Health Promotion International最新文献

School environments have the potential to promote healthy dietary behaviours among adolescents. In New Zealand, there is no regulation regarding the healthiness of foods and beverages available to purchase at school canteens. This qualitative study explored the barriers and enablers to providing healthy food and beverages in secondary school canteens. An electronic screening questionnaire was distributed to all secondary schools to identify schools with a canteen. Semi-structured interviews among participants representing purposively selected schools explored the experiences of providing healthier foods and beverages in the canteen. Among schools (n = 333) invited to participate in the survey, 78 schools (response rate 23.4%) responded, with 37 schools reporting a canteen onsite. Of these, 24 schools were purposively invited to participate. Ten interviews were completed with participants representing six schools and one interview with an external food service provider. Through reflexive thematic analysis, four key themes were identified: (i) an action-oriented over-arching school policy based on healthy eating principles facilitates healthier provisions, (ii) fully supported initiatives across the school environment facilitate healthier provisions, (iii) champions facilitate healthier school canteens, and (iv) healthy canteens are not prioritized within the school's broader needs. School canteens are more likely to follow healthy eating principles when food and beverage policies are clear and comprehensive, adequate resources are available to implement and sustain healthier options, champions are involved, and the canteen is part of a whole-school approach that benefits the overall school food environment.

According to the World Health Organization (WHO), tobacco use causes over 8 million deaths annually including 1.3 million due to second-hand exposure. Furthermore, data from the Tobacco Atlas show that the tobacco industry continues to target new markets in the WHO African region, one of two regions where absolute numbers of smokers continue to increase. Understanding context contributes to policy formulation and implementation ensuring relevance to a country's political economy. Focusing on the WHO African region, this scoping review (i) maps the extent of academic research examining contextual factors on the WHO Framework Convention on Tobacco Control (WHO FCTC) national-level implementation, and (ii) reports on contextual factors impacting the WHO FCTC implementation. Using a stepwise structured approach, we conducted a search across four academic databases, yielding 10 342 articles and 42 were selected for full data extraction. Leichter's four categories of context (situational, structural, cultural and exogenous) and the stages of heuristic policy model guided data extraction. Study findings indicated that situational contextual factors such as the burden of disease or its impact on health can push governments toward policy formulation. Structural contextual factors included political considerations, economic interests, funding, institutional congruence, strength of policy and institutional capacity as important. Cultural contextual factors included the influence of policy entrepreneurs, current social trends and public opinion. Exogenous contextual factors included the WHO FCTC, tobacco industry influence at the national-level and bi-lateral partnerships. Further understanding contextual factors affecting the WHO FCTC national implementation can strengthen policy formulation and align required support with the WHO FCTC Secretariat and other relevant bodies.

It is not understood how cardiopulmonary resuscitation (CPR) training, specifically the representation of sex in CPR manikins, contributes to inequitable outcomes in cardiac arrest survival. The aim of this study was to identify the sex and chest wall secondary sexual characteristics of CPR manikins on the global market. The secondary aim was to identify if manikin manufacturing companies had a publicly available sustainability policy or equivalent, and if these covered products were manufactured. We conducted an observational descriptive study of the secondary sex characteristics and named sex of CPR training manikins available on the global market, and equity, diversity and inclusion (EDI), human rights and sustainability policies of the companies that manufacture them. Nine CPR manikin manufacturers were identified. Twenty CPR manikins were included for analysis. Of the 20 manikins, 75% were identified as male (n = 8, 40%) or no gender specified (n = 7, 35%) and all these had flat torsos-one had a breast overlay available. One company had a 2020 sustainability report that addressed EDI for the workforce only, and a 2023 report addresses this for products manufactured. Adult CPR manikins available globally are largely homogenous, flat-chested and do not have secondary sex characteristics or a named sex. One company had a sustainability report that referenced workforce only and has since committed to EDI for products manufactured. We urge CPR training providers and manufacturers to collectively promote a rights-based approach to healthcare aligned with the commercial determinants of health by committing to improving the diversity of CPR training manikins.

Restrictive food policies are often contentious and controversial. Supporters of these policies view them as imperative for achieving public health aims while some opponents view them as overly paternalistic, infringing on consumer choice and potentially inequitable. As a consequence, their ethical status and permissibility are both contested and of importance in decision-making for policy. Traditional ethical analysis of these interventions has examined the ethical implications of the policies according to a direct, linear view of the relationships between government and consumer and the impact of government policy on the consumer. However, this approach to ethical analysis fails to take into account the role of the food industry as the subjects of the policies and intermediaries between government and consumers in the implementation and effectiveness of the policies. The actions of the food industry in response to a policy substantially determine how the policy translates to changes in the food supply and thus, the effect of the policy on consumers. This has significant implications for the ethical status of the policy. As a result, this article calls for complicating the common ethical approach to restrictive food policies by adopting a framing that recognizes the role of the food industry in the implementation of these policies. We then discuss three implications this framing has for ethical analysis: first that ethical analysis must be more nuanced and recognize the potentially complex outcomes of a policy, second that it must be dynamic and ongoing and third that underlying assumptions about policies' effects on choice, effectiveness and equity need to be reconsidered.

Public service announcements (PSAs) or campaigns aimed at preventing harm can inadvertently risk creating additional harms. It remains unclear whether these unintended effects are considered during campaign development, if risk mitigation strategies are implemented, or how professionals involved perceive these issues. It is in the context of illicit drug use prevention PSAs that our research investigates and explores the perspectives of practitioners-health support professionals and advertising campaign designers and creators. Semi-structured expert interviews were conducted to capture and synthesize practitioners' perspectives which were then analysed by applying a framework to address the unintended effects of public health interventions. The results indicated that practitioners from both sectors are aware of unintended harms but place varying levels of importance on different aspects. In the case of illicit drug prevention PSAs, incorporating practitioners' perspectives in campaign development may result in mitigating the risk of potential unintended harmful effects.

Through the commercial determinants of health framework, gambling has been identified as a powerful threat to health. This research critically examines cryptocurrency, which is promoted and sold as a highly gamblified product. Using the commercial determinants of health framework, the multifaceted ways in which cryptocurrency firm operations may impact health outcomes are highlighted. Political influence is exerted through substantial donations, with high-profile cases illustrating the sector's attempts to sway policy, whilst cryptocurrencies often operate in unregulated markets. Marketing strategies mirror those of traditional harmful industries, deploying immense advertising budgets and celebrity endorsements to promote highly speculative and risky financial products. Cryptocurrency mining, demanding considerable energy consumption, causes significant environmental damage. Financial practices include hundreds of outright frauds targeting low- and middle-income countries. Cryptocurrency investment, with 24/7 access and promises of huge wealth, mirrors gambling and is likely to result in public health harms through the same mechanisms as other forms of gambling. Despite the supposed potential of blockchain technology for improving payment and contract systems, the lack of realization of these benefits contrasts sharply with the immediate and growing costs associated with cryptocurrency speculation. Cryptoassets are a case study for the need for health promotion professionals to critically evaluate new technologies and advocate for regulatory measures to protect public health in the face of novel, high-risk products that overlap gambling and finance.

It is essential to provide the community with evidenced-based care to optimize healthcare outcomes; more specifically, women in underserved communities with limited access to healthcare services. The purpose of this research was to determine the effectiveness of a single virtual movement-based pelvic health education session on women's pelvic health knowledge, adherence to performing pelvic exercises and confidence in performing the exercises. Forty-two female participants were recruited in Western Arkansas. Participants completed an online pre-session (pre) questionnaire and then received a single virtual education session led by a healthcare provider trained in pelvic health. A post-session (post-1) questionnaire was completed by each participant as well as a 1-month follow-up (post-2) questionnaire. Thirty-five women completed all three questionnaires and pelvic health knowledge, adherence to pelvic floor exercises and confidence in performing pelvic floor exercises were assessed. After the participants completed the post-2 questionnaire, they were invited for a semi-structured interview and 13 women participated. Results of this study suggest pelvic health knowledge increased after a single session of movement-based education, and this was retained 1 month later. Adherence and confidence to perform the exercises did not change; however, learning about pelvic health in a virtual movement-based method was a positive experience and initiated an eagerness to learn more about pelvic health. Pelvic health education can be implemented in a virtual approach to engage women in underserved communities to learn more about pelvic health through a positive experience for an educational baseline to gain healthcare autonomy.

The Wash'Em process was developed to improve the design of handwashing behaviour change programmes during outbreaks and humanitarian crises. It aims to rapidly create evidence-based, contextualized handwashing programmes. Wash'Em was widely used during the COVID-19 pandemic. This multi-country secondary data analysis compares data emerging from Wash'Em during the pandemic, to understand whether commonalities in programming constraints or the determinants of handwashing behaviour existed across countries. Wash'Em datasets (n = 38) were verified prior to inclusion in secondary data analysis; descriptively summarized and then statistical summaries of homogeneity were derived. Wash'Em was implemented as intended during the pandemic, typically taking a small number of humanitarian staff less than a week to complete. Most actors reported using the recommendations suggested by the process but did so within relatively short-term and poorly financed prevention programmes. Homogeneity in the responses to the Wash'Em tools was low indicating that the determinants of handwashing behaviour during the pandemic were predominantly shaped by pre-existing factors rather than the nature of the health threat. Hygiene programmes during outbreaks should avoid 'copying and pasting' interventions from one setting to another and instead make time to holistically understand the behavioural determinants in a specific context and develop programme activities that are designed to address these. Particular attention should be given to factors in the physical and social environment that may enable or constrain handwashing behaviour, pre-existing disease vulnerabilities and the secondary and non-health impacts of outbreaks. Wash'Em provides one feasible way of contextualizing handwashing interventions in outbreak or humanitarian settings.

Flavoured oral nicotine pouches, manufactured and marketed by global tobacco companies, such as Philip Morris International (PMI) and British American Tobacco, entered the Australian market in 2024. Despite it being illegal for Australian retailers to sell nicotine pouches, the products have been seized in government enforcement raids of Australian retailers, and have also been promoted to young people by Australian social media influencers. The Australian Federal Government has recognized and expressed concern about the rising profile of nicotine pouches in Australia and the promotion of these products as unproven vaping and smoking cessation aids. Yet to date, there has been no published research on nicotine pouches in Australia. Using focus group and interview data collected in early 2024 as part of Generation Vape, an ongoing Australian national study into adolescent and young adult vaping and smoking, we explored their attitudes to and perceptions of nicotine pouches, including first-hand experiences and drivers of use. The participants perceived an increase in the use and popularity of oral nicotine pouches, including PMI's Zyn brand, for reasons including claimed sport performance enhancement, vaping cessation and as part of partying and clubbing culture. Some participants perceived nicotine pouches to be a 'healthier' alternative to smoking or vaping. It is critical that research on nicotine pouches is collected now to inform public health policy and to prevent the proliferation of a new class of addictive recreational nicotine products in Australia.

Patient and public involvement is increasingly advocated in health policy, research and practice. Patients and people with lived experience, carers and the general public should have a say in how policy is generated, how services are delivered and how research is conducted. Through this perspective article, we hope to stimulate discussion and debate around industry influence in patient and public involvement, specifically pertaining to patient organizations, which often play a key role in patient and public involvement activities. As momentum gathers around patient and public involvement in many countries, it is timely to discuss the nature and extent of commercial influences in such activities, the (un)anticipated consequences of industry-patient interactions, including conflicts of interest and motivated bias, and how we might better manage, or negate, such interactions. Patient and public involvement must be integral to research, policy and practice. While further research is needed to examine the interactions, and consequences of pharmaceutical industry interactions with patients, several practical steps can be taken in the interim. Structures, processes and supports, which are fit for purpose, are needed to ensure independence, power and legitimacy within patient and public involvement activities, and that patient advocates have their voices heard, and ultimately acted upon.