Health promotion research: dilemmas and challenges

OBJECTIVE—To analyse dilemmas and challenges in health promotion research, and to generate ideas for future development.
METHOD—The analysis is based on authors' experiences in working in the field of research and action in health promotion and on experiences of others as found in literature.
RESULTS—The assumptions underlying scientific research as based in the biomedical design are difficult to meet in community-based health promotion research. Dilemmas are identified in relation to the possibility of defining the independent and dependent variables beforehand and the intermingling of these variables (the intervention and outcome dilemma), the difficulty in quantifying the desired outcomes (the number dilemma), and the problem of diffusion of the programme to the control group (the control group dilemma).
CONCLUSION—Research in health promotion has specific reasons to reconsider the approach towards research, the selection of outcome variables, and research techniques. Strategies and methods to make activities and their outcomes clear are discussed and criteria to judge confidence and applicability of research findings are presented.


Keywords: health promotion research; research dilemmas; research challenge

Parental child-feeding strategies in relation to Dutch children's fruit and vegetable intake

Objective: To identify parental child-feeding strategies that may increase children's fruit or vegetable intake, since the relationship between these strategies and children's intake has never been investigated for fruit and vegetables as two separate food groups. Design: A survey study, where parents provided information about their practices in relation to feeding their children and about their own and their children's fruit and vegetable intake. Children completed a preference questionnaire about fruit and vegetables. To find underlying parental child-feeding strategies, factor analysis was applied to parents' practices in relation to fruit and vegetables separately. Regression analysis was used to predict the effect of these strategies on children's fruit and vegetable intake. The impact of the strategies was further analysed by estimating children's intake based on the frequency of use of specific strategies. Setting: The study was conducted at three primary schools in The Netherlands. Subjects: A total of 259 children between 4 and 12 years old and their parents (n242). Results: Parents used different strategies for fruit as compared with vegetables. The vegetable-eating context was more negative than the fruit-eating context. Parental intake and presenting the children with choice were positive predictors of children's intake of both fruit and vegetables. The intake difference based on frequency of use of the strategy 'Choice' was 40 g/d for vegetables and 72 g/d for fruit (

The influence of the method of preservation of forages on the digestion in dairy cows. 1. Composition of the forages and digestibility of dry matter, organic matter and nitrogen.

1. Grass from the same sward was ensiled without additive, with 14.6 g formic acid/100 g crude protein or 10.8 g formic acid and 10.6 g formaldehyde/100 g crude protein. Similar grass was dried and pelleted. Drying or ensiling with the mixture reduced solubility of N in the preserved grass but formic acid increased it, and ensiling without additive increased it even more. Apparent digestibility of N in the rumen of cows tended to decrease with decrease in solubility. Digestibility in vitro of the mixed diet given to the cows, calculated from digestibility of the separate components, agreed well with the values in vivo for diets with silages, but was high for that with dried grass. (Abstract retrieved from CAB Abstracts by CABI’s permission

A building-transmission model for improved propagation prediction in urban microcells

This paper presents a model for the propagation of radiowaves through buildings. The model can be used as a seamless extension to ray-based propagation prediction models that only consider external reflection and diffraction, as do most current models. This involves the use of so-called transmitted rays, which are traced through building walls. Outdoor-to-indoor propagation (building penetration) is automatically taken into account as a "by-product". The transmission model requires no information about each building's interior other than a specific attenuation factor that describes the global behavior of the field inside the building. This coefficient can be determined for individual buildings by measuring the excess loss associated with the propagation path through the building. It is shown, however, that no large errors are to be expected if all buildings are characterized by the average of the empirical values obtained in this study, at 1.9 GHz. Path loss predictions generated with the aid of the new model are shown and compared with measured data to illustrate the considerable improvement in accuracy that can be achieved in realistic urban microcell scenarios by taking into account building penetration and transmission

Think Big Start Small: Institutional Repositories: Policies, Strategies, Technological Options, Standards and Best Practices. The Case of the University of Buea

In order to achieve the Millennium Development Goal of reducing by half the number of people living in hunger and poverty and stimulating economic growth to enhance rural household economies, the stakeholders involved need to provide access to resources and technology as well as effective information services. Information and knowledge are fundamental for education and development as well as essential requirements to improve the quality of life for people living in regions where the population has not reached a high level of economic and social development. Libraries play an important role in this educational and research process. For strengthening educational capacity and building up research capacity, access to relevant information is of great importance. In this paper an initiative at a university in Cameroon is described. The purpose of this paper is to give insight into the challenges most African universities face in developing their institutional repositories. The aim is to investigate how evolving digital technologies could be integrated into the libraries of these African universities. In the light of existing realities in most African countries, the creation of an enabling institutional environment for information repositories to blossom is of prime importance. Information repositories often stand low on the scale of priorities and this can be attributed to the laxity in national and institutional regulation and policies. How therefore do we get to run an institutional repository when the platform for information resources (the library) is not a priority for policy makers and for the institutions themselves

Development of Sense of Coherence Stability in the AGORA Healthy Ageing Study

Sense of coherence (SOC) is a psycho-social trait formed in childhood or adolescence, allowing individuals to be more resilient to daily life stressors, stay well, and improve their personal health. Although SOC remains stable after the age of thirty, only a few studies investigated its stability in adulthood. The aim was to investigate the development of SOC over time in 489 participants and its association with age, gender, educational level, or negative life events. The study was performed as part of the Healthy Ageing project of the Academic Collaborative Centre AGORA, a longitudinal study involving four municipalities of Eastern Netherlands. A self-administrated questionnaire was used to monitor the SOC of the elderly in 2008, 2010, and 2013, using the Orientation to Life Questionnaire (SOC-13). The analysis included repeated-measures ANOVA analysis and bivariate analysis using Pearson’s chi square test. We found no statistically significant variation in SOC over time (F (2, 282) = 2.99, p = 0.052) and no significant association with age (F (2, 282) = 2.851, p = 0.06), gender (F (2, 282) = 0.845, p = 0.43), or educational level (F (2, 282) = 0.708, p = 0.49). SOC remained stable in the elderly population, even if they experienced negative events over their lifespan

A comparison of some laboratory techniques for the estimation of the digestibility of the organic matter in forage samples.

The 194 samples of forage were of 6 groups; grass or other forage dried, fresh or ensiled. Workers from 5 institutes analysed some of the samples by their usual methods, 10 methods altogether. Digestibility estimated with sheep was regressed on the other results and correlation coefficients and residual standard deviations were calculated; those were closer for groups of forages than for all forages together. The least accurate predictor of digestibility in vivo was crude fibre content, which is much used in the Netherlands. The best method for each fodder group was the method of Tilley and Terry (NAR 34, 156) as modified by Koelen, Kemmink and Dijkstra (De bepaling van de voederwaarde van ruwvoeders met behulp van de in vitroverteerbaarheid. Internal Report, Institute for Animal Feeding and Nutrition Research 'Hoorn' (1969), No. 27, available in English). It took least work but required sheep rumen fluid. For all groups together, the cell-wall constituents method of Gaillard and Nijkamp (NAR 38, 8034) was better for 54 samples but the residual standard deviation was higher than within groups; it required more labour, but not rumen fluid. (Abstract retrieved from CAB Abstracts by CABI’s permission