Understanding the importance of concepts of health.

Health is a concept that is central to nurse education and nursing practice. It remains a dynamic concept, however, that has evolved over time and can be examined from contrasting perspectives. This article explores the various perspectives of health, for example lay concepts of health and factors such as happiness and well-being and their effect on people's perceptions of health. It is recommended that nurses use a person-centred approach to explore patients' concepts of health, which can influence their capacity to self-care.

Empowerment: challenges in measurement.

Empowerment is core to health promotion; however, there is a lack of consensus in the wider literature as to how to define it and at what level it may occur. Definitional inconsistency inevitably leads to challenges in measuring empowerment; yet if it is as important as is claimed, this must be addressed. This paper discusses the complexities of measuring empowerment and puts forward a number of recommendations for researchers and policy makers as to how this can be achieved noting some of the tensions that may arise between theoretical considerations, research and practice. We argue that empowerment is a culturally and socially defined construct and that this should be taken into account in attempts to measure it. Finally we conclude that, in order to build up the evidence base for empowerment, there is a need for research clearly defining what it is and how it is being measured.

What makes health promotion research distinct?

There have been concerns about the decline of health promotion as a practice and discipline and, alongside this, calls for a clearer articulation of health promotion research and what, if anything, makes it distinct. This discussion paper, based on a review of the literature, the authors' own experiences in the field, and a workshop delivered by two of the authors at the 8th Nordic Health Promotion Conference, seeks to state the reasons why health promotion research is distinctive. While by no means exhaustive, the paper suggests four distinctive features. The paper hopes to be a catalyst to enable health promotion researchers to be explicit in their practice and to begin the process of developing an agreed set of research principles.

Attitudes towards human papillomavirus vaccination among African parents in a city in the north of England: a qualitative study.

BACKGROUND: Human papillomavirus (HPV) is sexually transmitted and has been conclusively linked to cervical cancer and genital warts. Cervical cancer is attributed to approximately 1100 deaths annually in UK, and is the second most common female cancer globally. It has been suggested that black African women are more predisposed to HPV infection and cervical cancer. A vaccine has been developed to reduce HPV infection, and in the UK, has been offered to 12-13 year old adolescent girls through schools as part of their childhood immunization programme since 2008. Upon programme initiation, it was noted that vaccine uptake was lower in schools where girls from ethnic minority groups were proportionately higher. The study's objectives were to explore factors influencing UK based African parents' acceptance or decline of the HPV vaccine, whether fathers and mothers share similar views pertaining to vaccination and any interfamily tensions resulting from differing views. METHODS: A qualitative study was conducted with five African couples residing in north England. Face to face semi-structured interviews were carried out. Participants were parents to at least one daughter aged between 8 and 14 years. Recruitment was done through purposive sampling using snowballing. RESULTS: HPV and cervical cancer awareness was generally low, with awareness lower in fathers. HPV vaccination was generally unacceptable among the participants, with fear of promiscuity, infertility and concerns that it's still a new vaccine with yet unknown side effects cited as reasons for vaccine decline. There was HPV risk denial as religion and good cultural upbringing seemed to result in low risk perceptions, with HPV and cervical cancer generally perceived as a white person's disease. Religious values and cultural norms influenced vaccine decision-making, with fathers acting as the ultimate decision makers. Current information about why the vaccine is necessary was generally misunderstood. CONCLUSION: Tailored information addressing religious and cultural concerns may improve vaccine acceptability in African parents.

Using storyboards in participatory research.

AIM: To draw on the authors' experience of research conducted with vulnerable young women to argue for the use of storyboards in focus groups. BACKGROUND: Creative methods are used increasingly in qualitative research to generate richer data and promote more meaningful participation. DISCUSSION: This paper discusses the authors' experiences of using storyboards in participatory research. This approach has a number of advantages such as promoting participation and engagement, empowering participants and enabling them to take more control over the research process. CONCLUSION: Using creative techniques with more traditional qualitative approaches may create additional, in-depth data as well as increased participation. Such approaches could be of value in nursing research in which patients, clients and service user perspectives are often vitally important. IMPLICATIONS FOR PRACTICE: Using creative methods in qualitative research promotes participation.

The impact of conditional cash transfers on child health in low- and middle-income countries: a systematic review.

OBJECTIVES: The review aimed to assess the effectiveness of conditional cash transfers (CCTs) in improving child health in low- and middle-income countries. METHODS: Seven electronic databases were searched for papers: MEDLINE, EMBASE, PubMed, PsychINFO, BIOSIS Previews, Academic Search Complete, and CSA Sociological Abstracts. The included studies comprised of randomised controlled trials and controlled before-and-after studies evaluating the impact of CCTs on child health. Due to the substantial heterogeneity of the studies, a narrative synthesis was conducted on the extracted data. RESULTS: Sixteen studies predominantly from Latin American countries met the inclusion criteria. The outcomes reported by the studies in relation to CCTs' effectiveness in improving child health were reduction in morbidity risk, improvement in nutritional outcomes, health services utilisation, and immunisation coverage. CONCLUSIONS: The review suggests that to a large extent, CCTs are effective in improving child health by addressing child health determinants such as access to health care, child and maternal nutrition, morbidity risk, immunisation coverage, and household poverty in developing countries particularly middle-income countries. Of importance to both policy and practice, it appears that CCTs require effective functioning of health care systems to effectively promote child health.

Motivational interviewing interventions and alcohol abuse among college students: a systematic review.

OBJECTIVE: The study sought to assess the effectiveness of Motivational Interviewing (MI) interventions in reducing alcohol consumption among college students, as compared to no intervention or alternative interventions. It also sought to identify the potential moderators to MI intervention effects. DATA SOURCE: Database sources consulted included Cochrane Central Register of Control Trials, PsycINFO, PsycARTICLE, PsycLIT, CINAHL, and MEDLINE. STUDY INCLUSION AND EXCLUSION CRITERIA: Included studies were (1) underpinned by experimental, quasi-experimental, and nonexperimental designs; (2) studies in which participants were either college males only or females only or both; and (3) studies in which adaptations of MI were based on key MI principles. Excluded studies were (1) non-English language studies; (2) studies not published from 2000-2012; (3) studies in which participants were not college students; (4) studies in which intervention was not delivered by face-to-face approach; and (5) studies that failed to embark on postintervention follow-ups. DATA EXTRACTION: A total of 115 abstracts were screened. These were narrowed down to 13 studies from which data for the study were extracted. DATA SYNTHESIS: Selected studies were underpinned by experimental, quasi-experimental, and nonexperimental designs. Owing to the heterogeneity in selected studies, a narrative synthesis was used. RESULTS: MI interventions were found to be effective in reducing alcohol consumption among college students, when compared to alternative interventions or no intervention. Potential moderators of MI intervention effects were identified to include practitioner's adherence to MI techniques and individual's drinking motives. CONCLUSION: MI presents itself as a promising tool that can augment the many existing social-environmental strategies of health promotion.

An evaluation of the condom distribution scheme (C-Card) with young people in Northeast England.

AIMS: To evaluate a local C-Card scheme from the perspectives of young people in order to determine how well it had worked in improving access to condoms and in providing young people with appropriate information to make healthier choices around safer sex. METHODS: Secondary analysis of a year's worth of existing registration and monitoring data routinely collected by the C-Card scheme, two focus group discussions with 14 young people (eight males and six females) and a short questionnaire-based survey of 55 young people. RESULTS: The evidence suggested that the C-Card scheme is an effective tool for ensuring that young people know how to use a condom correctly. Ease of access and increased knowledge were key issues of effectiveness to emerge from the findings. The scheme also served as a mechanism for young people to be referred on to other sexual health services and the data appear to indicate that this was something that was taken up by young people. CONCLUSIONS: The young people who used C-Card generally viewed the scheme as an effective mechanism in terms of accessing condoms and the number of outlets available for acquiring condoms. In order for C-Card to become successful with young people, advertising needs to be improved to increase their awareness of the scheme.

Accident and Emergency nurses' attitudes towards health promotion.

AIM: This paper presents a study exploring Accident and Emergency nurses' attitudes towards health promotion. BACKGROUND: Much has been written about nurses and health promotion. Research has focused mainly on community nurses, less on nurses working in acute hospital settings, and apparently not at all on those working in Accident and Emergency units. METHODS: Q methodology, a technique for extracting subjective opinions, was used. Eleven nurses working in Accident and Emergency departments completed 33-item Q-sorts and wrote personal definitions of health promotion. Based on published literature in the field, the Q sample was structured with reference to nurses' attitudes as they related to health promotion. Factor analysis was performed on the data, and the resulting factors were interpreted. The data were collected in 2003. RESULTS: Three alternative constructions emerged from the data, representing three alternate views about health promotion. The most widely held opinion (representing nine of the 11 nurses) was a positive view of health promotion and the nurses' role in health promotion in Accident and Emergency environments. CONCLUSIONS: It is not possible to generalize the findings of this study due to the small number of participants. However, their knowledge of, and commitment to, health promotion is encouraging. Recommendations for practice are that there is continued and increased post-registration education in health promotion for nurses and continuing exploration of the hospital nurses' health promotion role. Further research is needed to explore nurses' perceptions of barriers to effective health promotion and nurses' health promotion activities in Accident and Emergency environments.