Health_Promotion

Introduction: Health is “The state of complete physical, mental, and social well-being and, according to the World Health Organization (WHO), not merely the absence of disease or infirmity” (Barker, 2003, p. 192).  This definition is still widely referenced, but is often supplemented by other World Health Organization (WHO) reports such as the Ottawa Charter for Health Promotion which in 1986 stated that health is “a resource for everyday life, not the objective of living. Health is a positive concept emphasizing social and personal resources, as well as physical capacities.” Therefore Health may be regarded as a balance of physical, mental and social aspects of life in a being. Physical health Physical fitness is good bodily health, and is the result of regular exercise, proper diet and nutrition, and proper rest for physical recovery. A strong indicator of the health of populations is height, which is generally increased by improving nutrition and health care, and is also influenced by the standard of living and quality of life. Genetics is also a major factor in people's height. The study of human growth, its regulators, and its implications is known as Auxology. Mental health Mental health refers to a human individual's emotional and psychological well-being. Merriam-Webster (Merriam-Webster, which was originally the G. & C. Merriam Company of Springfield, Massachusetts, is an American company that publishes reference books, especially dictionaries that are descendants of Noah Websters An American Dictionary of the English Language (1828).)defines mental health as "A state of emotional and psychological well-being in which an individual is able to use his or her cognitive and emotional capabilities, function in society, and meet the ordinary demands of everyday life." According to the World Health Organization, there is no one "official" definition of mental health. Cultural differences, subjective assessments, and competing professional theories all affect how "mental health" is defined. In general, most experts agree that "mental health" and "mental illness" are not opposites. In other words, the absence of a recognized mental disorder is not necessarily an indicator of p.1 mental health. WHO (1980) WHO Chr., 34(2)80 One way to think about mental health is by looking at how effectively and successfully a person functions. Feeling capable and competent; being able to handle normal levels of stress, maintain satisfying relationships, and lead an independent life; and being able to "bounce back," or recover from difficult situations, are all signs of mental health. Encompassing your emotional, social, and—most importantly—your mental well-being; All these aspects—emotional, physical, and social—must function together to achieve overall health. Health promotion, as defined by the World Health Organization, is the process of enabling people to increase control over, and to improve, their health.. In the USA, health promotion is much more narrowly conceived as "the science and art of helping people change their lifestyle to move toward a state of optimal health. WHO/Europe - Ottawa Charter for Health Promotion, 1986. Discussion: A new health promotion program will be launched under the theme of “ Quit Smoking for Enhancing Personal and Others’ Health”. The programmer wishes to encourage smokers to reduce or stop their smoking behaviors at the presence other people. Instead of reaching out all smokers, the programmer tries to send the messages to those smoking clerical staffs of a government department. Our team members attempt to convert behavior of those clerical workers so that they can give up smoking at or near their offices. Once those smokers have reduced their smoking time and volume, passive smokers will absorb less poisonous subjects from their surrounding atmosphere. Hence, it is reasonable to foresee that their health status can be improved. In brief, our objectives including transmission of knowledge about consequences of smoking behaviors over those passive smokers to all clerical staff, and those smokers reconsider impacts of their behaviors over the other people. Hopefully, they would stop smoking, or at least reduce their period of smoking at the presence of their non-smoking colleagues. All participants are expected to halve their smoking period at least. The total length of smoking period before and after launch of the program can be measured as an indicator of our achievements. To reduce smoking time and volume by half is not an easy task for most smokers. However, our team guesses that those participants will ultimately reach the goal when positive reinforcements are given by all their surrounding people. After studying findings of many previous researches, our objectives are not unrealistic. Only a few healthcare resources should be applied to p.2 execute the program. Senior management of the concerned government department will offer us solid supports for working out positive reinforcements to those smoking staff. A period of three months will be reserved for the whole program. This program aims o reach those smoking staff who are working at different offices of a local government department. In order to follow government’s policy about keeping all working areas out of smoking, senior officers o the department seek for our helps in advance. Before the written instructions are delivered to all staff, the department wishes to encourage those smokers to convert their smoking behaviors at the beginning. When resistances for the future orders can be minimized, implementation of the new policy can be smooth. Although smoking has already been discouraged within those offices, many smoking staff still exercise their unhealthy behavior at public areas. Their behaviors can ruin health status of their non-smoking colleagues seriously. Adverse and side- effects of the behaviors are still commonly observed. It is especially true when senior clerical staff were concerned. The program can enhance health status of those smoking clerical staff as well as their non-smoking colleagues. They are chosen as the program can eliminate the escalating coat of sick leave and increase their efficient at work. Even though they have already distorted by their long term smoking behaviors, they are still unable to give up their slow suicide processes. As the number of smoking population is so enormous that adverse effects towards those passive smokers are very significant (Wwlls 1988). Thus, health promotion programs should be used to enhancing self-consciousness of those smokers through different activities. First of all, employers are invited to worksite prevention and health promotion initiatives as a means of controlling costs and maintaining a health and productive workforce. Similar programs have been evidenced as a powerful tool for increasing productivity, decrease absenteeism, decrease use of expensive medical care, and lower disability claims(Pender 1996). More important, many passive smokers are suffering from the same category of chronic diseases as those smokers. A great deal of pregnant women has their babies significant affected by nicotine and other harmful substances. Nevertheless, Chinese norms discourage most non-smoking people to strike for their own rights and protect their own health. Unless proper health promotion programs are held, both smokers and non-smokers may not know how what to do for maintaining health status of all members. At least 400,000 people in the United States died due to smoking-induced diseases every year. In order to rectify health care problems related to smoking, The US government spend at least $100 billion annually to compensate loss in productivity. Those healthcare professionals carry out health care programs of every kind p.3 (McKenzie Bartecchi, and Schrier 1994). Obviously, many health promotion program have terminated unsuccessfully. Health promotion programs cannot be effective in stopping smoking if incorrect strategies are applied. To implement concepts of primary health care, smoking cessation programs for our target population can achieve our objectives better. Otherwise, our scarce health care resources shpuld be spent on smoking-related diseases endlessly and wastefully. In this sense, an appropriate health promotion model for facilitating behavior change of those participants should be chosen with care. The Health Action Model (HAM) will be formed the theoretical basis for the program. It provides a framework and route to team for making sense of the situation, knowing where to start and what to do. Basically, HAM emphasizes the important influences of self-esteem on individual behavior. Somebody who has high self-esteem and a positive self-concept are concerned to be more likely to adapt ways of healthier living. If persons have a low self-esteem, they may feel that they are victims of bad luck or fate. The model is particularly favored by health promoters working in the field of drugs such as alcohol and cigarette. By boosting people self-esteem and their skills in resisting peer group pressure, they will be more capable of converting their present lifestyles. A variety of psychological, social and environmental influences are identified to be important determinants of a number of health-related choices. With respects to viewpoints of the model, health decisions and actions are determined by our beliefs, values, motivation, expectations of how other people will react to our actions, and our self-concept and self-esteem. Empowerment is a basis of the model, too. The process enables people to feel good about them, to value themselves, and to acquire the skills to assert themselves. When provision of a good circumstance that facilitate healthy choices is accompanied, the best outcomes can be expected (Ewles and Simnett 2003, p.272). Thus, participants are definitely concerned as partners to the health promoters. They are empower to assist themselves to acquire a better health status. The HAM has been chosen partially due to its competence in assisting participants have problems with drugs. Its assertions about self-esteem and self-concept can help those participants reflect on their own lives. It is especially true as our target population is a group of adults. They are not unfamiliar to those adverse effects of smoking over themselves and their surrounding people. They cannot make up their minds most likely because they do not have a motivation to such goals. Due to their delicate self image, they are certainly required to be empower for making real changes. If a supportive environment can be created to offer them encouragement and positive reinforcement, they will be able to convert their health beliefs. Affirmative responses shown by the others will accelerate their changes. Then, new actions will be p.4 performed in the accommodating atmosphere. Whenever a health promotion activity is being organized, some kinds of ethical problems will be met. Health promotion program organizers ought to carry out several types of corresponding preventive measure to ensure that three is nothing done against ethical principles. It is not uncommon that health care professionals may make their ethical decision merely according to consequentialist or teleological theories. We may tend to determine rightness or wrongness of an action exclusively due to the consequences of performing it solely (Mitchell, Kerridge & Lovat 1996, p.251). As a consequences, many colleagues try to impose their own standards directly on shoulders of their clients. Reasonable explanations may not be given to those participants. Rational aspects of their clients opinions and expression are likely to be ruled out. Health care professionals must be sure that modern scientific findings cannot rule out the existence of many kinds of lifestyles. Health care professionals should not stick to some trendy beliefs. We cannot drive our patients to s specific life style that we percept as good (Johnstone 1999, p.203-209). All patients should be treated should as rational human beings. Even health care professionals may know certain health related issues better than their patients do. Health care promoters cannot routinely apply principle of beneficence in this circumstance true as free will of those smoking staff cannot be restricted. Organizers of health promotion program should not force the participants to make unrealistic goals without concerning their limitations and ability. Health promoter should encourage their clients to convert their health beliefs and behaviors through persuasion. They need to aid their clients to make the best choices in a rational manner only. No restriction should be imposed on autonomy of those participants. Health promoters should remain alert to those possible traps (Thompson, Melia &Boyd 2000, p.745). Health care professionals cannot deny patients the option of being spared intolerable and intractable suffering. Rather than pushing our clients to follow a specific set of norms and values, health care workers should provide sufficient information and data for their clients to make their own decisions (Johnstone 1999, p. 203-209). To put the above principles into practice, statements about right of patients should be distributed to all participants. They will be informed about objectives and scope of the program clearly. They are also allowed to sign off at any stage of the program. Tactically, all participants will be guided to discover consequences of being an active or a passive smoker. Instead of imposing restrictions on those smokers, they are advised to reconsider impacts of smoking on health status of their own and their p.5 non-smoking colleagues. Participants are then divided into groups so that both smokers and non-smokers can discuss the problem altogether. Each group will be asked to generate some possible solutions to make possible improvements on a consensus. Those smokers will not be accused of their behaviors, but they are encouraged to adapt more favorable behaviors. Those non-smokers will hence act as facilitators of the new behaviors. Positive reinforcement given by non-smokers and senior officers will be applied to avoid making used of force. Autonomy of those participants will not be violated. The duration of the health promotion program will be about 3 months. Four different phrases will be seen during the whole program. Since most participants are not unfamiliar to possible consequences of long-term smoking, they are asked to explore their own understandings towards smoking though participating into group discussions. Firstly, health promoters will give participants chances to discuss their opinions towards smoking freely. More important, non-smokers are allowed to express their feelings about working in a smoky area. Some basic knowledge about the behaviors will be emphasized whenever it is required. Some published materials and guidelines will be distributed to all the participants for undergoing the discussion. Secondly, participants will be asked to form groups according to their own preferences. However, each group must consist of both smokers and non-smokers. They are requested to set up their own objectives about promoting health status of all group members. Certainly, smokers will then be advised not to smoke at the offices as far as possible. Meanwhile, each group should set their own schedule to monitor the progress. Rewards and other positive reinforcement should be decided to award those participants who can achieve the goals. Thirdly, each group will be met weekly to check progress of individuals. Those self-help groups should encourage those smoking participants for implementing their own plants. Some group members will act as facilitators to lead participants to reach their destinations. The physical responses of all those participants will be monitored closely. Any symbol of health problem will be located and reported. For instance, smokers will be checked whether they have kept their promises while no-smokers will be assessed according to their positive reinforcement delivered. This period will last for 2 months. Healthcare practitioners will provide assistance of all sorts for those participants. Say, they may recommend ways of cutting down smoking for those smokers. The results of each group will be announced and compared with one another. Whenever some smokers fail to compile to their schedules, healthcare practitioners will deliver interventions for putting back on their tracks. Health indicators of those participants will also be measured and recorded. Finally, awards will be given to all those successful groups at p.6 the end of the program. A health report of each participant will be written and sent to those participants. Those failed participants will be transferred to more specific program for quitting smoking. Senior officers of the department will present prized for those groups who achieve our objectives eventually. Follow-up investigations will be carried out several months after the program. Reminders of their achievements will be sent to each group so that the attainments can be sustained as long as possible. Obviously, concepts of HAM have been merged into the skeleton of the program. Self-esteem and self-concept of those smokers are being elevated at different stages of the program. Those smokers and non-smokers are being empowered simultaneously to exercise their rights for acquiring a better health. The establishment of groups may create a supportive circumstance. Smokers will be assisted to quit smoking while passive smokers are encouraged to monitor safety of their workplace. Unless outcome of a program is carefully assessed, its achievements or problems can hardly be made known, evaluation is a mean to assess achievements of some activities by comparing outcomes against a particular set of standards. According to those differences, outcomes can b measured on a logical basis (Red 1993,p. 199). In this program, four major aspects should be evaluated. Certainly, changes in beliefs, values, and actions of those participants should be the most important pointers of its triumph. Actual behavior changes can be observed at different stages during the program. According to those schedules set by each group, our team members can check progress of each group closely. Those group members will present all those relevant information to us as a proof of their achievements. Direct observations and written responses can hence be obtained. Secondly, understanding of those participants towards their roles in the program should be asked. The information helps us to decide whether a supportive circumstance has been created. If all participants are fully understood underlying meaning of the empowering process, it is more likely for them to sustain their attainment in the future. A self-administrative questionnaire will be distributed to all participants at the end of the program. Thirdly, collection and analysis of health indicators of all participants can illustrate how their health status has been improved. A series of tests will be performed to check health indicators such as BMI, blood pressure, pulse rates, and tidal volume. Although the program lasts only about three months, a significant improvement may be observed. Lastly, the percentage of successors should be counted. Both smokers and passive smokers can be regarded as successors if they accomplish their goals set at the very beginning of group formation. The representative of the department will assist us to collect the information as she need to count number of required award at the end. p.7 Obviously, completing the first categories of evaluation aids us to find out how well our term members have made used of the HAM. Only when health beliefs, values, and corresponding actions have been changed, no one can announce that potential of the model has been exploited. Besides, empowerment is the basic theme and foundation of our program. Both smokers and passive smokers need to be empowered enough to exercise their own rights (Ewles and Simnett 2003, p.95-97). Of cause, all health promotion programs aim to elevate health status of their participants. In general, health indicators of those participants can attain significant improvements. If no improvement has been observed, effectiveness of the program should be come questionable. Finally, health promotion program should be assessed according to its cost-effectiveness. It is clear that when more people have permanently changed their behaviors, the program can be announced as a more successful attempt. Since there are more than 100 people in the department, A higher percentage of success can efficiency of the program directly. Generally, those program that have reach out and convert the greatest number of participants will be considered the most valuable. Although it is necessary for a good program to be very cost-effective, the evaluation can still screen out those ineffective courses. p.8 Reference: Barker 2003 p.192 Ottawa Charter for Health Promotion in 1986 WHO (1980) WHO Chr., 34(2)80 1979 Health for all Wwlls 1988 Pender 1996 McKenzie Bartecchi, and Schrier 1994 Ewles and Simnett 2003 Mitchell, Kerridge & Lovat 1996 Johnstone 1999 Thompson, et al 2000 p.9