David V. McQueen

Global Perspectives on Health Promotion Effectiveness

The Global Programme on Health Promotion Effectiveness.- Global Perspectives on Health Promotion Effectiveness.- The Global Programme on Health Promotion Effectiveness (GPHPE).- The IUHPE Blueprint for Direct and Sustained Dialogue in Partnership Initiatives.- The Global Programme on Health Promotion Effectiveness.- Reports from the Field.- Policies for Health.- Strengthening the Evidence Base for Mental Health Promotion.- Effectiveness and Challenges for Promoting Physical Activity Globally.- School Health Promotion.- Health Promotion to Prevent Obesity.- Effective Health Promotion Against Tobacco Use.- Effectiveness of Health Promotion in Preventing Alcohol Related Harm.- Global Areas of Interest that Challenge the Assessment of Health Promotion Effectiveness.- Globalization and Health Promotion.- Urbanization and Health Promotion.- Community Interventions on Social Determinants of Health.- Strengthening Peace-Building Through Health Promotion.- The Role of Governance in Health Promotion Effectiveness.- Global Debates about Effectiveness of Health Promotion.- Evidence and Theory.- Measurement and Effectiveness.- Healthy Settings.- Feasibility for Health Promotion Under Various Decision-Making Contexts.- Evaluating Equity in Health Promotion.- Evaluation of Empowerment and Effectiveness.- Enhancing the Effectiveness and Quality of Health Promotion.

Domains of Core Competency, Standards, and Quality Assurance for Building Global Capacity in Health Promotion: The Galway Consensus Conference Statement

This paper reports the outcome of the Galway Consensus Conference, an effort undertaken as a first step toward international collaboration on credentialing in health promotion and health education. Twenty-nine leading authorities in health promotion, health education, and public health convened a 2-day meeting in Galway, Ireland, during which the available evidence on credentialing in health promotion was reviewed and discussed. Conference participants reached agreement on core values and principles, a common definition, and eight domains of core competency required to engage in effective health promotion practice. The domains of competency are catalyzing change, leadership, assessment, planning, implementation, evaluation, advocacy, and partnerships. The long-term aim of this work is to stimulate a global dialogue that will lead to the development and widespread adoption of standards and quality assurance systems in all countries to strengthen capacity in health promotion, a critical element in achieving goals for the improvement of global population health.

Social factors in the etiology of chronic disease: An overview

Our intention in this introductory article is to emphasize what we consider to be certain critical points in the current state of research into the social epidemiology of chronic disease. As will be outlined, these critical points need to be considered in future research. To begin with we provide a mild critique of research in this area which has had its tradition specified by social epidemiology, a term which has recently come into favor to describe research concerned with social factors in the etiology of chronic disease. Next we briefly summarize critical available evidence on an etiological relationship between social factors and cardiovascular disease, cancer and multiple disease outcomes. Following this a major emphasis will be placed on issues which directly relate to problems of methodology in social factors assessment. Finally, an emphasis will be given to the critical question of mechanisms which need to be clarified in this type of multivariate research.

Global priority setting for Cochrane systematic reviews of health promotion and public health research

Background: Systematic reviews of health promotion and public health interventions are increasingly being conducted to assist public policy decision making. Many intra-country initiatives have been established to conduct systematic reviews in their relevant public health areas. The Cochrane Collaboration, an international organisation established to conduct and publish systematic reviews of healthcare interventions, is committed to high quality reviews that are regularly updated, published electronically, and meeting the needs of the consumers. Aims: To identify global priorities for Cochrane systematic reviews of public health topics. Methods: Systematic reviews of public health interventions were identified and mapped against global health risks. Global health organisations were engaged and nominated policy-urgent titles, evidence based selection criteria were applied to set priorities. Results: 26 priority systematic review titles were identified, addressing interventions such as community building activities, pre-natal and early infancy psychosocial outcomes, and improving the nutrition status of refugee and displaced populations. Discussion: The 26 priority titles provide an opportunity for potential reviewers and indeed, the Cochrane Collaboration as a whole, to address the previously unmet needs of global health policy and research agencies.

Mobile breast screening: factors affecting uptake, efforts to increase response and acceptability.

In 1986, a breast screening project was set up to assess the feasibility of mobile breast screening in rural areas near Edinburgh. Secondary objectives included a study of factors affecting uptake, ways in which uptake might be encouraged and a study of the acceptability of this form of screening. This paper deals with the results of studies dealing with secondary objectives. We found that response rates to opportunistic screening was poor, 5,631 attenders out of 23,229 eligible women (24.2%). This was especially so in older women. Distance proved to be the single most significant factor affecting uptake, but car and house ownership were also highly significantly correlated with response. Leaflet drops had no demonstrable effect on response, but personal invitation by general practitioners produced a 75% response rate in women 50-64 who had failed to attend on the vans previous visit. Attenders found this form of screening both convenient and acceptable.

Health Behaviour Research and Health Promotion.

Part 1 The development of concepts and research in health behaviour: historical origins of health behaviour, David Armstrong the development of the concept of health behaviour and its application in recent research, Robert Anderson. Part 2 Approaches to the study of health behaviour: ethnographic approaches to health, Una Maclean what social groups think they can do about health, Janine Pierret the role of socio-structural factors in health behaviour, Horst Noack risk factors investigation of health behaviour - Hungarian experiences, Mihaly Kokeny et al. Part 3 National surveys of health behaviour: methodological issues in the study of health-related behaviour, Kathryn Dean health-behaviour measurement in the evaluation of community based health-promotion programmes, Don Nutbeam the behavioural risk factor surveys in the United States 1981-1983, Gary Hogelin national surveys of health behaviour in Finland, Esko Kalimo. Part 4 Research on health behaviour in local environments: health beliefs and behaviour in the home, Roisin Pill the evolution of the juvenile health habit study 1977-1985, Matti Rimpela et al health beliefs and behaviour in the workplace, Lamberto Briziarelli health promotion and the concept of community, John Ashton. Part 5 The application of research in health behaviour: the autonomous region of Madrid, Rose Martinez and Armando Perruga Urrea the Canadian experience, Irving Rootman national health education programmes, John K.Davies. Part 6 Discussion papers on a new agenda for research in health behaviour: new perspectives for research in health behaviour, Ilona Kickbusch the need for new social policy perspectives in health-behaviour research, Pierpaolo Donati directions for research in health behaviour related to health promotion - an overview, David V.McQueen a note on research priorities from participants in the Symposium on Health Behaviour, Pitlochry.

Enhancing global capacity in the surveillance, prevention, and control of chronic diseases: seven themes to consider and build upon

Background: Chronic diseases are now a major health problem in developing countries as well as in the developed world. Although chronic diseases cannot be communicated from person to person, their risk factors (for example, smoking, inactivity, dietary habits) are readily transferred around the world. With increasing human progress and technological advance, the pandemic of chronic diseases will become an even bigger threat to global health. Methods: Based on our experiences and publications as well as review of the literature, we contribute ideas and working examples that might help enhance global capacity in the surveillance of chronic diseases and their prevention and control. Innovative ideas and solutions were actively sought. Results: Ideas and working examples to help enhance global capacity were grouped under seven themes, concisely summarised by the acronym “SCIENCE”: Strategy, Collaboration, Information, Education, Novelty, Communication and Evaluation. Conclusion: Building a basis for action using the seven themes articulated, especially by incorporating innovative ideas, we presented here, can help enhance global capacity in chronic disease surveillance, prevention and control. Informed initiatives can help achieve the new World Health Organization global goal of reducing chronic disease death rates by 2% annually, generate new ideas for effective interventions and ultimately bring global chronic diseases under greater control.

The association of alcohol consumption and hypertension

Abstract A review of the literature on the association of alcohol consumption and hypertension shows increasing attention to this topic. The diversity in the nature of the populations studied leads to problems in comparisons across studies, and the differences in the measurement of alcohol consumption and the variety of research designs have led to problems in ascertaining the true relationship between levels of alcohol consumption and blood pressure. An historical review shows an increasing tendency for the assertion of a positive relationship, although the question of threshold effects and the physiological mechanism underlying the association remain unclear. Recent studies have shown the existence of a relationship in well-controlled studies of cohorts of workers, and numerous confounding factors have been adjusted for in the analyses. However, many questions remain in asserting a causal relationship between alcohol consumption and elevated blood pressure in general populations, given the relative dearth of findings for the female population as well as for various other subgroups.

Evidence-based health promotion: an emerging field

There is much debate around the use of evidence in health promotion practice. This article aims to sharpen our understanding of this matter by reviewing and analyzing the 26 case studies presented in this special issue. These case studies suggest that health promotion practitioners are using a wide range of research evidence in interventions for high-risk individuals, entire populations, and vulnerable groups according to all five strategies for action described in the Ottawa Charter for Health Promotion. In nearly every case, practitioners had to mediate and adapt research evidence for their case. Eight key levers helped practitioners embed research evidence into practice: local and cultural relevance of the evidence, community capacity-building, sustained dialogue from the outset with all stakeholders, established academic-supported partnerships, communication that responds to organizational and political readiness, acknowledgement and awareness of gaps between evidence and practice, advocacy, and adequate earmarked resources. These case studies provide some evidence that there is an evidence-based health promotion, that this evidence base is broad, and that practitioners use different strategies to adapt it for their case.

Social factors in the etiology of multiple outcomes: the case of blood pressure and alcohol consumption patterns

The literature addressing the relationships between biological and social factors in the etiology of multiple chronic diseases occurring simultaneously is presented. The rationale for studying such multiple outcomes is presented in terms of providing a realistic appraisal of the development of chronic diseases from a clinical perspective; i.e. persons with chronic illnesses often have more than one illness at the same time. Social processes related to the development of one joint disease outcome, namely clinically elevated blood pressure and heavy alcohol consumption patterns, are discussed, and emphasis is given to elaborating the role of stress and social support in the etiologic process. Several alternative models are presented to account for the etiology of the joint outcome, and a research agenda is suggested.