Health-promoting university: the implementation of an integrated guidance post for non-communicable diseases (Posbindu PTM) among university employees

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Abstract

Non-communicable diseases (NCDs) remain a challenge globally and in Indonesia. Workplace environments may place employees at risk for NCD behavioral factors. This study aimed to develop an integrated guidance post for NCD (in Indonesian, ‘pos pembinaan terpadu penyakit tidak menular’ [Posbindu PTM] early detection among employees in one of the Indonesian universities. Posbindu PTM is a community-based program oriented towards promotive and preventive efforts to control NCDs where the community acted as change agents. We conducted a process evaluation based on a quantitative approach through a survey ( n = 313) and a qualitative method using in-depth interviews ( n = 12) to support our findings that Posbindu PTM was acceptable and feasible to implement in a university context. High participation in Posbindu PTM showed that the program could encourage the university employees to join NCD prevention strategies from early detection to counseling and referral. All participants positively accepted Posbindu PTM for its benefits to health, the flexibility of the program, and the quality service provided by cadres. A need-based program planning, commitment from university leaders, adequate human resources and facilitation, and cooperation between departments, the clinic, and local primary health center and health department determined the success of Posbindu PTM implementation. In contrast, external activities negatively affected participants to join Posbindu PTM. There is a need for more routine scheduling and online-based application to enhance the program’s performance. Posbindu PTM is essential for engaging employees with their health and may serve as a model for NCD prevention and control in similar settings. With Posbindu PTM implementation’s success, a further stage is required to empower and sustain the Posbindu PTM program towards health-promoting universities.

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Towards an Effective Health Interventions Design: An Extension of the Health Belief Model

Rita Orji, Julita Vassileva, Regan Mandryk (2012)

Introduction The recent years have witnessed a continuous increase in lifestyle related health challenges around the world. As a result, researchers and health practitioners have focused on promoting healthy behavior using various behavior change interventions. The designs of most of these interventions are informed by health behavior models and theories adapted from various disciplines. Several health behavior theories have been used to inform health intervention designs, such as the Theory of Planned Behavior, the Transtheoretical Model, and the Health Belief Model (HBM). However, the Health Belief Model (HBM), developed in the 1950s to investigate why people fail to undertake preventive health measures, remains one of the most widely employed theories of health behavior. However, the effectiveness of this model is limited. The first limitation is the low predictive capacity (R2 < 0.21 on average) of existing HBM’s variables coupled with the small effect size of individual variables. The second is lack of clear rules of combination and relationship between the individual variables. In this paper, we propose a solution that aims at addressing these limitations as follows: (1) we extended the Health Belief Model by introducing four new variables: Self-identity, Perceived Importance, Consideration of Future Consequences, and Concern for Appearance as possible determinants of healthy behavior. (2) We exhaustively explored the relationships/interactions between the HBM variables and their effect size. (3) We tested the validity of both our proposed extended model and the original HBM on healthy eating behavior. Finally, we compared the predictive capacity of the original HBM model and our extended model. Methods: To achieve the objective of this paper, we conducted a quantitative study of 576 participants’ eating behavior. Data for this study were collected over a period of one year (from August 2011 to August 2012). The questionnaire consisted of validated scales assessing the HBM determinants – perceived benefit, barrier, susceptibility, severity, cue to action, and self-efficacy – using 7-point Likert scale. We also assessed other health determinants such as consideration of future consequences, self-identity, concern for appearance and perceived importance. To analyses our data, we employed factor analysis and Partial Least Square Structural Equation Model (PLS-SEM) to exhaustively explore the interaction/relationship between the determinants and healthy eating behavior. We tested for the validity of both our proposed extended model and the original HBM on healthy eating behavior. Finally, we compared the predictive capacity of the original HBM model and our extended model and investigated possible mediating effects. Results: The results show that the three newly added determinants are better predictors of healthy behavior. Our extended HBM model lead to approximately 78% increase (from 40 to 71%) in predictive capacity compared to the old model. This shows the suitability of our extended HBM for use in predicting healthy behavior and in informing health intervention design. The results from examining possible relationships between the determinants in our model lead to an interesting discovery of some mediating relationships between the HBM’s determinants, therefore, shedding light on some possible combinations of determinants that could be employed by intervention designers to increase the effectiveness of their design. Conclusion: Consideration of future consequences, self-identity, concern for appearance, perceived importance, self-efficacy, perceived susceptibility are significant determinants of healthy eating behavior that can be manipulated by healthy eating intervention design. Most importantly, the result from our model established the existence of some mediating relationships among the determinants. The knowledge of both the direct and indirect relationships sheds some light on the possible combination rules.

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Health Promotion: An Effective Tool for Global Health

Sanjiv Kumar, GS Preetha (2012)

Health promotion is very relevant today. There is a global acceptance that health and social wellbeing are determined by many factors outside the health system which include socioeconomic conditions, patterns of consumption associated with food and communication, demographic patterns, learning environments, family patterns, the cultural and social fabric of societies; sociopolitical and economic changes, including commercialization and trade and global environmental change. In such a situation, health issues can be effectively addressed by adopting a holistic approach by empowering individuals and communities to take action for their health, fostering leadership for public health, promoting intersectoral action to build healthy public policies in all sectors and creating sustainable health systems. Although, not a new concept, health promotion received an impetus following Alma Ata declaration. Recently it has evolved through a series of international conferences, with the first conference in Canada producing the famous Ottawa charter. Efforts at promoting health encompassing actions at individual and community levels, health system strengthening and multi sectoral partnership can be directed at specific health conditions. It should also include settings-based approach to promote health in specific settings such as schools, hospitals, workplaces, residential areas etc. Health promotion needs to be built into all the policies and if utilized efficiently will lead to positive health outcomes.