Health Promotion

Systems Theory Approach to the Health Care Organization on National Level

by Ryszard Stocki

Bielecki & Stocki

National health care systems have been found ineffective in most countries. The subsystems of the health care systems... more National health care systems have been found ineffective in most countries. The subsystems of the health care systems are not autonomous and as such cannot be competitive in the market. A participative health care system with empowered patients as customers and hospitals as providers is proposed. The consequences for both further modeling and implementation of such systems are discussed.

Health Professionals' Beliefs about ANPHA Objectives and Industry Representation on the Advisory Council

by Julia Anwar McHenry

Co-authored with R J Donovan & G Jalleh

Review of review-level evidence to inform the development of NICE public health guidance for the prevention of pre-diabetes among adults in high-risk groups

by Alison O'Mara-Eves

Suggested citation:
O’Mara, A. J., Marrero-Guillamón, I., Parry, W., Cooper, C., & Lorenc, T. (2010, Aug). Review of review-level evidence to inform the development of NICE public health guidance for the prevention of pre-diabetes among adults in high-risk groups. London: National Institute for Health and Clinical Excellence (NICE).

[Excerpt from the executive summary]

1.1 Introduction
This report presents the findings of a... more [Excerpt from the executive summary]

1.1 Introduction
This report presents the findings of a systematic review of review-level evidence concerning the prevention of pre-diabetes (raised and impaired glucose levels) in populations/groups at higher risk (black and minority ethnic [BME] or low socioeconomic status [SES]) using community- and population-level interventions.

The primary research question for the review was:
What is known from review-level evidence about the effectiveness and cost-effectiveness of population- and community-level interventions to improve modifiable risk factors associated with pre-diabetes and type 2 diabetes among BME and low-income / low-SES groups?

The secondary research questions were:
What is known about promising ways to tailor interventions for diabetes risk factors to BME or low-income groups, for outcomes including improved BMI, physical activity levels, and blood pressure?
What are the barriers/facilitators to the effectiveness of interventions?

1.2 Methods
To locate evidence, a range of databases and websites indexing relevant literature were searched. Review reports were included if they:
1. were related to diabetes or pre-diabetes, obesity, healthy eating or dietary behaviour relevant to diabetes, or physical activity. Studies containing populations that already had diabetes were excluded;
2. were reviews of literature;
3. were published in 1999 or later;
4. were published in English;
5. included studies of adults (18-74 years);
6. included evaluations of interventions using any design (e.g. RCT, comparative trial, one-group);
7. had a focus on population- or community-level interventions; and
8. had a focus on either (i) low-SES or disadvantaged groups or (ii) any BME group relevant to the UK.

The quality of included reviews was assessed and data were extracted using adaptations of the standard tools for NICE public health evidence reviews of reviews.

Using action research to improve health and the work environment for 3500 municipal bus drivers

by John Schostak

Mapping synergy and antagony in North–South partnerships for health: a case study of the Tanzanian women's NGO KIWAKKUKI

by Hope Corbin

Co-authored with Maurice Mittelmark and Gro Th. Lie

North–South partnerships for health aim to link resources, expertise and local knowledge to create synergy. The... more North–South partnerships for health aim to link resources, expertise and local knowledge to create synergy. The literature on such partnerships presents an optimistic view of the promise of partnership on one hand, contrasted by pessimistic depictions of practice on the other. Case studies are called for to provide a more intricate understanding of partnership functioning, especially viewed from the Southern perspective. This case study examined the experience of the Tanzanian women's NGO, KIWAKKUKI, based on its long history of partnerships with Northern organizations, all addressing HIV/AIDS in the Kilimanjaro region. KIWAKKUKI has provided education and other services since its inception in 1990 and has grown to include a grassroots network of >6000 local members. Using the Bergen Model of Collaborative Functioning, the experience of KIWAKKUKI's partnership successes and failures was mapped. The findings demonstrate that even in effective partnerships, both positive and negative processes are evident. It was also observed that KIWAKKUKI's partnership breakdowns were not strictly negative, as they provided lessons which the organization took into account when entering subsequent partnerships. The study highlights the importance of acknowledging and reporting on both positive and negative processes to maximize learning in North–South partnerships.

Incidental exposure to no-smoking signs primes craving for cigarettes

by Brian Earp

Earp, B. D., Dill, B., Harris, J., Ackerman, J., and Bargh, J. (2011). Incidental exposure to no-smoking signs primes craving for cigarettes: An ironic effect of unconscious semantic processing? Yale Review of Undergraduate Research in Psychology, Vol 2, No 1, 12-23.

The present study tests whether incidental exposure to no-smoking signs may ironically boost craving for cigarettes in... more The present study tests whether incidental exposure to no-smoking signs may ironically boost craving for cigarettes in smokers. Smokers viewed photographs in which no-smoking signs were either incon- spicuously embedded (prime) or edited out (control). Participants then used a joystick to make quick approach vs. avoid motions while viewing smoking-related and neutral stimuli on a computer screen (Chen & Bargh, 1999). We hypothesized that primed smokers, but not controls, would show an automatic reach bias toward the smoking- related stimuli. The data supported our prediction. Possible mecha- nisms for the effect are discussed, as well as implications for public health policy, negation-based social campaigns in general, and our understanding of the unconscious processing of semantic infor- mation.

A Tibetan Medical Perspective on Irritable Bowel Syndrome

by Eliot Tokar

Tokar, Eliot 1998, A Tibetan medical perspective on irritable bowel syndrome: building a means of discourse for integrative medicine, Alternative and Complementary Therapies, 4(5): 343-349

This article will compare the diagnostic approaches of Western biomedicine and Tibetan medicine. The biomedical... more This article will compare the diagnostic approaches of Western biomedicine and Tibetan medicine. The biomedical disease irritable bowel syndrome will be used as a case study. It will be contrasted with the multiple nosological categories that could be used in TIbetan medicine to achieve a differential diagnosis for patients with symptoms that are typical of this biomedical disease.

As a result of the grassroots alternative medicine movement, for four decades Americans have increasingly used a wide diversity of natural medical approaches. Among these are ancient systems of traditional natural medicine such as Tibetan medicine. As the use of such medical alternatives expand it is important to consider how they can be best utilized within our society.

The integration of such systems into the existing medical industrial complex is an approach sponsored by powerful voices within the government, academia and the medical industry. Alternatively, many laypeople and health professionals advocate for medical pluralism in order to provide a means for promoting the greatest possible healthcare diversity and freedom. In analyzing the debate between integration and pluralism it is vital to consider how they will each effect the actual practice of traditional natural medical systems as well as the indigenous cultures from which such disciplines originate. This article will draw upon the history of Tibetan medicine to inform the debate between integration and pluralism. Finally, it will pose some critical questions regarding medical reform.

Seeing to the distant mountain: diagnosis in Tibetan medicine.

by Eliot Tokar

Tokar, Eliot, 1999, Seeing to the distant mountain: Diagnosis in Tibetan medicine, Alternative Therapies In Health And Medicine, 5(2): 50-58

To make use of an ancient traditional medical system we must first be able to comprehend the singular concepts and... more To make use of an ancient traditional medical system we must first be able to comprehend the singular concepts and language it utilizes to understand and describe health and illness. The diagnostic procedure is the method by which a person's medical condition is interpreted into the epistemological categories and language of medical science. This article provides a description of traditional Tibetan medical diagnosis, and explains how a Tibetan physician perceives and analyzes a presenting illness. It discusses the spiritual, psychological and physical aspects of the Tibetan medical approach to diagnosis. By addressing these issues we can understand what is unique about this system of alternative medicine and how it can inform other models of medical practice.

Preservation and Progress: Using Tibetan Medicine as a Model to Define a Progressive Role for Traditional Asian Medicine in Modern Healthcare

by Eliot Tokar

Tokar, Eliot. 2007, Preservation And Progress: Using Tibetan Medicine As A Model To Define A Progressive Role For Traditional Asian Medicine In Modern Healthcare, Asian Medicine: Tradition and Modernity, 2(2): 303-314.

The history of Tibetan medicine's development provides an excellent model for planning the appropriate utilization of... more The history of Tibetan medicine's development provides an excellent model for planning the appropriate utilization of 'foreign' medical systems and traditions within a new culture that incorporates progressive approaches for the use of both medical pluralism and integration. This history takes on increasing relevance in the modern world as the practice of Tibetan medicine and other forms of traditional Asian medicine have been spreading in the West where they have been faced with commoditization and the hegemony of biomedicine. In the face of modern globalization, certain key questions have yet to be sufficiently addressed. How can systems of traditional Asian medicine be incorporated into western cultures in a manner that permits them to contribute to our understanding of health and disease while allowing them to retain their own integrity? How can they be utilized to aid in the solution of public health problems that exist in the West? What should be the proper interaction between traditional Asian medical systems (e.g., Tibetan medicine) and biomedicine? To determine the answer to these and other vital questions, we must take into account the many cultural, political, economic and scientific issues that affect the state of both public health and individual healthcare.

A Tibetan medicine doctor's view: Interview with Eliot Tokar

by Eliot Tokar

Laughlin, Matt 2006, Transformation and balance: The principles of Tibetan medicine in the context of American healthcare, Unified Energetics; 1:2, 19-25

This interview explores the nature of the study and the clinical practice of Tibetan medicine. Also included are... more This interview explores the nature of the study and the clinical practice of Tibetan medicine. Also included are topics such as the issues involved in the preservation of ancient forms of medicine in the modern world, medical integration, biopiracy, and the application of intellectual property rights to traditional culture. Eliot Tokar is a traditional Tibetan medicine doctor and internationally experienced writer and lecturer. He practices Tibetan medicine in NYC and is one of the first Westerners to have received extensive textual and clinical training in this field.

FUMANTES E NÃO-FUMANTES: NOVOS “EXCLUÍDOS” OU NOVAS “TRIBOS”?

by Roger Keller Celeste

Título: PROJETO MANTENDO SORRISOS/FALA CRIANÇA: UMA INTEGRAÇÃO ODONTOLOGIA E FONOAUDIOLOGIA

by Roger Keller Celeste

Projeto Agentes de Saúde Mirins

by Roger Keller Celeste

Analysis of the Brazilian/Mercosul and the British/European Union Food Labelling Legislation

by Roger Keller Celeste

The Blame Frame: Media Attribution of Culpability About the MMR–Autism Vaccination Scare

by Avery Holton

Co-authored with Brooke Weberling (South Carolina) , Christopher E. Clarke (Cornell) & Michael J. Smith (Louisville).

Scholars have examined how news media frame events, including responsibility for causing and fixing problems, and how... more Scholars have examined how news media frame events, including responsibility for causing and fixing problems, and how these frames inform public judgment. This study analyzed 281 newspaper articles about a controversial medical study linking the measles, mumps, and rubella (MMR) vaccination with autism. Given criticism of the study and its potential negative impact on vaccination rates across multiple countries, the current study examined actors to whom news media attributed blame for the MMR–vaccine association, sources used to support those attributions, and what solutions (e.g., mobilizing information), if any, were offered. This study provides unique insight by examining the evolution of these attributions over the lifetime of the controversy. Findings emphasize how news media may attribute blame in health risk communication and how that ascription plays a potentially vital role in shaping public behavior. Theoretical and practical implications are discussed.

Social capital and social inequality in adolescents’ health in 601 Flemish communities: A multilevel analysis

by Bart De Clercq

Although it is widely acknowledged that community social capital plays an important role in young people’s health,... more Although it is widely acknowledged that community social capital plays an important role in young people’s health, there is limited evidence on the effect of community social capital on the social gradient in child and adolescent health. Using data from the 2005-2006 Flemish (Belgium) Health Behavior among School-aged Children survey (601 communities, N = 10,915), this study investigated whether community social capital is an independent determinant of adolescents’ perceived health and well-being after taking account of individual compositional characteristics (e.g. the gender composition within a certain community). Multilevel statistical procedures were used to estimate neighborhood effects while controlling for individual-level effects. Results show that individual-level factors (such as family affluence and individual social capital) positively related to perceived health and well-being and that community-level social capital predicted health better than individual social capital. A significant complex interaction effect was found, such that the social gradient in perceived health and well-being (i.e. the slope of family affluence on health) was flattened in communities with a high level of community social capital. Furthermore it seems that SES differences in perceived health and well-being substantially narrow in communities where a certain (average) level of community social capital is present. This should mean that individuals living in communities with a low level of community social capital especially benefit from an increase in community social capital. The paper substantiates the need to connect individual health to their meso socio-economic context and this being intrinsically within a multilevel framework.

La participación social como estrategia central de la nutrición comunitaria para afrontar los retos asociados a la transición nutricional

by José Carlos Suárez-Herrera

Suárez-Herrera, J. C., Serra-Majem, L., & O’Shanahan, J. J. (2009). La participación social como estrategia central de la nutrición comunitaria para afrontar los retos asociados a la transición nutricional. Revista Española de Salud Pública, 83(6), 791-803.

In last decades modern societies are undergoing a rapid nutrition transition process that reinforces, at international... more In last decades modern societies are undergoing a rapid nutrition transition process that reinforces, at international level, the emergence of nutritional problems of contradictory nature, such as malnutrition and obesity. This represents a considerable challenge for contemporary Public Health leaders, who have been gradually developing a set of strategies which overwhelmingly adopt a population perspective. Nevertheless, the collective nature of these strategies could neglect the particular individual and family needs.

We consider social participation as an approach to simultaneously reinforce both individual and population perspectives during the divers phases of development of Community Nutrition programs which tackle the paradoxical nature of this problematic. However in relation to some contextual factors, we find a growing trend to develop a more technocratic dimension of participatory practices, which distorts the emancipator and transformative potential of social participation.

In order to avoid this tendency, we propose the use of the five intervention axes of the Ottawa Chart for Health Promotion as a guide for a systemic integration of social participation in planning, implementation and evaluation processes of community Nutrition programs. We therefore take into account the integration of social participation in the efforts made in developing individual capacitybuilding, reinforcing collective action, creating enabling environments, health care reorganization, and finally, implementing nutritional and public health policies.

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by Graciela Natansohn

Freedom's Body: Warfare, Welfare and People's Health Activism in Los Angeles

by Jenna Loyd

forthcoming book

Freedom’s Body unearths a rich history of Los Angeles-based health activism on the part of 1960s and 1970s Black... more Freedom’s Body unearths a rich history of Los Angeles-based health activism on the part of 1960s and 1970s Black freedom, antiwar and women’s movements. The arc of the book begins in 1963 with struggles against segregated health care, coerced sterilization, and nuclear terror. It ends in 1978 with a homeowners’ tax revolt that worked to contain such expansive redefinitions of health and to roll back gains to health and social services. The era began and ended with health care as a privilege, but health and health care had been decisively politicized. The gains of Black freedom, antiwar and women’s movements for establishing bodily integrity as a political issue were substantial. Collectively they shook the sturdy foundations of state-sanctioned sexist and racist medical practice and crafted new understandings of health that identified the centrality of war and militarization for creating grave ecologies at home and abroad.

Much of the scholarship of post-World War II US cities focuses either on the importance of war and the military-industrial complex to metropolitan and regional shifts, or on social and political conflicts within cities. Freedom’s Body grounds the era’s activism within the political geography of Los Angeles’ defense economy, an approach that can hopefully invigorate more in-depth studies of the relations between militarization and political mobilization in specific places. Resituating health politics within the militarized geographies and political movements from which they emerge enables Freedom’s Body to trace the far broader conceptualizations of healthy living for which the Black freedom, antiwar and women’s movements fought.

The focus on popular struggles for health – welfare, housing, jobs, parks, child care, a clean environment, peace, and justice – aims to capture the spirit and breadth of health demands that animated these movements, and sometimes drew them together. In highlighting how violence and social inequalities become objects of health activism, this book elucidates a theory of health and social change that stands at odds with those framed in terms of medical institutions, professional reform and individual responsibility. Such dominant understandings often have worked ideologically to isolate bodily harms from the social relations that systematically shape life possibilities. To that end, Freedom’s Body questions the ways in which narratives of the women’s health movement have been tethered to dominant health understandings. Resituating welfare and peace within this history profoundly alters white feminist paradigms of women’s health and reproductive rights activism. Ultimately, the book’s exploration of state violence as a health issue is perhaps the most sweeping departure from the dominant health ideology. But it was also this premise that enabled antiwar, welfare, and civil rights groups to organize for urban reconstruction as a shared project of peace and freedom. It also enabled to see how institutional reforms like universal health care and a guaranteed income were made impossible by a militarized economy.

The inclusion of parents or carers in the consultation process of developing health-promotion activities in the Australian context.

by Paul Bennett

Co-authored with - Gladman, J.
(2012) Health Education Journal, in Print

Objective: Patterns of health behaviour and lifestyle established in childhood carry on into adulthood.
Parents... more Objective: Patterns of health behaviour and lifestyle established in childhood carry on into adulthood.
Parents and carers have strong influences on the establishment of these patterns. Despite such influences,
parents and carers are often omitted from the planning process in health-promotion and early intervention
activities. This paper examines the literature to quantify the amount of consultation that occurs.
Method: A systemic review of the available literature was conducted of papers published in English
between 1998 and 2008 using OVID, Medline, CIAP, CINAHL, PsycINFO, SPORTDiscus, INFORMET and
PubMed databases. The search was not limited to age; however, some papers indicted that their research
were restricted to children over the age of five.
Results: Three hundred and thirty one articles were retrieved of which 32 met the inclusion criteria. It
was found that parents and carers are reliable and accurate reporters of the objective components of their
child’s health, such as physical functioning, but unreliable when it comes to subjective components including
pain and emotional psychosocial functioning of their children. However, parents and carers are often omitted
or at best superficially included in the development of health-promotion and early intervention programmes
in Australia.
Conclusions: The lack of consultation with parents and carers in health-promotion and early interventions
programmes by policy makers, programme developers and health advocates results in decreased consumer
ownership, dissatisfaction with service delivery and creates barriers to engagement. Without adequate and
appropriate engagement of parents and carers, early interventions and health-promotion programmes will
result in superficial and short-term health outcomes.
Keywords
carers and children, health promotion, parents, perception