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PubMed2004

Final regulations for health coverage portability for group health plans and group health insurance issuers under HIPAA Titles I & IV. Final regulation.

This document contains final regulations governing portability requirements for group health plans and issuers of health insurance coverage offered in connection with a group health plan. The rules contained in this document implement changes made to the Internal Revenue Code, the Employee Retirement Income Security Act, and the Public Health Service Act enacted as part of the Health Insurance Portability and Accountability Act of 1996.

Eligibility Determination↗
PubMed1987

Psychology and health: contributions of psychology to the improvement of health and health care.

Psychology as both a science and a profession has been closely identified with other disciplines in the broad field of health since the turn of the present century. Recent advances in health care have reinforced the growing belief that the promotion of health and the prevention and treatment of illness can be greatly enhanced by incorporating the scientific findings and modern techniques of psychology into everyday practices. This review outlines the contributions of psychology to health care throughout the world; only some of the most timely and relevant issues are mentioned, together with examples of current work in the field. After an introductory overview, special attention is given to each of the major areas within the broad field of health care where psychological applications have been particularly useful.

Community Mental Health Services↗
PubMed2005

When mental health becomes health: age and the shifting meaning of self-evaluations of general health.

Do self-evaluations of general health change as individuals age? Although several perspectives point to age-related shifts, few researchers have compared them. For this article, several competing hypotheses were tested using a large, nationally representative, and longitudinal data set. The results suggest two trends. First, the correspondence between functional limitations and self-rated health declines, especially after age 50. Similarly, the correspondence between various chronic conditions and self-rated health declines with age. These findings are consistent with social comparison theory. Yet, the results also suggest that the correspondence between depressive symptoms and self-rated health increases. Indeed, after age 74, the correspondence between self-rated health and some common symptoms of depression becomes stronger than that between self-rated health and several chronic, and often fatal, somatic conditions. This crossover has important implications for the detection and treatment of depressive symptoms in later life.

Adult↗
PubMed2004

Comparing need between health occupation and health education schools: which students benefit most from the school health education program.

Comparing need between Health Occupation and Health Education Schools: Which students benefit most from the School Health Education Program? First-year medical students taught general health topics at public high schools. Pre-test and post-tests were given for each presentation. Health Education students had lower pre-test scores but showed greater improvement. With greater need and fewer resources, Health Education students benefit most.

Adolescent↗
PubMed2005

Health perceptions of local community works: network women describe how flows of energy and space of action generate health and ill health.

This paper presents a theoretical model on how flows of energy and space of action generate health and ill health in a local community work. Local community work was assessed through a case study of women's networks in a peripheral region of northern Sweden. The aim of the study was to analyse what participation in women's networks can mean for the members health perceptions. A purposeful selection of women's networks was made for the purpose of carrying out a qualitative follow-up study. Grounded theory was used to analyse the data and to generate a theoretical model. The meaning of participation in networks proved to be plural, as both health-deteriorating and health-promotive mechanisms were found. Two core categories "flows of energy" and "a space of action" as well as the four ancillary categories: social relations within the network; increased awareness of gender and power; becoming visible; and material prerequisites for networking were grounded in the data. We suggest that under certain circumstances local community work can be of crucial importance for health promotion.

Adult↗
PubMed1986

A public health intervention model for work-site health promotion. Impact on exercise and physical fitness in a health promotion plan after 24 months.

We need effective ways of getting adults to exercise if we are to meet the Surgeon General's 1990 health goals for the nation. This study reports a comprehensive effort to evaluate the sustained effect of a public health intervention model to achieve these health goals. Employees at four companies (N = 2,600) were exposed to a health promotion program, while employees at three comparison companies (N = 1,700) were offered an annual health screen. Daily energy expenditure in vigorous activity increased 104% among employees at companies offering the health promotion program, compared with a 33% increase among employees at comparison companies. Changes in exercise habits were corroborated by estimates of maximal oxygen uptake. Exercise and physical fitness improvements were distributed throughout the work force. Meaningful population changes in exercise and physical fitness can be produced at the work site and are of a magnitude that makes it possible to meet the 1990 goals for exercise and physical fitness.

Adolescent↗
PubMed1994

A shotgun marriage--community health workers and government health services. Qualitative evaluation of a community health worker project in Khayelitsha.

In 1988 the Western Cape Regional Services Council (RSC) initiated a community health worker (CHW) project in Khayelitsha in order to extend its preventive services to people in the community and promote 'community upliftment'. An evaluation of this project was undertaken in 1991 and 1992 in order to examine the potential of this local health authority-run CHW project to be an appropriate primary health care model. Qualitative research methods were used to explore the nature of the work done by the CHWs, whether they were accepted in their communities, and whether the project functioned as part of an integrated health service infrastructure in Khayelitsha. The CHWs were found to provide the basis for a potentially effective, community-responsive service. However, several structural problems mitigated against this service. Relations between the CHWs and nurses in all the formal public health services in the area were superficial and fraught with problems. There were significant differences and conflicting policies between the RSC's CHW project and other neighbouring non-government CHW projects, and these posed various threats to both the RSC and the non-government projects. One of the most serious of these differences was that the RSC project had no structures or plans for community involvement in the running of the project. Before a CHW project is initiated, several critical issues need to be carefully considered and discussed with all the relevant stakeholders. Furthermore, CHWs need to be flexible, and accountable to the communities in which they work. Before employing CHWs, formal public health authorities need to consider carefully whether they are able to meet these criteria.

Community Health Services↗
PubMedDate not supplied

Performance indicators in women's health: incorporating women's health in the health plan employer data and information set (HEDIS).

The Health plan Employer Data and Information Set (HEDIS) is limited in its scope of women's health-related performance measures. Realizing this, the National Committee for Quality Assurance developed the Women's Health Measurement Advisory Panel (MAP) to expand and develop HEDIS measures to better represent women's health issues. This paper outlines the development of several new women's health-related performance measures and highlights the complexities of creating new measures to assess the quality of care provided to women through our nation's managed care organizations.

Contraception Behavior↗
PubMedDate not supplied

[Educational and health dimensions of health education at school: a participative total experience in 2 health regions of Murcia].

BACKGROUND: The results of and experience on School Health Education during two years and in two health areas, which intends to promote solid contacts between all people interested in carrying out activities included in daily work, and, this way, to improve the schoolchildren habits are shown. METHODS: The activity is situated in the Investigation Action paradigm. Quantitative and qualitative methods are used in the process and product evaluation. RESULTS: The programme has had an statistically significant effect on the habits considered to be of interest (dental hygiene and physical exercise) and no effects on those habits on which no work was done. There have been 13 Educational Centers, 2 Health Centers and the Faculty of Medicine Sociosanitary Sciences Department. Collaboration, among all interested people, has been increasing, although there have been found difficulties and giving up. CONCLUSIONS: Our opinion is that the role to be played by the Health Councils and the School Councils is essential to develop the recent ministerial dispositions on the matter, within the scope of health areas.

Adolescent↗
PubMedDate not supplied

Ecological influences on health-promoting and health-compromising behaviors: a socially embedded approach to urban African American girls' health.

An ecological framework provides the underpinnings for the examination of factors associated with the health-promoting and health-compromising behaviors of African American adolescent females (N=137). Findings indicate that more positive family, peer, and neighborhood factors were associated with less engagement in health-compromising behaviors and increased engagement in health-promoting behaviors. Also, more positive family interactions buffered the relationship between neighborhood characteristics and adolescents' engagement in health-compromising behaviors. Overall, the findings suggest that the health-related behaviors of African American adolescent females are best understood in the context of their social relationships and environmental contexts.

Adolescent↗
PubMed1980

Department of Health and Human Services Public Health Services. Notification of a new system of records: Three Mile Island mental health survey, respondent records.

In accordance with the requirements of the Privacy Act, the Public Health Service (PHS) is publishing notice of a proposal to establish a new system of records entitled "Three Mile Island Mental Health Survey, Respondent Records, HHS/ADAMHA/NIMH." The Disaster Assistance and Emergency Mental Health Section, Division of Special Mental Health Programs, National Institute of Mental Health, is responsible for the system. The purpose of the system is to enable the Government to arrange followup study to the currently-funded research project entitled "The Mental Health of Residents Near the Three Mile Island Reactor: A Comparative Study of Selected Groups." PHS invites interested persons to submit comments on the proposed routine uses on or before November 3, 1980.

Confidentiality↗
PubMed1999

[Health care needs and their assessment. Part 2. The need for health and health care].

Health needs assessment is primarily concerned with the benefits that can be expected from the provision of different kinds of health services. These are closely related to the levels of health risks and illness in the population and the expected effectiveness of the service in reducing health risks and the consequences of illness as indicated by results of evaluative research or by clinical consensus. Levels of disease and health risks in a population are commonly referred to as needs for health, and the levels of expected benefit are referred to as the needs for services or care.

Czech Republic↗
PubMed2001

Interim final rules for nondiscrimination in health coverage in the group market. Internal Revenue Service, Department of the Treasury; Pension and Welfare Benefits Administration, Department of Labor; Health Care Financing Administration, Department of Health and Human Services. Interim final rules with request for comments.

This document contains interim final rules governing the provisions prohibiting discrimination based on a health factor for group health plans and issuers of health insurance coverage offered in connection with a group health plan. The rules contained in this document implement changes made to the Internal Revenue Code of 1986 (Code), the Employee Retirement Income Security Act of 1974 (ERISA), and the Public Health Service Act (PHS Act) enacted as part of the Health Insurance Portability and Accountability Act of 1996 (HIPAA).

Employee Retirement Income Security Act↗
PubMed1989

[Evaluating health effects--a preventive medicine responsibility of public health offices. Summary of a workshop presentation by the public health services at the Travemünde federal congress 1989].

It appears that Federal Public Health services are getting increasingly engaged in curative activities both in individual medicine and in medicine concerned with the general population. Public Health services are expected to draw attention to this fact and to demand that suitable methods be employed to ensure that all the people live in healthy conditions. Such environmental health protection should not be just a safety valve to "let off steam" if planning had been based on miscalculations and false appraisals--it should function in advance to prevent such social and political mishaps. A method is presented utilising the systematic scrutiny of the effects of projects on healthy as an interactive process. Since Public Health offices possess multidisciplinary competence, they are likely to cope with the multifarious problems of environmental medicine. They should act as though they were the attorneys of the population in respect of popular health demands, and must enlist competent staff capable of handling the pertinent problems. It has become apparent that the average citizen is most inclined to comply with the demands made on him by the environment if he becomes aware of the ecological linkups via his own experience. This is precisely where Public Health offices have important educational chances to accomplish their mission.

Animals↗
PubMed1998

Health services researchers zero in on quality, policy, and practice in a changing health care system: report of the 15th annual meeting of the Association for Health Services Research.

BACKGROUND: The Association for Health Services Research (AHSR) drew a record attendance of more than 2,100 to its 15th annual meeting, "Health Services Research: Implications for Policy, Delivery, and Practice," in Washington, DC, June 21-23, 1998. The conference offered 113 sessions, identifying policy roundtables and research report and panel sessions according to ten themes, with the "quality" theme on top and the effects of managed care a key concern. Selected presentations are reported. THE NATIONAL AGENDA: The keynote address, "The Public and the Managed Care Backlash," examined managed care in the context of conditions shaping public issues in the United States. The tasks and prospects for the new President's Advisory Commission on Consumer Protection and Quality in the Health Care Industry got close attention from expert and Commission-member panelists. PROFESSIONAL ETHICS, ATTITUDES, AND PRACTICE UNDER MANAGED CARE: Competing viewpoints were brought to bear on questions about whether physicians are "double agents" under managed care and how managed care, considering its degree of market penetration, is affecting physicians' beliefs and practices. EVIDENCE-BASED MEDICINE: Experts reviewed the evidence about how practice guidelines are faring, what implementation methods work best, and how to overcome remaining barriers to use of evidence-based guidelines. Clinicians reported successful implementation experiences using collaborative benchmarking and practice-based assistance to improve prevention services delivery to children. THE QUALITY MEASURES: Panelists reported advances in quality measurement methods dealing with hard-to-measure entities, including a new pediatric outcome measure. Three groups reported early implementation experiences with report cards. REVAMPING, REPOSITIONING, AND RENAMING HEALTH SERVICES RESEARCH: AHSR's president gave researchers specific assignments of questions to answer, called for a commitment to delivering health care quality information to the public, and invited suggestions to rename the discipline.

Health Care Reform↗
PubMed1999

Health education's contributions to public health in the twentieth century: a glimpse through health promotion's rear-view mirror.

A lesson of the first half of the century was that growth and technological development brought new health problems and challenges in their wake, many of which were to prove more intractable to technological fixes than the ones that had been so dramatically fixed before. Massive expansions of resources in support of the extension of these medical fixes resulted in an escalation of costs that had to be reigned in by breaking from the resource-based planning cycle that had prevailed through two eras of expansion. The 1970s ushered in an era of cost containment as the central theme of new policies. They included provisions for health promotion that sought to find new handles on the intractable social and behavioral aspects of the demand for health care resources, especially through primary prevention and building of capacity for community, family, and individual self-management of health problems and programs. Lessons from this era for public health in the next century are considered.

Health Education↗
PubMed1991

The relationship between radon knowledge, concern and behavior, and health values, health locus of control and preventive health behaviors.

Understanding similarities between health-related and radon-related knowledge, attitudes, and behaviors may suggest application of effective strategies of radon-related education in targeted populations. A mail survey was returned by 300 randomly selected homeowners in a community at risk for high home radon concentrations (50% response). While 64% were concerned, only 7% tested their homes. The expected association between radon knowledge, radon concern, and information-seeking was identified. In addition, those who tested their homes had greater knowledge and did more information seeking. Health values and radon concern were only weakly related. Environmental concern explained the greatest variance in radon concern (10%). Internal health locus of controls were more likely to have high radon concern. Of the preventive health behaviors, not smoking and seat belt use were the best predictors of variance in radon concern (5%). Segmenting the population is suggested for best educational outcome. Relating information to environmental issues may be helpful. Health-conscious people may need awareness of risks. Issues of self-control and radon testing and reduction may be helpful for some. Synergy between smoke and radon, compounded by smokers lack of concern suggests targeting smokers for education efforts.

Environmental Exposure↗
PubMedDate not supplied

Occupational health care for the 21st century: from health at work to workers' health.

A survey of relevant national and international legislation and recommendations on occupational health (OH) organization revealed two fundamental approaches to OH: 1) the historically older labor approach, essentially seeing OH care as an obligation of the employer derived from the labor contract, and 2) an emerging health approach, including all workers and all aspects of health, A draft decree on OH in Flanders seeks to integrate the two approaches. It extends the scope of OH to all workers (not only employees), introduces holistic health surveillance, rejects the incapacity concept, provides for strong integration of health and workplace surveillance, and stresses ethics. Workers' satisfaction is seen as the first criterion in quality control. Systematic data collection and analysis, and when necessary, scientific research are recommended. Additional resources for OH services should be provided by stakeholders other than employers.

Accidents, Occupational↗