scholarly journals Do multiple community-based interventions on health promotion tackle health inequalities?

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Stefan Nickel ◽  
Olaf von dem Knesebeck
Keyword(s):  
Health Promotion ◽  
Health Inequalities ◽  
Economic Status ◽  
Research Question ◽  
Smoking Behavior ◽  
Component Community ◽  
Community Based Interventions ◽  
Community Based ◽  
Wide Range ◽  
The Impact

Abstract Background Previous systematic reviews of the impact of multi-component community-based health promotion interventions on reducing health inequalities by socio-economic status (SES) were restricted to physical activity and smoking behavior, and revealed limited and rather disillusioning evidence. Therefore, we conducted a comprehensive review worldwide to close this gap, including a wide range of health outcomes. Methods The Pubmed and PsycINFO databases were screened for relevant articles published between January 1999 and August 2019, revealing 87 potentially eligible publications out of 2876 hits. In addition, three studies out of a prior review on the effectiveness of community-based interventions were reanalyzed under the new research question. After a systematic review process, 23 papers met the inclusion criteria and were included in the synthesis. Results More than half (56.5%) of the studies reported improvements of socially disadvantaged communities overall (i.e. reduced inequalities at the area level) in at least one health behavior and/or health status outcome. Amongst the remaining studies we found some beneficial effects in the most deprived sub-groups of residents (8.2%) and studies with no differences between intervention and control areas (34.8%). There was no evidence that any program under review resulted in an increase in health disparity. Conclusions Our results confirm that community-based interventions may be reducing absolute health inequalities of deprived and disadvantaged populations, but their potential so far is not fully realized. For the future, greater attention should be paid to inequalities between sub-groups within communities when analyzing changes in health inequality over time.

scholarly journals 32.M. Workshop: Mig-HealthCare project: Reducing health inequalities of vulnerable migrants in Europe

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
◽  
Keyword(s):  
Health Care ◽  
Health Promotion ◽  
Health Inequalities ◽  
Structural Changes ◽  
Care Delivery ◽  
Public Health Response ◽  
Community Based ◽  
Care Community ◽  
Health And Social Care ◽  
Wide Range

Abstract This MigHealthCare Workshop will be a forum to present and discuss the project's final results with a wide range of health and social care professionals working on the field of migrant/refugee health. The Mig-HealthCare project is a collaboration of 14 partners, among them universities, national authorities and NGOs from 10 countries across Europe (Greece, France, Malta, Germany, Austria, Italy, Cyprus, Spain, Sweden and Bulgaria). The major aim of the project is to reduce health inequalities and improve the integration of vulnerable migrants and refugees into local communities in Europe. The project is co-funded by the III Health Programme of the European Commission from 2017-2020. The Mig-HealthCare project addresses the need for structural changes in the health systems to respond to the unmet needs of vulnerable migrants and refugees in Europe and promotes community-based care. Community-based health care has proven to be effective in reducing health inequalities in health, as well as improving accessibility to appropriate care. For this purpose, the consortium has produced an evidence-based Roadmap and Toolbox to reorient health care services to a community level which is a user-friendly online application focusing on the key steps for optimal health care delivery to migrants and refugees. In this regard and as part of these operative tools, within the Mig-HealthCare project, effective community-based care interventions focused on health promotion or prevention were designed and piloted in 8 different contexts and countries. As main results of the MigHealthCare project, the Roadmap and Toolbox comprise both the necessary factors that health policy and practice need to deliver culturally competent care as well as the particular health issues especially faced by migrants and refugees in order to better prepare public health response. Key messages Community-based care for vulnerable migrants and refugees has proven to be effective in reducing health inequalities. Evidence on the drivers of the success or failure of health promotion strategies for migrants and refugees should be considered when planning interventions.

scholarly journals And yet Again: Having Breakfast Is Positively Associated with Lower BMI and Healthier General Eating Behavior in Schoolchildren

Nutrients ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 1351
Author(s):  
Peggy Ober ◽  
Carolin Sobek ◽  
Nancy Stein ◽  
Ulrike Spielau ◽  
Sarah Abel ◽  
...  
Keyword(s):  
Weight Status ◽  
Economic Status ◽  
School Setting ◽  
School Type ◽  
Community Based Interventions ◽  
Community Based ◽  
Nutritional Behavior ◽  
Related Information ◽  
Starting Point ◽  
National Programs

Given the high prevalence of childhood overweight, school-based programs aiming at nutritional behavior may be a good starting point for community-based interventions. Therefore, we investigated associations between school-related meal patterns and weight status in 1215 schoolchildren. Anthropometry was performed on-site in schools. Children reported their meal habits, and parents provided family-related information via questionnaires. Associations between nutritional behavior and weight status were estimated using hierarchical linear and logistic regression. Analyses were adjusted for age, socio–economic status, school type, migration background, and parental weight status. Having breakfast was associated with a lower BMI-SDS (βadj = −0.51, p = 0.004) and a lower risk of being overweight (ORadj = 0.30, p = 0.009), while having two breakfasts resulting in stronger associations (BMI-SDS: βadj = −0.66, p < 0.001; risk of overweight: ORadj = 0.22, p = 0.001). Likewise, children who regularly skipped breakfast on school days showed stronger associations (BMI-SDS: β = 0.49, p < 0.001; risk of overweight: OR = 3.29, p < 0.001) than children who skipped breakfast only occasionally (BMI-SDS: β = 0.43, p < 0.001; risk of overweight: OR = 2.72, p = 0.032). The associations persisted after controlling for parental SES and weight status. Therefore, our data confirm the school setting as a suitable starting point for community-based interventions and may underline the necessity of national programs providing free breakfast and lunch to children.

The “Best of 2021 List” of Health Promotion Researchers

2021 ◽  
pp. 089011712110732
Author(s):  
Paul E. Terry
Keyword(s):  
Health Promotion ◽  
Research Question ◽  
Well Being ◽  
Editorial Team ◽  
Unique Contribution ◽  
Sources Of Information ◽  
Workplace Interventions ◽  
Award Winning ◽  
The Impact ◽  
Criteria For Selection

Each year the editorial team of the American Journal of Health Promotion selects our “Best of the Year List” of health promotion studies from the prior year. This editorial features the Editor’s Picks Awards, the Editor in Chief Awards, the Michael P. O’Donnell Award and the Dorothy Nyswander Award for the research and writing published in 2021 in this journal. Our criteria for selection includes: whether the study addresses a topic of timely importance in health promotion, the research question is clearly stated and the methodologies used are well executed; whether the paper is often cited and downloaded; if the study findings offer a unique contribution to the literature; and if the paper is well-written and enjoyable to read. Awardees in 2021 offered new insights into addressing discrimination against race or sexual identity, preferred sources of information about COVID-19 and the impact of community and workplace interventions on healthy lifestyles. This year’s award winning research spans from character to culture relative to improving well-being.

scholarly journals "It Isn't All about You": The Management of ICT and Non-ICT Information Resources via Human Information Behaviour

2021 ◽  
Author(s):  
◽  
Paul Daniel Atkinson
Keyword(s):  
Activity Theory ◽  
Information And Communication Technologies ◽  
Time Management ◽  
Information Seeking ◽  
Research Question ◽  
Information Use ◽  
Information Behaviour ◽  
Systems Model ◽  
Wide Range ◽  
The Impact

<p>"Applications that gather dust... Technologies no one understands... Information that's ignored... [thus, there is still very much a need to] pay attention to Information behaviour" (Davenport, 1997, p.2). Human Information Behaviour is as important a concept today as it has ever been, as there are still millions of dollars going into improving information technology. While information seeking behaviour has been rigorously studied over the years, information use has not received the same attention. Neither has the IT artefact or choice of such technologies at the hands of users of information. This research paper aims to produce a taxonomy of the information use behaviours and ICT and non-ICT resource use of IT academics through a qualitative study involving both observation (incorporating thinking aloud) and structured face-to-face interview techniques. The research question asks "How do IT Academics manage the integration between various Information and Communication Technologies (ICT) and non-ICT sources to support their information behaviours (IB) and, therefore, achieve their desired outcome? We observed and interviewed six IT academics carrying out their normal working activities, looking into actual information events as they occurred, information outcomes, information behaviours, and the technologies used by academics in their daily interactions with information. We developed a systems model, informed by activity theory, to frame the discussion. What was uncovered by the study was a tendency for academics to converge on a single technology - that of the laptop. This together with email was what academics tended to prefer to use, both at the office and in their homes; a surprising find as it was assumed that there would be a plethora of different ICTs in use. We found that technologies contributed to a blurring of the work/life equilibrium for many academics. Academics did exhibit a wide range of behaviours in their laptop and email use. Many of them were relatively unproductive, and involved moving information from one place, or one form to another, and finally ending in deletion rather than active use. Many of our interviewees reflected a need to use their time wisely through time management, and the impact of email on time management. These results also yielded the justification of Activity Theory which was used in the study, and of the systems framework which was constructed for the study. The study also confirmed the importance of environmental influences on academic's working lives, which tended to create a somewhat cyclic nature to their information events. Overall, it was not clear that patterns of use of ICTs contributed to effective information use behaviour by IT academics.</p>

scholarly journals Complexity, Evaluation and the Effectiveness of Community-based Interventions to Reduce Health Inequalities

2020 ◽  
Author(s):  
Anna Matheson ◽  
Kevin Dew ◽  
Jacqueline Cumming
Keyword(s):  
New Zealand ◽  
Health Inequalities ◽  
Comparative Case Study ◽  
Successful Implementation ◽  
Intervention Effectiveness ◽  
Community Based Interventions ◽  
Community Based ◽  
Theoretical Understanding ◽  
System Perspective

Reducing health inequalities has been part of the New Zealand government's agenda since the early 1990s. As a result, interventions have been implemented nationally with the explicit goal of reducing health inequalities. This paper describes findings from a comparative case study of two community-based interventions - carried out in different New Zealand communities. Complexity theory was used as an analytic tool to examine the case data, and provided a systematic way in which to explore 'local' issues by taking a 'whole system' perspective. The findings showed that two important influences on the successful implementation of the interventions were the existence and capacity of local organisations and their relationships with government agencies. The analysis provided a dynamic picture of shared influences on the interventions in different communities and in doing so offered insight into intervention effectiveness. It is argued in this article that, for examining intervention effectiveness, it is essential to have a theoretical understanding of the behaviour of the complex system in which they are implemented. This theoretical understanding has implications for the appropriate design of interventions to reduce health inequalities, and in turn should lead to more meaningful ways to evaluate them.

scholarly journals Complexity, Evaluation and the Effectiveness of Community-based Interventions to Reduce Health Inequalities

2020 ◽  
Author(s):  
Anna Matheson ◽  
Kevin Dew ◽  
Jacqueline Cumming
Keyword(s):  
New Zealand ◽  
Health Inequalities ◽  
Comparative Case Study ◽  
Successful Implementation ◽  
Intervention Effectiveness ◽  
Community Based Interventions ◽  
Community Based ◽  
Theoretical Understanding ◽  
System Perspective

Reducing health inequalities has been part of the New Zealand government's agenda since the early 1990s. As a result, interventions have been implemented nationally with the explicit goal of reducing health inequalities. This paper describes findings from a comparative case study of two community-based interventions - carried out in different New Zealand communities. Complexity theory was used as an analytic tool to examine the case data, and provided a systematic way in which to explore 'local' issues by taking a 'whole system' perspective. The findings showed that two important influences on the successful implementation of the interventions were the existence and capacity of local organisations and their relationships with government agencies. The analysis provided a dynamic picture of shared influences on the interventions in different communities and in doing so offered insight into intervention effectiveness. It is argued in this article that, for examining intervention effectiveness, it is essential to have a theoretical understanding of the behaviour of the complex system in which they are implemented. This theoretical understanding has implications for the appropriate design of interventions to reduce health inequalities, and in turn should lead to more meaningful ways to evaluate them.

Victorian Health Policy Reform: Impact on Community-based Health Promotion

1997 ◽  
Vol 3 (4) ◽  
pp. 7
Author(s):  
Sharon Parkinson
Keyword(s):  
Health Promotion ◽  
Health Policy ◽  
Community Health ◽  
Policy Reform ◽  
Health Centre ◽  
Community Action ◽  
Small Sample ◽  
Significant Shift ◽  
Community Based ◽  
The Impact

Since the Victorian Coalition Government was elected to office in 1992, community health policy has undergone considerable change as part of broader initiatives within the public sector. In the context of changing policy, concerns have been raised in the field of community health regarding the direction of community-based health promotion. The purpose of this study is to investigate the impact of policy reform on the conceptualisation, priority setting and practice of community-based health promotion. A series of interviews was conducted with a small sample of community health centre managers and staff within metropolitan Melbourne. Findings suggest that there has been a significant shift in the profile of community-based health promotion, with increasing emphasis on health promotion in clinical encounters and in groups, and less project work and community development. In terms of the principles of the Ottawa Charter, health promotion has moved away from the areas of community action and building healthy public policy as the centres focus increasingly on direct service provision. This study discusses the influences on and implications for the changing profile of community-based health promotion and considers directions for the future.

scholarly journals Valuing the impact of health and social care programs using social return on investment analysis: how have academics advanced the methodology? A systematic review

BMJ Open ◽  
2019 ◽  
Vol 9 (8) ◽  
pp. e029789 ◽  
Author(s):  
Claire Louise Hutchinson ◽  
Angela Berndt ◽  
Deborah Forsythe ◽  
Susan Gilbert-Hunt ◽  
Stacey George ◽  
...  
Keyword(s):  
Systematic Review ◽  
Return On Investment ◽  
Social Care ◽  
Assessment Tool ◽  
Research Question ◽  
Social Return On Investment ◽  
Health And Social Care ◽  
Wide Range ◽  
The Impact

ObjectivesTo identify how social return on investment (SROI) analysis—traditionally used by business consultants—has been interpreted, used and innovated by academics in the health and social care sector and to assess the quality of peer-reviewed SROI studies in this sector.DesignSystematic review.SettingsCommunity and residential settings.ParticipantsA wide range of demographic groups and age groups.ResultsThe following databases were searched: Web of Science, Scopus, CINAHL, Econlit, Medline, PsychINFO, Embase, Emerald, Social Care Online and the National Institute for Health and Care Excellence. Limited uptake of SROI methodology by academics was found in the health and social care sector. From 868 papers screened, 8 studies met the criteria for inclusion in this systematic review. Study quality was found to be highly variable, ranging from 38% to 90% based on scores from a purpose-designed quality assessment tool. In general, relatively high consistency and clarity was observed in the reporting of the research question, reasons for using this methodology and justifying the need for the study. However, weaknesses were observed in other areas including justifying stakeholders, reporting sample sizes, undertaking sensitivity analysis and reporting unexpected or negative outcomes. Most papers cited links to additional materials to aid in reporting. There was little evidence that academics had innovated or advanced the methodology beyond that outlined in a much-cited SROI guide.ConclusionAcademics have thus far been slow to adopt SROI methodology in the evaluation of health and social care interventions, and there is little evidence of innovation and development of the methodology. The word count requirements of peer-reviewed journals may make it difficult for authors to be fully transparent about the details of their studies, potentially impacting the quality of reporting in those studies published in these journals.PROSPERO registration numberCRD42018080195.

The application of the complexity theory to public health interventions: a review of the literature

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
P Contu ◽  
E Breton
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health Promotion ◽  
Complexity Theory ◽  
Health Care Services ◽  
Health Interventions ◽  
Review Of The Literature ◽  
Community Based Interventions ◽  
Community Based ◽  
Care Services

Abstract Background There is a growing recognition of the limitations of a linear cause-and-effect rationality in planning and evaluating public health interventions. Although this perspective is amenable to programme planning and evaluation, it leaves aside a whole array of mechanisms of change triggered by interactions taking place in complex social systems. Generative causality is one and recognized under a number of works referring to the complexity paradigm. Here we review the state of knowledge on what is often referred to as the complexity theory (CT), and present the results of a review of the literature on its application in public health. Methods We searched PubMed for articles, commentaries, editorials published in English, French and Italian, using the keywords 'Complexity Theory' (also plural). We categorized the fields of application of the CT according to the three core WHO's Essential Public Health Operations, i.e., Health Promotion, Prevention and Protection. All papers addressing issues related to health care services (but not prevention) were included in the category “health care services” while others were tagged as “others”. Results We found 203 papers meeting our inclusion criteria. The largest share of the research output applying the CT was in health care services (n = 167), followed by Health Promotion (5), Prevention (3) and Protection (2). 26 papers were labelled others. In health promotion/ prevention, applications of the CT have yet to integrate most of its concepts. Most authors tap into both the linear and generative rationality perspectives. Conclusions Although regularly deemed as promising in uncovering mechanisms for change triggered by public health intervention, applications of the complexity theory remain uncommon and has made little inroads in the public health domain. This is particularly the case for health promotion where one would assume that participatory community-based interventions would be an incentive to integrate this perspective. Key messages Although deemed promising the complexity theory has made little inroads in public health. Health promotion with its participatory community-based interventions can benefit from its application.

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