Promotion & Education current issue

Publication ethics: a collective responsibility

Perry, M. W., Mittelmark, M. B. — 2008-08-28

The ethics of Community Empowerment: tensions in health promotion theory and practice

Braunack-Mayer, A., Louise, J. — 2008-08-28

The concepts of community participation, empowerment and capacity building are central tenets of contemporary health promotion theory. They reflect the view that health and well-being are shaped by a wide range of social, economic, political and organisational forces that are outside the control of individuals.

Despite its theoretical appeal, the practice of Community Empowerment is ethically contentious and can produce ethical dilemmas for health promotion practitioners. In this paper we relate these dilemmas to theoretical considerations, and argue that the empowerment of communities should be understood as a means rather than an end . This leads us to argue for the adoption of what we call a Reflective Equilibrium Community Empowerment approach, which draws on both "top—down" and "bottom—up" methods to help resolve the ethical tensions in health promotion programmes. (Promot Educ 2008;15(3): 5-8)

Nurse and physician patient counseling about tobacco smoking in Jordan

Merrill, R. M., Madanat, H., Kelley, A. T., Layton, J. B. — 2008-08-28

The objective of this study was to identify whether nurses are as likely as physicians to feel prepared to assist patients to quit smoking, to have smoked in front of patients, or to have received training on counseling patients about smoking cessation. The sample consisted of 262 nurses and 251 physicians, ages 18 years and older, from public and private hospitals in Jordan. It was found that nurses were more likely than physicians to receive training on counseling patients about smoking cessation (41% vs. 18%); more likely to currently smoke (30% vs. 19%); and less likely to feel prepared to assist patients to quit smoking (78% vs. 95%). Smoking status and training were associated with counseling patients about smoking. Approximately 19% of nurses and 81% of physicians who currently or formerly smoked had previously smoked in front of patients. Nurses compared with physicians have lower agreement with statements involving smoking-related responsibilities and views on smoking policy, but higher agreement that second-hand smoke is related to selected diseases. Physicians felt more strongly than nurses that they should serve as role models for the public, routinely advise their smoking patients to quit, and speak to lay groups about smoking. In conclusion, a greater level of smoking cessation training among physicians and nurses in Jordan is warranted. (Promot Educ 2008; 15 (3): 9-14)

Getting serious about the social determinants of health: new directions for public health workers

Raphael, D. — 2008-08-28

International interest in the social determinants of health and their public policy antecedents is increasing. Despite evidence that as compared to other wealthy nations Canada presents a mediocre population health profile and public policy environments increasingly less supportive of health, the Canadian public health gaze is firmly — and narrowly — focused on lifestyle issues of diet, physical activity and tobacco use. Much of this has to do with Canada being identified as being driven by a liberal political economy, a situation shared with a cluster of other developed nations. Reasons for Canada's neglect of structural and public policy issues are explored and ways by which public health workers in Canada and elsewhere can help to shift policymakers and the general public's understandings of the determinants of health are outlined. (Promot Educ 2008;15(3): 15-20)

AIDS education in an Islamic nation: content analysis of Farsi-language AIDS-education materials in Iran

Kalkhoran, S., Hale, L. — 2008-08-28

Inconsistent statistics about the number of HIV/AIDS cases in Iran and misinformation about HIV/AIDS among Iranian adolescents necessitate proper understanding and knowledge of HIV/AIDS transmission and prevention. This is particularly important since many issues related to HIV/AIDS, such as sex, homosexuality, and drug use, are taboo topics in the Islamic world. We analyzed Farsi-language educational and informational small media items to ascertain the nature of HIV/AIDS-related material available in society. While all of the documents mentioned sexual contact as a means of transmitting the virus, and the majority (87%) mentioned condom use as a preventive means, mention of homosexuality (43%) and prostitution (17%) was lacking in most. Thus, mention of "safe sex" strategies was not avoided due to fear of promoting sex outside of marriage, as has been noted in other Islamic nations. Mention of intravenous drug use in 90% of the documents shows an acknowledgment of the drug problem in the nation, and an effort to curb its harmful sequelae. Therefore, while certain issues such as sex, condoms, and drug use were well represented in the documents analyzed, additional inclusion of topics such as homosexuality and prostitution, issues already discussed infrequently in society, can help to better educate the population and curb the spread of this life-threatening disease. (Promot Educ 2008;15(3): 21-25)

Abstracts

2008-08-28

The role of surveillance and data use in the development of public health policies

Stachenko, S. — 2008-08-28

Decision makers consider numerous factors besides surveillance data in establishing public health policies and programmes. In an evidence-informed system, it is important to collect, interpret, and present information that has maximum impact on the broader policy agenda.

Successful policies and programmes are rational, feasible, and practical, with wide public support. Surveillance systems must align and interact with the other parts of the policy infrastructure. There must be continuous links between data providers, collectors, and users. Data must be representative of population variations.

For chronic diseases, the major challenge is multiple risks. Surveillance systems must capture many factors from many sources. Data must be presented in plain language and tailored to the needs of various users — politicians, policy makers, health providers, researchers, and the public. Data must be linked to other policy areas such as taxation. Economic arguments, including modelling, strongly influence decisions. Broad data ownership through alliances also has significant impact. (Promot Educ 2008;15(3): 27-29)

An ethical question: Are health professionals promoters of the status quo or of social change?

Shuftan, C. — 2008-08-28

The topic of the above title has vividly interested the author for many years. Regretfully, the issues at stake have not changed for the last 25 years. As proof of this — and on purpose — references dug up and quoted are only those published before 1986. The end result has been the (re)construction of a scenario that has been stubborn to change and that looks into most of the burning questions of then and now pertaining to the title.

The materials here presented are an informal, non-systematic review of the literature on the ethical, ideological and political implications of health as a science and as a praxis. The materials here collected are, in a way, "out of the box" and, in the author's view very needed. The article sheds some light on the major issues at the core of this universal discussion that — whether we like it or not — was and continues to be at the very base of our daily work as health professionals. (Promot Educ 2008;15(3): 30-33)

Hunting happiness or promoting health? Why positive psychology deserves a place in health promotion

Bull, T. — 2008-08-28

This commentary asks the question of whether positive psychology represents an egoistic pursuit of happiness, which is in conflict with basic values within health promotion. A look at key concepts and research findings within positive psychology reveals common ground with health promotion. Similarities are evident in conceptualization of health, resource focus, value focus and consequences for policy. Some influences of happiness on health and functioning are described. (Promot Educ 2008;15(3): 34-35)

The future of health promotion in schools goes through the strengthening of teacher training at a global level

Jourdan, D., Samdal, O., Diagne, F., Carvalho, G. S. — 2008-08-28

Schools are considered to be settings for both health education and health promotion. But the core business of schools is actually focused on educational outcomes, not reducing health problems. In most countries, schools give low priority to health promotion, and school staffs, mainly teachers, are not aware of their role in health promotion. Studies show that teachers who have received health promotion training tend to be involved more frequently in health promotion projects and have a more comprehensive approach to health education. Pre-service and in-service staff training is then a main challenge. This is the reason why we have launched an initiative to join international forces to strengthen and advocate for teacher training in health promotion. The main goals are to develop research, affirm and reinforce the work done in teacher training in health promotion, support the institutes/colleges/universities in the provision of pre-service and in-service teacher training and stimulate international partnership work. (Promot Educ 2008;15(3): 36-38)

Three Year Work Plan (2007--10) of the IUHPE Northern Part of the Western Pacific Region

Nakahara, T. — 2008-08-28

The article presents the work plan of the Vice President for the Northern Part of the Western Pacific Region of the IUHPE. The highlights of the plan include, firstly, the organization of the First Asia-Pacific Conference on Health Promotion and Health Education, which will take place in July 2009. Secondly, the plan proposes the establishment of a liaison office and an Internet journal to facilitate collaboration among individuals, groups and organizations working in health promotion and education in this culturally and linguistically diverse region. (Promot Educ 2008; 15(3): 39-40)

Strengthening the European region of IUHPE -- Work Plan of IUHPE/EURO for 2008--10

Pyykko, M., Koskenkorva, S. — 2008-08-28

The commentary presents the Work Plan of the IUHPE European Region for 2008—10. The plan has been put together after a comprehensive discussion and review of the results of a survey of IUPHE European Region members. The result is a plan that provides overarching and future-oriented support for the development of the activities in the region. The main strategies of the new IUHPE/EURO Work Plan include: 1. effective working of the Regional Committee; 2. supporting and engaging IUHPE members; 3. advocacy and partnership building; 4. strengthening communications; and 5. follow-up and evaluation. (Promot Educ 2008;15(3): 41-43)

L'ethique des publications: une responsabilite collective

Perry, M. W., Mittelmark, M. B. — 2008-08-28

Resumes

2008-08-28

La etica de las publicaciones: una responsabilidad colectiva

Perry, M. W., Mittelmark, M. B. — 2008-08-28

Aire fresco, un programa participativo y entre iguales para reducir el consumo de tabaco en el ambito educativo

2008-08-28

Fundamento: En 2000, se puso en marcha el programa Aire fresco en los centros de secundaria de Asturias (España) para reducir o eliminar el tabaco en el ámbito educativo. Este estudio recoge la evaluación del proceso de esta intervención, que concluyó en 2005, en 23 centros de secundaria.

Métodos: El programa duraba un curso escolar y ponía en marcha un proceso con seis acciones, con el objetivo final de implicar a alumnado, personal y madres/padres en el establecimiento y cumplimiento de nuevas normas. Estas seis acciones eran: información, propuestas del personal, propuestas del alumnado, establecimiento de nuevas normas, difusión y actividades de refuerzo. Entre otras actividades, se ofertaban un taller entre iguales para el alumnado y un taller para dejar de fumar para personal y madres/padres. El programa lo llevaron a cabo 23 centros que constituyeron, con su alumnado y profesorado, la población de estudio. Mediante cuestionarios, se recogieron datos de acciones realizadas, participación en las actividades y opinión de alumnado y profesorado. También se realizaron grupos focales para conocer las dificultades, logros y propuestas de mejora.

Resultados: El 100% de los centros realizó actividades informativas, el 83% recogió propuestas del personal para limitar su consumo, el 91% las del alumnado, y el 70% estableció nuevas normas. Las opiniones de alumnado y profesorado sobre el programa, materiales y metodología fueron positivas. El taller para dejar de fumar se realizó en 18 centros y participaron 176 personas. Entre las que lo concluyeron, el 20% permanecía sin fumar a los seis meses.

Conclusiones: Aire Fresco fue una intervención novedosa, satisfactoria y útil para regular el consumo de tabaco en los centros educativos. La filosofía del programa, que buscaba la participación de la comunidad educativa y lo convertía en un proyecto educativo de centro, fue una de las claves para lograr estos resultados. (Promot Educ 2008; 15(3): 52-57)

Educacion para la salud con personas mayores: descripc de una experiencia

Pino Juste, M. R. — 2008-08-28

En este artículo se describe una experiencia llevada a cabo con pacientes mayores de 65 años en centros de Atención Primaria de salud situados en el medio rural.

Los objetivos planteados en el programa tienen como meta facilitar la consecución de hábitos saludables, conocer la sintomatología y tratamiento de las enfermedades más comunes en la vejez y como consecuencia conseguir una optimización de los recursos sanitarios.

La elección de los contenidos se ha realizado teniendo en cuenta las necesidades detectadas en el historial clínico del paciente, en las valoraciones geriátricas realizadas por los médicos y en las entrevistas realizadas por las educadoras para definir las características sociosanitarias de la población. Así como la edad y del nivel socio-cultural de los participantes. Para la evaluación de la experiencia se utilizaron diferentes técnicas como escalas, cuestionarios, entrevistas, observación, discusiones en grupo y registro de datos y se tuvo en cuenta la cobertura del programa, su desarrollo y el índice de impacto del mismo.

La asistencia al curso ha sido regular y el 92 % de los pacientes ha asistido a todas las sesiones y ha participado activamente.

El personal sanitario manifestó que a raíz de la experiencia, la comunicación médico-paciente se hizo más fluida y se detecta una mayor comprensión de la información que los médicos ofrecen al usuario.

Además se ha constatado la escasa formación de las personas mayores en temáticas de salud. Las temáticas que consideraron más importantes fueron el ejercicio físico, la estimulación cognitiva y la alimentación adecuada. Igualmente, se ha detectado una mejora del estado de ánimo, una mayor autonomía y una menor dependencia de los familiares para actividades de la vida diaria.

Los propios mayores revelan al médico la experiencia vivida como un auténtico aprendizaje, así como su deseo de continuar en otras ediciones del programa. (Promot Educ 2008;15(3): 58-62)

Resumenes

2008-08-28