Health Promotion International最新文献

In 2013, Uruguay became the first country to regulate the legal production, distribution and sale of recreational cannabis. While key officials have framed Uruguay's landmark legislation as part of the government's strategy to regulate cannabis, tobacco and alcohol, there is limited empirical research exploring the political considerations that influenced its approach. Drawing on the concept of policy coherence-the process by which policymakers seek to minimize conflicts and maximize synergies across policy agendas-this study explores the extent to which Uruguay's cannabis regulation was influenced by the promotion of policy coherence within health and across other policy spheres. Government documents, 43 semi-structured interviews and field observations were thematically analysed. The analysis shows that the pursuit of policy coherence across health issues was relatively limited, and where there is an element of regulatory coherence, there also appears to be minimal coordination. Efforts to promote substantive policy coherence were shaped by a desire to legitimate cannabis use without creating an upstream driver or structural force that would promote excessive consumption. The findings also reveal that the outcome of Uruguay's cannabis regulation was more directly shaped by broader political considerations, including how to resolve tensions between public security and unhealthy commodity regulation goals. This study raises important questions around the extent to which Uruguay's cannabis regulation was shaped by the explicit goal of policy coherence, suggesting rather that comparisons with tobacco and alcohol regulation were strategically used to justify the introduction of a legally regulated cannabis market.

E-cigarette use (or vaping) is widespread in young people and is a rapidly growing public health problem. While the tobacco and vaping industry has promoted vaping as a smoking cessation aid for adults, the industry has strategically targeted young people through marketing and appealing designs to orientate a new generation of consumers to use their products. These strategies are not new and replicate what we have previously seen employed by the tobacco industry in past decades to maintain and grow their tobacco profits. We review the evidence on tobacco and vaping industry interference, highlighting the calculated and strategic use of interference tactics as a discourse to curb tobacco control efforts. We demonstrate how these tried and tested strategies are now being purposefully re-used in the context of vaping. As Australia is currently undergoing significant policy reforms for the access and retail of vaping products, we also provide a case study of the industry response played out in this contemporary landscape. Government and public health advocates are in a key position to be one step ahead in proactively tackling the vaping crisis. We recommend that continued monitoring of industry activities and strategies, achieving political transparency and tightening loopholes in current regulations are all needed to identify and eliminate the tobacco and vaping industry's influence on policymaking. Given their previous track record, we emphasize the need to counter industry interference tactics with urgency to prevent a new generation of nicotine dependence and to support and protect future action in tobacco control.

Increases in migration pressure from sub-Saharan Africa to Europe have increased in recent years. Despite this trend, the health literacy needs of migrants in host communities have not been sufficiently studied. This research aims to explore the health literacy of migrants newly arriving in Europe and compare it with the health literacy levels of the European population, utilizing data obtained from the European health literacy survey. A convenience sampling cross-sectional study was conducted at the Temporary Immigrant Stay Center in Melilla (Spain) in June 2022 using a validated French and Arabic version of the 16-item European health literacy survey questionnaire. A total of 106 sub-Saharan migrants ≥ 18 years of age were surveyed. The general health literacy index of the migrants was 30.02 points (on a scale of 50), placing it in the 'problematic' level. Of the participants, 57.54% had a limited ability to obtain, understand and apply health information and make appropriate health-related decisions. The largest gap compared to European citizens was observed in skills to understand information related to disease prevention. These results reinforce that migrant status is a social determinant of low health literacy and suggest that health professionals should extend their educational role to this vulnerable group.

A relatively small number of for-profit asset managers-financial intermediaries that invest capital on behalf of other investors-have emerged in recent decades to become some of the most influential commercial actors in the global political economy. Despite their important role in society, asset managers have received little attention from a public health perspective. In this article, we aimed to propose a conceptual framework of potential pathways and mechanisms through which asset managers may influence health and equity. The framework included asset class-specific pathways related to investments in publicly listed corporate equity, private equity, 'real assets' (e.g. housing, hospitals, farmland) and commodities. The framework also included more generalized pathways, focusing on ways in which the large and highly concentrated asset management sector can drive economic inequities, influence policy and political decision-making and shape the global 'development' agenda. We argue that measures challenging so-called 'asset manager capitalism', such as promoting and protecting the public ownership of companies and assets in essential sectors, are imperative to address the commercial determinants of ill health and inequity.

Each year, more than 700 000 people die by suicide globally, the majority of whom are men. The United Nations and World Health Organization have set targets to reduce suicide rates by one-third by 2030. While large-scale suicide prevention programmes are required to meet these targets, diffusion of these types of initiatives is difficult-particularly with male populations. This qualitative study investigated the MATES in Construction suicide prevention programme in Australia. Guided by Social Identity Theory and the Social Identity Model for Collective Action, the study aimed to understand why construction workers chose to volunteer and advocate for industry-based suicide prevention programmes, and how their worker identity, solidarity and relationships impacted their volunteering and advocacy. Semi-structured interviews were conducted with 28 participants who had chosen to engage with MATES as volunteers. Data were interpreted using a reflexive approach to thematic analysis, and four themes were constructed from the data relating to feelings of belonging, connection and solidarity between workers and their industry; how specific context and roles impacted identity while existing within an overall sense of identity and solidarity; how industry mateship supported engagement in suicide prevention; and how the role of lived experience, mateship and responsibility provided hope for change. Providing intervention skills to workers, particularly workers with a lived experience of mental ill-health, empowered them to believe that they could make a difference by acting collectively. The MATES engagement model described in this study may have applications for other health promotion prevention programmes targeting male cultures.

Social and community service organizations (SCSOs) may be a promising new environment to more successfully reach people with a lower socioeconomic position (SEP) for smoking cessation support. However, studies that investigate clients' perspectives of the suitability of SCSOs as a setting to discuss smoking are scarce. This study aimed to (i) investigate the suitability of smoking cessation support provided by SCSOs, according to people with a low SEP, and (ii) explore their reasons for considering it suitable or unsuitable. Semi-structured interviews were conducted with 19 individuals with a low SEP who smoked regularly (N = 14) or had smoked regularly (N = 5). They have been in contact with SCSOs in a specific neighborhood in Amsterdam. Data were analyzed using a thematic approach. Participants generally considered SCSOs as suitable for providing smoking cessation support, as professionals are involved, build a relationship of trust, and offer personalized and holistic support. SCSOs are located nearby and familiar, they provide support in both group and individual settings and might offer additional supportive (group)activities. A number of participants expressed doubts about the waiting time for support, the fact that the needed support might exceed professionals' expertise, and the lack of aftercare. SCSOs can be an additional opportunity for providing smoking cessation support that aligns with the circumstances of lower SEP people. To harness the potential, smoking cessation could be integrated into education programs and training among professionals could be promoted. Policy changes within and outside SCSOs would be needed.

Many alcohol-industry-funded (AIF) organizations disseminate eHealth/mHealth tools that claim to assist users in making health decisions by monitoring alcohol consumption, e.g. blood alcohol calculators, AUDIT scores, consumption trackers. Previously, AIF materials were found to contain health misinformation that could increase consumption (dark nudges) or make healthy behaviour change more difficult (sludge). The accuracy and functionality of AIF tools have never been analysed, and given the history of AIF materials it is possible they contain misinformation and function as covert marketing channels to promote alcohol-industry-friendly narratives on the causes and possible solutions of alcohol-related harms. We evaluated the information accuracy and framing, behaviour change techniques (BCTs), and functions of AIF digital tools (n = 15, from the UK, Ireland, the USA, Canada, New Zealand, Australia; including Drinkaware, Drinkwise, Educ'alcool and others), compared to a non-industry-funded independent sample (n = 10). We identified misinformation and 'dark patterns' (interface design strategies for influencing users against their interest) throughout AIF tools; significantly fewer provided accurate feedback (33% vs 100%), and significantly more omitted information on cancer (67% vs 10%) and cardiovascular disease (80% vs 30%) and promoted industry-friendly narratives (47% vs 0%). AIF tools encouraged consumption through priming nudges (53%) and social norming (40%). AIF tools utilized fewer BCTs, provided users with more limited pre-set options (54%), and fewer drink choices (mean 24 vs 275). Their input structure often impeded their ability to provide guideline advice. We conclude that AIF tools contain pro-industry misinformation strategies and dark patterns that misinform users about their consumption and could 'nudge' them towards continuing to drink alcohol-characteristics of 'Dark Apps' designs.

We present findings from the Our Voice in Barú project, examining adolescent engagement in citizen science to address environmental and social factors affecting well-being in a semi-rural Afro-descendant community in Latin America. The project aimed to identify barriers and enablers of well-being, informing adolescent-led actions for sustainable environmental changes relevant to adolescent health. Utilizing the Our Voice citizen science method, which involved technology-enabled walks, participatory cartography workshops and community meetings, we engaged adolescents and other community members. Complex systems framework was employed to analyze results and assess the promotion of collective action and local change. Local enablers of well-being included availability of quality sports and recreational venues as safe spaces, educational settings and cultural aspects, fostering safety, community pride, and personal growth. Conversely, barriers included environmental contamination, deteriorated sports venues and drug addiction, indicating the community's limited access to services and exposure to harmful substances. Adolescent citizen scientists, in partnership with the research team and relevant community decision-makers, successfully achieved changes aimed at identified barriers, including infrastructural enhancements like the repair of pumps to remove stagnant water, improvements in the quality and safety of recreational venues, and the implementation of community-led initiatives to address substance abuse and promote healthier behaviors. The Our Voice in Barú project empowered adolescents to advocate for change and promoted collective action to tackle barriers identified as significant to their well-being.