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PubMed1998

Promoting health, promoting women: the construction of female and professional identities in the discourse of community health workers.

Community health worker (CHW) programs are implemented in the third world and among racial minorities in the U.S. by public health professionals with the goal of improving people's access to basic health services. There is a shared view that women's roles as mothers make them effective CHWs because most health practices are located within the realm of the family. The objective of this paper is to inquire how and what concepts of woman are constructed and promoted in CHW programs. Viewing CHW as a discourse, I examine literature on CHWs using a critical feminist perspective and insights from narrative and rhetorical analyses. I argue that CHW positions women living in the third world and non-white Hispanic women in the U.S. as the "other" woman. The natural attributes of this other woman include mother, care giver, oppressed, child-like, and victim of patriarchy, religion, poverty, and diseases. These attributes are used to define categories of the female such as "the third world woman" and "Hispanic woman". These categories, in turn, define two unnamed opposite categories: "the first world woman" and "the public health professional". I conclude that CHW is a colonizing discourse and that public health professionals and feminists need to practice reflexivity.

Caregivers↗
PubMed1998

Patient education and health promotion: clinical health promotion--the conceptual link.

A model linking health promotion, health education and patient education is presented. Claims to health education being distinguishable from patient education on the basis of setting and working with well, as opposed to sick, individuals are disputed. Many health education encounters create the role of proto-patient for the individual receiving care. A further distinction is made between patient education and clinical health promotion on the basis of the focus of care as seen by the professional. The linking elements in the model are those of the patient role and relationships adopted, another distinction is seen in the area of the focus of the encounter. Traditional patient education focuses on the disease process whereas clinical health promotion emphasises the place of illness in the person's life and looks to influence non-medical factors that impinge on the disease.

Health Education↗
PubMed2000

Youth health promotion and health promoting schools: what should be the aims?

The school plays a very important role in health education and promotion at the crucial stage of childhood and adolescence. It develops personal character, skills, attitude and physique, in addition to imparting knowledge. To sustain the concerted effort to address inter-wined social, educational, psychological and health needs of children, training and ongoing reinforcement must be given to teachers. A task force made up of parents, teachers, administrators, students and health professionals must be formed to develop core values, visions, goals and activities; and to provide new direction for health education and promotion. The 'Health Promoting Schools' Programme of the CUHK was launched in 1999 with the aim to promote physical, emotional and intellectual development of students through healthy and hygienic practices. The programme has also conducted researches on health of students, prioritise and evaluate relevant programmes. Recent research studies revealed that students in higher grades had more physical and psychological health problems, probably due to heavy workload and less emphasis on health education in their formal curriculum. Another research study has shown the lack of concrete school policies in health education. It is therefore important to develop policies, practices and structures, as well as regular curricular reviews to promote health of the school children. The "Health Promoting Schools' Programme has already initiated several district based health promotion programmes to pave the way for the formation of local task force on youth health promotion.

Adolescent↗
PubMed2004

[The effects of an elderly health promotion program on health promotion lifestyles, health status and quality of life in the elderly].

PURPOSE: The purpose of this research was to identify the effect of an elderly health promotion program on health promotion lifestyles, health status, and quality of life in the elderly. METHOD: The research design was a nonequivalent control group pre post experimental design. Thirty two elderly persons were in the experimental group and the other thirty two elderly were in the control group. A 16 week health promotion program was given to the experimental group. The measurement tools were HPLP II, grip strength, back lift strength, flexibility, body fat percentile, blood sugar, serum cholesterol, and quality of life. RESULT: The experimental group showed a higher score of health promoting lifestyles, flexibility, grip strength, back lift strength, and quality of life. There were no differences in body fat percentiles, blood sugar and serum cholesterol between the experimental and control group. CONCLUSION: This health promotion program for elderly can be recommended as an effective nursing intervention for elderly in a community.

Aged↗
PubMed1998

Current conceptualizations of mental health and mental health promotion.

Health promotion is generally agreed to be underpinned by a set of principles which distinguish it from other disciplines and professions. This paper takes these principles as the starting point for a review of the literature of mental health promotion. The aim is to clarify the ways in which mental health and mental health promotion are currently conceptualized, in order to identify areas where health promotion can make a unique contribution to complement that of other interest groups. In the first section, it is suggested that current definitions of mental health are inadequate for health promotion practice in that they either equate health with the absence of illness or present a culturally skewed, individualized and 'expert'-led version of what it means to be mentally healthy. The second section then traces the implications of these definitions as they emerge from the literature relating to mental health promotion practice. The paper concludes with a discussion of some ways in which health promotion specialists might begin to develop a mental health promotion agenda which is more consistent with health promotion principles.

Attitude to Health↗
PubMed2003

A holistic-existential approach to health promotion.

Health promotion seems to be implicit in many nursing theories, but the theoretical and philosophical basis of health promotion in nursing is not always explicitly stated. The interpretation of health promotion is closely related to the interpretation of man, health, illness and nursing. There is a need to clarify, refine and redefine health promotion in nursing because the concept is partly nonspecific and has not been used to identify a distinctive nursing focus. The aim of this study was to formulate a stipulative definition of health promotive nursing with a holistic-existential approach. A philosophical frame of reference in combination with conceptual analysis and theoretical synthesis were used as the methodological approach. The philosophical framework served as a basis in selecting the nursing theories and influenced the analysis. Two nursing theories and one nursing model were selected due to their influence on Norwegian nursing and because of their philosophical basis. Through analysis and synthesis of the selected nursing theories, the concepts man, health, illness/disease and nursing were analysed. The paper proposes a stipulative definition of health promotion in nursing based on a holistic-existential approach, supported by five necessary conditions. The definition and conditions needs to be further investigated by both empirical studies and by comparing with other relevant nursing theories, in order to formulate theoretical statements. The proposed definition may be the first step in a process of developing a theoretical framework of health promotive nursing with a holistic-existential approach.

Attitude of Health Personnel↗
PubMed1984

A conceptual approach to school-based health promotion.

Health and health promotion have become salient topics in American society in the 1980's. Still there is little consensus on what is meant by the term "health promotion," in what ways children and adolescents should be a targeted group, or whether such activities are appropriate for schools. This paper proposes a concept of health promotion as an intervention modality, based on a clarification of the notion of health and the efforts needed to foster improved health. The relevance of health promotion efforts to the school setting is argued from three perspectives. Three levels of analysis for conceptualizing school health promotion programs are then proposed and involve the school environment, student personality characteristics, and student behavior. The question of accomplishing changes in health-related behavior through the schools is addressed through changes that are accomplished at each of these three levels. The exploration of this change process through particular theoretical attributes at each of these levels forms the basis for designing and evaluating strategies for effective school health promotion programs. Finally, the relationship between the school and the extra-school environment is proposed as a final area for research in school health promotion.

Adolescent↗
PubMedDate not supplied

[Role of primary health care in health promotion].

HEALTH PROMOTION AND DISEASE PREVENTION: In the mid '80s the World Health Organization initiated the "Health Promotion" program considered as an essential strategy in achieving the general objective "Health for all"--health promotion for the population. Promotional and preventive measures require support from the community, health politics and multisectoral approach. THE ROLE OF HEALTH SECTOR: Health sector has an essential role in health promotion and disease prevention. It requires reorientation of work, education and financing towards these levels of prevention. THE ROLE OF PRIMARY HEALTH CARE: Primary health care (PHC) is on essential part of health care and its main principles are equity, health promotion and disease prevention, community participation, appropriate health technology and multisectoral approach. Organizational and management key elements of PHC are strategic management, decentralization, coordination and development of strategic systems.

Health Promotion↗
PubMed2004

Economics and health promotion.

Health promotion activities consume a growing proportion of health sector spending in most developed countries. Yet, there is still considerable debate in the non-economic literature about exactly what health promotion constitutes and precisely how its role is to be conceived. This paper provides one economic answer to such questions. It sets out an argument that health promotion may be viewed, through the lens of traditional welfare economics, as a response to problems of market failure. A Grossman-type health investment model is invoked to analyse individual deviations from equilibrium and the possible instruments and targets of health promotion policy. The paper concludes by suggesting some of the alternative conceptual approaches that might be brought to bear, as well as some ideas for empirical research.

Health Policy↗
PubMedDate not supplied

Health promotion and health education: theory and practice.

BACKGROUND: Since health promotion and health education are developing concepts around the world, the purpose of this paper was to compare theory and practice, at certain point in time in various countries. METHODS: Data were collected using the structured direct interview. We approached 16 participants at the XVI World Conference on Health Promotion and Education. The responses of 11 participants were analyzed. RESULTS: Health promotion is a separate profession in 4 out of 11 countries. Physicians are responsible for health promotion and education in all 11 countries. School was identified as a health promotion setting in all 11 countries, while community and hospital in 10. The Ottawa Charter (1986) guided the definition of health promotion for all participants, while 7 participants defined health promotion and health education differently. CONCLUSION: Unified definition of terms may allow similar practice at the international level; comprehensive approach to health includes all aspects of health, determinants, settings and practitioners; there occurs the need for health education as a separate profession globally.

Data Collection↗
PubMed1991

The marketing of empowerment and the construction of the health consumer: a critique of health promotion.

Health promotion claims to be empowering. However, this claim is not without major problematic contradictions and inconsistencies. The way in which health promotion is also controlling is identified in this article. To understand why the discourse of health promotion is traversed by this empowering/controlling contradiction, the discourse is critically analyzed, revealing a parallel with the structure of the discourse of marketing. Health promotion, rather than fulfilling its promise of empowerment, effectively constructs the individual subject as a "health consumer" in accordance with the model of consumer capitalism.

Community Health Services↗
PubMedDate not supplied

Translating social ecological theory into guidelines for community health promotion.

Health promotion programs often lack a clearly specified theoretical foundation or are based on narrowly conceived conceptual models. For example, lifestyle modification programs typically emphasize individually focused behavior change strategies, while neglecting the environmental underpinnings of health and illness. This article compares three distinct, yet complementary, theoretical perspectives on health promotion: behavioral change, environmental enhancement, and social ecological models. Key strengths and limitations of each perspective are examined, and core principles of social ecological theory are used to derive practical guidelines for designing and evaluating community health promotion programs. Directions for future health promotion research are discussed, including studies examining the role of intermediaries (e.g., corporate decision-makers, legislators) in promoting the well-being of others, and those evaluating the duration and scope of intervention outcomes.

Ecology↗
PubMed2004

Health promotion and health education: advancing the concepts.

BACKGROUND: Health education and health promotion activities are a fundamental requirement for all health professionals. These two paradigms are closely related but are not inter-dependent. Despite this, it is known that many nurses confuse the terms and use them interchangeably. With this in mind, it is necessary to re-conceptualize the terms in an attempt to bring them to a current form of 'maturity'. AIM: The aim of the paper is to provide an up-to-date analysis of health promotion and health education that serves as a conceptual and operational foundation for clinicians and researchers. METHOD: A concept analysis following the criterion-based methods described by Morse and her colleagues was applied to the terms health education and health promotion, using generic and nursing-related literature. RESULTS: The conceptual literature on health education is consistent between generic and nursing-related sources. On the contrary, earlier nursing literature on health promotion is now at odds with more recent socio-political and community action models of health promotion, in that it focuses on individualistic and behavioural forms of 'health promotion'. A significant proportion of later nursing-related literature, however, suggests a maturing of the concept that brings it further in line with a socio-political health promotion agenda. CONCLUSION: While the theoretical and conceptual literature surrounding health education has remained relatively constant and unchanged over the last decade or so, the same cannot be said for the health promotion literature. The evolving dominance of socio-political action in health promotion has overtaken individualistic and behaviourally-related forms. While the recent nursing literature addresses and acknowledges the place of socio-political activity as the mainstay of health promotion interventions, this is largely from a theoretical stance and is not applied in practice.

Concept Formation↗