Global Health Promotion

The practice of concurrent sexual partnerships (CP) is posited to be a contributor to the elevated risk of HIV transmission among youth in Malawi. The lens through which Malawian youth conceptualize the practices of CP and condom use has yet to be fully explored. The current study – a secondary data analysis of semi-structured in-depth interviews (n = 19) with Malawian youth aged 18 to 22 years – addresses this gap. Participants were interviewed about their sexual relationships and behavior, as well as their perceptions and knowledge regarding condom use and CP. In order to ensure that youth engaged in CP were oversampled, the recruitment process asked potential respondents to self-identify whether they currently participated in CP. Of the total sample (n = 19), 13 self-identified as currently engaging in CP. Data were analyzed using a grounded theory approach.

This qualitative study highlights a disconnect between the high level of knowledge youth exhibit about HIV prevention methods and their actual reported condom use and CP behaviors. While some youth claimed to use condoms, their discourse demonstrated fluidity in that use changed over time, or interest in changing behavior was expressed, or was inconsistent between partnerships. The disconnect between knowledge of the consequences of risky sexual behavior and actual behavior was most evident among inconsistent condom users engaged in CP. This finding indicates knowledge alone has a limited role in the adoption of lower risk behaviors such as condom use and reduction of CP among youth. Moreover, findings from this study can inform HIV prevention programs operating in Malawi and the sub-Saharan Africa region by enabling them to provide tailored, more persuasive health promotion and prevention messaging. (Global Health Promotion, 2012; 19(4): 20–28)

Most policies addressing Aboriginal health in Australia promote initiatives that are based on empowerment principles. Articulated programme components are necessary to support personal and group empowerment and to assist individuals in gaining the sense of control and purposefulness needed to exert their political and personal power in the face of the severe stress and powerlessness faced by the Australian Aboriginal people. This paper aims to provide a detailed description of the mechanisms underpinning a ‘bottom-up’ empowerment initiative, the Family well-being empowerment and leadership programme (FWB), and to analyze how the programme supports empowerment. The five stages of FWB were described and the validity of this model was assessed through the combination of participatory observation, documentation analysis, literature review, semi-structured interviews and iterative feedback with different analytical perspectives. Our study results articulated four distinct programme components: the setting plus inter-relational, educational and experiential actions. FWB is an example of the promotion of both outcome and process pathways towards empowerment. Potential applications of the programme are discussed.

Opportunities and liberties available to individuals allow them to function as full human beings and this should include freedom from persistent pain. Pain seems to be a downstream phenomenon which tells us that something has gone wrong. Health promoters, with their upstream perspective, should be concerned with pain. In this commentary we discuss conceptual issues concerning ‘health’ as the absence of pain, issues of health justice and issues of health education to raise awareness of pain. We suggest that pain should appear on the health promotion agenda and conclude that more awareness is needed in the epistemic health promotion community of physical pain as a factor in the distribution of health and well-being. We argue the need for more research on the extent to which pain follows the social gradient in the same way that other health inequalities do.

Based on a first-hand experience from Colombia in the context of a local dengue research project, this paper illustrates how social determinants of health are associated with public health and how they can affect disease surveillance systems. The paper shows how various issues related to dengue case notification procedures and health insurance systems in Colombia are intertwined with more structural socio-economic factors. We argue that there is a need for public health interventions and health related research to acknowledge and consider the important role social determinants play in public health dynamics.

Globally, tobacco kills more people than HIV-related conditions or AIDS, tuberculosis and malaria combined. In 1991, The World Bank, the world’s largest lender, pledged that it would no longer support tobacco-related projects. It was expected that other financial investors would follow, but most did not respond to this call. As a result, several financial institutions continue to invest in tobacco and fuel an epidemic to an unprecedented scale. Using tobacco as a case in point, this review highlights the continuing investments among financial institutions which do not conform to ‘socially responsible investments’ and calls for monitoring and reporting such unethical practices. The paper also underscores the need to harmonise the numerous criteria, principles and voluntary codes that govern socially responsible investing and ensure that financial institutions comply with them.

L’objectif de cet article est de présenter le processus suivi lors du développement, de la mise en œuvre et de l’évaluation d’un programme de promotion de la consommation de légumes et de fruits destiné à des collégiens. Un total de 385 collégiens québécois du Canada âgés de 18 ans en moyenne ont accepté volontairement de participer à cette étude. Le modèle de planification en six étapes de Bartholomew et collaborateurs (2006) a été utilisé. Basée sur la théorie du comportement planifié (Ajzen,1991), l’évaluation des besoins a été effectuée avec un questionnaire auto-administré développé à partir d’une revue de la littérature et de groupes de discussion focalisée auprès de collégiens. Cette première étape a permis d’identifier les déterminants psychosociaux sur lesquels intervenir spécifiquement. Les résultats consistent en un programme d’une durée de quatre heures et demie, qui a été offert à 167 collégiens (groupe expérimental). Adaptées à cette clientèle, et sur des bases théoriques, les activités incluaient l’utilisation d’outils d’auto-évaluation de la consommation quotidienne de légumes et de fruits, le calcul de portions avec une nutritionniste, un quiz sur le web, la rédaction d’un plan pour implanter ses intentions, les démonstrations culinaires de recettes d’un pair avec dégustations et tests de goût. Le programme s’est avéré efficace pour augmenter l’intention comportementale ainsi que le nombre de participants à consommer au moins cinq portions de légumes et de fruits chaque jour, à la fin du programme. Ce protocole permet de structurer une intervention sur mesure visant un changement comportemental chez une clientèle ciblée. Le développement d’un partenariat milieu/université accroît les chances de succès, tant pour l’implantation du programme que pour son efficacité.

El proceso de globalización ha tenido repercusiones no sólo en el área económico-financiera sino también en las esferas social, cultural y educativa. Uno de estos efectos es el desarrollo de procesos para lograr la acreditación de programas académicos y el tránsito regulado de profesionales certificados en diversos campos entre los que se incluyen la salud pública y la promoción de la salud (PS). En este trabajo, se reflexiona sobre los retos que enfrenta la formación en PS en el continente europeo. Se presentan datos sobre la capacitación a nivel pregrado de promotores de salud concebidos como profesionales autónomos y sobre la definición de competencias básicas referidas a PS que se incluirían en el curriculum de distintos tipos de personal en formación. Finalmente, se presenta el proyecto CompHP, que ha buscado contribuir a la consolidación de una identidad en los profesionales europeos que trabajan en PS y su reconocimiento en el mercado laboral.