Health Education Journal

Health promotion activity in community pharmacies was studied along with pharmacists' perceptions of the barriers and constraints to increasing health promotion activity within community pharmacy. A stratified sample (of 30 pharmacists) was investigated using a structured interview in the spring of 1993. Health promotion activities were undertaken by all study pharmacies. The number of times advice was given and/or a query dealt with was estimated to be around 1400 per week for the sample. It was found that the activity was 2.5 times more likely to be reactive rather than proactive. In general pharmacists felt isolated and excluded from formal activity: five pharmacists felt that they had enough support from local health promotion units and only one pharmacist had any liaison with a unit. There was evidence to suggest that these community pharmacies were an under-utilised resource for health promotion.

A literature review reveals that the role of community pharmacists in health education is supported strongly by the profession but is in practice still relatively undeveloped. A survey of contractors was undertaken in West Glamorgan in 1994 to examine the present state of health education among pharmacists, the costs and benefits they perceived, and what factors would lead to a significant increase in this activity. Qualitative analysis was employed to reveal the complexity of the issues facing pharmacists in developing this role. It shows that payment, training and relationships with other professions are crucial issues in the present context of a profession working in a market situation.

Community pharmacists are well placed to have a role in health pro motion. Most pharmacists already provide advice on health — either on a one-to-one basis through counselling, or through displaying leaflets. This paper reports on a practical system which helped pharmacists provide patients with individualised information relevant to their needs. Pharmacy customers with upper gastrointestinal disease received information booklets and a lifestyle questionnaire. After computer analysis of the completed questionnaire, pharmacists gave patients a personalised letter of advice. This method was used and studied in seven pharmacies for six months, after which patients and pharmacists were interviewed. Results confirmed that pharmacists have a clear role to play in health promotion. Patients were ready to receive lifestyle advice in areas not normally considered part of the traditional pharmacist's remit.

Semi-structured interviews with GP trainers and their associated practice nurses were conducted during March to July 1994 to identify their attitudes to, and knowledge about, the health benefits of physical activity. Par ticipants were asked about the health benefits of physical activity, personal exercise habits and information or training received about promoting healthy exercise. While there was unanimous agreement that physical activity is 'a good thing', specific knowledge of the health benefits of exercise was sketchy. Most of the nurses and all of the doctors had received no training in this area. The knowledge gaps found in the interviewees are therefore not surprising. This training issue must be addressed before effective promotion of physical activity can take place in primary health care.

This study, conducted in 1994, set out to explore food preferences, eating behaviour and food choice with Primary 7 children (mean age 11 years) in a small primary school in Edinburgh. A qualitative methodological approach was adopted, utilising focus groups and observational techniques. Analysis of the data indicated food choice was not determined by the health attributes of food but rather that values of preference, play, socialisation and convenience were given a higher priority than health by the children when making food choices. 'Healthy' foods were found to be associated with the concept of a proper meal and homemade foods. A different classification of foods based on like and dislike was proposed to explain children's food choice.

The Heartbeat Award for caterers was launched in 1990 by the Health Education Authority. Key management responsibility was transferred from national to local level in 1992. The study reported here was carried out in 1994 to provide an assessment of the award scheme following transfer to local management. Postal questionnaires were sent to every chief environ mental health officer, health promotion officer and dietitian in England; 380 responses were received. Local management was viewed as facilitating flexibility and ownership, but barriers to effective implementation were also identified. The Heartbeat Award was seen as an important component of local health promotion, but doubts were expressed about its efficacy in reaching target groups. Findings are discussed in terms of the wider implications for health promotion.

Bowel cancer is the third most common cancer in Australia. The Australian Cancer Society has set a national goal 'to exploit prevention opportunities and to increase early detection'. To address this goal, information about community perceptions is required. Through the use of a Delphi process, a questionnaire was developed to investigate community knowledge, attitudes and beliefs regarding primary prevention and early detection activities. This paper describes the results of a postal survey of a random sample of 855 Queensland adults selected from electoral rolls. Results indicate that there is a high level of uncertainty about bowel cancer and a belief that many behaviours are related to bowel cancer. While 74 per cent believed that tests could detect bowel cancer, only 52 per cent were confident that a doctor could accurately diagnose it. Only 35 per cent agreed that the public should be screened for bowel cancer and only 10 per cent would get a check-up. Perhaps reflecting the degree of uncertainty among health professionals about bowel cancer, there appears to be a high level of misinformation and confusion in the community. The need for an educational programme to address these issues is discussed.

This paper in the research methods series critically assesses the use of combined methods in health promotion research. A selection of pos sibilities for combining methods is described and examples given. The paper invites reflection on the assumption that a combination of quantita tive and qualitative methods will inevitably produce the most reliable and valid research results. A more critical approach in health promotion research is suggested based on consideration of issues of epistemology, methodology and practical application. The paper advocates that research reports address and analyse the contradictions as well as the compatibilities involved in the production of data using combined methods approaches.

This article addresses methodological and practical issues that arose during the evaluation of the Grampian Smokebusters Campaign. This longitudinal study started early in 1988, with a first follow-up in late-1989/early-1990, and a second follow-up in the Autumn of 1991. A number of problems became apparent and there are general lessons to be learnt from the attempts to deal with them. Before expanding on the evaluation problems, however, the principles and workings of this health promotion activity are briefly outlined.