75 research outputs found
Theorizing healthy settings: a critical discussion with reference to Healthy Universities
The settings approach appreciates that health determinants operate in settings of everyday life. Whilst subject to conceptual development, we argue that the approach lacks a clear and coherent theoretical framework to steer policy, practice and research.
Aims: To identify what theories and conceptual models have been used in relation to the implementation and evaluation of Healthy Universities.
Methods: A scoping literature review was undertaken between 2010-2013, identifying 26 papers that met inclusion criteria.
Findings: Seven theoretical perspectives or conceptual frameworks were identified: the Ottawa Charter; a socio-ecological approach (which implicitly drew on sociological theories concerning structure and agency); salutogenesis; systems thinking; whole system change; organisational development; and a framework proposed by Dooris. These were used to address interrelated questions on the nature of a setting, how health is created in a setting, why the settings approach is a useful means of promoting health, and how health promotion can be introduced into and embedded within a setting.
Conclusion: Although distinctive, the example of Healthy Universities drew on common theoretical perspectives that have infused the settings discourse more generally. This engagement with theory was at times well-developed and at other times a passing reference. The paper concludes by pointing to other theories that offer value to healthy settings practice and research and by arguing that theorisation has a key role to play in understanding the complexity of settings and guiding the planning, implementation and evaluation of programmes
Predicting Whole Forest Structure, Primary Productivity, and Biomass Density From Maximum Tree Size and Resource Limitations
In the face of uncertain biological response to climate change and the many
critiques concerning model complexity it is increasingly important to develop
predictive mechanistic frameworks that capture the dominant features of
ecological communities and their dependencies on environmental factors. This is
particularly important for critical global processes such as biomass changes,
carbon export, and biogenic climate feedback. Past efforts have successfully
understood a broad spectrum of plant and community traits across a range of
biological diversity and body size, including tree size distributions and
maximum tree height, from mechanical, hydrodynamic, and resource constraints.
Recently it was shown that global scaling relationships for net primary
productivity are correlated with local meteorology and the overall biomass
density within a forest. Along with previous efforts, this highlights the
connection between widely observed allometric relationships and predictive
ecology. An emerging goal of ecological theory is to gain maximum predictive
power with the least number of parameters. Here we show that the explicit
dependence of such critical quantities can be systematically predicted knowing
just the size of the largest tree. This is supported by data showing that
forests converge to our predictions as they mature. Since maximum tree size can
be calculated from local meteorology this provides a general framework for
predicting the generic structure of forests from local environmental parameters
thereby addressing a range of critical Earth-system questions.Comment: 26 pages, 4 figures, 1 Tabl
Health promoting settings in primary health care - "hÀlsotorg": an implementation analysis
Background
Sweden, like many other western countries, faces increasing rates of lifestyle
related diseases and corresponding rise in costs for health care. To meet these
challenges, a number of efforts have been introduced at different societal
levels. One such effort is "HĂ€lsotorg" (HS). HS is a new health promotion
setting that emerged in collaboration between the Swedish County Councils and
Apoteket AB, a state-owned pharmacy company. HS's overall aim was to improve
population health and facilitate inhabitants' responsibility for self-care. A
new National Public Health Policy, introduced in 2008, emphasizes more focus on
individual's needs and responsibility as well as strong need for county
councils to provide supportive environment for individual-centred health
services and increased health literacy among the population. In light of this
policy, there is a need to examine existing settings that can provide
supportive environment for individuals at community level. The aim of this
study was to explore HS's policy implementation at local level and analyse HS's
activities, in order to provide a deeper understanding of HS's potential as a
health promoting setting.
Methods
Materials included a survey and key documents related to the development and
nature of HS on local and national levels. A policy analysis inspired by Walt
and Gilson was used in data analysis. In addition, an analysis using the
principles of health promotion in relation to HS policy process and activities
was also carried out.
Results
The analysis illuminated strengths and weaknesses in the policy process, its
actors, contextual factors and activities. The health communication approach in
the analysed documents contained health promoting intentions but the health
promoting approach corresponding to a health promoting setting was neither
apparent nor shared among the stakeholders. This influenced the interpretation
and implementation of HS negatively.
Conclusions
The analysis indicates that HS has potential to be a valuable health promotion
setting for both population and individuals, given the strong intentions for a
health and empowerment building approach that is expressed in the documents.
However, for a more sustainable implementation of HS, there is need for an in-
depth understanding of the health promotion approach among HS stakeholders
Challenging the field: Bourdieu and men's health
©2014 Macmillan Publishers Ltd. This article considers how understandings of health promotion with men may be assisted by engagement with Bourdieu's theoretical work. The article outlines leading concepts within Bourdieu's work on 'field', 'habitus' and 'capital'; considers subsequent critical debates among gender, feminist and sociological theorists around structure and agency; and links these to discussions within men's health. A particular focus concerns structural disruption of, and movement of social actors between, 'fields' such as family, work and leisure settings. The article examines, through Bourdieu's critical legacy, whether such disruption establishes conditions for transformative reflexivity among men in relation to previously held dispositions (habitus), including those inflected by masculinities, that affect men's health practices. Recent work within Bourdieu's heritage potentially facilitates a re-framing of understandings of men's health practices. The article specifically explores masculine ambivalence within accounts of reflexivity, identities and practice, and considers how social and symbolic (masculine) capital are in play. Implications of Bourdieu's leading concepts for theorising settings-focused approaches to men's health promotion are exemplified with reference to a men's health project in a football stadium leisure setting. The article considers the benefits and challenges of applying gendered critical insights drawing on Bourdieu's work to men's health promotion, and discusses emerging theoretical dilemmas
Social marketing and healthy eating : Findings from young people in Greece
This document is the Accepted Manuscript version. The final publication is available at Springer via http://dx.doi.org/10.1007/s12208-013-0112-xGreece has high rates of obesity and non-communicable diseases owing to poor dietary choices. This research provides lessons for social marketing to tackle the severe nutrition-related problems in this country by obtaining insight into the eating behaviour of young adults aged 18â23. Also, the main behavioural theories used to inform the research are critically discussed. The research was conducted in Athens. Nine focus groups with young adults from eight educational institutions were conducted and fifty-nine participantsâ views towards eating habits, healthy eating and the factors that affect their food choices were explored. The study found that the participants adopted unhealthier nutritional habits after enrolment. Motivations for healthy eating were good health, appearance and psychological consequences, while barriers included lack of time, fast-food availability and taste, peer pressure, lack of knowledge and lack of family support. Participants reported lack of supportive environments when deciding on food choices. Based on the findings, recommendations about the development of the basic 4Ps of the marketing mix, as well as of a fifth P, for Policy are proposedPeer reviewe
Correlates, determinants, and effectiveness of childcare educatorsâ practices and behaviours on preschoolersâ physical activity and eating behaviours: a systematic review protocol
Abstract: Background: Worldwide, approximately 12% of children under the age of 5 are either overweight or obese. As many young children spend 30 h or more per week in childcare centres with childcare educators. Targeting childcare educators as role models may prove an effective strategy for the promotion of healthy eating and physical activity. This manuscript describes the methods to systematically review existing literature relating to how childcare educators influence childrenâs healthy eating and physical activity behaviours, as well as the links between specific practices and behaviours of childcare educators and childrenâs healthy lifestyle behaviours. Methods: Relevant peer-reviewed studies will be identified through a computerized literature search in six databases: PubMed, The Cochrane Library, Science Direct, CINAHL, Wiley and SportDiscus. Quantitative studies written in English or French reporting the correlates, predictors or effectiveness of childcare educatorsâ practices and behaviours on preschoolersâ healthy eating and physical activity behaviours will be included. The quality of retained studies will be assessed using the Quality Assessment Tool for Quantitative Studies. Descriptive summary statistics of study characteristics will be reported as well as the study designs and exposure and outcome measures. Inter-rater agreements for study selection and quality assessments will be reported and unadjusted, and adjusted results will be presented. Reporting of the systematic review will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Discussion: This systematic review will contribute to a better understanding of the potential of childcare educators as role models for young children, as well as the influence (or impact) of their behaviours and intervention on childrenâs short- and long-term health. It will provide important information that could be used to improve obesity prevention strategies and initiatives, as well as to guide the improvement or implementation of effective healthy eating and physical activity policies in childcare centres. Systematic review registration: PROSPERO (CRD42014012973
Wellbeing: The Challenge of âOperationalisingâ an Holistic Concept within a Reductionist Public Health Programme
Background
Wellbeing is a concept that, whilst contested, recognises individual and wider social, economic, political and environmental contextual influences â and is of growing interest and relevance locally and globally. In this paper, we report on one aspect of an evaluative research study conducted on a public health programme in North West England.
Aims
Within the context of a process evaluation that explored the delivery of a public health programme and sought to increase understanding of how and why different approaches worked well or not so well, this paper focuses specifically on the concept of wellbeing, examining perceptions of multiple stakeholders.
Methods
Interviews and focus groups were undertaken with 52 stakeholders involved in managing and facilitating the programme and its composite projects and with 90 community members involved as project participants. Data were subjected to thematic analysis, crossâcheck and refining.
Findings
Findings highlight stakeholdersâ diverse understandings of wellbeing, the complex relationship between health and wellbeing, and the perceived dissonance between the holistic concept of wellbeing and the reductionist design of the programme.
Conclusions
Wellbeing was understood to be âmore than healthâ and âmore than happinessâ, concerned with effective functioning, sense of purpose and flourishing. Essentially holistic, wellbeing offers opportunities to transcend clinical/pathogenic conceptions of âhealthâ and resonate with individuals, communities and local authorities. This raises concerns about how wellbeing can be meaningfully realised without compromising the concept, particularly when programmes are structured in reductionist ways requiring monitoring against discrete outcomes. Implications for practice include: utilising wellbeing as a driver for crossâcutting public health in challenging economic and organisational contexts; acknowledging that wellbeing is essentially social as well as individual; appreciating that wellbeing is experienced in relation to contexts and surroundings; and recognising that wellbeing defined in terms of individual happiness risks compromising the future wellbeing of societies and the planet
The influence of a Healthy Welcoming Environment on participation in club sport by adolescent girls: a longitudinal study
Background: This study investigated the perceived influence of a Healthy Welcoming Environment (HWE) on participation in sports clubs among adolescent girls, and how these perceptions changed longitudinally. HWE was defined in terms of a set of health promotion policies advocated by a health promotion foundation as the basis of sport club health promotion practice to promote structural reform in state sporting organisations and their affiliated associations and clubs. These included sports injury prevention, smoke-free, responsible serving of alcohol, sun protection, healthy eating, and welcoming and inclusive environments. Methods: Year 7 and 11 female students from metropolitan (n = 17) and non-metropolitan secondary schools (n = 14) in Australia were invited to participate in three annual surveys. These surveys collected information about current or past membership of a sports club and the influence of HWEs on their decision to participate (or not) in a sports club. Results: Year 7 (n = 328; 74.5%) and Year 11 (n = 112; 25.5%) female students completed all three waves (19.6% response rate; 82.7 and 74.0% retention rate). Most agreed that characteristics of HWEs were a positive influence on their participation in sports clubs, except those relating to alcohol and Sunsmart. Welcoming factors had consistent high agreement among respondents. Alcohol and friendliness factors of the club were regarded as being positively influential by higher percentages of non-metropolitan than metropolitan respondents. Conclusions: Welcoming factors were the most positive influences on decisions to participate in sports clubs. These factors may be important in reducing barriers to sport participation. Strategies supporting the social environment within sports clubs should be prioritised
Healthy Universities: a guiding framework for universities to examine the distinctive health needs of its own student population.
The underlying principle of settings for health is that investments in health are made within social systems in which health is not necessarily the main remit. In order to understand the health needs of its own community, a growing movement of Healthy Universities is interested in applying the approach within the higher education sector. This study examined the student health behaviours of one university so that future initiatives can be tailored to its own student population.Quantitative data were gathered from 3,683 students studying at a UK urban university. A 60-question online student questionnaire focusing on seven key topic areas was used to gather data and simple descriptive statistics are used to present key findings.The study has identified a need for considering alternative ways of engaging students with appropriate health services throughout the academic year. A focus for university initiatives around healthy eating options, how to cook healthy food and the importance of keeping hydrated is highlighted as a common need. Risky behaviour involving alcohol, drug and substance use and sexual activity suggests a strong argument for not separating university sexual health and alcohol interventions.Underpinned by the Healthy Universities settings concept, this study examined the health and wellbeing behaviours of one university's own student population. It highlights behaviours within the university that are similar to national averages, and some that are not. This understanding can inform the planning of future health promoting university initiatives to meet the distinctive needs of its own students
Moving prison health promotion along: Towards an integrative framework for action to develop health promotion and tackle the social determinants of health
The majority of prisoners are drawn from deprived circumstances with a range of health and social needs. The current focus within âprison healthâ does not, and cannot, given its predominant medical model, adequately address the current health and well-being needs of offenders. Adopting a social model of health is more likely to address the wide range of health issues faced by offenders and thus lead to better rehabilitation outcomes. At the same time, broader action at governmental level is required to address the social determinants of health (poverty, unemployment and educational attainment) that marginalise populations and increase the likelihood of criminal activities. Within prison, there is more that can be done to promote prisonersâ health if a move away from a solely curative, medical model is facilitated, towards a preventive perspective designed to promote positive health. Here, we use the Ottawa Charter for health promotion to frame public health and health promotion within prisons and to set out a challenging agenda that would make health a priority for everyone, not just âhealthâ staff, within the prison setting. A series of outcomes under each of the five action areas of the Charter offers a plan of action, showing how each can improve health. We also go further than the Ottawa Charter, to comment on how the values of emancipatory health promotion need to permeate prison health discourse, along with the concept of salutogenesis
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