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Nsubuga EJ, Fitzmaurice AG, Komakech A, Odoi TD, Kadobera D, Bulage L, Kwesiga B, Elyanu PJ, Ario AR, Harris JR. Community dialogue meetings among district leaders improved their willingness to receive COVID-19 vaccines in Western Uganda, May 2021. BMC Public Health 2023; 23:969. [PMID: 37237258 DOI: 10.1186/s12889-023-15903-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 05/16/2023] [Indexed: 05/28/2023] Open
Abstract
BACKGROUND Widespread COVID-19 vaccine uptake can facilitate epidemic control. A February 2021 study in Uganda suggested that public vaccine uptake would follow uptake among leaders. In May 2021, Baylor Uganda led community dialogue meetings with district leaders from Western Uganda to promote vaccine uptake. We assessed the effect of these meetings on the leaders' COVID-19 risk perception, vaccine concerns, perception of vaccine benefits and access, and willingness to receive COVID-19 vaccine. METHODS All departmental district leaders in the 17 districts in Western Uganda, were invited to the meetings, which lasted approximately four hours. Printed reference materials about COVID-19 and COVID-19 vaccines were provided to attendees at the start of the meetings. The same topics were discussed in all meetings. Before and after the meetings, leaders completed self-administered questionnaires with questions on a five-point Likert Scale about risk perception, vaccine concerns, perceived vaccine benefits, vaccine access, and willingness to receive the vaccine. We analyzed the findings using Wilcoxon's signed-rank test. RESULTS Among 268 attendees, 164 (61%) completed the pre- and post-meeting questionnaires, 56 (21%) declined to complete the questionnaires due to time constraints and 48 (18%) were already vaccinated. Among the 164, the median COVID-19 risk perception scores changed from 3 (neutral) pre-meeting to 5 (strong agreement with being at high risk) post-meeting (p < 0.001). Vaccine concern scores reduced, with medians changing from 4 (worried about vaccine side effects) pre-meeting to 2 (not worried) post-meeting (p < 0.001). Median scores regarding perceived COVID-19 vaccine benefits changed from 3 (neutral) pre-meeting to 5 (very beneficial) post-meeting (p < 0.001). The median scores for perceived vaccine access increased from 3 (neutral) pre-meeting to 5 (very accessible) post-meeting (p < 0.001). The median scores for willingness to receive the vaccine changed from 3 (neutral) pre-meeting to 5 (strong willingness) post-meeting (p < 0.001). CONCLUSION COVID-19 dialogue meetings led to district leaders' increased risk perception, reduced concerns, and improvement in perceived vaccine benefits, vaccine access, and willingness to receive the COVID-19 vaccine. These could potentially influence public vaccine uptake if leaders are vaccinated publicly as a result. Broader use of such meetings with leaders could increase vaccine uptake among themselves and the community.
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Affiliation(s)
| | | | - Allan Komakech
- Uganda Public Health Fellowship Program, Kampala, Uganda
| | - Tom Dias Odoi
- Baylor College of Medicine Children's Foundation, Kampala, Uganda
| | - Daniel Kadobera
- Uganda Public Health Fellowship Program, Kampala, Uganda
- Uganda National Institute of Public Health, Kampala, Uganda
| | - Lilian Bulage
- Uganda Public Health Fellowship Program, Kampala, Uganda
- Uganda National Institute of Public Health, Kampala, Uganda
| | - Benon Kwesiga
- Uganda Public Health Fellowship Program, Kampala, Uganda
- Uganda National Institute of Public Health, Kampala, Uganda
| | | | - Alex Riolexus Ario
- Uganda Public Health Fellowship Program, Kampala, Uganda
- Uganda National Institute of Public Health, Kampala, Uganda
| | - Julie R Harris
- United States Centers for Disease Control and Prevention, Kampala, Uganda
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Preliminary Findings of the Birmingham Policy Surveillance Initiative. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2023; 29:210-212. [PMID: 36126196 DOI: 10.1097/phh.0000000000001621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Policy surveillance is becoming an increasingly powerful tool in public health to identify policies and programs that influence individual and community health. However, not many systems exist to track or facilitate greater understanding of policies at a city or county level. Furthermore, relatively little is known about which policies are being implemented and how they relate to population health goals. In 2019, the University of Alabama at Birmingham School of Public Health joined a consortium of universities to specifically track municipal policies in Birmingham, Alabama. Since its inception, the Birmingham Policy Surveillance Initiative has identified 443 policies and program initiatives related to 6 key areas of focus. The purpose of this article is to describe a policy surveillance system in Birmingham, Alabama. Results are intended to raise the profile of policy surveillance and inform policy makers of opportunities and gaps in policies that influence individual and community health.
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Jongenelis M, Dixon H, Scully M, Morley B. Exploring Intended and Unintended Reactions to Healthy Weight and Lifestyle Advertisements: An Online Experiment. HEALTH EDUCATION & BEHAVIOR 2023; 50:58-69. [PMID: 35758183 DOI: 10.1177/10901981221104727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
BACKGROUND To address concerns that healthy weight and lifestyle campaigns (HWLCs) could have unintended psychological or behavioral consequences, this study tested reactions to TV advertisements from two HWLCs: LiveLighter® (employs graphic health effects messaging) and Swap It Don't Stop It (employs animation and light-hearted messaging). METHODS An online between-subjects experiment tested reactions to one of five advertisements: "Toxic Fat"; "Sugary Drinks" (both from LiveLighter); "Become a Swapper"; "How to Swap It" (both from Swap It); and "HSBC Bank" (control) among 2,208 adults from Western Australia and Victoria, Australia. Responses assessed were cognitive and emotional reactions, behavioral intentions, internalized weight bias, antifat attitudes, self-esteem and body dissatisfaction. RESULTS The HWLC advertisements prompted favorable cognitive reactions and weak to neutral positive and negative emotional responses. HWLC advertisements promoted stronger intentions to engage in adaptive lifestyle behaviors compared with the control advertisement. Intention to engage in maladaptive behaviors (e.g., skipping meals) was low overall and did not differ by condition. Compared with the control condition, participants who saw LiveLighter "Sugary Drinks" showed weaker disagreement with antifat attitudes; however, mean antifat attitude scores were still at the low end of the scale. HWLC advertisements did not promote internalized weight bias, reduced self-esteem or body dissatisfaction compared with the control advertisement. CONCLUSIONS Overall, HWLC advertisements performed favorably compared with the control advertisement and showed no clear evidence of adverse impacts. Findings suggest HWLC advertisements may not promote negative psychological and behavioral consequences and can continue to be used in obesity prevention efforts.
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Affiliation(s)
| | - Helen Dixon
- The University of Melbourne, Parkville, Victoria, Australia.,Curtin University, Bentley, Western Australia, Australia.,Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Maree Scully
- Cancer Council Victoria, Melbourne, Victoria, Australia
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O'Hara L, Taylor J. QATCHEPP: A quality assessment tool for critical health promotion practice. Front Public Health 2023; 11:1121932. [PMID: 37026119 PMCID: PMC10070830 DOI: 10.3389/fpubh.2023.1121932] [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: 12/12/2022] [Accepted: 03/01/2023] [Indexed: 04/08/2023] Open
Abstract
Background The origins of health promotion are based in critical practice; however, health promotion practice is still dominated by selective biomedical and behavioral approaches, which are insufficient to reduce health inequities resulting from the inequitable distribution of structural and systemic privilege and power. The Red Lotus Critical Health Promotion Model (RLCHPM), developed to enhance critical practice, includes values and principles that practitioners can use to critically reflect on health promotion practice. Existing quality assessment tools focus primarily on technical aspects of practice rather than the underpinning values and principles. The aim of this project was to develop a quality assessment tool to support critical reflection using the values and principles of critical health promotion. The purpose of the tool is to support the reorientation of health promotion practice toward a more critical approach. Research design We used Critical Systems Heuristics as the theoretical framework to develop the quality assessment tool. First, we refined the values and principles in the RLCHPM, then created critical reflective questions, refined the response categories, and added a scoring system. Results The Quality Assessment Tool for Critical Health Promotion Practice (QATCHEPP) includes 10 values and associated principles. Each value is a critical health promotion concept, and its associated principle provides a description of how the value is enacted in professional practice. QATCHEPP includes a set of three reflective questions for each value and associated principle. For each question, users score the practice as strongly, somewhat, or minimally/not at all reflective of critical health promotion practice. A percentage summary score is generated with 85% or above indicative of strongly critical practice, 50% ≤ 84% is somewhat critical practice, and < 50% minimally or does not reflect critical practice. Conclusion QATCHEPP provides theory-based heuristic support for practitioners to use critical reflection to assess the extent to which practice aligns with critical health promotion. QATCHEPP can be used as part of the Red Lotus Critical Promotion Model or as an independent quality assessment tool to support the orientation of health promotion toward critical practice. This is essential to ensure that health promotion practice contributes to enhancing health equity.
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Affiliation(s)
- Lily O'Hara
- Department of Public Health, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
- *Correspondence: Lily O'Hara
| | - Jane Taylor
- School of Health, University of the Sunshine Coast, Maroochydore, QLD, Australia
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Canfell OJ, Davidson K, Sullivan C, Eakin EE, Burton-Jones A. PREVIDE: A Qualitative Study to Develop a Decision-Making Framework (PREVention decIDE) for Noncommunicable Disease Prevention in Healthcare Organisations. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15285. [PMID: 36430005 PMCID: PMC9690592 DOI: 10.3390/ijerph192215285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 10/27/2022] [Accepted: 11/09/2022] [Indexed: 06/16/2023]
Abstract
Noncommunicable diseases (NCDs), including obesity, remain a significant global public health challenge. Prevention and public health innovation are needed to effectively address NCDs; however, understanding of how healthcare organisations make prevention decisions is immature. This study aimed to (1) explore how healthcare organisations make decisions for NCD prevention in Queensland, Australia (2) develop a contemporary decision-making framework to guide NCD prevention in healthcare organisations. Cross-sectional and qualitative design, comprising individual semi-structured interviews. Participants (n = 14) were recruited from two organisations: the state public health care system (CareQ) and health promotion/disease prevention agency (PrevQ). Participants held executive, director/manager or project/clinical lead roles. Data were analysed in two phases (1) automated content analysis using machine learning (Leximancer v4.5) (2) researcher-led interpretation of the text analytics. Final themes were consolidated into a proposed decision-making framework (PREVIDE, PREvention decIDE) for NCD prevention in healthcare organisations. Decision-making was driven by four themes: Data, Evidence, Ethics and Health, i.e., data, its quality and the story it tells; traditional and non-traditional sources of evidence; ethical grounding in fairness and equity; and long-term value generated across multiple determinants of health. The strength of evidence was directly proportional to confidence in the ethics of a decision. PREVIDE can be adapted by public health practitioners and policymakers to guide real-world policy, practice and investment decisions for obesity prevention and with further validation, other NCDs and priority settings (e.g., healthcare).
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Affiliation(s)
- Oliver J. Canfell
- UQ Business School, Faculty of Business, Economics and Law, The University of Queensland, St. Lucia, QLD 4072, Australia
- Centre for Health Services Research, Faculty of Medicine, The University of Queensland, St. Lucia, QLD 4072, Australia
- Queensland Digital Health Centre, Faculty of Medicine, The University of Queensland, Herston, QLD 4006, Australia
- Digital Health Cooperative Research Centre, Australian Government, Sydney, NSW 2000, Australia
| | - Kamila Davidson
- UQ Business School, Faculty of Business, Economics and Law, The University of Queensland, St. Lucia, QLD 4072, Australia
| | - Clair Sullivan
- Centre for Health Services Research, Faculty of Medicine, The University of Queensland, St. Lucia, QLD 4072, Australia
- Queensland Digital Health Centre, Faculty of Medicine, The University of Queensland, Herston, QLD 4006, Australia
- Metro North Hospital and Health Service, Department of Health, Queensland Government, Herston, QLD 4072, Australia
| | - Elizabeth E. Eakin
- School of Public Health, Faculty of Medicine, The University of Queensland, Herston, QLD 4072, Australia
| | - Andrew Burton-Jones
- UQ Business School, Faculty of Business, Economics and Law, The University of Queensland, St. Lucia, QLD 4072, Australia
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Tano M, Baek J, Ordonez A, Bosetti R, Menser T, Naufal G, Kash B. COVID-19 and communication: A sentiment analysis of US state governors' official press releases. PLoS One 2022; 17:e0272558. [PMID: 36040975 PMCID: PMC9426878 DOI: 10.1371/journal.pone.0272558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Accepted: 07/22/2022] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES This study examines the contents of official communication from United States governors' offices related to the COVID-19 pandemic to assess patterns in communication and to determine if they correlate with trends for COVID cases and deaths. METHODS We collected text data for all COVID-19 related press releases between March 1 and December 31, 2020 from the US governors' office websites in all 50 states. An automated parsing and sentiment analyzer assessed descriptive statistics and trends in tone, including positivity and negativity. RESULTS We included a total of 7,720 press releases in this study. We found that both positive and negative sentiments were homogenous across states at the beginning of the pandemic but became heterogeneous as the pandemic evolved. The same trend applied to the frequency and tone of press releases. Sentiments across states were overall positive with a small level of negativity. We observed a reactive official communication to the evolution of the number of COVID-19 cases rather than responsive or preventive. CONCLUSIONS The findings of both positivity and negativity in press communications suggest that the effect of discounted importance was present in official communications. Our findings support a state-dependent optimal communication frequency and tone, agreeing with the curvilinear communication model of organizational theory and implying that feedback cycles between government officials and public response should be shortened to rapidly maximize communication efficacy during the pandemic. Future research should identify and evaluate the drivers of the large differences in communication tone across states and validate the reactive characteristics of COVID-19 official communications.
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Affiliation(s)
- Mauricio Tano
- Nuclear Engineering Department, Texas A&M University, College Station, TX, United States of America
| | - Juha Baek
- Department of Health Care Policy Research, Korea Institute for Health and Social Affairs, Sejong-si, Korea
| | - Adriana Ordonez
- Department of Health Care Policy Research, Korea Institute for Health and Social Affairs, Sejong-si, Korea
| | - Rita Bosetti
- Department of Health Care Policy Research, Korea Institute for Health and Social Affairs, Sejong-si, Korea
| | - Terri Menser
- Department of Health Care Policy Research, Korea Institute for Health and Social Affairs, Sejong-si, Korea
- Department of Population Health Sciences, Weill Cornell Medical College, New York, NY, United States of America
| | - George Naufal
- Department of Health Care Policy Research, Korea Institute for Health and Social Affairs, Sejong-si, Korea
- Public Policy Research Institute, Texas A&M University, College Station, TX, United States of America
| | - Bita Kash
- Department of Health Care Policy Research, Korea Institute for Health and Social Affairs, Sejong-si, Korea
- Department of Health Policy and Management, School of Public Health, Texas A&M University, College Station, TX, United States of America
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Alodaibi FA, Alotaibi MA, Almohiza MA, Alhowimel AS. Perceptions of practising physiotherapists in Saudi Arabia about their role in the health promotion of patients with musculoskeletal conditions: a qualitative study. Glob Health Promot 2022; 29:17579759221094003. [PMID: 35570733 DOI: 10.1177/17579759221094003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE This study aimed to explore physiotherapists' perceptions in Saudi Arabia about their understanding and role in health promotion through lifestyle behaviours and risk factors assessment and management of patients with musculoskeletal pain and disabilities. STUDY DESIGN Qualitative study. METHOD One-to-one interviews with 12 physiotherapists (six females; mean age 34.5 ± 8) within a constructivist framework. Interviews were recorded, transcribed verbatim, and analysed using a thematic analysis approach. RESULT Three themes were identified: (1) the physiotherapists' awareness and knowledge of health promotion; (2) current practice of physiotherapists to implementing health promotion practice; and (3) the physiotherapists' perceived barriers to implementing health promotion practice. Participants generally perceived health promotion to be within their scope of practice. However, their understanding and approaches to deliver this practice were varied and non-standardised. Some barriers to routine engagement in health promotion were identified, including time constraints, the beliefs of healthcare practitioners, and limited education and training. CONCLUSION This study highlighted that physiotherapists acknowledged the role of health promotion in their practice. However, there were different explanations of the concept and it was informally practised.
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Affiliation(s)
- Faris A Alodaibi
- Health Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Saudi Arabia
| | - Mazyad A Alotaibi
- Department of Health and Rehabilitation Science, Prince Sattam Bin Abdulaziz University, Saudi Arabia
| | - Mohammad A Almohiza
- Health Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Saudi Arabia
| | - Ahmed S Alhowimel
- Department of Health and Rehabilitation Science, Prince Sattam Bin Abdulaziz University, Saudi Arabia
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Marcellus L, Pauly B, Martin W, Revai T, Easton K, MacDonald M. Navigating conflicting value systems: a grounded theory of the process of public health equity work in the context of mental health promotion and prevention of harms of substance use. BMC Public Health 2022; 22:210. [PMID: 35100999 PMCID: PMC8805448 DOI: 10.1186/s12889-022-12627-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 01/19/2022] [Indexed: 09/18/2023] Open
Abstract
BACKGROUND Promoting health equity and reducing heath inequities is a foundational aim and ethical imperative in public health. There has been limited attention to and research on the ethical issues inherent in promoting health equity and reducing health inequities that public health practitioners experience in their work. The aim of the study was to explore how public health providers identified and navigated ethical issues and their management related to promoting health equity within services focused on mental health promotion and preventing harms of substance use. METHODS Semi-structured individual interviews and focus groups were conducted with 32 public health practitioners who provided public-health oriented services related to mental health promotion and prevention of substance use harms (e.g. harm reduction) in one Canadian province. RESULTS Participants engaged in the basic social process of navigating conflicting value systems. In this process, they came to recognize a range of ethically challenging situations related to health equity within a system that held values in conflict with health equity. The extent to which practitioners recognized, made sense of, and acted on these fundamental challenges was dependent on the degree to which they had developed a critical public health consciousness. Ethically challenging situations had impacts for practitioners, most importantly, the experiences of responding emotionally to ethical issues and the experience of living in dissonance when working to navigate ethical issues related to promoting health equity in their practice within a health system based in biomedical values. CONCLUSIONS There is an immediate need for practice-oriented tools for recognizing ethical dilemmas and supporting ethical decision making related to health equity in public health practice in the context of mental health promotion and prevention of harms of substance use. An increased focus on understanding public health ethical issues and working collaboratively and reflexively to address the complexity of equity work has the potential to strengthen equity strategies and improve population health.
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Affiliation(s)
- Lenora Marcellus
- School of Nursing, University of Victoria, PO Box 1700 STN CSC, Victoria, BC, V8W 2Y2, Canada
| | - Bernie Pauly
- School of Nursing and Scientist, Canadian Institute for Substance Use Research, University of Victoria, Box 1700 STN CSC, Victoria, BC, V8W 2Y2, Canada
| | - Wanda Martin
- College of Nursing, University of Saskatchewan, Health Science Building - 1A10, Box 6, 107 Wiggins Road, Saskatoon, SK, S7N 5E5, Canada.
| | - Tina Revai
- First Nations Health Authority, 501-100 Park Royal South Coast Salish Territory, West Vancouver, BC V7T-1A2, Canada
| | - Kathy Easton
- Island Health, 345 Wale Rd, Victoria, BC, V9B 6X2, Canada
| | - Marjorie MacDonald
- School of Nursing, and Scientist, Canadian Institute for Substance Use Research, University of Victoria, Box 1700 STN CSC, Victoria, Canada
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Chinn V, Neely E, Shultz S, Kruger R, Hughes R, Page R, Coad J, Thunders M. Next Level Health: a holistic health and wellbeing program to empower New Zealand women. Health Promot Int 2022:6505283. [PMID: 35024852 DOI: 10.1093/heapro/daab205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Improving equity in women's health requires gender-specific and empowering approaches. However, health programs often disempower women by adopting a 'one-size-fits-all' approach that emphasizes diet, exercise and weight loss over other important aspects like sleep and mental wellbeing. This article reports on the design of Next Level Health (NLH), a program that aims to empower women through developing a wide range of health behaviors to support their holistic wellbeing. NLH is grounded by ethics, theory and evidence to support women to make achievable, sustainable changes that are relevant to their everyday lives. Women utilized the NLH framework to develop an integrative health routine across six domains: physical activity, sleep, nutrition, eating behavior, self-care and stress management. The framework guided them to set small, incremental goals that were adaptive to their needs and built from their existing circumstances. Participants reflected on their progress with a facilitator during monthly meetings, accessed a social media support page and received monthly text messages. Health programs remain an essential approach to improving women's health alongside community- and policy-level strategies. The development of NLH exemplifies how evidence may partner with modern health promotion values to inform relevant and ethical program design for women.
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Affiliation(s)
- V Chinn
- School of Health, Victoria University of Wellington, Easterfield Building, Kelburn Parade, Wellington 6012, New Zealand.,School of Health Sciences, Massey University, Wallace St, Mount Cook, Wellington 6021, New Zealand
| | - E Neely
- School of Health, Victoria University of Wellington, Easterfield Building, Kelburn Parade, Wellington 6012, New Zealand
| | - S Shultz
- Kinesiology Department, Seattle University, 12th Ave, Seattle, WA 98122, USA
| | - R Kruger
- School of Sport, Exercise & Nutrition, Massey University, SH17, Albany, Auckland 0632, New Zealand
| | - R Hughes
- Tasmanian School of Medicine, University of Tasmania, Liverpool St, Hobart, TAS 7000, Australia
| | - R Page
- School of Health Sciences, Massey University, Wallace St, Mount Cook, Wellington 6021, New Zealand
| | - J Coad
- School of Food & Advanced Technology, Massey University, Riddet Road, Palmerston North 4410, New Zealand
| | - M Thunders
- Department of Pathophysiology & Molecular Medicine, University of Otago, Mein St, Newtown, Wellington 6021, New Zealand
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KSHATRI JAYASINGH, PALO SUBRATAKUMAR, PANDA MEELY, SWAIN SUBHASHISA, SINHA RAJESHWARI, MAHAPATRA PRANAB, PATI SANGHAMITRA. Reach, accessibility and acceptance of different communication channels for health promotion: a community-based analysis in Odisha, India. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2021; 62:E455-E465. [PMID: 34604587 PMCID: PMC8451355 DOI: 10.15167/2421-4248/jpmh2021.62.2.1929] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Accepted: 02/11/2021] [Indexed: 12/01/2022]
Abstract
Introduction To achieve universal health coverage, improving demand generation at community is necessary. Media plays an important role by acting as a linking pin between health service providers and the community. This study intended to assess the penetration and acceptability of various forms of media for health communication in Odisha, India. Methods A cross-sectional mixed method study was conducted in 2016 in four districts. Following a desk review, a situational analysis was done at state, district and sub-district level. Data was collected through direct observation of study sites using a predefined checklist on knowledge awareness and practice, focussed group discussion and in-depth interviews using semi-structured questionnaire. Qualitative data was analyzed using framework approach while for quantitative data, we used SPSS 20.0. Results Major identified media houses were television (TV), radio and newspaper. Many health programs were being broadcasted in regional TV channels of the state, whereas leading public radio channel broadcasted highest number of health programs almost daily. The major source for information on disease symptoms and prevention was television (63.6%), remove hyphen (36.6%), newspaper (21.6%), health facility/service providers (17.7%), radio (9.2%), and other media like posters, pamphlets and folk dance (5.5%). Information on disease treatment or management was received mostly from television (61.2%), poster/leaflets (39.2%), remove hyphen (35.2%) and newspaper (19.7%). Only 8% of people received any health related message in mobile in past one year. Boards and hoarding provided information to 16.5% of study population. Nearly 36% respondents got information from health-wall, which are used to promote health awareness through wall paintings, graffiti etc. For immunization related information, interpersonal communication through frontline health workers was the most preferred. Conclusion Interpersonal communication is believed to be most acceptable source of information on maternal and child health, immunization and neonatal care. For people with low literacy, remove hyphen campaign, folk media and interpersonal communication were found to be effective.
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Affiliation(s)
- JAYA SINGH KSHATRI
- ICMR-Regional Medical Research Centre, Department of Health Research, Bhubaneswar, Odisha, India
| | - SUBRATA KUMAR PALO
- ICMR-Regional Medical Research Centre, Department of Health Research, Bhubaneswar, Odisha, India
| | - MEELY PANDA
- All India Institute of Medical Sciences, Hyderabad, India
| | | | | | - PRANAB MAHAPATRA
- Department of Psychiatry, Kalinga Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - SANGHAMITRA PATI
- ICMR-Regional Medical Research Centre, Department of Health Research, Bhubaneswar, Odisha, India
- Correspondence: Sanghamitra Pati, Regional Medical Research Centre, Indian Council of Medical Research, Department of Health Research, Govt. of India, Chandrasekharpur, Bhubaneswar, 751023 Odisha, India - Tel.: +91-94370-93306 - E-mail:
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Durand H, Mc Sharry J, Meade O, Byrne M, Kenny E, Lavoie KL, Molloy GJ. Content analysis of behaviour change techniques in government physical distancing communications for the reopening of schools during the COVID-19 pandemic in Ireland. HRB Open Res 2021. [DOI: 10.12688/hrbopenres.13357.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background: Effective government communications and leadership are central to the management of pandemics. Behavioural science can offer important insight into the development of such communications strategies. The extent to which established behaviour-change science is reflected in current government messaging campaigns to promote adherence to physical distancing measures in the context of the coronavirus disease 2019 (COVID-19) pandemic is unclear. The current study aimed to describe the behaviour-change content of a set of government-issued poster communications for the reopening of schools in Ireland during the COVID-19 pandemic in September 2020. Methods: Posters targeting physical distancing behaviours in school settings were retrieved from the Government of Ireland website for analysis. Posters were independently coded for behaviour change techniques (BCTs) using the BCT Taxonomy Version 1, a hierarchically clustered taxonomy of 93 distinct BCTs across 16 groups. The Theories and Techniques tool was used to identify mechanisms of action (MoAs) linked to each of the identified BCTs. Eight posters were independently content-analysed by two members of the research team for BCTs and linked MoAs. Results: Eight unique BCTs from six unique groups were identified in at least one poster. These BCTs were linked with 11 unique MoAs through which behaviour change is theorised to occur. Several theoretically important groups of BCTs, such as Natural Consequences, Social Support, Shaping Knowledge, and Comparison of Behaviour, were underutilised or not included in any of the posters. Conclusion: Future poster communications could benefit from including additional BCTs from key groups, particularly Natural Consequences. This article provides proof-of-concept evidence for future evaluations of government public health communications for behaviour-change content using existing taxonomies and tools.
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Analyzing Twitter Data to Evaluate People's Attitudes towards Public Health Policies and Events in the Era of COVID-19. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18126272. [PMID: 34200576 PMCID: PMC8296042 DOI: 10.3390/ijerph18126272] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 06/07/2021] [Accepted: 06/08/2021] [Indexed: 11/17/2022]
Abstract
Policymakers and relevant public health authorities can analyze people’s attitudes towards public health policies and events using sentiment analysis. Sentiment analysis focuses on classifying and analyzing text sentiments. A Twitter sentiment analysis has the potential to monitor people’s attitudes towards public health policies and events. Here, we explore the feasibility of using Twitter data to build a surveillance system for monitoring people’s attitudes towards public health policies and events since the beginning of the COVID-19 pandemic. In this study, we conducted a sentiment analysis of Twitter data. We analyzed the relationship between the sentiment changes in COVID-19-related tweets and public health policies and events. Furthermore, to improve the performance of the early trained model, we developed a data preprocessing approach by using the pre-trained model and early Twitter data, which were available at the beginning of the pandemic. Our study identified a strong correlation between the sentiment changes in COVID-19-related Twitter data and public health policies and events. Additionally, the experimental results suggested that the data preprocessing approach improved the performance of the early trained model. This study verified the feasibility of developing a fast and low-human-effort surveillance system for monitoring people’s attitudes towards public health policies and events during a pandemic by analyzing Twitter data. Based on the pre-trained model and early Twitter data, we can quickly build a model for the surveillance system.
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Healthy eating: a privilege for the better-off? Eur J Clin Nutr 2021; 76:134-142. [PMID: 33986488 DOI: 10.1038/s41430-021-00926-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 04/07/2021] [Accepted: 04/14/2021] [Indexed: 11/09/2022]
Abstract
BACKGROUND Food subsidies for healthier foods and higher taxes for less healthy alternatives have been increasingly used to promote a healthy diet. Yet, some have argued that the fiscal burden on unhealthy products would fall disproportionately on the worse-off, raising equity concerns. This study estimates the association between income and the consumption of key food groups linked to the Mediterranean diet in the adult Portuguese population. METHODS We used data from the Portuguese National Food, Nutrition and Physical Activity Survey (IAN-AF 2015-2016), which observed the daily diet of individuals aged above 18 and below 79 years old (n = 3242). Logistic regression models were used to estimate the magnitude of the association between self-reported household income categories and consumption of foods related to the Mediterranean diet (fish, vegetables, fruits and legumes), and not (sweets, sugar-sweetened beverages, cakes & pastries and processed meats). Stratified analyses were performed by education and age categories. RESULTS We observed that the intake of fish (35.8 vs 38.8 g p = 0.02), vegetables (146.7 vs 166.2 g p < 0.01), and fruits (119.8 vs 150.1 g p < 0.01) was positively related to income, with a clear gradient for the two latter. Yet, the positive income-consumption link for fish was only observed among low-educated people, and the one for legumes among high educated and youths. Conversely, the consumption of most non-Mediterranean foods was not positively related to income categories, with the exception of sweets (34.8 vs 31.8 g p = 0.01) and cakes (26.4 vs 21.4 g p < 0.01) (more prevalent among the better-off). CONCLUSIONS The consumption of healthy food is mostly consistently related to income, contrary to the intake of unhealthy ones. It may well be, therefore, that subsidies to healthy foods could allow access to the worse-off while taxing unhealthy food will not impose a disproportionate burden on them.
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Carins J, Bogomolova S. Co-designing a community-wide approach to encouraging healthier food choices. Appetite 2021; 162:105167. [PMID: 33596438 DOI: 10.1016/j.appet.2021.105167] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 02/08/2021] [Accepted: 02/09/2021] [Indexed: 10/22/2022]
Abstract
This research offers a novel perspective on encouraging healthier food choices through a community-wide approach. Using five co-design workshops with consumers and supermarket staff, and the abductive synthesis of qualitative data, this study uncovered the role of community in encouraging greater food well-being and allied behaviours. The results reveal rather critical consumer views on past paternalistic health promotion campaigns and offer alternative strategies for designing more balanced and holistic programs. Such a holistic approach can ensure more sustained programs, as they aim to achieve broader social, mental and physical health, and economic benefits, not just nutrition outcomes. The research offers practical recommendations on modifying retail marketing space, and the broader community setting, to create an environment where consumers find it easier, convenient, more socially desirable and pleasurable to make healthier choices.
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Affiliation(s)
- Julia Carins
- Social Marketing @ Griffith, Griffith Business School, Griffith University. 170 Kessels Road, Nathan, QLD, 4111, Australia.
| | - Svetlana Bogomolova
- Ehrenberg-Bass Institute for Marketing Science, UniSA Business, University of South Australia, GPO Box 2471, Adelaide, 5001, Australia.
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15
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Blackford K, Leavy J, Taylor J, Connor E, Crawford G. Towards an ethics framework for Australian health promotion practitioners: An exploratory mixed methods study. Health Promot J Austr 2021; 33:71-82. [PMID: 33565664 DOI: 10.1002/hpja.466] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 02/02/2021] [Accepted: 02/07/2021] [Indexed: 11/06/2022] Open
Abstract
ISSUE ADDRESSED Ethical values underpin the health promotion discipline and profession, and competencies required for professional practice. Understanding how ethical values are translated into professional practice is critical. The aim of this exploratory sequential mixed methods study was to explore Australian health promotion stakeholder perspectives about ethical health promotion practice. METHODS A face-to-face group-based workshop (n = 15), online survey (n = 77) and in-depth individual interviews (n = 15) collected qualitative and quantitative data from health promotion stakeholders. Descriptive statistics were used to analyse quantitative and thematic analysis to analyse qualitative data. RESULTS Tensions emerged regarding the nomenclature of ethical health promotion practice, with ethics framed largely by participants as related to formal approval for research. A range of barriers and enablers to ethical practice were identified. Barriers related to obtaining ethical approvals and working with specific population groups and communities. Enablers included professional development opportunities, access to a specialised human research ethics committee and a better understanding of what is meant by 'ethical practice'. CONCLUSION Findings suggest the need for an ethical health promotion practice framework and resources for practitioners and organisations throughout Australia. We propose a framework comprising two pillars: (a) developing critical practice; and (b) building the evidence-based for health promotion. SO WHAT?: This study recognises the need for increased dialogue about the ethical foundations of health promotion. The development of a health promotion ethics framework can better support the development of ethical practice in the Australian health promotion discipline and profession.
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Affiliation(s)
- Krysten Blackford
- Collaboration for Evidence, Research and Impact in Public Health (CERIPH), Curtin University, Bentley, WA, Australia.,School of Population Health, Curtin University, Bentley, WA, Australia
| | - Justine Leavy
- Collaboration for Evidence, Research and Impact in Public Health (CERIPH), Curtin University, Bentley, WA, Australia.,School of Population Health, Curtin University, Bentley, WA, Australia
| | - Jane Taylor
- School of Health and Behavioural Sciences, University of the Sunshine Coast, Sippy Downs, QLD, Australia
| | - Elizabeth Connor
- Collaboration for Evidence, Research and Impact in Public Health (CERIPH), Curtin University, Bentley, WA, Australia.,School of Population Health, Curtin University, Bentley, WA, Australia
| | - Gemma Crawford
- Collaboration for Evidence, Research and Impact in Public Health (CERIPH), Curtin University, Bentley, WA, Australia.,School of Population Health, Curtin University, Bentley, WA, Australia
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16
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Alissa NA. Advocating for Nutrition Education, Promotion, and Care Among Dementia Residents: Considerations for Long-Term Care Professionals. INTERNATIONAL QUARTERLY OF COMMUNITY HEALTH EDUCATION 2020; 42:233-236. [PMID: 33269980 DOI: 10.1177/0272684x20973835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
In 2015, a total of 5.3 million Americans had dementia. As the number of older adults continues to grow, the older adult population with dementia conditions is expected to increase from its current number of 5.1 million to 7.1 million by 2025, representing a 40% increase. This exponential growth places a tremendous burden on long-term care facilities at a rapid pace. Taking care of residents with dementia has already proven to be a costly undertaking with the care given to these individuals in 2014 amounting to 17.9 billion hours in unpaid hourly care. One area of care that is often neglected is the proper nutrition of dementia residents. Dementia residents often have problems with appetite and they may fail to completely consume their provided meals if no one is there to encourage them to eat. Proper nutrition is crucial for dementia patients not only to prevent weight loss, but also to slow the progress of the condition. Nutritional feeding helps to promote the health of dementia residents, and gives them the emotional stability that facilitates in coping with the condition. Thus, the purpose of this paper is to provide long-term care professionals with a listing of current rules and regulations for providing dietary rights to dementia residents as well as various strategies to advocate for nutritional education, promotion, and care policy changes for older adults in long-term care facilities with dementia. Additionally, this paper provides a collaborative framework for nutritional care delivery between long-term care communities and family members that healthcare professionals can implement at their facilities in the future.
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Affiliation(s)
- Nawal A Alissa
- Community Health Sciences Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
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17
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Campbell EJ, Lee Olstad D, Spence JC, Storey KE, Nykiforuk CIJ. Policy-influencer perspectives on the development, adoption, and implementation of provincial school-based daily physical activity policies across Canada: A national case study. SSM Popul Health 2020; 11:100612. [PMID: 32637553 PMCID: PMC7327280 DOI: 10.1016/j.ssmph.2020.100612] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Revised: 06/04/2020] [Accepted: 06/04/2020] [Indexed: 11/24/2022] Open
Abstract
Objectives School-based daily physical activity (DPA) policies represent a promising intervention for increasing physical activity levels among children. Between 2005 and 2010, five Canadian provinces adopted and implemented DPA policies. This national case study explored facilitators and challenges to developing, adopting and implementing DPA policies from the perspective of key stakeholders (‘policy-influencers’) in these five provinces. Methods Development, adoption and implementation of DPA policies at the provincial level was the phenomenon of interest, with each province constituting a distinct case. Semi-structured interviews were conducted with 15 purposively selected policy-influencers across the five case provinces. Cases were first analyzed separately, and then concurrently in a cross-case comparison. Qualitative content analysis was used to code interviews and develop themes. Results Four themes related to the development, adoption, and implementation of DPA policies emerged: existing resources and capacity for policy change; top-down policy development/adoption and bottom-up implementation; political will and windows of opportunity; and, ideology and policy change. Each of these themes encompassed facilitators and challenges related to policy processes surrounding development, adoption and implementation of DPA policies. Conclusion These findings can inform development of future health-related polices in schools. Stakeholders can, for instance, remain attuned to the opening of political windows and capitalize on them as an opportunity to advocate for policy change or create communities of practice to enhance coordination among policy stakeholders. Future studies that explore why other jurisdictions have failed to adopt DPA policies might yield novel insights regarding leverage points to support widespread diffusion of DPA policies. Between 2005 and 2010, five Canadian provinces adopted and implemented DPA policies. A national case study explored facilitators and challenges to adopting and implementing provincial DPA policies. Four key themes related to policy change: capacity, adoption and implementation, political will, and ideology. Recommendations can inform development and implementation of school-based physical activity and health promotion policy.
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Affiliation(s)
| | - Dana Lee Olstad
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada.,Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - John C Spence
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Alberta, Canada
| | - Kate E Storey
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
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18
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Aromatario O, Van Hoye A, Vuillemin A, Foucaut AM, Pommier J, Cambon L. Using theory of change to develop an intervention theory for designing and evaluating behavior change SDApps for healthy eating and physical exercise: the OCAPREV theory. BMC Public Health 2019; 19:1435. [PMID: 31675951 PMCID: PMC6824130 DOI: 10.1186/s12889-019-7828-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Accepted: 10/22/2019] [Indexed: 11/12/2022] Open
Abstract
Background Connected health devices and applications (referred to hereafter as “SDApps” - Smart devices and applications) are being portrayed as a new way for prevention, with the promise of accessibility, effectiveness and personalization. Many effectiveness evaluations (experimental designs) with strong internal validity exist. While effectiveness does appear to vary, the mechanisms used by these devices have not yet been thoroughly investigated. This article seeks to unpack this black box, and describes the process of elaboration of an intervention theory for healthy eating and physical activity SDApps. It includes a set of requirements relative to their impact on social health inequalities. Methods To build this theory, we drew on theory-driven approaches and in particular on the theory of change (ToC) method. To this end, we developed a cumulative and iterative process combining scientific data from the literature with knowledge from experts (researchers and practitioners) and from patients or users. It was a 3-step process, as follows: 1 - identifying the evidence base; 2 - developing the theory through design intervention and creating realistic expectations, including in our case specific work on social health inequalities (SHIs); 3 - modeling process and outcome. Results We produced an evidence-based theory according to the ToC model, based on scientific evidence and knowledge from experts and users. It sets out a causal pathway leveraging 11 key mechanisms - theoretical domains - with which 50 behavior change techniques can be used towards 3 ultimate goals: Capacity, Opportunity, Motivation – Behavior (COM-B). Furthermore, the theory specifically integrates requirements relative to the impact on SHIs. Conclusions This theory is an aid to SDAapp design and evaluation and it can be used to consider the question of the possible impact of SDApps on the increase in inequalities. Firstly, it enables developers to adopt a more overarching and thorough approach to supporting behavior change, and secondly it encourages comprehensive and contributive evaluations of existing SDApps. Lastly, it allows health inequalities to be fully considered.
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Affiliation(s)
- Olivier Aromatario
- UMR 6051 ARENES, EHESP, 20 avenue George Sand, La Plaine Saint Denis, 93210, Paris, France.
| | | | | | - Aude-Marie Foucaut
- Université Paris 13, Sorbonne Paris Cité, Laboratoire Educations et Pratiques de Santé (LEPS) EA 3412, UFR SMBH, F-93017, Bobigny, France
| | - Jeanine Pommier
- UMR 6051 ARENES, EHESP, 20 avenue George Sand, La Plaine Saint Denis, 93210, Paris, France
| | - Linda Cambon
- Chaire de Prévention, ISPED, Centre de recherche U1219 Bordeaux Population Health, Université de Bordeaux, Bordeaux, France
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Holt R, McLean L. Australian Psychotherapy for Trauma Incorporating Neuroscience: Evidence- and Ethics-Informed Practice. NEUROETHICS-NETH 2019. [DOI: 10.1007/s12152-019-09398-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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20
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Akrami F, Zali A, Abbasi M, Majdzadeh R, Karimi A, Fadavi M, Mehrabi Bahar A. An ethical framework for evaluation of public health plans: a systematic process for legitimate and fair decision-making. Public Health 2018; 164:30-38. [PMID: 30170266 PMCID: PMC7118744 DOI: 10.1016/j.puhe.2018.07.018] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Revised: 06/08/2018] [Accepted: 07/14/2018] [Indexed: 01/26/2023]
Abstract
OBJECTIVES Given the increasing threats of communicable and non-communicable diseases, it is necessary for policy-makers and public health (PH) professionals to address ethical issues in health policies and plans. This study aimed to develop a practical framework for the ethical evaluation of PH programs. STUDY DESIGN A multidisciplinary team developed an ethical framework to evaluate PH plans from 2015 to 2017. METHODS In this study, the multi-method approach was used. First, a list of moral norms in PH policy and practice was drafted and completed in two interactive sessions. Then, the Delphi method was used for consensus about the structural components to be adopted in the framework. After developing the framework, its efficiency was assessed by evaluating Iran's Fourth Strategic Plan for HIV/AIDS Prevention and Control. RESULTS The framework was developed in the following three sections: (i) determination of the general moral norms in PH practice and policy; (ii) five steps of evaluation; and (iii) a procedural evaluation step to ensure fair decision-making. The ratio of the ethical points of the PH plan increased by 46% after implementation of the framework, and the frequency of ethical points increased significantly after applying the framework (P = 0.001). CONCLUSION The application of the framework for the ethical evaluation of various PH programs ensures a comprehensive and scientific-deliberative decision-making process, while also contributing to the development of the framework.
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Affiliation(s)
- F Akrami
- Medical Ethics and Law Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - A Zali
- Functional Neurosurgery Research Center, Shohada Tajrish Neurosurgical Center of Excellence, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - M Abbasi
- Medical Ethics and Law Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - R Majdzadeh
- Community Based Participatory Research Center and Knowledge Utilization Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - A Karimi
- Faculty of Law and Political Science, University of Tehran, Tehran, Iran
| | - M Fadavi
- Medical Ethics Department, Faculty of Traditional Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - A Mehrabi Bahar
- School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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21
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Trends, fads and taboos in health promotion. Health Promot Int 2018; 33:735-738. [PMID: 30364955 DOI: 10.1093/heapro/day090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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22
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Paterson M, Lagosky S, Mason R. Health promotion and knowledge translation: two roads to the same destination? Glob Health Promot 2018; 25:65-69. [PMID: 30246629 DOI: 10.1177/1757975916665340] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Health Promotion (HP), a continuously evolving field, is riddled with complexities as experts and community members develop new approaches to researching social behaviours, addressing health concerns and advocating for the values of equity, empowerment and healthy public policy. Similarly complex is the field of knowledge translation (KT), putting research into action for the purpose of changing behaviours, policy and practice. Similar values, methods and techniques govern these two practices. This paper is based on a series of discussions between two young professionals who found themselves navigating the complexities of HP and KT and attempting to understand their chosen fields of practice. The discussions considered such issues as discipline-based silos, the use and purpose of new terminologies and languages in research, and whether or not existing practices are simply being renamed or branded in order to appear innovative and new.
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Affiliation(s)
- Maeve Paterson
- 1. Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | | | - Robin Mason
- 1. Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.,2. Women's College Hospital, Toronto, Ontario, Canada
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23
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Abbasi M, Majdzadeh R, Zali A, Karimi A, Akrami F. The evolution of public health ethics frameworks: systematic review of moral values and norms in public health policy. MEDICINE, HEALTH CARE, AND PHILOSOPHY 2018; 21:387-402. [PMID: 29124449 DOI: 10.1007/s11019-017-9813-y] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Given the evolution of the public health (PH) and the changes from the phenomenon of globalization, this area has encountered new ethical challenges. In order to find a coherent approach to address ethical issues in PH policy, this study aimed to identify the evolution of public health ethics (PHE) frameworks and the main moral values and norms in PH practice and policy. According to the research questions, a systematic search of the literature, in English, with no time limit was performed using the main keywords in databases Web of Science (ISI) and PubMed. Finally, the full text of 56 papers was analyzed. Most of the frameworks have common underpinning assumptions and beliefs, and the need to balance PH moral obligation to prevent harm and health promotion with respect for individual autonomy has been specified. As such, a clear shift from liberal values in biomedical ethics is seen toward the community's collective values in PHE. The main moral norms in PH practice and policy included protecting the population against harm and improving PH benefits, utility and evidenced-based effectiveness, distributive justice and fairness, respect for all, privacy and confidentiality, solidarity, social responsibility, community empowerment and participation, transparency, accountability and trust. Systematic review of PHE frameworks indicates utilization of the aforementioned moral norms through an practical framework as an ethical guide for action in the PH policy. The validity of this process requires a systematic approach including procedural conditions.
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Affiliation(s)
- Mahmoud Abbasi
- Medical Ethics and Law Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Reza Majdzadeh
- Community Based Participatory Research Center and Knowledge Utilization Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Zali
- Functional Neurosurgery Research Center, Shohada Tajrish Neurosurgical Center of Excellence, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Abbas Karimi
- Faculty of Law and Political Science, University of Tehran, Tehran, Iran
| | - Forouzan Akrami
- Medical Ethics and Law Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Vayena E, Ienca M. Digital Medicine and Ethics: Rooting for Evidence. THE AMERICAN JOURNAL OF BIOETHICS : AJOB 2018; 18:49-51. [PMID: 30235092 DOI: 10.1080/15265161.2018.1498955] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Affiliation(s)
- Effy Vayena
- a Eidgenossische Technische Hochschule Zurich
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25
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Johnstone G, Grant SL. Weight stigmatisation in antiobesity campaigns: The role of images. Health Promot J Austr 2018; 30:37-46. [PMID: 29956413 DOI: 10.1002/hpja.183] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Accepted: 06/26/2018] [Indexed: 01/21/2023] Open
Abstract
ISSUE ADDRESSED Antiobesity campaigns may inadvertently stigmatise individuals with obesity via the use of images that portray negative obesity stereotypes. This study investigated the impact of images on weight stigma using mock antiobesity campaigns featuring different types of images. METHODS Participants (N = 240) were randomly assigned to one of four campaign conditions: stereotypical images, counter-stereotypical images, neutral images, or no images. All four conditions used the same nonstigmatising message text. Participants indicated their attitudes towards being in social situations (desired social distance) with the target featured in the images, or individuals with obesity (no images), rated the target or individuals with obesity on various traits, and indicated to what extent the campaign was motivating and stigmatising. RESULTS Analysis of variance revealed that the stereotypical images were rated as the most stigmatising and were also associated with higher negative and lower positive trait ratings of the target and more desired social distance from the target. Neutral images generally produced the least weight stigma. CONCLUSION It is important to consider the impact of antiobesity campaign images that depict common obesity stereotypes. Developing, testing and disseminating nonstigmatising campaigns is important to reduce stigma and better engage individuals with antiobesity public health messages. SO WHAT?: Weight stigma has negative consequences for physical and psychological health, which may undermine obesity intervention efforts. Stereotypical images that blame individuals for their weight reinforce obesity stigma and are likely to be in-effective in increasing healthier behaviour and reducing obesity. The development of effective antiobesity campaigns should be a public health priority.
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Affiliation(s)
| | - Sharon L Grant
- Swinburne University of Technology, Hawthorn, Vic., Australia
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26
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'Buying Salad Is a Lot More Expensive than Going to McDonalds': Young Adults' Views about What Influences Their Food Choices. Nutrients 2018; 10:nu10080996. [PMID: 30061513 PMCID: PMC6116192 DOI: 10.3390/nu10080996] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Revised: 07/21/2018] [Accepted: 07/24/2018] [Indexed: 11/17/2022] Open
Abstract
Young adults (18⁻30 years of age) are an 'at-risk' group for poor dietary behaviours and less healthy food choices. Previous research with young adults has looked at the barriers and enablers driving their food choices, focusing primarily on university and college students. However, there is less research using qualitative methods with young adults as a broader population group. This study aimed to explore the experiences of young adults in two different yet similar settings: Sydney, Australia and Glasgow, Scotland. Eight focus groups of young adult participants, ranging in size from 2⁻6 participants, were held in Sydney, Australia (n = 14) and Glasgow, Scotland (n = 16) to discuss, explore and compare the determinants and influences of their food choices. Focus group transcripts were coded thematically based on a process of narrative analysis. Three major narratives were identified across both locations: value of food; appeal of food; and emotional connections with food. These narratives were underpinned by a broader narrative of 'performing adulthood.' This narrative reflected a belief amongst participants that they should make rational, informed choices about food despite this conflicting with their broader food environment. Future research could examine which environment-level or policy-based interventions are most acceptable to young adults in terms of influencing their food choices and dietary behaviours.
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27
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Thow AM, Downs SM, Mayes C, Trevena H, Waqanivalu T, Cawley J. Fiscal policy to improve diets and prevent noncommunicable diseases: from recommendations to action. Bull World Health Organ 2018; 96:201-210. [PMID: 29531419 PMCID: PMC5840623 DOI: 10.2471/blt.17.195982] [Citation(s) in RCA: 92] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Revised: 12/20/2017] [Accepted: 12/20/2017] [Indexed: 12/27/2022] Open
Abstract
The World Health Organization has recommended that Member States consider taxing energy-dense beverages and foods and/or subsidizing nutrient-rich foods to improve diets and prevent noncommunicable diseases. Numerous countries have either implemented taxes on energy-dense beverages and foods or are considering the implementation of such taxes. However, several major challenges to the implementation of fiscal policies to improve diets and prevent noncommunicable diseases remain. Some of these challenges relate to the cross-sectoral nature of the relevant interventions. For example, as health and economic policy-makers have different administrative concerns, performance indicators and priorities, they often consider different forms of evidence in their decision-making. In this paper, we describe the evidence base for diet-related interventions based on fiscal policies and consider the key questions that need to be asked by both health and economic policy-makers. From the health sector's perspective, there is most evidence for the impact of taxes and subsidies on diets, with less evidence on their impacts on body weight or health. We highlight the importance of scope, the role of industry, the use of revenue and regressive taxes in informing policy decisions.
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Affiliation(s)
- Anne Marie Thow
- Menzies Centre for Health Policy, School of Public Health, Charles Perkins Centre (D17), University of Sydney, New South Wales, 2006, Australia
| | - Shauna M Downs
- Department of Health Systems and Policy, Rutgers School of Public Health, New Brunswick, United States of America (USA)
| | - Christopher Mayes
- Alfred Deakin Institute for Citizenship and Globalisation, Deakin University, Geelong, Australia
| | - Helen Trevena
- Menzies Centre for Health Policy, School of Public Health, Charles Perkins Centre (D17), University of Sydney, New South Wales, 2006, Australia
| | - Temo Waqanivalu
- Prevention of Noncommunicable Diseases Department, World Health Organization, Geneva, Switzerland
| | - John Cawley
- Department of Policy Analysis and Management, Cornell University, New York, USA
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Bteich M, da Silva Miranda E, El Khoury C, Gautier L, Lacouture A, Yankoty LI. A proposed core model of the new public health for a healthier collectivity: how to sustain transdisciplinary and intersectoral partnerships. CRITICAL PUBLIC HEALTH 2017. [DOI: 10.1080/09581596.2017.1419167] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Michel Bteich
- École de santé publique, Université de Montréal, Montréal, Canada
- Department of Environmental and Occupational Health, Université de Montréal, Montréal, Canada
| | - Erica da Silva Miranda
- École de santé publique, Université de Montréal, Montréal, Canada
- Department of Social and Preventive Medicine, Université de Montréal, Montréal, Canada
| | - Caline El Khoury
- École de santé publique, Université de Montréal, Montréal, Canada
- Department of Management, Evaluation and Health Policy, Université de Montréal, Montréal, Canada
| | - Lara Gautier
- École de santé publique, Université de Montréal, Montréal, Canada
- Department of Social and Preventive Medicine, Université de Montréal, Montréal, Canada
| | - Anthony Lacouture
- École de santé publique, Université de Montréal, Montréal, Canada
- Department of Social and Preventive Medicine, Université de Montréal, Montréal, Canada
| | - Larisa Ines Yankoty
- École de santé publique, Université de Montréal, Montréal, Canada
- Department of Environmental and Occupational Health, Université de Montréal, Montréal, Canada
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Devine CM, Barnhill A. The Ethical and Public Health Importance of Unintended Consequences: the Case of Behavioral Weight Loss Interventions. Public Health Ethics 2017. [DOI: 10.1093/phe/phx026] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Fitzpatrick SJ. Reshaping the Ethics of Suicide Prevention: Responsibility, Inequality and Action on the Social Determinants of Suicide. Public Health Ethics 2017. [DOI: 10.1093/phe/phx022] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Evidence-Based Public Health 2017. BIOMED RESEARCH INTERNATIONAL 2017; 2017:2607397. [PMID: 29270427 PMCID: PMC5705863 DOI: 10.1155/2017/2607397] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/01/2017] [Accepted: 10/04/2017] [Indexed: 11/17/2022]
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Ledogar RJ, Hernández-Alvarez C, Morrison AC, Arosteguí J, Morales-Perez A, Nava-Aguilera E, Legorreta-Soberanis J, Caldwell D, Coloma J, Harris E, Andersson N. When communities are really in control: ethical issues surrounding community mobilisation for dengue prevention in Mexico and Nicaragua. BMC Public Health 2017; 17:410. [PMID: 28699548 PMCID: PMC5506591 DOI: 10.1186/s12889-017-4305-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
We discuss two ethical issues raised by Camino Verde, a 2011-2012 cluster-randomised controlled trial in Mexico and Nicaragua, that reduced dengue risk though community mobilisation. The issues arise from the approach adopted by the intervention, one called Socialisation of Evidence for Participatory Action. Community volunteer teams informed householders of evidence about dengue, its costs and the life-cycle of Aedes aegypti mosquitoes, while showing them the mosquito larvae in their own water receptacles, without prescribing solutions. Each community responded in an informed manner but on its own terms. The approach involves partnerships with communities, presenting evidence in a way that brings conflicting views and interests to the surface and encourages communities themselves to deal with the resulting tensions.One such tension is that between individual and community rights. This tension can be resolved creatively in concrete day-to-day circumstances provided those seeking to persuade their neighbours to join in efforts to benefit community health do so in an atmosphere of dialogue and with respect for personal autonomy.A second tension arises between researchers' responsibilities for ethical conduct of research and community autonomy in the conduct of an intervention. An ethic of respect for individual and community autonomy must infuse community intervention research from its inception, because as researchers succeed in fostering community self-determination their direct influence in ethical matters diminishes. TRIAL REGISTRATION ISRCTN 27581154.
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Affiliation(s)
| | | | - Amy C Morrison
- Department of Entomology and Nematology, University of California, Davis, CA, USA
| | | | - Arcadio Morales-Perez
- Centro de Investigación de Enfermedades Tropicales, Universidad Autónoma de Guerrero, Acapulco, Mexico
| | - Elizabeth Nava-Aguilera
- Centro de Investigación de Enfermedades Tropicales, Universidad Autónoma de Guerrero, Acapulco, Mexico
| | - José Legorreta-Soberanis
- Centro de Investigación de Enfermedades Tropicales, Universidad Autónoma de Guerrero, Acapulco, Mexico
| | | | - Josefina Coloma
- Division of Infectious Diseases and Vaccinology, School of Public Health, University of California, Berkeley, CA, USA
| | - Eva Harris
- Division of Infectious Diseases and Vaccinology, School of Public Health, University of California, Berkeley, CA, USA
| | - Neil Andersson
- Centro de Investigación de Enfermedades Tropicales, Universidad Autónoma de Guerrero, Acapulco, Mexico.,Department of Family Medicine, McGill University, Montreal, Canada
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Reilly T, Crawford G, Lobo R, Leavy J, Jancey J. Ethics and health promotion practice: exploring attitudes and practices in Western Australian health organisations. Health Promot J Austr 2017; 27:54-60. [PMID: 27041127 DOI: 10.1071/he15059] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2015] [Accepted: 02/12/2016] [Indexed: 11/23/2022] Open
Abstract
Issue addressed Evidence-informed practice underpinned by ethics is fundamental to developing the science of health promotion. Knowledge and application of ethical principles are competencies required for health promotion practice. However, these competencies are often inconsistently understood and applied. This research explored attitudes, practices, enablers and barriers related to ethics in practice in Western Australian health organisations. Methods Semistructured, in-depth interviews were conducted with 10 health promotion practitioners, purposefully selected to provide a cross-section of government and non-government organisations. Interviews were recorded, transcribed and then themed. Results The majority of participants reported consideration of ethics in their practice; however, only half reported seeking Human Research Ethics Committee (HREC) approval for projects in the past 12 months. Enablers identified as supporting ethics in practice and disseminating findings included: support preparing ethics applications; resources and training about ethical practice; ability to access HRECs for ethics approval; and a supportive organisational culture. Barriers included: limited time; insufficient resourcing and capacity; ethics approval not seen as part of core business; and concerns about academic writing. Conclusion The majority of participants were aware of the importance of ethics in practice and the dissemination of findings. However, participants reported barriers to engaging in formal ethics processes and to publishing findings. So what? Alignment of evidence-informed and ethics-based practice is critical. Resources and information about ethics may be required to support practice and encourage dissemination of findings, including in the peer-reviewed literature. Investigating the role of community-based ethics boards may be valuable to bridging the ethics-evidence gap.
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Affiliation(s)
- T Reilly
- Collaboration for Evidence, Research and Impact in Public Health, School of Public Health, Curtin University, GPO Box U1987, WA 6845, Australia
| | - G Crawford
- Collaboration for Evidence, Research and Impact in Public Health, School of Public Health, Curtin University, GPO Box U1987, WA 6845, Australia
| | - R Lobo
- Collaboration for Evidence, Research and Impact in Public Health, School of Public Health, Curtin University, GPO Box U1987, WA 6845, Australia
| | - J Leavy
- Collaboration for Evidence, Research and Impact in Public Health, School of Public Health, Curtin University, GPO Box U1987, WA 6845, Australia
| | - J Jancey
- Collaboration for Evidence, Research and Impact in Public Health, School of Public Health, Curtin University, GPO Box U1987, WA 6845, Australia
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O'Mullan C, Debattista J, Browne M. Risky business or not? FIFOs, sexual risk taking and the Australian mining industry. Health Promot J Austr 2017; 27:4-9. [PMID: 26603027 DOI: 10.1071/he15011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2015] [Accepted: 08/21/2015] [Indexed: 11/23/2022] Open
Abstract
Issue addressed The fly-in, fly-out (FIFO) and drive-in, drive-out (DIDO) models of mining in Australia have led to concerns about adverse health and psychosocial impacts. Despite speculation that increased levels of sexually transmitted infections (STIs) in Australia, including HIV, are associated with FIFO/DIDO work, we know little about sexual risk-taking behaviours in mining populations. This study explores differences in sexual risk taking and perceptions of risk between FIFO/DIDO miners and residential miners. Methods A cross-sectional survey was administered to a sample (n=444) of male miners working in Queensland, Australia. The self-completed survey contained 49 questions relating to knowledge, attitudes and behaviour and included demographic information and specific items related to sex and relationships. Results FIFO/DIDO status was not associated with any differential sexual risk-taking behaviours, except for an increased probability of reporting 'ever being diagnosed with an STI'; 10.8% of FIFO/DIDO respondents versus 3.6% of others (x(2) (1)=4.43, P=0.35). Conclusions Our results appear to counter anecdotal evidence that FIFO/DIDO miners engage in higher sexual risk behaviours when compared with residential miners. So what? Anecdotal evidence linking the rise of sexually transmitted infections with the FIFO/DIDO mining workforce could drive costly and unnecessary approaches to prevention. Further research, surveillance and monitoring are required to inform health promotion interventions.
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Affiliation(s)
- Cathy O'Mullan
- School of Human, Health and Social Sciences, Central Queensland University, Locked Bag 3333, Bundaberg, Qld 4670, Australia
| | - Joseph Debattista
- Metro North Public Health Unit, Locked Bag 2, Stafford, Qld 4053, Australia
| | - Matthew Browne
- School of Human, Health and Social Sciences, Central Queensland University, Locked Bag 3333, Bundaberg, Qld 4670, Australia
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Abedi H, Abbaszadeh A, Motaghi M. Factors Influencing School Health in Elementary Schools in Isfahan, Iran: A Qualitative Study. INTERNATIONAL JOURNAL OF COMMUNITY BASED NURSING AND MIDWIFERY 2016; 4:352-362. [PMID: 27713898 PMCID: PMC5045979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Students' health and future health of the community are related to providing health care in schools and since in every society, different contextual factors affect this matter, the present study aims to recognize the factors influencing the health care elementary students are provided with. METHODS This qualitative content analysis was performed in 2014 in Isfahan. This study was conducted on school health instructors of elementary schools. Through targeted sampling, 15 health care providers, two mothers and 3 principals from 23 elementary schools were selected. Twenty-two semi-structured interviews were performed. Qualitative data analysis was done using qualitative content analysis. RESULTS In this study, 3 concepts were extracted: family umbrella over health (with two sub-categories of 'family's social status and its effect on health' and 'family and health'), functional resources (with two sub-categories of 'opportunity', 'availability of resources for diagnosis') and health components (with two sub-categories of 'culture', 'the value of school health'). These contextual factors must be considered in providing health care for schools. CONCLUSIONS Consideration of effective contextual factors on providing elementary students with health care can help improve health for this group.
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Affiliation(s)
- Heidarali Abedi
- Department of Nursing, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan, Iran;
| | - Abbas Abbaszadeh
- Department of Medical-Surgical Nursing, School of Nursing & Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran;
| | - Minoo Motaghi
- Department of Nursing, Kerman University of Medical Sciences, Kerman, Iran
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Graham K, Treharne GJ, Ruzibiza C, Nicolson M. The importance of health(ism): A focus group study of lesbian, gay, bisexual, pansexual, queer and transgender individuals’ understandings of health. J Health Psychol 2016; 22:237-247. [DOI: 10.1177/1359105315600236] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
This study investigated understandings of health among lesbian, gay, bisexual, pansexual, queer and/or transgender people, who are under-represented in research. The study involved 12 focus groups in Aotearoa/New Zealand with 47 participants who identified as lesbian, gay, bisexual, pansexual, queer and/or transgender and responded to an advert inviting participants without chronic illnesses. Three themes were inductively formulated: health is important because education and protection efforts are seen as required to preserve health, health is seen as holistic, and contextual factors are seen as creating health risks. These findings provide insights into how lesbian, gay, bisexual, pansexual, queer and/or transgender people’s understandings of health draw upon notions of healthism.
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Weight-related teasing and internalized weight stigma predict abnormal eating attitudes and behaviours in Emirati female university students. Appetite 2016; 102:44-50. [DOI: 10.1016/j.appet.2016.01.019] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Revised: 12/12/2015] [Accepted: 01/12/2016] [Indexed: 11/23/2022]
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Delany C, Fryer C, van Kessel G. An ethical approach to health promotion in physiotherapy practice. Health Promot J Austr 2016; 26:255-262. [PMID: 26502179 DOI: 10.1071/he15052] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Accepted: 09/17/2015] [Indexed: 11/23/2022] Open
Abstract
ISSUE ADDRESSED With increased emphasis on reducing the global burden of non-communicable disease, health professionals who traditionally focused on the individual are being encouraged to address population-level health problems. While physiotherapists are broadening their clinical role to include health promotion strategies in their clinical practice, the ethical foundations of this practice focus have received less attention. METHODS We use a physiotherapy clinical scenario to highlight different physiotherapeutic approaches and to analyse underpinning ethical values and implications for practice. RESULTS We suggest there are potential harms of incorporating health promotion into physiotherapy management of individuals if the population-based research does not resonate with an individual's particular circumstances, capacity to change or view of what counts as important and meaningful. We propose that critical reasoning and ethical judgment by the physiotherapist is required to determine how health promotion messages applied in primary care settings might work to benefit and enhance a client's well being rather than impose burdens or cause harm. CONCLUSION We suggest four ethical reasoning strategies designed to assist physiotherapists to frame and understand fundamental ethical principles of beneficence, harm, autonomy and justice when implementing health promotion and self-management approaches in clinical practice.
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Affiliation(s)
- Clare Delany
- Children's Bioethics Centre, Royal Children's Hospital, 50 Flemington Road, Parkville, Vic. 3052, Australia
| | - Caroline Fryer
- International Centre for Allied Health Evidence, University of South Australia, GPO Box 2471, Adelaide, SA 5001, Australia
| | - Gisela van Kessel
- International Centre for Allied Health Evidence, University of South Australia, GPO Box 2471, Adelaide, SA 5001, Australia
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McPhail-Bell K, Bond C, Brough M, Fredericks B. 'We don't tell people what to do': ethical practice and Indigenous health promotion. Health Promot J Austr 2016; 26:195-199. [PMID: 26599355 DOI: 10.1071/he15048] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2015] [Accepted: 10/06/2015] [Indexed: 11/23/2022] Open
Abstract
Health promotion aspires to work in empowering, participatory ways, with the goal of supporting people to increase control over their health. However, buried in this goal is an ethical tension: while increasing people's autonomy, health promotion also imposes a particular, health promotion-sanctioned version of what is good. This tension positions practitioners precariously, where the ethos of empowerment risks increasing health promotion's paternalistic control over people, rather than people's control over their own health. Herein we argue that this ethical tension is amplified in Indigenous Australia, where colonial processes of control over Indigenous lands, lives and cultures are indistinguishable from contemporary health promotion 'interventions'. Moreover, the potential stigmatisation produced in any paternalistic acts 'done for their own good' cannot be assumed to have evaporated within the self-proclaimed 'empowering' narratives of health promotion. This issue's guest editor's call for health promotion to engage 'with politics and with philosophical ideas about the state and the citizen' is particularly relevant in an Indigenous Australian context. Indigenous Australians continue to experience health promotion as a moral project of control through intervention, which contradicts health promotion's central goal of empowerment. Therefore, Indigenous health promotion is an invaluable site for discussion and analysis of health promotion's broader ethical tensions. Given the persistent and alarming Indigenous health inequalities, this paper calls for systematic ethical reflection in order to redress health promotion's general failure to reduce health inequalities experienced by Indigenous Australians.
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Affiliation(s)
- Karen McPhail-Bell
- Queensland University of Technology, GPO Box 2434, Brisbane, Qld 4001, Australia
| | - Chelsea Bond
- Queensland University of Technology, GPO Box 2434, Brisbane, Qld 4001, Australia
| | - Mark Brough
- Queensland University of Technology, GPO Box 2434, Brisbane, Qld 4001, Australia
| | - Bronwyn Fredericks
- Central Queensland University, Bruce Highway, North Rockhampton, Qld 4702, Australia
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Axford A, Carter D. Building workforce capacity for ethical reflection in health promotion: a practitioner's experience. Health Promot J Austr 2016; 26:222-230. [PMID: 26686061 DOI: 10.1071/he15031] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Accepted: 10/29/2015] [Indexed: 11/23/2022] Open
Abstract
Health promotion does not have a code of ethics, although attempts have been made to assist practitioners in their understanding and application of ethical concepts. This article describes and analyses one such attempt, sustained from 2006 to 2014 in rural South Australia. The attempt comprised capacity-building activities that were informed by principles of organisational change management, especially the principle of creating champions. The article also presents a framework (largely comprising ethical questions) that may help practitioners as a prompt and guide to ethical reflection. The framework was developed to be as accessible as possible in light of the diverse educational backgrounds found in rural settings. Finally, the article highlights some philosophical dimensions to the framework and defends its role, proposing that ethical reflection is integral to good practice and never simply the province of theorists. The article does all this with a view to stimulating discussion on how to increase the frequency and quality of ethical reflection undertaken by health promotion practitioners.
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Affiliation(s)
- Annabel Axford
- School of Education, University of South Australia, GPO Box 2471, Adelaide, SA 5001, Australia
| | - Drew Carter
- School of Public Health, Mail Drop DX 650 550, University of Adelaide, SA 5005, Australia
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O'Hara L, Taylor J, Barnes M. The extent to which the public health 'war on obesity' reflects the ethical values and principles of critical health promotion: a multimedia critical discourse analysis. Health Promot J Austr 2016; 26:246-254. [PMID: 26608800 DOI: 10.1071/he15046] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2015] [Accepted: 10/18/2015] [Indexed: 11/23/2022] Open
Abstract
ISSUE ADDRESSED The discipline of health promotion is responsible for implementing strategies within weight-related public health initiatives (WR-PHI). It is imperative that such initiatives be subjected to critical analysis through a health promotion ethics lens to help ensure ethical health promotion practice. METHODS Multimedia critical discourse analysis was used to examine the claims, values, assumptions, power relationships and ideologies within Australian WR-PHI. The Health Promotion Values and Principles Continuum was used as a heuristic to evaluate the extent to which the WR-PHI reflected the ethical values of critical health promotion: active participation of people in the initiative; respect for personal autonomy; beneficence; non-maleficence; and strong evidential and theoretical basis for practice. RESULTS Ten initiatives were analysed. There was some discourse about the need for participation of people in the WR-PHI, but people were routinely labelled as 'target groups' requiring 'intervention'. Strong evidence of a coercive and paternalistic discourse about choice was identified, with minimal attention to respect for personal autonomy. There was significant emphasis on the beneficiaries of the WR-PHI but minimal attention to the health benefits, and nothing about the potential for harm. Discourse about the evidence of need was objectivist, and there was no discussion about the theoretical foundations of the WR-PHI. CONCLUSION The WR-PHI were not reflective of the ethical values and principles of critical health promotion. So what? Health promotion researchers and practitioners engaged in WR-PHI should critically reflect on the extent to which they are consistent with the ethical aspects of critical health promotion practice.
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Affiliation(s)
- Lily O'Hara
- Emirates College for Advanced Education, PO Box 126662, Abu Dhabi, United Arab Emirates
| | - Jane Taylor
- School of Health and Sport Sciences, Faculty of Science, Health and Education, University of the Sunshine Coast, Sippy Downs Drive, Sippy Downs, Qld 4556, Australia
| | - Margaret Barnes
- School of Nursing and Midwifery, Faculty of Science, Health and Education, University of the Sunshine Coast, Sippy Downs Drive, Sippy Downs, Qld 4556, Australia
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Liabsuetrakul T, Suntharasaj T, Sangsupawanich P, Kongkamol C, Pornsawat P. Implementation of evidence-based medicine in a health promotion teaching block for Thai medical students. Glob Health Promot 2016; 24:62-68. [PMID: 27154911 DOI: 10.1177/1757975915626871] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Evidence-based medicine (EBM) is well known in medical practice. Although health promotion (HP) is promoted worldwide, there is still some debate as to whether EBM is needed or useful in the teaching of health promotion. OBJECTIVE To assess the perceived usefulness of EBM in the teaching of HP among medical students and faculty members. METHODS A comparative study was conducted between two groups of fourth-year medical students in the academic year 2012 during the five-week Health Promotion Teaching Block at Prince of Songkla University, southern Thailand. A one-week EBM course was conducted with half the students in the first week of the block and the other half of the students in the last week of the block. All activities in the HP block were similar except for the different periods of the one-week of EBM teaching. The effect on knowledge, ability and perceived application of EBM in future practice was assessed by student self-evaluations before versus after taking the EBM course, and by faculty member evaluation of the students' end-of-block presentations. All evaluation items were rated from 1 (lowest) to 5 (highest). Data were analyzed using a t-test or Wilcoxon test, as appropriate. RESULTS The students' self-evaluations of knowledge and ability on EBM between the two groups were similar. The perception that teaching EBM is beneficial in health promotion and future practice increased significantly ( p<0.001) in both groups. Faculty members rated higher scores for the first group than the second group, although the rating differences were not at the level of significance. Ninety percent of the students believed that EBM was a useful addition to the teaching of HP. CONCLUSIONS Medical students and faculty members perceived that EBM is useful in the HP context. Future studies to evaluate the effect of using evidence-based teaching for health promotion are needed.
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Affiliation(s)
- Tippawan Liabsuetrakul
- 1. Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
| | - Thitima Suntharasaj
- 2. Department of Obstetrics and Gynecology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
| | - Pasuree Sangsupawanich
- 3. Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
| | - Chanon Kongkamol
- 4. Department of Community Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
| | - Panumad Pornsawat
- 5. Division of Medical Education, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
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Dixon H, Murphy M, Scully M, Rose M, Cotter T. Identifying effective healthy weight and lifestyle advertisements: Focus groups with Australian adults. Appetite 2016; 103:184-191. [PMID: 27079189 DOI: 10.1016/j.appet.2016.04.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2015] [Revised: 03/29/2016] [Accepted: 04/07/2016] [Indexed: 11/30/2022]
Abstract
This study explored adult's attitudes and reactions to a range of television advertisements (ads) promoting healthy weight, physical activity and healthy eating. Twenty-four focus groups (N = 179) were conducted in metropolitan and regional areas of the Australian states of Victoria, New South Wales (NSW) and Queensland, with participants segmented by sex, education (no tertiary, at least some tertiary) and life stage (young adults, parents). Each group was assigned to one of the three advertising streams - Weight, Activity, or Nutrition - where responses to five different ads were explored using semi-structured, moderator-led discussions. Discussion transcripts were qualitatively content analysed using a conventional approach. Four main themes were identified in participants' discussions about the ads' main messages - (i) Why is it a problem? (ii) Who is it a problem for? (iii) What should I do about it? (iv) How do I make the changes? Reactions varied by demographic factors and current weight and lifestyle status. Participants furthest from achieving public health recommendations for weight, diet and activity were motivated by 'what' and 'how' ads involving gentle persuasion and helpful hints. Participants who were closer to meeting these recommendations were motivated by 'why' ads featuring more graphic and emotive content and new information. Findings suggest a strategic approach is important for the development of public health ads promoting healthy weight and lifestyle, with consideration given to the specific communication goals and who the target audience is. This should help ensure an appropriate message is delivered to priority population subgroups in the most informative and motivating manner.
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Affiliation(s)
- Helen Dixon
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, 615 St Kilda Road, Melbourne, 3004, Australia.
| | - Michael Murphy
- Michael Murphy Research, 5/8A Dickens Street, Elwood, 3184, Australia
| | - Maree Scully
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, 615 St Kilda Road, Melbourne, 3004, Australia
| | - Mischa Rose
- Michael Murphy Research, 5/8A Dickens Street, Elwood, 3184, Australia
| | - Trish Cotter
- Vital Strategies, 61 Broadway, Suite 2800, New York, 10006, USA
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Golden SD, McLeroy KR, Green LW, Earp JAL, Lieberman LD. Upending the social ecological model to guide health promotion efforts toward policy and environmental change. HEALTH EDUCATION & BEHAVIOR 2016; 42:8S-14S. [PMID: 25829123 DOI: 10.1177/1090198115575098] [Citation(s) in RCA: 119] [Impact Index Per Article: 14.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Efforts to change policies and the environments in which people live, work, and play have gained increasing attention over the past several decades. Yet health promotion frameworks that illustrate the complex processes that produce health-enhancing structural changes are limited. Building on the experiences of health educators, community activists, and community-based researchers described in this supplement and elsewhere, as well as several political, social, and behavioral science theories, we propose a new framework to organize our thinking about producing policy, environmental, and other structural changes. We build on the social ecological model, a framework widely employed in public health research and practice, by turning it inside out, placing health-related and other social policies and environments at the center, and conceptualizing the ways in which individuals, their social networks, and organized groups produce a community context that fosters healthy policy and environmental development. We conclude by describing how health promotion practitioners and researchers can foster structural change by (1) conveying the health and social relevance of policy and environmental change initiatives, (2) building partnerships to support them, and (3) promoting more equitable distributions of the resources necessary for people to meet their daily needs, control their lives, and freely participate in the public sphere.
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Affiliation(s)
- Shelley D Golden
- Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | | | | | - Jo Anne L Earp
- Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
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Degeling C, Johnson J, Kerridge I, Wilson A, Ward M, Stewart C, Gilbert G. Implementing a One Health approach to emerging infectious disease: reflections on the socio-political, ethical and legal dimensions. BMC Public Health 2015; 15:1307. [PMID: 26715066 PMCID: PMC4696140 DOI: 10.1186/s12889-015-2617-1] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2015] [Accepted: 12/16/2015] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND 'One Health' represents a call for health researchers and practitioners at the human, animal and environmental interfaces to work together to mitigate the risks of emerging and re-emerging infectious diseases (EIDs). A One Health approach emphasizing inter-disciplinary co-operation is increasingly seen as necessary for effective EID control and prevention. There are, however, socio-political, ethical and legal challenges, which must be met by such a One Health approach. DISCUSSION Based on the philosophical review and critical analysis of scholarship around the theory and practice of One Health it is clear that EID events are not simply about pathogens jumping species barriers; they are comprised of complex and contingent sets of relations that involve socioeconomic and socio-political drivers and consequences with the latter extending beyond the impact of the disease. Therefore, the effectiveness of policies based on One Health depends on their implementation and alignment with or modification of public values. Despite its strong motivating rationale, implementing a One Health approach in an integrated and considered manner can be challenging, especially in the face of a perceived crisis. The effective control and prevention of EIDs therefore requires: (i) social science research to improve understanding of how EID threats and responses play out; (ii) the development of an analytic framework that catalogues case experiences with EIDs, reflects their dynamic nature and promotes inter-sectoral collaboration and knowledge synthesis; (iii) genuine public engagement processes that promote transparency, education and capture people's preferences; (iv) a set of practical principles and values that integrate ethics into decision-making procedures, against which policies and public health responses can be assessed; (v) integration of the analytic framework and the statement of principles and values outlined above; and (vi) a focus on genuine reform rather than rhetoric.
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Affiliation(s)
- Chris Degeling
- Centre for Values, Ethics and the Law in Medicine, K25 Level 1, Medical Foundation Building, University of Sydney, Sydney, NSW, 2006, Australia.
- Marie Bashir Institute for Infectious Disease and Biosecurity, University of Sydney, Sydney, Australia.
| | - Jane Johnson
- Centre for Values, Ethics and the Law in Medicine, K25 Level 1, Medical Foundation Building, University of Sydney, Sydney, NSW, 2006, Australia.
- Faculty of Veterinary Medicine, University of Sydney, Sydney, Australia.
| | - Ian Kerridge
- Centre for Values, Ethics and the Law in Medicine, K25 Level 1, Medical Foundation Building, University of Sydney, Sydney, NSW, 2006, Australia.
- Marie Bashir Institute for Infectious Disease and Biosecurity, University of Sydney, Sydney, Australia.
| | - Andrew Wilson
- Menzies Centre for Health Policy, University of Sydney, Sydney, Australia.
| | - Michael Ward
- Marie Bashir Institute for Infectious Disease and Biosecurity, University of Sydney, Sydney, Australia.
- Faculty of Veterinary Medicine, University of Sydney, Sydney, Australia.
| | | | - Gwendolyn Gilbert
- Centre for Values, Ethics and the Law in Medicine, K25 Level 1, Medical Foundation Building, University of Sydney, Sydney, NSW, 2006, Australia.
- Marie Bashir Institute for Infectious Disease and Biosecurity, University of Sydney, Sydney, Australia.
- Centre for Infectious Disease and Microbiology - Public Health, Westmead Hospital, Sydney, Australia.
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Ward PR, Coffey C, Javanparast S, Wilson C, Meyer SB. Institutional (mis)trust in colorectal cancer screening: a qualitative study with Greek, Iranian, Anglo-Australian and Indigenous groups. Health Expect 2015; 18:2915-27. [PMID: 25271975 PMCID: PMC5810636 DOI: 10.1111/hex.12276] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/05/2014] [Indexed: 11/28/2022] Open
Abstract
INTRODUCTION Colorectal cancer (CRC) has the second highest cancer mortality rate in Australia. The Australian National Bowel Cancer Screening Program (NBCSP) aims to increase early detection of CRC by offering free Faecal Occult Blood Testing (FOBT), although uptake is low for culturally and linguistically diverse (CALD) groups. AIM OF PAPER To present data on trust and mistrust in the NBCSP by population groups with low uptake and thus to highlight areas in need of policy change. METHODS A qualitative study was undertaken in South Australia, involving interviews with 94 people from four CALD groups: Greek, Iranian, Anglo-Australian, and Indigenous peoples. RESULTS Our study highlights the complexities of institutional trust, which involves considerations of trust at interpersonal, local and national levels. In addition, trust and mistrust was found in more abstract systems such as the medical knowledge of doctors to diagnose or treat cancer or the scientific procedures in laboratories to test the FOBTs. The object of institutional (mis)trust differed between cultural groups - Anglo-Australian and Iranian groups indicated a high level of trust in the government, whereas Indigenous participants were much less trusting. CONCLUSION The level and nature of trust in the screening process varied between the CALD groups. Addressing program misconceptions, clarifying the FOBT capabilities and involving medical services in collecting and transporting the samples may increase trust in the NBCSP. However, broader and more enduring mistrust in services and institutions may need to be dealt with in order to increase trust and participation.
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Affiliation(s)
- Paul R Ward
- Discipline of Public Health, Flinders University, Adalaide, SA, Australia
| | - Cushla Coffey
- Discipline of Public Health, Flinders University, Adalaide, SA, Australia
| | - Sara Javanparast
- South Australian Community Health Research Unit, Flinders University, Adalaide, SA, Australia
| | - Carlene Wilson
- School of Medicine, Flinders University, Adalaide, SA, Australia
| | - Samantha B Meyer
- Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada
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Smith JA, Schmitt D, Fereday L, Bonson J. Ethics and health promotion within policy and practice contexts in a small jurisdiction: perspectives from the Northern Territory. Health Promot J Austr 2015; 26:231-234. [PMID: 26535486 DOI: 10.1071/he15058] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2015] [Accepted: 10/07/2015] [Indexed: 11/23/2022] Open
Affiliation(s)
- James A Smith
- Office of Pro Vice Chancellor - Indigenous Leadership, Charles Darwin University, Ellengowan Drive, Casuarina, NT 0909, Australia
| | - Dagmar Schmitt
- Health Development Branch, Northern Territory Department of Health, PO Box 40586, Casuarina, NT 0811, Australia
| | - Lisa Fereday
- Health Development Branch, Northern Territory Department of Health, PO Box 40586, Casuarina, NT 0811, Australia
| | - Jason Bonson
- Health Development Branch, Northern Territory Department of Health, PO Box 40586, Casuarina, NT 0811, Australia
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Ward PR, Coffey C, Meyer S. Trust, choice and obligation: a qualitative study of enablers of colorectal cancer screening in South Australia. SOCIOLOGY OF HEALTH & ILLNESS 2015; 37:988-1006. [PMID: 25912247 DOI: 10.1111/1467-9566.12280] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Colorectal cancer (CRC) has the second highest cancer prevalence and mortality rates in Australia. The Australian National Bowel Cancer Screening Program (NBCSP) aims to increase early detection of CRC by offering free faecal occult blood testing. The NBCSP aims to offer choice to consumers about whether or not to participate in screening. This article presents data on trust, choice and perceived obligation to participate in the NBCSP by population groups with low uptake. A qualitative study was undertaken in South Australia. We interviewed 94 people from four culturally distinct groups: Greek, Iranian, Anglo-Australian and Indigenous peoples. This article demonstrates the complexity of factors shaping the choice, or lack thereof, to participate in the NBCSP. Informed choice is based on adequate knowledge, although this varied among our participants, highlighting the need for more health education in appropriate languages. An obligation to participate was found in the Iranian and Anglo-Australian groups and resulted from an established personal relationship with the doctor, a sense of duty, the acknowledgement of government investment and appreciation. Overall, this article makes a link between trust, choice and obligation, adding to literature on the sociology of trust and medical screening and highlighting important issues in the need of a policy and practice to improve CRC screening rates.
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Affiliation(s)
- Paul R Ward
- Discipline of Public Health, Flinders University, Australia
| | - Cushla Coffey
- Discipline of Public Health, Flinders University, Australia
| | - Samantha Meyer
- School of Public Health and Health Systems, Waterloo University, Canada
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Dixon H, Scully M, Durkin S, Brennan E, Cotter T, Maloney S, O'Hara BJ, Wakefield M. Finding the keys to successful adult-targeted advertisements on obesity prevention: an experimental audience testing study. BMC Public Health 2015; 15:804. [PMID: 26290169 PMCID: PMC4546051 DOI: 10.1186/s12889-015-2159-6] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2014] [Accepted: 08/14/2015] [Indexed: 11/10/2022] Open
Abstract
Background Mass media communications are an important component of comprehensive interventions to address population levels of overweight and obesity, yet we have little understanding of the effective characteristics of specific advertisements (ads) on this topic. This study aimed to quantitatively test audience reactions to existing adult-focused public health television ads addressing overweight and obesity to determine which ads have the highest levels of message acceptance, argument strength, personalised perceived effectiveness and negative emotional impact. Methods 1116 Australian adults aged 21-55 years recruited from a national online panel participated in this web-based study. Quotas were applied to achieve even numbers of males and females, those aged 21-29 years and 30-55 years, and those with a healthy weight (BMI = 18.5-24.9) and overweight/obesity (BMI = 25+). Participants were randomly assigned to view and rate four of eight ads that varied in terms of message content (health consequences, supportive/encouraging or social norms/acceptability) and execution style (graphic, simulation/animation, positive or negative testimonial, or depicted scene). Results Toxic fat (a graphic, health consequences ad) was the top performing ad on all four outcome measures and was significantly more likely than the other ads tested to promote strong responses in terms of message acceptance, argument strength and negative emotional impact. Measure up (a negative testimonial, health consequences ad) performed comparably on personalised perceived effectiveness. Most ads produced stronger perceptions of personalised perceived effectiveness among participants with overweight/obesity compared to participants with healthy weight. Some ads were more likely to promote strong negative emotions among participants with overweight/obesity. Conclusions Findings provide preliminary evidence of the most promising content and executional styles of ads that could be pursued as part of obesity prevention campaigns. Ads emphasising the negative health consequences of excess weight appear to elicit stronger cognitive and emotional responses from adults with overweight/obesity. However, careful pre-testing of these types of ads is needed prior to their inclusion in actual campaigns to ensure they do not have unintended negative impacts such as increased stigmatisation of vulnerable individuals and increased levels of body dissatisfaction and/or eating-disordered behaviour among at-risk population sub-groups. Electronic supplementary material The online version of this article (doi:10.1186/s12889-015-2159-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Helen Dixon
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, 615 St Kilda Road, Melbourne, Victoria, 3004, Australia.
| | - Maree Scully
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, 615 St Kilda Road, Melbourne, Victoria, 3004, Australia.
| | - Sarah Durkin
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, 615 St Kilda Road, Melbourne, Victoria, 3004, Australia.
| | - Emily Brennan
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, 615 St Kilda Road, Melbourne, Victoria, 3004, Australia.
| | - Trish Cotter
- World Lung Foundation, 61 Broadway, Suite 2800, New York, NY, 10006, USA.
| | - Sarah Maloney
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, 615 St Kilda Road, Melbourne, Victoria, 3004, Australia.
| | - Blythe J O'Hara
- Prevention Research Collaboration, Sydney School of Public Health, The University of Sydney, Level 2, Medical Foundation Building, K25, The University of Sydney, Sydney, New South Wales, 2006, Australia.
| | - Melanie Wakefield
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, 615 St Kilda Road, Melbourne, Victoria, 3004, Australia.
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Community pharmacy as a setting for public health nutrition action: Australian nutritionists' perspectives. Public Health Nutr 2014; 18:1864-72. [PMID: 25295409 DOI: 10.1017/s1368980014002201] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To explore public health nutritionists' perceptions of nutrition and its place in community pharmacy (CP) presently and into the future; and to explore perceived opportunities, feasibility and scope of public health nutrition (PHN) interventions in CP, with a focus on maternal and infant nutrition. DESIGN Qualitative data were gathered through semi-structured interviews and drew on hermeneutics as the theoretical framework for analysis and interpretation. SETTING Queensland, Australia. SUBJECTS Public health nutritionists, identified through purposive, criterion sampling, were chosen due to (i) their role as potential stakeholders, (ii) their knowledge and emphasis on nutrition and (iii) their practice experience. RESULTS Opportunities for PHN action focused primarily on actions relating to early nutrient supplementation in pregnancy and breast-feeding protection and promotion. Opportunities in CP were constrained by practitioners' perception of (i) conflict between health care and commercial interests in CP, (ii) problematic practices in CP and (iii) values and motivations of practitioners and other stakeholders in the CP sector. Strategies were suggested to improve practices and enhance the setting from a PHN perspective. Participants suggested both collaborative and regulatory approaches to achieve settings-based changes, identifying the need for these to coexist for effective outcomes. CONCLUSIONS Public health nutritionists suggest that opportunities for PHN action are constrained by perceived conflicted interests and that consumers need to be adequately protected from the influence of commercial interests. PHN action in this setting needs adequate reflection on evidence as well as ethics ensuring that practices are 'for the good' of mothers and infants.
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