Lydia Makrides, Gilles R. Dagenais, Arun Chockalingam, Jacques LeLorier, Natalie Kishchuk, Josie Richard, John Stewart, Christine Chin, Karine Alloul and Paula Veinot
The purpose of this paper is to docoment a randomized controlled trial, with follow‐up at three and six months, to determine the impact of a coronary risk factor modification…
Abstract
Purpose
The purpose of this paper is to docoment a randomized controlled trial, with follow‐up at three and six months, to determine the impact of a coronary risk factor modification program for employees.
Design/methodology/approach
Intervention participants received a 12‐week health promotion program involving exercise, education seminars, nutritional analysis and smoking cessation counselling. Outcome measures included differences in coronary risk factors of control and intervention participants between baseline and three and six‐month follow‐up visits.
Findings
The participants included 566 individuals employed in the Halifax area, Nova Scotia, Canada. They were between 19 and 66 years old with at least two modifiable coronary risk factors. There were statistically significant differences at three months in coronary risk score improvement, smoking cessation, physical activity level increases, body mass index reductions and serum cholesterol. At six months, improvements remained significant except for cholesterol. Reduction in blood pressure was not significantly different. Intervention participants compared to control participants showed significant differences in both cardiac and stroke risk at three and six‐month visits.
Practical implications
This study demonstrates that employees had a significant coronary disease risk reduction as a result of a relatively short health promotion intervention. Benefits three months post‐intervention were not sustained to the same extent as during the intervention. This underscores the need for long‐term commitment with lifestyle changes and raises the issue of the need for a comprehensive approach that also addresses environmental factors.
Originality/value
This paper contributes to the current research base on this topic as there are few well‐designed studies to reduce coronary risk factors for employees.
Details
Keywords
Jean-Francois Pelletier, Denise Fortin, Marc Laporta, Marie-Pascale Pomey, Jean-Luc Roelandt, Pauline Guézennec, Michael Murray, Paul DiLeo, Larry Davidson and Michael Rowe
– The purpose of this paper is to update the Global Model of Public Mental Health (GMPMH) in light of the WHO QualityRights project.
Abstract
Purpose
The purpose of this paper is to update the Global Model of Public Mental Health (GMPMH) in light of the WHO QualityRights project.
Design/methodology/approach
Being able to refer to international conventions and human rights standards is a key component of a genuine global approach that is supportive of individuals and communities in their quest for recovery and full citizenship. The GMPMH was inspired by the ecological approach in health promotion programs, adding to that approach the individuals as agents of mental health policies and legislation transformation. The GMPMH integrates recovery- and citizenship-oriented psychiatric practices through the Ottawa Charter for Health Promotion (WHO, 1986).
Findings
Updating the GMPMH through the WHO QualityRights Toolkit highlights the need for a new form of governance body, namely the Civic Forum, which is inclusive of local communities and persons in recovery. People with mental health disabilities, intellectual disabilities, and substance use conditions can be “included in the community” (UN Convention on the Rights of Persons with Disabilities, Article 19) only if the community is informed and welcoming, for instance through a Civic Forum and its organizing Local Council of Mental Health.
Research limitations/implications
Transition from social marginalization to full citizenship represents a daunting challenge in public mental health care. An approach that focuses primarily on individuals is not sufficient in creating access to valued roles those individuals will be able to occupy in community settings. Instead, public intervention and debate are required to promote and monitor the bond of citizenship that connects people to their communities.
Originality/value
The GMPMH is the result of a conceptual cross-breeding between recovery and health promotion (WHO, 1986). The GMPMH is an offspring of the ecological approach in health promotion programs, adding to that approach individuals as agents of mental health transformation. It refers to international conventions and human rights standards as a central component of a genuine global approach. A community-based participatory research design is well suited, which includes a Civic Forum for local communities to become involved and supportive of service users in their quality and human rights assessments.