in real-time and in context, from the perspectives of Community Developers (CDs) who promote community participation. This study uses a process evaluation approach and semi-structured interviews with CDs to explore the challenges they face in implementing a community development, participatory process in the City of Hamilton's strategy to reduce health inequities - Neighbourhood Action. Findings demonstrate that municipal government can facilitate and suppress community participation in complex ways. CDs serve as significant but conflicted intermediaries as they negotiate and navigate power differentials between city and community actors, while also facing structural challenges. We conclude that community participation is important to bottom-up, resident-led social change, and that CDs are central to this work.
Collapse
|
33
|
Bloch P, Toft U, Reinbach HC, Clausen LT, Mikkelsen BE, Poulsen K, Jensen BB. Revitalizing the setting approach - supersettings for sustainable impact in community health promotion. Int J Behav Nutr Phys Act 2014; 11:118. [PMID: 25218420 PMCID: PMC4172849 DOI: 10.1186/s12966-014-0118-8] [Citation(s) in RCA: 78] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2014] [Accepted: 09/08/2014] [Indexed: 11/10/2022] Open
Abstract
Background The concept of health promotion rests on aspirations aiming at enabling people to increase control over and improve their health. Health promotion action is facilitated in settings such as schools, homes and work places. As a contribution to the promotion of healthy lifestyles, we have further developed the setting approach in an effort to harmonise it with contemporary realities (and complexities) of health promotion and public health action. The paper introduces a modified concept, the supersetting approach, which builds on the optimised use of diverse and valuable resources embedded in local community settings and on the strengths of social interaction and local ownership as drivers of change processes. Interventions based on a supersetting approach are first and foremost characterised by being integrated, but also participatory, empowering, context-sensitive and knowledge-based. Based on a presentation of “Health and Local Community”, a supersetting initiative addressing the prevention of lifestyle diseases in a Danish municipality, the paper discusses the potentials and challenges of supporting local community interventions using the supersetting approach. Discussion The supersetting approach is a further development of the setting approach in which the significance of integrated and coordinated actions together with a participatory approach are emphasised and important principles are specified, all of which contribute to the attainment of synergistic effects and sustainable impact of supersetting initiatives. The supersetting approach is an ecological approach, which places the individual in a social, environmental and cultural context, and calls for a holistic perspective to change potentials and developmental processes with a starting point in the circumstances of people’s everyday life. The supersetting approach argues for optimised effectiveness of health promotion action through integrated efforts and long-lasting partnerships involving a diverse range of actors in public institutions, private enterprises, non-governmental organisations and civil society. Summary The supersetting approach is a relevant and useful conceptual framework for developing intervention-based initiatives for sustainable impact in community health promotion. It strives to attain synergistic effects from activities that are carried out in multiple settings in a coordinated manner. The supersetting approach is based on ecological and whole-systems thinking, and stipulates important principles and values of integration, participation, empowerment, context and knowledge-based development.
Collapse
Affiliation(s)
- Paul Bloch
- Steno Health Promotion Center, Steno Diabetes Center, Niels Steensens Vej 8, Gentofte, DK-2820, Denmark.
| | | | | | | | | | | | | |
Collapse
|
34
|
Baron-Epel O, Ivancovsky M. A socio-ecological model for unintentional injuries in minorities: a case study of Arab Israeli children. Int J Inj Contr Saf Promot 2013; 22:48-56. [DOI: 10.1080/17457300.2013.855794] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
35
|
Potvin L, McQueen DV, De Leeuw E, Mendes R, Abel T, Larouche A. Fostering innovation in health promotion research: the critical role of the IUHPE. Glob Health Promot 2013; 20:3-4. [DOI: 10.1177/1757975913491887] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Louise Potvin
- Community Approaches and Health Inequalities, University of Montreal, Montreal, Canada
| | | | - Evelyne De Leeuw
- Community Health Systems and Policy, Deakin University, Australia
| | | | - Thomas Abel
- Institute of Social and Preventive Medicine, University of Bern, Switzerland
| | - Annie Larouche
- Public Health Research Institute (IRSPUM), University of Montreal, Quebec, Canada
| |
Collapse
|
36
|
Abstract
The Global Working Group on Health Promotion Research (GWG HPR) of the International Union for Health Promotion and Education (IUHPE) presents a collection of four articles illustrating innovative avenues for health promotion research. This commentary synthesizes the contributions of these articles while attempting to define the contours of research in health promotion. We propose that innovation in research involves the adoption of a reflexive approach wherein consideration of context plays different roles. The reflexive process consists of questioning what is taken for granted in the conceptualization and operationalization of research. It involves linking research findings and its theoretical foundations to characteristics and goals of the field and observed realities, while orienting reflection on specific objects. The reflexive nature of the research activity is of paramount importance for innovation in health promotion. With the publication of this series, the GWG HPR wishes to strengthen health promotion research capacity at the global level and reaffirm health promotion as a specific research domain. (Global Health Promotion, 2013; 20(2): 64–69)
Collapse
Affiliation(s)
- Annie Larouche
- Institut de recherche en santé publique de l’Université de Montréal (IRSPUM), Québec, Canada
- Strategic Training Program in Transdisciplinary Research on Public Health Interventions: Promotion, Prevention and Public Policy (4P), a partnership of the Institute of Population and Public Health and the Institute of Health Services and Policy Research of the CIHR and the Québec Population Health Research Network, Canada
| | - Louise Potvin
- Institut de recherche en santé publique de l’Université de Montréal (IRSPUM), Québec, Canada
- Strategic Training Program in Transdisciplinary Research on Public Health Interventions: Promotion, Prevention and Public Policy (4P), a partnership of the Institute of Population and Public Health and the Institute of Health Services and Policy Research of the CIHR and the Québec Population Health Research Network, Canada
| |
Collapse
|
37
|
Potvin L, McQueen DV, de Leeuw E, Mendes R, Abel T, Larouche A. Fomentar la innovación en la investigación sobre promoción de la salud: el papel decisivo de la UIPES. Glob Health Promot 2013. [DOI: 10.1177/1757975913492617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Louise Potvin
- Cátedra de enfoques comunitarios y desigualdades en la salud, Universidad de Montreal, Montreal, Canadá
| | | | - Evelyne de Leeuw
- Cátedra Community Health Systems & Policy, Faculty of Health, Deakin University, Geelong Waterfront Campus, Deakin, Australia
| | | | - Thomas Abel
- Institute of social and preventive medicine, University of Bern, Bern, Suiza
| | - Annie Larouche
- Public Health Research Institute of the University of Montreal (IRSPUM), Quebec, Canadá
| |
Collapse
|
38
|
Potvin L, McQueen DV, de Leeuw E, Mendes R, Abel T, Larouche A. Encourager l’innovation dans la recherche en promotion de la santé : le rôle central de l’UIPES. Glob Health Promot 2013. [DOI: 10.1177/1757975913491888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Louise Potvin
- Chaire de Recherche Approches communautaires et inégalités de santé, Montréal, Canada
| | | | - Evelyne de Leeuw
- Chaire Community Health Systems & Policy, Faculty of Health, Deakin University, Geelong Waterfront Campus, Deakin, Australie
| | | | - Thomas Abel
- Institut de médicine sociale et préventive, Université de Bern, Bern, Suisse
| | - Annie Larouche
- Institut de recherche en santé publique de l’Université de Montréal (IRSPUM), Québec, Canada
| |
Collapse
|