Detailed and thought-provoking discussion of lifestyle regulation and how preventive lifestyle policies need to be shaped with the ′saturated society′ - a society of self-controlled, fully autonomous ...individuals - in mind.
Objective This systematic review aimed to provide an overview of the effectiveness of health promotion interventions at the workplace on physical and mental health outcomes related to chronic ...diseases. Methods A search for reviews published between 2009 and 2018 was performed in electronic databases. References of the included reviews were checked for additional reviews. Workplace health promotion interventions were included if they studied metabolic risk factors as important predictors of type 2 diabetes mellitus (T2DM) and cardiovascular diseases (CVD) or if they studied mental or musculoskeletal health outcomes. Review quality was assessed using the AMSTAR checklist. Results Of the 23 reviews included, 9 were of high quality. For weight-related outcomes, there was strong evidence for favorable effects of workplace interventions, especially for interventions targeting physical activity and/or diet. For the remaining metabolic risk factors, there was no evidence for a positive effect of workplace health promotion interventions due to the absence of high quality reviews and mixed conclusions between the reviews. There was also strong evidence for a positive, small effect on the prevention of mental health disorders of workplace psychological interventions, especially those that use e- health and cognitive behavioral therapy techniques. Furthermore, strong evidence was found for the prevention of musculoskeletal disorders through workplace interventions, especially resistance exercise training. Conclusions This review found evidence for the effectiveness of workplace interventions on the prevention of weight-related outcomes as well as mental health and musculoskeletal disorders. Future research is however needed on the factors that contribute to the successful implementation of an intervention.
Business Strategies to Promote Health/Reply Cahan, Eli M; Koh, Howard K; Singer, Sara J ...
JAMA : the journal of the American Medical Association,
06/2019, Letnik:
321, Številka:
21
Journal Article
The sustainability of school-based health interventions after external funds and/or other resources end has been relatively unexplored in comparison to health care. If effective interventions ...discontinue, new practices cannot reach wider student populations and investment in implementation is wasted. This review asked: What evidence exists about the sustainability of school-based public health interventions? Do schools sustain public health interventions once start-up funds end? What are the barriers and facilitators affecting the sustainability of public health interventions in schools in high-income countries?
Seven bibliographic databases and 15 websites were searched. References and citations of included studies were searched, and experts and authors were contacted to identify relevant studies. We included reports published from 1996 onwards. References were screened on title/abstract, and those included were screened on full report. We conducted data extraction and appraisal using an existing tool. Extracted data were qualitatively synthesised for common themes, using May's General Theory of Implementation (2013) as a conceptual framework.
Of the 9677 unique references identified through database searching and other search strategies, 24 studies of 18 interventions were included in the review. No interventions were sustained in their entirety; all had some components that were sustained by some schools or staff, bar one that was completely discontinued. No discernible relationship was found between evidence of effectiveness and sustainability. Key facilitators included commitment/support from senior leaders, staff observing a positive impact on students' engagement and wellbeing, and staff confidence in delivering health promotion and belief in its value. Important contextual barriers emerged: the norm of prioritising educational outcomes under time and resource constraints, insufficient funding/resources, staff turnover and a lack of ongoing training. Adaptation of the intervention to existing routines and changing contexts appeared to be part of the sustainability process.
Existing evidence suggests that sustainability depends upon schools developing and retaining senior leaders and staff that are knowledgeable, skilled and motivated to continue delivering health promotion through ever-changing circumstances. Evidence of effectiveness did not appear to be an influential factor. However, methodologically stronger primary research, informed by theory, is needed.
The review was registered on PROSPERO: CRD42017076320, Sep. 2017.
IntroductionThe growing population of the elderly, the rising costs of medical care and the low use of preventive services are three factors that highlight the importance of using preventive health ...care services in the Iranian population. This study aimed to determine the status of the use of preventive care services and its associated socio-demographic factors in the elderly referred to health centers. MethodsIn this analytical cross-sectional study, a number of 160 elderly people referred to health centers in East Guilan, Iran was selected by multi-stage cluster sampling. Data were obtained from May to September, 2021 using a questionnaire containing utilization of preventive care services (9 items) and socio-demographic characteristics. ResultsThe highest and the lowest utilization rates of preventive care services among study participants were related to the blood pressure test (96.9%) and colonoscopy (17.5%), respectively. Multivariate analysis showed that only income had a significant association with performing fasting blood sugar test (p = 0.004), blood lipid test (p = 0.004), and blood pressure test (p = 0.013). Also, the associations between having an underlying disease and performing fasting blood sugar test (p = 0.032) and blood pressure test (p = 0.002), the association between gender and performing the bone mineral density test (p < 0.001), and the association between occupation and performing Pap-smear test (p = 0.011), were statistically significant. ConclusionsThe utilization rates of screening tests for most cancers, including gastrointestinal cancers, were low. Since, there were a significant association between income, disease, gender and occupation with the utilization of some preventive care services, considering them in health centers' preventive care program design might be useful.
In this trial involving black male barbershop patrons with uncontrolled hypertension, health promotion by barbers resulted in larger blood-pressure reduction when coupled with medication management ...in barbershops by specialty-trained pharmacists.
These are challenging times for health care executives. The health care field is experiencing unprecedented changes that threaten the survival of many health care organizations. To successfully ...navigate these challenges, health care executives need committed and productive physicians working in collaboration with organization leaders. Unfortunately, national studies suggest that at least 50% of US physicians are experiencing professional burnout, indicating that most executives face this challenge with a disillusioned physician workforce. Burnout is a syndrome characterized by exhaustion, cynicism, and reduced effectiveness. Physician burnout has been shown to influence quality of care, patient safety, physician turnover, and patient satisfaction. Although burnout is a system issue, most institutions operate under the erroneous framework that burnout and professional satisfaction are solely the responsibility of the individual physician. Engagement is the positive antithesis of burnout and is characterized by vigor, dedication, and absorption in work. There is a strong business case for organizations to invest in efforts to reduce physician burnout and promote engagement. Herein, we summarize 9 organizational strategies to promote physician engagement and describe how we have operationalized some of these approaches at Mayo Clinic. Our experience demonstrates that deliberate, sustained, and comprehensive efforts by the organization to reduce burnout and promote engagement can make a difference. Many effective interventions are relatively inexpensive, and small investments can have a large impact. Leadership and sustained attention from the highest level of the organization are the keys to making progress.
The global surges in obesity and nutrition-related non-communicable diseases (NCDs) have created a need for decisive new food policy initiatives. A major concern has been the impact of ...ultra-processed foods (UPFs) and ultra-processed drinks on weight gain and on the risk of several NCDs. These foods, generally high in calories, added sugar, sodium, and unhealthy fats, and poor in fibre, protein, and micronutrients, have extensive negative effects on human health and on the environment (due to their associated carbon emission and water use). There is a growing tendency worldwide, and especially in South America, for food companies to add micronutrients to UPFs to make health claims regarding these products, to which food-regulating authorities refer to fake foods. Although more than 45 countries and smaller subregional or urban entities have created taxes on ultra-processed drinks, such as sugar-sweetened beverages, only a few have adopted taxes on snacks and other UPFs, and none have added major subsidies for truly healthy, fresh or minimally processed food for people from lower socioeconomic backgrounds. Another major focus has been on developing effective package labelling. A smaller number of countries have selected the most impactful warning labels and linked them with other measures to create a mutually reinforcing set of policies; a few other countries have developed effective school food policies. We herein present in-depth results from key countries involved in all these actions and in comprehensive marketing controls, and conclude with our recommendations for the future. This field is quite new; progress to date is substantial, but much more is left to learn.
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