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1.
Am J Manag Care ; 26(12): 502-504, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-33315324

RESUMO

The scale of the coronavirus disease 2019 pandemic and its disproportionate impact on vulnerable populations has spurred unprecedented focus on and investment in social determinants of health (SDOH). Although the greater focus on social determinants is laudable and necessary, there is a tendency for health care organizations to implement SDOH programs at scale without rigorous evidence of effect, rather than targeting interventions to specific patients and assessing their impact. This broad, and sometimes blind, application of SDOH interventions can be costly and wasteful. We argue for rejecting the "more is better" mindset and specifically targeting patients who truly need and would substantially benefit from SDOH interventions. Matching interventions to the most appropriate patients involves screening for social needs, developing rigorous evidence of effect, and accompanying policy reform.


Assuntos
/epidemiologia , Serviços de Saúde Comunitária/organização & administração , Promoção da Saúde/organização & administração , Determinantes Sociais da Saúde/tendências , Serviços de Saúde Comunitária/economia , Serviços de Saúde Comunitária/normas , Assistência Integral à Saúde/organização & administração , Política de Saúde , Promoção da Saúde/economia , Promoção da Saúde/normas , Disparidades nos Níveis de Saúde , Humanos
2.
Artigo em Inglês | MEDLINE | ID: mdl-32899848

RESUMO

During menopause and midlife, female workers, particularly those in low-paid jobs, experience more occupational health problems than other groups of workers. Workplace interventions are often lacking, however. In the Netherlands, a workplace health promotion intervention-the work-life program (WLP)-has been developed to support female workers. Here, we tailored the WLP to the needs of female workers in low-paid jobs working at Amsterdam University Medical Center. In an exploratory mixed-methods study with a convergent design, among 56 participants, we used questionnaires before and after the intervention and semi-structured, in-depth interviews to address the following research question: What is the impact of the WLP on the women's health and work functioning? Our quantitative data showed that menopausal symptoms improved significantly after the WLP. Our qualitative data, derived from 12 participants, showed that the WLP initiated a process of mental empowerment that initiated positive changes in four domains: behavior, physical health, mental wellbeing, and in the workplace. Taken with caution, our findings suggest that the WLP mentally empowers female workers to make choices that enhance their health and wellbeing, both at work and in their private lives, as summarized in the quote of one participant: "I get that spirit in me!".


Assuntos
Saúde do Trabalhador , Local de Trabalho , Grupos Étnicos , Feminino , Promoção da Saúde/normas , Humanos , Menopausa/fisiologia , Países Baixos , Poder Psicológico , Salários e Benefícios
3.
Health Educ Behav ; 47(5): 665-670, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32896177

RESUMO

Health education and promotion researchers and practitioners are committed to eliminating health disparities, and the Society for Public Health Education (SOPHE) has continuously supported this effort through its journals, professional development, annual conferences, and advocacy. The COVID-19 pandemic elucidated inequities directly caused by racism and other social determinants of health. In order to achieve health equity, we need to become antiracist in our research, practice, and advocacy work by standing united against racist policies and practices. I invite us all to heed the call to action on these five points: place racism on the agenda, practice cultural humility, claim your privilege and eliminate microaggressions, utilize strategies that promote inclusion and equity, and embrace your inner leader and activist. Just as SOPHE as an organization pivoted its annual conference from on ground to virtual in March 2020, so can we be innovative and brave as professionals to face the hard work and dedication needed to become antiracist.


Assuntos
Infecções por Coronavirus/epidemiologia , Equidade em Saúde/organização & administração , Promoção da Saúde/organização & administração , Pneumonia Viral/epidemiologia , Determinantes Sociais da Saúde/etnologia , Betacoronavirus , Equidade em Saúde/normas , Promoção da Saúde/normas , Humanos , Pandemias , Racismo
4.
PLoS One ; 15(8): e0237571, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32810195

RESUMO

BACKGROUND: Pre-gestational diabetes mellitus is associated with increased risk of maternal and perinatal adverse outcomes. This systematic review was conducted to evaluate the effectiveness and safety of pre-conception care (PCC) in improving maternal and perinatal outcomes. METHODS: Databases from MEDLINE, EMBASE, WEB OF SCIENCE, and Cochrane Library were searched, including the CENTRAL register of controlled trials, and CINHAL up until March 2019, without any language restrictions, for any pre-pregnancy care aiming at health promotion, glycemic control, and screening and treatment of diabetes complications in women with type I or type II pre-gestational diabetes. Trials and observational studies were included in the review. Newcastle-Ottawa scale and the Cochrane collaboration methodology for data synthesis and analysis were used, along with the GRADE tool to evaluate the body of evidence. RESULTS: The search identified 8500 potentially relevant citations of which 40 reports of 36 studies were included. The meta-analysis results show that PCC reduced congenital malformations risk by 71%, (Risk ratio (RR) 0.29; 95% CI: 0.21-0.40, 25 studies; 5903 women; high-certainty evidence). The results also show that PCC may lower HbA1c in the first trimester of pregnancy by an average of 1.27% (Mean difference (MD) 1.27; 95% CI: 1.33-1.22; 4927 women; 24 studies, moderate-certainty evidence). Furthermore, the results suggest that PCC may lead to a slight reduction in the risk of preterm delivery of 15%, (RR 0.85; 95% CI: 0.73-0.99; nine studies, 2414 women; moderate-certainty evidence). Moreover, PCC may result in risk reduction of perinatal mortality by 54%, (RR 0.46; 95% CI: 0.30-0.73; ten studies; 3071 women; moderate-certainty evidence). There is uncertainty about the effects of PCC on the early booking for antenatal care (MD 1.31; 95% CI: 1.40-1.23; five studies, 1081 women; very low-certainty evidence) and maternal hypoglycemia in the first trimester, (RR 1.38; 95% CI: 1.07-1.79; three studies; 686 women; very low- certainty evidence). In addition, results of the meta-analysis indicate that PCC may lead to 48% reduction in the risk of small for gestational age (SGA) (RR 0.52; 95% CI: 0.37-0.75; six studies, 2261 women; moderate-certainty evidence). PCC may reduce the risk of neonatal admission to intensive care unit (NICU) by 25% (RR 0.75; 95% CI: 0.67-0.84; four studies; 1322 women; moderate-certainty evidence). However, PCC may have little or no effect in reducing the cesarean section rate (RR 1.02; 95% CI: 0.96-1.07; 14 studies; 3641 women; low-certainty evidence); miscarriage rate (RR 0.86; 95% CI: 0.70-1.06; 11 studies; 2698 women; low-certainty evidence); macrosomia rate (RR 1.06; 95% CI: 0.97-1.15; nine studies; 2787 women, low-certainty evidence); neonatal hypoglycemia (RR 0.93; 95% CI: 0.74-1.18; five studies; 880 women; low-certainty evidence); respiratory distress syndrome (RR 0.78; 95% CI: 0.47-1.29; four studies; 466 women; very low-certainty evidence); or shoulder dystocia (RR 0.28; 95% CI: 0.07-1.12; 2 studies; 530 women; very low-certainty evidence). CONCLUSION: PCC for women with pre-gestational type 1 or type 2 diabetes mellitus is effective in improving rates of congenital malformations. In addition, it may improve the risk of preterm delivery and admission to NICU. PCC probably reduces maternal HbA1C in the first trimester of pregnancy, perinatal mortality and SGA. There is uncertainty regarding the effects of PCC on early booking for antenatal care or maternal hypoglycemia during the first trimester of pregnancy. PCC has little or no effect on other maternal and perinatal outcomes.


Assuntos
Cuidado Pré-Concepcional , Resultado da Gravidez , Gravidez em Diabéticas/terapia , Feminino , Promoção da Saúde/métodos , Promoção da Saúde/normas , Promoção da Saúde/estatística & dados numéricos , Humanos , Recém-Nascido , Cuidado Pré-Concepcional/métodos , Cuidado Pré-Concepcional/organização & administração , Cuidado Pré-Concepcional/normas , Cuidado Pré-Concepcional/estatística & dados numéricos , Gravidez , Resultado da Gravidez/epidemiologia , Gravidez em Diabéticas/diagnóstico , Gravidez em Diabéticas/epidemiologia , Prognóstico , Avaliação de Programas e Projetos de Saúde/estatística & dados numéricos , Resultado do Tratamento
5.
Pediatr Phys Ther ; 32(3): 172-179, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32604355

RESUMO

PURPOSE: To share reflections on themes that have become important to me as a developing pediatric physical therapy researcher contributing to knowledge generation in our field. KEY POINTS: The themes are: select strong mentors, assemble a research team with diverse perspectives and strengths, be family-centered, be rigorous in approaches to study design to match the research question, mentor the next generation, and engage in knowledge translation and exchange. CONCLUSIONS: I encourage everyone to reflect on who has been or could be your mentors or mentees, and on how you can be a part of an effective, family-centered research team, by encouraging a breadth of research designs to answer the many research questions that remain and by assisting in the implementation of knowledge to practice. CLINICAL RELEVANCE: Outcomes for children and families receiving pediatric physical therapy services are enhanced through the use of evidence-based knowledge.


Assuntos
Prática Clínica Baseada em Evidências/normas , Enfermagem Familiar/normas , Promoção da Saúde/normas , Mentores , Pediatria/normas , Modalidades de Fisioterapia/normas , Guias de Prática Clínica como Assunto , Adulto , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estados Unidos
6.
PLoS One ; 15(7): e0236019, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32667953

RESUMO

BACKGROUND: Delivery of preventive care and chronic disease management are key components of a high functioning primary care practice. Health Centers (HCs) funded by the Health Resources and Services Administration (HRSA) have been delivering affordable and accessible primary health care to patients in underserved communities for over fifty years. This study examines the association between health center organization's health information technology (IT) optimization and clinical quality performance. METHODS AND FINDINGS: Using 2016 Uniform Data System (UDS) data, we performed bivariate and multivariate analyses to study the association of Meaningful Use (MU) attestation as a proxy for health IT optimization, patient centered medical home (PCMH) recognition status, and practice size on performance of twelve electronically specified clinical quality measures (eCQMs). Bivariate analysis demonstrated performance of eleven out of the twelve preventive and chronic care eCQMs was higher among HCs attesting to MU Stage 2 or above. Multivariate analysis demonstrated that Stage 2 MU or above, PCMH status, and larger practice size were positively associated with performance on cancer screening, smoking cessation counseling and pediatric weight assessment and counseling eCQMs. CONCLUSIONS: Organizational advancement in MU stages has led to improved quality of care that augments HCs patient care capacity for disease prevention, health promotion, and chronic care management. However, rapid technological advancement in health care acts as a potential source of disparity, as considerable resources needed to optimize the electronic health record (EHR) and to undertake PCMH transformation are found more commonly among larger HCs practices. Smaller practices may lack the financial, human and educational assets to implement and to maintain EHR technology. Accordingly, targeted approaches to support small HCs practices in leveraging economies of scale for health IT optimization, clinical decision support, and clinical workflow enhancements are critical for practices to thrive in the dynamic value-based payment environment.


Assuntos
Promoção da Saúde/normas , Informática Médica/normas , Assistência Centrada no Paciente/normas , Atenção Primária à Saúde/normas , Melhoria de Qualidade , Qualidade da Assistência à Saúde/normas , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Adulto Jovem
7.
Clin Pediatr (Phila) ; 59(11): 978-987, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32486901

RESUMO

The American Academy of Pediatrics provides guidance for pediatric primary care providers to promote healthy weight during childhood. Screening questions on diet and activity habits can help provider assessment and assist counseling for targeted behavior change. We implemented the parent completed, 10-item 5210 Healthy Habits Questionnaire (Ages 2-9 year) in our primary care practice serving low-income minority children with high rates of overweight and obesity. Adherence to the intervention protocol was high, and providers found the content and method of assessment useful for their counseling of individual patients. The aggregate Healthy Habits Questionnaire data provided a snapshot of the health habits in our local clinic population of children, prompting greater awareness for providers and informing their patient care.


Assuntos
Promoção da Saúde/normas , Obesidade Pediátrica/prevenção & controle , Pediatria/normas , Atenção Primária à Saúde/normas , Índice de Massa Corporal , Pré-Escolar , Aconselhamento , Estudos de Viabilidade , Feminino , Humanos , Lactente , Masculino , Pais/educação , Guias de Prática Clínica como Assunto
9.
CA Cancer J Clin ; 70(4): 245-271, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32515498

RESUMO

The American Cancer Society (ACS) publishes the Diet and Physical Activity Guideline to serve as a foundation for its communication, policy, and community strategies and, ultimately, to affect dietary and physical activity patterns among Americans. This guideline is developed by a national panel of experts in cancer research, prevention, epidemiology, public health, and policy, and reflects the most current scientific evidence related to dietary and activity patterns and cancer risk. The ACS guideline focuses on recommendations for individual choices regarding diet and physical activity patterns, but those choices occur within a community context that either facilitates or creates barriers to healthy behaviors. Therefore, this committee presents recommendations for community action to accompany the 4 recommendations for individual choices to reduce cancer risk. These recommendations for community action recognize that a supportive social and physical environment is indispensable if individuals at all levels of society are to have genuine opportunities to choose healthy behaviors. This 2020 ACS guideline is consistent with guidelines from the American Heart Association and the American Diabetes Association for the prevention of coronary heart disease and diabetes as well as for general health promotion, as defined by the 2015 to 2020 Dietary Guidelines for Americans and the 2018 Physical Activity Guidelines for Americans.


Assuntos
Exercício Físico/fisiologia , Comportamento Alimentar/fisiologia , Promoção da Saúde/normas , Estilo de Vida Saudável/fisiologia , Neoplasias/prevenção & controle , American Cancer Society , Humanos , Estados Unidos
10.
Br J Soc Psychol ; 59(3): 674-685, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32583423

RESUMO

Structural inequalities and identity processes are pivotal to understanding public response to COVID-19. We discuss how identity processes can be used to promote community-level support, safe normative behaviour, and increase compliance with guidance. However, we caution how government failure to account for structural inequalities can alienate vulnerable groups, inhibit groups from being able to follow guidance, and lead to the creation of new groups in response to illegitimate treatment. Moreover, we look ahead to the longitudinal impacts of inequalities during pandemics and advise government bodies should address identity-based inequalities to mitigate negative relations with the public and subsequent collective protest.


Assuntos
Betacoronavirus , Infecções por Coronavirus/prevenção & controle , Promoção da Saúde/métodos , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Controle de Doenças Transmissíveis , Planejamento em Desastres , Promoção da Saúde/normas , Disparidades nos Níveis de Saúde , Disparidades em Assistência à Saúde , Humanos , Liderança , Equipamento de Proteção Individual , Comportamento de Redução do Risco , Grupos de Autoajuda , Normas Sociais , Fatores Socioeconômicos , Confiança
11.
Hosp Pract (1995) ; 48(5): 282-288, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32597257

RESUMO

OBJECTIVE: Farshchian Heart Center is the fifth health-promoting hospital and the first center of its type in Western Iran that officially joined the International Network of Health Promoting Hospitals and Health Services (HPH) in 2016. The purpose of the present study is to evaluate the health promotion standards at this center in 2018. METHODS: We conducted this cross-sectional study at Farshchian Heart Center of Hamadan. The main data collection instruments included questionnaires obtained from indicators of five different main standards of health-promoting hospitals developed by the World Health Organization (WHO) which were evaluated from three different perspectives: Management staff, hospital employees, and patients. The data were analyzed by SPSS version 21 software. RESULTS: We evaluated 111 hospital employees, 109 patients, and 6 management staff. Nurses (46.8%) comprised the majority of the hospital staff respondents. Less than half (42.3%) of the hospital staff expressed awareness of hospital health promotion policies; however, only 13.5% had attended various health promotion programs. Only 51.4% of patients knew about the hospital health promotion policies and 17.4% of them participated in relevant programs. The mean score for patient satisfaction with the hospital health promotion programs according to the visual analogue scale (VAS, range: 0-10) was 7.16 ± 2.45, which was significantly higher in outpatients (8.16 ± 1.85) compared to inpatients (6.44 ± 2.59, p = 0.001). Two thirds (66.7%) of the management staff expressed awareness of implementation of these programs. CONCLUSION: The results of this study demonstrated that health promotion policies based on WHO standards were not well-recognized among patients, hospital employees, and management staff in Farshchian Heart Center of Hamadan, Iran.


Assuntos
Guias como Assunto , Pessoal de Saúde/psicologia , Pessoal de Saúde/estatística & dados numéricos , Promoção da Saúde/estatística & dados numéricos , Promoção da Saúde/normas , Cardiopatias/prevenção & controle , Administração Hospitalar/estatística & dados numéricos , Administração Hospitalar/normas , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Irã (Geográfico) , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários
12.
BMC Public Health ; 20(1): 964, 2020 Jun 19.
Artigo em Inglês | MEDLINE | ID: mdl-32560718

RESUMO

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.


Assuntos
Promoção da Saúde/normas , Avaliação de Programas e Projetos de Saúde , Fortalecimento Institucional , Implementação de Plano de Saúde , Planejamento em Saúde/organização & administração , Promoção da Saúde/organização & administração , Humanos
13.
BMC Psychiatry ; 20(1): 314, 2020 06 18.
Artigo em Inglês | MEDLINE | ID: mdl-32552878

RESUMO

BACKGROUND: Refugee populations have particularly high rates of mental health problems, including Posttraumatic Stress Disorder (PTSD) and depression. However, uptake of mental health care may be low even when severe depression and PTSD symptoms are present in individuals following resettlement. This is likely due, at least in part, to cultural influences on refugees' knowledge and beliefs about mental health problems and their treatment. We sought to provide preliminary evidence for the effectiveness of a culturally tailored mental health promotion program for Arabic-speaking refugees. METHODS: A total of 33 Arabic-speaking refugees resettled in South Western Sydney were recruited and completed intervention which consisted of weekly three-hour sessions for 4 weeks delivered in Arabic. Key aspects of mental health literacy, help-seeking intentions and levels of general psychological distress were assessed, by means of a self-report survey, pre-intervention, (immediately) post-intervention and 3 months following intervention. RESULTS: Of the 33 participants that completed the intervention, 31 completed the immediate post-intervention survey and 29 completed the 3 months follow-up survey. Improvements in most aspects of mental health literacy assessed were found immediately post-intervention and at follow-up, although only changes relating to stigmatising attitudes were statistically significant. Additionally, a statistically significant decrease in participants' levels of general psychological distress was observed immediately following the intervention, and this decrease was sustained at follow-up. CONCLUSION: While further research employing a more rigorous study design and larger sample size will be needed, results of this initial trial suggest that a culturally tailored mental health promotion program targeting key aspects of mental health literacy can improve the mental health of Arabic-speaking refugees resettled in a Western nation.


Assuntos
Árabes/psicologia , Árabes/estatística & dados numéricos , Promoção da Saúde/normas , Idioma , Saúde Mental/estatística & dados numéricos , Refugiados/psicologia , Refugiados/estatística & dados numéricos , Depressão/diagnóstico , Depressão/epidemiologia , Depressão/terapia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , New South Wales/epidemiologia , Avaliação de Programas e Projetos de Saúde , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Transtornos de Estresse Pós-Traumáticos/terapia
14.
Curr Hematol Malig Rep ; 15(4): 241-247, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32533390

RESUMO

PURPOSE OF REVIEW: The Choosing Wisely® initiative, led by the American Board of Internal Medicine Foundation in collaboration with national professional medical societies, aims to help patients choose care that is essential, free from harm, and evidence-based. The American Society of Hematology has advocated practices specific to hematology for physicians and patients to examine carefully. Here, we summarize various barriers to adopting these practices, interventions used to improve adoption, and challenges in measuring the effectiveness of these interventions. RECENT FINDINGS: The Choosing Wisely® campaign has become an international effort with more than 20 countries worldwide having embraced it. Such widespread interest indicates that the campaign initiated an important dialog between patients and physicians about overutilization of resources. Evidence showing the positive impact of interventions on adopting these practices is accumulating, but their effect on improving clinical outcomes is uncertain. Decreasing overuse of resources is a cultural change in perspective for practitioners and patients alike. We believe that healthcare delivery is transitioning from being volume-based to value-based. As we continue to support the Choosing Wisely® campaign, we need to implement strategies to document and measure the influence of our value-based recommendations on physician practices, patient care and attitudes, and healthcare costs.


Assuntos
Tomada de Decisão Clínica , Medicina Baseada em Evidências/normas , Promoção da Saúde/normas , Hematologia/normas , Participação do Paciente , Segurança do Paciente/normas , Padrões de Prática Médica/normas , Comportamento de Escolha , Análise Custo-Benefício , Prestação Integrada de Cuidados de Saúde/normas , Medicina Baseada em Evidências/economia , Custos de Cuidados de Saúde , Hematologia/economia , Humanos , Sobremedicalização/prevenção & controle , Segurança do Paciente/economia , Padrões de Prática Médica/economia , Medição de Risco , Fatores de Risco , Seguro de Saúde Baseado em Valor
15.
Holist Nurs Pract ; 34(4): 221-233, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32404725

RESUMO

Breast cancer is the most frequently diagnosed cancer and the chief cause of cancer-related death among women worldwide, with the incidence increasing exponentially particularly in low- to middle-income countries. The increase in the incidence of breast cancer is partly accounted for by increases in life expectancy due to improvements in public health, but also related to an increase in risk factors for cancer including smoking, excess body weight, decreased physical activity, and changes in reproductive activity. Health-promoting lifestyle is therefore one of the major topics of importance in studying chronic illnesses and cancer. Health promotion interventions, including the use of care models, have a vast contribution to make in terms of timely diagnosis and improved survival. One such care model, which has been designed to increase self-care, adherence, and performance in chronic patients, is the continuous care model (CCM). This study was conducted with the purpose of determining the influence of the CCM on the health-promoting lifestyle of patients with breast cancer during 2017-2018. In this randomized clinical trial, 60 patients with breast cancer were chosen by convenience sampling followed by random allocation into treatment and control groups. Six sessions of group discussion were held for the treatment group according to the CCM and items in the health-promoting lifestyle questionnaire. Data collection tools included a general health questionnaire, a demographic questionnaire, a family support questionnaire, and the Health Promoting Lifestyle Profile (HPLP), which respondents completed before and after the intervention. P values ≤ .05 were considered significant. When comparing the mean score of health-promoting lifestyle in both the control and treatment groups, before and after the intervention, significant increases in every dimension were observed. The average overall health promotion lifestyle was revealed to be significantly elevated from 123.48 to 147.12. However, in the control group the mean scores had slightly increased or were the same in all the dimensions. In addition, the average overall health promotion lifestyle had increased from 119.89 to 121.32. The observed difference in mean scores was not statistically significant. The CCM increased the score of health-promoting lifestyle of patients with breast cancer. Therefore, this caring model can be considered an alternative to improve healthy lifestyles of patients with cancer.


Assuntos
Neoplasias da Mama/terapia , Promoção da Saúde/normas , Modelos Psicológicos , Sobreviventes/psicologia , Adulto , Neoplasias da Mama/psicologia , Feminino , Promoção da Saúde/métodos , Promoção da Saúde/estatística & dados numéricos , Humanos , Estilo de Vida , Pessoa de Meia-Idade , Inquéritos e Questionários , Sobreviventes/estatística & dados numéricos
16.
PLoS One ; 15(5): e0231155, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32365124

RESUMO

People's perceptions about health risks, including their risk of acquiring HIV, are impacted in part by who they see portrayed as at risk in the media. Viewers in these cases are asking themselves "do those portrayed as at risk look like me?" An accurate perception of risk is critical for high-risk populations, who already suffer from a range of health disparities. Yet, to date no study has evaluated the demographic representation of health-related content from social media. The objective of this case study was to apply automated image recognition software to examine the demographic profile of faces in Instagram posts containing the hashtag #HIV (obtained from January 2017 through July 2018) and compare this to the demographic breakdown of those most at risk of a new HIV diagnosis (estimates of incidence of new HIV diagnoses from the 2017 US Centers for Disease Control HIV Surveillance Report). We discovered 26,766 Instagram posts containing #HIV authored in American English with 10,036 (37.5%) containing a detectable human face with a total of 18,227 faces (mean = 1.8, standard deviation [SD] = 1.7). Faces skewed older (47% vs. 11% were 35-39 years old), more female (41% vs. 19%), more white (43% vs. 26%), less black (31% vs 44%), and less Hispanic (13% vs 25%) on Instagram than for new HIV diagnoses. The results were similarly skewed among the subset of #HIV posts mentioning pre-exposure prophylaxis (PrEP). This disparity might lead Instagram users to potentially misjudge their own HIV risk and delay prophylactic behaviors. Social media managers and organic advocates should be encouraged to share images that better reflect at-risk populations so as not to further marginalize these populations and to reduce disparity in risk perception. Replication of our methods for additional diseases, such as cancer, is warranted to discover and address other misrepresentations.


Assuntos
Comunicação , Infecções por HIV/transmissão , Comportamentos de Risco à Saúde , Processamento de Imagem Assistida por Computador/métodos , Percepção/fisiologia , Saúde Pública , Mídias Sociais , Adolescente , Adulto , Fatores Etários , Idoso , Grupos Étnicos , Feminino , HIV/fisiologia , Promoção da Saúde/métodos , Promoção da Saúde/normas , Humanos , Processamento de Imagem Assistida por Computador/normas , Masculino , Pessoa de Meia-Idade , Redes Neurais de Computação , Saúde Pública/métodos , Saúde Pública/normas , Assunção de Riscos , Fatores Sexuais , Mídias Sociais/normas , Estados Unidos/epidemiologia , Adulto Jovem
17.
Artigo em Inglês | MEDLINE | ID: mdl-32259276

RESUMO

This paper reports Phase 4 of the Culture is Prevention Project where we validated the Cultural Connectedness Scale - California (CCS-CA) with a sample of 344 Indigenous adults in the San Francisco Bay Area, California. In Phase 3 of this project, the CCS-CA was modified from the original Canadian Cultural Connectedness Scale (CCS) developed by Dr. Angela Snowshoe and colleagues to be a better fit for the more multi-tribal communities in urban California. Both the CCS-CA and CCS consist of 29 items that measure culture on 3 sub-scales: identity, traditions, and spirituality. The project demonstrated a positive link between cultural connectedness and mental health/well-being using the Herth Hope Index. We report results similar to the original CCS study by Snowshoe et al., where we found the CCS-CA to be a valid and reliable strength-based instrument and to support the conclusion that culture is a social determinant of mental health/well-being for Indigenous/Native peoples.


Assuntos
Promoção da Saúde/normas , Índios Norte-Americanos/psicologia , Saúde Mental/etnologia , Determinantes Sociais da Saúde/etnologia , Identificação Social , Adulto , California , Características Culturais , Feminino , Humanos , Masculino , Resiliência Psicológica , Autoeficácia , Inquéritos e Questionários
18.
Recurso na Internet em Português | LIS - Localizador de Informação em Saúde | ID: lis-47039

RESUMO

O Ministério da Saúde lançou, nesta sexta-feira (28), a campanha publicitária de prevenção ao coronavírus que já começou a ser veiculada em TV aberta, rádio e internet. As peças publicitárias orientam a população a prevenir a doença adotando hábitos de higiene, como lavar as mãos com água e sabão várias vezes ao dia, fazer uso do álcool em gel a 70% e não compartilhar objetos de uso pessoal.


Assuntos
Promoção da Saúde/normas , Brasil/epidemiologia , Laboratórios/normas , Coronavirus , Infecções por Coronavirus/prevenção & controle
20.
BMC Endocr Disord ; 20(Suppl 1): 14, 2020 Mar 12.
Artigo em Inglês | MEDLINE | ID: mdl-32164685

RESUMO

BACKGROUND: The clinical and economic burden of type 2 diabetes mellitus on society is rising. Effective and efficient preventive measures may stop the increasing prevalence, given that type 2 diabetes mellitus is mainly a lifestyle-driven disease. The Feel4Diabetes-study aimed to tackle unhealthy lifestyle (unhealthy diet, lack of physical activity, sedentary behaviour, and excess weight) of families with a child in the first grades of elementary school. These schools were located in regions with a relatively low socio-economic status in Belgium, Bulgaria, Finland, Greece, Hungary and Spain. Special attention was paid to families with a high risk of developing type 2 diabetes mellitus. METHODS: The aim of this paper is to describe the detailed methodology of the intervention's cost-effectiveness analysis. Based on the health economic evaluation of the Toybox-study, both a decision analytic part and a Markov model have been designed to assess the long-term (time horizon of 70 year with one-year cycles) intervention's value for money. Data sources used for the calculation of health state incidences, transition probabilities between health states, health state costs, and health state utilities are listed. Intervention-related costs were collected by questionnaires and diaries, and attributed to either all families or high risk families only. CONCLUSIONS: The optimal use of limited resources is pivotal. The future results of the health economic evaluation of the Feel4Diabetes-study will contribute to the efficient use of those resources.


Assuntos
Análise Custo-Benefício/métodos , Diabetes Mellitus Tipo 2/prevenção & controle , Serviços Preventivos de Saúde/economia , Serviços Preventivos de Saúde/métodos , Adulto , Criança , Diabetes Mellitus Tipo 2/epidemiologia , Diabetes Mellitus Tipo 2/etiologia , Dieta , Europa (Continente)/epidemiologia , Exercício Físico , Família , Feminino , Promoção da Saúde/economia , Promoção da Saúde/métodos , Promoção da Saúde/organização & administração , Promoção da Saúde/normas , Estilo de Vida Saudável , Humanos , Estilo de Vida , Masculino , Serviços Preventivos de Saúde/organização & administração , Fatores de Risco , Inquéritos e Questionários
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