Lyme Disease: A Case Report

Abstract

Using a needs-assessment technique called story-boarding to determine characteristics of health promotion and wellness among university students is discussed. Storyboarding allows students to work together as they generate ideas and eliminates the territorial defensiveness that often occurs when new ideas are suggested. Sixteen graduate students in a health education teaching methods course demonstrated the use of the technique to identify characteristics of wellness for university students. In addition, they identified content areas and outlined key programs, services, personal habits, and skills useful for enhancing university students' wellness.     

Achieving spiritual wellness: using reflective questions.

Health care professionals are increasingly recognizing the importance of spiritual health as a precursor of physical health. As we emerge into the 21st century, we must place greater emphasis on promoting spiritual wellness so that clients do not develop spiritual distress. Assisting clients in developing their spiritual wellness is a rewarding experience for nurses. As health care providers, we have the opportunity to educate the public about spiritual wellness to prevent physical problems. Attentiveness to one's spirit is a key component to healing and becoming a whole person. With guidance, clients can initiate a plan to maintain their own spiritual needs.     

Colleges and Universities Should Give More Broad-Based Attention to Health and Wellness—At All Levels

Abstract

Higher Education needs to give more broad-based attention to health and wellness. Our graduates will all have to deal with the facts that the general state of health of Americans is not good and our national health care system is badly in need of reform. We should offer innovative approaches to helping our graduates establish positive, lifetime health habits and we should demonstrate to them our own model approaches to promoting health and wellness through more effective health insurance and worksite wellness programs.     

Health promotion and disease prevention: a look at demand management programs

This Issue Brief describes employers' efforts to contain health expenditures through demand management programs. These programs are designed to reduce utilization by focusing on disease prevention and health promotion. Demand management includes work site health promotion, wellness programs, and access management. Work site health promotion is a comprehensive approach to improving health and includes awareness, health education, behavioral change, and organizational health initiatives. Wellness programs usually include stress management, smoking cessation, weight management, back care, health screenings, nutrition education, work place safety, prenatal and well baby care, CPR and first aid classes, and employee assistance programs (EAPs). These programs are often viewed positively by workers and can have long-term benefits for employers above and beyond health care cost containment. Demand management can benefit employers by increasing productivity, employee retention, and employee morale and by reducing turnover, absenteeism, future medical claims, and ultimately expenditures on health care. Even though a growing number of employers are offering wellness programs, only 37 percent of full-time workers employed in medium and large private establishments were eligible for wellness programs by 1993. However, a recent survey found that 88 percent of major employers have introduced some form of health promotion, disease prevention, or early intervention initiative to encourage healthy lifestyles among their salaried employees. Distinctions must be drawn between short- and long-term strategies. Demand management can be thought of as a short-term strategy when the focus of the program is on creating more appropriate and efficient health care utilization. Disease prevention is characterized by longer-term health improvement objectives. Whether the purpose is to reduce utilization in the short term or in the long term, the ultimate goal remains the same: to reduce health care expenditures while improving overall health. This goal can be achieved through the use of health risk appraisals, organizational health risk appraisals, high risk programs, awareness programs, medical call centers, return to work programs, EAPs, and smoking cessation programs. Studies of a health program's cost effectiveness must disentangle the effects of many competing factors on cost effectiveness. For example, a health risk appraisal program may identify health problems of which the patient and the health care provider were unaware, resulting in the treatment of these health problems. At the same time, the employer may have switched from a nonmanaged pharmaceutical program to a managed program with incentives for participants to utilize generic and/or mail order drugs. As a result, when evaluating a health promotion program, the long-run impact on the program's cost effectiveness is most important.     

Health Maintenance Organizations: Legislative and Training Implications

The Health Maintenance Organization Act of 1973 provides Americans with the opportunity to join prepaid group health plans. HMOs are not a panacea for the ills that beset our health delivery system but their emphasis on health maintenance and preventive interventions will provide new social work practice and student training opportunities. This article reviews and analyzes the major features of the HMO Act. Expanded roles for social work practitioners are discussed and suggestions are made for strengthening social work training programs in order to prepare social work professionals for practice in HMOs and in the health care field.     

Chapter 11: Motorola Drives Strategic Initiatives Through Collaboration and Interdependence

Abstract

This article describes an integrated approach to implementing a wellness program in a corporate setting. Motorola's wellness program is reviewed, including its history, rationale and strategic focus. Successful integration partners are identified, and strategies for integrated programs are outlined. Education, communication and prevention initiatives and program components are discussed, including recommendations and shared learnings for both small and large-scale wellness programs.     

Chapter 10: Ceridian's Experience in the Integration of EAP,Work-Life and Wellness Programs

SUMMARY

This article considers EAP services, work-life and wellness programs and the implications of integrating these services. The concept of how wellness programs enter into this equation is explored as well as how Web-based services have played a significant role. Ceridian's experience in providing these services is explored through a case study, anecdotal information, and other data. This article reviews why integrated EAP services, work-life and wellness programs offer more value when compared to programs that contain individual components. It is concluded that wellness and the Internet continue to play a key role in programs becoming more integrated. It is also suggested that integration is now larger than traditional EAP, work-life, and wellness programs. Other human resource services are becoming more important components of integrated services.     

Psychologist and Physician Interest in Telehealth Training and Referral for Mental Health Services: An Exploratory Study

The current study explored psychological and medical professionals’ interest in videoconferencing telehealth training and mental health telehealth referral. An online survey assessed 782 participants comprised of 669 psychological (45% male, Mean Age = 47.01, SD = 16.82) and 113 medical professionals (58% male, Mean Age = 46.19, SD = 12.40). Z-test analyses indicated that although psychological professionals were statistically more interested in receiving telehealth training, both groups reported some interest. Ranked responses indicated efficacy data, ethical issues, and legal concerns as the most endorsed areas of training interest. Referral concerns were also found. Findings were discussed related to both statistical and clinical significance. Application of findings is discussed related to future work, practice, and program creation. The development of telehealth training programs will provide interested professionals with tools required for practice and may serve as an impetus to increase utilization and/or referral.     

Preholiday grief. Facing it alone.

These strategies for coping with the holidays following a loss can be shared not only in a group format such as a preholiday workshop, but also on a one-to-one basis by caring health professionals. To be effective in promoting adaptation to loss, it is vital that health-care professionals heighten their awareness of the needs and reactions of the grieving person. Their sensitivity to the anxiety and pain that can accompany the holiday season must increase. Only when awareness and sensitivity increase will there be an increase in the development of effective bereavement outreach programs. Through such programs the bereaved can experience positive encounters with caring professionals who can help them establish a new sense of hope, purpose, and renewed self-esteem.     

Tailored program evaluation: Past, present, future

This paper discusses measurement issues related to the evaluation of computer-tailored health behavior change programs. As the first generation of commercially available tailored products is utilized in health promotion programming, programmers and researchers are becoming aware of the unique challenges that the evaluation of these programs presents. A project is presented that used an online tailored health behavior assessment (HBA) in a worksite setting. Process and outcome evaluation methods are described and include the challenges faced, and strategies proposed and implemented, for meeting them. Implications for future research in tailored program development, implementation, and evaluation are also discussed.     

Young African American Males: Barriers to Access to Health Care

African American males continue to experience an unacceptable and disproportionate number of health disparities when compared with other racial and ethnic groups. Young African American males can expect to live the least amount of time when compared to any other ethnic minority or racial sub-group. Understanding the obstacles and barriers that impede access to health care and wellness services among young African American males is essential to begin the process of decreasing health disparities. The goal of this qualitative study was to explore and identify the barriers experienced by young African American males in accessing health care services while also creating a rare opportunity to give voice to young African American males. The study results indicate that young African American males have multiple perceptions of barriers to health care services. Their perceptions fell into three categories: the negative impact of environment or community, lack of finances or no insurance, and distrust of medical practices associated with race history resulting in accessing healthcare as a last resort. Additional research is needed to craft community-based programs to: a) educate young African American males on the importance of preventative strategies to maintain wellness; and b) ensure that the appropriate medical and wellness services are available and reaching young African American males in need.     

Chapter 3: Health and Productivity Management

SUMMARY

This article focuses on the emergence of Health and Productivity Management (HPM) as a context for understanding the integration of health and wellness into employee assistance and work-life programs. Major factors influencing the growth of HPM are raising medical costs as well as the rising incidence of obesity. The Wake-up Call to Corporate America underscores the need to manage these costs and improve health through the proactive alignment of health-related benefits and programs. HPM is described as an integrated approach to capture direct medical costs as well as the indirect costs associated with poor health and lost productivity. Critical design and implementation features that are likely to contribute to a successful integrated approach are described and highlighted. An HPM case example of a large pharmaceutical company examines a unique cross referral program including considerations for continuous improvement. Finally, the article concludes with key challenges related to marketplace competition, pricing pressures, concerns regarding the sub-optimization of programs and the influence of current health care system changes.     

A pilot intervention to promote walking and wellness and to improve the health of college faculty and staff

There is a need to investigate novel interventions that promote worksite physical activity and wellness. OBJECTIVE: The authors' purpose in this study was to evaluate the effectiveness of a 12-week walking program supplemented with a pedometer, computer educational program, and weekly e-mails. METHODS: College faculty and staff participated in a one-group pre-posttest study to determine whether the 12-week walking intervention had an effect on body mass index (BMI), blood pressure, blood glucose, and cholesterol. The authors also determined participant-perceived wellness effects. RESULTS: The authors observed differences between baseline and follow-up in BMI (p = .024), blood glucose (p = .06), and total cholesterol (p = .09). The program had a moderate effect on fitness, mood, health awareness, nutrition, and health. CONCLUSIONS: It is incumbent that experts develop innovative worksite physical activity and wellness programs. A pedometer-monitored walking program is one way that a worksite health initiative can improve the health and wellness of its employees and simultaneously reduce health-care costs.     

Conceptualization and measurement of the spiritual and psychological dimensions of wellness in a college population

Wellness is commonly conceptualized as having many dimensions, but little effort has been made to evaluate how spiritual and psychological dimensions are related to overall wellness. To explore the relationship between measures of spiritual and psychological wellness and perceived wellness in a college student population, the authors administered a series of survey instruments to 112 undergraduate students under quiet classroom conditions. They used the Life Attitude Profile to measure spiritual wellness, the Life Orientation Test and the Sense of Coherence Scale to measure psychological wellness, and the Perceived Wellness Survey to measure overall wellness. Path analysis performed with a proposed theoretical model revealed that the effect of life purpose on perceived wellness was mediated by optimism and sense of coherence, which had independent effects on perceived wellness beyond that of life purpose. The findings suggested that an optimistic outlook and sense of coherence must be present for life purpose to enhance a sense of overall well-being.     

Selling EAPs Using Total Quality Management Initiatives

Qualify Management is striving to perform to standard work processes that will achieve the results customers are seeking. EAPs do just that by focusing their performance early in the healthcare delivery process to help insure a healthy and productive workforce. Selling Quality is educating employers, who are wrestling to maintain employee benefits at reasonable costs, to the fact that Quality Management of behavioral healthcare works. Promoting health and wellness at the workplace, intervening early and professionally, and managing care to healthy outcomes is what EAPs and managed care programs are doing today, and convincing employers through their performance that Quality Management works.     

A competency-based approach to preparing staff as recreation and youth development leaders

Youth development professionals and parks and recreation professionals often are charged with providing services to youth. However, the approach of each can be quite different as recreation is a primary focus for recreation professionals and part of many services offered by youth development specialists. Despite the differences, these two groups of professionals can learn a great deal from each other. This article examines youth development and staff training with examples from the field and suggests how youth development professionals can learn from recreation professionals and vice versa. It suggests that parks and recreation professionals can strengthen degree programs, accreditation, certification, and continuing education by incorporating specific youth development competencies established by the National Collaboration for Youth. For their part, youth development professionals can learn from parks and recreation professionals how to enhance recreation programming as part of their services by gaining an understanding of program design, program and activity leadership, and administrative practices. With much debate over whether more education or more experience is a better path for those working with youth, the authors suggest that a combination of both will adhere to the quality of staff. Staff gain further knowledge and skill from academic preparation at the undergraduate and graduate levels, field-based training through jobs and internships, and continuing education courses specializing in youth development competencies and recreation-based competencies set within a youth development environment.     

Exploring the role of gender norms in nutrition and sexual health promotion in a piloted school-based intervention: The Philadelphia Ujima™ experience

Perceptions of masculinity and femininity influence behaviors and can be identified in young children and adolescents (Brannon, 2004). Thus, adolescents’ engagement in health risk or promoting behaviors is influenced by perceptions of masculinity and femininity and the differences in expectations, norms and responsibilities for girls and boys (WHO, 2007). Girls and boys have different needs, and gender-based interventions that consider similarities as well as differences are needed. A gender-based nutrition and sexual health promotion program was developed and piloted by the Philadelphia Ujima Coalition in a high school setting. To explore the gender differences in adolescents’ perceptions of the influence of gender norms on weight, nutrition, physical activity, and sexual health and the implication of these differences in future gender-integrated health promotion programming for youth, a content analysis of student and facilitator debriefing forms were implemented for the participating schools. The content analysis was used to identify central themes, concepts gained, and overall impact of the intervention sessions. Overall, gender norms influence healthy eating practices and activity through influencing perceptions of body type in adolescents. Gender norms also influence sexual activity and decision making through influencing perceptions of beauty, masculinity, femininity, pressures and popular concepts related to sexual activity. Thus, interventions that address gender may more effectively promote health and wellness in adolescents.     

On the Integration of Science and Practice in College Health

Abstract

College health professionals want to assure the unique healthcare and health education needs of college students will continue to be met under national and state healthcare reform. This may be an “all or nothing” proposition. Either colleges and universities will have exclusive control of healthcare delivery for the college student population or else college health will not be a major force in healthcare reform. If college health is to play a meaningful role in future government-controlled health insurance programs, it must first demonstrate that current health services and insurance financing programs meet minimum quality standards. This proposal calls for expanding existing federal laws to create qualified student health plans and integrating the college health model into a reform package based on employer-sponsored health insurance. The concept of qualified student health plans allows for a high degree of flexibility that can be integrated into the majority of state and federal healthcare reform proposals, including the plan proposed by President Clinton, that are not based on a single-payer system. Ultimately, the authors suggest, their proposed plan would eliminate the current situation, in which large numbers of college students are uninsured or underinsured.     

A qualitative exploratory study of substance abuse prevention outcomes in a heterogeneous prevention system

The prevention of abuse of alcohol and other drugs is a concern for parents, policy-makers, educators, and social service professionals. Prevention programs are sponsored by many different types of social and educational agencies using a variety of intervention strategies. This article reports a study of a sample of such programs in the state of Nevada. The overall prevention system in the state espouses a "risk and resiliency" approach to prevention. Focus group methodology was used to study perception of outcomes of these programs from the viewpoints of various program stakeholders (youth participating in the programs, parents of participants and program staff). Analysis of the qualitative data yielded findings about potential outcomes as well as implicit program theories. Implications for future planning efforts as well as further evaluation efforts are discussed.