The health promotion sciences in chronic disease prevention. The scientific base of health promotion.
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Biomedical subjects
Publications and source records attributed to D C Iverson.
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The Center for Health Promotion and Education, Centers for Disease Control, and the Office of Disease Prevention and Health Promotion, US Dept. of Health and Human Services, contracted with Abt Associates, Inc., to evaluate the School Health Curriculum Project as compared with three other approaches to school health education. Background on the reasons for initiating this project, a summary of the original design, and highlights of the main features of the actual implementation of the School Health Education Evaluation (SHEE) are detailed.
Smoking cessation programs are usually evaluated in terms of the percentage of participants who have stopped smoking at least 6 months after the program's completion. This paper shows how a relatively low rate of behavior change may actually result in a high ratio of benefits to costs. Cost-benefit analysis is done for a specific program but the procedures and cost estimates are generalizable to other smoking cessation programs. Benefits to the firm included reduced costs of insurance and the savings due to employee absenteeism and disability. Costs included the program costs as well as the opportunity costs of the participants. Data from the literature and from the specific program are combined to form conclusions about the effectiveness of the program.
In 1981, the Office of Health Information and Health Promotion of the U.S. Department of Health and Human Services launched a national health promotion media campaign titled Health Style. The purposes of the Health Style campaign were: to increase public awareness of the effects of life-style on health; to enable persons to assess which life-style changes would be most conducive to their health; to stimulate information-seeking behavior and; to foster the development of local health promotion activities and referral networks. The campaign was implemented in nine test communities across the United States. This article: provides an overview of the campaign; examines strategies used to implement the campaign in three local communities and; presents the findings of evaluations conducted at both the national and local levels. A summary of lessons learned from the Health Style campaign experience is included in the article.
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Investigators interested in conducting school health research face many important challenges. First, an appropriate research course for school health must be charted so the most important research issues are addressed in a systematic way. Second, there is a continuing need to develop scientifically sound research methods that can be used in the school setting. Third, there is the immediate need to identify ways of overcoming the usual problems encountered in the conduct of school health research. This paper focuses on the third challenge, via an analysis of the research design and measurement issues that most frequently confront school health researchers. The research design issues addressed include randomization of experimental units to treatments and selection of the appropriate statistical unit of analysis. The measurement issues addressed included use of existing versus newly developed instruments, use of norm-referenced versus criterion-referenced instruments, use of self-report techniques, and appropriate use of affective instruments. Following an analysis of the issues a series of relevant questions are posed.
The history and evolution, during the past decade, of the national disease prevention and health promotion strategy is recounted, culminating with a description of the national prevention objectives. Objectives that directly could be attained by: (1) school health education; (2) school health services; (3) efforts to ensure healthy school environments; and (4) school physical education programs are delineated, as are objectives that could be influenced in important ways by school health programs. The nation's schools could contribute significantly and measurably toward improving the health of all Americans, if school health professionals, individually as well as within their various organizations, could seize and create opportunities to work with other health and educational professionals, and the public, to impel and enable schools to attain relevant national prevention objectives.
The purposeful integration of school and community efforts indeed may be the critical element in a formula to promote the health of school-aged children and youth. Obviously there are numerous strategies, policies, and methods to functionally integrate school and community activities. As concluded by the Director of the U.S. Office of Maternal and Child Health in a paper on "New Policies in School Health": What is required, then, are not new policies in school health, but, a reaffirmation and implementation of policies that have been with us for many years.
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The effectiveness of health education is ultimately determined by whether it is implemented, and how it is implemented. Although a given health education innovation may be designed and experimentally assessed to promote well-being with some measure of effectiveness and efficiency, the actual impact of the innovation will depend upon the manner in which it is disseminated, initiated, and maintained. The implementation of health education programs in schools or elsewhere is a function of the types of innovations available, certain characteristics of those innovations that influence their use, and the manner in which the innovations are brought into practice. This paper has been prepared to review, synthesize, and apply current and relevant information about educational innovations and social change to provide a conceptual base for the design, execution, and analysis of efforts to implement health education in schools. The American system of public and private schools could be an agent vitally important to the realization of a second public health revolution. Indeed, in a democratic society, the implementation of health education in schools seems a condition necessary for such a revolution. By analyzing and learning from our own health education efforts, as well as the efforts of those experienced with implementing other types of educational innovations in schools, we might ensure that future populations are informed sufficiently about factors that influence their health and well-being.
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The School Health Curriculum Project (SHCP), initiated over a decade ago to provide a health education curriculum package for elementary students, has been widely and variously evaluated. In analyzing studies designed to assess the effectiveness of the SHCP, it was recognized that the measured impact of this project (or any health education intervention) would derive from the adequacy of the theory upon which the program is based, the adequacy of its implementation, and the adequacy of its measurement. Hence, an examination of the theoretical base of the SHCP and its variance in practice was conducted. In addition, a metaevaluation of 24 studies designed to access the effectiveness of the SHCP was completed. Results suggest that the project is effective in influencing health-related knowledge and attitudes. A rationale for future evaluation efforts in school health education is subsequently outlined.
The practice of allowing juvenile participants in a drug intervention program to extend their participation in the program was examined. The program's therapists felt that such additional participation would be therapeutically beneficial to the juveniles, but at the same time it would deny other juveniles entrance into the program. The results suggest that the practice of allowing participants to attend additional groups in programs which are rather highly structured is not beneficial, and in some cases may result in a loss of the gains made during the initial group.
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