American Journal of Health Promotion

Current research has provided evidence that nearly 90 percent of all cancers may be related to diet, environment, and lifestyle. Of this number, 30 to 40 percent of cancers in men and up to 60 percent of cancers in women may be related to diet and nutrition. The two-stage process in the formation of many cancers, defined as initiation and promotion, is influenced by many dietary components. Vitamins C, E, and the mineral selenium are nutrients that function as antioxidants, reducing potential cancer-causing chemicals in the body. These natural anticarcinogens are thought to alter the cancer process and are currently under study for their cancer prevention properties. The functions, Recommended Dietary Allowances, food sources, research evidence for cancer prevention, and recommendations for supplementation are presented for these three nutrients. Research suggests that the proper and prudent use of nutrients, along with a healthy diet and lifestyle, may offer protection against this devastating disease.

Demographic, attitudinal, and behavioral differences between health fair attenders and a community comparison group were examined along with predictions of health promoting behaviors from demographic and attitudinal variables. Differences between questionnaire responses of 155 health fair attenders and 71 grocery shoppers indicated attenders perceived themselves having better current health and greater internal control of their health, and reported more behaviors indicating health responsibility, exercise, and nutrition than the comparison group. Psychological variables — particularly perceptions of greater self-efficacy and better health status — were the best predictors of attenders' health promoting behaviors; demographic variables were less important. On the other hand, demographic variables were most predictive of comparison group health promoting behaviors with psychological variables playing a lesser role. Further studies of relationships between the variables examined here and experimental studies of the effects of health fair attendance on health knowledge and performance of health promoting behaviors are needed. Assuming health fairs are effective in educating attenders, it was concluded that health fair planners should: 1) encourage nonattenders to become attenders and attenders to be repeat attenders, 2) carefully promote and advertise health fairs, and 3) hold health fairs in locations easily accessible to large numbers of people.

The Checkerboard Cardiovascular Curriculum (CCC) project was designed to develop a culturally-oriented educational program for reducing coronary heart disease (CHD) risk factors in rural American Indians and Hispanics in the state of New Mexico. Because so little information is available on children from these ethnic groups, the purposes of this paper are: 1) to describe and compare some physical characteristics of Hispanics and Navajo, Laguna and Acoma Indians which are associated with CHD risk factors; and 2) to assess the short-term effectiveness of the CCC in altering these CHD risk factors.

Body weight, height, blood pressure, one mile walk/run data, and triceps, subscapula, and calf skinfold thicknesses were collected for 97 boys and 79 girls from the four ethnic groups. Results of analyses of covariance (ANCOVA), controlling for age, indicated ethnic differences for all dependent variables. The average body mass index of all Indian children exceeded the median values reported in the second National Health and Nutrition Examination Survey (NHANES-II). The average sum of the triceps and subscapula skinfolds of the children from all ethnic groups failed to meet acceptable standards established by The National Children and Youth Fitness Study (NCYFS). The results of the CCC project suggest that these children are in need of health promotion and physical fitness programs that emphasize obesity and cardiovascular fitness and provide for ethnic and cultural differences.

A health promotion and wellness survey questionnaire was sent to all 143 accredited medical schools in the United States, Canada, and Puerto Rico. Of the 120 responding schools, 29 (24.2%) offer health promotion programs and 91 (75.8%) do not; most programs began only recently (average 5.42 years). Nineteen schools plan to begin programs soon. Most emphasized in the programs is physical well-being and least emphasized is spiritual well-being. Over 50% of the schools offer these components: study skills (62.1%), support groups (62.1%), time management (58.6%), aerobics (55.2%), intramural sports (55.2%), and financial planning (51.7%). Most programs are administered by the Dean of Student Affairs, 48.3% have a budget, and 51.7% have an evaluation component. All schools with programs expressed an interest in developing a network to share information. Emphasizing health promotion and disease prevention throughout medical education is important, particularly as an approach to enhancing the doctor-patient relationship.

A significant portion of the deaths in the United States could have been prevented or postponed using known interventions. One reason this did not occur is because medical science and medical education are disease, not health, oriented. Since physicians are at the center of the health care delivery system, their disease orientation pervades the industry. Historically, there have been calls for physicians to focus more on disease prevention; however, medical education does not teach disease prevention/health promotion.

There are several reasons for this: 1) medical school faculty conceptual discordance between “certainty” of curative disease vs. the “probability” of risk factor reduction; 2) gaps in the knowledge of effective interventions; 3) the concept that health promotion/disease prevention are outside the province of physicians; 4) the significant role of biomedical research grants on medical school funding; 5) the close association of medical education and the acute care hospital; and 6) the use of rote memory/lecture based teaching methods of traditional medicine vs. the problem-based learning necessary to teach disease prevention/health promotion.

Some medical schools have begun to use problem based learning and to introduce health promotion concepts. Widespread and long-lasting change requires support of the leadership in medical schools and the preventive medicine/public health community, and grant funding from state and federal sources to support research on medical education research and change.

This study investigates, in a case study setting, whether participation in the Kimberly-Clark Corporation Health and Weight Loss Program can be associated with reduced participant health care claims. A pretest, post-test comparison group research design is utilized to ascertain whether there have been any measurable health care cost savings for participants versus their non-participating matched employee counterparts. The significance of any measured differences is then tested through analysis of variance and analysis of covariance. In addition, results are reported from tests designed to assess whether any specific employee sub-populations appeared to differentially benefit from program participants in terms of reduced health care cost incurrence. Finally, tests are run to provide further assurance that those potential test subjects who were excluded from the final sample did not systematically differ from the final sample subjects.

This paper also illustrates, with references to the present study, the difficulties of adapting behavioral and social science research techniques to actual occupational health promotion settings.