Promoting participation in EHAPs (employee health and assistance programs) by those employees most in need of health improvements is important to increasing the effectiveness of these programs. Programs which are designed to reduce perceived barriers to participation and to meet the specific needs and interests of these employees have resulted in higher participation. The purpose of this investigation was to determine the extent to which demographics and perceived health status were associated with employees preferences and perceptions of EHAPs. This was done through survey analysis of four hundred and one employees of a municipal government. It was found that there were no significant differences in employees' anticipated use of these programs based on any of the demographic or perceived health variables studied with the exception of the variable "current frequency of exercise". However, different interests in program components were apparent among the various sub-groups of employees. There were also reported differences among the sub-groups for preferred program times and facilities. There were significant differences among some of the sub-groups in reported barriers to the use of EAPs and in reported comfort in exercising with fellow workers. It was also found that current frequency of exercise was significantly related to perceived health status. From these observations, recommendations for promoting participation among these sub-groups have been made. This research has added to the understanding of the differences between the various sub-groups of employees in terms of their preferences for EHAP components and the barriers they perceive toward participating in these programs. A better understanding of these factors as they pertain to employees in other workplaces may aid in the development of programs which better meet the needs of these employees, and hence, may increase their participation in EHAPs. / Education, Faculty of / Curriculum and Pedagogy (EDCP), Department of / Graduate

This study conducted an experiment with 139 staff volunteers from a suburban school district (K-12) who participated in an eight-week program of exercise, nutritional practices, and stress control measures. All participants were pretested and posttested for mental well-being and physical fitness. Two treatment groups set goals, wrote contracts, and met weekly to hear speakers and share experiences, and made weekly reports to a director of the project. One treatment group was provided with leaders who organized supporting activities; the other treatment group was divided into support groups without leaders. A third group was composed of individuals who did not participate in the formal program but were present in the schools where general wellness activities may have affected their health-related activities. The program produced significant changes in mental and physical health, whereas the informal influences on the third group produced no significant change in physical fitness but did, to a lesser degree, produce a significant change in the mental health of its members. Significant relationships were found between the level of health-related behavior sustained in the program and changes in mental and physical health; physical health levels and improvement were not found to be related to mental health levels or improvement. The levels of support produced significant results only when comparing treatment groups with the third group (that did not participate in the formal program); leader-led groups did not produce significantly different results from the leaderless groups. The description of the wellness program and the results of its use provide a model for school administrators who wish to improve the health and productivity of their staff. It also represents a method of introducing wellness into the school curriculum. Staff members become models for wellness and enthusiasts for the benefits of such programs.

Research is lacking on the efficacy of aggression management training programs based on clinical outcomes. This study examined the efficacy of an aggression management training on managing aggression and violent behavior at East Mississippi State Hospital (EMSH), an inpatient behavioral health program. This training, The Mandt System, replaced a previous training, Techniques for the Management of Aggressive Behavior (TMAB), which was considered to be non-replicable outside state facilities in Mississippi. This study should not be seen as a comparative study between The Mandt System and TMAB, but rather as an investigation into the effects of implementing The Mandt System as a new training at EMSH. The efficacy of The Mandt System was examined through 4 key variables: patient to patient incidents, patient to staff incidents, seclusion episodes and restraint episodes. Over a 6 year period, incidents of aggression and violence were identified by extracting archival data from incident reports. Archival data were examined 3 years prior to the implementation of The Mandt System and 3 years after the implementation of the training. The researcher found that the rate of patient to patient incidents decreased as well as the rate of seclusions and restraint episodes following implementation of The Mandt System training. The rate of the patient to staff incidents did not decrease. Effective training on the management of aggression is essential in decreasing aggressive and violent behavior. Nevertheless, these findings are difficult to validate due to a scarcity of research that is supported by evidence from randomized controlled studies. A review of the literature revealed that researchers do not give precedence to the study of aggression management training when dealing with aggressive behavior in inpatient behavior health settings. This is possibly due to the findings of Hage, Van Meijel, Fluttert, and Berden (2009) that research on the effectiveness of intervention strategies requires a more complicated study design and involves many methodological and logistical challenges. Although the results of this study suggest that this training can have a positive effect on aggression and violence, much more needs to be done to evaluate the effectiveness of aggression management training programs.

Background: Lifestyle-related chronic disease is the leading cause of mortality and morbidity in the United States, accounting for more than 63% of deaths. Minority communities experience a disproportionate burden of adverse health outcomes related to these diseases. Collaborative partnerships with faith-based organizations (FBO) present a unique platform to effectively implement lifestyle-related health programs, especially in minority communities. Studies have consistently recognized a growing need to improve FBO capacity and readiness to design, deliver, and sustain programs more effectively. Methods: This research includes three phases: 1) preliminary research to gain the perspective of FBO, community, health and research partners actively involved in development and implementation of a collaborative lifestyle-related faith-based health program and to further explore capacity and readiness factors; 2) formative research to develop, pilot, revise, and improve content, format, measures, and implementation of a mixed methods questionnaire, Capacity and Readiness Church Health Assessment (CRCHA), that will further identify and assess FBO organizational capacity and readiness to implement lifestyle-related health and wellness programs; and 3) culminating research to pilot the CRCHA with descriptive and statistical analysis of associations between church characteristics and health programming. Results: Phase 1: Eighteen of 31 capacity and readiness factors were collectively rated as extremely important to participant roles and partnership experience. Qualitative analysis further contextualizes these factors. Phase 2: The CRCHA comprises four major sections with thirteen subsections to gather information about factors, characteristics, and attributes deemed relevant to FBO organizational capacity and readiness. Phase 3: Churches of varying size and capacity successfully completed the CRCHA. Data indicate potential utility for individual churches for self-assessment and capacity and readiness building and for researchers to identify church characteristics most strongly associated with effective health programming. Implications: Exploration of capacity and readiness within a larger and more diverse group of FBO will help to further identify capacity and readiness factors to facilitate active FBO participation in the development and implementation of effective lifestyle-related health and wellness programs. Thus, FBO would be better positioned to actively lead and/or partner in faith-based health programs that address their community's most pressing health issues. / Ph. D.

This study is concerned with the problem of determining the types and characteristics of wellness programs presently offered by selected junior and community colleges throughout the United States. The purposes include (1) the investigation of the extent to which the six dimensional scheme of wellness, as developed by William Hettler, M. D. [Family and Community Health, May, 1980], has been implemented on the campuses of junior and community colleges and (2) an exploration of the validity of Hettler's model of wellness for these institutions. The study population sample is the membership list of the junior and community college section of the American College Health Association, which is a multidisciplinary professional organization for university and college health administrators. The specially designed survey instrument produced a 73 per cent response return. Response frequencies and percentages were gathered to show the current and anticipated prevalence of different types of wellness programs and the current and anticipated management related characteristics of wellness offerings in these college settings. Several open-ended questions also produced narrative respondent opinions.

This study was to determine if the importance assigned by health educators (judges) to components of corporate health promotion programs is the same as or different from program components most frequently offered by corporations for employees. This involved establishing a list of program components that judges felt were important for wellness programs and comparing this list with programs actually existing in polled corporations. A literature review was used to establish an initial list of program components. Thirty-eight judges returned questionnaires incorporating the list. A Spearman's rho and scattergram were used to test for correlations between judges' opinions and corporate practices. The report concludes that no correlation exists but that there is agreement among the judges polled that corporations should promote employee wellness programs.

Thesis (D.P.H.)--Boston University / PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you. / Introduction: How college undergraduates manage challenges with alcohol, drugs, tobacco, sex, stress, sleep, exercise, and diet can shape their current and future health habits and status. Health risk behaviors can result in outcomes that damage lives, threaten individual academic success, and jeopardize college retention. Online health education (e-Health) is an emerging intervention modality that offers cost-effective mass delivery of health information, with the potential for broad benefits. Questions remain regarding levels of student engagement with e-Health programs and the influence of demographic and personality traits on engagement. The purpose of this dissertation is to identify effective methods for measuring undergraduate engagement with health education websites and to assess differential website engagement and associated student characteristics. Methods: This study used a multi-method design involving all class years of full-and part-time students (18-24 years) at Wheaton College in Norton, Massachusetts. One hundred thirty-eight of the original209 study volunteers completed the baseline survey, accessed the study website, MyStudentBody (MSB), during the nine-week viewing period, and completed the post-engagement survey. Major categories of measurement included baseline measures of sociodemographic and psychobehavioral characteristics (predictor variables) and subsequent measures of website engagement including MSB utilization tracking data, and website engagement surveys (outcome variables). Cohorts of study and non-study students participated in post-study focus group discussions. Results: Findings showed rapidly declining website engagement over the nine-week access period and significant student non-engagement overall, despite regular use of incentive offers and email prompts. Quantitative findings showed no significant statistical associations between predictor and outcome measures. Qualitative data presented recurrent themes including factors that discouraged and encouraged participant e-Health program use. Conclusion: Further study is necessary to examine the potential predictors of undergraduate engagement in online health education. Study focus groups revealed patterns of student behaviors, beliefs, and preferences that can help explain content avoidance and point to student-centered strategies that can improve engagement in MSB and similar e-Health products. / 2031-01-01

Trata-se de um estudo de abordagem qualitativa sob a perspectiva socioantropológica, que teve como objetivo interpretar os significados do Programa de Ostomizados para os estomizados intestinais e familiares, em um município do interior paulista. Foram entrevistadas catorze pessoas, entre estomizados intestinais e familiares, com experiência de cadastramento no Programa de Ostomizados. A coleta de dados ocorreu no período de dezembro de 2010 a janeiro de 2011, na residência dos informantes. Utilizou-se o referencial metodológico do estudo de caso instrumental, do método do relato oral, com entrevista semiestruturada em profundidade, apreendendo-se os significados do Programa de Ostomizados para estes informantes, por meio da análise de conteúdo indutivo. Foram decodificados dois núcleos de sentidos denominados de \"Estomizado intestinal: busca e superação de barreiras para a resolução do problema de saúde\" e \"Cadastramento e atendimento no Programa de Ostomizados e mudanças na vida de pacientes e familiares\". A partir destes, construimos três núcleos temáticos: \"Estomizado intestinal: da acessibilidade aos serviços de saúde à concretude de sua condição\"; \"Assistência ao estomizado intestinal no Programa de Ostomizados\"; e \"Programa de Ostomizados: intermediação da identidade e da vida do estomizado intestinal e da família\". No primeiro núcleo temático interpretamos as dificuldades enfrentadas pelos estomizados intestinais no itinerário em busca da definição do diagnóstico, da internação e cirurgia, da assistência hospitalar e do encaminhamento para o Programa de Ostomizados. No segundo tema emergiram como principais aspectos o direito à aquisição de equipamentos e o aprendizado do autocuidado, a focalização da reunião bimestral como a principal estratégia, bem como a sua importância para os entrevistados. No terceiro tema abordamos a condição de ser estomizado intestinal como o principal foco de preocupação inicial, que ao longo do processo é substituído pelo direito de aquisição de bolsas coletoras, considerada condição imprescindível para a manutenção da vida cotidiana. Os significados do Programa de Ostomizados são construídos pelas experiências individuais, familiares, de acessibilidade e atendimento no sistema de saúde, das relações com os profissionais, além do acesso aos equipamentos, constituindo-se em um espaço cotidiano de reconquista da sua normalidade e de direito de cidadania. Acreditamos que este estudo poderá subsidiar o planejamento da assistência prestado a essa clientela, principalmente no que tange ao contexto vivido por essas pessoas, as dificuldades e as possibilidades, com ampliação do alcance de resultados neste Programa. / This qualitative and socio-anthropological study aimed to interpret the meanings of the Ostomy Program for ostomates and family members in a city of the interior of the state of São Paulo, Brazil. Fourteen people were interviewed including ostomates and family members, with the experience of registration in the Ostomy Program. Data collection occurred between December 2010 and January 2011, at the residence of the participants. It was used the methodological approach for instrumental case study of the method of oral reports, with in-depth semi-structured interviews, searching for the meanings of the Ostomy Program for these participants through inductive content analysis. Two groups of meaning called \"Intestinal ostomy: search and overcome of barriers to solving the problem of health\" and \"Enrollment and care in the Ostomy Program and changes in the lives of patients and families\" were decoded. From these, three thematic groups were identified: \"Intestinal ostomy patients: from accessibility to health services to the concreteness of their condition,\" \"Care to the intestinal ostomy patients in the Ostomy Program\", and \"Ostomy Program: mediation of identity and life of intestinal ostomy patients and family\". In the first thematic group, it was interpreted the difficulties faced by intestinal ostomy patients on the itinerary in search of definition of diagnosis, hospitalization and surgery, hospital care and referral to the Ostomy Program. In the second thematic group, the major issues were the right to acquire equipment and the learning of self-care, the focus of the bimonthly meeting as the main strategy as well as its importance to respondents. In the third thematic group, it was addressed the condition of being intestinal ostomy patient as the main focus of initial concern that throughout the process is replaced by the right to acquire collection bags, which was considered the essential condition for the maintenance of everyday life. The meanings of the Ostomy Program are built by the experiences of individuals, family members, and accessibility and care in the health care system, relationships with professionals, besides of the access to equipment, thus becoming an everyday space of reconquest of normality and right to citizenship. This study may help the planning of care provided to these clients, especially with regard to the environment in which these people live, the difficulties and possibilities, expanding the reach of this Program results.

Estima-se que aproximadamente 400 milhões de indivíduos sejam portadores crônicos do vírus da hepatite B no mundo. Quando incide em adultos, a doença apresenta elevada proporção de evolução para a cura, ao passo que na ocorrência de transmissão vertical, o risco de cronificação chega a 90%, aumentando muito a possibilidade de graves conseqüências para a criança, entre as quais cirrose e hepatocarcinoma primário. A possibilidade de triagem para a identificação das gestantes portadoras do vírus da hepatite B e a conseqüente adoção de medidas profiláticas – imunização ativa e passiva – permite a prevenção segura da transmissão vertical. Em 1999, o Programa do Pré-Natal da Secretaria Municipal da Saúde de Ribeirão Preto introduziu em sua rotina o screening para o HBsAg, com a finalidade de identificar as gestantes portadoras do vírus. Este trabalho objetiva estudar alguns aspectos referentes à hepatite B entre as gestantes atendidas pela Rede Municipal de Saúde, bem como realizar uma avaliação sistematizada do Programa do Pré-Natal. Para este trabalho foram criados dois grupos de gestantes. O primeiro formado pelas pacientes com primeira avaliação sorológica do Pré-Natal para aquela gestação, realizada no período de 01 de novembro de 2001 a 31 de outubro de 2002, com a finalidade de estimar a prevalência do HBsAg e também verificar a proporção de recém-nascidos, filhos de mães portadoras deste marcador, que receberam os cuidados preconizados para tal situação. Já o segundo grupo foi formado pelas pacientes, na mesma condição, avaliadas no período de 01 de julho de 2002 a 30 de junho de 2003, com a finalidade de também estimar a prevalência do HBsAg, bem como a proporção de portadoras do HbeAg e anti-Hbe. Os valores de prevalência do HBsAg encontrados foram os seguintes: para o primeiro grupo 0,5 (IC 95% : 0,3 – 0,7) e, 0,4 (IC 95%: 0,2 – 0,6) para o segundo. Verificou-se que em 25,0% dos 24 partos realizados no município não foram realizados os procedimentos de profilaxia preconizados como ideais, no que diz respeito à rapidez da solicitação de vacina e imunoglobulina. Isso foi devido, parcialmente, a deficiências na qualidade de registro das informações em diferentes instâncias. As proporções de portadoras do HBeAg e anti-HBe foram respectivamente 5,9% (IC 95%: 0 – 17,1) e 90,5% (IC 95%: 77,9 – 100). Este trabalho procura apresentar informações que sirvam de base para reflexões a respeito do fluxo de procedimentos do Programa do Pré-Natal, visando elevar sua efetividade e superar os obstáculos encontrados. / It is estimated that about 400 million persons are chronic carriers of the hepatitis B virus worldwide. When it occurs in adults, the disease shows high proportions of benign evolution, meanwhile in vertical transmission the risk of becoming a chronic carrier approaches 90%, elevating the possibilities of serious consequences to the child, including cirrhosis and primary hepatocellular carcinoma. The possibility of performing screening tests for the identification of pregnant women carriers of the hepatitis B virus and the consequent adoption of prophylactic measures – active and passive immunization – allow safe prevention of the vertical transmission. In 1999, the Pre-Natal Program of the Municipal Secretary of Health of Ribeirão Preto, SP, Brasil, included in its routine services the screening for the HBsAg, towards the identification of pregnant carriers of the virus. This study aims to look into some aspects referring to hepatitis B among the pregnants being attended by the Municipal Health Network, as well as perform a careful systematic evaluation of the Pre-Natal Program. In order to perform this study, two groups of pregnants were selected. The first one formed by those patients having had their first pre-natal serological evaluation done for that pregnancy during the period of November 1, 2001 until October 31, 2002, with the purpose of estimating the HBsAg prevalence and also to verify the proportion of the new-borns of HBsAg carriers that received the recommended care for that situation. The second group was formed by those patients on the same condition, evaluated during the period of July 1, 2002 until June 30, 2003, with the purpose of also estimating the HBsAg prevalence, as well as estimating the proportion of HBeAg and anti-HBe carriers. The HBsAg prevalences were the following: for the first group of pregnants 0,5 (CI 95% : 0,3 – 0,7) and 0,4 (CI 95%: 0,2 – 0,6) for the second one. It was verified that in 25,0% of the 24 births that happened in the city, the recommended care were not taken, when it comes to the prompt request of the specific vaccine and immunoglobulin. This fact was, partially, due to deficiency in the data files quality of the different institutions. The proportions of HBeAg and anti-HBe carriers found were, respectively, 5,9% (CI 95%: 0 – 17,1) and 90,5% (CI 95%: 77,9 – 100). This study intends to present data that can be the starting point towards reflections on the established procedures of the Pre-Natal Program, in order to increase its effectiveness and surpass the found obstacles.

Estima-se que aproximadamente 400 milhões de indivíduos sejam portadores crônicos do vírus da hepatite B no mundo. Quando incide em adultos, a doença apresenta elevada proporção de evolução para a cura, ao passo que na ocorrência de transmissão vertical, o risco de cronificação chega a 90%, aumentando muito a possibilidade de graves conseqüências para a criança, entre as quais cirrose e hepatocarcinoma primário. A possibilidade de triagem para a identificação das gestantes portadoras do vírus da hepatite B e a conseqüente adoção de medidas profiláticas – imunização ativa e passiva – permite a prevenção segura da transmissão vertical. Em 1999, o Programa do Pré-Natal da Secretaria Municipal da Saúde de Ribeirão Preto introduziu em sua rotina o screening para o HBsAg, com a finalidade de identificar as gestantes portadoras do vírus. Este trabalho objetiva estudar alguns aspectos referentes à hepatite B entre as gestantes atendidas pela Rede Municipal de Saúde, bem como realizar uma avaliação sistematizada do Programa do Pré-Natal. Para este trabalho foram criados dois grupos de gestantes. O primeiro formado pelas pacientes com primeira avaliação sorológica do Pré-Natal para aquela gestação, realizada no período de 01 de novembro de 2001 a 31 de outubro de 2002, com a finalidade de estimar a prevalência do HBsAg e também verificar a proporção de recém-nascidos, filhos de mães portadoras deste marcador, que receberam os cuidados preconizados para tal situação. Já o segundo grupo foi formado pelas pacientes, na mesma condição, avaliadas no período de 01 de julho de 2002 a 30 de junho de 2003, com a finalidade de também estimar a prevalência do HBsAg, bem como a proporção de portadoras do HbeAg e anti-Hbe. Os valores de prevalência do HBsAg encontrados foram os seguintes: para o primeiro grupo 0,5 (IC 95% : 0,3 – 0,7) e, 0,4 (IC 95%: 0,2 – 0,6) para o segundo. Verificou-se que em 25,0% dos 24 partos realizados no município não foram realizados os procedimentos de profilaxia preconizados como ideais, no que diz respeito à rapidez da solicitação de vacina e imunoglobulina. Isso foi devido, parcialmente, a deficiências na qualidade de registro das informações em diferentes instâncias. As proporções de portadoras do HBeAg e anti-HBe foram respectivamente 5,9% (IC 95%: 0 – 17,1) e 90,5% (IC 95%: 77,9 – 100). Este trabalho procura apresentar informações que sirvam de base para reflexões a respeito do fluxo de procedimentos do Programa do Pré-Natal, visando elevar sua efetividade e superar os obstáculos encontrados. / It is estimated that about 400 million persons are chronic carriers of the hepatitis B virus worldwide. When it occurs in adults, the disease shows high proportions of benign evolution, meanwhile in vertical transmission the risk of becoming a chronic carrier approaches 90%, elevating the possibilities of serious consequences to the child, including cirrhosis and primary hepatocellular carcinoma. The possibility of performing screening tests for the identification of pregnant women carriers of the hepatitis B virus and the consequent adoption of prophylactic measures – active and passive immunization – allow safe prevention of the vertical transmission. In 1999, the Pre-Natal Program of the Municipal Secretary of Health of Ribeirão Preto, SP, Brasil, included in its routine services the screening for the HBsAg, towards the identification of pregnant carriers of the virus. This study aims to look into some aspects referring to hepatitis B among the pregnants being attended by the Municipal Health Network, as well as perform a careful systematic evaluation of the Pre-Natal Program. In order to perform this study, two groups of pregnants were selected. The first one formed by those patients having had their first pre-natal serological evaluation done for that pregnancy during the period of November 1, 2001 until October 31, 2002, with the purpose of estimating the HBsAg prevalence and also to verify the proportion of the new-borns of HBsAg carriers that received the recommended care for that situation. The second group was formed by those patients on the same condition, evaluated during the period of July 1, 2002 until June 30, 2003, with the purpose of also estimating the HBsAg prevalence, as well as estimating the proportion of HBeAg and anti-HBe carriers. The HBsAg prevalences were the following: for the first group of pregnants 0,5 (CI 95% : 0,3 – 0,7) and 0,4 (CI 95%: 0,2 – 0,6) for the second one. It was verified that in 25,0% of the 24 births that happened in the city, the recommended care were not taken, when it comes to the prompt request of the specific vaccine and immunoglobulin. This fact was, partially, due to deficiency in the data files quality of the different institutions. The proportions of HBeAg and anti-HBe carriers found were, respectively, 5,9% (CI 95%: 0 – 17,1) and 90,5% (CI 95%: 77,9 – 100). This study intends to present data that can be the starting point towards reflections on the established procedures of the Pre-Natal Program, in order to increase its effectiveness and surpass the found obstacles.