Community-based health interventions

Innovative projects to reduce disparities in cancer treatment and research include partnerships between academic and community cancer centers, patient navigation programs and strategies to promote community awareness, education and engagement. A 4 h training program about cancer clinical trials was developed through a needs assessment and in collaboration with community health workers who served as consultants and a larger advisory board comprised of community health workers, educators and clinical trialists. This program was delivered first as a collaboration between a phsycian who is experienced in the conduct of clinical research and two community health workers, and subsequently by the community health workers alone. We report on four workshops attended by a total of 61 community health workers recruited from Boston-area hospitals, community health centers and outreach programs. Support for and knowledge of clinical trials was measured in a pretest and post-test, which also included a satisfaction rating. Participants had a range of prior experience with clinical trials in the context of their personal and professional experience. Mean accuracy of knowledge about clinical trials increased from 72 to 84%, support for clinical trials improved considerably, and satisfaction with the training experience was high. Knowledge gaps and low levels of support for cancer clinical trials among community health workers can be improved with a short training program delivered by other community health workers. Further research is needed to identify the impact of this training on accrual to cancer clinical trials.

Objectives: Implementation of a large-scale, child weight management program in low-income, ethnically diverse communities provided an important opportunity to evaluate its effectiveness under service level conditions (i.e. provision as a primary care child weight management service). Methods: MEND 7–13 is a community-based, multicomponent, childhood obesity intervention designed to improve dietary, physical activity and sedentary behaviors. It comprises twice weekly sessions for 10 consecutive weeks (35 contact hours) and is delivered to groups of children and accompanying parents/caregivers. The evaluation used an uncontrolled, repeated measures design. 3,782 children with overweight or obesity attended 415 MEND 7–13 programs in eight US states. 2,482 children (65.6%) had complete data for change in zBMI. The intervention targeted low-income, ethnically diverse families. Changes in anthropometric, cardiovascular fitness and psychological outcomes were evaluated. A longitudinal multivariate imputation model was used to impute missing data. Peer effects analysis was conducted using the instrumental variables approach and group fixed effects. Results: Mean changes in BMI and zBMI at 10 weeks were -0.49 kg/m 2 (95%CI: -0.67, -0.31) and -0.06 (95%CI: -0.08, -0.05) respectively. Benefits were observed for cardiovascular fitness and psychological outcomes. Mean peer reduction in zBMI was associated with a reduction in participant zBMI in the instrumental variables model (B=0.78, p=0.04, 95%CI: 0.03, 1.53). Mean program attendance and retention were 73.9% and 88.5% respectively. Conclusion: Implementing MEND 7–13 under service level conditions was associated with short-term improvements in anthropometric, fitness and psychological indices in a large sample of low-income, ethnically diverse children with overweight and obesity. A peer effect was quantified showing that benefits for an individual child were enhanced, if peers in the same group also performed well. To our knowledge, this is the first US study to evaluate outcomes of an up-scaled community-based, child weight management program and to show positive peer effects associated with participation in the intervention.

Does the Bell Let’s Talk mental health campaign successfully articulate and undertake one of its core mandates: the reduction of stigma and promoting awareness of mental health? Bell Let’s Talk uses a variety of media to communicate and deliver its campaign messages, and I will examine a piece of their print media: The Bell Let’s Talk Toolkit: Starting the Conversation about Mental Health to determine why and how the material has a sociological approach.

A country's Healthcare system speak volumes about her developmental stage. This paper examines  Mozambique healthcare system and identified the leading health challenges.  HIV/AIDS and Malaria are the two major leading cause of death for adult and children, respectively. Mozambique has a very stunted economic growth with about 6-7 percent which mainly benefits the urban population of which its over 80 percent population lives in the rural areas. Despite the intervention of international organisation, the current healthcare in the country is highly unfair and in a state of disarray.  With the health care system being driven by fee payment method, it is a huge problem for the most of the population to access good health care services due to their poor social and economic status. Introducing national health insurance policy may reduce the burden of self-pay method for the treatment of diseases and ill-health among the Mozambican population.

Barbershops represent a promising setting for reaching men and promoting health (Cowart et al., 2004; Magnus, 2004; Madigan et al., 2007; Releford et al., 2010; Victor et al., 2009). Hart and Bowen (2004) have discussed the feasibility of partnering with Black barbershops to provide prostate cancer education (Hart and Bowen, 2004). However, no published studies have attempted to assess shop owner preferences for learning and sharing general health information with their customers. This is the first populationbased survey to assess owner preferences with a focus on differences between owners of Black and White barbershops. Results will be used to help plan for and design culturally and contextually appropriate barbershop-based interventions.

USA Leadership networks Evidence-based interventions Social network analysis Faith-based organizations a b s t r a c t Through two case studies of Catholic parishes in Massachusetts, this study explores the implications of leader-centered versus distributed leadership in Catholic parishes for the implementation of evidencebased health interventions. The two parishes involved in the study differ from each other in several ways. In the first, parishioners are less engaged in leadership activities at the decision-making level in the parish. A small group of lay volunteers work with the parish priest and other ordained leaders on parish activities. In the second parish, a large and active lay volunteer leadership have forged an organizational structure that allows more independence from the pastor's direct oversight. In this parish, lay volunteer leaders are the prime drivers of organizational programs and events. In 2012e2013, three types of networks were assessed at each parish: discussion, collaboration, and outside-of-parish ties. The contrasts between each parish include differences in density of collaboration, in frequency of discussion, and network centrality of the respective parish priests. We further identified key actors in the network structures at each parish. We discuss the implications of these findings for understanding organizational capacity in the context of health program implementation.

Reported by: SW Nicholas, MD, VE Hutchinson, MD, B Ortiz, MD, S Klihr-Beall, MA, Dept of Pediatrics, Harlem Hospital Center; B Jean-Louis, PhD, K Shoemaker, MPP, C Singleton, MSW, J Credell, R Swaner, MPA, Harlem Children's Zone, Inc.; RD Vaughan, DrPH, ME Northridge, PhD, LF Cushman, PhD, E Polley, C Golembeski, Harlem Health Promotion Center, Columbia Univ, New York.

Since 1980, asthma prevalence, hospitalization, and mortality have been increasing in the United States (1). Because of concern about asthma-related morbidity among children in Central Harlem, New York City (NYC), the Harlem Children's Zone Asthma Initiative (HCZAI) was established in 2001 to reduce asthma-related morbidity through improved surveillance, health-care use, and health-care service delivery for children aged <12 years living in a 60-block radius of Central Harlem known as the Harlem Children's Zone Project*. Families of children with asthma or asthma-like signs† or physical findings consistent with asthma are invited to participate in the program. This report summarizes preliminary data collected during 2001--2004 on the effectiveness of the program in reducing asthma-related morbidity; data indicate decreased parental/guardian reports of school absences among children enrolled in the program, both for any reason and because of asthma. In addition, emergency department and unscheduled physician office visits for treatment of asthma decreased from 35% to 8% after 18 months of the program, indicating improved asthma management and appropriate use of health-care services by program enrollees. The effectiveness of HCZAI underscores the utility of community-based public health programs in reducing asthma morbidity.

objectives Further scale-up of antiretroviral therapy (ART) to those in need while supporting the growing patient cohort on ART requires continuous adaptation of healthcare delivery models. We describe several approaches to manage stable patients on ART developed by M edecins Sans Fronti eres together with Ministries of Health in four countries in sub-Saharan Africa.

Interventionists usually blame cultural factors and traditional attitudes for non-compliance of target populations, a framework Didier Fassin terms as culturalism. Despite their efforts, what the Roll Back Malaria employees find in southeastern Nigeria is a 'troubling' nonchalance towards the programme because target populations' perceptions of malaria differ from the donor/programme perspective. The RBM employees cast the local attitude as culturalism, accordingly framing their exhortations in terms of this discourse. How the Roll Back Malaria employees deployed culturalism to fit with the neoliberal individualizing framework of current international health practices is one more nuanced analytical perspective the article brings to intervention literature.

Information on the costs of public health interventions is crucial for policy makers to assess whether scarce resources are being used efficiently. There is growing recognition of the importance of cost analyses of health interventions at a local level particularly in developing countries. There are several methods available for costing of public health interventions but each method has its own strengths and weaknesses. This paper gives an

In Central and Eastern Europe (CEE), health‐mediation programs (HMPs) have become central policy instruments targeting health inequities between segregated Roma and general populations. Social determinants of health (SDH) represent the root causes behind health inequities. We therefore evaluated how an HMP based in Slovakia addressed known SDH in its agenda and its everyday implementation. To produce descriptive data on the HMP&#39;s agenda and everyday implementation we observed and consulted 70 program participants across organizational levels and 30 program recipients over the long‐term. We used a World Health Organization framework on SDH to direct data acquisition and consequent data content analysis, to structure the reporting of results, and to evaluate the program&#39;s merits. In its agenda, the HMP did not address most known SDH, except for healthcare access and health‐related behaviours. In the HMP&#39;s everyday implementation, healthcare access facilitation activities w...

Despite political change over the past 25 years in Britain there has been an unprecedented national policy focus on the social determinants of health and population-based approaches to prevent chronic disease. Yet, policy impacts have been modest, inequalities endure and behavioural approaches continue to shape strategies promoting healthy lifestyles. Critical public health scholarship has conceptualised this lack of progress as a problem of 'lifestyle drift' within policy whereby 'upstream' social contributors to health inequalities are reconfigured 'downstream' as a matter of individual behaviour change. While the lifestyle drift concept is now well established there has been little empirical investigation into the social processes through which it is realised as policies are (re)formulated and implementation is localised. Addressing this gap we present empirical findings from an ethnography conducted in a deprived English neighbourhood in order to explore: (i) the local context in the process of lifestyle drift and; (ii) the social relations that reproduce (in)equities in the design and delivery of lifestyle interventions. Analysis demonstrates how and why 'precarious partnerships' between local service providers were significant in the process of 'citizen shift' whereby government responsibility for addressing inequity was decollectivised.

Thirty-three community-based health care programmes were surveyed in 19 districts all over Uganda. Programmes and projects calling themselves community-based health care cover a wide variety of sectors and activities. Most CBHC programmes have highly evolved formal administrative structures; most have, or claim to have, baseline surveys, written plans and budgets, formal plan review mechanisms, standing committees with regular and minuted meetings, etc.  Most CBHC programmes are hierarchically organised and run; they lack democratic control at grassroots level. Most CBHC programmes are heavily dependent on outside agencies (e.g. churches, donors, UN) for equipment, supplies, and funding. The emphasis of these outside agencies on achieving quantifiable targets in short time periods may have had adverse consequences on the quality of the programmes.

Background: This study was conducted to gauge how the demographic profile of smokeless tobacco (SLT) users from Gujarat and Andhra Pradesh, India, differs from that of smokers. It also addresses how factors associated with the initiation and continuation of smokeless tobacco vary by age, gender, and education.
Materials and Methods: We analyzed 2011 cross-sectional survey data collected from 4,759 respondents (smokers/SLT users/non-users) in both states. Chi-square analysis was used to make comparisons between the demographic profiles of smokers and SLT users. Multivariable logistic regression analysis was used to obtain the odds ratios (ORs) for initiation and continuation factors regressed on socio-demographic variables (age, gender, education).
Results: Initiation-women were less likely than men to report “peer pressure”, “fashion statement”, and “stress/coping” as
relevant factors for SLT use (OR: 0.45 CI: 0.30-0.70; OR: 0.42 CI: 0.24-0.74; OR: 2.47, CI: 1.47-4.15). Older age groups had lower odds of choosing “peer pressure” than the 15-24 year olds. Respondents with 11 or more years of education were more likely to report “stress/coping” than those with no education (OR: 2.82, CI: 1.06-7.48).
Continuation-women were less likely than men to choose “relaxation”, and “distance from family” as important continuation factors (OR: 0.50, CI:0.32-0.80; OR: 0.20, CI: 0.06-0.65). All age groups were less likely to choose “stimulation” as a factor than the youngest group. Conclusions: Along with confirming and expanding upon previous literature, the findings of this study should encourage further SLT research in women and younger age groups (15-24 and 24-44). They also confirm the need for SLT prevention and cessation interventions in India in other community-based settings, besides schools.

Globally, the population is ageing, which has serious consequences for businesses. The prosperity of companies is crucially dependent on the ability to effectively manage their employees, including older workers. Best practice in age management is defined as those measures that combat age barriers and/or promote age diversity. These measures may entail specific initiatives aimed at particular dimensions of age management; they may also include more general employment or human resources policies that help to create an environment in which individual employees can achieve their potential without being disadvantaged by their age (Walker, 1999).
Promoting early retirement is generally not encouraged. Companies now have to encourage longer working lives. Much needs to be done to ensure that work remains a positive experience for workers throughout their career trajectories, and it does not damage their health. It has been found by studies that health is significantly related to retirement timing (both planned and unplanned) (Goyer, 2013, Adams et al., 2014), influences work performance (Merrill et al., 2012; Ilmarinen, 2009), and health-related organisational policies can positively influence employee retention (Towers, 2005). The major contemporary challenges to health at work are those associated with the way work, and work organisations are designed and managed. This is especially true for older workers. A comprehensive and effective approach towards age management can be very beneficial for them. How should companies implement age management? Some possible ways are set out in this policy brief below, which focuses on best practices in age management regarding ergonomic aspects and health interventions for older workers at an organisational level. The intention is to discuss the current situation and to illustrate some organisational techniques in selected countries. This policy brief can serve as an inspiration for, among others, companies and policymakers. Recommendations for successful practice are included. In total, this policy brief covers 8 COST  member countries (the Czech Republic, Finland, Germany, the Netherlands, Slovenia, Spain, Sweden and the United Kingdom) to give a glimpse of the current situation of best practice in age management and show how companies in various states deal with ergonomic aspects, health interventions and the ageing of their labour force.

Perspectives into Better Communication Practices at this Conference

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Theatre-based interventions have been used in health promotion with young people to address HIV and sexual health. In this study, we explored the experience of undergraduate student performers participating in a theatre-based HIV prevention and sexual health education intervention for high school students in the USA.
Undergraduate students enrolled in a credit-bearing course to learn about HIV and sexual health, participatory theatre and health education techniques. We analysed students’ reflective essays written throughout the semester to identify any changes and the intervention processes that promoted these changes. Students experienced five interrelated forms of transformation: (1) increased knowledge about HIV and sexual health; (2) changes in attitudes and communication about sex; (3) artistic growth; (4)
emotional growth; and (5) clarification of career goals and future plans. Intervention processes that contributed to these transformations included improvisation, guided writing exercises, the creation of a close-knit cohesive group and interactions with
a group of HIV-positive speakers. Theatre-based, peer-led sexual health programmes can provide a transformative experience for undergraduate student performers. These transformative effects are linked to specific activities and processes of the intervention
and require examination in future research.

Theatre-based interventions have been used in health promotion activities among young people to address HIV and sexual health. In this study, we explored the experience of undergraduate student performers participating in a theatre-based HIV prevention and sexual health education intervention for high school students in the USA. Undergraduate students enrolled in a creditbearing course to learn about HIV and sexual health, participatory theatre and health education techniques. We analysed students' reflective essays written throughout the semester to identify any changes and the intervention processes that promoted these changes. Students experienced five interrelated forms of transformation: (1) increased knowledge about HIV and sexual health; (2) changes in attitude and communication about sex; (3) artistic growth; (4) emotional growth; and (5) clarification of career goals and future plans. Intervention processes that contributed to these transformations included improvisation, guided writing exercises, the creation of a close-knit cohesive group, and interactions with a group of HIV-positive speakers. Theatre-based, peer-led sexual health programmes can provide a transformative experience for undergraduate student performers. The transformative effects are linked to specific activities and processes of the intervention and require examination in future research.

A variety of health financing schemes shaped on pre-payment scheme have been implemented across Sub-Saharan Africa (SSA) to address the Millennium Development Goals (MDGs). In Mauritania, the Obstetric Risk Insurance package (ORI) focusing on maternal and perinatal health has been progressively implemented at the health district level since 2002. Here, our main objective was to assess the effectiveness of the ORI in increasing facility-based delivery rates, as well as increases in family planning, antenatal and postnatal care, caesarean delivery and neonatal health, from demographic and health survey data between 2002 and 2011. We also examined whether the effects of the ORI varied between strata of the population. The study was based on a quasiexperimental before-and-after design to assess the causal link between availability of ORI and increase in use of maternal health services and neonatal mortality. In combination with geographical information system, difference-indifferences and odd ratio approaches were used to address our objectives. Indicators of access to care for pregnant women and neonatal health and improved in both non-intervention and intervention groups during the study period. There was no global effect of the availability of ORI on facility-based delivery rates, nor on the use of antenatal and postnatal care services, except for qualified antenatal services. However, delivery rates in local health centres with ORI increased more rapidly than in those with no ORI, the contrary was shown for hospitals. Caesarean delivery and family planning decreased with ORI. Although late neonatal mortality rates remained low in the country, a significant decrease was seen in districts without ORI. Except for some strata of the population, ORI has not really met its objective of attracting more pregnant women towards facility-based health care.

This case study is about Master A. A, a 4 year old boy with sickle cell disease who was diagnosed of osteomyelitis with pathological fracture of the right humerus. Patient has been hospitalised before for dactylitis on the 7 th July, 2015, was treated and discharged home on the 16 th July, 2015. He was however readmitted via Children Outpatient Department of Oni and Son Memorial Hospital, Ibadan, Nigeria on the 21 st July, 2015 on account of history of fever of 6 days duration and swelling of the distal 2/3 third of the left forearm, there was also swelling of the right upper hand which was associated with pain and loss of function. A provisional diagnosis of osteomyelitis with pathological fracture of the right humerus was made by the doctor in charge. He was later reviewed by the paediatric team and was admitted into Ward I for further investigations and proper management. Afterwards, Master A, A had cast applied on the right humerus due to the fracture as confirmed by the X-ray report. Nursing management was carried out by adopting Quality Care Model which was proposed by Duffy J. R (2005).

Abstract

The use of community health workers to administer prompt treatments is gaining popularity in most sub-Saharan African countries. Their performance is a key challenge because it varies considerably, depending on the context, while being closely associated with the effectiveness of case management strategies. What determines community health workers' performance is still under debate. Based on a realist perspective, a systematic review recently hypothesized that several mechanisms are associated with good performance and successful community interventions. In order to empirically investigate this hypothesis and confront it with the reality, we conducted a study in Burkina Faso, where in 2010 health authorities have implemented a national program introducing community case management of malaria. The objective was to assess the presence of the mechanisms in community health workers, and explore the influence of contextual factors. In 2012, we conducted semi-structured interviews with 35 community health workers from a study area established in two similar health districts (Kaya and Zorgho). Results suggest that they perceive most of the mechanisms, except the sense of being valued by the health system and accountability to village members. Analysis shows that drug stock-outs and past experiences of community health workers simultaneously influence the presence of several mechanisms. The lack of integration between governmental and non-governmental interventions and the overall socio-economic deprivation, were also identified as influencing the mechanisms' presence. By focusing on community health workers' agency, this study puts the influence of the context back at the core of the performance debate and raises the question of their ability to perform well in scaled-up anti-malaria programs.

Background: Community-based health programs (CBHPs) with participatory approaches has been recognized as an important tool in health promotion. The goal of this study was to understand the nature of participation practice in CBHP and to use the data to advocate for more participation-friendly policies in the community, academy and funding organizations.

Community-based health programs (CBHPs) with participatory approaches has been recognized as an important tool in health promotion. The goal of this study was to understand the nature of participation practice in CBHP and to use the data to advocate for more participation-friendly policies in the community, academy and funding organizations. In this qualitative study, 13 CBHPs, which were active for last 5 years have been assessed using semi-structural in-depth interviews with programs principal and managers and focus group discussions with volunteers and service users. Data analysis was based on the deductive-inductive content analysis considering the participatory approaches in these programs. The results show that, the main category of participation was divided to community participation and intersectional collaboration. The community participation level was very different from &quot;main,&quot; &quot;advisory&quot; or &quot;supporting&quot; level. The process of recruitment of v...

By David Ayre, Lucy Capron, Pedro Guertler and Sarah Royston

The Warm and Informed project was launched in September 2014 as a partnership between Northern Gas Networks (NGN) and The Children’s Society, focusing on two low income areas of Bradford.  The findings in this report are based on:
 Five interviews with project workers and staff from Northern Gas Network
 17 interviews with service users accessing the Warm and Informed project
 16 interviews with service users that had not accessed the project
 Review of Key Performance Indicator data collected by the Bradford Children’s Centres
This evaluation report identifies key themes that have emerged from our interviews with families who have accessed the Warm and Informed project, and brings together our key findings about what worked, what issues there were, and what can be learned for an expansion of any similar work.

Fundamental conceptual tensions underlie current debates regarding the implementation of psychosocial interventions with war-affected populations. Three particular tensions structuring current discourse concern the generalisability versus uniqueness of relevant knowledge, the valuing of technical versus indigenous understandings, and the planning of targeted versus community-based intervention. The implications of working out these tensions in the implementation of programmes are explored, leading to the proposal of a model of phased response to psychosocial needs. This distinguishes four discrete phases of potential response: 1 minimal disruption of intact protective influences; 2 re-establishment of protective influences; 3 provision of compensatory support; and 4 targeted therapeutic intervention.

Thirty years after Alma-Ata, there has been an upsurge of interest in community health workers (CHWs) in low- and middle-income countries. This echoes several strategic policies recently endorsed by the World Health Organization and its global call to re-establish the primary healthcare (PHC) policy. However, we are witnessing a reframing of this approach rather than its renewal. In particular, the way CHWs are conceptualized has changed considerably. Far from serving as promoters of social change and community empowerment, today we expect them to act as front-line clinicians. This medicalization of CHWs results from a systemic erosion of health promotion’s influence over the last 20 years. Community case management of malaria perfectly illustrates this shift towards a pragmatic, medically centered, use of CHWs. Taking this example, we will discuss the pitfalls of this task-shifting strategy put forward by international health actors, and make suggestions to reattribute a mission of health promotion to CHWs, as intended by the Alma-Ata’s PHC policy

This supplement provides a comprehensive and indepth
examination of proven clinical-community
health strategies employed by the Alliance to Reduce
Disparities in Diabetes, across five sites located in
diverse geographic regions of the United States,
including a tribal community. Alliance projects in
these communities focused on African Americans,
Hispanics/Latinos, and American Indians as priority
populations. Each project was implemented with an
understanding that there are cultural norms, community
characteristics, and health care system challenges
that require sustained multicomponent
approaches to ameliorate factors that exacerbate poor
disease management and health outcomes. The articles
increase understanding of what is required to
implement evidence-based approaches shaped by
local experiences in order to meet the needs of diverse
communities affected by diabetes. Lessons learned
have generic elements that can be used in other priority
populations and settings.

Background and Objectives: Based on different studies, substance use is one of the health problems in the Iranian society. The prevalence of substance use is on a growing trend; moreover, the age of the onset of substance use has declined to early adolescence and even lower. Regarding this, the present study aimed to develop a family-based early-onset substance use prevention program in children (i.e., My Family-Study) by using intervention mapping approach. Materials and Methods: This study descirbes the research protocol during which the intervention mapping approach was used as a framework to develop My Family-Study. In this study, six steps of intervention mapping were completed. Interviews with experts and literature review fulfilled the need assessment. In the second step, the change objectivs were rewritten based on the intersection of the performance objectives and the determinants associated in the matrices. After designing the program and planning the implementation of the intervention, the evaluation plan of the program was accomplished. Results: The use of intervention mapping approach facilitated the developpment of a systematic as well as theory-and evidence-based program. Moreover, this approach was helful in the determination of outcomes, performance and change objectives, change of determinants, theoretical methods, practical application, intervention, dissemination, and evaluation program. Conclusions: As the findings of this study indicated, the intervention mapping provided a systematic as well as theory-and evidence-based approach to develop a quality continuing health promotion program.

Background. Childhood poisoning is an important cause of morbidity in both developed and developing countries. Epidemiological studies on accidental poisoning in children show a consistent pattern regarding age and gender. Childhood poisoning is predominant in children &lt;6 years of age and has a male preponderance, as boys are more active with a drive to explore the environment. Objective. To document the epidemiology of home poisonings in Kumasi and its environs. Methods. We conducted a retrospective study from January 2007 to January 2012 at the Komfo Anokye Teaching Hospital, a tertiary hospital in Ghana. Results. Poisoning is a significant health problem in the study area. A total of 253 children reported to the hospital with poisoning over the 61­month period, with an average of four cases per month. The male to female ratio was 1.58:1. The median age of the children was 24 months (interquartile range 24 ­ 48 months). Kerosene was the leading cause of poisoning (39.5%). Concl...

In Central and Eastern Europe (CEE), health-mediation programs (HMPs) have become central policy instruments targeting health inequities between segregated Roma and general populations. Social determinants of health (SDH) represent the root causes behind health inequities. We therefore evaluated how an HMP based in Slovakia addressed known SDH in its agenda and its everyday implementation. To produce descriptive data on the HMP&#39;s agenda and everyday implementation we observed and consulted 70 program participants across organizational levels and 30 program recipients over the long-term. We used a World Health Organization framework on SDH to direct data acquisition and consequent data content analysis, to structure the reporting of results, and to evaluate the program&#39;s merits. In its agenda, the HMP did not address most known SDH, except for healthcare access and health-related behaviours. In the HMP&#39;s everyday implementation, healthcare access facilitation activities w...

Background and Objectives: Based on different studies, substance use is one of the health problems in the Iranian society. The prevalence of substance use is on a growing trend; moreover, the age of the onset of substance use has declined to early adolescence and even lower. Regarding this, the present study aimed to develop a family-based early-onset substance use prevention program in children (i.e., My Family-Study) by using intervention mapping approach. Materials and Methods: This study descirbes the research protocol during which the intervention mapping approach was used as a framework to develop My Family-Study. In this study, six steps of intervention mapping were completed. Interviews with experts and literature review fulfilled the need assessment. In the second step, the change objectivs were rewritten based on the intersection of the performance objectives and the determinants associated in the matrices. After designing the program and planning the implementation of the intervention, the evaluation plan of the program was accomplished. Results: The use of intervention mapping approach facilitated the develop-pment of a systematic as well as theory-and evidence-based program. Moreover, this approach was helful in the determination of outcomes, performance and change objectives, change of determinants, theoretical methods, practical application, intervention, dissemination, and evaluation program. Conclusions: As the findings of this study indicated, the intervention mapping provided a systematic as well as theory-and evidence-based approach to develop a quality continuing health promotion program.