International Journal of Environmental Research and Public Health

Research

15 pages, 1563 KiB

Open AccessArticle

Propagating Change: Using RE-FRAME to Scale and Sustain A Community-Based Childhood Obesity Prevention Initiative

by Lynn Kennedy, Susan Pinkney, Selina Suleman, Louise C. Mâsse, Patti-Jean Naylor and Shazhan Amed

Int. J. Environ. Res. Public Health 2019, 16(5), 736; https://doi.org/10.3390/ijerph16050736 - 1 Mar 2019

Cited by 10 | Viewed by 4165

Abstract

Sustainable Childhood Obesity Prevention through Community Engagement (SCOPE) has developed Live 5-2-1-0, a multi-sectoral, multi-component community-based childhood obesity prevention initiative grounded in systems thinking and participatory research principles. Building on previous work, this study continued implementation of an innovative knowledge exchange model, RE-FRAME, [...] Read more.

Sustainable Childhood Obesity Prevention through Community Engagement (SCOPE) has developed Live 5-2-1-0, a multi-sectoral, multi-component community-based childhood obesity prevention initiative grounded in systems thinking and participatory research principles. Building on previous work, this study continued implementation of an innovative knowledge exchange model, RE-FRAME, in two ‘new’ and two ‘existing’ Live 5-2-1-0 communities. This mixed-methods study examined follow-up data to determine the nature and extent of the model’s ability to build and sustain community capacity and facilitate the scale-up and sustainability of systems- and community-level change. Qualitative and quantitative data were collected using stakeholder interviews, and quantitative process tracking (PTT) and capacity building tools (CCBT), and were analyzed using thematic analysis and descriptive statistics, respectively. Results from three communities with baseline and follow-up CCBT data showed capacity domain scores increased (15/27; 56%) or remained constant (10/27; 37%) over the study period. PTT data showed over 50 multi-sectoral community partnerships formed in Community D (new) and 108 actions implemented. Stakeholder interviews identified having a common cause, co-ownership, champion networks and consistency of the Live 5-2-1-0 message as essential to sustainability of the initiative. RE-FRAME supports knowledge exchange and community capacity-building that is integral to initiating and sustaining a community-based childhood obesity prevention initiative. Full article

(This article belongs to the Special Issue Community Health Intervention to Reduce Chronic Disease)

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14 pages, 535 KiB

Open AccessArticle

Creating a Collaborative Platform for the Development of Community Interventions to Prevent Non-Communicable Diseases

by Sebastian del Busto, Inés Galindo, Juan Jesús Hernandez, Francisco Camarelles, Esther Nieto, Águeda Caballero and María Sandín Vázquez

Int. J. Environ. Res. Public Health 2019, 16(5), 676; https://doi.org/10.3390/ijerph16050676 - 26 Feb 2019

Cited by 11 | Viewed by 3783

Abstract

Chronic diseases, also known as non-communicable diseases (NCD) are one of the most important public health problems of our time. Many of these diseases can be reduced by achieving healthy lifestyles. Community interventions are very useful in reducing these types of diseases since [...] Read more.

Chronic diseases, also known as non-communicable diseases (NCD) are one of the most important public health problems of our time. Many of these diseases can be reduced by achieving healthy lifestyles. Community interventions are very useful in reducing these types of diseases since they have a direct impact over daily conditions and are adjustable to the complex situations that they carry. This article describes the process of the creation of a collaborative platform for the design and implementation of community interventions to prevent NCDs. This platform includes six non-governmental organizations who have aligned their prevention and health promotion objectives to develop joint community interventions. The intervention levels approach, based on the socio-ecological model has been the basic model to structure the working groups of the platform. Dealing with institutional differences, complexity and variability of contexts, defining the roles and responsibilities and managing the resources are key elements to have in mind to achieve good relations and functional partnerships to design and implement effective community interventions at different levels. Institutional recognition, support and planning based on local priorities are also key elements for these kinds of platforms to be successful, sustainable and, therefore, have an impact on people’s health. Full article

(This article belongs to the Special Issue Community Health Intervention to Reduce Chronic Disease)

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11 pages, 272 KiB

Open AccessArticle

Exploring Drug-Related Problems in Diabetic Patients during Ramadan Fasting in Saudi Arabia: A Mixed-Methods Study

by Waleed Saleh Alluqmani, Mohammed Misri Alotaibi, Waleed Jamal Almalki, Abdulrahman Althaqafi, Hamed Abdullah Alawi, Fahad Althobiani, Amjad Abdullah Albishi, Amjad Ahmad Madkhali, Layal Yahia Baunes, Razan Ibrahim Alhazmi, Elaf Mohammed Doman, Anwar Hussain Alhazmi, Majid Ali and Ejaz Cheema

Int. J. Environ. Res. Public Health 2019, 16(3), 499; https://doi.org/10.3390/ijerph16030499 - 11 Feb 2019

Cited by 9 | Viewed by 4453

Abstract

This study aimed to identify any drug-related problems (DRPs) in diabetic patients during Ramadan fasting in Saudi Arabia. The study used a mixed-methods approach consisting of two phases and was conducted in Makkah, Saudi Arabia from December 2017 to March 2018. The first [...] Read more.

This study aimed to identify any drug-related problems (DRPs) in diabetic patients during Ramadan fasting in Saudi Arabia. The study used a mixed-methods approach consisting of two phases and was conducted in Makkah, Saudi Arabia from December 2017 to March 2018. The first phase of the study involved qualitative semi-structured individual interviews with diabetic patients. A 13-item questionnaire was used in the second phase to further identify DRPs in the wider population. The data was mainly presented as frequencies and percentages. Inferential statistics was performed using Statistical Package for Social Sciences (SPSS) version 21 to compare relevant variables/questions using the chi-square test. Twenty patients (10 male, 10 female) attended face-to-face interviews during the first phase of the study while 95 (40 male, 55 female) completed the questionnaire in the second phase of the study. Two possible risk factors for DRPs were identified from the qualitative data: patient-related factors, including changes in their medicine intake during fasting, and healthcare professionals-related factors, including lack of advice from healthcare professionals regarding fasting. The quantitative results indicated that 52 (54%) of the 95 participants who observed fasting reported to have changed the way they were taking their medicines. Furthermore, 41% of the participants experienced general healthcare problems such as hypoglycemia, hyperglycemia, fatigue, excessive sweating, and gastrointestinal disturbances. Healthcare professionals need to educate patients who are at risk of DRPs by providing structured education and counseling. Full article

(This article belongs to the Special Issue Community Health Intervention to Reduce Chronic Disease)

15 pages, 764 KiB

Open AccessArticle

Evaluation of “Healthy Learning. Together”, an Easily Applicable Mental Health Promotion Tool for Students Aged 9 to 18 Years

by Susanne Schwager, Uwe Berger, Anni Glaeser, Bernhard Strauss and Katharina Wick

Int. J. Environ. Res. Public Health 2019, 16(3), 487; https://doi.org/10.3390/ijerph16030487 - 8 Feb 2019

Cited by 9 | Viewed by 3942

Abstract

Schools play an important role in adolescents’ health promotion. Due to the limited resources of teachers, there is a need for short-time interventions that can be easily implemented in a regular class without extensive training. Therefore, the tool “Healthy learning. Together.” was developed [...] Read more.

Schools play an important role in adolescents’ health promotion. Due to the limited resources of teachers, there is a need for short-time interventions that can be easily implemented in a regular class without extensive training. Therefore, the tool “Healthy learning. Together.” was developed within a joint venture research project in Jena, Germany. The tool consists of a box with 60 exercises and a poster exhibition for students in 5th grade and higher. One thousand one hundred and forty four (1144) students (56% female) from nine schools were assessed at an interval of 10 weeks in a parallelized pre-post-design with class-wise assignment to intervention group (IG) and control group (CG). In the IG, regular teachers implemented the health promotion tool. Before and after the intervention social integration, class climate, self-efficacy (as primary outcomes) and mental and physical wellbeing (as secondary outcomes) were measured using standardized questionnaires. ANCOVA analysis revealed that students of the IG showed more positive changes on primary outcomes with small effect sizes. Additional implementation outcomes showed high teacher and student enthusiasm but sometimes low exposure rates. Regarding the relatively small amount of time and preparation for teachers to get noticeable effects, the introduced tool is suitable as a first step into health promotion for schools. Full article

(This article belongs to the Special Issue Community Health Intervention to Reduce Chronic Disease)

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12 pages, 503 KiB

Open AccessArticle

Effect of a Multicomponent Intervention on Lifestyle Factors among Brazilian Adolescents from Low Human Development Index Areas: A Cluster-Randomized Controlled Trial

by Valter Cordeiro Barbosa Filho, Alexsandra da Silva Bandeira, Giseli Minatto, Jair Gomes Linard, Jaqueline Aragoni da Silva, Rafael Martins da Costa, Sofia Wolker Manta, Soraya Anita Mendes de Sá, Thiago Sousa Matias and Kelly Samara da Silva

Int. J. Environ. Res. Public Health 2019, 16(2), 267; https://doi.org/10.3390/ijerph16020267 - 18 Jan 2019

Cited by 19 | Viewed by 7901

Abstract

Promoting healthy lifestyle factors (e.g., physical activity, healthy eating, less screen time) among young people is a relevant and challenging step toward reducing non-communicable diseases. This study aimed to evaluate the effect of a multicomponent intervention on lifestyle factors among adolescents from schools [...] Read more.

Promoting healthy lifestyle factors (e.g., physical activity, healthy eating, less screen time) among young people is a relevant and challenging step toward reducing non-communicable diseases. This study aimed to evaluate the effect of a multicomponent intervention on lifestyle factors among adolescents from schools in low Human Development Index (HDI < 0.500) areas. The Fortaleça sua Saúde program was conducted with 548 adolescents aged 11–18 years old in the intervention group and 537 in the control group. The four-month intervention included strategies focused on training teachers, new opportunities for physical activity in the school environment, and health education strategies for the school community (including parents). Moderate- to-vigorous physical activity level (≥420 min/week), TV watching and computer use/gaming (<2 h/day), daily consumption of fruit juice, fruit, vegetables, soft drinks, savory foods and sweets, and current alcohol and tobacco use were measured before and after intervention. McNemar’s test and logistic regression (odds ratio [OR] and a 95% confidence interval [95% CI]) were used, considering p < 0.05. In the intervention schools, a significant increase occurred in the number of adolescents who met physical activity guidelines (5.3%; 95% CI = 0.8; 9.8) and who reported using computer for <2 h a day (8.6%; 95% CI = 3.8; 13.4) after intervention. No changes were observed in the control schools. At the end of the intervention, adolescents from intervention schools were more likely to practice physical activity at recommended levels (OR = 1.44; 95% CI = 1.00; 2.08) than adolescents from control schools. No significant change was observed for the other lifestyle factors. In conclusion, this multicomponent intervention was effective in promoting physical activity among adolescents from vulnerable areas. However, other lifestyle factors showed no significant change after intervention. This study is registered at Clinicaltrials.gov NCT02439827. Full article

(This article belongs to the Special Issue Community Health Intervention to Reduce Chronic Disease)

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20 pages, 376 KiB

Open AccessArticle

Biomedical Variables and Adaptation to Disease and Health-Related Quality of Life in Polish Patients with MS

by Joanna Dymecka and Mariola Bidzan

Int. J. Environ. Res. Public Health 2018, 15(12), 2678; https://doi.org/10.3390/ijerph15122678 - 28 Nov 2018

Cited by 19 | Viewed by 4099

Abstract

The aim of this research was to assess the level of adaptation to multiple sclerosis (Sclerosis multiplex; MS) and health-related quality of life (HRQoL) of the study population as well as to determine the relationship between biomedical factors related to the [...] Read more.

The aim of this research was to assess the level of adaptation to multiple sclerosis (Sclerosis multiplex; MS) and health-related quality of life (HRQoL) of the study population as well as to determine the relationship between biomedical factors related to the course of multiple sclerosis, adaptation to the disease, and HRQoL. Analysis of medical records, clinical and psychological interviews, the Extended Disability Status Scale (EDSS), Guy’s Neurological Disability Scale (GNDS), the Acceptance of Illness Scale (AIS), and the Multiple Sclerosis Impact Scale 29 (MSIS-29) were collected from 137 patients with MS. It was found that there was a relation between motor impairment, neurological disability, adaptation to illness, and HRQoL; it was also found that there were negative correlations between adaptation to illness and the severity of lower-limb disability, fatigue, mood disorders, other problems related to MS, and upper-limb disability. Of all the symptoms, lower-limb disability, fatigue, and mood disorders had the strongest relation with adaptation. All of the analysed symptoms were found to correlate with HRQoL. Of all the symptoms, HRQoL was most affected by lower- and upper-limb disability, fatigue, other MS problems, and mood disorders. Full article

(This article belongs to the Special Issue Community Health Intervention to Reduce Chronic Disease)

14 pages, 320 KiB

Open AccessArticle

Faithful Families Cooking and Eating Smart and Moving for Health: Evaluation of a Community Driven Intervention

by Caitlin Torrence, Sarah F. Griffin, Laura Rolke, Kelli Kenison and AltaMae Marvin

Int. J. Environ. Res. Public Health 2018, 15(9), 1991; https://doi.org/10.3390/ijerph15091991 - 13 Sep 2018

Cited by 6 | Viewed by 5111

Abstract

Background: There is an increasing need to adapt and use community interventions to address modifiable behaviors that lead to poor health outcomes, like obesity, diabetes, and heart disease. Poor health outcomes can be tied to community-level factors, such as food deserts and [...] Read more.

Background: There is an increasing need to adapt and use community interventions to address modifiable behaviors that lead to poor health outcomes, like obesity, diabetes, and heart disease. Poor health outcomes can be tied to community-level factors, such as food deserts and individual behaviors, like sedentary lifestyles, consuming large portion sizes, and eating high-calorie fast food and processed foods. Methods: Through a social ecological approach with family, organization and community, the Faithful Families Cooking and Eating Smart and Moving for Health (FFCESMH) intervention was created to address these concerns in a rural South Carolina community. FFCESMH used gatekeepers to identify 18 churches and four apartment complexes in low-income areas; 176 participants completed both pre- and post-survey measures. Results: Paired t-test measures found statistically significant change in participant perception of food security (0.39, p-value = 0.005, d = 0.22), self-efficacy with physical activity and healthy eating (0.26, p-value = 000, d = 0.36), and cooking confidence (0.17, p-value = 0.01, d = 0.19). There was not significant change in cooking behaviors, as assessed through the Cooking Behaviors Scale. Conclusion: FFCESMH shows that a social ecological approach can be effective at increasing and improving individual healthy behaviors and addressing community-level factors in low-income rural communities. Full article

(This article belongs to the Special Issue Community Health Intervention to Reduce Chronic Disease)

10 pages, 769 KiB

Open AccessArticle

Pap Testing in a High-Income Country with Suboptimal Compliance Levels: A Survey on Acceptance Factors among Sicilian Women

by Vincenzo Restivo, Claudio Costantino, Antonello Marras, Giuseppe Napoli, Sabrina Scelfo, Tiziana Scuderi, Alessandra Casuccio, Achille Cernigliaro, Angela Giusti and Stefania Spila Alegiani

Int. J. Environ. Res. Public Health 2018, 15(9), 1804; https://doi.org/10.3390/ijerph15091804 - 22 Aug 2018

Cited by 25 | Viewed by 4020

Abstract

Cervical cancer screening is uncommon, especially in low-income countries and among lower socioeconomic status people in high-income countries. The aims of this study were to examine the adherence of Sicilian women to Pap testing and to identify the determinants of this in a [...] Read more.

Cervical cancer screening is uncommon, especially in low-income countries and among lower socioeconomic status people in high-income countries. The aims of this study were to examine the adherence of Sicilian women to Pap testing and to identify the determinants of this in a population with a secondary prevention attitude lower than high-income countries and the national average. A cross-sectional study called “Save Eva in Sicily” was conducted among all women aged 25–64 years, with a sample drawn by the list of general practitioners (GPs), using a proportional sampling scheme, stratified by age and resident population. The study outcome was performing a Pap test within the past three years. The association between the outcome and Pap test determinants was analyzed through a multivariable logistic regression. Among the 365 interviewed women, 66% (n = 243) had a Pap test during the last 3 years. On the other hand, 18% of the other women (n = 66) had performed at least one Pap test previously and 16% (n = 56) had never had a Pap test. In a multivariable model, GPs’ advice (adjusted OR 2.55; 95% CI 1.57–4.14) and perceived susceptibility (adjusted OR 3.24; 95% CI 1.92–5.48) increased the likelihood of the execution of a Pap test. The “Save Eva in Sicily” study identified GP advice and perceived cancer severity as the main correlates of Pap testing among Sicilian women, producing evidence regarding how policy makers can increase compliance. Interventions to increase Pap test adhesion should focus on stimulating GPs to identify patients who regularly do not undergo it and to recommend testing on a regular basis to their patients. Full article

(This article belongs to the Special Issue Community Health Intervention to Reduce Chronic Disease)

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15 pages, 661 KiB

Open AccessArticle

Project SoL—A Community-Based, Multi-Component Health Promotion Intervention to Improve Healthy Eating and Physical Activity Practices among Danish Families with Young Children Part 2: Evaluation

by Bent Egberg Mikkelsen, Paul Bloch, Helene Christine Reinbach, Tine Buch-Andersen, Lise Lawaetz Winkler, Ulla Toft, Charlotte Glümer, Bjarne Bruun Jensen and Jens Aagaard-Hansen

Int. J. Environ. Res. Public Health 2018, 15(7), 1513; https://doi.org/10.3390/ijerph15071513 - 18 Jul 2018

Cited by 14 | Viewed by 6012

Abstract

Project SoL is implemented over a period of four years with the aim to promote healthy eating and physical activity among children aged 3–8 years by targeting the families in a Danish municipality based on the multi-component, supersetting strategy. Interventions are implemented in [...] Read more.

Project SoL is implemented over a period of four years with the aim to promote healthy eating and physical activity among children aged 3–8 years by targeting the families in a Danish municipality based on the multi-component, supersetting strategy. Interventions are implemented in childcare centres, schools and supermarkets in three local communities as well as in local mass media and social media during a 19 months period in the Municipality of Bornholm. The matching Municipality of Odsherred serves as a control site based on its similarity to Bornholm regarding several socio-demographic and health indicators. The present paper gives an account of the design used for the summative and formative evaluation based on a realistic evaluation and a mixed methods approach combining qualitative and quantitative methods. Summative studies are conducted on changes of health behaviours among the involved families and within the municipalities in general, changes in community awareness of the project, changes in purchase patterns, changes in overweight and obesity among the targeted children and changes in knowledge and preferences among children due to sensory education workshops. The formative research comprises studies on children’s perceptions of health, perceptions of staff at supermarkets and media professionals on their roles in supporting the health promotion agenda, and motivations and barriers of community stakeholders to engage in health promotion at community level. The paper discusses operational issues and lessons learnt related to studying complex community interventions, cross-disciplinarily, interfaces between practice and research and research capacity strengthening; and suggests areas for future research. The development and implementation of the intervention and its theoretical foundation is described in a separate paper. Full article

(This article belongs to the Special Issue Community Health Intervention to Reduce Chronic Disease)

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21 pages, 2605 KiB

Open AccessArticle

Project SoL—A Community-Based, Multi-Component Health Promotion Intervention to Improve Eating Habits and Physical Activity among Danish Families with Young Children. Part 1: Intervention Development and Implementation

by Ulla Toft, Paul Bloch, Helene C. Reinbach, Lise L. Winkler, Tine Buch-Andersen, Jens Aagaard-Hansen, Bent Egberg Mikkelsen, Bjarne Bruun Jensen and Charlotte Glümer

Int. J. Environ. Res. Public Health 2018, 15(6), 1097; https://doi.org/10.3390/ijerph15061097 - 28 May 2018

Cited by 23 | Viewed by 6553

Abstract

Project SoL was implemented over a period of four years from 2012–2015 with the aim to promote healthy eating and physical activity among families with children aged 3–8 years, living in selected communities in two Danish municipalities. This was done by applying the [...] Read more.

Project SoL was implemented over a period of four years from 2012–2015 with the aim to promote healthy eating and physical activity among families with children aged 3–8 years, living in selected communities in two Danish municipalities. This was done by applying the supersetting approach to implement complex multi-component interventions in a participatory, coordinated, and integrated manner in childcare centres, schools, and supermarkets in three local communities, as well as in local media during a 19-month period in the Regional Municipality of Bornholm, which served as the intervention site. The matching municipality of Odsherred served as a control site based on its similarity to Bornholm regarding several socio-demographic and health indicators. The present paper describes the design of Project SoL as well as the processes of developing and implementing its complex interventions. Moreover, the theoretical and conceptual framework of the project is described together with its organisational structure, concrete activities, and sustainability measures. The paper discusses some of the key lessons learned related to participatory development and the implementation of a multi-component intervention. The paper concludes that coordinated and integrated health promotion activities that are implemented together with multiple stakeholders and across multiple settings in the local community are much more powerful than individual activities carried out in single settings. The supersetting approach was a useful conceptual framework for developing and implementing a complex multi-component health promotion intervention and for fostering ownership and sustainability of the intervention in the local community. The research and evaluation approach of the project is described in a separate paper (Part 2). Full article

(This article belongs to the Special Issue Community Health Intervention to Reduce Chronic Disease)

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19 pages, 1202 KiB

Open AccessArticle

Active Ottumwa: Adapting Evidence-Based Recommendations to Promote Physical Activity in a Micropolitan New Destination Community

by Barbara Baquero, Christine M. Kava, Sato Ashida, Jason Daniel-Ulloa, Helena H. Laroche, Heidi Haines, Rebecca Bucklin, Adriana Maldonado, Mayra Coronado Garcia, Sandy Berto, Dan Sewell, Nicole Novak, Kathleen Janz, Claudia Gates and Edith A. Parker

Int. J. Environ. Res. Public Health 2018, 15(5), 917; https://doi.org/10.3390/ijerph15050917 - 4 May 2018

Cited by 6 | Viewed by 6969

Abstract

Background: Evidence-based interventions have been developed and tested to promote physical activity, but fewer studies have focused on identifying effective intervention strategies for mid-size rural communities, especially new immigrant destinations. We report here on the design and implementation of Active Ottumwa, a [...] Read more.

Background: Evidence-based interventions have been developed and tested to promote physical activity, but fewer studies have focused on identifying effective intervention strategies for mid-size rural communities, especially new immigrant destinations. We report here on the design and implementation of Active Ottumwa, a community-wide intervention using a lay health advisor approach to increase physical activity in a micropolitan new destination community in the rural state of Iowa. Methods: The Active Ottumwa study is part of a community-academic partnership in Ottumwa, IA. Evidence-based strategies recommended by the Community Guide for Preventive Services guided study implementation and included behavioral and social, campaign and informational, and environmental and policy approaches. Evaluation methods for this study are multi-faceted and include a cross-sectional community survey, longitudinal cohort assessment, observational data, key informant interviews, and project records. Results: We are currently in our second year of intervention implementation, with 45 lay health advisors (termed physical activity leaders here) trained to carry out behavioral and social intervention approaches, including walking groups, tai chi, and yoga. We have completed a communication and informational campaign utilizing five channels. Our longitudinal cohort has been recruited, with baseline and 12-month data collection completed. Conclusions: This study will assess the effectiveness and impact of a community-wide intervention to support physical activity. Full article

(This article belongs to the Special Issue Community Health Intervention to Reduce Chronic Disease)

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27 pages, 1112 KiB

Open AccessArticle

The Coaching on Lifestyle (CooL) Intervention for Overweight and Obesity: A Longitudinal Study into Participants’ Lifestyle Changes

by Celeste Van Rinsum, Sanne Gerards, Geert Rutten, Nicole Philippens, Ester Janssen, Bjorn Winkens, Ien Van de Goor and Stef Kremers

Int. J. Environ. Res. Public Health 2018, 15(4), 680; https://doi.org/10.3390/ijerph15040680 - 4 Apr 2018

Cited by 27 | Viewed by 9365

Abstract

Combined lifestyle interventions (CLIs) can be effective in reducing weight and improving lifestyle-related behaviours but it is unclear how CLIs can best be implemented in practice in order to achieve sustained lifestyle changes. The Coaching on Lifestyle programme (CooL) is a CLI in [...] Read more.

Combined lifestyle interventions (CLIs) can be effective in reducing weight and improving lifestyle-related behaviours but it is unclear how CLIs can best be implemented in practice in order to achieve sustained lifestyle changes. The Coaching on Lifestyle programme (CooL) is a CLI in the Netherlands, in which professional lifestyle coaches counsel adults and children (and/or their parents) who are obese or at high risk of obesity to achieve a sustained healthier lifestyle. The CooL intervention consists of group and individual sessions addressing the topics of physical activity, dietary behaviours, sleep and stress. Our longitudinal one-group pre-post study aimed to identify lifestyle changes among participants (adults, children and their parents) at 8 and 18 months after initiation. We assessed constructs ranging from motivation and behaviour-specific cognitions to behaviours and health outcomes. Positive and sustained changes among adults were found regarding perceived autonomy, motivation, perceived barriers, lifestyle behaviours, quality of life and weight. Among children and their parents, few improvements were found regarding behaviours and quality of life. CooL has been successful in coaching adult participants towards sustained behavioural change during the intervention period. Mixed results and smaller effect sizes were found for children and their parents. Full article

(This article belongs to the Special Issue Community Health Intervention to Reduce Chronic Disease)

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23 pages, 339 KiB

Open AccessArticle

Improving Chronic Disease Self-Management by Older Home Health Patients through Community Health Coaching

by Cheryl Dye, Deborah Willoughby, Begum Aybar-Damali, Carmelita Grady, Rebecca Oran and Alana Knudson

Int. J. Environ. Res. Public Health 2018, 15(4), 660; https://doi.org/10.3390/ijerph15040660 - 2 Apr 2018

Cited by 30 | Viewed by 10451

Abstract

The purpose of the study was to pilot test a model to reduce hospital readmissions and emergency department use of rural, older adults with chronic diseases discharged from home health services (HHS) through the use of volunteers. The study’s priority population consistently experiences [...] Read more.

The purpose of the study was to pilot test a model to reduce hospital readmissions and emergency department use of rural, older adults with chronic diseases discharged from home health services (HHS) through the use of volunteers. The study’s priority population consistently experiences poorer health outcomes than their urban counterparts due in part to lower socioeconomic status, reduced access to health services, and incidence of chronic diseases. When they are hospitalized for complications due to poorly managed chronic diseases, they are frequently readmitted for the same conditions. This pilot study examines the use of volunteer community members who were trained as Health Coaches to mentor discharged HHS patients in following the self-care plan developed by their HHS RN; improving chronic disease self-management behaviors; reducing risk of falls, pneumonia, and flu; and accessing community resources. Program participants increased their ability to monitor and track their chronic health conditions, make positive lifestyle changes, and reduce incidents of falls, pneumonia and flu. Although differences in the ED and hospital admission rates after discharge from HHS between the treatment and comparison group (matched for gender, age, and chronic condition) were not statistically significant, the treatment group’s rate was less than the comparison group thus suggesting a promising impact of the HC program (90 day: 263 comparison vs. 129 treatment; p = 0.65; 180 day 666.67 vs. 290.32; p = 0.19). The community health coach model offers a potential approach for improving the ability of discharged older home health patients to manage chronic conditions and ultimately reduce emergent care. Full article

(This article belongs to the Special Issue Community Health Intervention to Reduce Chronic Disease)

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Barriers and Facilitators for Health Behavior Change among Adults from Multi-Problem Households: A Qualitative Study

by Gera E. Nagelhout, Lette Hogeling, Renate Spruijt, Nathalie Postma and Hein De Vries

Int. J. Environ. Res. Public Health 2017, 14(10), 1229; https://doi.org/10.3390/ijerph14101229 - 15 Oct 2017

Cited by 14 | Viewed by 9743

Abstract

Multi-problem households are households with problems on more than one of the following core problem areas: socio-economic problems, psycho-social problems, and problems related to child care. The aim of this study was to examine barriers and facilitators for health behavior change among adults [...] Read more.

Multi-problem households are households with problems on more than one of the following core problem areas: socio-economic problems, psycho-social problems, and problems related to child care. The aim of this study was to examine barriers and facilitators for health behavior change among adults from multi-problem households, as well as to identify ideas for a health promotion program. A qualitative study involving 25 semi-structured interviews was conducted among Dutch adults who received intensive family home care for multi-problem households. Results were discussed with eight social workers in a focus group interview. Data were analyzed using the Framework Method. The results revealed that the main reason for not engaging in sports were the costs. Physical activity was facilitated by physically active (transport to) work and by dog ownership. Respondents who received a food bank package reported this as a barrier for healthy eating. Those with medical conditions such as diabetes indicated that this motivated them to eat healthily. Smokers and former smokers reported that stress was a major barrier for quitting smoking but that medical conditions could motivate them to quit smoking. A reported reason for not using alcohol was having difficult past experiences such as violence and abuse by alcoholics. Mentioned intervention ideas were: something social, an outdoor sports event, cooking classes, a walking group, and children’s activities in nature. Free or cheap activities that include social interaction and reduce stress are in line with the identified barriers and facilitators. Besides these activities, it may be important to influence the target group’s environment by educating social workers and ensuring healthier food bank packages. Full article

(This article belongs to the Special Issue Community Health Intervention to Reduce Chronic Disease)

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Open AccessArticle

Dynamics of Implementation and Maintenance of Organizational Health Interventions

by Mohammad S. Jalali, Hazhir Rahmandad, Sally Lawrence Bullock and Alice Ammerman

Int. J. Environ. Res. Public Health 2017, 14(8), 917; https://doi.org/10.3390/ijerph14080917 - 15 Aug 2017

Cited by 15 | Viewed by 7045

Abstract

In this study, we present case studies to explore the dynamics of implementation and maintenance of health interventions. We analyze how specific interventions are built and eroded, how the building and erosion mechanisms are interconnected, and why we can see significantly different erosion [...] Read more.

In this study, we present case studies to explore the dynamics of implementation and maintenance of health interventions. We analyze how specific interventions are built and eroded, how the building and erosion mechanisms are interconnected, and why we can see significantly different erosion rates across otherwise similar organizations. We use multiple comparative obesity prevention case studies to provide empirical information on the mechanisms of interest, and use qualitative systems modeling to integrate our evolving understanding into an internally consistent and transparent theory of the phenomenon. Our preliminary results identify reinforcing feedback mechanisms, including design of organizational processes, motivation of stakeholders, and communication among stakeholders, which influence implementation and maintenance of intervention components. Over time, these feedback mechanisms may drive a wedge between otherwise similar organizations, leading to distinct configurations of implementation and maintenance processes. Full article

(This article belongs to the Special Issue Community Health Intervention to Reduce Chronic Disease)

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Review

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18 pages, 2035 KiB

Open AccessReview

Are Parent-Held Child Health Records a Valuable Health Intervention? A Systematic Review and Meta-Analysis

by Muhammad Chutiyami, Shirley Wyver and Janaki Amin

Int. J. Environ. Res. Public Health 2019, 16(2), 220; https://doi.org/10.3390/ijerph16020220 - 14 Jan 2019

Cited by 12 | Viewed by 7674

Abstract

Parent-held child health record (PHCHR), a public health intervention for promoting access to preventive health services, have been in use in many developed and developing countries. This review aimed to evaluate the use of the records toward promoting child health/development. We searched PubMed, [...] Read more.

Parent-held child health record (PHCHR), a public health intervention for promoting access to preventive health services, have been in use in many developed and developing countries. This review aimed to evaluate the use of the records toward promoting child health/development. We searched PubMed, PsycINFO, CINAHL, Cochrane Library and Google Scholar to identify relevant articles, of which 32 studies met the inclusion criteria. Due to considerable heterogeneity, findings were narratively synthesised. Outcomes with sufficient data were meta-analysed using a random-effects model. Odds Ratio (OR) was used to compute the pooled effect sizes at 95% confidence interval (CI). The pooled effect of the PHCHR on the utilisation of child/maternal healthcare was not statistically significant (OR = 1.31, 95% CI 0.92–1.88). However, parents who use the record in low- and middle-income countries (LMIC) were approximately twice as likely to adhere to child vaccinations (OR = 1.93, 95% CI 1.01–3.70), utilise antenatal care (OR = 1.60, 95% CI 1.23–2.08), and better breastfeeding practice (OR = 2.82, 95% CI 1.02–7.82). Many parents (average-72%) perceived the PHCHR as useful/important and majority (average-84%) took it to child clinics. Health visitors and nurses/midwives were more likely to use the record than hospital doctors. It is concluded that parents generally valued the PHCHR, but its effect on child health-related outcomes have only been demonstrated in LMIC. Full article

(This article belongs to the Special Issue Community Health Intervention to Reduce Chronic Disease)

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14 pages, 669 KiB

Open AccessReview

Inappropriate Use of Medication by Elderly, Polymedicated, or Multipathological Patients with Chronic Diseases

by Virtudes Pérez-Jover, José J. Mira, Concepción Carratala-Munuera, Vicente F. Gil-Guillen, Josep Basora, Adriana López-Pineda and Domingo Orozco-Beltrán

Int. J. Environ. Res. Public Health 2018, 15(2), 310; https://doi.org/10.3390/ijerph15020310 - 10 Feb 2018

Cited by 66 | Viewed by 12793

Abstract

The growth of the aging population leads to the increase of chronic diseases, of the burden of multimorbility, and of the complexity polypharmacy. The prevalence of medication errors rises in patients with polypharmacy in primary care, and this is a major concern to [...] Read more.

The growth of the aging population leads to the increase of chronic diseases, of the burden of multimorbility, and of the complexity polypharmacy. The prevalence of medication errors rises in patients with polypharmacy in primary care, and this is a major concern to healthcare systems. This study reviews the published literature on the inappropriate use of medicines in order to articulate recommendations on how to reduce it in chronic patients, particularly in those who are elderly, polymedicated, or multipathological. A systematic review of articles published from January 2000 to October 2015 was performed using MEDLINE, EMBASE, PsychInfo, Scopus, The Cochrane Library, and Index Medicus databases. We selected 80 studies in order to analyse the content that addressed the question under consideration. Our literature review found that half of patients know what their prescribed treatment is; that most of elderly people take five or more medications a day; that in elderly, polymedicated people, the probability of a medication error occurring is higher; that new tools have been recently developed to reduce errors; that elderly patients can understand written information but the presentation and format is an important factor; and that a high percentage of patients have remaining doubts after their visit. Thus, strategies based on the evidence should be applied in order to reduce medication errors. Full article

(This article belongs to the Special Issue Community Health Intervention to Reduce Chronic Disease)

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17 pages, 21364 KiB

Open AccessConcept Paper

A Multisensory Multilevel Health Education Model for Diverse Communities

by Olajide Williams and Ewelina M. Swierad

Int. J. Environ. Res. Public Health 2019, 16(5), 872; https://doi.org/10.3390/ijerph16050872 - 10 Mar 2019

Cited by 16 | Viewed by 10137

Abstract

Owing to their enormous capacity to improve health and save lives, public health researchers and practitioners have worked on developing effective frameworks for the optimization of health promotion strategies. A multilevel focus, as exemplified by the Socio-Ecological Model (SEM), is one common denominator [...] Read more.

Owing to their enormous capacity to improve health and save lives, public health researchers and practitioners have worked on developing effective frameworks for the optimization of health promotion strategies. A multilevel focus, as exemplified by the Socio-Ecological Model (SEM), is one common denominator among these frameworks. The SEM highlights important social and ecological influences on health behavior by delineating the different levels of influence. These include public policy, organizational, community, interpersonal, and intrapersonal levels, which, when considered during the development of health promotion campaigns—especially those that focus on health education—strengthen the influence of that campaign on targeted behaviors. However, the SEM lacks a complimenting framework for understanding the role of conventional and unconventional approaches to health education; that is, how to design a health education intervention that considers both the context, such as the social and ecological levels of influence, and the best approaches for developing and delivering the health education in a manner that optimizes its effectiveness in today’s modern and increasingly diverse world. Addressing this gap, the current article presents an integrative Multisensory Multilevel Health Education Model (MMHEM), which incorporates three key domains—(1) Art (innovativeness/creativity), (2) Culture (cultural tailoring), and (3) Science (evidence-based), while promoting the importance of considering the socio-ecological levels of influence on targeted behaviors. Using a successful health education intervention, called the Hip Hop Stroke, we deconstruct the Multisensory Multilevel Health Education Model and discuss its potential role as a guide for developing public health education interventions. Full article

(This article belongs to the Special Issue Community Health Intervention to Reduce Chronic Disease)

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