Interdisciplinary health promotion: a call for theory-based interventions drawing on the skills of multiple disciplines

Development and Application of an Interdisciplinary Rapid Message Testing Model for COVID-19 in North Carolina

INTRODUCTION

From the onset of the COVID-19 pandemic, public health officials have sought to develop evidence-based messages to reduce COVID-19 transmission by communicating key information to media outlets and the public. We describe the development of an interdisciplinary rapid message testing model to quickly create, test, and share messages with public health officials for use in health campaigns and policy briefings.

METHODS

An interdisciplinary research team from the University of North Carolina at Chapel Hill assembled in March 2020 to assist the state health department in developing evidence-based messages to influence social distancing behaviors in the state. We developed and iteratively executed a rapid message testing model; the components of the 4-step model were message creation, survey development, survey administration, and analysis and presentation to health department officials. The model was executed 4 times, each during a 7-day period in April and May, and each subsequent survey included new phrasing and/or messaging informed by the previous week's survey. A total of 917 adults from North Carolina participated in the 4 surveys.

RESULTS

Survey participants rated messages focused on protecting oneself and others higher than messages focused on norms and fear-based approaches. Pairing behaviors with motivations increased participants' desire to social distance across all themes and subgroups. For example, adding "Protect your grandmother, your neighbor with cancer, and your best friend with asthma," to messaging received a 0.9-point higher score than the base message, "Stay 6 feet apart from others when out in public."

PRACTICE IMPLICATIONS

Our model to promote social distancing in North Carolina during the COVID-19 pandemic can be used for rapid, iterative message testing during public health emergencies.

Managers’ Support for Employee Wellness Programs: An Integrative Review

Objective:

The aim of this integrative literature review is to synthesize the existing evidence regarding managers’ support for employee wellness programs.

Data Source:

The search utilized multiple electronic databases and libraries.

Study Inclusion and Exclusion Criteria:

Inclusion criteria comprised peer-reviewed research published in English, between 1990 and 2016, and examining managers’ support in the context of a worksite intervention. The final sample included 21 articles for analysis.

Data Extraction:

Two researchers extracted and described results from each of the included articles using a content analysis.

Data Synthesis:

Two researchers independently rated the quality of the included articles. Researchers synthesized data into a summary table by study design, sample, data collected, key findings, and quality rating.

Results:

Factors that may influence managers’ support include their organization’s management structure, senior leadership support, their expected roles, training on health topics, and their beliefs and attitudes toward wellness programs and employee health. Managers’ support may influence the organizational culture, employees’ perception of support, and employees’ behaviors.

Conclusions:

When designing interventions, health promotion practitioners and researchers should consider strategies that target senior, middle, and line managers’ support. Interventions need to include explicit measures of managers’ support as part of the evaluation plan.

Effectiveness of a Web-Based Health Education Program to Promote Oral Hygiene Care Among Stroke Survivors: Randomized Controlled Trial

Background

Oral hygiene care is of key importance among stroke patients to prevent complications that may compromise rehabilitation or potentially give rise to life-threatening infections such as aspiration pneumonia.

Objective

The aim of this study was to evaluate the effectiveness of a Web-based continuing professional development (CPD) program on “general intention” of the health carers to perform daily mouth cleaning for stroke patients using the theory of planned behavior (TPB).

Methods

A double-blind cluster randomized controlled trial was conducted among 547 stroke care providers across 10 hospitals in Malaysia. The centers were block randomized to receive either (1) test intervention (a Web-based CPD program on providing oral hygiene care to stroke patients using TPB) or (2) control intervention (a Web-based CPD program not specific to oral hygiene). Domains of TPB: “attitude,” “subjective norm” (SN), “perceived behavior control” (PBC), “general intention” (GI), and “knowledge” related to providing oral hygiene care were assessed preintervention and at 1 month and 6 months postintervention.

Results

The overall response rate was 68.2% (373/547). At 1 month, between the test and control groups, there was a significant difference in changes in scores of attitude (P=.004) and subjective norm (P=.01), but not in other TPB domains (GI, P=.11; PBC, P=.51; or knowledge, P=.08). At 6 months, there were significant differences in changes in scores of GI (P=.003), attitude (P=.009), SN (P<.001) and knowledge (P=.001) between the test and control groups. Regression analyses identified that the key factors associated with a change in GI at 6 months were changes in SN (beta=.36, P<.001) and changes in PBC (beta=.23, P<.001).

Conclusions

The Web-based CPD program based on TPB increased general intention, attitudes, subjective norms, and knowledge to provide oral hygiene care among stroke carers for their patients. Changing subjective norms and perceived behavioral control are key factors associated with changes in general intention to provide oral hygiene care.

Trial Registration

National Medical Research Register, Malaysia NMRR-13-1540-18833 (IIR); https://www.nmrr.gov.my/ fwbLoginPage.jsp

The impact of social determinants on schoolchildren's oral health in Brazil

The aim of this study was to evaluate the impact of socioeconomic status, home environment, and self-perception of health conditions on schoolchildren's dental caries experience. A total of 515 twelve-year-old schoolchildren from Juiz de Fora, State of Minas Gerais, Brazil, were selected into a random multistage sample. The schoolchildren were examined for the presence of caries lesions using the decayed/missing/filled teeth (DMFT) index and categorized as caries-free (DMFT = 0) or with caries experience (DMFT > 0). The participants and their parents were asked to answer a questionnaire about socioeconomic status, home environment, and self-perception of their health conditions. The hierarchical multiple regression model was used to assess the associations, since a binary response variable was assumed. The bivariate analysis revealed that variables at four levels, such as type of school, monthly family income, parents' education, home ownership, number of people living in the household, household overcrowding, parents' perception of their children's oral health, and schoolchildren's self-perception of their oral health (p < 0.05), were significantly associated with children's worse dental caries conditions. The regression model results showed that type of school and monthly family income had a strong negative effect on schoolchildren's dental caries experience (p < 0.05) in the final statistical model, where all levels were included. It was observed that socioeconomic factors were considered a strong risk indicator of schoolchildren's caries experience among the investigated social determinants of oral health.