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Delivering the Science
and the Art of Health Promotion |
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Robert F. Allen
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| Michael P. O'Donnell | iv | Editor’s Notes:
Legislation to Stimulate Investment in Comprehensive Workplace Health
Promotion Programs |
| v-vi | Recognition of Reviewers | |
| THE SCIENCE OF HEALTH PROMOTION | ||
| Interventions | ||
| Smoking Control | ||
| Ami L. Hurd Erik M. Augustson Cathy L. Backinger Candace Deaton Mary Anne Bright |
481 | Impact of National ABC
Promotion on 1-800-QUIT-NOW During November 2005, ABC World News Tonight (WNT) highlighted the National Network of Tobacco Cessation Quitlines’ toll-free number, 1-800-QUIT-NOW, during the month-long series, “Quit to Live: Fighting Lung Cancer.” Overall call volume in the United States (49 states and D.C.) increased markedly in November; 37,049 calls compared to 16,145 in October. Although there was large variability across states, there was an average of 317 calls pre-promotion, 726 calls during the promotion, and 397 calls post-promotion. The promotion highlighted the need for capacity building both in terms of sustained promotion and ability of quitlines to provide service as the number of calls increased, as well as the importance of coordinating efforts so adjustments to individual state quitlines can be made. |
| Substance Abuse | ||
| Michael T. French Silvana K. Zavala |
484 | The Health Benefits of Moderate
Drinking Revisited: Alcohol Use and Self-Reported Health Status Adults who drink moderately have the highest odds of reporting above-average health status compared with lifetime alcohol abstainers, former drinkers and all other current drinking groups, based on an analysis of data obtained from 31,044 adults who participated in the 2002 National Health Interview Survey. The positive association between current moderate alcohol drinking and self-reported above-average health status remained after controlling for the presence of chronic conditions such as cancer, diabetes and hypertension; risk factors such as smoking and exercise; and demographic factors such as age, race, income and education level. |
| Weight Control | ||
| Bruce W. Bailey Larry A. Tucker Travis R. Peterson James D. LeCheminant |
492 | A Prospective Study of Physical
Activity Intensity and Change in Adiposity in Middle-aged Women Does the intensity of physical activity (PA) affect body composition in middle-aged women? This question was addressed in a 20-month prospective cohort study of middle-aged women aged 35-45 years whose PA intensity and body fat (expressed as BF%) were measured at baseline (n = 275) and at 20 months (n = 228). Sixty-five percent of women who decreased their PA intensity had a higher BF% at 20 months than women who maintained or increased their PA intensity. Women who maintain or increase their PA intensity as they age appear to be less likely to gain fat over time. |
| Stewart C. Alexander Truls Østbye Kathryn I. Pollak Margaret Gradison Lori A. Bastian Rebecca J. Namenek -Brouwer |
498 | Physicians’ Beliefs About
Discussing Obesity: Results From Focus Groups This study examined physicians’ beliefs, outcome expectancies, and strategies for addressing weight with patients. Two focus groups of family physicians and internists (n=17) were conducted and analyzed using grounded theory methodology. Physicians’ responses centered on five key themes: responsibility, barriers, target populations, introducing topic, and ways to talk about obesity. In addition, three notable tensions among and within physicians arose concerning issues of responsibility, treatment of obesity, and determining how to decide whom to talk with about obesity and weight loss. |
| Strategies | ||
| Behavior Change | ||
| Ronald C. Plotnikoff Stephanie Brunet Kerry S. Courneya John C. Spence Nicholas J. Birkett Bess Marcus Jessica Whiteley |
501 | The Efficacy of Stage-Matched
and Standard Public Health Materials for Promoting Physical Activity in the
Workplace: The Physical Activity Workplace Study (PAWS) The effects of stage-matched and standard print materials for physical activity change were compared with a control group (which received no materials) among 507 employees of three Canadian worksites. At 12 months, mean weekly metabolic equivalent (MET) minutes increased more in the stage-matched group than in the standard and control groups, but the differences were not significant. Among women in the stage-matched group, however, the increase in weekly MET minutes was significantly different at the end of 12 months compared with the standard and control groups, suggesting that women may actively use tailored information about physical activity. |
| Steven G. Aldana Roger Greenlaw Audrey Salberg Ray M. Merrill Ron Hager Rick B. Jorgensen |
510 | The Effects of an Intensive
Lifestyle Modification Program on Carotid Artery Intima-Media Thickness: A
Randomized Trial This study evaluates the effect of the Dr. Dean Ornish Program for Reversing Heart Disease on cardiovascular disease as measured by the intima-media thickness of the common carotid artery and compares this effect to outcomes from patients participating in traditional cardiac rehabilitation. Ninety three patients with clinically confirmed coronary artery disease were randomly assigned to the intervention (n = 46) or traditional cardiac rehabilitation (n = 47). There was no significant reduction in the carotid intima-media thickness of the carotid artery in the Ornish group or the cardiac rehabilitation group. Ornish program participants had significantly improved dietary habits, weight, and body mass index as compared to the rehabilitation group. The decrease in the number of patients with angina from baseline to 12 months was 44% in Ornish and 12% in cardiac rehabilitation. The Ornish program appears to cause improvements in cardiovascular risk factors, but does not appear to change the atherosclerotic process as it affects the carotid artery. |
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Deborah L. Helitzer Arlana Bobo Peterson Margaret Sanders Janice Thompson |
517 | Relationship of Stages of Change
to Attendance in a Diabetes Prevention Program Seventy-five adult American Indian women participated in the study to determine if pre-intervention Stage of Change measures were indicative of subsequent attendance at diabetes prevention intervention sessions. The measures included attendance, Stage of Change questions for seven diabetes prevention behaviors, and mean Stage of Change score to reflect the combined Stages of Change for all behaviors. There was a significant relationship between the mean Stage of Change and attendance. Participants whose mean Stage of Change was lower were less likely to attend all five sessions than those with higher mean Stage of Change. Participants in the action stage (preparation, action, maintenance) before the intervention were 6.7 times more likely to be “high attenders” than those in the “pre-action stages” (pre-contemplation, contemplation). The pilot study suggests that stage of change may be a good predictor of attendance. |
| Population Health | ||
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Laura Linnan Bryan Weiner Amanda Graham Karen Emmons |
521 | Manager Beliefs Regarding
Worksite Health Promotion: Findings from the Working Healthy Project 2 Previous research has indicated that managers are critically important to the successful adoption and implementation of worksite health promotion programs. This cross-sectional study was the first to systematically investigate the health promotion beliefs of a large sample of managers, and to characterize beliefs based on the age, experience of having worked in a company that offered health programs previously, and level of manager (senior managers, middle managers, and line supervisors). A total of 1,047 managers from 24 different worksites were surveyed. Seventy-five percent agreed that offering worksite health promotion programs in their company was important. More than 50% strongly believed that improving employee health, reducing health care costs, improving employee morale, improving employee relations, reducing absenteeism, improving production levels and improving the company’s public image were likely benefits of offering worksite health promotion programs. Lack of time (among employees and staff), and production conflicts were most likely to be endorsed as barriers to offering worksite health promotion programs. Managers recognized that providing information alone would not be an effective strategy for promoting health and realized that providing social support and health promoting worksite policies were stronger approaches. These overall results, along with differences in manager beliefs based on their age, level, and experience with health promotion programs, point to interesting challenges and opportunities for future worksite health promotion program programming and research. |
| Research Methods | ||
| Financial Analysis | ||
| D. Adam Long Theodore L. Perry |
529 | An Application of Survival
Analysis to Population Health Management Program Evaluation Medical care claims were compared among 142 matched participants and 142 non-participants in smoking cessation and weight management programs provided in 1997. Between 1997 and 2003, participants experienced 27% more claims than non-participants, but non- participants total claims costs were 31% higher than participants. Participants and non-participants were equally likely to have a moderately large or large claim in the first 18 months, but non-participants were more likely to have a moderately large or large claim in 18 to 78 months. Study limitations include the small predominately female sample, lack of random assignment and sample attrition. |
| Measurement Issues | ||
| Christine M. Hoehner Andrae Ivy Laura K. Brennan - Ramirez Susan Handy Ross C. Brownson |
534 | Active Neighborhood Checklist:
A User-Friendly and Reliable Tool for Assessing Activity-Friendliness A good tool for assessing how well neighborhoods support physical activity should be reliable, require little training and administration time, and be easy to use by a diverse group of interested parties, including community stakeholders, public health practitioners and researchers. The authors describe the testing of the inter-rater reliability of the Active Neighborhood Checklist, an instrument that assesses land use characteristics, sidewalks, shoulders and bike lanes, street characteristics and quality of the environment for pedestrians. The Checklist demonstrated good reliability when completed by trained raters evaluating 64 street segments in St. Louis and southeast Missouri. |
| Abstracts | 538 | 8 abstracts are featured from a variety of publications. |
| DataBase: Research and Evaluation Results | 541 | Four new studies are critiqued and added to the DataBase chart. |
| 546 | Call for Conference Proposals | |
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The Art of Health Promotion |
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Larry S. Chapman Nancy Lesch MaryBeth Pappas Baun |
1 | The Role of Health and Wellness
Coaching in Worksite Health Promotion Health and wellness coaching has rapidly become a best practice element of worksite health promotion programs. Coaching as a process is a very old technology, but its use in the field of health promotion is relatively new. Coaching can be provided in different forms or modalities yet currently lacks a rigorous science base or a defined set of standards or common elements. In larger worksite settings several variants or forms of coaching are usually provided to employee populations. The need for more proactive and direct forms of intervention in health promotion is contributing to the rapid growth of coaching programs. There are currently an assortment of coaching strategies or techniques that are in common use in most coaching interventions. A main contention of current coaching practice is that coaching that uses facilitation strategies rather than prescriptive advice is more effective at producing long term behavior change. The congruence and size of wellness incentives with the coaching process are likely to be of significant importance. From a long term perspective, coaching is likely to become a staple of worksite health promotion practice. |
| 11 | Selected Abstracts Abstracts are provided for three (3) articles that address coaching issues. |
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| Larry S. Chapman | 11 | Closing Thoughts Editorial comments on the evolution of coaching practice and the role of incentives are presented. |
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American Journal of Health Promotion | 248-682-0707 |
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