Perceived Factors Influencing Blue-Collar Workers' Participation in Worksite Health Promotion Programs in Freight Transport: A Qualitative Investigation Using the TDF and COM-B.

Blue-collar workers in the freight transport industry report a high risk of developing chronic diseases, partly due to an unhealthy lifestyle. Worksite health promotion programs (WHPPs) may be able to promote a healthier lifestyle, but participation among blue-collar workers in these programs is generally lower than among other workers. The current study aimed to further examine factors that can explain participation of blue-collar workers in these programs. A pragmatic, qualitative study was conducted, and semi-structured interviews were held with 32 blue-collar workers in freight transport in the Netherlands (94% men, 81% driver, mean age 48 (SD = 11)). The interview guide was based on the Theoretical Domains Framework (TDF) and Capability-Opportunity-Motivation-Behavior (COM-B) model, and was used to assess perceived determinants that influence participation. A combination of framework analysis and thematic analysis was conducted, which yielded the following nine main themes: (i) not being aware of WHPPs on offer, (ii) no clear picture of what to expect, (iii) (not) giving priority to health, (iv) expecting feedback and practical support, (v) being open and ready to change, (vi) preferring to be self-dependent, (vii) being offered a practical, fun and joint WHPP, (viii) having an employer who cares, thinks along and facilitates participation, and (ix) working and living in an environment in which a healthy lifestyle is not the norm. With these insights we were able to formulate recommendations to enhance the participation of blue-collar workers in WHPPs.

Mind Your Heart: A Mindful Eating and Diet Education eHealth Program.

OBJECTIVE: Examine user perceptions of the Mind Your Heart (MYH) program, a mindful eating and nutrition education program delivered via an eHealth system. METHODS: Sixteen participants (41.5 ± 13.1 years) completed sample MYH lessons over 3 weeks. We examined changes in mindfulness from the State Mindfulness Scale via text messages sent 3 times per week. We assessed MYH user perceptions in a semistructured interview after 3 weeks. Analyses included Spearman's correlation, repeated measures ANOVA, and thematic analysis. RESULTS: State Mindfulness Scale scores were significantly improved (F[1,15] = 5.35, P = 0.01) from week 1 (M = 2.28 ± 0.80) to week 3 (M = 2.75 ± 1.04). Four themes emerged: (1) MYH is supportive of health goals, (2) text messages act as an intervention, (3) facilitators or inhibitors of use, and (4) enhancing engagement. CONCLUSIONS AND IMPLICATIONS: Based on participant feedback, the final version of MYH should include example-based learning to translate abstract concepts like mindful eating into action.

Efecto de la implementación de programas de gerontología comunitaria sobre el envejecimiento saludable o activo en adultos mayores en México: Revisión sistemática y meta-análisis / Effect of the implementation of community gerontology programs on healthy or active aging in older adults in Mexico: Systematic Review and meta-analysis

Introducción: El incremento de la población de adultos mayores y el aumento de la esperanza de vida han sido determinantes para la incidencia de las enfermedades crónico no trasmisibles en la vejez, lo que conlleva al riesgo de tener una limitación funcional física, psicológica y social. Por tal motivo, la intervención comunitaria para el Envejecimiento Saludable (ES) y Envejecimiento Activo (EA), es una oportunidad para que el adulto mayor mantenga, prolongue o recupere la capacidad funcional (CF), elemento clave del ES Método: se realizó una búsqueda de artículos científicos en las bases de datos PubMed, Scopus, SciELO, LILACS, TESIUNAM. Resultados: Se encontraron 378 artículos (PubMed n=173, Scopus n=95, SciELO n=56, LILACS n=54, TESIUNAM n=17), de los cuales ocho cumplieron los criterios para el análisis cualitativo (revisión sistemática), solo 2 estudios fueron incluidos en el análisis cuantitativo (Meta-análisis). Respecto al MA los parámetros incluidos; concentración sanguínea de glucosa y colesterol (CL)así como en las cifras de presión arterial diastólica (PAD), índice de masa corporal (IMC) y peso. Es así como se encontró una disminución estadísticamente significativa después de la intervención en la concentración sanguínea, TG (-40.91, IC95% -53.90, -27.93 p<0.0001); CL (-19.39, IC95% -30.14, -8.63 p<0.0004) y PAS (-11.21 IC95% -20.29, -2.13 y p<0.02). Conclusiones: Nuestros hallazgos muestran un efecto positivo de los programas de intervención comunitaria de ES y EA, sobre las CF físicas, psicológicas y sociales, aunque existe una alta heterogeneidad en los métodos, tiempo de intervención y parámetros de medición, es a cabo estudios con una metodología similar.

Introduction: The increase in the population of older adults and the increase in life expectancy have been decisive for the incidence of chronic non-communicable diseases in old age, which entails the risk of having a physical, psychological and social functional limitation. For this reason, the community intervention for Healthy Aging (ES) and Active Aging (EA) is an opportunity for the elderly to maintain, prolong or recover functional capacity (FC), a key element of ES Method: a search of scientific articles was carried out in the PubMed, Scopus, SciELO, LILACS, TESIUNAM databases. Results: 378 articles were found (PubMed n=173, Scopus n=95, SciELO n=56, LILACS n=54, TESIUNAM n=17), of which eight met the criteria for qualitative analysis (systematic review), only 2 studies were included in the quantitative analysis (Meta-analysis). Regarding the MA, the parameters included; blood glucose and cholesterol (CL) concentration, as well as diastolic blood pressure (DBP), body mass index (BMI) and weight. This is how a statistically significant decrease was found after the intervention in blood concentration, TG (-40.91, 95% CI -53.90, -27.93 p<0.0001); CL (-19.39, 95%CI -30.14, -8.63 p<0.0004) and PAS (-11.21 95%CI -20.29, -2.13 and p<0.02). Conclusions: Our findings show a positive effect of SE and EA community intervention programs on physical, psychological and social CF, although there is a high heterogeneity in the methods, intervention time and measurement parameters, it is carried out studies with a similar methodology.

Introdução: O aumento da população de idosos e o aumento da esperança de vida têm sido decisivos para a incidência de doenças crónicas não transmissíveis na velhice, o que acarreta o risco de ter uma limitação funcional física, psicológica e social. Por esta razão, a intervenção comunitária para o Envelhecimento Saudável (ES) e o Envelhecimento Ativo (EA) constitui uma oportunidade para os idosos manterem, prolongarem ou recuperarem a capacidade funcional (CF), elemento fundamental do ES. Método: foi realizada busca de artigos científicos nas bases de dados PubMed, Scopus, SciELO, LILACS, TESIUNAM. Resultados: foram encontrados 378 artigos (PubMed n=173, Scopus n=95, SciELO n=56, LILACS n=54, TESIUNAM n=17), dos quais oito atenderam aos critérios de análise qualitativa (revisão sistemática), apenas 2 estudos foram incluídos na análise quantitativa (Meta-análise). Em relação ao MA, os parâmetros incluídos; concentração de glicemia e colesterol (CL), bem como pressão arterial diastólica (PAD), índice de massa corporal (IMC) e peso. Foi assim que foi encontrada uma diminuição estatisticamente significativa após a intervenção na concentração sanguínea, TG (-40,91, IC 95% -53,90, -27,93 p<0,0001); CL (-19,39, IC95% -30,14, -8,63 p<0,0004) e PAS (-11,21 IC95% -20,29, -2,13 e p<0,02). Conclusões: Nossos resultados mostram um efeito positivo dos programas de intervenção comunitária de SE e EA na FC física, psicológica e social, embora haja uma alta heterogeneidade nos métodos, tempo de intervenção e parâmetros de medição, são realizados estudos com metodologia semelhante.

Health promotion programs in prison: attendance and role in promoting physical activity and subjective health status.

Introduction: Maintaining an inmate's health can serve as a challenge due to unhealthy background, risky behavior, and long imprisonment. This study aimed to analyze the prevalence of participation in health promotion activities among Israeli inmates and its association with their physical activity levels and subjective health status. Methods: A cross-sectional study was designed to examine 522 inmates (429 males, 93 females). The data were collected by trained face-to-face interviewers and self-report questionnaires. Results: Most of the participants (82.37%) did not meet the recommended physical activity level. Half of the participants reported that their physical activity levels decreased since they were in prison compared with 29.50% who reported that their physical activity levels increased. Physical activity and subjective health status were significantly higher among younger male inmates. Furthermore, participation in health-promoting activities was associated with higher levels of physical activity and subjective health status. Discussion: Health promotion activities may play an important role in addressing the challenges of maintaining inmate health. Implications of the findings are further discussed.

[CENTER FOR PUBLIC HEALTH AND MEDICAL PREVENTION IN MOSCOW: ISSUES OF FORMATION AND DEVELOPMENT PROSPECTS].

The authors have identified the priorities of the CPHMC based on the results of the Center's work in 2021 and the trends in the development of public health in Moscow. Along with this, the preferred directions for the development of the public health system in the city of Moscow are highlighted. Scientific research in the areas of work of the Center for Medical Health Care allows using reliable and up-to-date scientific information in the work of health care in Moscow, which makes it possible to improve not only the quality, but also the volume of work performed, projects of management decisions in the field of public health. As part of the activities of the CPHMC, it is planned to expand the range of activities related to the formation of the health of labor collectives and to draw the attention of employers to corporate public health programs to the maximum.

An Individually Tailored Program to Increase Healthy Lifestyle Behaviors among the Elderly.

A healthy lifestyle among the elderly is associated with improved health. However, many older adults are not engaging in such behavior. The purpose of the study was to develop an individually tailored online/telephone program to increase healthy lifestyle behaviors among community-dwelling elderly people. The program includes individually tailored healthy lifestyle recommendations based on participants' functional level. Community-dwelling elderly people aged 60+ years (n = 77; mean age: 72.98 ± 6.49) participated in the study. Significant associations were observed between health promotion activities and health status (r = 0.23, p = 0.04) and physical functional level (r = 0.44, p < 0.001). Twenty-seven percent of participants claimed that they learned "a lot" of new things about themselves, and 31% claimed that the recommendations received were new to them. Most participants engaged in the recommendations at least 1-2 times a week. Regression analyses showed that barriers significantly predicted reduced compliance with the health-related recommendations received (adjusted R2 = 0.18). The main barrier for compliance was inaccessible information about services (32.46% of the participants). The most prevalent facilitator for compliance with the recommendation was health behavior motivation (59.74% of the participants). In conclusion, this study provided evidence on the effectiveness of a multicomponent tailored intervention program among the elderly in increasing health-related knowledge and behavior about the recommendations.

Adolescent risk behaviours and family settings in Bulgaria: An evidence-based approach to effective family support policies.

BACKGROUND: The paper focuses on Bulgarian adolescents' behaviours that put their health at risk and their relationship to family-related characteristics: structure of family and material status, family support, communication with parents, parental monitoring and school-related parental support. It also discusses intervention programs with a focus on parent support gradient. MATERIAL AND METHODS: The analysis is based on the Bulgarian sample of Health Behaviour in School-Aged Children survey, the 2018 round. Logistic regression models of current cigarette smoking, regular alcohol consumption, sexual debut and current cannabis use are applied. Main national programs on adolescent health and the parental involvement component in them are also discussed. RESULTS: The statistical analyses reveal significant gender and age differences in Bulgarian adolescents' health risk behaviours. Girls have significantly higher odds of smoking and are less likely to report an early start of sexual life. Odds of cigarette smoking and regular alcohol consumption increase with age. Children living with one parent have significantly higher odds of smoking, regular alcohol consumption and current cannabis use. Interactions between FAS and family support reveal that students who report low family support, regardless of the material status of the family, have significantly higher odds of health risk behaviours. CONCLUSION: The main contribution of the analysis reveals the alleviating effect of family support on socio-economic inequalities between families. An evidence-based approach delineating a preventive potential of family support on Bulgarian adolescents' health risk behaviours despite the level of family affluence provides solid arguments for increasing national family support programs.

Municipal health promotion programs: is childhood obesity a concern at local level in Portugal?

Health promotion programs, targeted at distinct health outcomes such as childhood obesity, at local level are increasingly used worldwide. Therefore, there is a need to better understand the role of local governments (municipalities) as key public health promoters namely in the prevention of obesity in children. We aimed to provide some input regarding this issue in Portugal. First, we identified health-enhancing programs promoted by Portuguese municipalities in which children could participate. Then, we conducted a document analysis to provide clues about how municipalities conceptualized child health by retrieving information on which topics the programs were focused in, or acted upon, and identifying which socio-ecological model levels were addressed (or not) by each program. The 77 identified programs were promoted by 30 of the 308 Portuguese municipalities and only 11 programs addressed childhood obesity. Most programs focused in the individual health determinants and provided limited information which disabled its deeper analysis. Portuguese municipalities seem to disregard their potential as public health promoters. Childhood obesity is a major public health concern at national (and global) level but the same does not emerge locally. Municipalities are the closest government entities to the population, and it is their responsibility to ensure the population's quality of life, by addressing the social determinants and the physical environments. Therefore, municipalities should acknowledge health in their actions and delineate health improvement programs considering current evidence, specifically in the case of childhood obesity prevention that besides being a health problem in itself, is a risk factor for non-communicable diseases.

Health promotion programs at local level are increasingly used worldwide, specifically targeted at tackling childhood obesity. Thus, local governments (municipalities) become key public health promoters and play an important role in the prevention of obesity in children. We identified health-enhancing programs promoted by Portuguese municipalities in which children could participate. The 77 identified programs were promoted by 30 of the 308 Portuguese municipalities and only 11 programs addressed childhood obesity. It appears that a large number of Portuguese municipalities disregard their potential as public health promoters. Despite the clear governmental concern about childhood obesity at national level, the same does not emerge locally. Municipalities' are responsible for ensuring the population's quality of life, namely through multisectoral actions, which is particularly relevant in the prevention of childhood obesity. Therefore, all municipalities should include childhood obesity prevention in their concerns.

Barriers and facilitators to the implementation of workplace health promotion programs: Employers' perceptions.

Background: Workplace health promotion programs (WHPPs) can benefit the lifestyle and health of employees. However, not all WHPPs have been successful in their implementation, and thus their effectiveness. This study aimed to identify the barriers and facilitators to implementing an integrated WHPP, which targets multiple lifestyle factors at different levels (individual and organizational), from an employer's perspective. Methods: Data were collected by two online focus groups among 18 representatives of eight different organizations. Data from the focus group discussions were transcribed verbatim and analyzed using thematic analysis. Data were coded both inductively and deductively, using the Consolidated Framework for Implementation Research (CFIR) consisting of the following five domains: (1) intervention characteristics, (2) outer setting, (3) inner setting, (4) characteristics of individuals, and (5) process. Ratings were performed to indicate the positive or negative influence and strength of a construct regarding the implementation of WHPPs. Results: Barriers and facilitators in all domains of the CFIR were found. Regarding characteristics of the WHPP, complexity and costs hindered implementation, while high adaptability facilitated it. An organization that met the needs of employees (the outer setting) facilitated implementation. Available resources, access to knowledge, leadership involvement, and continuity of communication were facilitators within the inner setting. Barriers were different approaches to implementation within one organization and the perceived interference with employees' lives. For the implementation process, the involvement of key stakeholders, including employees, was identified as an important facilitator. Conclusion: Various barriers and facilitators in different domains play a role in the implementation of integrated WHPPs, according to employers. Strategies that tackle the identified barriers and incorporate the facilitators will likely contribute to the successful implementation of integrated WHPPs.

Interventions to promote physical and mental health of nurses in elderly care: A systematic review.

This systematic review focuses on the current evidence on interventions to promote physical and mental health in elderly care nurses. The literature was identified through the electronic databases Medline, PsycINFO and CINAHL using a combination of synonyms of the terms "elderly care nurses", "physical activity", "stress management", "occupational stress", "musculoskeletal diseases" and "incapacity to work". The search was performed in January 2020 and repeated in November 2020. N = 6 randomized controlled studies were included investigating the effect of physical activity interventions, cognitive-behavioral interventions, organizational interventions and multicomponent interventions on physical and mental health in elderly care nurses. Both, the content of the interventions and the used outcome measures were heterogeneous. Four of the included studies had a high quality. They scored same or higher than seven (out of a maximum quality score of 14) with low risks of performance and attrition bias. Results suggest that cognitive-behavioral and multicomponent interventions seem to have an influence on physical and mental health factors such as job satisfaction, burnout, mental health symptoms and neck complaints. This systematic review demonstrated the potential of health promotion programs in elderly care nurses. Nevertheless, high quality randomized controlled trials are needed. Further research should consider the bottom-up approach for planning programs as well as recommended and standardized outcome measures and interventions.

Current status and issues concerning Health Japan 21 (second term).

The national health promotion program, Health Japan 21 (second term), began in 2013. This program has set 5 basic goals: to extend healthy life expectancy and reduce health disparity, to prevent noncommunicable disease, to improve function for social life, to establish a social environment for health, and to improve lifestyle. To achieve these goals, Health Japan 21 (second term) set 53 targets for the period between 2013 and 2022. At the interim evaluation in 2018, only 21 of the 53 targets were judged likely to be achieved by 2022. In addition, 18 targets were judged as unchanged, and 1 target was judged to be deteriorating. Thus, to achieve the goals of Health Japan 21 (second term), further efforts to strengthen health promotion programs across Japan are needed.

Migrant Workers' Willingness to Participate in Workplace Health Promotion Programs: The Role of Interpersonal and Political Trust in China.

High-level willingness to participate in WHPPs (Workplace Health Promotion Programs) can not only benefit employers and employees, but also can produce many positive social effects. In order to expand the existing body of research, the effects of subject cognition, interpersonal trust, political trust, and occupational safety and health concerns were explored. We surveyed 680 Chinese migrant workers who were in charge of participation decisions in their households (2,500 residents involved) from the three typical provinces. The association of social-economic determinants with the willingness to participate and the participating behavior was studied by logistic regression analysis. We find that almost all of workers show relatively high levels of willingness to participate, while nearly seventy percent of the migrant workers had not engaged in actual participation behavior. Regression analyses revealed that subject cognition, interpersonal trust, political trust, and concern for occupational safety and health were factors significantly influencing participating subjects' willingness to engage in WHPPs. Furthermore, mediation analyses demonstrated that the influence of subject cognition was partially mediated by political trust. The influence of subject cognition was partially mediated by political trust. We discuss why political trust may impact the influence of subject cognition on the willingness to participate. Our results provided important insights for both academic and practical application.

The Association Between School Health Promotion Programs and School Wellness Policies.

OBJECTIVE: Determine school wellness policy quality and evaluate the association between health promotion programs on school wellness policy quality. METHODS: A descriptive cross-sectional study of 344 school districts in Oklahoma, a south-central region of the US. Secondary data including school districts' participation in health promotion programs for school years 2015 and 2016 and school wellness policy scores were used for this study. Descriptive statistics and Cohen d were used in the analysis. RESULTS: School wellness policies had a mean comprehensiveness score of 43.7% and a mean strength score of 21.8%. The presence of ≥3 health promotion programs had a small effect (Cohen d range = 0.20 to 0.48) on school wellness policy scores. CONCLUSIONS AND IMPLICATIONS: School wellness policies have room for improvement in both comprehensiveness and strength. Engagement in ≥3 health promotion programs may contribute to improved policy quality.

Implementation of the 'Healthier Drinks at Healthcare Facilities' strategy at a major tertiary children's hospital in Brisbane, Australia.

OBJECTIVE: The World Health Organization recommends people reduce their free sugar consumption to <10% of daily energy intake. This study aimed to determine the viability of the 'Healthier Drinks at Healthcare Facilities' strategy to reduce the amount of free sugar available in beverages and influence consumer purchasing patterns. METHODS: Beverage environment modifications at a children's hospital limited the availability of less healthy options. Using a convergent parallel mixed-methods design, sales data from retail food outlets (n=7) and vending machines (n=14) were collected from January 2017 to May 2018. Employees (n=105) and visitors (n=102) completed surveys, and retail food outlet managers (n=3) completed semi-structured interviews. Data were analysed via descriptive statistics, independent t-tests and content analysis. RESULTS: The strategy decreased the availability of less healthy beverages and resulted in a significant increase in the proportion of 'green' (healthier) beverages sold (3%, p=0.002), and a decrease in the proportion of 'red' (less healthy) beverages sold (5%, p=0.011). Overall, sales did not change (p=0.243). The majority of participants supported the strategy. CONCLUSIONS: Overall, a shift in consumer purchasing patterns resulted. Further modification of the beverage environment is encouraged to increase impact. Implications for public health: This strategy was feasible and acceptable in a healthcare setting.

Sustainable by design: a systematic review of factors for health promotion program sustainability.

BACKGROUND: Sustaining health promotion programs (HPP) is critical to maintain their intended health benefits, community capacity, and to optimize resources and investment. However, not all programs are sustained beyond their initial implementation period. This is partly due to uncertainty regarding sustainability: lack of a clear definition; infrequent use of a sustainability framework; and lack of understanding of the factors that influence sustainability. The aim of this systematic review is to identify barriers and facilitators that promote or inhibit the sustainability of HPP, particularly those that can be considered in program planning. METHODS: Two search strategies were used: 1) electronic database searching; and 2) grey literature searching. Inclusion criteria included papers published since 1998, in English, focusing on the sustainability of HPP that explicitly used a sustainability framework and specifically reported on facilitators and barriers to sustainability. Exclusion criteria included papers that addressed environmental, system or sector sustainability. Quality assessment was conducted on all included papers and a quality assessment tool was developed for grey literature. Data analysis included a thematic analysis, using an a priori framework to initially code barriers and facilitators, which were then grouped into factors for HPP sustainability. Factors were then analyzed for frequency, importance, and relevance, and categorized into one of three tiers. RESULTS: Sixteen papers were included in this review. Eleven definitions of sustainability and 13 sustainability frameworks were used. A total of 83 barriers and 191 facilitators were identified and categorized into 14 factors: nine from the a priori framework, and five additional ones based on the results of our analysis. Tier 1 factors were the most important for sustainability with organizational capacity scoring the highest; tier 3, the least important. CONCLUSION: This review provides clarity regarding existing definitions of sustainability and sustainability frameworks. It identifies fourteen factors that influence program sustainability, which practitioners can consider when planning, developing and implementing HPP. In addition, it is important for practitioners to clearly articulate program elements that should be sustained, define sustainability as it relates to the context of their program, select a sustainability framework to guide their work, and consider these factors for sustainability.

If We Build It, Will They Come? Challenges of Adapting and Implementing a Smoking Cessation Program for the LGBTQ Community in Southcentral Texas.

Studies indicate that tobacco use among lesbian, gay, bisexual, transgender, or queer (LGBTQ) community members is consistently higher than the general population. The Last Drag is a tobacco cessation program developed and implemented in 1991 in San Francisco, California, that has shown promise in assisting LGBTQ members with tobacco cessation. This article describes the practical challenges of adapting The Last Drag to be implemented in a southcentral Texas community. Primary challenges included short time line to expected implementation, issues with culturally insensitive language, and barriers to participant recruitment. Acknowledging and overcoming these challenges can assist public health educators who are addressing tobacco cessation in LGBTQ populations.

Growing from Our Roots: Strategies for Developing Culturally Grounded Health Promotion Interventions in American Indian, Alaska Native, and Native Hawaiian Communities.

Given the paucity of empirically based health promotion interventions designed by and for American Indian, Alaska Native, and Native Hawaiian (i.e., Native) communities, researchers and partnering communities have had to rely on the adaptation of evidence-based interventions (EBIs) designed for non-Native populations, a decidedly sub-optimal approach. Native communities have called for development of Indigenous health promotion programs in which their cultural worldviews and protocols are prioritized in the design, development, testing, and implementation. There is limited information regarding how Native communities and scholars have successfully collaborated to design and implement culturally based prevention efforts "from the ground up." Drawing on five diverse community-based Native health intervention studies, we describe strategies for designing and implementing culturally grounded models of health promotion developed in partnership with Native communities. Additionally, we highlight indigenist worldviews and protocols that undergird Native health interventions with an emphasis on the incorporation of (1) original instructions, (2) relational restoration, (3) narrative-[em]bodied transformation, and (4) indigenist community-based participatory research (ICBPR) processes. Finally, we demonstrate how culturally grounded interventions can improve population health when they prioritize local Indigenous knowledge and health-positive messages for individual to multi-level community interventions.

A educação e o governamento dos corpos na atualidade: uma análise do "Movimento 21 dias por uma vida mais saudável" / Education and governance of bodies today: an analysis of the "Movimento 21 dias por uma vida mais saudável"

Resumo Este trabalho teve como objetivo analisar os enunciados do programa de promoção da saúde "Movimento 21 dias por uma vida mais saudável" (M21), vinculado à Secretaria de Estado da Saúde do Espírito Santo. Para realizar tal proposta, investigamos, no período de setembro de 2015 a junho de 2017, os materiais disponíveis no site do programa, como notícias, textos, imagens, vídeos e peças publicitárias, dando ênfase aos elementos mais recorrentes. Nosso escopo de análise foi baseado no aporte foucaultiano, articulando os conceitos de biopolítica e poder pastoral com os conteúdos apresentados na página do M21. A partir das nossas leituras e análises, identificamos o uso corrente de enunciados econômicos e científicos - acionados por dados estatísticos e falas de gestores e autoridades da área da saúde - nos materiais do M21, tendo como pano de fundo traços de uma racionalidade (neo)liberal, com o intuito de propagar conselhos sobre modos de viver a vida. O conteúdo do M21 adquire um tom moralista, que coloca nos sujeitos uma responsabilidade cada vez maior por seus estilos de vida, independentemente das condições em que vivem e a que são expostos, desconsiderando, assim, fatores estruturais que incidem sobre a saúde dessas pessoas.

Abstract This paper aims at analyze the statements expressed in the program for health promotion entitled "Movimento 21 dias por uma vida mais saudável" (M21, from Portuguese "21 days for a healthier life movement"), linked to the Secretary of State for Health of Espírito (Brazil). For such, we investigated, from September 2015 to June 2017, the materials available on the program's website, such as news, texts, images, videos and advertising, focusing on recurrent elements. Our scope of analysis was based on Foucaultian framework, articulating the concepts of biopolitics and pastoral power with the content presented on M21's official webpage. Based on literature review and analyses, we identified the current use of economic and scientific statements - triggered by statistical data and statements from health managers and authorities - in the materials of M21, having traits of a (neo)liberal rationality as background, with the intention of propagating pieces of advice on ways of living life. The content of M21 carries a moralistic tone, which assigns individuals a growing responsibility for their lifestyles, regardless of the conditions in which they live and to which they are exposed, thus disregarding structural factors that affect those people's health.

Work-Related Burdens and Requirements for Health Promotion Programs for Nursing Staff in Different Care Settings: A Cross-Sectional Study.

Nursing staff in all settings have multiple work-related problems due to patient handling and occupational stressors, which result in high stress levels and low back pain. In this context the importance of health promotion becomes apparent. The aim of this study is to analyse whether nursing staff (in elderly care, hospitals, home care, or trainees) show different levels of work-related burdens and whether they require individualized components in health promotion programs. N = 242 German nurses were included in a quantitative survey (Health survey, Screening Scale (SSCS) of Trier Inventory for Chronic Stress, Slesina). The differences were tested using Chi2-Tests, Kruskal-Wallis Test and one-way ANOVA. Nurses differed in stress loads and were chronically stressed (F(3236) = 5.775, p = 0.001). Nurses in home care showed the highest SSCS-values with time pressure as the most important straining factor. The physical strains also placed a particular burden on nurses in home care, whereas they still reported higher physical well-being in contrast to nurses in elderly care (Chi2 = 24.734, p < 0.001). Nurses in elderly care and home care preferred strength training whereas nurses in hospitals and trainees favoured endurance training. Targeted programs are desirable for the reduction of work-related burdens. While nurses in elderly care and home care need a combination of ergonomic and strength training, all nurses require additional stress management. Planning should take into account barriers like perceived additional time consumption. Therefore, health promotion programs for all settings should be implemented during working time at the work setting and should consider the working schedule.

Clinical Effectiveness and Cost-Effectiveness of Oral-Health Promotion in Dental Caries Prevention among Children: Systematic Review and Meta-Analysis.

The objective of this study was to evaluate the clinical effectiveness and cost-effectiveness of oral-health promotion programs (OHPPs) aiming to improve children's knowledge of favorable oral health behavior to lower decayed/-missing/-filled teeth (DMFT) while reducing the financial cost on health institutions. An electronic search was performed in seven databases. Studies were restricted to human interventions published in English. The search study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, and the risk of bias was assessed based on the Drummonds Checklist. A total of 1072 references were found. Among these, 19 full texts were included. Most studies had a strong quality. The overall pooled impact of OHPPs estimates children suffering from DMFT/S to have 81% lower odds of participating in OHPP (95% CI 61-90%, I2: 98.3%, p = 0). Furthermore, the program was shown to be effective at lowering the cost in 97 out of 100 OHPPs (95% CI 89-99%, I2: 99%, p = 0). Three subgroups analyses (age groups, study countries, studies of the last five years) were performed to evaluate the influence modification on the pooled effect. A comprehensive analysis of the OHPPs confirmed a reduction effect on child DMFT, hence, lowering the financial burden of dental-care treatment on health institutions.