▶ Conclusion

Effective health promotion programs help people live healthy and fulfilled lives. Interventions that are successful can improve the well-being and self-sufficiency of individuals, families, organizations, and communities. Much is known about how to design theoretically grounded interventions that are targeted to certain populations; the most common health behavior theories are described in this chapter. The challenge is to create interventions that are appropriate, meaningful, and engaging to the population, to maximize success in the short and long term. As technology advances, there are more ways to collect behavior data, engage patients, and monitor health status. Frameworks to evaluate health promotion interventions exist to elucidate their impact on individuals, communities, and societies.

Study and Discussion Questions

  1. What is the goal of the field of study of health promotion?

  2. What are the core components of health promotion programs?

  3. What are the most prominent health behaviors that contribute to the burden of morbidity and mortality in the United States?

  4. What is theory? Why are theories useful in health promotion planning?

  5. Choose one behavioral theory described in this chapter, and describe how it could be used to support a behavioral intervention.

  6. Name one framework for evaluating health promotion interventions, and describe the core components of the framework.

Suggested Readings and Websites

  1. The National Cancer Institute’s Theory at a Glance (2nd ed.). 2005. Available at cancercontrol.cancer.gov/brp/research/theories_project/theory.pdf (accessed May 23, 2019).

  2. Partnering4Health. National Implementation and Dissemination for Chronic Disease Prevention Initiative. Available at https://partnering4health.org (accessed May 23, 2019).

  3. Centers for Disease Control and Prevention. National Center for Chronic Disease Prevention and Health Promotion. Available at https://www.cdc.gov/chronicdisease/index.htm (accessed May 23, 2019).

  4. U.S. Department of Health and Human Services, Office of Disease Prevention and Health Promotion. Available at www.health.gov (accessed May 23, 2019).

  5. Centers for Disease Control and Prevention. Framework for Program Evaluation. Available at https://www.cdc.gov/eval/framework/index.htm (accessed May 23, 2019).

  6. RE-AIM Model. www.re-aim.org (accessed May 23, 2019).

References

  1. 1. World Health Organization. Ottawa Charter for Health Promotion. Adopted November 21, 1986. Available at https://www.who.int/healthpromotion/conferences/previous/ottawa/en/index.html (accessed on February 19, 2019).

  2. 2. McGinnis JM, Foege WH. Actual causes of death in the United States. JAMA. 1993;270:2207–2212.

  3. 3. Centers for Disease Control and Prevention. Current cigarette smoking among adults in the United States. Available at https://www.cdc.gov/tobacco/data_statistics/fact_sheets/adult_data/cig_smoking/index.htm (accessed on February 19, 2019).

  4. 4. Centers for Disease Control and Prevention. Quick facts on the risks of e-cigarettes for kids, teens, and young adults. Available at https://www.cdc.gov/tobacco/basic_information/e-cigarettes/Quick-Facts-on-the-Risks-of-E-cigarettes-for-Kids-Teens-and-Young-Adults.html (accessed on February 19, 2019).

  5. 5. Murray CJ, Atkinson C, Bhalla K, Birbeck G, Burstein R, Chou D, et al. The state of US health, 1990-2010: burden of diseases, injuries, and risk factors. JAMA. 2013;310(6):591–608.

  6. 6. U.S. Department of Health and Human Services and U.S. Department of Agriculture. 2015–2020 Dietary Guidelines for Americans (8th ed.). Available at https://health.gov/dietaryguidelines/2015/guidelines/ (accessed on February 19, 2019).

  7. 7. Lee-Kwan SH, Moore LV, Blanck HM, Harris DM, Galuska D. Disparities in state-specific adult fruit and vegetable consumption — United States, 2015. MMWR Morb Mortal Wkly Rep. 2017;66:1241–1247.

  8. 8. Larson NI, Story MT, Nelson MC. Neighborhood environments: disparities in access to healthy foods in the U.S. Am J Preventive Medicine. 2009;36(1):74–81.

  9. 9. U.S. Department of Health and Human Services. Physical Activity Guidelines for Americans. 2nd Edition. Available at https://health.gov/paguidelines/second-edition/pdf/Physical_Activity_Guidelines_2nd_edition.pdf (accessed on February 19, 2019).

  10. 10. Blackwell DL, Clarke TC. State variation in meeting the 2008 federal guidelines for both aerobic and muscle-strengthening activities through leisure-time physical activity among adults aged 18–64: United States 2010–2015. National Health Statistics Reports; no. 112. Hyattsville, MD: National Center for Health Statistics; 2018.

  11. 11. Ekelund U, Steene-Johannessen J, Brown WJ, Fagerland MW, Owen N, Powell KE, et al. Does physical activity attenuate, or even eliminate, the detrimental association of sitting time with mortality? A harmonised meta-analysis of data from more than 1 million men and women. Lancet. 2016;388(10051):1302–1310.

  12. 12. World Health Organization. Global status report on alcohol and health, 2018. Available at https://www.who.int/substance_abuse/publications/global_alcohol_report/gsr_2018/en/ (accessed on February 19, 2019).

  13. 13. Stahre M, Roeber J, Kanny D, Brewer RD, Zhang X. Contribution of excessive alcohol consumption to deaths and years of potential life lost in the United States. Prev Chronic Dis. 2014;11:E109.

  14. 14. National Institute on Alcohol Abuse and Alcoholism. What is a standard drink? Available at https://www.niaaa.nih.gov/alcohol-health/overview-alcohol-consumption/what-standard-drink (accessed on February 19, 2019).

  15. 15. Esser MB, Hedden SL, Kanny D, Brewer RD, Gfroerer JC, Naimi TS. Prevalence of alcohol dependence among US adult drinkers, 2009–2011. Prev Chronic Dis. 2014;11:140329.

  16. 16. Centers for Disease Control and Prevention. Fact Sheets: Binge Drinking. Available at https://www.cdc.gov/alcohol/fact-sheets/binge-drinking.htm (accessed on February 19, 2019).

  17. 17. U.S. Department of Health and Human Services. The Surgeon General’s Call to Action to Prevent and Reduce Underage Drinking. Washington, DC: U.S. Department of Health and Human Services, Office of the Surgeon General, 2007.

  18. 18. Centers for Disease Control and Prevention. Behavioral Risk Factor Surveillance System. Data available at https://www.cdc.gov/brfss/index.html (accessed on February 19, 2019).

  19. 19. Centers for Disease Control and Prevention. Youth Risk Behavior Surveillance System. Data available at https://www.cdc.gov/healthyyouth/data/yrbs/index.htm (accessed on February 19, 2019).

  20. 20. Substance Abuse and Mental Health Services. National Survey on Drug Use and Health. Data available at https://nsduhweb.rti.org/respweb/homepage.cfm (accessed on February 19, 2019).

  21. 21. Centers for Disease Control and Prevention. Pregnancy Risk Assessment Monitoring System. Data available at https://www.cdc.gov/prams/index.htm (accessed on February 19, 2019).

  22. 22. Public Health Management Corporation. Community Health Database. Available at http://www.chdbdata.org (accessed on February 19, 2019).

  23. 23. Institute of Medicine. Capturing Social and Behavioral Domains in Electronic Health Records: Phase 1. Washington, DC: The National Academies Press;2014.

  24. 24. Gartner. Worldwide Wearable Device Sales to Grow 26 Percent in 2019. November 29, 2018. Available at https://www.gartner.com/en/newsroom/press-releases/2018-11-29-gartner-says-worldwide-wearable-device-sales-to-grow- (accessed on February 19, 2019).

  25. 25. U.S. Food and Drug Administration. FDA approves pill with sensor that digitally tracks if patients have ingested their medication. November 13, 2017. Available at https://www.fda.gov/newsevents/newsroom/pressannouncements/ucm584933.htm (accessed on February 19, 2019).

  26. 26. Segura Anaya LH, Alsadoon A, Costadopoulos N, Prasad PWC. Ethical implications of user perceptions of wearable devices. Sci Eng Ethics. 2018 Feb;24(1):1–28.

  27. 27. Regalado A. Big data gets personal. MIT Technol Rev. July-Aug 2013. Available at http://www.technologyreview.com/news/514346/the-data-made-me-do-it/ (accessed on February 19, 2019).

  28. 28. Glanz K, Rimer BK. Theory at a Glance: A Guide to Health Promotion Practice. NIH Publication 97-3896. Bethesda, MD: National Cancer Institute; 1995.

  29. 29. Glanz K, Lewis FM, Rimer BK, eds. Health Behavior and Health Education: Theory, Research, and Practice. San Francisco: Jossey-Bass; 1990.

  30. 30. Glanz K, Lewis FM, Rimer BK, eds. Health Behavior and Health Education: Theory, Research, and Practice (2nd ed.). San Francisco: Jossey-Bass; 1996.

  31. 31. DiClemente RJ, Crosby RA, Kegler MC, eds. Emerging Theories in Health Promotion Practice and Research. San Francisco: Jossey-Bass; 2002.

  32. 32. Glanz K, Rimer BK, Viswanath K, eds. Health Behavior and Health Education: Theory, Research, and Practice (4th ed.). San Francisco: Jossey-Bass; 2008.

  33. 33. Hochbaum GM, Sorenson JR, Lorig K. Theory in health education practice. Health Educ Q. 1992;19:295–313.

  34. 34. Green LW. Toward cost–benefit evaluations of health education: some concepts, methods, and examples. Health Educ Monogr. 1974; 2(Suppl. 2):34–64.

  35. 35. Hochbaum GM. Public Participation in Medical Screening Programs: A Socio-psychological Study. Washington, DC: U.S. Department of Health, Education, and Welfare; 1958.

  36. 36. Rosenstock IM. The health belief model and preventive health behavior. Health Educ Monog. 1974;2(4):354–386.

  37. 37. Johnson CE, Mues KE, Mayne SL, Kiblawi AN. Cervical cancer screening among immigrants and ethnic minorities: a systematic review using the Health Belief Model. J Low Genit Tract Dis. 2008 Jul;12(3):232–241.

  38. 38. Ajzen I. The theory of planned behavior. Org Behav Human Decis Process. 1991;50(2):179–211.

  39. 39. Hackman CL, Knowlden AP. Theory of reasoned action and theory of planned behavior-based dietary interventions in adolescents and young adults: a systematic review. Adolesc Health Med Therap. 2014;5:101–114.

  40. 40. Prochaska JO, DiClemente CC. Stages and processes of self-change of smoking: toward an integrative model of change. J Consult Clin Psychol. 1983;51(3):390–395.

  41. 41. Cahill K, Lancaster T, Green N. Stage-based interventions for smoking cessation (review). Cochrane Database Syst Rev. 2010;11: CD004492.

  42. 42. Bandura A. Social Foundations of Thought and Action: A Social Cognitive Theory. Englewood Cliffs, NJ: Prentice Hall; 1986.

  43. 43. Young MD, Plotnikoff RC, Collins CE, Callister R, Morgan PJ. Social cognitive theory and physical activity: a systematic review and meta-analysis. Obes Rev. 2014;15:983–995.

  44. 44. Centers for Disease Control and Prevention. A Framework for Program Evaluation. Available at https://www.cdc.gov/eval/framework/index.htm (accessed on February 19, 2019).

  45. 45. Kessler RS, Purcell EP, Glasgow RE, Klesges LM, Benkeser RM, Peek CJ. What does it mean to “employ” the RE-AIM model? Eval Health Prof. 2013;36(1):44–66.