Search results

Purpose: We estimate national health expenditures on prevention using precise definitions, a transparent methodology, and a subdivision of the estimates into components to aid researchers in applying their own concepts of prevention activities.

Methodology/Approach: We supplemented the National Health Expenditure Accounts (NHEA) with additional data to identify national spending on primary and secondary prevention for each year from 1996 to 2004 across eight spending categories.

Findings: We estimate that NHEA expenditures devoted to prevention grew from $83.2 billion in 1996 to $159.8 billion in 2004, in current dollars. As a share of NHEA, this represents an increase from 7.8 percent in 1996 to 8.6 percent in 2004. This share peaked at 9 percent in 2002 and then declined due to reductions in public health spending as a percent of NHEA between 2002 and 2004. Primary prevention represents about half the expenditures, consisting largely of public health expenditures – the largest prevention element.

Originality/Value of Paper: Our 2004 estimate that 8.6 percent of NHEA goes to prevention is nearly three times as large as the commonly cited figure of 3 percent, but depends on the definitions used: our estimate falls to 8.1 percent when the research component is excluded, 5.1 percent when consideration is limited to primary prevention plus screening, 4.2 percent for primary prevention alone, and 2.8 percent if we count only public health expenditures. These findings should contribute to a more informed discussion of our nation's allocation of health care resources to prevention.

The purpose of this paper is to test whether the simple exposure to different types of products can trigger different motivational orientation on consumers (prevention vs promotion), which in turn would match message frame and increase persuasion.

Three experiments test whether exposure to product categories can trigger consumer’s regulatory focus orientation. Participants in the pilot study are students, while participants in the two other studies are consumers.

A first pilot study randomly exposed participants to a product that could trigger promotion orientation (e.g. orange juice) versus a product that could trigger prevention orientation (e.g. sunscreen). Participants exposed to promotion (prevention) product suggest more promotion (prevention) strategies to reach a particular goal (preparing for their final exam). Study 2 shows that gain (vs loss)-framed messages using health appeals have better evaluations when featuring promotion (vs prevention) products. Study 3 generalizes these results using another sample and different product categories.

The paper uses some product categories and including other categories would increase external validity.

The practical implication is to help marketers to choose the right health argument to match the product category they are trying to sell.

Theoretically, the results from three studies show that exposure to products can temporarily trigger a consumer’s regulatory focus and that messages using health arguments that are consistent with this regulatory focus are more persuasive than those that are not. Managerially, these results help managers to adapt the right message in function of the product category.

This article discusses the state of the art concerning the meaning and value of model programmes in mental health promotion and mental disorder prevention. Model programmes are considered an important instrument for improving the quality, social impact and cost‐effectiveness of promotion and prevention. However, there is a lack of conceptual clarity and insight in the processes and mechanisms for successful use of model programmes in this field. This article offers a further clarification of the concept of model programmes and discusses its pros and cons and current views on the process of programme development and programme use. The discussion will be based particularly on recent experiences with model programmes in Europe. Until recently, prevention research was directed mainly at the design and testing of new model programmes. However, successful use of the ‘model programme strategy’ requires more attention to the pre‐conditions for effective dissemination, adoption and implementation of model programmes. Only when this multi‐phased process is taken into account and the required pre‐conditions and quality criteria are specified can one expect that model programmes will be more effective at a community level. The consequences of this view for prevention science and prevention research policies are discussed. To implement such a multi‐phased process successfully, not only are conceptual clarity and a scientific underpinning crucial, but also collaborative organisational structures are needed at national and international level if the range of complementary tasks is to be executed effectively and efficiently.

Older adults’ sexual health is becoming an increasingly important component of healthy aging in the wake of the HIV/AIDS epidemic and rising infection rates among this age cohort. The increase in HIV/AIDS diagnoses in the older adult population ignites the need to understand the reasons why older adults are omitted from HIV/AIDS prevention education policy.

This chapter examines the social forces that influence HIV/AIDS policy at the state and community levels. Through qualitative methodology and analysis, including interviews with state policymakers and managers of AIDS service organizations in four Midwestern states (n=31), I look for trends and patterns as to whether or not older adults are considered as an “at-risk” group for HIV infection.

Findings reveal that HIV/AIDS policy may be impacted by enduring sexual scripts about older adults. To some extent both state policymakers and AIDS service organization personnel adhere to stereotypes about older adults’ sexuality and sexual activity, which is then implemented in their health promotion activities. The result is that gaps exist in HIV/AIDS prevention education for older adults, despite the fact that current trends show an increase in new HIV infections and AIDS diagnoses among people over the age of 50.

While this is an exploratory study of the available HIV/AIDS prevention education and health promotion activities for older adults, as well as the viewpoints of state policymakers and AIDS service organization personnel, the findings do indicate the need for additional research on the potentially dangerous sexual behaviors – lack of HIV testing, low condom usage, multiple partners – exhibited by older adults. Future research involving interviews with older adults, physicians, and medical personnel may add new perspectives to the current research.

As the baby boomers continue to age and challenge cultural stereotypes of sexual behaviors among older adults, research in the area of sexual health and HIV/AIDS prevention education will remain an important component of healthy aging. This research begins what will ultimately be a necessary conversation.

During times of budgetary restraint, the opportunity costs of health care expenditure are highlighted. As a result, policies on the prevention of ill‐health, which may have always been desirable for their own sake, are increasingly being viewed as alternatives to expenditures on curative care. Within a fixed budget, such alternatives share a common objective to maximise the overall return, measured in terms of reduced morbidity and mortality, to the expenditure. Health education is advocated as a major instrument of prevention policy. Since the link between increased knowledge, changed attitudes and altered behaviour is unproved, this article considers only those health education programmes which aim at specific behavioural changes. These programmes alone yield a return which can be com‐pared with those from expenditures in curative care.

This chapter depicts the burden of suicidal behavior among African American males. It describes the public health approach to preventing suicidal behavior among African American males. This approach includes assessing and describing the problem; identifying causes or risk and protective factors; developing and evaluating programs and policies; and implementing and disseminating findings and activities. The chapter provides a review of the epidemiology of fatal and non-fatal suicidal behavior; a summary of what is known about the risk and protective factors of the problem; and a descriptive analysis of the circumstances associated with suicides among young African American males is presented. Lastly, the authors give a summary of evidenced-based prevention programs which could be applied in preventing male suicidal behavior.

Building a culture of safety in transportation is not dissimilar from building a culture of safety in health. Public health is widely known for protecting the public from diseases through milk pasteurization and chlorination of drinking water, and from injuries by implementing environmental and occupational safeguards and fostering behavioral change. Lifestyle and environmental changes that have contributed to the reductions in smoking and heart disease can also help change driving, walking and cycling behaviors, and environments. Stimulating a culture of safety on the road means providing safe and accessible transportation for all. The vision for a culture of traffic safety is to change the public’s attitude about the unacceptable toll from traffic injuries and to implement a systems approach to traffic injury prevention as a means for improving public health and public safety. Framing the motor vehicle injury problem in this way provides an opportunity for partnerships between highway safety and public health to improve the culture of safety.

Suicide as a stigmatising issue presents a huge challenge for prevention policy. Also, policy itself is often difficult to turn into action. This research describes the interpretative repertoires found in the suicide prevention strategies of England and Finland, and explores their potential functions and audiences. It was found that the political repertoire was formed from four sub‐repertoires: the public health epidemiology, the everyday, the preventive action and the reflective repertoires. This paper discusses the polyphonic and multilayered nature of these policy documents and how different repertoires may be used for various functions. The polyphonic nature of policy documents is necessary to reach a wide readership and to capture suicide as a controversial phenomenon. However, the downside is that the argumentative style may also undermine some of the measures and actions recommended.

There is limited research examining community-based youth empowerment that addresses smoking prevention in the rural Indonesian context. This paper describes participatory action research (PAR) applied to develop a framework for empowering youth aged 17–25 years toward smoking prevention. This research conducted in the Indonesian rural community setting was divided into four stages: diagnosing, planning action, taking action and evaluating action.

PAR was chosen as the approach to developing a framework for youth empowerment in smoking prevention programs. In this study, the PAR cycle started with a prestep stage through interviews with village heads, community leaders, youth organization organizers, observations of target resources and observations of participation in youth activities as well as forming teamwork with target participants. The diagnosis stage consists of three activities, that is, focus group discussions with youth groups of male and female, youth assessment of empowerment domains through the Participatory Rural Appraisal (PRA) with the Empowerment Assessment Rating Scale (EARS) and measuring individual and group involvement levels related to the smoking behavior prevention program by questionnaire. The EARS assessment results were presented in the action planning stage, followed by a discussion on youth empowerment plans and strategies. In the action stage, activities and programs are planned according to the planning discussion, that is: training in healthy life skills (outbound and training) and initiating youth health programs without smoking called “Remaja Berdaya Sehat Tanpa Rokok” (Empowered Youth Healthy Without Smoking) or the JayaStar Program. After these community participation activities, the evaluating action stage will assess the empowerment domain in the youth groups, conduct focus group discussions with parents, evaluate the impact of empowerment on individual and group changes with a questionnaire and facilitate self-reflection by the youth community called Madiska.

This protocol describes a doctoral research project on developing a youth empowerment framework in smoking prevention programs through PAR. The intended study will provide valuable information on the planning, implementation and evaluation of youth empowerment in the prevention of smoking behavior.

This research project is expected to contribute to the literature relating to PAR for rural settings and the use of empowerment strategies to prevent youth smoking behavior. The results can be replicated in the same settings, but the process of empowerment must still be adapted to the characteristics and local wisdom of the community.