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PubMedDate not supplied

[Mental health and work environment of a group of public health preventive service users].

BACKGROUND: In a previous organizational study we proposed shared technical initiatives in public occupational health and mental health public services dedicated to mental health at work which is now completely neglected. OBJECTIVES: To study the occupational mental health demand in public health services users by improving shared tools among public health services. METHODS: Data collection on socio-demographic characteristics, relationship between mental health and working environment, organizational constraints in a group of mental, occupational and public health service users (no 90). RESULTS: A third of the users, mostly women, described the working environment as negative for mental health. The main reported organizational constraints were poor career possibilities, relationship with the public and workload. Inadequate workload is the leading cause for a negative evaluation of working conditions for mental health. CONCLUSIONS: This study confirms that mental health at work is a public health problem that has to be better investigated using tools shared between mental and occupational health services.

Adult↗
PubMedDate not supplied

[Activities of the industrial physician in a state preventive health service. The case of Italy].

We analyzed the occupational health activities of physicians in a public occupational health service using the Method of Organizational Congruences (MOC). Occupational health activities are changing in Italy with the application of the European Community Directives (Decreto Legislativo 626/94). We identified four major organizational constraints: a lack and difficult in interdisciplinary work, absence of worker control on the activities, limitations in planning specific industrial area studies, increased conflict between prevention and control activities. We predict for the future an increase of these constraints with a reduction in the professional level of the physicians employed in the state system of local occupational health units.

Humans↗
PubMed2006

Improving preventive service delivery at adult complete health check-ups: the Preventive health Evidence-based Recommendation Form (PERFORM) cluster randomized controlled trial.

BACKGROUND: To determine the effectiveness of a single checklist reminder form to improve the delivery of preventive health services at adult health check-ups in a family practice setting. METHODS: A prospective cluster randomized controlled trial was conducted at four urban family practice clinics among 38 primary care physicians affiliated with the University of Toronto. Preventive Care Checklist Forms were created to be used by family physicians at adult health check-ups over a five-month period. The sex-specific forms incorporate evidence-based recommendations on preventive health services and documentation space for routine procedures such as physical examination. The forms were used in two intervention clinics and two control clinics. Rates and relative risks (RR) of the performance of 13 preventive health maneuvers at baseline and post-intervention and the percentage of up-to-date preventive health services delivered per patient were compared between the two groups. RESULTS: Randomly-selected charts were reviewed at baseline (n = 509) and post-intervention (n = 608). Baseline rates for provision of preventive health services ranged from 3% (fecal occult blood testing) to 93% (blood pressure measurement), similar to other settings. The percentage of up-to-date preventive health services delivered per patient at the end of the intervention was 48.9% in the control group and 71.7% in the intervention group. This is an overall 22.8% absolute increase (p = 0.0001), and 46.6% relative increase in the delivery of preventive health services per patient in the intervention group compared to controls. Eight of thirteen preventive health services showed a statistically significant change (p < 0.05) in favor of the intervention (adjusted RR (95% C.I.)): counseling on brushing/flossing teeth (9.2 (4.3-19.6)), folic acid counseling (7.5 (2.7-20.8)), fecal occult blood testing (6.7 (1.9-24.1)), smoking cessation counseling (3.9 (2.2-7.2)), tetanus immunization (3.0 (1.7-5.2)), history of alcohol intake (1.33 (1.2-1.5)), history of smoking habits (1.28 (1.2-1.4)) and blood pressure measurement (1.05 (1.00-1.10)). CONCLUSION: This simple, low cost, clinically relevant intervention improves the delivery of preventive health services by prompting physicians of evidence-based recommendations in a checklist format that incorporates existing practice patterns. Periodic updates of the Preventive Care Checklist Forms will allow a feasible and easy-to-use tool for primary care physicians to provide evidence-based preventive health services to adults at routine health check-ups. The forms can also be incorporated into an electronic health record. The Preventive Care Checklist Forms are accessible in English and French at the College of Family Physicians of Canada web site.

Adult↗
PubMedDate not supplied

[Analysis of a preventive health service].

This paper reports the experience and organization of an Occupational Health Service for health-care workers, in order to improve the effectiveness of the unit. The Authors describe the activities of the unit, its organization, and evaluate the amount of working time spent in the different activities.

Health Personnel↗
PubMed1999

Expanding health promotion to individuals with spinal cord injuries.

Health promotion and preventive health services, though related, are not synonymous. Unlike preventive services, health promotion reaches beyond a specific action or inaction and nurtures a positive lifestyle. Many nurses believe in providing preventive health services to clients with spinal cord injuries (SCI) but describe them as clients who "will never get well." Nurses then question the relevance of health promotion services to those with SCI. This limited perspective fails to acknowledge that many individuals with physical disabilities perceive themselves as healthy. They know how to manage their disabilities and want to learn more about how they can actualize their potential in the context of their physical disabilities. Attitudes, overt or covert, that fail to recognize these individuals potential for health add to the disenfranchisement that they experience daily from society. This disenfranchisement often leads to hopelessness, anger, and depression. None of these emotions fosters health or happiness. The nurse who forges into health promotion expands his/her practice beyond the traditional "fix a problem" role. In the health promotion setting, the nurse's influence must move beyond preventing a specific complication and impact the more global outcome of promoting lifestyle choices, habits, and attitudes.

Activities of Daily Living↗
PubMedDate not supplied

The Preventive Health and Health Services Block Grant: the Massachusetts experience.

The Preventive Health and Health Services Block Grant funds a variety of disparate programs in health promotion and disease prevention. Many of these programs were funded by categorical grants to the States prior to the creation of this block grant in 1981. This block grant allows States to set priorities among the different programs by shifting their funding allocations. In addition, there is considerable opportunity to use these funds creatively in shaping the content of their programs. The Massachusetts Department of Public Health's experience with this block grant is reviewed, showing the grant's critical importance in the department's statewide disease prevention efforts. In order to maximize public health impact, the department has shifted its funding allocations based on explicit criteria. These criteria represent a model that may have widespread applicability for other State health departments.

Fluoridation↗