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1.
Rev Med Suisse ; 16(694): 1049-1055, 2020 May 20.
Artículo en Francés | MEDLINE | ID: mdl-32432423

RESUMEN

Global warming is considered by most scientists as one of the greatest public health threats of the 21st century. Some individual behaviours and consumption habits related to the food and mobility sectors are responsible for a high amount of CO2 emissions, the main greenhouse gas. Thus, some messages promoted by health professionals will have an impact on the fight against the epidemic of lifestyle-related chronic diseases but will also have an environmental co-benefit. With a population increasingly aware of current environmental issues, environmental considerations could be an additional motivating factor for patients when promoting a healthier diet or physical activity.


Asunto(s)
Agricultura/estadística & datos numéricos , Dieta/estadística & datos numéricos , Calentamiento Global/estadística & datos numéricos , Promoción de la Salud/estadística & datos numéricos , Salud Pública/estadística & datos numéricos , Ejercicio Físico , Humanos
3.
PLoS One ; 14(12): e0225694, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31790483

RESUMEN

Community mobilization has been recognized as a critical enabler for HIV prevention and is employed for challenging gender inequalities. We worked together with community partners to implement the 'One Man Can' intervention in rural Mpumalanga, South Africa to promote gender equality and HIV risk reduction. During the intervention, we conducted longitudinal qualitative interviews and focus group discussions with community mobilizers (n = 26), volunteer community action team members (n = 22) and community members (n = 52) to explore their experience of being part of the intervention and their experiences of change associated with the intervention. The objective of the study was to examine processes of change in community mobilization for gender equity and HIV prevention. Our analysis showed that over time, participants referred to three key elements of their engagement with the intervention: developing respect for others; inter-personal communication; and empathy. These elements were viewed as assisting them in adopting a 'better life' and associated with behaviour change in the intervention's main focus areas of promoting gender equality and HIV risk reduction behaviours. We discuss how these concepts relate to the essential domains contained within our theoretical framework of community mobilization-specifically critical consciousness, shared concerns and social cohesion -, as demonstrated in this community. We interpret the focus on these key elements as significant indicators of communities engaging with the community mobilization process and initiating movement towards structural changes for HIV prevention.


Asunto(s)
Redes Comunitarias/organización & administración , Participación de la Comunidad/estadística & datos numéricos , Infecciones por VIH/prevención & control , Conducta de Reducción del Riesgo , Sexismo/prevención & control , Adolescente , Adulto , Redes Comunitarias/estadística & datos numéricos , Enfermedades Endémicas/prevención & control , Femenino , Infecciones por VIH/epidemiología , Promoción de la Salud/organización & administración , Promoción de la Salud/estadística & datos numéricos , Humanos , Liderazgo , Masculino , Prevalencia , Población Rural/estadística & datos numéricos , Sexismo/estadística & datos numéricos , Factores Socioeconómicos , Sudáfrica/epidemiología , Adulto Joven
4.
Adv Gerontol ; 32(4): 652-657, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31800196

RESUMEN

This study examines older adults' perceptions about their participation in vigorous physical activity (VPA) and the association between VPA and self-related health. A total of 686 older adults responded to self-reported questionnaires, and Pearson's ꭓ2 test and binary logistic regression were used to present findings. About 74% of older adults reported experiencing dislocations, fractures, or/and other forms of injury in intense physical activities lasting 30 minutes or more a day. After controlling for relevant socio-demographic factors, older adults who participated in VPA for 30 or more minutes a day were less likely (OR=0,129; p=0,000) to report good health compared with those who participated in VPA for less than 30 minutes. It is concluded that VPA in older populations can result in casualties that may compel older adults to underrate their health, which can discourage active living habits in older populations and discredit PA/health promotion programs.


Asunto(s)
Ejercicio Físico , Geriatría , Promoción de la Salud , Heridas y Traumatismos , Anciano , Ejercicio Físico/psicología , Geriatría/tendencias , Promoción de la Salud/estadística & datos numéricos , Promoción de la Salud/tendencias , Humanos , Luxaciones Articulares/psicología , Autoimagen , Autoinforme , Encuestas y Cuestionarios , Heridas y Traumatismos/psicología
5.
Artículo en Inglés | MEDLINE | ID: mdl-31861367

RESUMEN

BACKGROUND: Prior research has investigated various strategies to improve health, wellbeing and the job-related outcomes of nurses. However, the scope of this evidence is not clear and the types of intervention most likely to have positive outcomes are unknown. OBJECTIVE: To provide an overview and synthesis of the effectiveness of interventions conducted with the goal of improving health, wellbeing and the job-related outcomes of nurses. METHODS: A systematic database search was conducted from January 2000 to December 2018, with pre-defined criteria (Cochrane Central Register of Controlled Trials; MEDLINE and PubMed; EMBASE; CINAHL; PsycINFO; and BioMed Central). In total, 136 intervention studies with a total sample of 16,129 participants (range 9-3381) were included and evaluated. Data extraction, quality assessment and risk of bias analyses were performed. RESULTS: Studies included randomised controlled trials (RCTs; n = 52, 38%), randomised crossover design studies (n = 2, 1.5%) and non-randomised pre-post studies with a control group (n = 31, 23%) and without a control group (n = 51, 37.5%). The majority of interventions focused on education, physical activity, mindfulness, or relaxation. Thirty-seven (27%) studies had a multimodal intervention approach. On average, studies had relatively small samples (median = 61; mode = 30) and were conducted predominantly in North America (USA/Canada, n = 53). The findings were mixed overall, with some studies reporting benefits and others finding no effects. Dietary habits was the most successfully improved outcome (8/9), followed by indices of body composition (20/24), physical activity (PA) (11/14), and stress (49/66), with >70% of relevant studies in each of these categories reporting improvements. The lowest success rate was for work-related outcomes (16/32). Separate analysis of RCTs indicated that interventions that focus solely on education might be less likely to result in positive outcomes than interventions targeting behavioural change. CONCLUSIONS: Interventions targeting diet, body composition, PA, or stress are most likely to have positive outcomes for nurses' health and/or wellbeing. The methodologically strongest evidence (RCTs) is available for body composition and stress. Interventions relying solely on educational approaches are least likely to be effective. Organisational outcomes appear to be more challenging to change with lifestyle intervention, likely requiring more complex solutions including changes to the work environment. There is a need for more high-quality evidence since many studies had moderate or high risk of bias and low reporting quality.


Asunto(s)
Ejercicio Físico , Promoción de la Salud/estadística & datos numéricos , Estilo de Vida , Atención Plena/estadística & datos numéricos , Enfermeras y Enfermeros/estadística & datos numéricos , Relajación , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad
6.
Rev. Paul. Pediatr. (Ed. Port., Online) ; 37(4): 486-493, Oct.-Dec. 2019. graf
Artículo en Inglés | LILACS | ID: biblio-1041358

RESUMEN

ABSTRACT Objective: To describe the experience of the 25-year-old trajectory of the Baby Friendly Hospital Initiative (BFHI) in Brazil. The first unit was implemented in 1992. Methods: Information and data were collected from publications on the World Health Organization (WHO), the United Nations International Children's Emergency Fund (UNICEF) and the Ministry of Health websites and in national and international journals, about the period 1990-2017. The descriptors used were: "iniciativa hospital amigo da criança", "hospital amigo da criança", "baby friendly initiative hospital", "aleitamento materno" and "breastfeeding". The number of hospitals in the 25 years, the course of the BFHI and its repercussions on breastfeeding in Brazil were evaluated. Results: The BFHI is an intervention strategy in hospital care at birth focused on the implementation of practices that promote exclusive breastfeeding from the first hours of life and with the support, among other measures of positive impact on breastfeeding, of the International Code of Marketing of Breastmilk Substitutes. Currently, the initiative has been revised, updated and expanded to integrate care for newborns in neonatal units and care for women since prenatal care. It can be concluded that, during these 25 years, the quantity of hospitals varied greatly, with numbers still below the capacity of hospital beds. BFHI shows higher rates of breastfeeding than non-accredited hospitals. However, the number of hospitals are still few when compared to other countries. Conclusions: The BFHI has contributed to breastfeeding in Brazil in recent decades. Greater support for public policies is needed to expand the number of accredited institutions in the country.


RESUMO Objetivo: Descrever a experiência de 25 anos da Iniciativa Hospital Amigo da Criança (IHAC) no Brasil, cuja primeira unidade foi implementada em 1992. Métodos: Informações e dados foram obtidos em publicações nos sites da Organização Mundial da Saúde (OMS), do Fundo Internacional de Emergência para a Infância das Nações Unidas (UNICEF) e do Ministério da Saúde e em periódicos nacionais e internacionais, abrangendo o período de 1990 a 2017. Utilizaram-se os descritores: "iniciativa hospital amigo da criança", "hospital amigo da criança", "baby friendly initiative hospital", "aleitamento materno" e "breastfeeding". Foram avaliados o número de hospitais nos 25 anos, a trajetória da IHAC e suas repercussões sobre o aleitamento materno no Brasil. Resultados: A IHAC é uma estratégia de intervenção na assistência hospitalar ao nascimento com foco na implementação de práticas que promovem o aleitamento materno exclusivo desde as primeiras horas de vida e com o apoio, entre outras medidas de impacto positivo na amamentação, do Código Internacional de Comercialização de Substitutos do Leite Materno. Atualmente, a iniciativa foi revisada, atualizada e expandida para integrar o cuidado aos recém-nascidos nas unidades neonatais e na atenção à mulher desde o pré-natal. Pôde-se concluir que, ao longo desses 25 anos, a quantidade de hospitais variou muito, com números ainda aquém da capacidade de leitos hospitalares. Hospitais credenciados como o Hospital Amigo da Criança mostram índices de amamentação superiores ao de hospitais não credenciados, entretanto o número de hospitais credenciados no Brasil ainda é pouco se comparado com outros países. Conclusões: A IHAC contribuiu para o aleitamento materno no Brasil nessas últimas décadas. Mais apoio pelas políticas públicas é necessário para ampliar o número de instituições credenciadas no país.


Asunto(s)
Humanos , Femenino , Embarazo , Recién Nacido , Adulto , Lactancia Materna/métodos , Lactancia Materna/estadística & datos numéricos , Promoción de la Salud/normas , Hospitales/normas , Cuidado del Lactante/normas , Brasil , Mejoramiento de la Calidad/estadística & datos numéricos , Promoción de la Salud/métodos , Promoción de la Salud/estadística & datos numéricos , Cuidado del Lactante/métodos , Cuidado del Lactante/estadística & datos numéricos
7.
Rural Remote Health ; 19(4): 5449, 2019 11.
Artículo en Inglés | MEDLINE | ID: mdl-31760754

RESUMEN

Evaluation expertise to assist with identifying improvements, sourcing relevant literature and facilitating learning from project implementation is not routinely available or accessible to not-for-profit organisations. The right information, at the right time and in an appropriate format, is not routinely available to program managers. Program management team members who were implementing The Fred Hollows Foundation's Indigenous Australia Program's Trachoma Elimination Program required information about what was working well and what required improvement. This article describes a way of working where the program management team and an external evaluation consultancy collaboratively designed and implemented an utilisation-focused evaluation, informed by a developmental evaluation approach. Additionally, principles of knowledge translation were embedded in this process, thereby supporting the evaluation to translate knowledge into practice. The lessons learned were that combining external information and practice-based knowledge with local knowledge and experience is invaluable; it is useful to incorporate evaluative information from inception and for the duration of a program; a collaborative working relationship can result in higher quality information being produced and it is important to communicate findings to different audiences in different formats.


Asunto(s)
Promoción de la Salud/organización & administración , Servicios de Salud del Indígena/organización & administración , Hospitales Filantrópicos/organización & administración , Grupo de Ascendencia Oceánica/estadística & datos numéricos , Calidad de la Atención de Salud/organización & administración , Australia , Promoción de la Salud/estadística & datos numéricos , Servicios de Salud del Indígena/estadística & datos numéricos , Hospitales Filantrópicos/estadística & datos numéricos , Humanos , Calidad de la Atención de Salud/estadística & datos numéricos
8.
BMC Public Health ; 19(1): 1588, 2019 Nov 28.
Artículo en Inglés | MEDLINE | ID: mdl-31779598

RESUMEN

BACKGROUND: In response to the chronic disease burden, web- and community-based programs have the potential to address targeted behaviors, such as physical activity (PA), using a novel approach with large audiences. The purpose of this study was to preliminarily evaluate an established team centered, web-based community PA program in Texas. METHODS: Walk Across Texas! (WAT!) is an eight-week community program delivered through a web-based platform to help people of various ages and abilities establish the habit of regular PA. Teams are challenged to walk a minimum of 832 miles. Changes in self-reported PA (miles/week; days/week) and leisure-time sitting (hours/day) were examined from 11,116 adult participants who participated in the program in 2016. Further analysis determined changes in physical activity (miles/week) between groups of pre-program assessment self-reported physical activity levels (0, 1-2, 3-4, or 5-7 days/week). Statistical analysis included paired-sample t-tests, repeated measures ANOVA and participant descriptors for PA change. RESULTS: Overall, mean changes in PA in all variables were statistically significant (p < .001), with the largest, clinically significant changes in submitted miles/week (mean increase of 4.89 ± 20.92). Self-reported PA increased 0.63 ± 2.89 days/week, while leisure-time sitting decreased less than 1 h per day (0.87 ± 1.86 h/day). All sub-groups (inactive, low active, active, high active at pre-program assessment) increased in self-reported miles per week, on average. Both the inactive and low-active groups experienced a statistically significant increase in mileage from week 1 to week 8 (5.48 miles/week or 12,330 steps /week, and 3.91 miles/week or 8797 steps /week, respectively). CONCLUSIONS: The results provide initial support for the effectiveness of WAT! to initially increase and maintain moderate levels of PA of participants over 8-weeks, even in inactive or low-active participants. Descriptor variables were unable to differentiate between those who increased PA and those who did not. However; the results provide a canvas for future research questions regarding PA enhancement within a team-centered, web-based approach.


Asunto(s)
Promoción de la Salud/estadística & datos numéricos , Intervención basada en la Internet/estadística & datos numéricos , Adulto , Ejercicio Físico , Femenino , Promoción de la Salud/métodos , Humanos , Actividades Recreativas , Masculino , Persona de Mediana Edad , Evaluación de Programas y Proyectos de Salud , Conducta Sedentaria , Autoinforme , Texas , Caminata
9.
Res Theory Nurs Pract ; 33(4): 357-391, 2019 11 01.
Artículo en Inglés | MEDLINE | ID: mdl-31666394

RESUMEN

BACKGROUND AND PURPOSE: Dialysis involves a complex regimen including diet, fluid, medication, and treatment. Therapeutic regimen adherence determines the therapeutic success, quality of life, and survival of patients on dialysis. Complying with fluid management is the most difficult among the therapeutic regimen. Several theory-based interventions have been designed to promote fluid intake compliance in patients receiving dialysis. This review has two aims. One is to explore the effectiveness of theory-based interventions. The other is to examine the extent of the combination of theory and interventions in improving adherence to fluid intake among dialysis patients. METHODS: A literature review was performed using PubMed, PsycINFO, Embase, Web of Science, and the Cochrane Library to acquire associated studies. Data were extracted independently by two researchers. The degree of theory application was accessed using a theory coding scheme (TCS). RESULTS: Eight studies were identified as eligible for inclusion, and five theories were cited as basis (health belief model, social cognitive theory, self-regulation model, transtheoretical model). According to the TCS, adherence outcomes and the extent of theory use were not optimal. IMPLICATIONS FOR PRACTICE: Combining theory with patient health education might be beneficial in improving fluid intake adherence of dialysis patients. The framework and TCS could be considered to guide theory utilization and promote nursing education in improving the quality of renal nursing care.


Asunto(s)
Fluidoterapia/métodos , Fluidoterapia/psicología , Promoción de la Salud/métodos , Cooperación del Paciente/psicología , Cooperación del Paciente/estadística & datos numéricos , Diálisis Renal/métodos , Autocuidado/psicología , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Promoción de la Salud/estadística & datos numéricos , Humanos , Masculino , Persona de Mediana Edad , Calidad de Vida/psicología , Diálisis Renal/estadística & datos numéricos , Autocuidado/estadística & datos numéricos
10.
Int J Equity Health ; 18(1): 169, 2019 11 05.
Artículo en Inglés | MEDLINE | ID: mdl-31690340

RESUMEN

OBJECTIVE: This narrative review aimed to identify and categorize the barriers and facilitators to the provision of brief intervention and behavioral change programs that target several risk behaviors among the Indigenous populations of Australia, Canada, and New Zealand. METHODS: A systematic database search was conducted of six databases including PubMeD, Embase, CINAHL, HealthStar, PsycINFO, and Web of Science. Thematic analysis was utilized to analyze qualitative data extracted from the included studies, and a narrative approach was employed to synthesize the common themes that emerged. The quality of studies was assessed in accordance with the Joanna Briggs Institute's guidelines and using the software SUMARI - The System for the Unified Management, Assessment and Review of Information. RESULTS: Nine studies were included. The studies were classified at three intervention levels: (1) individual-based brief interventions, (2) family-based interventions, and (3) community-based-interventions. Across the studies, selection of the intervention level was associated with Indigenous priorities and preferences, and approaches with Indigenous collaboration were supported. Barriers and facilitators were grouped under four major categories representing the common themes: (1) characteristics of design, development, and delivery, (2) patient/provider relationship, (3) environmental factors, and (4) organizational capacity and workplace-related factors. Several sub-themes also emerged under the above-mentioned categories including level of intervention, Indigenous leadership and participation, cultural appropriateness, social and economic barriers, and design elements. CONCLUSION: To improve the effectiveness of multiple health behavior change interventions among Indigenous populations, collaborative approaches that target different intervention levels are beneficial. Further research to bridge the knowledge gap in this topic will help to improve the quality of preventive health strategies to achieve better outcomes at all levels, and will improve intervention implementation from development and delivery fidelity, to acceptability and sustainability.


Asunto(s)
Ejercicio Físico , Promoción de la Salud/métodos , Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Estado Nutricional , Educación del Paciente como Asunto/métodos , Fumar Tabaco/terapia , Australia , Canadá , Promoción de la Salud/estadística & datos numéricos , Humanos , Nueva Zelanda , Grupos de Población , Cese del Hábito de Fumar/métodos , Cese del Hábito de Fumar/estadística & datos numéricos , Fumar Tabaco/prevención & control
11.
Rural Remote Health ; 19(4): 5249, 2019 11.
Artículo en Inglés | MEDLINE | ID: mdl-31670971

RESUMEN

INTRODUCTION: Research has not been conducted on physical activity in early child education and care (ECEC) settings in low-income, rural communities in South Africa. This study aimed to describe the physical activity environment of these settings and identify child and contextual factors associated with physical activity in these settings. By understanding physical activity in this environment, it will be possible to identify context-specific opportunities, including with teachers, to overcome potential challenges and maximise physical activity in a low- and middle-income country setting. METHODS: The study was conducted in rural Bushbuckridge, Mpumalanga in 2014. Preschool-aged children (n=55) were recruited from five ECEC settings, including three preschools and two primary schools, where preschool-aged children are in their reception year, grade R. Preschool environment characteristics were assessed using an observational tool adapted from existing tools. Children's physical activity was assessed using the Observational System for Recording Physical Activity in Children - Preschool Version. Differences between preschool and grade R settings were assessed using χ2 analyses, and multinomial logistic regression analysis was used to determine factors associated with physical activity in the ECEC settings. RESULTS: The physical activity environment differed between preschool and grade R ECEC settings in terms of space (preschoolpgrade R, p<0.001). On average, children spent 28.7% of their day in the ECEC settings engaged in physical activity, of which 22.3% was moderate- to vigorous-intensity physical activity (MVPA). Children spent the greatest proportion of the day in sedentary activities (69.9%) and this differed significantly between preschool (63.2%) and grade R children (81.3%, p<0.001). Preschool children were significantly more active than grade R children, and spent greater proportions of time in light-intensity physical activity (8.6% v 2.7%, p<0.001) and MVPA (25.4% v 15.3%, p<0.001). Irrespective of ECEC setting, children were significantly more likely to participate in MVPA if they were outdoors (p=0.001), and significantly less likely to do MVPA if they were overweight/obese (p=0.006). CONCLUSION: These findings provide insight into child-level and contextual factors associated with preschool-aged children's physical activity within ECEC settings in a low-income, rural community in South Africa. Particularly, the physical and social features of ECEC settings are important in the promotion of physical activity. Findings from this study suggest that it is necessary to upskill and encourage teachers in ECEC settings to maximise opportunities for physical activity in rural low-income communities in South Africa.


Asunto(s)
Cuidado del Niño/normas , Ejercicio Físico/psicología , Promoción de la Salud/métodos , Promoción de la Salud/estadística & datos numéricos , Pobreza/estadística & datos numéricos , Guías de Práctica Clínica como Asunto , Población Rural/estadística & datos numéricos , Escuelas de Párvulos/normas , Niño , Preescolar , Femenino , Humanos , Masculino , Factores Socioeconómicos , Sudáfrica
12.
PLoS One ; 14(11): e0224427, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31693703

RESUMEN

BACKGROUND: Most parents with young children pay routine visits to Well-Baby Clinics, or so-called Preventive Child Health Care (PCHC) services. This offers a unique opportunity to promote and deliver interconception care. This study aimed to integrate such care and perform an implementation evaluation. METHODS: In seven Dutch municipalities, PCHC professionals were instructed to discuss the possibility of an interconception care consultation during each routine six-months well-baby visit. The primary outcome of this study was coverage of the intervention, quantified as the proportion of visits during which women were informed about interconception care. Secondary outcomes included adoption, fidelity, feasibility, appropriateness, acceptability and effectiveness of the intervention, studied by surveying PCHC professionals and women considering becoming pregnant. RESULTS: The possibility of interconception care was discussed during 29% (n = 1,849) of all visits, and 60% of the PCHC physicians adopted the promotion of interconception care by regularly informing women. About half of the PCHC professionals and most women judged integration of interconception care in PCHC appropriate and acceptable. Estimated feasibility was poor, since 13% of the professionals judged future integration in daily practice as probable. The uptake of interconception care consultations was low (n = 4 consultations). CONCLUSIONS: Promotion of interconception care was achieved in approximately one-third of the routine PCHC consultations and appeared promising with regards to adoption, appropriateness and acceptability. However, concerns on feasibility and uptake of interconception care consultations in daily practice remain. Suggestions for improvement may include further integration of interconception care health promotion in routine PCHC consultations, while allocating sufficient resources.


Asunto(s)
Servicios de Salud del Niño/organización & administración , Promoción de la Salud/organización & administración , Atención Preconceptiva/organización & administración , Atención Prenatal/organización & administración , Servicios Preventivos de Salud/organización & administración , Adolescente , Adulto , Anciano , Salud del Niño , Servicios de Salud del Niño/estadística & datos numéricos , Femenino , Personal de Salud/estadística & datos numéricos , Implementación de Plan de Salud , Promoción de la Salud/estadística & datos numéricos , Humanos , Recién Nacido , Persona de Mediana Edad , Atención Preconceptiva/estadística & datos numéricos , Embarazo , Atención Prenatal/estadística & datos numéricos , Servicios Preventivos de Salud/estadística & datos numéricos , Adulto Joven
13.
Rural Remote Health ; 19(4): 5524, 2019 11.
Artículo en Inglés | MEDLINE | ID: mdl-31766852

RESUMEN

INTRODUCTION: Lifelong health behaviour habits are often consolidated in adolescence, with primary health care an important element of current and future health and wellbeing. Barriers to adolescent primary healthcare access are complex and include social, behavioural and geographical issues as well as organisational and systemic barriers. METHOD: This article describes the first year of implementation of a Doctors in Secondary School program in a rural setting in Victoria, Australia. RESULTS: The program provided 332 primary healthcare appointments over 10 months, equating to 102.33 hours of general practitioner contact with students. The program offered scheduled and unscheduled (drop-in) appointments with above-average consultation times. Cancellations and 'no-shows' were low, at 9% overall. Health promotion resources, material and information, were sourced and provided by the clinic practice nurse. CONCLUSION: The role of the practice nurse has been instrumental in providing a needs-based service for students, connecting to local and regional health and community services. Adolescents in rural areas require holistic primary care including provision of resources, basic wellbeing needs and advocacy. Programs to support rural adolescents should be integrated across the strengths and opportunities that exist in each unique context.


Asunto(s)
Promoción de la Salud/métodos , Promoción de la Salud/estadística & datos numéricos , Médicos/estadística & datos numéricos , Población Rural/estadística & datos numéricos , Servicios de Salud Escolar/organización & administración , Servicios de Salud Escolar/estadística & datos numéricos , Instituciones Académicas/estadística & datos numéricos , Adolescente , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudiantes/estadística & datos numéricos , Victoria
14.
Am J Public Health ; 109(12): 1739-1746, 2019 12.
Artículo en Inglés | MEDLINE | ID: mdl-31622155

RESUMEN

Objectives. To determine whether (1) participating in HealthLinks, and (2) adding wellness committees to HealthLinks increases worksites' evidence-based intervention (EBI) implementation.Methods. We developed HealthLinks to disseminate EBIs to small, low-wage worksites. From 2014 to 2017, we conducted a site-randomized trial in King County, Washington, with 68 small worksites (20-200 employees). We assigned worksites to 1 of 3 arms: HealthLinks, HealthLinks plus wellness committee (HealthLinks+), or delayed control. At baseline, 15 months, and 24 months, we assessed worksites' EBI implementation on a 0% to 100% scale and employees' perceived support for their health behaviors.Results. Postintervention EBI scores in both intervention arms (HealthLinks and HealthLinks+) were significantly higher than in the control arm at 15 months (51%, 51%, and 23%, respectively) and at 24 months (33%, 37%, and 24%, respectively; P < .001). Employees in the intervention arms perceived greater support for their health at 15 and 24 months than did employees in control worksites.Conclusions. HealthLinks is an effective strategy for disseminating EBIs to small worksites in low-wage industries.Public Health Implications. Future research should focus on scaling up HealthLinks, improving EBI maintenance, and measuring impact of these on health behavior.


Asunto(s)
Conductas Relacionadas con la Salud , Promoción de la Salud/organización & administración , Servicios de Salud del Trabajador/organización & administración , Pequeña Empresa/organización & administración , Lugar de Trabajo/organización & administración , Adolescente , Adulto , Anciano , Medicina Basada en la Evidencia , Femenino , Promoción de la Salud/estadística & datos numéricos , Humanos , Masculino , Persona de Mediana Edad , Servicios de Salud del Trabajador/estadística & datos numéricos , Evaluación de Programas y Proyectos de Salud , Pequeña Empresa/estadística & datos numéricos , Washingtón , Lugar de Trabajo/estadística & datos numéricos , Adulto Joven
15.
Artículo en Inglés | MEDLINE | ID: mdl-31597340

RESUMEN

The asset-based community development (ABCD) approach have been widely used to map local assets and to ensure participation of local communities in public health promotion strategies. Participatory practices, such as ABCD, have been applied to shift public health strategies towards addressing health inequities. In this meta-synthesis, we ask if, and how, ABCD enhance the level of participation for children, youth and schools. Three thousand eight hundred eight titles and abstracts were identified in ten databases and transferred to the online program Rayyan. Through a blinded process we excluded texts that did not meet the inclusion criteria. The twelve included texts on ABCD for children, youth and schools are of varying quality. The research on ABCD for children, youth and schools have not been cumulative. Nevertheless, the texts show that ABCD provides strategies that enhance the participation of children, youth, and schools, in health promotion projects. The projects were categorized according to Robert Hart's classical participation ladder, and we found that the projects with the highest level of adherence to ABCD principles also had the highest level of participation. The projects with high levels of participation were supported by adult facilitators that created learning environments where children and youth developed their participatory skills.


Asunto(s)
Conducta del Adolescente , Conducta Infantil , Participación de la Comunidad/estadística & datos numéricos , Promoción de la Salud/estadística & datos numéricos , Factores Socioeconómicos , Adolescente , Niño , Femenino , Humanos , Masculino , Investigación Cualitativa
16.
J Am Assoc Nurse Pract ; 31(10): 575-582, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31567835

RESUMEN

BACKGROUND AND PURPOSE: Heart disease is the leading cause of mortality for American women, claiming 289,753 lives annually. Research has show that female veterans are more sedentary after separating from service and that mobile apps can assist in increasing physical activity. The purposes of this study were to: 1) implement a mobile application to increase physical activity, 2) compare the exercise data, and 3) determine the sustainability of using a mobile application in female active duty soldiers, military retirees, and veterans with prior service. METHODS: A convenience sample of 30 participants, aged 19-64 years, was recruited from the Womack Army Medical Center, Fort Bragg, North Carolina. Active duty soldiers, retired military, and family members are eligible for care at Womack. Six of the participants with prior military service are spouses of active duty and retired military and were included in the sample. The participants documented the type of physical activity and amount of time exercised over 12 weeks using the closed discussion group. Clinically significant differences were demonstrated in individual averages of minutes exercised per week in the group of veterans (n = 4; Z = -0.944, p = .345, r = 0.3) and active duty group (n = 5; Z = -1.826, p = .068, r = 0.65). CONCLUSIONS: The study did not demonstrate a statistically significant increase in physical activity using technology. IMPLICATIONS FOR PRACTICE: Mobile technology provides nurse practitioners with tools to empower patients. The use of technology to increase physical activity is relatively new and continues to evolve.


Asunto(s)
Ejercicio Físico/psicología , Promoción de la Salud/métodos , Veteranos/psicología , Adulto , Femenino , Promoción de la Salud/estadística & datos numéricos , Humanos , Persona de Mediana Edad , North Carolina , Veteranos/estadística & datos numéricos
17.
J Altern Complement Med ; 25(12): 1156-1162, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31638407

RESUMEN

Objectives: The main purpose of this study was to measure the effect of a single session of Reiki on physical and psychological health in a large nonclinical sample. Design: The study design was a single arm effectiveness trial with measures at pre-and postintervention. Settings: The study took place at private Reiki practices across the United States. Subjects: Reiki practitioners were recruited from an online mailing list to participate in the study with their Reiki clients. A total of 99 Reiki practitioners met the inclusion criteria and participated in the study. Reiki practitioners were instructed to give a flyer to each of their Reiki clients that contained information about the study and invited the client to complete a survey before and after their Reiki session. Interventions: Trained and certified Reiki Masters conducted the Reiki sessions in person, with each session lasting between 45 and 90 min. Outcome measures: The well-validated 20-item Positive and Negative Affect Schedule was used to assess affect, and brief, single-item self-report measures were used to assess a wide range of physical and psychological variables immediately before (pre) and after (post) the Reiki session. Results: A total of N = 1411 Reiki sessions were conducted and included in the analysis. Statistically significant improvements were observed for all outcome measures, including positive affect, negative affect, pain, drowsiness, tiredness, nausea, appetite, shortness of breath, anxiety, depression, and overall well-being (all p-values <0.001). Conclusions: The results from this large-scale multisite effectiveness trial suggest that a single session of Reiki improves multiple variables related to physical and psychological health.


Asunto(s)
Tacto Terapéutico , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Ansiedad , Apetito , Depresión , Disnea , Estudios de Factibilidad , Femenino , Promoción de la Salud/economía , Promoción de la Salud/métodos , Promoción de la Salud/estadística & datos numéricos , Humanos , Masculino , Salud Mental , Persona de Mediana Edad , Manejo del Dolor/economía , Manejo del Dolor/estadística & datos numéricos , Proyectos de Investigación , Encuestas y Cuestionarios , Tacto Terapéutico/economía , Tacto Terapéutico/estadística & datos numéricos , Resultado del Tratamiento , Adulto Joven
18.
Int J Behav Nutr Phys Act ; 16(1): 94, 2019 10 28.
Artículo en Inglés | MEDLINE | ID: mdl-31661004

RESUMEN

BACKGROUND: Insufficient physical activity, short sleep duration, and excessive recreational screen time are increasing globally. Currently, there are little to no data describing prevalences and correlates of movement behaviours among children in low-middle-income countries. The few available reports do not include both urban and rural respondents, despite the large proportion of rural populations in low-middle-income countries. We compared the prevalence of meeting 24-h movement guidelines and examined correlates of meeting the guidelines in a sample of urban and rural Mozambican schoolchildren. METHODS: This is cross-sectional study of 9-11 year-old children (n = 683) recruited from 10 urban and 7 rural schools in Mozambique. Moderate- to vigorous-intensity physical activity (MVPA) and sleep duration were measured by waist-worn Actigraph GT3X+ accelerometers. Accelerometers were worn 24 h/day for up to 8 days. Recreational screen time was self-reported. Potential correlates of meeting 24-h movement guidelines were directly measured or obtained from validated items of context-adapted questionnaires. Multilevel multivariable logit models were used to determine the correlates of movement behaviours. Meeting 24-h movement guidelines was defined as ≥60 min/day of MVPA, ≤2 h/day of recreational screen time, and between 9 and 11 h/night of sleep. RESULTS: More rural (17.7%) than urban (3.6%) children met all three 24-h movement guidelines. Mean MVPA was lower (82.9 ± 29.5 min/day) among urban than rural children (96.7 ± 31.8 min/day). Rural children had longer sleep duration (8.9 ± 0.7 h/night) and shorter recreational screen time (2.7 ± 1.9 h/day) than their urban counterparts (8.7 ± 0.9 h/night and 5.0 ± 2.3 h/day respectively). Parental education (OR: 0.37; CI: 0.16-0.87), school location (OR: 0.21; CI: 0.09-0.52), and outdoor time (OR: 0.67; CI: 0.53-0.85) were significant correlates of meeting all three 24-h movement guidelines. CONCLUSIONS: Prevalence and correlates of meeting movement guidelines differed between urban and rural schoolchildren in Mozambique. On average, both groups had higher daily MVPA minutes, shorter sleep duration, and higher recreational screen time than the 24-h movement guidelines recommend. These findings (e.g., higher than recommended mean daily MVPA minutes) differ from those from high-income countries and highlight the need to sample from both urban and rural areas.


Asunto(s)
Ejercicio Físico , Promoción de la Salud/estadística & datos numéricos , Población Rural/estadística & datos numéricos , Instituciones Académicas/estadística & datos numéricos , Población Urbana/estadística & datos numéricos , Niño , Estudios Transversales , Monitores de Ejercicio , Humanos , Mozambique/epidemiología , Prevalencia , Conducta Sedentaria
19.
Diabetes Educ ; 45(6): 616-628, 2019 12.
Artículo en Inglés | MEDLINE | ID: mdl-31608798

RESUMEN

PURPOSE: The purpose of this study was to identify patient and program delivery characteristics associated with engagement and weight loss in a Diabetes Prevention Program (DPP) implemented in an urban hospital system. METHODS: Patient and program delivery data were collected between July 2015 and December 2017. DPP eligibility was determined based on age, body mass index (BMI), and hemoglobin A1C data via the electronic health record. Engagement was measured at 3 levels: ≤3 sessions, 4 to 8 sessions, and ≥9 sessions. Weight was measured at each DPP session. RESULTS: Among the eligible patients (N = 31 524), referrals and engagement were lower in men than women, in Spanish speakers than English speakers, in younger (18-34 years) and middle-aged (35-54 years) than older adults, and in patients receiving Medicaid than other patients. Referral and engagement were higher in patients with higher BMIs and those prescribed ≥5 medications. Current smokers were less frequently engaged. Prior health care provider contact was associated with higher engagement. Overall, 28% of DPP participants achieved ≥5% weight loss; younger and middle-aged patients and those who gained weight in the prior 2 years were less likely to lose weight. CONCLUSION: This assessment identified characteristics of patients with lower levels of referral and engagement. The DPP staff may need to increase outreach to address barriers to referral and during all points of engagement among men, younger patients, and Spanish speakers. Future research is needed to increase understanding with regard to why referrals and engagement are lower among these groups.


Asunto(s)
Diabetes Mellitus Tipo 2/prevención & control , Promoción de la Salud/estadística & datos numéricos , Participación del Paciente/estadística & datos numéricos , Derivación y Consulta/estadística & datos numéricos , Adolescente , Adulto , Índice de Masa Corporal , Femenino , Hemoglobina A Glucada/análisis , Promoción de la Salud/métodos , Hospitales Urbanos , Humanos , Masculino , Persona de Mediana Edad , Evaluación de Programas y Proyectos de Salud , Pérdida de Peso , Adulto Joven
20.
Rev Bras Epidemiol ; 22Suppl 1(Suppl 1): e190010, 2019.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-31576986

RESUMEN

INTRODUCTION: Care continuum models have supported recent strategies against sexually transmitted diseases, such as HIV and Hepatitis C (HCV). METHODS: HIV, HCV, and congenital syphilis care continuum models were developed, including all stages of care, from promotion/prevention to clinical control/cure. The models supported the intervention QualiRede, developed by a University-Brazilian National Health System (SUS) partnership focused on managers and other professionals from six priority health regions in São Paulo and Santa Catarina. Indicators were selected for each stage of the care continuum from the SUS information systems and from the Qualiaids and QualiAB facility's process evaluation questionnaires. The indicators acted as the technical basis of two workshops with professionals and managers in each region: the first one to identify problems and to create a Regional Technical Group; and the second one to design action plans for improving regional performance. RESULTS: The indicators are available at www.qualirede.org. The workshops took place in the regions of Alto Tietê, Baixada Santista, Grande ABC, and Registro (São Paulo) and of Foz do Rio Itajaí (Santa Catarina), which resulted in regional action plans in São Paulo, but not in Santa Catarina. A lack of awareness was observed regarding the new HIV and HCV protocols, as well as an incipient use of indicators in routine practices. CONCLUSION: Improving the performance of the care continuum requires appropriation of performance indicators and coordination of care flows at local, regional, and state levels of management.


Asunto(s)
Continuidad de la Atención al Paciente/estadística & datos numéricos , Infecciones por VIH/terapia , Investigación sobre Servicios de Salud/estadística & datos numéricos , Hepatitis C/terapia , Evaluación de Programas y Proyectos de Salud/estadística & datos numéricos , Sífilis Congénita/terapia , Brasil , Infecciones por VIH/epidemiología , Promoción de la Salud/métodos , Promoción de la Salud/estadística & datos numéricos , Hepatitis C/epidemiología , Humanos , Programas Nacionales de Salud , Encuestas y Cuestionarios , Sífilis Congénita/epidemiología
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