Evaluation of the Effectiveness of Workplace Health Promotion Programs from 2000 to 2020: Literature Review

Introduction. Recognition of best practices in workplace health promotion is an important task that significantly affects the expansion of those programs. Once the program has been developed, its effectiveness becomes the most critical point of evaluation to guarantee achievements in the improvement of workers’ health. Objectives. To identify the practices for evaluating the effectiveness of workplace health promotion programs. Material and Methods: A search was performed on MEDLINE through PubMed with the MeSH: “Occupational Health”, “Health Promotion” and “Program Evaluation”, from the year 2000 to the year 2020 for studies with the following designs: Meta-analyses, Systematic reviews, Randomized Clinical Trials and Clinical Trials. Results: The most common topic of workplace health promotion programs (WHP) was increasing physical activity and avoiding a sedentary lifestyle, followed by stress management and finally smoking cessation and musculoskeletal disorders. The post-intervention measurements were most often done at 6 months and 12. The most commonly used indicators were the number of steps, weight, BMI, % body fat, waist circumference, blood pressure, sedentary time, level of physical activity and time of moderate-vigorous physical activity, daily energy output, life purpose, life satisfaction, mood and stress level. Conclusions: Although a great variability was observed in the evaluation of WHP programs, there were also common aspects. These results will help with designing WHP programs and defining evidence-based evaluation of their effectiveness. It is important to remember that WHP programs must be customized, taking into consideration the needs of each organization’s workforce.

Framework of behavioral indicators evaluating TB health promotion outcomes: a modified Delphi study of TB policymakers and health workers

Background:Although TB health promotion directed at policy makers and healthcare workers(HCWs)is considered important to tuberculosis(TB)control,no indicators currently assess the impact of such promotional activities.This article is the second in a series of papers that seek to establish a framework of behavioral indicators for outcome evaluation of TB health promotion,using the Delphi method.In the first article,we sought to establish a framework of behavioral indicators for outcome evaluation of TB health promotion among TB suspects and patients.The objective of this second article is to present an indicator framework that can be used to assess behavioral outcomes of TB health promotion directed at policy makers and HCWs.Methods:A two-round,modified Delphi method was used to establish the indicators.Sixteen experts who were knowledgeable and experienced in the field of TB control were consulted in Delphi surveys.A questionnaire was developed following 4 steps,and involved ranking indicators on a five-point Likert scale.The consensus level was 70%.Median,mode,and Coefficient of variation(CV)were used to describe expert responses.An authority coefficient(Cr)was used to assess the degree of each expert’s authority.Results:Consensus was achieved following the two survey rounds and several iterations among the experts.For TB health-promotion activities directed at policymakers,the experts reached consensus on 2 domains(“Resource inputs”and“Policymaking and monitoring behaviors”),4 subdomains(“Human resources”among others),and 13 indicators(“Human resources per 100,000 person”among others).For TB health-promotion activities directed at HCWs,the experts reached consensus on 5 domains(“Self-protective behaviors”among others),6 sub-domains(“Preventing infection”among others),and 15 indicators(“Average hours of daily workplace disinfection by ultraviolet radiation”among others).Conclusions:This study identified a conceptual framework of core behavioral indicators to evaluate TB health-promotion activities directed at policymakers and HCWs involved in TB control.Validation in other parts of the world could lead to global consensus on behavioral indicators to evaluate TB health promotion targeted at policymakers and HCWs.

Net Effect of Short-Term Smoking Cessation on Mental Health Changes:Inverse Probability of Treatment Weighting and Difference-in-Differences Method

Background:In response to the need for research clearly demonstrating the net effect of smoking cessation on mental health status,considering the causal relationship between smoking cessation and changes in mental health status,this study was undertaken.Thus,this study aimed to examine the net effect of short-term smoking cessation on five specific mental health metrics and the overall mental health status score.Methods:We used data from the first wave of the Korean Health Panel(KHP)Survey(2011–2013,2016–2018)and focused on men aged 19 years and older,to explore the effects of smoking cessation.We compared mental health status before and after cessation among current non-smokers who had quit smoking and continuous smokers.We ensured homogeneity between the two groups via inverse probability of treatment weighting(IPTW)and employed a difference-in-differences(DID)analysis to assess changes in mental health status.This study controlled for factors that could influence mental health and explored the net effect of short-term smoking cessation through difference-in-differences model using multiple regression analysis.Results:The results showed that short-term smoking cessation significantly alleviated mental and physical stress(p<0.1),reduced experiences of frustration(p<0.01),and improved the overall mental health status score(p<0.1).Conclusion:Thus,these results highlight a meaningful link between positive health behavior changes,such as smoking cessation,and enhanced mental health.Moreover,the application of temporal variables further improved the understanding of the causal relationship between health behaviors and mental health.

Assessing Barriers to Mental Healthcare Interventions for Deaf People in Ghana

While mental health issues are increasingly gaining attention in Ghana, little is known about the situation among deaf people. This study assessed the mental health care needs of deaf people in Ghana. A descriptive design, consisting of interviews and focus group discussions, was used to collect data from 97 participants. Findings indicated that participants had limited knowledge on mental health issues. Mental health stigma, inaccessible mental health information and exclusion from mental health programmes were the major barriers hindering access to mental health care services. This study bridges the knowledge gap and provides evidence for the implementation of deaf-friendly services.

Assessing Community Health Interventions in Reducing Infant and Child Mortality in the Southeastern Benin

Background: To reduce infant and child mortality in Benin, a package of high-impact interventions per healthcare level was implemented in 2009. This study aimed to assess the quality of community-based health interventions in reducing infant and child mortality within the municipality of Pobè in southeastern Benin. Methods: This was a cross-sectional evaluative study carried out in November 2021 focused on children aged 0 - 59 months, their mothers, health workers, community facilitators, community health workers and the Town Hall health focal point. Mothers and their children were targeted by cluster sampling, and exhaustive selection was used to recruit all other participants. Predetermined scores based on rating criteria were used to assess the quality of community health interventions using the “input, process and outcome” of Donabedian approach. Results: Over 300 mother-child couples, 46 community health workers, 7 health agents, 1 community facilitator and 1 health focal point from Pobè town hall were surveyed. Intervention quality was judged as “average”, with a score of 73.80%. The “inputs” and “outcomes” components were the weakest links. Conclusion: Improving access to the inputs needed by community health workers can enhance the quality of PIHI interventions.

Impact of Plastic Waste on the Human Health in Low-Income Countries: A Systematic Review

Background: Plastic pollution is the accumulation of waste composed of plastic and its derivatives all over the environment. Whether in the form of visible garbage or microparticles, as it slowly degrades, plastic pollution poses significant threats to terrestrial and aquatic habitats and the wildlife that call them home, whether through ingestion, entanglement or exposure to the chemicals contained in the material. Unfortunately, there is a lack of documentation on the impact of plastic waste on human health in low- and middle-income countries (LMICs). Methods: We searched five electronic databases (PubMed, Embase, Global Health, CINAHL and Web of Science) and gray literature, following the preferred reporting elements for systematic reviews and meta-analyses (PRISMA), for the impact of plastic waste on human health in developing countries. We included quantitative and qualitative studies written in English and French. We assessed the quality of the included articles using the Mixed Methods Appraisal tool (MMAT). Results: A total of 3779 articles were initially identified by searching electronic databases. After eliminating duplicates, 3167 articles were reviewed based on title and abstract, and 26 were selected for full-text review. Only three articles were retained. The three articles dealt with practices likely to lead to oral exposure to plastic chemicals in human health, as well as the level of awareness of participants concerning the possible impact of plastic on human health, namely, the use of plastic baby bottles, the use of microwaves to cook food and reheat precooked food, the use of plastic bottles to store water in the refrigerator, water purifier containers with plastic bodies and plastic lunch boxes, the reuse of plastic bags and the inadequacy of treatment facilities. Conclusion: Plastic waste poses different risks to human health at every stage of its life cycle. Hence, strategies must be adopted to raise public awareness of the dangers of plastic waste to their health. Trial registration: The review protocol is registered in the PROSPERO international prospective register of systematic reviews (ID = CRD42023409087).

Association between Diabetes Mellitus and Oral Health Status in Japanese Adults

Aim The objective of this study was to analyze the oral health among Japanese adults, with and without diabetes mellitus. Methodology The subjects were 518 community residents aged 20 to 91 years in Japan, who participated in the ＂Akita health and nutrition survey＂ and the ＂Akita dental disease survey＂, conducted in 2006. The surveys comprised a self-administered questionnaire, along with medical and dental examinations. Results Using the community periodontal index （CPI）, the mean numbers of sextants presenting codes 0, 1 and 2 were significantly lower in diabetics than non-diabetics among the 59 years or younger age group. Although the mean numbers of sextants with codes 0, 1 and 2 among the 60 to 69 years age group were lower, and sextants with a code X among the 59 years or younger age group were higher in diabetics than non-diabetics, no statistically significant differences were detected. The tendency of lower mean numbers of natural teeth and functional tooth units in diabetics than non-diabetics was observed, however no differences were statistically significant. Conclusion The outcome of periodontal disease seemed to be influenced by the diabetic state to some degree, but a clear association between diabetes and oral health status was not found.

Promoting physical activity in a public health context

In this special issue of the Journal of Sport and Health Science entitled Physical Activity and Public Health,5 papers,1 commentary,and 1 research highlight discuss efforts using public health approaches to increase physical activity(PA)in global settings.Such efforts are warranted based on the prevalence of adults(23%)worldwide who are insufficiently active at levels recommended by the World Health Organization(WHO).

Calcium intake,calcium homeostasis and health

Calcium,as the most abundant mineral in human body,is involved in many physiological and pathological processes.Here,we reviewed the key mechanisms of calcium homeostasis,including calcium sensing receptor regulation,intestinal calcium absorption,renal calcium reabsorption and bone calcium resorption.We further discussed the roles of dietary calcium and vitamin D in diseases associated with dysfunctional regulation of calcium.However,the over-dosed consumption of calcium could increase the risks for a series of diseases,such as kidney stone,myocardial infarction and stroke.

Sedentary behavior and physical activity predicting depressive symptoms in adolescents beyond attributes of health-related physical fitness

Background： Sedentary behavior （SB）, physical activity （PA）, and attributes of physical fitness have been shown to be related to depressive symptoms in adolescents. The purpose of the present study was to investigate whether SB and fitness-producing activity predicted depression in active adolescents over and above gender and fitness attributes. Methods： Participants were 249 adolescents （age： 12.85 ± 0.89 years, mean ± SD） from 3 public middle schools who wore Actical accelerometers to assess their SB and PA. Participants also completed the FITNESSGRAM health-related fitness assessment and a brief depression questionnaire. A 3-step hierarchical regression analysis was conducted with gender and fitness attributes （i.e., body mass index （BMI）, maximal volume oxygen uptake （VO2max）, curlups, and pushups）, moderate- and vigorous-intensity activity, and SB entered in respective steps. Results： Regression analysis indicated activity variables （i.e., moderate- and vigorous-intensity activity） significantly predicted depression （△R^2= 0.12, p 〈 0.01） beyond gender and fitness attributes. Overall, gender, fitness attributes, activity variables, SB explained 31% of the variance in depression. Structure coefficients revealed VO2max （rs= -0.77）, moderate-intensity activity （rs= -0.67）, vigorous-intensity activity （rs = -0.81）, and SB （rs = 0.57） were substantially correlated with the criterion variable; thus, they were the strongest predictors of depression. Conclusion： The findings of the current study indicated SB and PA were both significant predictors of depression; however, sufficient fitness-producing activity and adequate cardiorespiratory fitness may nullify the negative influence of SB on depressive symptoms in active adolescents.2018 Published by Elsevier B.V. on behalf of Shanghai University of Sport. This is an open access article under the CC BY-NC-ND license. （http：//creativecommons.org/licenses/by-nc-nd/4.0/）.

The moderating effect of physical activity on the relationship between bullying and mental health among sexual and gender minority youth

Background:Sexual and gender minority youth frequently experience bullying,which often contributes to higher depressive symptoms and lower self-esteem.Given that physical activity(PA)can mitigate depressive symptoms and improve self-esteem,we examined the moderating effect of PA on the relationship between bullying and mental health among sexual and gender minority youth.Methods:Data from the Lesbian,Gay,Bisexual,Transgender,and Queer National Teen Survey(n=9890)were analyzed.Hierarchical regression analyses examined the influence of history and frequency of being bullied,PA,and the interaction of these variables on depressive symptoms and self-esteem.Simple slopes analyses were used to probe significant interactions.Results:Results indicated the importance of accounting for bullying history when examining effects of PA on mental health.PA was negatively related to depression(t=-4.18,p<0.001)and positively related to self-esteem(t=12.11,p<0.001).Bullying frequency was positively related to depression(t=19.35,p<0.001)and negatively related to self-esteem(t=-12.46,p<0.001).There was a significant interaction between bullying frequency and PA for depression(t=4.45,p<0.001)and self-esteem(t=-4.69,p<0.001).Post hoc analyses suggested that the positive effects of PA on mental health may be limited to those not bullied because it had a negligible effect on those who were bullied.Conclusion:Results suggest that sexual and gender minority youth exercise interventions aiming to improve mental health should first address bullying history;otherwise,their effectiveness may be limited to those who have been bullied.

The Current Status of Health Literacy in China

The overall level of health literacy （HL） in China in 2013 stood at 9.48% , contrasting the rural level of 6.92% with theurban level of 13.80%.Hae level of t tI, in Eastern China was 12.81%, while it was 6.93% in West China and 7.10% in Cenlxal China Region.The level of III, lbr female was 9.73%, higher than the male level of 9.23%. In addition, the tlL rates of health knowledge and concept, healfla skills, mad health life-style and behaviors was 20.42%, 12.47% and 10.62% respectively. The HI, rates of chronic diseases prevention, infectious diseases prevention, basic medical care, alty mad llrst aid, scientilic healthconcept, and health inlbnnation was respectively 11.59%, 17.12%, 8.30%, 43.53%, 32.12% and 18.46%. The results suggest that the level of health literacy of Chhaese urban and rural residents is low, but still differs substantially across different areas and sub-populations.

Evaluation of health determinants for sustaining workability in aging US workforce

Growth of older population in United States requires multi-generational evaluation to characterize health measures for sustaining workability. Investigation of measures that working population would need and use with their work-life in an attempt to stay healthy and fit, could potentially reveal significant association that could extend workability and enhance work productivity such as performance, presenteeism, job satisfaction. Evaluation with selective longitudinal health profiling;employment prerequisites;socio-economic and psychological scales could characterize health measures significantly associated with work sustainability. Such health measures could potentially be employed by US working population early in their life and occupation to sustain and improve workability in their later epoch.

“I Felt Defeated. I Felt Helpless”: Social Determinants of Health Influencing the Cancer Survivorship of a Young Latina Mother

Social determinants of health (SDOH) contribute to cancer disparities among young Latina women (<50 years) residing in the counties along the US-Mexico border. These SDOH are particularly burdensome to young Latina mothers diagnosed with cancer while they are raising school-age children. Conexiones, a culturally adapted program designed to improve mother and child adjustment to maternal cancer, was piloted with diagnosed Latina mothers residing in border counties in New Mexico and Texas. The purpose of this case analysis was to highlight the SDOH affecting a young Latina mother’s cancer survivorship in the U.S.-Mexico border region. The participant’s Conexiones education sessions were recorded, transcribed, translated to English, back translated to Spanish to establish accuracy, and inductively coded. The participant’s baseline survey indicated she was a young (<50 years), married, Spanish-speaking Latina mother diagnosed with breast cancer while raising a teenage daughter. Seventeen SDOH themes affecting the participant’s cancer experience were identified in the cancer-related emotional triggers she reported across five Conexiones sessions. These themes were organized using Yanez’s conceptual model of determinants of cancer outcomes in Hispanics (i.e., socioeconomic, healthcare, cultural context, and psychosocial). Findings provide direction for cultural adaptations of evidence-based programs.

Preliminary Expert Consensus on the Scientific Evaluation Standard of Health Works for Public

The popularization of health science is an important part of the Plan of Healthy China 2030.It is of great significance to establish the evaluation standard of health works for public in order to solve the problem of mixed quality in the field of health science popularization in China.The scientific evaluation of health science should be based on evidence-based method,according to six aspects:author,evidence selection,evidence application,evidence evaluation,peer review&publishing platform and conflict of interest.

Frameworks for health systems performance assessment:how comprehensive is Ghana’s holistic assessment tool?

Background:Measuring the performance of a health system is an essential requirement in creating systems that generate efficient,equitable,patient-focused,accessible and sustainable results.A fundamental requirement for a performance measurement system is the development of an assessment framework within which specific performance measures could be defined and applied regularly.This paper examines the comprehensiveness of Ghana’s health system assessment framework called the Holistic Assessment Tool in relation to some of the internationally recognized frameworks.The paper also analyzes trends in the performance of the health system to understand whether or not an improvement has been recorded following the adoption and implementation of the Holistic Assessment Tool.Methods:Mainly secondary data were used in this analysis.Searches were conducted on Google Scholar,PubMed,Scopus and Science Direct between May and July,2019 for published documents on health system performance assessment.We also obtained unpublished documents from Ghana’s Ministry of Health,Ghana Health Service website,and Ghana Statistical Service database.Descriptive statistics were used to examine trends in the performance of the Ghanaian health system.Results:While the tool provides a national framework for evaluating the performance of the Ghana Health system in several domains,the Holistic Assessment Tool does not cover key health system domains such as information systems for health,access to essential medicines,and patient-centeredness.Also,the scope of the assessment program seems limited to the evaluation of the Ministry of Health’s annual plans,programs and projects.However,the health system has recorded improvements in population health indicators,such as life expectancy at birth,infant mortality,under-5 mortality,HIV prevalence and disease burden(in terms of disability adjusted life years).Conclusions:The Holistic Assessment Tool is a useful framework,but needs further refinement,both in scope and in conceptual robustness.Future studies should consider exploring factors influencing performance of the Ghanaian health system.Such information will help in strategizing for better and more improvements.

Knowledge, attitude and practice of healthcare workers concerning Crimean-Congo hemorrhagic fever in Western Iran

Objective: To determine the knowledge, attitude and practice of healthcare workers in Kermanshah Province about Crimean-Congo hemorrhagic fever(CCHF).Methods: This study was conducted in 2014 on healthcare personnel in different job categories including physicians, nurses, midwives, laboratory staff and network health staff of Kermanshah Province by direct interview.Results: A total of 367 respondents who had more than 5 years of experience in their jobs were interviewed. Among them 91% of physicians and nurses, 97% of midwives and health workers and 96% of laboratory staff stated that they had not been confronted with CCHF patients so far. Regarding knowledge, 76% of physicians, 78% of nurses, 77% of midwives and 58% of laboratory staff believed that the disease is remediable. Most of the interviewed participants stated that the disease pertains to people who are in close contact with domestic animals, but they did not consider their own occupations as one of the risk factors. More than 70% of the respondents believed that the disease may exist in the province or their work field. Generally, the knowledge about CCHF was inadequate, with nurses having the lowest level of knowledge.Conclusions: Knowledge of Kermanshah healthcare staff about CCHF was poor,especially nurses in a high risk job category. Therefore, it is necessary to conduct specific training programs for the disease identification, transmission, prevention, and treatment as well as the use of personal protection and safety devices.

Development of a Systematic Review of Public Health Interventions to Prevent Children Drowning

Drowning is the leading cause of death from unintended injury in children globally. Drowning is preventable, and mechanisms exist which can reduce its impact, however the peer-reviewed literature to guide public health interventions is lacking. This paper describes a protocol for a review of drowning prevention interventions for children. Electronic searching will identify relevant peer-reviewed literature describing interventions to prevent child drowning worldwide. Outcome measures will include: drowning rates, water safety behaviour change, knowledge and/or attitude change, water safety policy and legislation, changes to environment and water safety skills. Quality appraisal and data extraction will be independently completed by two researchers using standardised forms recording descriptive and outcome data for each included article. Data analysis and presentation of results will occur after data have been extracted. This review will map the types of interventions being implemented to prevent drowning amongst children and identify gaps within the literature.

Effective Factors in Urinary Tract Infection Prevention among Children: Application of Health Belief Model

Urinary Tract Infection (UTI) is one of the most common bacterial infections among children using preventive manipulations, especially among children less than 6 years old. This study aimed at exploring factors which could affect urinary tract infection prevention among children. A descriptive analytical study was conducted on 70 mothers who had children less than 6 years old in 2013. Multistage cluster sampling method was utilized in which each kindergarten was considered as a cluster and data were collected by a researcher-made questionnaire designed based on Health Belief Model (HBM). Validity and reliability of questionnaire were confirmed by a pilot study. ANOVA and Pearson Correlation Coefficient were conducted using SPSS, version 18. The mean and standard deviation of knowledge and practice were 6.96 ± 2.14 and 15.47 ± 1.54 respectively. Means and standard deviation of Health Belief Model constructs (perceived susceptibility, perceived severity, perceived benefits, perceived barriers and self-efficacy) were 17.64 ± 2.50, 22.02 ± 2.55, 20.90 ± 2.38, 27.56 ± 5.20 and 21.49 ± 3.18 respectively. More participants were in the moderate levels of knowledge (74.3%) and practice (45.7%). These findings revealed a significant relation between practice and perceived susceptibility (p = 0.02), perceived barriers (p = 0.001), self-efficacy (p = 0.014) and cues to action (p = 0.016). Based on the current study, the intervention based on Health Belief Model can be useful to improve preventive behaviors of Urinary Tract Infection.

Workplace mistreatment: Health, working environment and social and economic factors

Objective: To explore patterns of workplace mistreatment, relationships with health and with selected workplace, economic and social factors in 34 countries. Methods: Secondary data analysis of the European Working Conditions Survey. Results: Patterns of ill treatment (across occupational groups, and sectors) were broadly consistent with smaller, less representative studies. Prevalence was lower than many studies but corresponds with estimates of serious mistreatment. Mistreatment increases the risk of both physical and mental ill health and is associated with a range of work environment factors. Mistreatment is more prevalent in countries with smaller gender gaps, better performance on the GINI index for income inequality and for countries with specific anti-bullying legislation. Conclusions: Mistreatment in work is complex, and interventions are required at the level of the organization. Implementation issues need to be addressed, as specific anti-bullying legislation does not appear to provide sufficient protection.