Health promotion as practiced by public health inspectors: the BC experience.

OBJECTIVE: To explore the experiences of British Columbia's (BC's) Public Health Inspectors in practicing health promotion. METHODS: We administered a mixed qualitative-quantitative survey to 15 BC Public Health Inspectors (in BC, titled Environmental Health Officers--EHOs), selected to represent different levels of authority, areas of work and geographic regions. We queried whether and how they practice health promotion, strategies utilized, how health promotion relates to their enforcement mandates, perceived effectiveness of health promotion, and barriers and enabling factors affecting its adoption. RESULTS: Fourteen respondents (93%) practiced health promotion. Common practices included building healthy public policy, developing personal skills, and creating environments that support health. Health promotion was most often applied as " part of enforcement"; EHOs first attempted to educate and create environments that support regulatory standards and best practices, utilizing enforcement measures should the former prove ineffective. Enforcement was recognized as an important tool. Most respondents did not feel that their enforcement mandate limited their use of health promotion; however barriers exist where the EHO is perceived unfavourably as an "enforcer". The majority felt that an increased use of health promotion would make their protection work more effective. Strategies to facilitate its application include practical training in implementation, clear expectations and accountability at all levels of planning, resources, and relationships with stakeholders. CONCLUSION: EHOs engage in a broad and varied health promotion practice. Practical training with a focus on health promotion implementation in the BC context, and clear and consistent direction regarding expectations and accountability, would facilitate greater involvement.

Implementing a province-wide mandatory vaccinate-or-mask policy at healthcare facilities in British Columbia, Canada.

OBJECTIVES: In 2012, British Columbia (BC) became the first Canadian province to implement an influenza prevention policy requiring healthcare workers (HCW) to either be vaccinated annually against influenza or wear a mask in patient care areas during the influenza season. This study describes an evaluation of influenza policy implementation processes and identifies supports and challenges related to successful policy implementation at the level of healthcare facilities, during the second policy year (2013/14). METHODS: Implementation leaders from 262 long-term care (LTC) and acute care facilities, mostly in three of BC's five regional Health Authorities, were invited to participate in an online survey following the 2013/14 influenza season. Descriptive quantitative and qualitative analyses identified common and effective strategies for improving vaccination coverage and policy compliance. RESULTS: A total of 127 respondents completed the survey on behalf of 33 acute care and 99 LTC facilities, representing 36% of acute care and 27% of LTC facilities in BC. Respondents agreed that the policy was successfully implemented at 89% of facilities, and implementation was reported to be easy at 52% of facilities. The findings elaborate on communication and leadership strategies, campaign logistics and enforcement approaches involved in policy implementation. CONCLUSION: Implementation of a vaccinate-or-mask influenza policy is complex. This study provides insight for other jurisdictions considering implementing such a policy and offers practical recommendations for facilities and health authorities.

Understanding the social consequences of chronic obstructive pulmonary disease: the effects of stigma and gender.

Stigma is a social construction that defines people in terms of a distinguishing characteristic or mark, and devalues them as a consequence. Stigma occurs when society labels someone as tainted, less desirable, or handicapped. There is emerging evidence that chronic obstructive pulmonary disease (COPD) is a physical condition with social consequences. The valuing, and devaluing, of individuals within society are social judgments that have roots in sociocultural values and beliefs. Cultural norms and values dictate the distinct roles and behaviors that are expected of men and women in a given culture. Social reactions to individuals with COPD can have an effect on their illness experience. This article explores the relationships between COPD and stigma and gender, particularly how these key elements may interact to affect experiences of individuals with COPD within their social milieu. The aim of this article is to begin to set out questions and issues that require further empirical exploration. The stigma of COPD arises because people are held responsible for their disease, are noted to have engaged in a stigmatized behavior (smoking), are marked with oxygen equipment and bodily changes, and experience a disruption in their social interactions.