preventive program Dotaz Zobrazit nápovědu
At the medical faculty in Brno we succeeded in combining the public health improvement project with the practical education of preventive medicine of medical students. The project "Know and improve your health" should enable individual estimation of the risk factors in people involved and, most of all, effectively decrease the risks by individual modification of their lifestyle. Until now, 1.588 participants were examined in the framework of the project and 147 medical students were actively involved during their preventive care rotations. Among the identified risk factors, the most prevalent were low physical activity (79% females and 75% males), imperfect nutrition (approx. 45% females and 65% males), increased level of blood cholesterol (33% females and 47% males), overweight and obesity (30 % females and 45% males), excessive alcohol intake (3% females and 30% males), increased blood pressure (19% females and 31% males) and smoking (22% females and 27% males). The efficiency of the intervention is determined by sending brief anonymous questionnaire to the participants after several months following the examination. We received 54% of the questionnaires back. 87% of respondents state change in their knowledge, opinions and attitudes as an effect of the project, 86% state their effort to change their lifestyle and 71% successfully realized change in their lifestyle. Students taking part in the project are influenced in the sense of "Broader application of preventive methods in their future medical practice" (79% probably, 21% definitely). Positive effect is perceived as beneficial above average by 62% of students for themselves and 59% for examined persons. 96% of students and 100% of involved people think the project should go on in future. Participation in the real preventive program seems to be very effective form in the study of preventive medicine.
- MeSH
- anamnéza MeSH
- dospělí MeSH
- fyzikální vyšetření MeSH
- hodnocení programu MeSH
- kardiovaskulární nemoci prevence a kontrola MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- nádory prevence a kontrola MeSH
- preventivní lékařství výchova MeSH
- rizikové faktory MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- služby preventivní péče organizace a řízení MeSH
- zdraví - znalosti, postoje, praxe MeSH
- zdravotní výchova MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Česká republika MeSH
We established a Geriatrics Workforce Enhancement Program (GWEP) clinic to enhance resident training on comprehensive preventive care and chronic disease management, and to increase the number of older patients who received Medicare Annual Wellness Visit (AWV) preventive services. A total of 1,104 patients were tracked at baseline and during the intervention period. Patients were grouped into two categories: Adult (aged 55-64) and Senior (aged 65+). Clinical quality measures were monitored by electronic health record and tracked through monthly reports at baseline (May 2018) and during the intervention period (July 2018-June 2019). In the Senior group, the proportion of patients receiving the Medicare AWV increased after GWEP began (p <.001). Additionally, the Senior group showed significant improvements in the frequency of body mass index assessments (p = .04), colorectal cancer screenings (p < .001), advance directive documentation (p < .001), cognitive screenings (p < .001), and pneumococcal vaccinations (p < .001). In the Adult group, a trending increase was seen in influenza vaccinations (p = .06). Curricular innovations including the establishment of a GWEP clinic in our residency outpatient center, development of new educational materials, and use of a nurse coordinator resulted in significant improvements in the percentage of older adults who received the Medicare AWV benefit and preventive health performance metrics.
- Klíčová slova
- Medicare annual wellness visit, preventative health,
- MeSH
- geriatrie * výchova MeSH
- lidé MeSH
- Medicare * MeSH
- pracovní síly MeSH
- senioři MeSH
- služby preventivní péče MeSH
- Check Tag
- lidé MeSH
- senioři MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Spojené státy americké MeSH
- MeSH
- komunismus MeSH
- lidé MeSH
- preventivní lékařství MeSH
- služby zdravotní péče o pracující MeSH
- socialismus MeSH
- veřejné zdravotnictví * MeSH
- vláda MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Československo MeSH
AIMS: One of the most widely used evidence-based anti-bullying programs, KiVa, originates from Finland and aims to change students' peer context, activate teachers, and inform parents with two main components (universal preventive actions and indicated actions when bullying occurs), complemented by monitoring. Because research documented somewhat varied KiVa outcomes in different countries and because there is a lack of research focusing solely on the effectiveness of the universal and indicated actions, this study aimed to evaluate the effectiveness of KiVa main components when implemented in a new country. This two-arm parallel cluster randomized control trial (RCT) evaluated the effectiveness of the KiVa anti-bullying program in elementary schools in the Czech Republic. It examined the effects of the universal and indicated actions on self-reported bullying and victimization as primary outcomes and well-being as a secondary outcome, while keeping monitoring constant across the intervention and control schools. The study also examined the role of implementation fidelity on the proposed outcomes. METHODS: Schools were allocated via stratified randomization into a KiVa intervention group (12 schools, 35 classes, N = 407 students) or a wait-list control group (12 schools, 32 classes, N = 400 students). The study employed data from baseline and post-measurement waves, which were 10 months apart. RESULTS: The data were analyzed using linear mixed effects models, which showed no significant intervention or fidelity effects for bullying, victimization, and well-being. However, promising trends (at α < .10) were revealed, such as lower levels of bullying observed in the intervention group and in schools with high implementation fidelity. Additional analysis using Bayes factors supported these promising trends and provided moderate support for lower levels of victimization in the intervention group compared to the control schools. CONCLUSIONS: Evaluation of effectiveness of anti-bullying programs could benefit from a more targeted fidelity assessment at the classroom or individual level and from distinguishing between the effects of the main components of the programs and the effects of monitoring. The promising yet non-significant intervention and fidelity effects suggest that schools may require enhanced support and longer implementation time frames than a single school year, especially when implementation faces structural obstacles, such as the Covid-19 pandemic.
- Klíčová slova
- Anti-bullying programs, Bullying, Effectiveness, KiVa, Victimization, Well-being,
- MeSH
- dítě MeSH
- hodnocení programu * MeSH
- lidé MeSH
- oběti zločinu MeSH
- šikana * prevence a kontrola MeSH
- školní zdravotnické služby organizace a řízení MeSH
- školy organizace a řízení MeSH
- studenti psychologie MeSH
- vyrovnaná skupina MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- randomizované kontrolované studie MeSH
- Geografické názvy
- Česká republika MeSH
In the last decade evidence-based medicine (EBM) has become popular between clinicians and epidemiologists as a tool to facilitate the translation of scientific research into clinical practice. In public health, this approach is important for health protection, different levels of disease prevention, and health promotion practice. EBM concept applicable to public health follows the same principles, but some additional aspects have to be considered. For example, in preventive medicine, there is the strong need to compare the relative effectiveness of various interventions in prolonging survival or preventing the occurrence or complications of a disease, as it is crucial for setting preventive priorities. Usually, systematic reviews and meta-analyses quantify the effects of treatments on selected endpoints (health outcomes). However, in setting preventive priorities the reverse perspective is important. The judgement about preventive action cannot be done without an adequate consideration of ethical and social context. In view of emerging evidence-based medicine to health professionals became of paramount importance. In the paper, this course of action has been discussed as an aftermath of the EB training workshop organized in Pavia (Italy) by the International Center for Studies and Research in Biomedicine.
Effective preventive care programs are urgently needed during humanitarian crises, as has been especially obvious during the COVID-19 pandemic. A pragmatic trial was designed: hybridized intervention (Diabetes Prevention Program [DPP] + medical nutrition therapy + liquid diet [LD]; LD group) vs. DPP only (DPP group). The participants were adults who were overweight/obese and at high risk of type 2 diabetes mellitus (T2DM). The LD consisted of a “homemade” milk- and fruit-juice-based beverage. Pandemic restrictions delayed the program by nine months, tripled the amount of time required for screening, and reduced the total sample to 60%. Eventually, 127 participants were randomized, and 94/127 participants (74.0%) completed the first phase. Participant dropout was influenced by migration, COVID-19 symptoms, education level, and socioeconomic status. In two months, the LD group lost 2.9 kg (p < 0.001) and the DPP group, 2.2 kg (p < 0.001) (between-group p = 0.170), with improvements in their cardiometabolic risk factors. At this stage, the DPP was shown to be feasible and effective, demonstrating weight loss with the improvement of cardiometabolic risk factors in a primary setting in Venezuela, a middle-income country with a chronic humanitarian crisis, during the COVID-19 pandemic.
- Klíčová slova
- COVID-19, humanitarian crisis, primary prevention, type 2 diabetes mellitus,
- MeSH
- COVID-19 * epidemiologie prevence a kontrola MeSH
- diabetes mellitus 2. typu * epidemiologie etiologie prevence a kontrola MeSH
- dospělí MeSH
- lidé MeSH
- pandemie prevence a kontrola MeSH
- SARS-CoV-2 MeSH
- studie proveditelnosti MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- randomizované kontrolované studie MeSH
- Geografické názvy
- Venezuela epidemiologie MeSH
OBJECTIVES: According to published reports from the WHO, health care is undergoing a transformation that reflects the increasing importance of community care based on social, group, and individual needs. Community health care is provided by multidisciplinary teams, with nurses occupying irreplaceable positions. Nurse competencies constitute significant potential in the area of community based preventive care as well as the more traditional roles in treatment and recovery. METHODS: Data was obtained from health care professionals and the public through a structured interview. The study population included 1,007 physicians, 1,005 nurses and 2,022 laypersons. Respondents were selected randomly with the aid of quotas. The parameters for the selection of health care workers (nurses and physicians) were constructed based on registration data from the Institute of Health Information and Statistics. Layperson selection was based on data from the Czech Statistical Office. The Statistical Analysis of Social Data program (version 1.4.4) was used to process the data, which was in the form of 1st and 2nd degree contingency tables. The dependence level was determined based on χ2 and other testing criteria (according to the character of the signs). RESULTS: The results show that respondents perceive the concept of a "community nurse" as a nurse working independently in local neighborhoods and communities. Results also showed that work in senior care, followed by home care, and care for chronically ill patients were the most preferred. A role for nurses in health care education centers was only supported by 13.1% of physicians, 13.8% of nurses, and 6.8% of laypersons. The results also reveal that community nursing is perceived by both health care professionals and laypersons as fieldwork (i.e. work not based in a hospital or clinic environment), yet, at the same time, it was perceived as work that dealt with people needing health care. The results also reflect the opinion that the establishment of an independent nurse in the workplace (in the form of preventive care) could lead to an increase in the quality of care for employees (65.7% of physicians and 70.8% of nurses), an improvement in workplace health education (33% of physicians and 34.7% of nurses) and would provide support for healthy work environments (31.4% of physicians and 30.4% of nurses). CONCLUSION: Our results lead us to conclude that the health care system in the Czech Republic needs to better utilize the potential of trained nurses in the field of community health care. Additionally, steps need to be taken to increase job opportunities and staffing for nurses wanting to work in community health and preventive care.
- MeSH
- dospělí MeSH
- komunitní lékařství metody MeSH
- komunitní ošetřovatelská péče metody MeSH
- lékaři MeSH
- lidé středního věku MeSH
- lidé MeSH
- personál sesterský MeSH
- preventivní lékařství metody MeSH
- role ošetřovatelky * MeSH
- služby preventivní péče metody MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Geografické názvy
- Česká republika MeSH
- Klíčová slova
- INDUSTRIAL MEDICINE *, PREVENTIVE MEDICINE *,
- MeSH
- lidé MeSH
- podpora zdraví * MeSH
- pracovní lékařství * MeSH
- preventivní lékařství * MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- MeSH
- lidé MeSH
- nádory ženských pohlavních orgánů * diagnóza prevence a kontrola MeSH
- primární prevence MeSH
- Check Tag
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Československo MeSH
Unplugged is a school prevention programme widely implemtend in Europe, with some positive evaluations. This research aims to measure the impact of this program on tobacco use by means of the lifetime and last-30-day tobacco use prevalence indicators and verify the duration of the intervention's measurable effect over time. The study was designed as a randomised controlled prevention trial. The intervention is based on the Comprehensive Social Influence model and consists of 12 lessons delivered to Czech adolescents in the 2007-2008 academic year. The prevalence indicators were calculated to assess the differences between the experimental (N = 914) and control (N = 839) groups on each outcome 1, 3, 12, 15, and 24 months after the end of the intervention. Data were collected using the 2003 version of the ESPAD questionnaire. As regards the 30-day smoking prevalence indicator, the tests performed after the completion of the intervention showed statistically significant differences between both groups in favour of the experimental one. Two years after the completion of the intervention the experimental and control groups showed 30-day prevalence rates of 26.7% and 33.1%, respectively (p = .01). The progression of smoking in the 30-day prevalence among the experimental group was significantly slower than that among the control group over the period of time. The differences in the lifetime prevalence rates were not statistically significant. The implementation of Unplugged resulted in a statistically significant measurable positive effect on tobacco use in Czech adolescents.
- MeSH
- dítě MeSH
- hodnocení programu MeSH
- lidé MeSH
- mladiství MeSH
- prevence kouření * MeSH
- prospektivní studie MeSH
- školní zdravotnické služby MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- mladiství MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
- práce podpořená grantem MeSH
- randomizované kontrolované studie MeSH
- Geografické názvy
- Česká republika MeSH
