This policy is aimed at patients, relatives and staff. Thank you for recommending British Journal of General Practice. Patient information leaflets (PILs) form part of this policy and have been shown to affect patient health outcomes; however, many are poorly written. Of the PILs, 47.8% were classified as systems navigation (information regarding services); 22.9% were disease prevention (screening and immunisations); 14.2% personal and public safety; and less than 10% were for managing illness or health promotion. There are obvious limitations with this: a well-understood word may have multiple syllables, such as television, whereas a less well-known medical term may have fewer, such as stoma. In the field of health promotion so far there is only little awareness. Government policy in the UK places emphasis on providing patients with good- quality health information to encourage better patient participation in their health care, particularly with reference to managing long-term conditions or promotion of wellbeing. In any case, they should be observed and documented once they occur within the context of health promotion interventions, at the very least to give credit to the intervention. Online ISSN: 1478-5242. The WHO Global Strategy on Diet, Physical Activity and Health states that all sectors of health need to act at a global, regional, and local level to improve the health of the population. . Literature on unintended effects of health promotion is rather scarce and fairly difficult to find. This research was funded by Stoke-on-Trent City Council. If you have a subscription to The BMJ, log in: Subscribe and get access to all BMJ articles, and much more. To provide data on the effectiveness of printed health-educational materials. In fields like medicine and biology, the study of, and accountability for, unintended effects is an integral part of assessment processesthere is awareness that an intervention may have effects that were not planned and researchers aim at documenting and preventing them. Health here is viewed as a resource and health promotion is aimed at increasing the control of people over this resource and improve equity for all. What do you want your leaflet to achieve? (, Riley K. E., Ulrich M. R., Hamann H. A, Ostroff J. S. (, Rootman I., Goodstadt M., Hyndman B., Potvin L., Springett J., Ziglio E. The formulas do not take account of whether the words are strung together in a cohesive fashion; they have no measure of sense-making. Health promotion is the process of enabling people to increase control over, and to improve, their health. There is some variation between the average readability scores between categories. Several health promotion methods have been implemented by the MOH, surveys and studies have shown that these methods have shown positive impact on the health promotion interventions like peer led interventions (Georgie, 2016), media advocacy (Wallack, 1996) that advocates the issues, shows its side effects on health, lifestyle and family of an . Only 24.3% meet recommended reading-level criteria. However, about one in five of the materials require a minimum readability level of that of a 16-year-old school leaver, and some have a grade level as high as 14.2, which is equivalent to the readability level of a second-year university student. One way of assessing the complexity of written materials is to measure the readability using formulas that assess word and sentence length, such as Flesch Reading Ease and FleschKincaid Grade Level.13,14 Although these formulas are not without criticisms in the literature (for example, they do not take account of the use of necessary medical terms and they were developed in the US rather than the UK), they have excellent reproducibility, high correlations with other readability scales, and have been used in many previous studies.15,16. Background Government policy in the UK emphasises providing patients with good health information to encourage participation in their health care. In comparison with the national skills levels (which show that 15% of the English population have literacy skills lower than US grade 6), these data show that over 75% of the PILs collected were written at a level too complex for 15% of the English population. Research evidence has variously concluded that PILs do affect patient health outcomes, but that many are poorly written. Stoke-on-Trent is a particularly apposite area in which to conduct this research as a recent equality and diversity audit from the council reported that Stoke-on-Trent remains lower than average across most health indicators in England.22. Therefore, we can see that we need to tackle this challenge at a community and setting based as well as a structural approach. The research was conducted in elementary schools in the Zenica-Doboj Canton. To contribute towards your professional development and local registration renewal . The versatility of posters makes them an ideal form of promotion. They want to save money in every possible way, but they know that investments in the promotion are necessary. In Payne et al's study, "bad" and "good" days were identified. Agarwar and Brydges have chosen an ethnographic methodological approach, arguing that this way they could gain a holistic view of the intervention programme, which also incorporates the observation of, what they call, spin-off effects (Agarwar and Brydges, 2018). Restricted publications. 2023 British Journal of General Practice, Print ISSN: 0960-1643 This review aimed to identify the effectiveness of the use of traditional health promotion media (leaflets and posters) in a community setting in the digital era. Access. There are also other underlying determinants including poverty, stress and hereditary factors. It is possible that this is a conservative estimate as the 2011 Skills for Life Survey included only people of working age, and published evidence suggests that literacy and health literacy decline with age.23 It is also worth noting that only 24% of the PILs were written at the level recommended for writing health materials.15,18. Resources go down the drain when your message doesn't reach your audience. (2018) conclude that school food programmes can contribute to stigmatization and social exclusion. On the other hand there are a few disadvantages of using mass media to promote heath education, such as cost effectiveness. Gupta R, Ingle NA, Kaur N, Ingle E, Charania Z. More and more children are being diagnosed as obese at a young age where they tend to be extremely self-conscious about their weight and physical appearance. There have been many anti-smoking campaigns designed to raise awareness of this public health challenge and to try and make smokers think twice before taking their next cigarette. (1999) documented that oral rehydration solutions, used to treat cholera patients in Guinea-Bissau, were easily contaminated when prepared in the field, allowing the growth of many types of bacteria. Disadvantages Focuses on the absence of disease rather than on promoting positive health Based on a medical definition of health Ignores the social and environmental dimensions of health Encourages dependency on medical knowledge and compliance with treatments Removes health decisions from nonprofessional people Methods The data suggest that, on average, the materials collected have readability levels suitable for US grade 8, equivalent to that expected of a 1314-year-old schoolchild. radionz. The lower the score, the easier it is to understand the document. We should embrace the interdisciplinarity of our field and use several approaches and perspectives for the complex issue of unintended effects. Effect of educational leaflets and questions on knowledge of contraception in women taking the combined contraceptive pill: randomised controlled trial. The Wanless review of health care funding (2002) showed that public engagement with health could help to reduce health care costs. Tel: +44 (0)20 3188 7400 It moves beyond a focus on individual behaviour towards a wide range of social and environmental interventions. 4 Pages. Unable to load your collection due to an error, Unable to load your delegates due to an error. Treasure Island (FL): StatPearls Publishing; 2022 Jan. Again, it is worth looking at resources from other fields, where in the context of social development programmes, Jabeen has developed the unintended outcomes evaluation approach (Jabeen, 2018). Focus on the way in which an environment shapes behavior. Please note: your email address is provided to the journal, which may use this information for marketing purposes. Standard 1 - Management policy. Health promotion. 1450 Words. As a core function of public health, health promotion supports governments, communities and individuals to cope with and . The effectiveness of school-based family asthma educational programs on the quality of life and number of asthma exacerbations of children aged five to 18 years diagnosed with asthma: a systematic review protocol. It is necessary to go to a higher level and look at environmental and structural approaches. 92, Systems thinking and complexity: considerations for health promoting schools, Empowerment implementation: enhancing fidelity and adaptation in a psycho-educational intervention, Theory-informed health promotion: seeing the bigger picture by looking at the details, The Author(s) 2018. 3. Keywords: continuing education, health promotion, knowledge transfer, poster presentations, systematic . Two way communication could also be used in the form of leaflets, letters or posters detailing some basic information about the health promotion. Considerations for School Food Programs, Canadian Journal of Dietetic Practice and Research, Unintended effects in settings-based health promotion, Evaluationg health promotion Progress, problems and solutions, Healthism and weight-based discrimination: the unintended consequences of health promotion in the workplace, Decreasing smoking but increasing stigma? Having considered the advantages and disadvantages of using a leaflet you will want to consider the aims of your leaflet. This means that patients are being given very different information about the effects of the same surgery, depending on where they live and which leaflets are used. In this essay I will be discussing the 'settings' based approach (SBA) of Health Promotion (HP) as a process for achieving sustainable improvements in health outcomes. Patil University. Manchester, and senior lecturer in general practice, Research Institute for Primary Care and Health Sciences, Keele University, Keele, Staffordshire. 75120. Method PILs were assessed for readability (Flesch Reading Ease and FleschKincaid Grade Level) and compared with national skills level data and with the recommended level for medical information. schools, hospitals and cities) as dynamic open systems where an intervention does not have a clear foreseeable outcome but can cause a series of effects (Dooris, 2006; Rosas, 2017). In conclusion, managing cardiovascular disease in New Zealand needs to have more initiatives using inter-sectoral approaches as no single health promotion approach by itself is enough to solve this leading cause of mortality in New Zealand. Smoking is strongly associated with CVD and is the most preventable cause. Valid evaluation is important, but difficul . Affordability and accessibility of health services are important factors in not only whether people will exhibit positive changes in behaviors, but also in whether these changes will be long term. DISADVANTAGES They Are Discarded Once Read If They're Poor Quality Leaflets lack long term impact as many consumers may read the leaflet but they will not keep them. 30 Euston Square A poor promotional strategy for a small local gardening business might involve advertising on national TV combined with sponsorship of a local gardening competition. The individual and lifestyle approach looks at the individuals choices and behaviours that need changing to decrease risks of any diseases. Anti-tobacco campaigns, public health, and cancer care, WHO Regional Publications European Series, No. Aim: A study that investigated the awareness of risk of osteoporosis warned that making women uncertain and worried could be a 'serious side effect of health promotion' ( Hvas et al., 2005 ). As this study is in the context of primary care, specifically general practice, a broader contextual framework of health would be appropriate. A study of a school health promotion network showed that gaining new skills and new relationships through their health promotion work as well as benefitting from improved infrastructure were some positive unintended effects for the teachers involved in the implementation work (Gugglberger et al., 2017). Despite the rhetoric, we are a long way away from truly informed decision making for all. The individual and lifestyle approach is the most commonly used when addressing the public health challenge of cardiovascular disease (CVD). In the same survey, 43% of the working-age population had literacy skills less than or equal to 1314-year-old schoolchildren (equivalent to US grade 89). Critical analysis of health promotion leaflet This essay aims to critically appraise a health promotion leaflet (Appendix 1), which at present is incorporated in a health promotion campaign from the NHS. The findings regarding readability of PILs are in line with previous literature examining PILs. . The purpose of a PIL is for patient education and information, and patient empowerment,2,3 but clearly to be useful for this, leaflets must be appropriately written and cover a wide range of content, depending on their context. Although they can be found almost anywhere that healthcare services are provided, one of the most common places for patients to access PILs is in the waiting room of their general practice. Besides that, some disadvantages are easily solvable. The total number of respondents was 120. The authors thank Stoke-on-Trent City Council. To understand how health promotion approaches can be embedded in your role and enhance the overall effectiveness of your practice. For example, a score of 8.0 means someone from the eighth grade can understand the document. The .gov means its official. Keywords: MECC has disadvantages within acute health settings, this is due to the approach not being implemented, for example within emergency departments, nurses struggle to achieve smoking health promotion outcomes due to the high dependency care they specialise in. In regards to harmful effects of health promotion the primary aim should therefore be to anticipate and prevent or, at least, to monitor them and find strategies to contain or control them. The method of distribution of health-educational posters shows a lower but still present statistical significance (p<0.05) in relation to the acquired knowledge and a change in attitudes between the conducted surveys at different time points. Let's have a look at some disadvantages compared to the other marketing methods out there. Before A poster must attract attention. The Health Promotion Agency is a great organisation that raises awareness amongst the population on nutrition and physical activity, two factors strongly linked to CVD. Much more problematic are unintended effects that are undesirable; cases where interventions have negative consequences for the target group or people involved in the implementation. Bookshelf nz/what-we-do/nutrition-and-physical-activity ). As shown in Table 1, although 80.9% of the PILs had a readability level suitable for US grade 9 and below, only 24.3% were within the recommended reading-level criteria for PILs of US grade 6 or below. Please enable it to take advantage of the complete set of features! Current PILs in the waiting rooms of general practices are not likely to be promoting the health literacy of a significant proportion of patients. This site needs JavaScript to work properly. For full access to this pdf, sign in to an existing account, or purchase an annual subscription. 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