Shaping global health promotion:a comprehensive analysis of the 10 Global Conferences on Health Promotion Conferences(1986-2021)

Objective This study analyzed how the 10 Global Conferences on Health Promotion have played a significant role in shaping and promoting a worldwide consensus and actions on health promotion,effectively addressing diverse health challenges that evolved over different periods.Methods The textual analysis method was used in this study and text encoding was conducted to systematically examine the declarations and reports presented by the 10 Global Conferences on Health Promotion held during 1986-2021.We summarized the themes and key achievements,and key vocabulary in the conference declarations was extracted and analyzed to construct the global health promotion consensus and actions.Results The fundamental principles of the conferences are to foster consensus and initiate actions in the realm of health promotion on a global scale.The primary purpose and goal are to promote health from regional to global.Significantly,our findings highlight a transition in the primary actors driving health promotion.It underscores a shift in health promotion from being driven primarily by organizations like the World Health Organization,governments,and international bodies,to a more inclusive approach involving non-governmental organizations and the general public.This development implies that health promotion has evolved into a collective global endeavor,demanding the proactive involvement of various stakeholders,and forging new alliances in public health.Meanwhile,the coronavirus disease 2019(COVID-19)pandemic has further shaped the landscape of health promotion,underscoring the need for intensified focus on areas including disease prevention,health education,and the integration of digital health technologies,and emphasizing the importance of a multidimensional,responsive approach in public health initiatives.Conclusions Sustained collaboration and innovative strategies are pivotal to advancing health promotion globally.Countries,together with public and private entities,should intensify cooperation.Multisectoral collaboration among partners such as healthcare,education,social security,and the industry is vital for health promotion and achieving global health goals.

Decision-Making and Management of Self-Care in Persons with Traumatic Spinal Cord Injuries: A Preliminary Study

Patients and physicians understand the importance of self-care following spinal cord injury (SCI), yet many individuals with SCI do not adhere to recommended self-care activities despite logistical supports. Neurobehavioral determinants of SCI self-care behavior, such as impulsivity, are not widely studied, yet understanding them could inform efforts to improve SCI self-care. We explored associations between impulsivity and self-care in an observational study of 35 US adults age 18 - 50 who had traumatic SCI with paraplegia at least six months before assessment. The primary outcome measure was self-reported self-care. In LASSO regression models that included all neurobehavioral measures and demographics as predictors of self-care, dispositional measures of greater impulsivity (negative urgency, lack of premeditation, lack of perseverance), and reduced mindfulness were associated with reduced self-care. Outcome (magnitude) sensitivity, a latent decision-making parameter derived from computationally modeling successive choices in a gambling task, was also associated with self-care behavior. These results are preliminary;more research is needed to demonstrate the utility of these findings in clinical settings. Information about associations between impulsivity and poor self-care in people with SCI could guide the development of interventions to improve SCI self-care and help patients with elevated risks related to self-care and secondary health conditions.

Implementation Research on the Effects and Results of a National Health Promotion Project

The purpose of this study was to describe the implementation of the Finnish government’s 2017-2018 key project titled “Effective lifestyle counselling for social and health care cross-functionally” (VESOTE) in primary health care organizations in Southwest Finland. The study also aimed to illustrate the project’s impacts on nursing practices in primary health care organizations in terms of lifestyle counselling. Data were collected from all of the primary health care organizations in Southwest Finland by using a questionnaire. The data were analyzed qualitatively and by using descriptive statistics. The participants considered the VESOTE project important in terms of its contents. However, only individual measures of the project were adopted into practice. Organizations require tools to monitor the implementation of a new operating model. This should be taken into account when launching national projects.

Application of self-care based on full-course individualized health education in patients with chronic heart failure and its influencing factors

BACKGROUND The treatment of heart failure not only needs to relieve the clinical symptoms and improve the quality of life for patients but also needs to select scientific and reasonable ways to prevent or delay the progression of the disease,thus reducing the mortality and hospitalization rate.Although the previous regimen can effectively relieve symptoms in the early stage of treatment,long-term use may cause adverse events,such as arrhythmia,and even increase mortality.Therefore,conventional treatment cannot meet the actual health needs of patients,and scientific nursing intervention is very necessary.AIM To investigate the application of self-care based on full-course individualized health education (FCIHE) and its influencing factors in patients with chronic heart failure (CHF).METHODS We enrolled CHF patients who were admitted to our center between September 2015 and June 2016 and divided them into an intervention group (n = 50) and control group (n = 50) using a random number table.Routine nursing care was applied to the control group,and FCIHE was offered to the intervention group.The self-care behavior,6-min walking distance (6MWD),and 36-item short form health survey (SF-36) scores were compared between the two groups.The influencing factors of the self-care were also analyzed.RESULTS The 6MWD was not significantly different between the two groups at admission (P > 0.05);however,at 3 and 6 mo after discharge,6MWD was significantly increased,and it was significantly longer in the intervention group (P < 0.05).The scores for self-care behavior showed no significant difference at admission between the two groups (P > 0.05);however,at 3 and 6 mo after discharge,the total scores for self-care maintenance,management,confidence,and behavior of the intervention group were significantly higher than those of the control group (P < 0.05).There were no significant differences in the SF-36 scores at admission (P > 0.05);however,at 3 mo and 6 mo after discharge,the scores for all eight subscales,including physical functioning,role limitations due to physical problems,bodily pain,general health perceptions,vitality,social functioning,role-limitations due to emotional problems,and mental health,were significantly higher in the intervention group (P < 0.05).As shown by logistic regression analysis,the influencing factors of self-care mainly included age,cardiac function class,and education background (odds ratio > 1;all P < 0.05).CONCLUSION FCIHE improved self-care behavior and cardiac function in CHF patients.Age,cardiac function,and education level affected the implementation of self-care among CHF patients.

Impact of COVID-19 pandemic on health-promoting lifestyle behaviors:A cross-sectional study

Objective:To explore health-improving behaviors during COVID-19 pandemic and to reveal the impact of the risk perception of COVID-19 on these behaviors.Methods:We recruited a total of 510 participants for this cross-sectional study.The data were collected online using a questionnaire booklet covering a form inquiring about the participants’demographic,physical,and mental characteristics,the Generalized Anxiety Disorder-7 Scale,and the COVID-19 Perceived Risk Scale.Results:The mean age of the participants was(28.7±10.1)years,and 76.1%were females.Of the participants,31.8%were overweight and obese.While 35.1%experienced negative alterations in their dietary patterns,23.9%reported positive changes to their diet during the pandemic.Besides,47.8%reported their sleep to be negatively affected during the pandemic.While the rate of those with extended screen time was 72.5%,it was 44.3%for the participants engaging in regular exercise.More than one-third of the participants(35.9%)had high and severe anxiety.We also found increased risk perception of COVID-19 among females,obese,those with disturbed eating and sleep quality,healthcare workers,and those with severe anxiety.Conclusions:Overall,the pandemic has appeared to have brought both positive and negative impacts on maintaining and improving eating,sleep,physical activity,and mental health.

Self-care practices and health-seeking behavior among older persons in a developing country:Theories-based research

Purpose:The aim of this study was to examine the self-care practices and health-seeking behaviours of older adults in urban Indonesia.Methods:The cross-sectional study was performed from January to March 2014 in the Tammua sub-district of Indonesia.At the time of the study,273 older adults resided in Tammua,and half of them(51.2%)participated in this study.Data collection was carried out including self-care practices,health literacy,self-efficacy and basic conditioning factors.Results:It was found that most respondents(124;88.6%)always ate various protein sources daily.However,many participants never limited consumption of sugar(55;39.3%)or salt(40;28.6%),and more than half of respondents(96;68.6%)did not regularly visit MHCs.Health status(p<0.05),health maintenance(p<0.01)and salt limitation(p<0.05)were all significantly associated with salt limitation.It was found that respondents with higher selfefficacy,those who did not want to get information,and those of younger ages are less likely to visit MHCs regularly.Conclusion:An understanding of self-care practices and self-efficacy is needed to improve health care in developing countries.High self-efficacy should be promoted along with adequate health literacy.Older persons should learn the importance of regular health examinations to promote health,prevent diseases,and slow the progress of chronic diseases.The number of respondents who never limit their sugar and salt intake was especially surprising.An intervention program should be developed to limit salt and sugar intake of Indonesian elderly and to motivate older persons to use primary health services.

The Evidenced Effects of Early Childhood Interventions to Promote Mental Health and Parenting in the Nordic Countries: A Systematic Review

Thefirst years of life and the family context are key to the promotion and protection of children’s health and well-being,emphasizing the need for interventions aimed to support families with young children.This review aimed to explore the effectiveness of early childhood interventions developed for promoting mental health and parenting among families with young children in the Nordic countries.Six electronic databases were systematically searched,and 20 articles covering 16 studies applying various quantitative and qualitative methods met the study inclusion criteria.The studied interventions were assessed as universal health-promoting interventions and health-promoting interventions with elements of prevention.Outcomes of interest encompassed mental health,related risk and protective factors among the parents and/or the children,or child-parent interaction.The results from studies applying statistical methods show significant improvements in parents’self-efficacy,self-esteem,and parental satisfaction,while few improvements in parents’social support or parental relationship were identified.Improvements in social support and parental relationships were however reported in qualitative studies.Most quantitative studies reporting on parents’mental health problems and stress found a significant decrease,and qualitative studies highlighted experienced positive effects on mental health and well-being.The majority of stu-dies reporting on children’s mental health and/or development as well as strengths and difficulties indicated a statistically significant positive development.No significant changes were however found for existing behavioral problems.The majority of studies examining parenting strategies and/or parent-child interaction found signifi-cant positive changes after the interventions.In sum,althoughfindings are heterogeneous,early childhood inter-ventions show various positive effects on the parenting and mental health of both children and their parents.The fact that different types of initiatives have been developed and implemented can be seen as an advantage,con-sidering the varying needs and expectations of different families.

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.

Preventing Behavioral-Risks Incidence among School Children: The Role of School-Based Health Promotion Program

This article addresses the important role school health education program can play in reducing youth risky behaviors that lead to incarceration, diseases and fatalities or that impact their academic performance in school. Children growing up are at risks of exposure to different behaviors and common social influences which if unchecked result in unexpected health consequences common among youth in America today. According to US Centers for Disease Control & Prevention, the six leading behaviors that cause death, disability, and social problems among American children are: unintentional injuries and violence, alcohol and drug use, tobacco use, unhealthy diets, inadequate physical activities, and sexual behaviors and diseases. This article shows that school health program: 1) can provide the foundation for children to learn desired healthy behaviors in order to preserve life, 2) protects the future of children and that of the nation, 3) can teach students skills to recognize risky behaviors and resist them, 4) can boost community efforts to achieve desired health behaviors, 5) closes socio-economic gaps that interfere with basic nurturing of children, and 6) finally links local stakeholders as partners in promoting community safety. Through review of literature, the authors found that it costs ($588) daily or (214,620) annually to incarcerate a juvenile and only $75 daily for the cost of individualized community-based services. The cost to New York is over $900,000, yet does not address the causative issues. The authors recommend that schools teach comprehensive school health from kindergarten to grade 12 and employ health educators to support teachers teach health promotion and education.

School health promotion:A cross-sectional study on Clean and Healthy Living Program Behavior(CHLB)among Islamic Boarding Schools in Indonesia

Objective:This study aims to identify the knowledge,attitude,and behavior of students using eight indicators of Clean and Healthy Living Behavior(CHLB)in relation to the health education and grade levels in Islamic Boarding Schools(IBS)in Jember regency,East Java Province,Indonesia.Methods:A cross-sectional school-based survey design was used.About 114 students(mean age of 13.17 years old)selected through a multi-stage random sampling completed a selfadministered questionnaire to measure the eight indicators of CHLB,such as washing hands with running water and soap,eating healthy snacks,using clean and healthy latrines,exercising regularly and measurably,eradicating mosquito larvae,not smoking at school,weighing and height measurement every 6 months,and disposing garbage properly.The data analyses included descriptive and comparative analyses of the difference in knowledge,attitude,and behavior toward CHLB by health education and grade level.Results:About 66.7% students received health education.Significant knowledge in CHLB in relation to health education and grade was observed(P<.05),including in-depth knowledge of exercises,measurable weight and height,smoking,and healthy latrines.Meanwhile,no significant difference was observed between the attitude toward CHLB and health education in different grade levels.Furthermore,CHLB was associated with health education,including habitual exercise and using of clean and healthy latrines.

Application of network meta-analysis in the field of physical activity and health promotion

Continued advancement in the field of physical activity and health promotion relies heavily on the synthesis of rigorous scientific evidence.As such,systematic reviews and meta-analyses of randomized controlled trials have led to a better understanding of which intervention strategies are superior(i.e.,produce the greatest effects)in physical activity-based health behavior change interventions.Indeed,standard meta-analytic approaches have allowed researchers in the field to synthesize relevant experimental evidence using pairwise procedures that produce reliable estimates of the homogeneity,magnitude,and potential biases in the observed effects.However,pairwise meta-analytic procedures are only capable to discerning differences in effects between a select intervention strategy and a select comparison or control condition.In order to maximize the impact of physical activity interventions on health-related outcomes,it is necessary to establish evidence concerning the comparative efficacy of all relevant physical activity intervention strategies.The development of network meta-analysis(NMA)-most commonly used in medical-based clinical trials-has allowed for the quantification of indirect comparisons,even in the absence of direct,head-to-head trials.Thus,it stands to reason that NMA can be applied in physical activity and health promotion research to identify the best intervention strategies.Given that this analysis technique is novel and largely unexplored in the field of physical activity and health promotion,care must be taken in its application to ensure reliable estimates and discernment of the effect sizes among interventions.Therefore,the purpose of this review is to comment on the potential application and importance of NMA in the field of physical activity and health promotion,describe how to properly and effectively apply this technique,and suggest important considerations for its appropriate application in this field.In this paper,overviews of the foundations of NMA and commonly used approaches for conducting NMA are provided,followed by assumptions related to NMA,opportunities and challenges in NMA,and a step-by-step example of developing and conducting an NMA.

Mental health promotion for elderly populations in World Health Organization South-East Asia Region:Needs and resource gaps

The accelerated population growth of the elderly(individuals aged 60 years or more)across the globe has many indications,including changes in demography,health,the psycho-social milieu,and economic security.This transition has given rise to varied challenges;significant changes have been observed in regard to developing strategies for health care systems across the globe.The World Health Organization(WHO)is also engaging in initiatives and mediating processes.Furthermore,advocacy is being conducted regarding a shift toward the salutogenic model from the pathogenic model.The concept behind this move was to shift from disablement to enablement and from illness to wellness,with the notion of mental health promotion(MHP)being promoted.This article attempts to discuss the MHP of elderly individuals,with special reference to the need to disseminate knowledge and awareness in the community by utilizing the resources of the health sector available in the WHO South-East Asia Region countries.We have tried to present the current knowledge gap by exploring the existing infrastructure,human resources,and financial resources.There is much to do to promote the mental health of the elderly,but inadequate facilities are available.Based on available resources,a roadmap for MHP in elderly individuals is discussed.

Health Literacy, Self-Care Behavior and Quality of Life in Acute Coronary Syndrome Patients: An Integrative Review

Purpose: The review aimed to find the best evidence on the relationship between health literacy, self-care behavior and perceived quality of life (QoL) among patients with acute coronary syndrome (ACS). Methods: Searching engines included Cumulative Index to Nursing Allied Health Literature (CINAHL), Pro Quest, MEDLINE, Google Scholar, SAGE Journals, Wiley on Line Library, and Science Direct electronic databases from 2010 to 2018. Fifteen research articles assessed the main variables and their associations with demographic and clinical variables. Results: Different methodologies and samples were analyzed: analytic descriptive, systematic review, a randomized control trial, retrospective cohort, a prospective Cohort, cross-sectional, and correlational designs. The fifteen studies showed that the patients with ACS have inadequate health literacy. Patients’ ability to understand basic and complex information or to accurately assess health risks was impaired and may hinder patients’ engagement in self-care. Low HL in patients having ACS is consistently associated with poor QoL. Physical domain of QoL remained the significant outcome of both self-care behavior and health literacy after adjusting for demographics and clinical variables in patients with ACS. Conclusion: The literature pointed to the importance of considering health literacy and self-care behaviors as predictors of quality of life among patients with ACS. However, there has been no previous evidence on the best process of the association between these three variables.

Integration of Health Promotion into Nursing Practice: A Case Study in Pakistan

The purpose of this study was to understand the concept of health promotion and perceptions related to the integration of health promotion in nursing practice in Pakistan. The study utilized the qualitative single case study approach to explore and describe the concept of health promotion, its significance and ways to integrate health promotion strategies in nursing practice. The data were collected from three different sources;focus group discussion among final year Post-RN BScN students, key informant interviews of practicing nurses, faculty, and MScN students, as well as a document review of the Post-RN BScN curriculum. Data analysis included a content and thematic analysis, yielding four major themes—”Health Promotion as Diverse”, “Health Promotion as Necessary”, “Health Promotion as Nursing Role”, and “Health Promotion as a Strategic Imperative”. Further, the findings highlighted the competencies, support mechanisms, and barriers which select nurses faced while integrating the health promotion strategies in practice.

Health Promotion and Life Course Dynamics: Transitions of Brazilian Elderly

Background: Understanding life transitions is important to help people to achieve their developmental needs. No studies have examined the patterns of responses to life transitions, eliciting the experiences of growing old of retired Brazilian older adults. Aim: To identify and describe the patterns of responses to life transitions of retired Brazilian older adults. Design: Using a theoretical perspective of transition as a guide, a qualitative, secondary narrative research design was incorporated to obtain data from 11 interviews. Method: Initial data collection took place during a broader study on the influence of people’s working life history. Eleven autonomous and independent persons, 64 - 82 years old, were interviewed at a geriatric outpatient unit in Rio de Janeiro to obtain their perceptions of old age. The secondary, narrative holistic-content analysis focused on the patterns of responses to life transitions. Results: The first turning point was a childhood event and the next was their first job. The third turning point was moving to another place/house or another city, the fourth starting a family, and retirement was the last turning point. Conclusions: While older people may feel environmentally disconnected throughout life, their patterns of response, together with the available resources and prevention/interventions influence the transition process. Health Promotion actions are needed at vulnerable points during the transition process, thereby facilitating the health outcomes.

Theoretical Foundation of Family Health Promotion——the Orientation of Family Planning Development in Urban Area

Objective To make a theoretical exploration of the function of family-based health promotion in family planning development. Methods Given the notion of reproductive health and the Junction of family in society, the author bring Jorward a new mode of family planning service, that was ＂healthy, happy household promotion ＂ based on the principle of health education and health promotion. Results The mode of ＂healthy,, happy household promotion ＂ reflected the new KP. service mode, and was the direction of family planning service. It might benefit both service provider and clients to make the family as the entrance point of quality care of reproductive health in communities, to develop health education and health promotion, and promote fiunily health and fanily happiness. Conclusion Family health and family happiness should be the final goal of family planning.

Health Promotion in Ecuador: A Solution for a Failing System

In 2008, the newly written Ecuadorian Constitution guaranteed access to healthcare for all citizens. Consequently, a vast amount of resources have been directed toward rebuilding the public healthcare system, which was in shambles due to the effects of neoliberalism. Although national healthcare studies show positive outcomes, community-based research studies from an impoverished rural barrio in southern Ecuador indicate that the public healthcare system has been unable to address a health epidemic. Based on several years of fieldwork, we argue that the failure originates from the continued functioning of the biomedical model of healthcare as the dominant health discourse in Ecuador. The ensuing result has been the construction of health system governed by an “administrative state” that enforces health policies from the top-down and delivers “episodic” emergency-style care. Accordingly, we maintain that the Ministry of Health (MOH) should create a nationwide community-based health promoter program guided by the principles of health promotion.

Culture- and evidence-based health promotion group education perceived by new-coming adult Arabic-speaking male and female refugees to Sweden—Pre and two post assessments

Objective: According to a theoretical approach, events that elicit stress after arrival in the reception country, i.e., post-migration stress, have a negative impact on health-related quality of life among newly-arrived refugees. With the aim of paying attention to such symptoms, a revised culturally-tailored clinical health promotion model developed at Harvard Program in Refugee Trauma was used for invited groups of new-coming adult refugees in a town south of the Swedish capital. Methods: A coordinator administered the five-weekly sessions, 2 hours/week, with a professional interpreter. It covered major topics from Western and Arabic worldviews: 1) introduction;2) health care: organisation and access to;3) exercises;4) stress management and coping, 5) medical doctor-patient communication. Each topic was led by a nurse, a physiotherapist, a psychologist and a physician with experience of encounters with this target group in health care. Data cover results from 70 participants attending six groups;39 participants with pre-course findings and, post-course and six-month follow-ups. There were no significant differences in background factors between the participants and the drop-outs. Results: Participants’ perceptions of their health, measured by EQ-5D, changed positively over time, above all immediately after the course, with no significant differences between the two follow-ups. In the follow-ups, female participants perceived their health as significantly worse than males. Qualitative data at the six-month follow-up assessed the course as useful but expressed a wish to continue a similar course with a focus on post- migration stress. Conclusion: The results sup- port earlier findings. A course, administered to a small group in a dialogue setting, has value for the participants’ empowerment and perception of health. It is recommended that reception be more adapted to coping of post-migration stress of new-coming refugees. Practical Implications: The results have implications for education in clinical health promotion, intercultural communication and inter-professional collaboration in refugee reception.

Assessment of Mothers’ Oral Health Knowledge: Towards Oral Health Promotion for Infants and Children

Aim: To assess the knowledge and oral health practices of a selected population of mothers in order to develop appropriate oral health promotion program for children in the area. Method: A cross sectional study was carried out among a convenient sample of mothers who attended two well-baby clinics—a tertiary and a primary health care centre in Lagos, Nigeria. A questionnaire requesting personal information, previous exposure to and source of oral health education (OHE), knowledge of oral health, diet and oral hygiene practices was administered. Results: There were 104 participants, aged 21 - 46 years (mean 32.01 ± 4.85 years);58.7% had received OHE, 23.1% from electronic media, 22.1% dentist and 9.6%, doctor or nurse. Only 44 (42.3%) had attended the dentist, 5 (4.8%) in <1 year and 10 (9.6%) within 1 - 2 years. Most younger mothers, compared with older mothers had knowledge of fluoride (x2 = 8.51, p = 0.014). Only 44 (42.3%) and 20 (19.2%) respectively believed the type of baby food and supplement affect the child’s teeth. Conclusion: Participants in this study showed inadequate knowledge of preventive oral health care. Regular OHE is recommended for mothers at the well baby and immunization clinics where they can be easily reached by health professionals.

Patient’s Experience of the Outcomes of Engaging in a Broadly Applicable Health Promotion Intervention for Individuals Facing Chronic Illness

The aim of this study was to explore the health-related outcomes of a new health promotion intervention designed to be broadly applicable among people diagnosed with chronic illness. Qualitative process analysis was applied and a purposeful sample of 52 patients, representing a variety of long-term conditions, was invited to participate in the pilot-implementation and evaluation of the program. Participants attended individually or in groups in seven sessions held over a six-month period. A lay-based conceptual framework that revealed the bodily knowledge of patients with chronic illness as a resource for health was used as the frame for the program content and interdisciplinary health professionals who had undergone 80 hours of training led the program. The pedagogical approaches were varied in order to engage patients in health promotion work. In-depth evaluation interviews took place soon after program completion and data were analyzed in-depth by means of content analysis in order to identify patterns of health-related themes and the program’s possible active ingredients. The intervention was implemented successfully across clinical sites and diagnostic categories. Participants reported improved ability to manage illness-related problems and greater awareness and utilization of personal resources for health after they had participated in the program. They were able to think more positively about their own capabilities, gained greater understanding of factors that made their health condition better or worse, and became more active. Participants identified empowerment and social participation as important outcomes of engaging in the new program.