Health Promotion Practice

Substance use by adolescents is a growing public health problem, especially among youth in low-income neighborhoods. School-based substance use prevention programs can be effective but are compromised by the alcohol, tobacco and other drug (ATOD) messages that saturate the community environments. The Teen Activists for Community Change and Leadership Education (TACCLE) program engaged ethnically diverse high school students from low-income communities in advocacy activities that addressed environmental influences related to ATOD in their schools and communities. The intervention took place during the 1996-1997 school year and involved 116 students in the 9th and 10th grades at six sites. Using social learning and empowerment theories, teens identified an ATOD advocacy issue on which to focus. The program succeeded in engaging teens from at-risk communities in advocacy projects that successfully modified negative ATOD influences in their schools and communities. Ten guiding principles and their implications for practitioners are presented and discussed.

Few studies in the literature describe how to combine quantitative and qualitative methods to enhance the development of health education interventions. This article describes the evolution and refinement of an innovative disease management program “take PRIDE” for older adults with heart disease. Over 15 years, information obtained from data collection methods including telephone interviews, focus groups, face-to-face interviews, and program process data illuminated and guided subsequent refinement of the program and led to new iterations for different participants. Qualitative and quantitative data were incorporated into the two key areas of program development (theoretical framework, objectives, format, and content) and evaluation (evaluation design, sampling, and measurement). Combining both types of data enhanced the opportunity to detect needed program changes, to increase understanding of the mechanisms by which the program effects were produced, and to enhance the relevance of the program to different groups of program participants.

Prevention-based activities and other Certified Health Education Specialist (CHES) skills are currently in demand in managed care organizations. An important set of roles for managed care that requires select health education skills continues to emerge through the National Committee for Quality Assurance (NCQA) and the Health Plan Employer Data and Information Set^® (^HEDIS®). This article identifies expanded roles for health educators in managed care organizations by comparing CHES responsibilities to HEDIS^® and NCQA standards. The responsibilities for CHES in relation to both HEDIS^® and NCQA are complementary. These health education functions within managed care are clearly associated to the responsibilities of certified health education specialists and quality assurance managers. To increase marketability and collaboration with clinical staff, professional health educators must be trained to perform key health education functions that relate to the practice roles of managed care organizations. Specific recommendations for professional preparation and professional practice are discussed.

University health educators have long promoted comprehensive school health programs. Faculty members in other disciplines can also provide support and assistance. Successful collaboration between colleges and universities and public schools requires understanding the expectations and needs of faculty members and administrators in each setting. This article presents important barriers and opportunities related to successful school health partnerships between public schools and higher education. Fourteen Prevention Research Centers participated in a project funded by the Centers for Disease Control and Prevention. The purpose was to study innovative partnerships to identify practical methods for higher education to work with public schools to improve the health of young people. This article includes selected results of the project and related recommendations for partnership activities. Specific examples illustrate the importance of gaining the trust and support of gatekeepers. The intent of the authors is to provide guidance to others interested in establishing collaborative partnerships.

This article describes the process and results of an effort to develop an outcome measurement system for evaluating and improving hospital-based wellness programs and services. The authors defined a set of outcome measures for each of the wellness programs and services offered by the hospital and piloted health-related outcome and patient satisfaction measures in the following four different types of programs: (a) a disease screening program (osteoporosis), (b) an educational program (diabetes), (c) an instructional participatory program (yoga and tai chi), and (d) a behavioral intervention program (group weight loss). These programs were chosen to represent the array of wellness programs and services available at the hospital. Results are reported for each pilot test, and recommendations are offered for dealing with issues and challenges encountered in developing a system for measuring wellness program performance.

The effects of a wellness education presentation on body image were investigated. Fifty-seven college men and women completed two questionnaires on body image; one before and one after undergoing skinfold measurement. The participants were divided into two groups: (a) receiving a wellness education program after being assessed, and (b) not receiving a wellness education program after being assessed. The data were analyzed with a multifactor randomized ANOVA. The body-image scores of noneducation group decreased significantly, with no difference between the sexes. The body-image scores of the education group did not decrease significantly for either gender. This study indicated that wellness education incorporated into body composition testing could minimize the negative effects of body composition knowledge on body image.

The purpose of this paper is to describe a community-based participatory process of developing computer tailored messages (a form of technologically advanced health education materials) within a community-based lay health adviser program. This process included: 1) identifying the desired characteristics of the health education materials, 2) prioritizing the content and format of the health education materials, and 3) developing methods for distributing these materials. An overview of the lay health adviser program is presented, followed by a description of how each step was taken, a review of the health education method chosen (computer-tailored messages), and a discussion of the challenges and benefits of using community-based participatory processes to bring appropriate technology to communities.