[The role of food in the workplace for health promotion and education to the future]. / Il ruolo dell'alimentazione sui luoghi di lavoro per la promozione del benessere organizzativo e l'educazione al futuro.

Health promotion and education to the future and sustainability are a new potential approach in order to try to reduce diet- and lifestyle-related diseases (cancer, metabolic disorders, obesity, neurodegenerative diseases). Inclusion of educational pathways associated to food consumption out of the home, especially in the workplace, may represent a brand new strategy of intervention, an alternative to the disappointing results of more traditional information-educational strategies implemented so far.

A Model for Developing Comprehensive Initiatives to Improve the Health of the Worksite: The WorkWell KS Strategic Framework.

Background: Worksite wellness programs that target individual employees, rather than worksites, have demonstrated limited long-term success. The purpose of this overview was to describe the theoretical basis for implementing an effective worksite wellness initiative, WorkWell Kansas (WorkWell KS). WorkWell KS is not a traditional worksite wellness initiative, as its goal is to create healthy worksites, rather than target workers. Methods: The WorkWell KS Strategic Framework is based on academic research that identified successful worksite wellness elements that produce sustainably healthy worksites. The curricula were built around the 3-4-80: three modifiable behaviors (tobacco use, poor access to nutritious foods and beverages, and physical inactivity) contribute to at least four chronic diseases (heart disease, type II diabetes, lung disease, and some cancers), which in turn contribute to approximately 80% of the premature deaths in the United States. Findings: To properly address these modifiable behaviors, the WorkWell KS Strategic Framework was developed to guide worksites to first build a solid worksite wellness foundation, which consists of five elements: the wellness committee, exercising leadership, communications, incentives, and data. Once built, worksites are then encouraged to employ a socio-ecological approach to developing a comprehensive, multi-strategy (information, program, benefit design, policy, and environment) intervention, focusing on one health behavior at a time. Conclusions/Application to Practice: The goal of WorkWell KS was to create healthy worksites, which creates environments for employees to practice these healthy behaviors. Worksite wellness committees, occupational health professionals, and others interested in altering health behaviors at worksites have an opportunity to reframe their approach using this framework.

What Could Total Worker Health® Look Like in Small Enterprises?

Small enterprises have fewer resources, are more financially precarious, and have higher rates of occupational injury and illness compared with larger enterprises. Interventions that address the promotion of health and well-being in addition to traditional occupational safety and health hazards, a Total Worker Health® (TWH) approach, may be effective in reducing injuries and preventing illness. However, little research has examined the impact of TWH interventions in small enterprises. The aim of this research was to explore and characterize health and safety practices, policies, and programs in small Midwestern enterprises from a TWH perspective. Utilizing a case studies approach, site visits were conducted with small business, between 10 and 250 employees, from 2014 through 2016 and included workplace audits and interviews with multiple employees in varying roles within each organization. Both open and closed coding were used to identify specific themes. Eight themes emerged from the site visits: value and return on investment, organizational factors, program design, engaging employees, low-cost strategies, evaluation, and integration. These themes overlapped with both the National Institute for Occupational Safety and Health's (NIOSH) Essential Elements of TWH and the NIOSH Fundamentals. Industry sector and enterprise size also affect resources and integration of these resources. As TWH expands to organizations of all sizes, it is necessary to address the unique needs of smaller enterprises.

A graduate course in work site health promotion for occupational health practitioners.

This paper describes the rationale, teaching strategies, outcomes, and a 6-month follow-up of an academic course in work site health promotion, in which 35 occupational health practitioners participated. The one-semester course was part of the Masters in Science program in occupational health at the Tel-Aviv University Medical School. The primary goals of the study were to teach the theoretical bases of work site health promotion and their application to specific health needs, and to train better role models for employees. The primary teaching strategies were: (1) facilitation of experiential learning, by encouraging students to undergo health screening and then engage in a personal health promotion plan; (2) use of health promotion experts as guest teachers; and (3) an increase in formal knowledge through formal lectures and background reading. At the time of follow-up, most of the students were still adhering to their plans and maintaining much of their health promotion achievements. Additional outcomes included increased awareness of health risks and health promotion issues, and positions as role models in the private and professional domains. The primary barrier to adherence was low frustration tolerance, which can be regarded as the major challenge to health promotion programs and courses. It is suggested that the course format is an effective means of educating health promoters.

Physical fitness for retirees.

Demographic projections predict a substantial growth in adults age 65 or older relative to the rest of the population. Currently, the cost to employers to provide health benefits for retirees has skyrocketed. To address this issue, a change in the concept of health promotion is advocated to include the maintenance and rehabilitation of functional capacity for retired employees. The physiological and psychological benefits of group exercise are presented. The development of a group exercise program to meet the specific needs of older adults is discussed. Future trends in corporate health promotion are suggested, and issues relevant to the development of exercise programs for older adults are addressed.

The future of allied health in the health promotion/disease prevention movement.

Although allied health was not included in the earliest stages of the health promotion/disease prevention movement, it now has a unique opportunity to assume a leadership position. To a great extent, realization of that potential will depend on the individual and collective efforts of the American Society of Allied Health Professions (ASAHP) and its constituencies, allied health educational institutions, professional associations, and individual professionals.

Modos de pensar dos profissionais do Programa Academia da Saúde sobre saúde e doença e suas implicações nas ações de promoção de saúde / Modes of thinking of the professionals of the Health Academy Program about health and disease and their implications in actions of health promotion

Resumo O Programa Academia da Saúde (PAS) foi criado para contribuir com a promoção da saúde, produção do cuidado e melhoria do acesso à prática de atividade física, a partir da visão holística do cuidado. Objetivo: compreender representações de profissionais do PAS sobre saúde/doença, que fundamentam as atividades de promoção à saúde, dirigidas à população. Metodologia: estudo qualitativo fundamentado na teoria das Representações Sociais, entendendo-as como pontos de vista, explicitados na ação humana. Entrevistas em profundidade, com profissionais de educação física do PAS de Belo Horizonte, foram interpretadas pela Análise Estrutural de Narração. Resultados: existem representações centrais que definem a saúde como o oposto à doença, representações periféricas, sendo saúde mais do que ausência de doença. O modelo biomédico presente convive com pontos de vista que ampliam a prática em saúde, voltada para a construção da promoção da saúde como um bem e um direito. Para manterem paralelas estas representações, os profissionais se utilizam, contraditoriamente, do discurso oficial que criou o Programa, ancorado na Saúde Coletiva, e do discurso da ciência e do senso comum, ancorados na Biologia. A implicação do profissional nas ações torna-se paradoxal, exigindo melhorias em sua formação para continuar a mudança de paradigma na atenção à saúde.

Abstract The Health Academy Program was created to contribute to health promotion, care production and improvement of access to the practice of physical activity, based on the holistic view of care. Aim: to understand the HAP professionals' representations about health/disease and its implications for health promotion activities. A qualitative study based on the theory of Social Representations, understanding them as the points of view, which are explicit in human action. In-depth interviews with physical education professionals from the PAS of Belo Horizonte were interpreted by the Structural Analysis of Narration. Results: There are central representations that define health as the opposite of disease, and, peripherally, health is more than absence of disease. The biomedical model coexists with viewpoints that expand health practice, focused on the construction of health promotion as a good and a right. The representations remain parallel, use the official discourse that created the Program, supported by Collective Health, and the discourse of science and common sense, supported by Biology. The implication of the professional in the actions is paradoxical, and requires improvements in their training to continue the paradigm shift in health care.

Family practice in Turkey.

The national project 'Transformation in Health' was started in 2005 to provide expert primary care by family physicians, and decrease expenses in Turkey. The number of family physicians was far below the need, so public physicians were promoted to family physician status after a 10-day intensive course. The government declared some satisfactory results, but privately paid family physicians were not accepted into the system. Furthermore, the government stopped paying for their services from private settings. Some family physicians became unemployed as the major payer for all forms of medical care in Turkey denied their services. The process showed it's value in time. Nevertheless, family physicians should be the core of this transformation as family medicine is an academic and a scientific discipline and a primary care-oriented specialty with its own specific educational content, research and base of evidence, which cannot be achieved through standard medical education.

Sentidos y prácticas en promoción de la salud en el noroeste de montevideo: orientaciones de la acción médica en el primer nivel de atención / Meaning and practices regarding health promotion in the northeast of Montevideo: medical action orientations at primary health care level / Sentidos e práticas na promoção da saúde no noroeste se Montevidéu: diretrizes para a ação no primeiro nível de ciudados médicos

En este trabajo se presentan los resultados de unainvestigación en torno a los significados atribuidos a lapromoción de la salud en el noroeste de Montevideo.El estudio abarcó a Médicos/as del primer nivel deatención y a actores sociales de la zona. En este trabajosólo se desarrolla lo referido al personal sanitario. Desdeun enfoque cualitativo se realizaron 10 entrevistas enprofundidad a Médicos/as y un grupo de discusión.De los resultados principales se destacan las múltiplessignificaciones y la heterogeneidad de prácticas depromoción de la salud. A su vez, se visualizaronsignificaciones tendientes a lo establecido, donde lacentralidad en la enfermedad y lo curativo individuales lo característico; articuladas con significacionestransformadoras orientadas a la participación y a la organización comunitaria. Ambos universos de significaciones se combinan y aparecen demodo interrelacionado en el personal médico.

In this work we present the results of a research regarding the meaning given to healthpromotion in the northeast of Montevideo. The study included Doctors from primary healthcare level and social actors from the area. Only the information related to health staff isdeveloped in this work. In a qualitative approach, ten deep interviews and a discussion groupwere carried out with doctors. From the main results, the multiple significances and theheterogeneity in health promotion practices are highlighted. In turn, significances towardswhat is established were visualized, where the characteristic is the centrality in the illnessand the individual in the cure; articulated with transforming significances oriented towardscommunity participation and organization. Both universes of significances are combinedand appear interrelated with the medical staff.

Neste artigo apresentam-se os resultados de uma pesquisa sobre os significados atribuídosà promoção da saúde no noroeste de Montevidéu. O estudo abrangeu Médicos/as doprimeiro nível de cuidados e atores sociais dessa área. Neste trabalho só é desenvolvidoaquilo que tem relação com o pessoal sanitário. A partir de uma abordagem qualitativaforam realizadas 10 entrevistas em profundidade a Médicos/as e a um grupo de discussão.Dentre os principais resultados destacam-se os múltiplos significados e heterogeneidadedas práticas de promoção da saúde. Por sua vez, evidenciaram-se significados, tendentes aoestabelecido, onde a centralidade na doença e a cura indivídual é a característica visualizada;articuladas com significados transformadores orientados para a participação e organizaçãocomunitária. Ambos os universos de sentido são combinados e aparecem interligados nopessoal médico.