Health promotion, health protection, and preventive services

Health promotion, health protection, and preventive services reflect the 21 priority areas of Healthy People 2000. This article focuses on the cost-effectiveness of health promotion and the role that primary care physicians can play in this initiative.     

Health risks and health promotion for older women: utility of a health promotion diary

Elderly women require health screening and health promotion services from nurses and other health care providers. Nurses serving this population require knowledge of age-specific health screening and health promotion services. A case study from a geriatric nurse practitioner's practice demonstrates the complexity of these activities. A diary of such services can help nurses focus on elderly women's needs for health promotion interventions.     

Healthy endings. A collaborative health promotion project for the elderly

This article describes a collaborative health promotion project between a graduate nursing program at a state university and a small community hospital. The Healthy Endings program provided health promotion education to groups of older adults at a local senior center. Health promotion in this population is vital to prevent complications and decrease risks that affect quality of life. Health promotion programs were designed to be accomplished through three major components: education, health screenings/services, and the referral process. Specific project objectives focused on safety, sensory deprivation, exercise, screening, compliance with medications, and a variety of psychosocial issues. Graduate nursing students functioning proactively in a senior center on a consistent basis were viewed as valuable by both members and staff.     

Health promotion in the workplace: A prescription for good health.

Encourages health promotion in the workplace, asserting that the growing awareness of the effectiveness of preventive activities in reducing health care costs presents a challenge to psychologists and other mental health professionals because changes in attitudes and behaviors are at the core of preventive efforts. The present author describes his introduction in 1983 of the Preventive Health Care Incentive Act to provide a tax credit for employers who provide preventive health programs to their employees. Examples of health-promotion programs for the workplace are offered, and advantages of such programs are considered. (3 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Health promotion and health education: what role should the nurse adopt in practice?

Health promotion is widely accepted as part of the role of the nurse, midwife and health visitor. Theoretical definitions of health promotion and health education are presented. The author suggests that a variety of different approaches to health promotion can be adopted by nurses in practice, including education, persuasion, manipulation and attempts to promote an environment where healthy decisions about lifestyle can be made. Each strategy is examined and the advantages and the ethical limitations are explored. It is suggested that nurses may theoretically accept the notion of being a health promoter, but that in the reality of practice, their role may be primarily that of the health educator. The importance of recognizing that there are a variety of determinants of health, including social and environmental factors, as well as individual lifestyle, is emphasized throughout the paper.     

The second revolution in health: Health promotion and its environmental base.

New attention is being given to how individual behavior and one's physical environment influence health. Half of the mortality in the US is due to unhealthy behavior or life-style, and a further 20% is due to environmental factors. Disease prevention and health promotion represent developing trends in health policy. Schools of public health play a key role in training health professionals to address issues of health promotion. Environmental factors such as air pollution, improper use of pesticides, and rising noise levels contribute to producing a health crisis. A new environmental ethic is needed. (7 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Benefits to volunteers in a community-based health promotion and chronic illness self-management program for the elderly

1. Volunteers for health promotion programs tend to be younger and healthier than program participants. 2. Volunteers in a health promotion program reported improved health and function. 3. Nurses involved in health promotion programs can extend their efforts by using trained volunteers.     

Managed care, school health programs, and adolescent health services: opportunities for health promotion

The rapid expansion of managed care creates opportunities and dilemmas for those involved in school health and adolescent health promotion. Managed care organizations (MCOs), public health agencies, and school and adolescent health providers share certain common goals and priorities including an emphasis on prevention, cost-effectiveness, and quality of care--and a willingness to explore innovative approaches to health promotion and disease prevention. However, MCOs often face conflicting challenges, balancing the goals of cost containment and investment in prevention. In considering support for school health programs, MCOs will be interested in evidence about the effectiveness of services in improving health and/or reducing medical expenditures. Mechanisms for improving prevention efforts within MCOs include quality assurance systems to monitor the performance of health plans, practice guidelines from professional organizations, and the contracting process between payers and health care providers. Development of partnerships between MCOs and schools will be a challenge given competing priorities, variation in managed care arrangements, structural differences between MCOs and schools, and variability in services provided by school health programs.     

Health promotion practices of the old-old

Normal pregnancy is characterized by increased in vivo thrombin generation. A greater proportion of endogenously generated thrombin is complexed to heparin cofactor II in plasma from pregnant women compared to plasma from nonpregnant ones. The increase in thrombin-heparin cofactor II complexes suggests that the site of the additional thrombin generation is relatively rich in dermatan sulfate. We postulated that the site of thrombin generation may be the placenta since endogenous thrombin generation returns rapidly to normal after delivery. This report describes the isolation and characterization of placental dermatan sulfate proteoglycan from villous tissue of the term human placenta. Placental dermatan sulfate was isolated by guanidine HCI extraction and anion exchange chromatography. The isolated material was found to have anticoagulant activity with a relative activity of approximately 40% of that of a porcine mucosal dermatan sulfate which is undergoing clinical trial as an antithrombotic agent. The dermatan sulfate was present as a proteoglycan with a molecular mass of 90-150 kD. Upon degradation with chondroitin ABC lyase, the core protein was demonstrated to be a doublet with molecular masses of 42 and 44 kD. This core protein reacted with antiserum against the core protein of decorin on Western analysis. The role of this placental dermatan sulfate in local regulation of thrombin in the placenta warrants further study.     

Student/faculty practice and research in occupational health. Health promotion and outcome evaluation

Unrelated donor bone marrow transplants have been associated with relatively high rates of acute graft-vs.-host disease and treatment-related mortality. These complications reflect histo-incompatibility between donor and recipient. Molecular technology has recently been applied to HLA typing to identify alleles not distinguishable with serologic typing techniques. We report results in 92 unrelated marrow transplant recipients who were HLA seroidentical with donor HLA-A, -B, and -DR antigens and assess the effect of DR beta 1 and DQ beta compatibility using sequence specific oligonucleotide primers. Forty-eight patients received T-cell depleted marrow grafts, and 44 received unmodified grafts. Among recipients of unmodified marrow grafts, matching for both DR beta 1 and DQ beta reduced the rate of grade 3-4 acute graft-vs.-host disease to 38 +/- 20% vs. 73 +/- 20% among recipients mismatched for either allele (p = 0.02). This difference was not observed in recipients of T-cell depleted marrow grafts. Multivariate analysis confirmed matching for both DR beta 1 and DQ beta loci (p = 0.015), and receiving a T-cell depleted graft (p = 0.008) independently predicted for reduced risk of grade 3-4 acute graft-vs.-host disease. In conclusion, both DR beta 1 and DQ beta appear biologically important for development of acute graft-vs.-host disease in patients receiving unmanipulated marrow grafts for unrelated donor transplant.     

Health promotion ideology and nursing education

Nursing has been concerned primarily with the visible aspects of health promotion and has shown little regard for what is invisible. Yet the hidden ideology powerfully shapes current approaches to health promotion. This paper examines and makes visible the ideology of individual responsibility which is embedded in individualistic health promotion, the primary orientation to health promotion. Ways in which this ideology is perpetuated within nursing curricula are described. Concrete strategies are proposed that may be considered by nurse educators as they seek to prepare students in health promotion, with particular emphasis on strategies that highlight its ideological underpinnings.     

Social support, activity, and health among the elderly]

The present study examined the relationship between social support, activity level and physical health among a sample of 96 Puerto Rican elderly persons. The Spanish version of the Inventory of Socially Supportive Behaviors (ISSB28) was used to assess social support. Two structured questionnaires were administered to obtain measures of activity level and physical health. A multiple correlation-regression analysis was performed, and partial correlation coefficients were also obtained. A partial correlation of .48 (p < .001) was observed between the ISSB scores and the measure of physical health, indicating a direct relationship between poor health and social support. This finding is inconsistent with previous studies, which suggest that better health is associated with higher levels of social support. Moderate-low, negative correlations were found between activity level and 3 indicators of poor health. Thus, higher activity levels were associated with better physical health. For example, partial correlations of-.31 (p = .003) and -.29 (p = .007), respectively, were found between the activity level and the number and length of hospital stays. The correlation between the amount of surgical interventions undergone by the patient during the previous year and the activity level was -.28 (p = .009). These findings demonstrate that higher levels of activity are associated with better physical health in elderly persons, as indicated by less frequent and shorter hospital stays, and lower frequency of surgical interventions. Several multiple regression analyses showed that social support and activity level, taken together, are statistically significant predictors of the number and length of hospital stays, and the number of surgical interventions undergone by the elderly patient. Together, these two factors explain from 11 to 18% of the variability in several indicators of physical health.     

Health promotion, wellness programs, quality of life and the marketing of psychology.

This paper focusses on 15 yrs of research into the definition of quality of life and the factors that influence it. Four studies with 3 samples of 780 residents of London, Ontario, are presented. Results suggest (1) that different measures of global quality of life and well being are measuring essentially the same thing; (2) that there may be some basis for viewing the mental health component measure on the SF-36 Health Survey as highly indicative of quality of life; and (3) that important psychological factors contributing to health and quality of life include such personality factors as hardiness, self-esteem, optimism, locus of control, and extraversion. The application of the research to health promotion and the development of wellness programs is discussed. A strategy to enhance quality of life using the Quality of Life Questionnaire, and group interventions to enhance specific personality characteristics are described. The current research program is used as a case study to demonstrate some of the factors that contribute to the invisibility of psychology. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

What is health promotion?

With change abounding in Canada's health care system, nurses must redefine their roles. One role is in health promotion, a field where nurses have created a unique identity for themselves. But before advocating, the concept must be fully understood.     

Health promotion and schizophrenia: the year 2000 and beyond

The health promotion needs of persons with schizophrenia have not been emphasized as a result of historical stigma, the effort required to stabilize symptoms, the relapsing nature of the disease, and the helplessness felt by caregivers. Family members and individuals with schizophrenia experience shame, grief, guilt, fear, and isolation, all of which render them less able to be proactive. Health promotion strategies that change attitudes, build self-esteem, increase insight into the illness, modify behavior, provide sources of income and access to medical care, and support companionship are necessary while research efforts seek a cure for this historically misunderstood illness.