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This study aims to elucidate the health care organization, management and policy barriers and facilitators associated with implementation of an evidence-based health promotion intervention in primary care centers in the Basque Country, Spain.

Seven focus groups were conducted with 49 health professionals from six primary care centers participating in the Prescribing Healthy Life program. Text was analyzed using the Consolidated Framework for Implementation Research (CFIR) focusing on those constructs related to health care organization, management and policy.

The health promotion intervention was found to be compatible with the values of primary care professionals. However, professionals at all centers reported barriers to implementation related to: (1) external policy and incentives, (2) compatibility with existing workflow and (3) available resources to carry out the program. Specific barriers in these areas related to lack of financial and political support, consultation time constraints and difficulty managing competing day-to-day demands. Other barriers and facilitators were related to the constructs networks and communication, culture, relative priority and leadership engagement. A set of six specific barrier-facilitator pairs emerged.

Implementation science and, specifically, the CFIR constructs were used as a guide. Barriers and facilitators related to the implementation of a health promotion program in primary care were identified. Healthcare managers and policy makers can modify these factors to foster a more propitious implementation environment. These factors should be appropriately monitored, both in pre-implementation phases and during the implementation process, in order to ensure effective integration of health promotion into the primary care setting.

This chapter provides a historical contextualisation of health tracking and public health communication from the post-World War Two development of the welfare state, through the birth of neoliberalism, until today’s individualising practices of digital health tracking and quantification of bodies. Through an examination of these three phases of public health quantification of bodies, encompassing the socio-economic, cultural and political shifts since 1948, combined with the development and wide adoption of digital health and self-quantifying technologies, this chapter traces the changing landscape and the dramatic implications this has had for shifting who is responsible for maintaining ‘good’ health. This chapter illustrates how neoliberal free market principles have reigned over UK public health discourse for many decades, seeing health as no longer binary to illness, but as a practice of individual self-quantification and self-care. In turn, the chapter explores how the quantification and health tracking of bodies has become a dominant discourse in public health promotion, as well as individual citizenship and patient practices. This discourse still exists pervasively as we move into the digital society of the 2020s, through the Covid-19 pandemic and beyond; with public health strategies internationally promoting the use of digital health tools in our everyday, further positioning citizens as entrepreneurial subjects, adopting extensive technological measures in an attempt to measure and ‘optimise’ health, normalising the everyday quantification of bodies.

There is a growing interest in research focusing on performance management practices in the public sector, but research is still limited with regards to public primary healthcare services (PHSs), which play an important role in national healthcare systems. These organisations are frequently criticised for alleged poor performance management practices and misuse of resources, though such claims are not always substantiated. The purpose of this study is to examine performance management practices in public PHSs.

Three case studies of PHSs organisations were conducted resulting in interview material and archival data. Otley's performance management framework was used to examine the data.

It is found that the performance management systems of the studied PHSs were disjoint and lacked consistency and coherence. Lack of direction and motivational were key issues in PHSs. Furthermore, the observations indicate that vertical controls between PHSs and parent organisation were weak and accountability poor.

Generalisability of findings and social desirability bias are the important limitations. A key research implication is that the conceptual framework adopted can be meaningfully used to generate insights into performance management issues in public sector healthcare organisations.

The study highlights the implications of the poor design and use of performance management systems and highlights areas for improvement in the organisations studied, and potentially across the sector.

This study is the first to draw upon Otley's performance management framework to examine performance management practices in PHSs and to demonstrate its usefulness in this context.

The purpose of this study is to explore how healthcare professionals in Denmark perceived and enacted their role as diabetes trainers for Arabic-speaking immigrants in three new local authority settings. The paper used positioning theory, which is a dynamic alternative to the more static concept of role in that it seeks to capture the variable, situationally specific, multiple and shifting character of social interaction, as the analytical tool to examine how people situationally produce and explain behaviour of themselves and others.

The paper generated data through observation of diabetes training and of introductory interviews with training participants in three local authority healthcare centres over a total of five months. The authors conducted 12 individual interviews and two group interviews with healthcare professionals.

Healthcare professionals shifted between three positionings – caregiver, educator and expert. The caregiver was dominant in professionals’ ideals but less in their practice. Healthcare professionals other-positioned participants correspondingly as: vulnerable, difficult students and chronically ill. The two first other-positionings drew on dominant images of an ethnic other as different and problematic.

Becoming more reflexive and explicit about one's positionings offer the potential for a more conscious, confident, flexible and open-ended teaching practice. Such reflexivity may also reduce the perception that teaching challenges are rooted in participants’ ethnic background.

The paper provides a new understanding of healthcare practice by showing professionals’ multiple and reciprocal positionings and the potential and risks in this regard. The paper demonstrates the need for healthcare workers to reflect on their positionings not only in relation to immigrants, but to all patients.

The purpose of this paper is to discuss the construction of the theoretic model of systematic knowledge creation in the healthcare process according to professionals' collaboration using clinical‐pathways.

Healthcare is a knowledge‐intensive service conducted by professionals. A clinical‐pathway is an effective tool in the knowledge management aspect of this service. The theoretic model of the medical knowledge management which used the clinical‐pathway from case studies in two hospitals is constructed.

The theoretical model shows the interaction between explicit knowledge and tacit knowledge in the healthcare process using clinical‐pathways. This theoretical model is a knowledge creation model which creates new knowledge continuously. Therefore, the clinical‐pathways are suggested as an effective tool for knowledge management in healthcare.

Promotion of knowledge communication between healthcare professionals by clinical‐pathways activities is important for excellent healthcare management.

This paper will be valuable for sustained improvement of healthcare quality by knowledge management with clinical‐pathways. In this paper, the detailed theoretic model which explains medical knowledge management with clinical‐pathways has been constructed.

This paper explores the relationship between health promotion and active aging among seniors in Malaysia. The specific objectives were to (1) identify the contributing factors for seniors undergoing full medical check-up and (2) to explore the association between selected active aging factors and health promotion behavior and beliefs.

The study used data from 662 seniors from three different states in Peninsular Malaysia. Logistic regression was used to identify significant determinants of full medical check-up, and chi-square statistics were used to explore the association of active aging and selected health promotion behavior and beliefs. Healthy aging was characterized by being employed or traveling outdoors for leisure.

Household income was found to be a significant barrier to seniors undergoing a full medical check-up. Overall, active seniors were more likely to have positive self-rated health, positive health responsibility and health promotion beliefs but were less likely to undergo a full medical check-up.

Given that cost of a medical check-up could be a barrier for seniors, authorities could consider subsidizing medical check-ups to promote early detection of disease. There is also a need for continuous effort to educate seniors on health risk factors and the importance of taking fuller responsibility for their own health.

This study examined the relationship between active aging and health promotion together, as both components are essential in enhancing the mental and physical well-being of seniors.

This study was carried out to examine the volume and annual growth pattern of research on e-health literacy research, investigate the open-access types of e-health literacy research and perform document production by country and by sources. The study also mapped the keywords used by authors to represent e-health literacy research and performed an analysis of the clusters of the keywords to reveal the thematic focus of research in the area.

The research was guided by a bibliometric approach involving visualization using VosViewer. Data were sourced from Scopus database using a syntax that was tested and verified to be capable of yielding reliable data on the subject matter. The analysis in this study was based on bibliographic data and keywords.

A total number of 1,176 documents were produced during 2006 and 2022. The majority of the documents (18.90%) were published based on hybrid open-access processes, and the USA has the highest contributions. The Journal of Medical Internet Research is the venue for most of the documents on the subject. The 1,176 documents were described by 5,047 keywords, 4.29 keywords per document, and the keywords were classified into five clusters that aptly capture the thematic structure of research in the area.

e-Health literacy has experienced significant growth in research production from 2006 to 2022, with an average of 69 documents per year. Research on e-health literacy initially had low output but began to increase in 2018. The majority of e-health literacy documents are available through open access, with the USA being the leading contributor. The analysis of keywords reveals the multifaceted nature of e-health literacy, including access to information, attitudes, measurement tools, awareness, age factors and communication. Clusters of keywords highlight different aspects of e-health literacy research, such as accessibility, attitudes, awareness, measurement tools and the importance of age, cancer, caregivers and effective communication in healthcare.

This study has practical implications for health promotion. There is also the element of patient empowerment in which case patients are allowed to take an active role in their healthcare. By understanding their health information and having access to resources that help them manage their conditions, patients can make informed decisions about their healthcare. Finally, there is the issue of improved health outcomes which can be achieved by improving patients' e-health literacy. Visualisation of e-health literacy can help bridge the gap between patients and healthcare providers, promote patient-centered care and improve health outcomes.

Research production on e-Health literacy has experienced significant growth from 2006 to 2022, with an average of 69 documents per year. Many e-health literacy documents are available through open access, and the USA is the leading contributor. The analysis of keywords reveals the nature of e-health literacy, including access to information, attitudes, measurement tools, awareness and communication. The clusters of keywords highlight different aspects of e-health literacy research, such as accessibility, attitudes, awareness, measurement tools and the importance of age, cancer, caregivers, and effective communication in healthcare.

The purpose of this paper is to validate empirically a theoretical model that integrates an innovative construct capturing consumers’ non-adoption risk belief associated with not using a mobile service designed to support them in a non-leisure activity.

A theoretical model contrasting perceived non-adoption risk to perceived adoption risk of a mobile service supporting health promotion was developed and tested with a sample of potential consumers in North America.

Results show that non-adoption risk is a moderately strong antecedent of motivational factors in contrast to adoption risk that hinders the acceptance of a mobile service supporting health promotion.

Healthcare is a highly sensitive social sector, so possible negative consequences of not using the support of a mobile service are an additional motivation for adopting this service. Future research should test the role of non-adoption risk in other contexts of technology use, including non-leisure settings.

Making potential users see the possible negative consequences of not using a mobile service designed to support them in a non-leisure activity increases their motivation and, subsequently, intention to use the service.

Educational efforts to making consumers see the risks of not using a supporting technology application appear to be justified.

This study demonstrates the significant role of non-adoption risk belief that captures the negative consequences individuals may perceive if they fail to use as expected a mobile service application designed specifically to help them.

Prisons offer a public health opportunity to access a group with multiple and complex needs and return them to the community with improved health. However, prisons are not conducive to optimal health and there are few frameworks to guide efforts. This study aims to generate insights into health literacy across a young adult prison population, specifically examining the level of limitations, barriers and characteristics associated with these limitations.

The study took place in a single prison in England for young adult men aged 18–21 years old. A mixed-methods design was adopted with 104 young men completing a quantitative survey and qualitative semi-structured interviews with 37 young men.

72% (n = 75) of young men scored as limited in their health literacy. Barriers included structural restrictions, limited access to formal support and social and natural disruptions. No demographic characteristics or smoking intentions/behaviours predicted limited health literacy, but characteristics of the prison were predictive. Physical problems (sleep, nausea, tiredness and headaches), mental health and well-being (anxiety, depression and affect) and somatisation problems were also predictive of limitations.

Prison healthcare services and commissioners should undertake regular health literacy needs assessments to support developments in reducing barriers to healthcare and increasing health improvement efforts. Action also requires greater political will and investment to consider broader action on the wider determinants of (prison) health.

The study provides a framework to understand and guide prison health efforts and highlights attention needed at the level of governments, prison leaders and their health systems.

This paper provides an overview of the range and development of health informatics, with examples from the literature world wide covering the types of information involved, the areas of application, the impact of evidence based medicine and other professional issues, integrated information systems, and the needs of the public, patients and their carers. While medical informatics certainly comprises a major part of health informatics it is not the main focus of this paper. Medical informatics is the older term and involves the use of information technology and computing specifically for medical science research, and the diagnosis and treatment of disease involving, for example, X‐rays, imaging, resonance, and magnetic scanning techniques. Rather, the scope of this review is the literature relating to the wider concept of the management of information through the interdisciplinary application of information science and technology for the benefit of patients, scientists, managers, staff, and carers involved in the whole range of healthcare activity.