‘Improving Health through Reducing Stress’: Parents′ Priorities in the Participatory Development of a Multilevel Family Health Programme in a Low-Income Neighbourhood in the Netherlands

In order to reduce health inequities, a socio-ecological approach and community engagement are needed to develop sustained interventions with a positive effect on the health of disadvantaged groups. This qualitative study was part of the development phase of a community health promotion programme. The study aimed to provide insight into the perceptions of parents in a disadvantaged neighbourhood about health, and their priorities for the community health programme. It also described the process of integrating these perceptions in the development of a multilevel plan for this programme. Participatory methods were applied to enable the engagement of all groups involved. Ten parents from a low-income neighbourhood in the Netherlands participated in five panel sessions. Parents’ priorities for improving family health were reducing chronic stress and not so much healthy eating and physical activity. They prioritised solutions to reduce their financial stress, to provide a safe place for their children to meet and play and to establish good quality communication with authorities. The programme development process resulted in objectives in which both parents and professionals were willing to invest, such as a safe playground for children. This study shows that target population engagement in health programme development is possible and valuable.

EFFECTIVENESS OF HEALTH PROMOTION PROGRAMME ON LEVELS OF KNOWLEDGE AND ATTITUDE REGARDING LIFE STYLE MODIFICATION AMONG PATIENTS WITH DIABETES MELLITUS AT GALAXY HOSPITAL

Diabetes mellitus is a chronic condition but people with diabetes can lead a normal life. Life style modification can be a very effective way to keep diabetes under control. The research design used was pre-experimental, one group pre and post-test design.Non probability, purposive sampling was adopted to select 50 samples. Structured questionnaire was used to assess levels of knowledge and attitude regarding life style modification. Descriptive and inferential statistics were used for analysis and interpretation of data. Findingsof the study showed that the pre-test mean value for levels of knowledge was 15.8 and post-test mean value was 32. The mean difference was 16.2. The computed ‘t’ value (‘t’ = 14) was higher than table value (3.66) at p< 0.001 level. The chi-square values of selected demographic variables on post-test levels of knowledge showage, gender, religion, education, occupation, residential area, sources of information were significant at level p<0.05. Marital status, monthly income, type of family, type of food, family history of DM, previous knowledge on DM were notsignificant at p<0.05 level. The pre-test mean value for levels of attitude was 28 and post-test was 41. The mean difference was 13. The computed’ value (‘t’ = 14) was higher than table value (3.66) at p< 0.001 level. The chi-square values of selected demographic variables on post-test levels of attitude were notsignificant at level p<0.05. The study concludes that the most of the patients with diabetes mellitus have improvement in levels of knowledge and attitude after health promotion programme regarding life style modification.

Star Babies: Evaluation of a health visiting initiative for first-time parents in Northern Ireland

Star Babies is an enhancement of the universal Child Health Promotion Programme in Northern Ireland, where first-time parents are offered additional regular health visiting support from the antenatal period until the baby is 12 months of age. This study was carried out to evaluate outcomes of first-time parents who received the core Child Health Programme or the enhanced Star Babies programme to identify the areas where the programmes are successful and to quantitatively assess the magnitude of their impact. First-time parents were invited to participate in the study and were divided into two groups: those in the Star Babies programme (n=189) and those in the core Child Health Promotion Programme (n=125). The study found differences between the two groupings of first-time parents and the evaluation of the health visiting services received in terms of infant feeding, knowledge of preventing home accidents and overall satisfaction varied across the two groups. The findings highlight the positive outcomes from an enhanced health visitor-led programme such as Star Babies, with implications for policy, practice and service development.

Time in Nature Associated with Decreased Fatigue in UK Truck Drivers

Heavy goods vehicle (HGV) driving is recognised as a highly hazardous occupation due to the long periods of sedentary behaviour, low levels of physical activity and unhealthy food options when working. These risk factors combine with shift work and concomitant irregular sleep patterns to increase the prevalence of fatigue. Fatigue is closely linked with stress and, subsequently, poor physiological and psychological health. In parallel, a wealth of evidence has demonstrated the health and wellbeing benefits of spending time in nature. Here, we sought to examine whether spending time in nature was associated with lower levels of fatigue, anxiety and depression in HGV drivers. 89 long-distance drivers (98.9% male, mean ± SD age: 51.0 ± 9 years, body mass index: 29.8 ± 4.7 kg/m2) participating in a wider health promotion programme reported time spent in nature (during and before the Covid-19 pandemic) and symptoms of occupational fatigue, depression and anxiety. After controlling for covariates, truck drivers who visited nature at least once a week exhibited 16% less chronic fatigue prior to the pandemic, and 23% less chronic fatigue and 20% less acute fatigue during the pandemic. No significant differences were observed for either anxiety or depression. As fatigue has a range of physical and mental health sequelae, we propose that increased exposure to natural settings may make a valuable contribution to interventions to promote the health and wellbeing of this underserved group.

How can a coordinated regional smoking cessation initiative be developed and implemented? A programme logic model to evaluate the ‘10,000 Lives’ health promotion initiative in Central Queensland, Australia

ObjectiveThis study used a programme logic model to describe the inputs, activities and outputs of the ‘10,000 Lives’ smoking cessation initiative in Central Queensland, Australia.DesignA programme logic model provided the framework for the process evaluation of ‘10,000 Lives’. The data were collected through document review, observation and key informant interviews and subsequently analysed after coding and recoding into classified themes, inputs, activities and outputs.SettingThe prevalence of smoking is higher in the Central Queensland region of Australia compared with the national and state averages. In 2017, Central Queensland Hospital and Health Services set a target to reduce the percentage of adults who smoke from 16.7% to 9.5% in the Central Queensland region by 2030 as part of their strategic vision (‘Destination 2030’). Achieving this target is equivalent to 20,000 fewer smokers in Central Queensland, which should result in 10,000 fewer premature deaths due to smoking-related diseases. To translate this strategic goal into an actionable smoking cessation initiative, the ‘10,000 Lives’ health promotion programme was officially launched on 1 November 2017.ResultThe activities of the initiative coordinated by a senior project officer included building clinical and community taskforces, organising summits and workshops, and regular communications to stakeholders. Public communication strategies (e.g., Facebook, radio, community exhibitions of ‘10,000 Lives’ and health-related events) were used to promote available smoking cessation support to the Central Queensland community.ConclusionThe ‘10,000 Lives’ initiative provides an example of a coordinated health promotion programme to increase smoking cessation in a regional area through harnessing existing resources and strategic partnerships (e.g., Quitline). Documenting and describing the process evaluation of the ‘10,000 Lives’ model is important so that it can be replicated in other regional areas with high prevalence of smoking.

Weight loss, hypertension and mental well-being improvements during COVID-19 with a multicomponent health promotion programme on Zoom: a service evaluation in primary care

BackgroundObesity is a risk factor for complications from SARS-CoV-2 infection, increasing the need for effective weight management measures in primary care. However, in the UK, COVID-19 restrictions have hampered primary care weight management referral and delivery, and COVID-19 related weight gain has been reported. The present study evaluated outcomes from a multicomponent weight loss and health promotion programme in UK primary care, delivered remotely due to COVID-19 restrictions.MethodPatients with obesity, type 2 diabetes or pre-diabetes attended six 90 min sessions over 10 weeks on Zoom. The dietary component comprised a low-carbohydrate ‘real food’ approach, augmented with education on physical activity, intermittent fasting, gut health, stress management, sleep and behaviour change. Anthropometric and cardiometabolic data were self-reported. Mental well-being was assessed with the Warwick Edinburgh Mental Wellbeing Scale. Subjective outcomes and participant feedback about the programme were collected with an anonymous online survey.ResultsTwenty participants completed the programme. Weight loss and improvements in body mass index, waist circumference, systolic and diastolic blood pressure and mental well-being achieved statistical and clinical significance. Mean weight loss (5.8 kg) represented a 6.5% weight loss. Participants’ subjective outcomes included weight loss without hunger (67%) and increased confidence in their ability to improve health (83%). All participants reported the usage of Zoom to access the programme as acceptable with 83% reporting it worked well.ConclusionA multicomponent weight loss and health promotion programme with a low-carbohydrate dietary component, clinically and statistically significantly improved health outcomes including weight status, blood pressure and mental well-being in a group of primary care patients when delivered remotely. Further research is warranted.

Beyond coping with chronic NCDs: reflections on paradigms in one Brazilian Health Promotion Programme

This study provides reflections on the hybridisation of paradigms resulting from the creation of the Academy of Health Programme created by the Brazilian National Ministry of Health. This was a descriptive study, analysing the National Health Promotion Policy (first published in 2006 and revised in 2014), the National Strategic Action Plan to Battle Chronic Non-Communicable Diseases (NCDs) and the Academy of Health Programme (established by Ordinance no. 719/GM/MS in 2011). The scientific disputes seen during the development of the programme have had an impact on the practices it advises and on its implementation. We reflect that the Academy of Health Programme can and should create a space where, beyond the chronic NCDs, the model of dominator and dominated can be subverted and the transformation idealised by collective health through the health promotion movement can be made concrete.

Intervention Effects of the Health Promotion Programme “Join the Healthy Boat” on Objectively Assessed Sedentary Time in Primary School Children in Germany

Sedentary behaviour (SB) in children is related to negative health consequences that can track into adulthood. The programme “Join the Healthy Boat” promotes reduced screen time and a less sedentary lifestyle in schoolchildren. This study investigated the effects of the programme on children’s SB. For one year, teachers delivered the programme. A total of 231 children (7.0 ± 0.6 years) participated in the cluster-randomised study; there were 154 one year later at follow-up. Children’s SB was assessed using multi-sensor accelerometery, screen time via parental questionnaire. Effects were analysed using (linear) mixed effects regression models. At baseline, children spent 211 (±89) min daily in SB, at follow-up 259 (±109) min/day with no significant difference between the intervention (IG) and control group (CG). SB was higher during weekends (p < 0.01, for CG and IG). However, at follow-up, daily screen time decreased in IG (screen time of >1 h/day: baseline: 33.3% vs. 27.4%; follow-up: 41.2% vs. 27.5%, for CG and IG, respectively). This multi-dimensional, low-threshold intervention for one year does not seem to achieve a significant reduction in children’s SB, although screen time decreased in IG. Therefore, it should be considered that screen time cannot be the key contributor to SB and should not solely be used for changing children’s SB. However, if screen time is targeted, interventions should promote the replacement of screen time with active alternatives.

Physical Activity as Part of an Intramural Health Promotion Programme for People with and without Chronic Diseases. A New Tool in Health Care Run by a Public Social Health Insurance

Background: Regular physical activity is a corner stone for healthy living, and preventing the onset or progression of diseases. The Social Insurance Fund for Public Service, Railway and Mining Industries is building an intramural health promotion facility in Austria with the aim to provide a comprehensive evidence-based health promotion programme for their insured. The target group are all people who, regardless of their health status and the presence of diseases, are ready to make their lifestyle more health-oriented. The health promotion facility offers health promotion measures in five areas: promoting physical training, optimizing nutritional patterns, managing everyday stress, increasing social capital, and improving health literacy. The focus is on increasing resources and on overcoming barriers. Depending on age, previous illnesses, range of motion, stress level, body weight and personal aims and expectations, the measures are individually tailored. The stay is divided into a two-week initial stay and a follow-up week. A comprehensive scientific evaluation concept of all measures and the entire stay is an integral part of the design. Conclusion: This project combines the advantages of comprehensive active health promotion, and an intramural stay. It is a pioneering social insurance project for sustainable health promotion and integrated care.