Article Abstracts
(Health Promotion Journal of Australia 1995;5(2):4-9.)
Method: Qualitative formative research was undertaken to inform the development of strategies and materials. The 12 focus groups involved 90 people aged 31 to 72 years. The groups were stratified by socioeconomic status, gender and physical activity participation (sedentary and low to moderate exercisers).
Results: Promoting walking is likely to be positively received and is consistent with already held positive views that walking is the 'best' type of exercise. There is perceived growing pressure to exercise from the mass media, doctors and weight loss groups. Strategies are needed that will build on the impression that 'everyone is doing it'; provide social support; maintain the salience of light to moderate exercise as a means of preventing and solving health problems; and assist people to incorporate light to moderate exercise into their daily activities. For highly resistant groups, general practitioners are an important key intermediary to promote physical activity on health grounds. Guidance is needed about the intensity, duration and frequency. Nevertheless, promoting the recommended level of light to moderate exercise as 'one hour each day' is unlikely to be an acceptable message for the sedentary and low to moderate exercisers.
Conclusion: Walking is perceived as an acceptable form of light to moderate exercise and it is more likely that the sedentary and low to moderate exercisers could be encouraged to take up or do more walking than to adopt any other type of exercise. Maintaining the pressure to do light to moderate exercise is important because for some the benefits of participation have not been internalised.
So what? While there appear to be opportunities to encourage the sedentary to participate in more walking, care needs to be taken in the framing of messages about intensity, duration and frequency. For those highly resistant to change, general practitioners appear to be a key intermediary in encouraging participation.
(Health Promotion Journal of Australia 1995;5(2):10-17.)
Method: The qualitative evaluation comprised structured interviews with Centre Coordinators and local health administrators, and focus groups with Wellness Centre participants. It involved gathering information about how Wellness Centres have been accepted by local health authorities, and about their popularity and utility for older people.
Results: The qualitative evaluation showed a positive response from most participants, coordinators and health administrators; they are happy with the program as it operates. The main reasons given by short-term and non-participants for not attending a Wellness Centre related to other commitments and not identifying themselves with the target group.
Conclusion: Centres seem to be fulfilling two key objectives - first, by broadening the social networks of the participants and second, by the dissemination of health information and reinforcement of positive health attitudes. This is occurring in a satisfactory way for participants.
So What? This evaluation reveals the potential for Wellness Programs to improve and maintain the health of older people.
(Health Promotion Journal of Australia 1995;5(2):18-21.)
Methods: Key stakeholders were involved in the planning and development of health education programs in six Senior Citizens Centres (SCCs), four Adult Leisure Leaming Centres (ALLCs) and four social groups. 'Pre' and 'post' questionnaires were used to evaluate the project at process and impact level. Evaluation tools measuring changes in social connections and levels of participation were developed.
Results: Twenty-one programs (327 participants) were implemented and of these 11 (129 participants) were evaluated. Findings of the project indicated that there were increases in the range and number of health education programs organised by seniors' centres. There were also increases in attendance at programs, and in older people's level of participation, social connections and self-esteem. The project has been maintained by older people after the withdrawal of the project worker.
Conclusions: The involvement of key stakeholders and the use of the existing infrastructure were the two crucial strategies leading to the success of the project.
So what? This project gives an example of how to evaluate key concepts such as social support and level of participation in a community health promotion intervention with older people. The strategies and health education programs employed in this project have excellent potential to be transferred and adopted in other Area Health Services.
(Health Promotion Journal of Australia 1995;5(2):22-26.)
Method: Data from a representative population survey of 3,004 South Australians aged 15 years or more were used to determine awareness of the risks of passive smoking, how concerned people are about being exposed, what non-smokers report they would do in response to actual or imminent exposure, and what smokers do when they wish to light a cigarette in a public place.
Results: There was a high degree of public acknowledgment that passive smoking can cause or aggravate certain health conditions. Almost 90 per cent of non-smokers and one-third of current smokers were at least somewhat concerned about being exposed to environmental tobacco smoke. Despite this, few non-smokers would ask a nearby smoker to stop and nearly one-third of non-smokers would agree to a person's request to smoke, when they themselves would rather this not occur. However, only a small minority of smokers reported that they would 'light up' in an indoor public place if they were unsure about the existence of a ban.
Conclusions: Despite the high levels of knowledge and concern among non-smokers, when responding to situations where exposure is occurring or is imminent, non-smokers frequently report that they would take the line of least resistance, either by removing themselves from the situation, or acquiescing to the requests of the smoker, even though they would rather not be exposed. However, most smokers report that they are considerate of non-smokers' rights in an indoor public place where a smoking ban may be in force.
So what? These findings underline the importance of the regulatory strategies which ban or restrict smoking in public places as a mechanism for protecting the health of non-smokers.
Key words: Passive smoking; public opinion; attitude to health; questionnaire.
(Health Promotion Journal of Australia 1995;5(2):27-30.)
Methods: The study design consisted of two stages. Stage one consisted of 20 in-depth interviews during which qualitative data were gathered on women's beliefs about cancer and their knowledge of screening. Results were used to design a questionnaire which was administered in Stage two to a further 150 Italian-born women between the ages of 40 and 65 years living in the western suburbs of Melbourne.
Results: Italian-Australian women of this age group reported frequent attendance at general practices but were infrequent users of other (community) primary health services. Most reported having knowledge about Papanicolaou (Pap) smears and mammography although there was considerable variation in reported beliefs about what these tests could detect and their perceived risks and benefits. Women also reported conflicting beliefs about the efficacy of detecting cancer in its early stages and qualitative data indicate that this is due to a complex system of cultural beliefs about cancer.
Conclusions: The results indicate that while women report to be open about their participation in breast and Pap smear screening, specific cultural beliefs about the cause and early treatment of cancer may act to either enhance or lower their actual utilisation of these services.
So what? Findings from this study strongly suggest that culturally appropriate health promotion strategies for breast and cervical cancer screening must go beyond the recruitment stage to the development of sensitive recall, diagnosis and treatment services for women of non-English speaking background.
(Health Promotion Journal of Australia 1995;5(2):31-36.)
Method: Fellows of the Royal Australasian College of Obstetricians and Gynaecologists (RACOG) practising in NSW were surveyed.
Results: The response rate was 73 per cent. Respondents' estimates of the prevalence of smoking among women with abnormal Pap smears ranged from 5 to 95 per cent (mode 50 per cent; median 60 per cent). Seventy-two per cent and 65 per cent agreed that smoking was a risk factor for onset and progression of cervical intraepithelial neoplasia (CIN), respectively. However, 17 per cent never advised smoking cessation. Of the remainder who did, 55 per cent 'always' advised quitting completely although 34 per cent 'always' advised the patient to cut down. Less frequently cited strategies were giving literature to smokers and referral to group counselling or public clinics. Sixty per cent never used 'quit dates'. Fifty per cent thought less than 10 per cent of patients gave up with their advice. Those who advised quitting completely rather than cutting down were more likely to perceive themselves as effective (p=0.011).
Conclusion: The potential for effective smoking cessation advice in gynaecology practice remains relatively untapped. To advance health promotion in specialist medical practice, future research should evaluate prospectively the acceptability and effectiveness of gynaecologists' smoking cessation advice.
(Health Promotion Journal of Australia 1995;5(2):37-40.)
(Health Promotion Journal of Australia 1995;5(2):41-44.)
Methods: Ten child-care centres were randomly selected and divided into an intervention and a control group. Parents of children attending the centres in the intervention group received a pamphlet about the Hib vaccine. Several weeks later questionnaires were given to the selected child-care centres.
Results: Forty-six per cent of children were reported by parents to have received the Hib vaccine. The most common reason given by parents for not vaccinating their child was lack of information about the Hib vaccine. Younger children were more likely to have been vaccinated than older children and children from families with economic resources in the upper 50 per cent level were more likely to have received the Hib vaccine compared to children from families with economic resources in the lower 50 per cent level. Fewer than half of the parents reported that their doctor had discussed Hib vaccination during their child's consultation.
Conclusion: Hib vaccination programs need to target children attending child care, especially those in families in the lower income bracket.
So what? This study emphasises the importance of accurate, up-to-date educational material on new vaccines.
(Health Promotion Journal of Australia 1995;5(2):45-48.)
Method: This paper describes and critiques the process of implementation and evaluation of the multi-strategic "Caring for Children" project. Strategies included the development, marketing and statewide distribution of a new nutrition book for child care staff, local nutrition workshops for cooks and directors, the creation of training opportunities for cooks, and statewide "Train the Trainer" workshops to promote the transferability of the project. Local, State and national policy changes were also advocated.
Results: The project has been readily implemented by dietitians throughout NSW with a high level of activity recorded. Results of quantitative statewide evaluation were inconclusive, however qualitative data showed a high acceptance of the book and improvements in child care nutrition, particularly with respect to nutrients at risk.
Conclusions: This was the first time in NSW that a multi-strategic nutrition project had been developed, managed and implemented statewide by a community nutrition team operating from a local base. This provided a valuable learning experience for the project team and positive outcomes for child care nutrition.
So what? It is the view of the authors that a locally based statewide nutrition project can be successfully managed and implemented provided there is careful attention to planning, securing of adequate resources and high level support for structural change.
(Health Promotion Journal of Australia 1995;5(2):49-54.)
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