Student voice could improve the effectiveness of sex education curricula, student input, however, is generally limited or totally absent in sex education development. This dissertation explores student content preferences in sex education curricula and how school officials can incorporate student feedback to ensure content is relevant, relatable, and reliable. Results also show that adolescents are in favor of receiving social media-delivered sex education from local health departments. To build an adolescent following and greater awareness about SNS accounts that disseminate sex education, participants suggested LHDs 1) inform intended audiences about products by building offline connections 2) use promotions to create awareness 3) emphasize price during giveaways, publicize free services and 4) use the right people to motivate others to follow accounts.

Hierdie navorsing het die bevordering van die regering se gesondheidsbevorderingsdoelwitte soos vervat in die Witskrif vir die Transformasie van die Gesondheidstelsel in Suid-Afrika, Kennisgewing 667 van 1997 (White Paper for the Transformation of the Health System in South Africa Notice 667 of 1997) ten doel. 'n Verdere doel was om die behoefte na beroepsgesondheidsbevorderende programme in geselekteerde beroepsituasies vanuit 'n verpleegkundige perspektief vas te stel. Die resultate van hierdie navorsing het aangedui dat daar wel 'n behoefte bestaan aan beroepsgesondheidsbevorderende programme in geselekteerde beroepsituasies. Hierdie behoefte is vasgestel deur middel van die literatuurstudie en deur die versameling van inligting deur middel van 'n opname. 'n Holistiese en bemagtigingsbenadering tot beroepsgesondheidsbevorderende, asook 'n gesondheidsbevorderende verplegingsbenaderingsraamwerk word voorgestel. Addisioneel word riglyne vir die ontwikkeling en implementering van beroepsgesondheidsbevorderingsprogramme asook 'n gesondheidsbevorderende verpleegopleidingsprogram voorgestel. Daar word aanbeveel dat gesondheidsbevorderende verpleegkunde ingesluit word in alle verpleegkunde praktyke en verpleegkunde kurrikula. Aanbevelings ten opsigte van toekomstige navorsing sentreer rondom 'n ondersoek na die huidige status van beroepsgesondheidsbevordering, navorsing met betrekking tot die gesondheidsbevorderende werkplek en kampus - wat alle belanghebbendes insluit - die status van gesondheidsbevorderende opleiding; en navorsing gelyksoortig aan hierdie een in ander streke van Suid-Afrika. Die skeiding tussen beroeps- en primere gesondheidsorg in werkplekke behoort ook ondersoek te word. / This research is aimed at furthering the health promotion and occupational health objectives of the government as is set out in the "The White Paper for the Transformation of the Health System in South Africa Notice 667 of 1997". The aim of this research was to determine the need for occupational health promotion programmes in selected occupational settings from a nursing perspective. The overall outcome of this research demonstrated that a need exists for occupational health promotion programmes in selected occupational settings. This was illustrated by the literature study and by the information collected through a survey. Three frameworks are proposed, namely a holistic approach to an occupational health promotion programme, an empowerment occupational health promotion approach, and a health promoting nursing framework. In addition, guidelines for the development and implementation of an occupational health promotion programme and a health promotion and health promoting nursing training programme are recommended. It is also recommended that health promoting nursing be included in all nursing practice and nursing training curricula. Recommendations for future research centred on the investigation of the present status of occupational health promotion, research regarding the health promoting workplace and campus that involves all stakeholders, the status of health promotion training, and research similar to this one in other regions of South Africa. The division of occupational health and primary health care in occupational health settings needs to be investigated as well. / Health Studies / M.A. (Advanced Nursing Sciences)

All children have the right to a safe school environment that promotes good health. The fact that children’s feeling of well-being is declining is a vital public health concern. Health promotion in schools can help to create an environment that fosters good health, and the Swedish school environment is in need of improvement. The main aim of the thesis was to examine the health promotion activities that have been performed in Karlstad municipality primary schools between 2006 and 2012, from different perspectives, focusing on the school environment. This thesis includes four studies. Studies I and II are qualitative, and are based on interviews with all school managers in a municipality and children’s suggestions for improvement, respectively. Studies III and IV are quantitative and feature a cross-sectional design based on a questionnaire that was distributed at different points in time. In study I the categories: ‘Organization and collaboration’, ‘Optimize the arena’ and ‘Strengthening the individual’ emerged as vital by the school managers in health promotion, to enable ‘Opportunities for learning and a good life’. In Study II, ‘Psychosocial climate’ and ‘Influence’ emerge by the children as essential to increase school satisfaction and improve social relations among peers. Study III shows that classmates’ characteristics and class composition were associated with different perceptions of the classroom climate. Study IV shows that the school environment improved during 2005-2011 in the project municipality schools, and compared to the other municipalities in the county. In sum, it is always important to endeavor to provide a health supportive school environment, as it is a vital prerequisite for children’s health, well-being and academic achievements. This thesis contributes to the field by showing what is needed to enhance future health promotion in Swedish schools from different perspectives, to improve children’s opportunities for learning and a good life. / All children have the right to a safe school environment that promotes good health. Health promotion in schools can help to create an environment that fosters good health. The aim of this thesis was to examine the health promotion activities that have been performed in Karlstad municipality primary schools, between 2006 and 2012 from different perspectives, focusing on the school environment. The results complement with new knowledge about how schools work with health promotion, and describe how school satisfaction and social relations might be improved, if children’s perspectives are considered in the planning of health promotion. The school environment has improved in the Karlstad municipality secondary schools 2005-2011, at both the municipality- and school level. The thesis contributes to the field of public health sciences, by showing what might be needed to further enhance school health promotion in Sweden and thereby improving schoolchildren’s opportunities for learning and living a good life.

published_or_final_version / Community Medicine / Doctoral / Doctor of Philosophy

ABSTRACT Background: Bolivia has a high child mortality rate and many children´s living conditions are inadequate. In order to reach the Millennium Development Goals non-governmental organizations play an important role when the governmental efforts are insufficient. ChildFund Bolivia works with the Early Childhood Development [ECD] program in order to reinforce the development, growth and health for children under the age of eight. Aim: The aim of this study was to illuminate factors that affect the care given by health workers working with the ECD-program in the urban area of La Paz, Bolivia. Method: An empirical study with qualitative method was performed, using participant observations with an ethnographic approach. The data was analyzed through inductive content analysis where different themes were developed. Results: The results are presented in five themes, Creativity, Different needs, Environment, Continuity and Love and passion. All five themes showed sign of significant health promotion strategies that conform to Nola Pender´s Health Promotion Model. Conclusion: This study illuminates how ChildFund’s health workers in La Paz care for children through the globally used ECD-Program. This contributes to the shared global objective to reach the Millennium Development goals by enhancing children´s opportunity to grow and develop.  Health workers cared for the children with multiple strategies within the common method of the ECD-program. Implications for clinical practice: The outcome of this study might give people better knowledge about similarities and areas of diversity in pediatric nursing care worldwide, hence enjoy better knowledge in global nursing. / SAMMANFATTNING Bakgrund: Barnadödligheten i Bolivia är hög och många barns levnadsförhållanden är otillfredsställande.  För att nå Millenium målen spelar icke-statliga organisationer en viktig roll då de statliga insatserna är otillräckliga. ChildFund Bolivia arbetar med Early Childhood Development-programmet för att införliva utveckling, tillväxt och hälsa för barn under åtta års ålders. Syfte: Syftet med studien var att belysa faktorer som påverkar hälsoarbetares omvårdnad då de arbetar med ECD-programmet i det urbana La Paz, Bolivia. Metod: En empirisk studie med kvalitativ metod har gjorts, baserad på deltagande observationer med en etnografisk ansats. Informationen analyserades med en induktiv innehållsanalys där olika teman arbetades fram. Resultat: Resultatet presenteras i fem teman: Kreativitet, Olika Behov, Miljö, Kontinuitet och Passion och Kärlek. Samtliga fem teman visade prov på betydande hälsofrämjande strategier som överensstämmer med Nola Penders hälsofrämjande model. Slutsats: Den här studien belyser hur hälsoarbetare hos ChildFund i La Paz ger omvårdnad till barn genom det globalt använda ECD-programmet. Detta bidrar till det gemensamma globala målet att nå Millenniemålen genom att förbättra barns möjlighet att växa och utvecklas. Hälsoarbetare använde ett flertal olika strategier för att ge barnen omvårdnad, samtliga giltiga för ECD-programmets metod. Klinisk betydelse: Studiens resultat skulle kunna ge sjuksköterskor bättre kunskap om likheter och olikheter inom pediatrisk omvårdnad världen över, och därmed även ökad kunskap om global omvårdnad.

The purpose of the study was to determine whether it was possible to predict the socio-demographic characteristics of physicians who adopt a new paradigm in medicine, wellness. A major objective of the research was to test the "marginal man" hypothesis. The literature suggested that there are at least three types of innovations: technological, organizational, and paradigmatic. Literature on the diffusion of innovations in medicine showed that high status physicians adopt technical innovations; more marginal, particularly young physicians and those of a liberal political orientation, most often adopt organizational innovations. Few studies dealing with paradigmatic innovations were found. Historical evidence supports the notion that family practitioners might be more accepting of the new paradigm. Physicians in Tucson, Arizona were surveyed concerning their attitudes and practices in the areas of health education and wellness, examples of the new paradigm in medicine. They were also asked about hospital-based health education services and competition between physicians and hospitals, examples of organizational innovation. The analyses revealed that family practitioners, women and government physicians were most supportive of wellness, affirming the research hypothesis and the "marginal man" hypothesis. The analysis also suggested that younger and more liberal physicians were more favorably disposed toward hospital involvement in health education. Liberal physicians were also not concerned about competition in health education service. These findings are similar to those found by other researchers of organizational innovations in medical care. Several methodological problems were noted, which render the findings suggestive rather than conclusive. The findings do suggest, however, that physician resistance to wellness will continue because of a medical paradigm conflict.

Otillräcklig aktivitet har blivit ett stort folkhälsoproblem i världen. Många människor är otillräckligt aktiva och ju mer stillasittande personerna är desto högre risk har de att drabbas av sjukdom. Syftet med studien var att undersöka vad som orsakar en otillräcklig fysisk aktivitet hos personer i åldern 40-75 år. Studien genomfördes som en integrativ litteraturstudie som hanterar både kvantitativ och kvalitativ forskning. Resultatet grundar sig på tolv artiklar och presenteras under fem teman: beteendemässiga faktorer, konkurrerande krav, upplevda hinder, situationsspecifika aspekter och personliga faktorer. Inställningen till fysisk aktivitet grundar sig bland annat på personernas uppväxt och tidigare erfarenheter. Många saknar kunskap om aktiviteternas positiva effekt på hälsan och vid avsaknad av uppmuntran och stöd riskerar personerna att bli otillräckligt aktiva. Orsaker till otillräckligt aktivitet var bland annat bristen på tid som istället ägnades åt familj och arbete samt bristande tillgänglighet till träningsanläggningar. Personer som tidigare har upplevt positiva hälsoeffekter och får stöd har lättare att genomföra en hälsoförändring. Stödet kan utgöras av hälsosamtal som kan inge trygghet hos personen och öka sannolikheten att en förändring genomförs. För att kunna motivera till hälsoförändring är det viktigt att distriktssköterskor har kunskap om vad som orsakar att människor är otillräckligt aktiva. / Insufficiently activity has become a major public health problem throughout the world. Many people are insufficiently active and the more sedentary individuals are, the higher risk that they will suffer from a disease. The aim of this study was to investigate the causes of an inadequate physical activity among people aged 40-75 years. The study was conducted as an integrative literature review that handles both qualitative and quantitative research. The results are based on twelve articles and presented under five themes: behavioral factors, competing demands, perceived barriers, situational aspects and personal factors. Attitudes towards physical activity are based on people's upbringing and past experiences. Many lack knowledge about the positive effects of physical activity and, when coupled with a lack of encouragement and support, there is a risk that people will be insufficiently active. One of the primary reasons for insufficient activity was lack of time which was otherwise devoted to family and work. People who have experienced health benefits and receive support have an easier time implementing a healthy change in their level of physical activity. This support can take the form of health talks which foster a sense of security for the person and increase the likelihood that a positive change is implemented. To motivate improved health, it is important that district nurses have a good background  knowledge as to the common reasons why people are insufficiently active.

Introduction The Swedish Work Environment Authority has developed a new guideline that gives employees a great responsibility to promote a good working environment and prevent ill health among their employees. The reason that these guidelines have been developed is that illness among employees at work in Sweden has increased. Background At a workplace in a medium sized city in Sweden a group of employees was offered to participate in a health promotion intervention. The goal of the intervention was to give the employees the best conditions for prosperous health and a chance to improve their lifestyle, if they had a need for it. With the help from a coach, the employees worked in groups and individually in areas such as stress, nutrition, physical activity, ergonomics and mental health, and it was the individual´s needs and interests that guided the entire process. The aim of the study was to examine what the participants experienced when participating in a workplace intervention with focus on health promotion. The method used in the study was a semi-structured interview with four participants, both men and women aged twenty five to sixty three, which were subsequently analyzed through a qualitative content analysis. The result showed that the workplace as an arena was of great importance for the individuals. It was perceived as positive that the intervention took place during work hours, otherwise it would have been doubtful that the participants would have participated. It was important for the individuals to discuss the process they went through with their colleagues. However, all participants experienced a sense of shame and did not want to share their inner thoughts with their colleagues. It turned out to be difficult to formulate their individual goals, their focus was instead on what others expected from them. The conclusion was that fear of failure among the participants was the reason why they did not want to share their individual goals with their colleagues. In order to continue to feel motivated for a change in life style, the support from the coach and colleagues was necessary. / Inledning Arbetsmiljöverket i Sverige har tagit fram nya riktlinjer där arbetsgivaren har fått ett större ansvar att främja en god arbetsmiljö och förebygga ohälsa hos sina anställda. Anledningen till att dessa riktlinjer utformats är att ohälsa bland anställda på arbetsplatser i Sverige har ökat. Bakgrund På en arbetsplats i en mellanstor stad i Sverige erbjöds en grupp anställda att delta i en hälsofrämjande intervention. Målet med interventionen var att ge personalen de bästa förutsättningar till välmående och en möjlighet att förbättra sin livsstil, om de upplevde ett behov av det. Med hjälp av en coach fick de anställda arbeta i grupp och individuellt inom områden såsom stress, näringslära, fysisk aktivitet, ergonomi och mental hälsa och det var individens behov och intresse som styrde processen. Syftet med studien var att undersöka hur deltagarna upplevde att det var att delta i en arbetsplatsintervention beträffande hälsofrämjande insatser. Metoden för studien var semistrukturerade intervjuer med fyra deltagare, både män och kvinnor i åldrarna tjugofem till sextiotre år gamla, som sedan analyserades med hjälp av en kvalitativ innehållsanalys. Resultatet visade att arbetsplatsen som arena var av stor betydelse för individen. Det upplevdes positivt att interventionen pågick under arbetstid annars hade det varit tveksamt om deltagarna skulle ha deltagit. Det var viktigt för deltagarna att diskutera processen som man genomgick tillsammans med sina arbetskamrater. Däremot upplevde samtliga intervjuade en känsla av skam som man inte gärna ville dela med sig av till sina arbetskamrater. Att formulera sina individuella behov var till en början svårt för alla då de fokuserade mer på vad andra förväntade sig att de skulle åstadkomma. Slutsatsen är att rädslan för att misslyckas gjorde att de inte villa dela med sig av sina individuella målformuleringar till sina arbetskamrater. För att deltagarna skulle känna motivation för en livsstilsändring så var stödet från arbetskamrater och coach positivt.

Esta pesquisa teve o objetivo de analisar os cuidados de crianças nascidas prematuras egressas de unidades neonatais, com foco nas perspectivas maternas sobre as necessidades essenciais e de atenção especial de saúde, em uma região brasileira de fronteira. Estudo misto, com análise quantitativa de informações em saúde de 951 prontuários de prematuros hospitalizados entre 2013 e 2017, utilizando-se testes estatísticos dos programas IBM SPSS Statistics versão 25 e R i386 versão 3.4.0; e abordagem qualitativa como eixo central, na perspectiva da hermenêutica filosófica, realizada a partir de quatro encontros com 18 mães de crianças prematuras egressas de terapia intensiva neonatal. O primeiro encontro aconteceu no hospital, para caracterizar crianças/famílias e classificar Crianças com Necessidades Especiais de Saúde (CRIANES), aplicando-se o roteiro \"Triagem CRIANES\", utilizado nas quatro etapas do estudo; a seguir, visita domiciliar, realizada após 15 dias da alta hospitalar, com entrevista em profundidade; dois contatos telefônicos ou por mensagem de texto instantânea (30 dias após a visita e aos seis meses de idade da criança). Oportunizaram-se novos encontros/contatos a partir das necessidades das mães. Elegeu-se para a análise, a interpretação de sentidos. A coleta de dados ocorreu em Foz do Iguaçu-Paraná-Brasil, entre julho de 2017 e maio de 2018. Os resultados mostram que o nascimento prematuro representou 10,3% e 43,3% necessitaram hospitalização. A prematuridade foi maior para mães argentinas. A idade média materna foi 27,2 anos, peso ao nascer 1.700g, idade gestacional 31,5 semanas, período de internação 23,1 dias, e diagnóstico de problemas pulmonares. A mortalidade apresentou uma média de 21,3%. O menor número de consultas pré-natal, intercorrências maternas, Apgar de 5º minuto abaixo de sete e complicações com o bebê foram correlacionados ao aumento dos dias de hospitalização. O menor peso ao nascer, menor idade gestacional, índices de Apgar de 1º e 5º minuto inferiores a sete e complicações aumentaram as chances de óbito. No tocante aos cuidados maternos, apreendeu-se que a interação entre mãe e filho se fortalece no processo de cuidar em domicílio, e são apontadas dificuldades para compartilhamento e aprendizado no hospital. As mães salientam fragilidades no preparo para cuidar, identificam os bebês como frágeis e pequenos, buscam atender as necessidades essenciais do filho pelo reconhecimento da relevância de um bom desenvolvimento e do entendimento das práticas de estimulação nos momentos do cuidado cotidiano. Consideram primordiais o aleitamento materno, afeto e seguimento à saúde para bom desenvolvimento. A falta de oportunidades institucionais para amparar o cuidado domiciliar repercutiram em desatenção no âmbito hospitalar e na atenção primária. As mães encontram dificuldades no reconhecimento de necessidades no hospital e manifestam preocupação com a saúde dos bebês após a alta e com sequelas advindas das complicações. As necessidades de \'uso de serviços\' e \'dependência medicamentosa\', foram reportadas para quatro crianças. Visitas domiciliares e contatos telefônicos foram considerados relevantes, indicativos de potencialização de apoio ao cuidado domiciliar. Compartilhar informações, reconstruir experiências e favorecer o diálogo são aspectos importantes para proporcionar confiança e autonomia para o cuidado no domicílio e incrementar a atenção às necessidades da criança prematura / This study aimed to analyze the care of children born prematurely in neonatal units, focusing on maternal perspectives on essential needs and special health care in a Brazilian border region. Varied study, with quantitative of health information from 951 medical records of premature hospitalized between 2013 and 2017, using statistical tests provided by IBM SPSS Statistics version 25 and R i386 version 3.4.0 programs; and qualitative approach as central axis, in the perspective of philosophical hermeneutics, realized from four appointment with 18 mothers of premature children who were hospitalized from intense neonatal therapy. The first appointment happened in the hospital to characterize the children/family and classify Children with Special Health Care Needs (CSHCN) applying the script \"Screening CSHCN\" using in the four stages of the study; next, home visit, realized after 15 days of discharge, with in-depth interview; two phone contacts or by instant message (30 days after the visit and six months of age of the child). It has become available new meetings/contacts from the maternal needs. The sense interpretation was elected for analysis. The data collection happened in Foz do Iguaçu- ParanáBrazil, between July 2017 and May 2018. The results shown that the premature born represented 10.3% and 43.3% needed hospitalization. The maternal mean age was 27,2 years, birth weight 1.700g, gestational age 31,5 weeks, hospitalization period 23,1 days and diagnosis of pulmonary problems. Mortality presented an average of 21.3%. The lower number of prenatal consultations, maternal complications, Apgar scores of 5 minutes below seven and complications with the baby were correlated with the increase in the days of hospitalization. The lower birth weight, the lower gestational age, Apgar scores of first and fifth minutes less than seven and complications increases the death chances. Regarding maternal care, it was found that the interaction between mother and son strengthened in the process of home care, and difficulties were identified for sharing and learning in hospital environment. The mothers accentuate fragilities in the preparation to care, identify the babies as fragile and small, search to meet the essential needs of the child for relevance recognition of a good development and the understanding the practices of stimulation in the moments of daily care. Breastfeeding, affection and health follow-up for good development are considered paramount. The lack of institutional opportunities to support the home care had repercussions about inattention in hospitable scope and primary care. The mothers find difficulties in recognition of needs in the hospital and manifest concern about the health of their babies after discharge and with sequels due to complications. The needs of \"use of service\" and \"medicine dependency\" were reported relevant for four kids. Home visits and phone contacts were considered relevant, how indicative of potentialization of support for home care. Sharing information, rebuild experiences and favor dialogue are important aspects to provide confidence and autonomy for home care and increase the attention to the needs of the premature children

Government’s major challenge is to become more effective with limited resources. Perceptions of state employees and the level of awareness about Employee Health and Wellness Programmes is a policy issue that this study attempts to understand inasmuch as it relates to performance of institutions. The objectives of the study were to gauge the level of awareness about Employee Health and Wellness programmes together with the perceptions of employees about the programme, in line with the hypothesis that suggested a contributory link between level of awareness, perceptions about a programme and organisational performance. A mixed method approach was used, which included both qualitative and quantitative methods, to determine both perception and level of awareness as it related to the performance of institutions. The study found that wellness programmes, if well managed and employees were made aware of them, could lead to increased output by employees, thus improving performance. It further established that there is an average level of awareness about employee health and wellness programmes within Public Works. The study concludes that the perceptions of employees about a policy matter and their level of awareness of programme objectives would contribute to overall performance of that institution.