Suchergebnisse

Este artigo tem como objetivo relatar a experiência de formação de esteticistas licenciados para promover saúde no salão de beleza e descreve os recursos necessários dentro da comunidade em geral, os fatores dentro das organizações, o design de programas e os fatores de implementação, bem como outros componentes essenciais do modelo RE-AIM, que foram considerados no "planejamento" para a sustentabilidade de um componente de intervenção eficaz do projeto BEAUTY and Health (Beleza e Saúde) no Estado da Carolina do Norte, EUA. A sustentabilidade de programas de promoção da saúde eficazes merece consideração especial dada à escassez de literatura sobre o tema, bem como para a redução de custos de manutenção de importantes benefícios críticos para a saúde e os esforços de capacitação.

Purpose. To explore differences in manager beliefs about worksite health promotion programs (HPPs). Design. Cross-sectional written survey. Setting. Twenty-four manufacturing worksites, with 11,811 employees and 1719 eligible managers. Subjects. Sixty-six percent (1133/1719) of managers completed the survey; 1047 managers were categorized by level (169 senior, 567 middle, and 311 line supervisors). Analysis. Results are reported on overall manager beliefs (and by manager level) about importance, efficacy, barriers, and benefits of HPPs. Multilevel analysis modeled the influence of manager level, age, and experience with HPPs on beliefs about HPPs, while accounting for worksite-level effects. Results. Seventy-five percent of managers believed that offering HPPs is highly important. Eighty percent believed that HPPs improved employee health, 68% believed that they reduced health care costs, and 67% believed that they improved employee morale. Few significant differences by manager level were observed on the perceived importance of health promotion, employer responsibilities for health promotion and protection, and efficacy of health promotion strategies or perceived benefits. Senior managers (vs. line supervisors) were significantly less likely to believe that space or cost was a barrier to offering HPPs and were less likely than middle managers or line supervisors to believe that production conflicts were barriers to offering HPPs. Conclusion. Targeted interventions to address manager beliefs, including differences by age, experience, and manager level, are worth consideration when planning worksite HPPs.

Purpose. To examine occupational differences in social influences supporting quitting smoking and their relationships to intentions and self-efficacy to quit smoking and to quitting. Design. Data were collected as part of a large worksite cancer prevention intervention trial. Setting. Forty-four worksites. Subjects. Subjects included 2626 smokers from a total baseline survey sample of 11,456 employees (response rate = 63%). Measures. Differences by job category in social support for quitting, pressure to quit smoking, rewards for quitting, and nonacceptability of smoking were measured using mixed model analysis of variance and the Cochran–Mantel–Haenszel test. Their association to self-efficacy, intention to quit, and quitting smoking was assessed using mixed model analysis of variance and linear logistic regression modeling. Results. Compared with other workers, blue-collar workers reported less pressure to quit ( p = .0001), social support for quitting ( p = .0001), and nonacceptability of smoking among their coworkers ( p < .001). Intention to quit was associated with higher levels of social pressure to quit smoking ( p = .0001) and social support for quitting ( p = .002). Self-efficacy was associated with social pressure to quit ( p = .0001), social support for quitting ( p = .004), and perceiving greater rewards for quitting ( p = .0001). Conclusions. Although these results are limited somewhat by response and attrition rates, these results suggest that differing social environments may contribute to the differences by occupational category in smoking prevalence and smoking cessation.

Purpose: To provide a nationally representative snapshot of workplace health promotion (WHP) and protection practices among United States worksites. Design: Cross-sectional, self-report Workplace Health in America (WHA) Survey between November 2016 and September 2017. Setting: National. Participants: Random sample of US worksites with ≥10 employees, stratified by region, size, and North American Industrial Classification System sector. Measures: Workplace health promotion programs, program administration, evidence-based strategies, health screenings, disease management, incentives, work–life policies, implementation barriers, and occupational safety and health (OSH). Analysis: Descriptive statistics, t tests, and logistic regression. Results: Among eligible worksites, 10.1% (n = 3109) responded, 2843 retained in final sample, and 46.1% offered some type of WHP program. The proportion of comparable worksites with comprehensive programs (as defined in Healthy People 2010) rose from 6.9% in 2004 to 17.1% in 2017 ( P < .001). Occupational safety and health programs were more prevalent than WHP programs, and 83.5% of all worksites had an individual responsible for employee safety, while only 72.2% of those with a WHP program had an individual responsible for it. Smaller worksites were less likely than larger to offer most programs. Conclusion: The prevalence of WHP programs has increased but remains low across most health programs; few worksites have comprehensive programs. Smaller worksites have persistent deficits and require targeted approaches; integrated OSH and WHP efforts may help. Ongoing monitoring using the WHA Survey benchmarks OSH and WHP in US worksites, updates estimates from previous surveys, and identifies gaps in research and practice.

Purpose: Small employers, while motivated to implement wellness programs, often lack knowledge and resources to do so. As a result, these firms rely on external decision-making support from insurance brokers. The objective of this study was to analyze brokers' familiarity with wellness programs and to characterize their role and interactions with small employers. Design: Using a newly developed common interview guide (20 questions), protocol and analysis plan, 20 interviews were conducted with health insurance brokers in Illinois, Minnesota, North Carolina and Washington in 2016 and 2017. In addition to exploring patterns of broker interactions and familiarity by segment, we propose a framework to conceptualize the broker-client relationship using social capital theory and the RE-AIM model. Methods: Interviews were transcribed, summarized and a common codebook was established using DeDoose. Themes were identified following multi-rater coding and structured within the framework. Results: Participating brokers reported having a high to moderate familiarity with wellness programs (65%) and a majority (80%) indicated that they have previously advised their small business clients on the availability and features of them. Further, we find that brokers may help eliminate barriers to resources and act as a connector to wellness opportunities within their professional network. Conclusion: New initiatives to promote small employer wellness programs can benefit from examining the influence of brokers on the decision-making process. When engaged and supported with resources, brokers may be effective champions for employer wellness programs.

Purpose: We examined the extent to which demographic, chronic disease burden, and financial strain characteristics were associated with a preference for engaging in the Chronic Disease Self-Management Program (presented as a "health self-management program" [HSMP]) over a financial self-management program (FSMP) and a no program preference (NPP) group among employed adults. Design: Cross-sectional, correlation design using baseline data from a randomized controlled trial (RCT). Subjects: The analytic sample included 324 workers aged 40 to 64 years with 1 or more chronic disease conditions recruited into the RCT from 2015 to 2017. Measures: Chronic disease burden measures included the number of chronic conditions, body mass index (BMI), and the 8-item and 15-item Patient Health Questionnaire (PHQ-8 and PHQ-15). Financial strain was measured as the inability to purchase essentials and food assistance receipt. Both individual and household measures of income were assessed. Analyses: Multinomial logistic regression and post-hoc marginal effects models. Results: Moderate-to-severe depressive symptoms increased the likelihood of having an HSMP preference when compared with those preferring the FSMP (RR = 4.2, P < .05) but not those having NPP; while higher BMI marginally increased HSMP preference over FSMP preference, but not NPP groups (RR = 1.04, P < .05). Financial strain differentially, but significantly, reduces the likelihood of HSMP preference at varying levels of household poverty, depressive symptom severity, and financial strain. Conclusion: Middle-aged, lower-to-middle income workers with moderate-to-severe depressive symptoms opt for HSMPs over FSMPs, but preference for HSMPs significantly diminished when they are experiencing financial strain.

Purpose: To examine if employee health literacy (HL) status moderated reach, retention, and weight outcomes in a worksite weight loss program. Design: The study was a two-group cluster randomized controlled weight loss trial. Setting: The study was conducted in 28 worksites. Subjects: Subjects comprised 1460 employees with a body mass index >25 kg/m2. Interventions: Two 12-month weight loss interventions targeted diet and physical activity behaviors: incentaHEALTH (INCENT; incentivized individually targeted Internet-based intervention) and Livin' My Weigh (LMW; less-intense quarterly newsletters). Measures: A validated three-item HL screening measure was self-completed at baseline. Weight was objectively assessed with the Health Spot scale at baseline and 12-month follow-up. Analysis: The impact of HL on program effectiveness was assessed through fixed-effect parametric models that controlled for individual (i.e., age, gender, race, ethnicity, income, education) and worksite random effects. Results: Enrolled employees had significantly higher HL status [13.54 (1.68)] as compared to unenrolled [13.04 (2.17)] ( p < .001). This finding was consistent in both interventions. Also, HL moderated weight loss effects ( beta = .66; SE = 027; p = .014) and losing >5% weight ( beta = −1.53; SE = .77; p < .047). For those with lower baseline HL, the INCENT intervention produced greater weight loss outcomes compared to LMW. The HL level of employees retained was not significantly different from those lost to follow-up. Conclusion: HL influences reach and moderates weight effects. These findings underscore the need to integrate recruitment strategies and further evaluate programmatic approaches that attend to the needs of low-HL audiences.

CONTEXT: : Currently, significant attention is focused on improving care for patients with concussions through legislative mandates that include educational interventions. Few researchers have examined young athletes' concussion knowledge and the factors that may influence their knowledge. OBJECTIVE: : To use the socioecological model to examine demographic, parental, and personal factors associated with youth athletes' knowledge of concussion. Our ultimate goal is to inform the planning and implementation of youth sport concussion-related interventions. DESIGN: : Cross-sectional survey. SETTING: : Gymnasium and classroom. PATIENTS OR OTHER PARTICIPANTS: : North Carolina and Arizona youth athletes (n = 225; age = 8 to 15 years) active in football, boys' or girls' soccer, boys' or girls' ice hockey, or boys' or girls' lacrosse in 2012–2013. MAIN OUTCOME MEASURE(S): : Participants completed a validated, self-administered survey. The intention and belief measures were guided by the theory of planned behavior. Perceptions of concussion and intention to seek care were examined using descriptive statistics. Athletes' concussion knowledge was modeled using linear regressions and generalized estimating equations, with child demographic and personal factors and parental knowledge and attitudes about concussion as predictors. RESULTS: : Geography, sport, parental attitudes toward concussion, and athlete age were associated with athlete knowledge in the univariable analyses (P 12 years, MD = 1.6; 95% CI = 0.5, 2.6) were associated with better knowledge about concussion. CONCLUSIONS: : Geographic location, sport, parental attitudes about concussion, and ...

O objetivo deste artigo é descrever o processo e os resultados associados com a adoção no estudo Worksite Weight Control (Controle de Peso no Local de Trabalho). Este é um estudo quantitativo desenvolvido no Estado da Virginia nos Estados Unidos entre os anos de 2007 e 2010. Um total de 119 locais de trabalho foram identificados como potencialmente elegíveis com base em tamanho, no acesso à internet e vontade de realizar um questionário breve de saúde no local de trabalho. Setenta e três foram elegíveis, 28 (38,3%) foram inscritos, e 26 completaram os 12 meses de intervenção (35,6%). Estes locais incluíram quatro instalações médicas (14,3%), seis centros de distribuição e produção (21,4%), cinco grupos profissionais das áreas de direito, publicidade, engenharia, vendas e suporte de tecnologia da informação (17,9%), dois centros de atendimento (7,1%), quatro faculdades e universidades pequenas (14,3%), e sete agências governamentais (25,0%). Não houve diferenças estatisticamente significativas nas taxas de adoção com base no tipo de local de trabalho. No entanto, houve tendências sugerindo que grupos profissionais e faculdades pequenas eram mais propensos a recusar a participação, sendo que as fábricas e agências governamentais eram mais aptos à participação. Os resultados sugerem que os programas foram aceitáveis para uma variedade de tipos de local de trabalho, mas programas aplicados pela internet podem não ser tão atraentes para grupos profissionais e faculdades de pequeno porte.

Purpose. This study compares the efficacy of a self-help intervention tailored to the individual's stage of motivational readiness for exercise adoption with a standard self-help exercise promotion intervention. Design. Interventions were delivered at baseline and 1 month; assessments were collected at baseline and 3 months. Setting. Eleven worksites participating in the Working Healthy Research Trial. Subjects. Participants (n = 1559) were a subsample of employees at participating worksites, individually randomized to one of two treatment conditions. Intervention. Printed self-help exercise promotion materials either (1) matched to the individual's stage of motivational readiness for exercise adoption (motivationally tailored), or (2) standard materials (standard). Measures. Measures of stage of motivational readiness for exercise and items from the 7-Day Physical Activity Recall. Results. Among intervention completers (n = 903), chi-square analyses showed that, compared to the standard intervention, those receiving the motivationally tailored intervention were significantly more likely to show increases (37% vs. 27%) and less likely to show either no change (52% vs. 58%) or regression (11% vs. 15%) in stage of motivational readiness. Multivariate analyses of variance showed that changes in stage of motivational readiness were significantly associated with changes in self-reported time spent in exercise. Conclusions. This is the first prospective, randomized, controlled trial demonstrating the efficacy of a brief motivationally tailored intervention compared to a standard self-help intervention for exercise adoption. These findings appear to support treatment approaches that tailor interventions to the individual's stage of motivational readiness for exercise adoption.

OBJECTIVE: Establishment of core competencies for education and training of professionals entering the emerging field of Total Worker Health®. METHODS: Compilation and distillation of information obtained over a 5-year period from Total Worker Health symposia, workshops, and academic offerings, plus contributions from key stakeholders regarding education and training needs. RESULTS: A proposed set of Total Worker Health competencies aligns under six broad domains: Subject Matter Expertize; Advocacy and Engagement; Program Planning, Implementation and Evaluation; Communications and Dissemination; Leadership and Management; and Partnership Building and Coordination. CONCLUSIONS: Proposed set of core competencies will help standardize education and training for professionals being trained in Total Worker Health. It serves as an invitation for further input from stakeholders in academia, business, labor, and government.

The fourth edition of Community Organizing and Community Building for Health and Social Equity provides both classic and recent contributions to the field, with a special accent on how these approaches can contribute to health and social equity. The 23 chapters offer conceptual frameworks, skill- building and case studies in areas like coalition building, organizing by and with women of color, community assessment, and the power of the arts, the Internet, social media, and policy and media advocacy in such work. The use of participatory evaluation and strategies and tips on fundraising for community organizing also are presented, as are the ethical challenges that can arise in this work, and helpful tools for anticipating and addressing them. Also included are study questions for use in the classroom. Many of the book's contributors are leaders in their academic fields, from public health and social work, to community psychology and urban and regional planning, and to social and political science. One author was the 44th president of the United States, himself a former community organizer in Chicago, who reflects on his earlier vocation and its importance. Other contributors are inspiring community leaders whose work on-the-ground and in partnership with us "outsiders" highlights both the power of collaboration, and the cultural humility and other skills required to do it well. Throughout this book, and particularly in the case studies and examples shared, the role of context is critical, and never far from view. Included here most recently are the horrific and continuing toll of the COVID-19 pandemic, and a long overdue, yet still greatly circumscribed, "national reckoning with systemic racism," in the aftermath of the brutal police killing of yet another unarmed Black person, and then another and another, seemingly without end. In many chapters, the authors highlight different facets of the Black Lives Matter movement that took on new life across the country and the world in response to these atrocities. In other chapters, the existential threat of climate change and grave threats to democracy also are underscored. View the Table of Contents and introductory text for the supplementary instructor resources. (https://d3tto5i5w9ogdd.cloudfront.net/wp-content/uploads/2022/02/04143046/9781978832176_optimized_sampler.pdf) Supplementary instructor resources are available on request: https://www.rutgersuniversitypress.org/communityorganizing