The unique effects of environmental strategies in health promotion campaigns: a review

Various strategies are used as tools in health promotion campaigns to increase health-related outcomes among target populations. Evaluations of these campaigns examine effects on changing people's knowledge, attitudes, and/or behaviors. Most evaluations examine the combined impact of multiple strategies. Less is known about the unique effects of particular strategies. To address this gap, we used highly systematic methods to identify and review scientifically rigorous evaluations of 18 campaigns that examined the unique effects of three sets of intervention strategies (entertainment education, law enforcement, and mass media) on changes in knowledge, attitudes, and practice with regard to various health behaviors. Results showed differences in evaluation processes based on the type of strategy used to promote campaign messages. For instance, evaluations of mass-media based campaigns were more likely to examine changes in knowledge, relative to evaluations of campaigns that used law enforcement strategies. In addition, campaign effects varied by particular strategies. Mass media-based campaigns were more likely to affect knowledge, relative to behaviors. Law enforcement and entertainment education-based campaigns showed positive effects on behaviors. The implications for planning and evaluating health promotion campaigns are described.     

中国老年人口健康预期寿命延长还是缩短？——基于Sullivan方法的实证研究

随着老年人口数量在总人口中不断增长,中国人口的总体健康水平。特别是老年人的健康预期寿命将会发生新的变化。中国老年人口的健康预期寿命是在增长还是在缩短？老年人口的健康预期寿命在总预期寿命中的比例是在增大还是在缩小？搞清楚这个问题对于我们合理地制定老龄政策至关重要。本文尝试应用国际上最为流行的Sullivan方法回答上述问题。     

青少年学业压力、父母支持与精神健康

追求学业上的成就,并由此实现社会流动、赢得尊敬和家庭的荣耀是中国文化的传统。但对教育成就的重视也导致儿童承受很大的压力,引发心理和身体的疾病。对上海685名学生学业压力与精神健康的调查证实,学业压力是加剧学生焦虑的风险因素,而父母的情感支持是促进儿童精神健康的保护性因素。因此促进父母对儿童的学习参与是重要的,但要注意时机,动态了解儿童的学习压力状况并提供及时的情感支持,这样有助于儿童的精神健康。     

Significance of action plans in the development of occupational well-being in the schools of Finland and Estonia

This article is part of a long term project “Promoting the Occupational Well-Being of School Staff—Action Research Project in Finland and Estonia, 2009–2014.” The purpose of this article is to describe the significance of action plans in the promotion of the occupational well-being of primary and upper secondary school staff in Finland and Estonia from 2010 to the turn of the year 2011–2012. An electronic open questionnaire was sent to occupational well-being groups in Finland (N = 18) and in Estonia (N = 39). In Finland, the questionnaire was responded to by 16 (n = 16) occupational well-being groups, and in Estonia, by 38 (n = 38) groups. The qualitative data were analyzed using the inductive-deductive method and content analysis. The obtained results indicate that the schools had named goals for action plans in all aspects of the promotion of occupational well-being in schools (worker and work, working conditions, professional competence, working community) and that these goals were mainly realized in the schools in a systematic way. Schools felt that the action plan for occupational well-being helped them to set goals for occupational well-being and that the planned actions were realized in a more systematic way than before.     

The embeddedness of organizational performance: Multiple Membership Multiple Classification Models for the analysis of multilevel networks

We present a Multiple Membership Multiple Classification (MMMC) model for analysing variation in the performance of organizational sub-units embedded in a multilevel network. The model postulates that the performance of organizational sub-units varies across network levels defined in terms of: (i) direct relations between organizational sub-units; (ii) relations between organizations containing the sub-units, and (iii) cross-level relations between sub-units and organizations. We demonstrate the empirical merits of the model in an analysis of inter-hospital patient mobility within a regional community of health care organizations. In the empirical case study we develop, organizational sub-units are departments of emergency medicine (EDs) located within hospitals (organizations). Networks within and across levels are delineated in terms of patient transfer relations between EDs (lower-level, emergency transfers), hospitals (higher-level, elective transfers), and between EDs and hospitals (cross-level, non-emergency transfers). Our main analytical objective is to examine the association of these interdependent and partially nested levels of action with variation in waiting time among EDs – one of the most commonly adopted and accepted measures of ED performance. We find evidence that variation in ED waiting time is associated with various components of the multilevel network in which the EDs are embedded. Before allowing for various characteristics of EDs and the hospitals in which they are located, we find, for the null models, that most of the network variation is at the hospital level. After adding these characteristics to the model, we find that hospital capacity and ED uncertainty are significantly associated with ED waiting time. We also find that the overall variation in ED waiting time is reduced to less than a half of its estimated value from the null models, and that a greater share of the residual network variation for these models is at the ED level and cross level, rather than the hospital level. This suggests that the covariates explain some of the network variation, and shift the relative share of residual variation away from hospital networks. We discuss further extensions to the model for more general analyses of multilevel network dependencies in variables of interest for the lower level nodes of these social structures.     

Social Work and Complex Care Systems: The Case of People Hospitalised with a Disability

Health and hospital system reforms prioritise efficiency. However, initiatives can impact on people with new or existing disabilities who require time to maximise functional independence. With greater demands for shorter hospital stays social workers face increasing pressure to facilitate discharge. This paper reports findings from research identifying factors contributing to extended stays for adults with disabilities. We sought to better understand patient characteristics and discharge planning challenges by analysing a clinical dataset of 80 patients and qualitative interviews with five experienced hospital social workers. Three key factors are identified: issues around rehabilitation services; assessment and planning for community care; and availability of and access to discharge options. Strategies to reduce length of stay are reported. We argue that building collaborative partnerships and working across multiple, complex systems and disciplines are vital to ensure these patients access appropriate community-based resources within the current health reform environment.     

Imprisonment and (inequality in) population health

This article extends research on the consequences of mass imprisonment and the factors shaping population health and health inequalities by considering the associations between imprisonment and population health—measured as life expectancy at birth and the infant mortality rate—and black-white differences in population health using state-level panel data from the United States (N = 669), 1980-2004. Results show that imprisonment is significantly associated with poorer population health, though associations between imprisonment and infant mortality and female life expectancy are somewhat more consistently statistically significant than are associations with male life expectancy, and associations are more pronounced and statistically significant for blacks than they are for whites. Results also show, however, that increases in imprisonment are associated with decreases in the mortality rates of young black men. Thus, though imprisonment tends to be associated with higher mortality risk and greater black-white differences in mortality, it may, in the short-run, have some paradoxical mortality benefits for young black men.     

Use of concurrent mixed methods combining concept mapping and focus groups to adapt a health equity tool in Canada

The aim of this project was to identify and prioritize a set of conditions to be considered for incorporating a health equity tool into public health practice. Concept mapping and focus groups were implemented as complementary methods to investigate the conditions of use of a health equity tool by public health organizations in Quebec. Using a hybrid integrated research design is a richer way to address the complexity of questions emerging from intervention and planning settings. This approach provides a deeper, operational, and contextualized understanding of research results involving different professional and organizational cultures, and thereby supports the decision-making process. Concept mapping served to identify and prioritize in a limited timeframe the conditions to be considered for incorporation into a health equity tool into public health practices. Focus groups then provided a more refined understanding of the barriers, issues, and facilitating factors surrounding the tools adoption, helped distinguish among participants’ perspectives based on functional roles and organizational contexts, and clarified some apparently contradictory results from the concept map. The combined use of these two techniques brought the strengths of each approach to bear, thereby overcoming some of the respective limitations of concept mapping and focus groups. This design is appropriate for investigating targets with multiple levels of complexity.     

Concept mapping as an approach for expert-guided model building: The example of health literacy

Concept mapping served as the starting point for the aim of capturing the comprehensive structure of the construct of ‘health literacy.’ Ideas about health literacy were generated by 99 experts and resulted in 105 statements that were subsequently organized by 27 experts in an unstructured card sorting. Multidimensional scaling was applied to the sorting data and a two and three-dimensional solution was computed. The three dimensional solution was used in subsequent cluster analysis and resulted in a concept map of nine “clusters”: (1) self-regulation, (2) self-perception, (3) proactive approach to health, (4) basic literacy and numeracy skills, (5) information appraisal, (6) information search, (7) health care system knowledge and acting, (8) communication and cooperation, and (9) beneficial personality traits. Subsequently, this concept map served as a starting point for developing a “qualitative” structural model of health literacy and a questionnaire for the measurement of health literacy. On the basis of questionnaire data, a “quantitative” structural model was created by first applying exploratory factor analyses (EFA) and then cross-validating the model with confirmatory factor analyses (CFA). Concept mapping proved to be a highly valuable tool for the process of model building up to translational research in the “real world”.     

Sick building syndrome and perceived indoor environmental quality: A survey of apartment buildings in Hong Kong

The outbreak of a highly communicable disease, SARS, in Asia in 2003 has revealed the health risk of living in a high-density environment. To show the important connection between human health and environmental quality, this study surveys the prevalence of sick building syndrome (SBS) among apartment residents and their evaluation of indoor environmental quality (IEQ). Based on a sample of 748 households living in Hong Kong, two interesting findings are revealed: (1) nasal discomfort was the commonest home-related SBS symptom despite the absence of any central ventilation system in apartment buildings; (2) noise, rather than ventilation, was the major IEQ problem perceived by residents. Our statistical analysis further showed that residents with SBS symptoms were less satisfied with their IEQ than those without. That is, despite a positive evaluation of specific IEQ criteria with respect to the building residents lived in, if they reported feeling SBS related symptoms, the overall IEQ evaluation of their building could still be negative. This perception bias gives rise to a sample selection problem in measuring perceived IEQ, which has implications on housing management practices and the formulation of a healthy housing policy.