Health authority administrators were interviewed for their perspectives on what makes a good health care system; on tailored population-specific services as a way to address health inequities; and on how they perceive themselves to be making good funding decisions on the public’s behalf. The qualitative descriptive research dataset includes 24 hour-and-a-half long interviews with administrators from four BC health authorities, health region documents, memos, and field notes. Participants support the continuation of a public health care system and all participants acknowledge using tailored services as a route towards reducing health inequities. However, these identified services have not been evaluated for their overall effectiveness. When it comes to decision-making, participants describe using a series of governance and bioethical principles that help them frame what and how issues can be considered. Decision situations are framed in a way that informs them whether they need to use formal or informal processes. In both cases participants collect information that allows others to understand that they have made wise decisions. The Recognition-Primed Decision Model accurately reflects the intuitive processes that participants describe using during informal decision-making and portions of formal decision-making. However, in relation to formal decision situations, there is less alignment with existing Decision-Analysis literature. Seven practice and future research recommendations are provided: 1. Increase health authority participation in intersectoral partnerships that address non-medical determinants of health. 2. Develop new strategies for addressing health inequities. 3. Evaluate the efficacy of using tailored services beyond their ability to remove barriers to access. In addition, increase focus on testing new strategies for reducing the inequities gap. 4. Enhance existing decision-making processes by including the explicit review of decision tradeoffs, value weighting, and mechanisms for requesting revisions. 5. Focus future research on developing and evaluating the usefulness of formal decision-making tools in health authority structures and their relation to decision latitude. 6. Launch a longitudinal research study that examines how health authority expert decision-makers use judgmental heuristics and how they avoid the negative effects of bias. 7. Commission public dialogue on shifting the current illness-based system to one that is wellness based.

Introduktion: En fysiskt aktiv livsstil är förenlig med många positiva hälsoeffekter hos både vuxna och ungdomar. Dessutom är upplevelsen av fysisk aktivitet i ungdomsåren en viktig parameter för en fortsatt fysiskt aktiv livsstil i vuxen ålder. Dock finns en stor grupp ungdomar som inte når rekommendationerna för fysisk aktivitet. Samtidigt anses ökad delaktighet, tillgänglighet och möjligheter till egna val vara viktiga aspekter för att ungdomar ska bli fysiskt aktiva. Syfte: Syftet med föreliggande studie är att undersöka vilka idrotts- och motionsanläggningar som ungdomar vill att det satsas på. Metod: Studiens design är en tvärsnittsstudie, där underlaget består av en enkätundersökning innehållandes 2,404 skolungdomar. Enkätunderlaget införskaffades inom projektet ”Ung livsstil” i Stockholms stad. Urvalet för denna studie består av skolungdomar i stadsmiljö och fokus var på vilka anläggningar för utövande av fysisk aktivitet som ungdomar ansåg att deras kommun ska satsa på. Enkäten innehöll dessutom bakgrundsfrågor om respondenternas aktuella fysiska aktivitetsnivå, föreningsmedlemskap, kön, invandrarbakgrund, socioekonomiska levnadsförhållanden och ålder. Resultat/Diskussion: Bland de mest frekvent valda anläggningarna finns fotbollsplan, sporthall, äventyrsbad, simhall, gym och bowlinghall. Det tydliggörs också att ungdomarnas önskan, av vilka satsningar de vill se, skiljer sig mellan olika sociala grupper. Det förefaller att bakgrundsfaktorerna kön, skolstadier, grad av motion och invandrarbakgrund har ett samband med ungdomarnas val, samtidigt påvisas endast ett fåtal samband med socioekonomisk bakgrund. / Introduction: A physically active lifestyle is compatible with many health effects benefits for both adults and adolescents. Moreover, physical activity in adolescence is an important parameter for a continued physically active lifestyle in adulthood. However, many young people do not meet the recommendations for physical activity. Empowerment, accessibility and opportunities for their own choices are important aspects for young people to become physically active. Purpose: The purpose of the present study is to investigate which sports- and recreation facilities young people prefer and would like to see developed. Method: The design is a cross-sectional study, in which the base is a survey that covers 2,404 school children in an urban environment. The focus was on which facilities for physical activity young people felt their municipality should focus on. The questionnaire also contained background questions about the respondents’ current physical activity levels, sports club memberships, gender, immigrant background, socio-economic conditions and age. Results/Discussion: The young people most frequent selected the football field, bowling alley, gym, indoor swimming pool, sports hall and water park as their preferred exercise facilities. It is also evident that young people´s preferences for particular facilities differed among different social groups. The background factors of gender, age, physical activity and immigrant background are related to young people´s choices. At the same time, only a few choices were related to socio- economic background.

Non-governmental organizations (NGO) in Lithuania are new juridical subjects in its sovereign society, a new expression of the civic community. As there is no any detailed and classified data base made for the Lithuanian NGO yet, it is difficult to find out what organizations are engaged in health promotion, and to determine the effect of this activity on the Lithuanian health service sector and how NGO programmes and services complement the governmental sector’s activities. Aim of the study: Evaluation of the structure, functions and the role in public health promotion of the existing Lithuanian NGO. Objectives: 1. To determine the functions, work scope and finance principles of the health NGO. 2. To evaluate the sociodemographic characteristics of the managers of health and other NGO, their knowledge and awareness concerning the national health policy, the value of public health promotion for the region population. 3. To define the involvement of the health NGO in the formation of the public health policy. 4. To explore the cooperation of the health NGO with other NGO, offices, partners. Methods. Questionnaires filled by the existing Lithuanian organizations and their managers. 409 questionnaires were sent by post. 157 answers were received. It means a very low activity of the respondents. Inquiry by post was made twice. The first inquiry by random sampling of 200 organizations resulted in only 84 answers (42% of all questionnaires... [to full text]

According to several studies, there have been improvements in adolescent sexual behaviour; declining adolescent pregnancies, fewer adolescents having more than one sexual partner, and an increasing numbers of adolescents using contraceptives. Notwithstanding these improvements, there are concerns regarding adolescents’ sexual health including adolescents’ limited knowledge of sexual health issues, high rates of sexually transmitted infections and the need to eliminate barriers to adolescent sexual health services. The purpose of this study was to explore adolescents’ perceptions of the facilitators and barriers to the promotion of healthy sexuality of adolescents living in PEI. A qualitative descriptive design guided by CST and a socio-ecological framework was used to explore participants’ perceptions. Six female high school students, 16-18 years of age, participated in a face-to-face semi-structured interview followed by a second face-to-face follow up interview. Seven themes emerged from the data that was analyzed through thematic analysis: The Illusion of Accessible Resources; Risky Behaviours; Peer Pressure Alive and Well in High School; Cyberbullying; Parental Influence on Adolescent Decision Making; Inefficient and Underutilized School Health Resources; and Inefficient and Underutilized Community Health Resources. While it is evident that some promotion of healthy sexuality of adolescents is occurring in PEI, more investigation and development is needed to better support adolescents with comprehensive school services including guidance and education. The results of this study can be used to guide this future development.

Nature positively affects the physical, mental, emotional, and spiritual wellbeing of all people. In the natural environment, fresh air, daylight, organic materials and plant life exist in harmony. When we come into contact with this harmony, it provides a calming effect and have a direct positive impact on people undergoing cancer treatment, as well as patients’ families and friends, and the doctors, nurses and caregivers whose job it is to care for them. This thesis explores specific architectural interventions to an existing hospital that would provide a complementary healing environment to increase health and reduce stress. Using the Cross Cancer Institute in Edmonton as a project site, this design shows how we might provide therapeutic spaces and gardens to promote holistic healing of the mind, body and spirit.

The Canadian healthcare system has become increasingly decentralised as a result of neoliberal policy leanings. Many responsibilities have shifted from federal to provincial to regional health authorities. As a result of their heavy workloads and strained budgets, these regional health authorities have begun striking up new community partnerships. This thesis examines the role that lay institutions play within the Canadian healthcare system via a case study of Dalhousie University’s handling of the 2009/2010 H1N1 pandemic. Document analysis and participant interviews reveal how the institution worked to protect the health of its population, why it was inclined to take on this responsibility, and how doing so impacted the everyday work of Dalhousie University employees. Based on this case study, the thesis argues that the capacity of lay institutions and their employees to respond to health crises is likely to depend on a number of factors, which has important public health implications.

Objective: Assess the effectiveness of an ecological approach to promote healthy food choices in early childhood education through an educational workshop series. Design: Utilizing play-based learning, the workshops emphasized an ecological approach to health and food choice by letting children explore and experience healthy foods through various play-based and experiential activities. Data were collected and analyzed using grounded theory of semi-structured interviews with children, parents, and early childhood educators (ECEs), thematic analysis of children’s drawings, and quantitative food preference and food categorization surveys conducted with the children. Setting: The work was undertaken in three YMCA child care centres located in the Greater Toronto Area: Newcastle, Unionville, and inner-city Toronto. Participants: Participants comprised of 19 children, 5 parents, and 9 ECEs. Conclusions: The ecological approach to the promotion of healthy food choices in early childhood education was demonstrated to be an effective health promotion strategy for children aged 3 to 5.

The concept of health promotion is an alternative and emerging orientation. Here the belief is that all people have strengths and are capable of determining their own needs, finding their own answers, and solving their own problems. Most health care professional have been educated in the medical model of health. In this model, the health care professional, especially the physician, plays an active part as an expert on disease; the patient or client has essentially a passive role, and the disease rather than the person is the focus. The role of health care professionals in health promotion is an important one and will continue to expand with the new focus of the province of Alberta's health system. The focus of that system, and other health systems in Canada and abroad, is increasingly upon health promotion rather than disease treatment. The purpose of this study was to determine the perceptions of a variety of health care professionals working in the community and in the hospital setting relating to health promotion. The study takes a non-experimental approach utilizing a descriptive design. All professional staff including registered nurses, occupational therapists, recreational therapists, physiotherapists, respiratory therapists, social workers, dental workers, nutritionists, speech-language pathologists, and physicians working in Palliser Health Authority were asked to participate in the survey. Two hundred and thirteen staff responded to a questionnaire desgined to reflect their perceptions on the importance of health promotion, determinants of health, principles of health promotion, and skills and knowledge of health promotion. Staff were also asked to identify health promotion activities occuring at their work site, possible barriers to health promotion, and what was needed regarding training and support. Some of the major findings include: 1) Staff perceive health promotion to be an important part of their job. However staff working in the community perceive health promotion to be more important than those working in the hospital. Physicians were the least positive about questions pertaining to the importance of health promotion. 2) Staff perceive that the purpose of health promotion is to strengthen peoples' control over their health, but responses also indicate uncertainty concerning how control is to be defined and effected. 3) When asked to identify health promotion activities at their work site, the majority of staff pointed to the provision of information to individuals and groups. Community development was listed by very few staff. 4) When staff were asked to identify barriers to health promotion they identified the following in the order: lack of resources, old attitudes about health and health promotion, lack of support from the organization and doctors, lack of knowledge/education, and lack of communication between health care workers. / v, 101 leaves : ill. ; 28 cm.

This study explored the effectiveness of Handle With Care, a mental health promotion training program for child care practitioners working with children between birth to age 6. Handle With Care program content is based on research evidence. Training units are intended to deepen practitioners’ understanding of how children’s social-emotional development, centre and family connections and positive workplace activities link to children’s well-being and practitioners’ roles in these areas. Fifty-seven front-line practitioners from three different regional groups (Rural, Suburban, Urban) completed Handle With Care workshops and were compared to 56 comparison participants, matched according to region, who were not exposed to training. The evaluation utilized a time series repeated measures design and consisted of mixed quantitative and qualitative measures to determine training outcomes related to practitioner’s mental health promotion knowledge and practices. Findings indicated that child care practitioners who participated in Handle With Care training demonstrated increased mental health promotion knowledge. In particular, they acquired better comprehension of issues concerning practitioner and child attachment relationships, children’s self-esteem, emotion expression and regulation and peer relationships. Training participants significantly differed from comparison participants in their knowledge of these topics. In terms of practices, training participants also evidenced significantly improved practices relative to comparison participants. These gains were especially observed in relation to practitioners building trusting relationships with children, fostering children’s sense of self and competence, positive peer interactions and practitioners promoting their own mental health. In contrast, Handle With Care training did not show the intended consistent outcomes with respect to practitioners helping children with emotional communication, dealing with diversity, changes and transitions and practitioners building relationships with children’s parents. Results tended to be discrepant across regional groups, and in some instances, gains in mental health promotion and knowledge were not sustained over time. Overall, the study suggests that Handle With Care is a useful way to augment child care practitioners’ capacity to consider the mental health of all children in their care and flexibly implement strategies to help children reach their optimal potential. The study also provides important information concerning regional differences and areas of training content that may benefit from revision.

Bakgrund: Den medicinska och ekonomiska kostnaden för hjärt- kärlsjukdomar är idagmycket omfattande. Största delen av dessa sjukdomar liksom andra kroniska, ickesmittsamma sjukdomar som cancer, lungsjukdom och diabetes, hör ihop med påverkbara,livsstilsrelaterade riskfaktorer. Genom att göra hälsosamma val när det gäller mat, rökning,alkohol och motion kan livsstilssjukdomar förhindras eller fördröjas. Livsstilsfrågor är enav distriktssköterskans huvuduppgifter och efter vårdvalet är det få distriktssköterskor somverkligen får arbeta med detta. Syfte: Syftet med denna studie är att beskriva hurdistriktssköterskan arbetar med sjukdomsförebyggande metoder inom primärvården.Metod: Studien är baserad på en kvalitativ metod med en induktiv ansats. Genomintervjuer samlades data in från sex distriktssköterskor och analyserades med hjälp avinnehållsanalys. Resultat: I resultatet framkom två huvudteman som benämndes; Att finnavägar till förändring och Att utgå från tillgängliga resurser. Konklusion:Livsstilsförändringar är ett svårt område att arbeta med, livsstilen är något som är starktförankrat hos alla. Det krävs att patienten har förmåga till egenvård samt är beroende avdistriktssköterskans kompetens för att resultatet skall bli lyckat. Detta arbete underlättasinte av att resurserna blivit färre inom primärvården. Vårdvalet tros vara den störstaorsaken till att arbete med diagnosrelaterade sjukdomar prioriteras. / Background: The medical and economic cost of cardiovascular disease is now very extensive. Most of these diseases as well as other chronic, non-communicable diseases such as cancer, lung disease and diabetes, is associated with modifiable lifestyle -related risk factors. By making healthy choices when it comes to food, smoking, alcohol and exercise lifestyle diseases can be prevented or delayed. Lifestyle issues are one of the main tasks of the district nurse but after the health care election, few district nurses really get to work on this. Aim: The aim of this study is to describe the work of the district nurse with disease prevention methods in primary care. Method: The study is based on a qualitative content analysis with an inductive approach. Through interviews, data were collected from six district nurses and analyzed using content analysis. Results: The results revealed two main themes called: Finding ways to change and Using available resources. Conclusions:Lifestyle modification is a difficult area to work with, the lifestyle is something that is deeply rooted in all of us.It requires that the patient is capable of self-care and dependent on district nursing skills for the result to be successful. This work is not being helped by the fact that resources are cut down in primary care. The health care election is believed to be the largest cause that diagnosis related work is prioritized.