Delivering the Science and the Art of Health Promotion

Robert F. Allen
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Editor's Notes: Evolving Definition of Health Promotion: What Do You Think?

Call for Conference Proposals

Critical Issues and Trends

Stephen S. Johnston
Tami L. Mark
Riad Dirani

Smoking Cessation: The Value of a Comprehensive Carved-in Benefit
This qualitative narrative review examines the potential returns from providing smoking cessation treatments (SCTs) through an insurance plan’s standard benefit package versus through an optional supplementary wellness (‘rider’) program.  Research indicates most employers offer SCTs as part of a rider available for purchase. Studies demonstrate that the higher the cost of SCTs, the lower the SCT participation rates; when employees receive SCTs, smoking cessation rates increase, effecting lower employee healthcare costs and improved productivity. Employers may receive a considerable return on the investment of offering SCTs as part of comprehensive insurance benefit for their employees as opposed to a rider.

Interventions

Dan J. Graham
Margaret Schneider
Dan M. Cooper
 

Television Viewing: Moderator or Mediator of an Adolescent Physical Activity Intervention?
This study assessed whether amount of TV watched by 122 adolescent females enrolled in a physical activity intervention mediates or moderates program effectiveness. The intervention was supervised in-class exercise, health education, and internet-based self-monitoring. TV viewing moderated the intervention’s effect on vigorous activity; the intervention significantly predicted physical activity among high (β = -.45; p <.001), but not low (p >.05), TV watchers. TV viewing did not mediate the intervention effect. Consistent with displacement theory, adolescents who watched more television prior to the intervention showed post-intervention increases in vigorous physical activity and concomitant decreases in television viewing, whereas those who watched less TV showed no change in physical activity or television viewing.

Medical Self-Care

Chudley E. Werch
Hui Bian
Michele J. Moore
Steven C. Ames
Carlo C. DiClemente
Dennis Thombs
Steven B. Pokorny
 

Brief Multiple Behavior Health Interventions for Older Adolescents
This study examined whether brief intervention strategies, founded on the Behavior-Image Model and addressing positive images of college and career success, could be efficacious in impacting multiple health habits of 375 high risk adolescents transitioning into adulthood.  Participants were stratified by grade level and drug use and randomized to one of the three Plan for Success interventions.  Data were collected baseline and one month post-intervention.  Brief interventions founded on the Behavior-Image Model may have potential to improve selected health and personal development habits among older adolescents.

Aimee S. James
Sandra Hall
K. Allen Greiner
Dan Buckles
Wendi K. Born
Jasjit S. Ahluwalia
 

The Impact of Socioeconomic Status on Perceived Barriers to Colorectal Cancer Testing
Colorectal cancer screening rates for low-income and uninsured adults are low. This prospective study of 291 adults aged 40 years and older examined associations among colorectal cancer screening, screening barriers and low socioeconomic status (SES).  Barriers associated with fecal occult blood testing did not differ by SES. However, barriers to endoscopy were associated with several markers of SES: fear of injury (associated with income and insurance), fear of test results (associated with education and insurance), and embarrassment about the procedure (associated with insurance and unemployment). Some barriers to screening among these low-income participants were economic.

Nutrition

Sandra R. Parkington
Stergios Roussos
 

Measuring Salt Consumption to Guide Behavior Change in Applied Settings: A Critical Review
This review examines issues that affect the valid measurement of salt consumption and highlights ways to improve measurement. Observational, intervention, and measurement studies (n=18) were included if they used at least one measure of behavior indicative of salt consumption. The results indicate the need for more specific measures of behaviors related to salt consumption and to produce tools that clinicians and patients may use for more accurate, and possibly real-time, salt consumption measurement. The precision of definitions may improve by breaking “salt consumption” into behavioral steps leading from how salt gets from store to plate to table to actual consumption.

Arnell J. Hinkle
Ritesh Mistry
William J. McCarthy
Antronette K. Yancey
 

Adapting a 1% or Less Milk Campaign for a Hispanic/Latino Population: The Adelante Con Leche Semi-descremada 1% Experience
The “1% or Less” milk campaign, which promotes substitution of 2% fat or whole milk with 1% or less fat milk, was adapted for Latino/Hispanic communities and implemented in two low-income California communities using an uncontrolled pre/post test design. There were decreases in the proportion of whole milk sold and increases in the proportion of reduced-, low- and non-fat milk sold; however, these changes were sustained in the rural but not the urban community. Highly focused campaigns to promote the substitution of high-fat milk with low- or non-fat milk can show dramatic initial changes in sales patterns, but it is not clear whether such campaigns can have a sustained impact.

Tobacco Control

Nancy L. York
Ellen J. Hahn
Mary Kay Rayens
Jeff Talbert
 

Community Readiness for Local Smoke-Free Policy Change
A cross-sectional design was used to assess the Community Readiness Model to examine local smoke-free policy development in 64 Kentucky communities. Dimensions of readiness included a community's: (a) knowledge of the problem and existing voluntary smoke-free policies; (b) leadership for policy development; (c) resources for policy development; (d) climate surrounding policy development; (e) existing voluntary policy efforts; and (f) political climate for policy development. Dimension scores were summed to identify one of six overall readiness stages.  One-way ANOVA evaluated regional trends and multiple regression assessed the influence of sociodemographic/political variables on policy readiness.  The knowledge dimension rated highest with community climate the lowest. Most communities were in the lower stages of readiness. Smaller communities were less ready for local policy development than larger ones (adjusted r2 = .25; p = .003). The Community Readiness Model is appropriate for understanding local policy development and provides advocates with information that may prove helpful in advancing smoke-free policy.

Weight Control

Larry A. Tucker
Amy J. Cook
Neil R. Nokes
Troy B. Adams
 

Telephone-Based Diet and Exercise Coaching and a Weight-loss Supplement Result in Weight and Fat Loss in 120 Men and Women
A randomized, placebo-controlled experiment was conducted to determine the effects of telephone-based coaching and a weight loss supplement on the weight and body fat (BF) of overweight or obese adults (60 men and 60 women). Eleven 30-minute telephone coaching sessions were spaced throughout the 17 week study, and supplement or placebo capsules were taken daily. Adults receiving both the supplement and coaching had the greatest losses of weight and BF, suggesting an additive effect (F=3.2, p=0.026; F=2.9, p=0.039, respectively). Together the two interventions may be useful in helping to curb the costly and growing problem of obesity.

Adam Reppert
Bruce F. Steiner
K. Chapman-Novakofski
 

Prevalence of Metabolic Syndrome and Associated Risk Factors in Illinois
The 2005 Illinois Behavioral Risk Factor Surveillance System data were analyzed for prevalence rates and relative risk (RR) of risk factors for metabolic syndrome (MS) among a sample of 5,077 non-institutionalized Illinoisans aged ≥18. The prevalence of MS was 16.2% and was highest in those over 65 years; with incomes < $15,000; and among Blacks. The RR for MS was 8 for those having diabetes; 20 for hypertension; 14 for hypercholesterolemia; 6 for angina; and 7 for obesity.  Findings from this research can be used to plan intervention and treatment programs for the MS, and suggest interventions should target lifestyle factors and lower-income, older, and Black populations.

Hilary Pike
Joseph Walker
John Collins
Jan Hodges
 

An Investigation of ADA Compliance of Aquatic Facilities in the North Texas Area
This study comparing accessibility compliance scores of 52 aquatic facilities in North Texas built either pre or post 1990 Title III Americans with Disabilities Act Architectural Guidelines (ADAAG). A focus group provided insight into interpreting which features function as barriers or constraints to participation. No facility was 100% overall ADA compliant though some facilities were 100% compliant with specific structural domains.  Restrooms rated the lowest of all features.  Focus group results indicated that improperly designed restrooms and pool entry are primary barriers to participation.  The findings support a need for stronger enforcement of policies that improve accessibility of facilities.  The structural barriers and constraints identified can be limiting factors in efforts aimed at increasing physical activity among individuals with disabilities.

The Art of Health Promotion

Michael P. O'Donnell

The Face of Wellness: Aspirational Vision of Health, Renewing Health Behavior Change Process and Balanced Portfolio Approach to Planning Change Strategies
Health promotion needs to be made more practical and more memorable so that practitioners are not confused or overwhelmed by the theoretical and technical aspects of assuring the effectiveness of programming efforts. In this edition of The Art of Health Promotion the Editor-in-Chief of the American Journal of Health Promotion presents a planning strategy consisting of an aspirational model of health, a renewing behavior change process and a portfolio balancing approach to strategy planning.

American Journal of Health Promotion |  248-682-0707