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TP-WED-015 EMPOWERING PEOPLE IS PROMISING TO REDUCE CARDIOVASCULAR DISEASE IN
DEVELOPING COUNTRIES: THE PRORIVA PROGRAM IN YOGYAKARTA, INDONESIA
F. Tetradewi* 1 , L. Weinehall 2 , S. Supriyati 1 , S. Soewardi 3
1 Public Health Department, Faculty of Medicine, Gadjah Mada University, Yogyakarta, Indonesia,
2 Epidemiology and Global Health Department, Umeå International School of Public Health, Umeå University,
Umeå, Sweden, 3 Health Promotion Coordination Board, Provincial Health Office, Yogyakarta, Indonesia
Background: Non-communicable disease (NCD) including Cardiovascular disease (CVD) becomes the
major public health problem in the developing countries especially to the poor communities. It is essentials
for developing countries such as Indonesia, to take a CVD control program by modifying behavioural risk
factors of CVD (1). Individually behavioral modification is not enough to consistently modify unhealthy
behavior because behavior is influenced by individual but also by supporting environment and provided
facilities. A sustainable control programwith optimum community participation is a must, thus a community
empowerment pogram is essential.
Objectives: To modify unhealthy behavior such as smoking, physical inactivity and unhealthy diet in the
community based on empowerment principles.
Underlying values and principles: Community empowerment is flexible to accommodate the need of the
community, so the program is more suitable for them, encourage their participation, more willing to share
community‟s resources; finally a sustainable program is more likely to gained. Community empowerment
could be the alternative to solve the limited resources in developing countries.
Knowledge base/ Evidence base: Community empowerment has been extensively utilized in the health
field(2), but not much in behavioral modification of CVD and in developing countries.
Context of intervention/project/work: The intervention focus on the reduction of behavioral CVD risk
factors: smoking, physical inactivity and low fiber diet among adult people who live in low SES area of Kricak
village, Jetis sub-region, Yogyakarta Province, Indonesia. The local people main occupation is blue collar
worker, small retailer, and public officer. The community member is unique in their working together spirit,
which is indicated with many collective working such as cleaning their environment, preparing wedding
ceremony, preparing religious ceremony, measuring the weight of under-five-year-children to control
children‟s health, etc.
Methods: The external team was approaching the community leaders to gain their trust and to increase their
awareness about the danger of CVD. To draw the real burden of CVD both the local knowledge of CVD
cases and formal health office data were identified together. A community program was aggreed to initiate,
the program called PRORIVA (Program to recude cardiovascular disease risk factors in Yogyakarta).
Community organization was developed based on the existing systems and structures the community. The
external team working together with the internal team from the community. The working team was facilitating
the community leaders to identify three main risk factors of CVD and the suitable strategy to modify their own
community‟s behavior. The working team helped the community to plan, perform and evaluate the program.
Results and Conclusions: Community leaders agree to initiate the PRORIVA program and appoint a team
from their community member as a working team with the external team. Some activities were developed by
the working team and offered to the community‟s leaders before executed. Community‟s leaders actively
mobilize their community‟s member to participate on the behavior modification activities. Members of
community happily participate on the Proriva activities. An information center about CVD, called Posko
Projabar was developed to provide information service, physical measurement and further consultation
services. External team had been working for 7 months before leaving the community in an independent
condition to continue their activities. Community empowerment is a promising strategy to consistently modify
behavior in the community level. However time and energy spent during the program should be anticipated.
References: 1. Ng N, Stenlund H, Bonita R, Hakimi M, Wall S, Weinehall L. Preventable risk factors for
noncommunicable diseases in rural Indonesia: prevalence study using WHO STEPS approach. Bulletin of
World Health Organization. 2006 Apr;84(4):305-13.
2. Beeker C, Guenther-Grey C, Raj A. Community empowerment paradigm drift and the primary prevention
of HIV/AIDS. Soc Sci Med. 1998 Apr;46(7):831-42.
Disclosure of Interest: None declared

TP-WED-016 PEER HELPER PROGRAM IN DISADVANTAGED VILLAGE POPULATION
E. Kovacs* 1
1 Dept. of Paediatrics, Pecs University, Pecs, Hungary
Background: Sustainable practice of health promotion and disease prevention in low resource setting with
poor health care infrastructure is a challenge. In county Baranya, Hungary, we piloted a new version of peer
counsellor/helper program in favour of achieving this.
Objectives: We introduced a self-help program contributing to the reduction of cardiovascular mortality,
leading cause of death in this region.
Underlying values and principles: By using the peer approach we stressed two main aspects: breaking
the external locus of control attitude in the management of own health and the the community building.
Knowledge base/ Evidence base: Scientific evidences proved that though peer education is capable
transferring limited information compared to programs realized by professionals, this disadvantage is
balanced by providing channel to even marginalized population. It is usually well-accepted by the target
population, remains permanently in the given setting and it is cheaper. All these factors contribute to
sustainability.
Context of intervention/project/work: Baranya county has a settlement structure of small villages: there
are 206 villages with population less than 500, in total with 54 500 inhabitants. 3-5 villages belong to one GP
praxis; consulting hours are limited to once a week. This area is characterized by low socio-economic status:
the proportion of retired-aged population is more than 40%, unemployment ratio is 18-54%. Lifestyle
counselling/preventive care should be solved locally in lack of external resources.
Methods: We implemented a two-phase training. First, we organized a 36-hours training about the role, the
responsibilities and limits of the volunteer helper; including the basics the psychology of helping, of
communication and conflict-solving skills, home care and community organization. Next, for those who were
engaged we introduced a further step targeting the secondary prevention of non-communicable diseases
with special attention to cardiovascular diseases. This included lifestyle risk factors, possibilities of
intervention in village setting, technique of blood pressure measurement, continuous care and follow-up,
consulting with GP. The typical trainees were middle-aged unemployed women of educational degree max.
ISCED 3C. Those volunteers who passed the exam received automatic sphygmomanometer and
methodological descriptions of the above topics.
Results and Conclusions: The peer helpers screened by blood pressure, BMI and main lifestyle riks
factors this village population older than 40 years. 14,3% were hypertensive but haven‟t been identified by
the primary care previously. 69,6% of the known and treated hypertensive patients were actually
hypertensive. GPs stressed as main achievement that the peer helpers could involve all those members of
the community who had no contacts with the health care service. This project proved that peer approach
could be a cost-effective way of secondary prevention, involving disadvantaged elderly population to health
promotion activities.
Disclosure of Interest: None declared

TP-WED-017 HEART HEALTH IN OBERWART – AN EVIDENCE-BASED REGIONAL HEALTH
PROMOTION PROGRAMME
E. Gollner* 1 , G. Raggam 1 , I. Ballmann 1 , M. Stangl 1 , E. Matyas 2 , W. Habacher 3 , T. Augustin 3 , U. Pueringer 2
1 Health Managment and Health Promotion, FHSTG Burgenland GmbH, Pinkafeld, 2 EBM Review Center
Graz, Med Uni, 3 Research, Joanneum, Graz, Austria
Background: In the district of Oberwart, Burgenland, Austria, cardiovascular mortality is above the Austrian
average. A high prevalence of several risk factors for cardiovascular disease like overweight, smoking, lack
of physical activity, high blood pressure and high cholesterol values is evident.
Objectives: Thus - for the first time in Austria - a three-year (January 2009-January 2012) regional,
comprehensive, gender and culturally sensitive heart health programme is initiated in the school and
community setting aiming at the development of sustainable health promotion structures to improve the
health status of the population.
Underlying values and principles: Empowerment, gender-sensitivity, the diversity of the settings, an
approach focusing on key-communicators and the participation of the local population at risk are the key
elements of the programme. Additionally, it is intended to introduce the concept of “Health in all Policies” at
the community level.
Knowledge base/ Evidence base: : After a comprehensive literature research the programme was
designed along the lines of successful regional heart health programmes.
Since the beginning of the project, intersectoral and multidisciplinary co-operations and communication
between the project participants, stakeholders and key communicators have been aimed for.
Context of intervention/project/work: Context of the intervention are the setting community and the setting
school.
Methods: Interventions include health communication and information as well as group approaches to
individual behavioural change and school/community health promotion programmes comprising capacity
building. Furthermore, the programme is designed to reach those segments of the population that need
special support concerning their cardiovascular health because of their particular living conditions and social
status. This concerns the target groups teachers and students of educationally disadvantaged schools, since
these students suffer from social discrimination, thus exposing the teachers to additional stress.
Community and school readiness were assessed in group discussions and interventions influencing major
lifestyle factors like diet, smoking and physical activity have been planned in a participatory way involving the
target groups of the project.
Results and Conclusions: Interim results of the baseline survey, the community/school readiness
assessment and the participatory planning of the interventions will be presented at the IUHPE conference.
Disclosure of Interest: None declared

TP-WED-018 THE APPLICATION OF PENDER‟S HEALTH PROMOTION MODEL FOR REDUCTION OF
SERUM CHOLESTEROL AMONG THE ROYAL THAI NAVY
P. SUKSIRI* 1 , S. LAGUMPAN 2 , R. CHONGSUWAT 2 , A. JIRAPONGSUWAN 2
1 Mahidol University, 2 , Mahidol University, Bangkok, Thailand
Background: High serum cholesterol levels in members of the Royal Thai Navy are continuously increasing
due to health-damaging behavior.
Objectives: This quasi-experimental study was to examine the effectiveness of the application of Pender‟s
health promotion model for reduction of serum cholesterol levels among members of the Royal Thai Navy.
Underlying values and principles: The sample is composed of 131 Royal Thai Navy sailors who have a
serum cholesterol level within the range of 190-290 mg./dl. Participants were randomly divided into an
experimental group (n=66) and a control group (n=65).
Knowledge base/ Evidence base: The application of Pender‟s health
Context of intervention/project/work: The experimental group received an application of Pender‟s health
promotion model three times within 4 weeks. Activities included raising awareness of the benefits of serum
cholesterol reduction, analysing and managing barriers to action, promoting self-efficacy, enhancing
commitment to practice, and raising interpersonal influence through support from a commander for 8 weeks
of the intervention period.
Methods: The data were collected by self administered questionnaire 3 times, once before, once during the
4th, and once during the 8 th week of intervention. Serum cholesterol testing was done 2 times, once before
and once after intervention. Data were analysed using descriptive statistics; frequency, percentage, mean,
standard deviation, and inferential statistics (including t-test), repeated measures one-way ANOVA, and
Bonferroni correction.
Results and Conclusions: The results revealed that the experimental group showed significantly higher
levels of perceived benefits of action, self-efficacy, interpersonal influences from commander support, and
commitment to action than before the experiment, and that of the control group (p < .05). On the other hand,
they showed a significantly lower level of perceived barrier to actions than before the experiment and that of
the control group (p < .05). Finally, the serum cholesterol, total cholesterol, and low-density lipoprotein levels
of the experimental group were significantly lower than before the experiment and that of the control group,
while the high-density lipoprotein levels were higher than before and that of the control group (p < .05).
References: -Bandura, A. (1997). Self-efficacy : The exercise of control. New York: W.H.Freeman
-ESC Committee for Practice Guidelines. (2008). European Society of Cardiology : recommendations for
Task Force creation and report production. A document for Task Force members and expert panels
responsible for the creation and production of Guidelines and Expert Consensus Documents.
-Fritsch M.A., Montpellier J., & Kussman C. (2009) Worksite Wellness a Cholesterol awareness Program
AAOHN Journal,57, 69-76.
-Kishmoto, Matsuoka, Imamura, & Mizuno., (2003). A novel colorimetric assay for the determination of
lysophosphatidic acid in plasma using an enzymatic cycling method. Clinica Chimica Acta, 333, 59-67.
-Pender, N.J., Murdaugh, C.L., & Parsons, M.A., (2006). Health Promotion in Nursing Practice. Norwalk, CT:
Appleton & Lange.
-WHO Global Strategy on Diet. (2007) Physical Activity and Health. Facts related to chronic diseases.
Retrieved November 15, 2007, from http://www.who.int/dietphysicalactivity/publiccations/facts/chronic/en/
Disclosure of Interest: Lt.PREMCHAI SUKSIRI Speakers Bureau
SUNEE LAGAMPAN, Ed.D.Consultant
REWADEE CHONGSUWAT, Ph.D.Consultant
ANN JIRAPONGSUWAN, Ph.D.Consultant

TP-WED-019 THE CARDIOVASCULAR HEALTH PROMOTION IN THE COMMUNITY CARRIED OUT
BY STUDENTS OF INFIRMARY
D. Juvinya* 1 , C. Bertran 2 , J. Olivet 2 , N. Brugada 2 , D. Ballester 2 , C. Fuentes 2 , A. Domingo 2 , J. Doltra 2
1 Research Group on Health Assisstance, 2 Reasearch Group on Health Assistance, Universtity of Girona,
Girona, Spain
Background: One of the most frequent causes of high mortality is cardiovascular diseases. To prevent them
the Nursing Faculty of the University of Girona (Spain) has been organizing since over 6 years ago a week of
activities on health promotion and prevention about this type of pathologies, in which the students of nursing
are the key agents.
Objectives: -To raise awareness of the arterial hypertension risk among the population.
-To promote the blood pressure control among both healthy populations and sick population.
-To introduce the risk factors and measures of prevention among the population.
-To identify the most frequent errors related to the lifestyle
-To give the students competences to work with the community.
Underlying values and principles: -For the students: they have the first opportunity to practice and assist
true population as an integrating part of their learning process.
-For the community: they are receiving information about their disease and they learn how to manage it.
-Assessment value: from the application of different techniques to obtain measurements on arterial tension,
food habits and the cardiovascular risk factors we obtain the information that allows an individual
assessment to each individual.
Knowledge base/ Evidence base: Given that the cardiovascular diseases are the first cause of death, and
that the factors of risk that cause these diseases are known, it is essential to spread the knowledge of the
risk factors that affect these diseases among the populations in order to promote health and prevent
problems.
Context of intervention/project/work: From the university level a community level action takes place.
Methods: Design of a program of community intervention that takes place in a centric part of the city where
students measures the MT, IMC, and the cardiovascular risk is carried out using the REGICOR tables. They
also revise the diet, the consumption of tobacco, and the physical activity. From the analysis of these
parameters they give their advice on health.
Results and Conclusions: In the last five years 841people has participated in the program. The average
age ranges from 50 to 59 years old, 60% were women, 56% presented normal values of arterial pressure,
80% have taken the arterial pressure in the last five months. The number of non smokers is higher than
80%, 50% do not make physical activity and they mostly make a correct diet.
The participation has been success and it confirms the importance of on approaching the people and, at the
same time, it facilitates the acquisition of competences in the area of the communication and the health
attention process to the students of infirmary.
Disclosure of Interest: None declared

TP-WED-020 "YOU CAN´T FEEL HIGH BLOOD PRESSURE. YOU HAVE TO MEASURE IT! PASS THE
WORD AND MEASURE YOURS" CAMPAIGN
F. C. R. R. Louro* 1 , A. L. P. N. Curto 1 , A. P. Duarte 1
1 Occupational Health Service, Almada Municipality, Almada, Portugal
Background: The Occupational Health Service (OHS) of Almada Municipality in Portugal celebrates 20
years of experience in preventing disease, promoting health and well-being at the workplace.
Objectives: Aware of the negative impact of the hypertensive disease and the potential of the OHS activities
throughout the city, we developed a Campaign directed to promote the empowerment of our working
population (2100 people) and the Almada‟s region (161.000 People), concerning the perception of the risk of
the disease, its silent nature, the target values, the possibilities to assure a regular and accurate blood
pressure (BP) monitoring, and also the importance to control other risk factors that interact with HBP.
Underlying values and principles: Empowerment, Equity, Health Literacy, Local Governance
Workplaces can be used to promote health and improve health literacy and there are several possibilities for
local initiatives on health promotion.
Knowledge base/ Evidence base: Hypertension is one of the most important cardiovascular risk factors,
determining high morbidity and mortality. In Portugal, recent epidemiological studies showed that the
prevalence of High Blood Pressure (HBP) is about 42%, more than 50% are not aware of this situation, less
than 40% are under medication, and only a small group of this (11%) has their blood pressure effectively
controlled.
Context of intervention/project/work: The Project results from a partnership between the OHS of Almada
Municipality and the city Primary Health Care Services.
Methods: Since April 2009:
- Edition and personalized distribution of mensal thematic flyers with the salary receipt (2100) and the water
receipt (110.000)distributed among Almada population;
- Edition and distribution of posters to the local commercial agents and small and medium enterprises;
- As the self monitoring of BP is considered the most important aspect of this Campaign, we are promoting
and facilitating the access to home and public BP devices, in respect with the accuracy and certification by
independent authorities;
- During 2010, we are going to strengthen our commitment with the local universities, along with the regional
General Physicians, to define representative samples that can express our results and potentiate the
Campaign.
Results and Conclusions: Depends on the improvement of the awareness of HBP, the adoption of the best
standards to self measurement of BP and its effective control.
During long-term follow-up, we may evaluate the impact of this Campaign on the prevention of
cardiovascular diseases at Almada city.
Home BP monitoring is becoming increasingly important in the diagnosis and management of HBP. The
deeper involvement and the knowledge of patients about HBP in the management of their disease along with
the doctor and the wide diffusion of this approach in larger populations, will improve cardiovascular
prevention and health gains, in accordance with Ottawa Chart.
Disclosure of Interest: None declared

TP-WED-021 THE EFFECTS OF EDUCATION ON SELF-MONITORING OF BLOOD PRESSURE
AMONG PATIENTS WITH HYPERTENSION BASED ON BASNEF MODEL
m. baghianimoghadam* 1 , z. Rahaei 1 , m. Morowatisharifabad 1 , a. Andishmand 1
1 health services, shahid sadughi college, yazd, Iran (Islamic Republic of)
Background: The high prevalence of hypertension along with its serious complications on the organs of the
body, have changed this disease to an important health problem in around the world. Lack of symptom is the
most important sign of hypertension and the prevalent remedies have not been effective in controlling the
disease, yet. Meanwhile hypertension monitoring in the house may be an effective method. BASNEF model
is one of the most complete mixed models which have applied to study and distinguish the behavior and
creating new behaviors in the societies.
Objectives: the aim of this study is to explore the effectiveness of education on hypertension self-monitoring
in patients with hypertension based on BASNEF model in Yazd.
Underlying values and principles: The high prevalence of hypertension along with its serious
complications on the organs of the body, have changed this disease to an important health problem in
around the world
Knowledge base/ Evidence base: educational program based on the BAZNEF model was effective in
promoting behavior
Context of intervention/project/work: It is an experimental study. Convenience sampling was employed to
recruit 150(75 case group and 75 control group) outpatients with hypertension referring to a private clinic in
Yazd, Iran to participate in the study
Methods: The data were collected by interview, using a survey questionnaire which was adapted by the
researchers. Before starting the interview, validity and reliability of the scales approved by expert panel and
cronbach alpha (�= 0.62 to 0.85). An educational program based on the results of pretest stage was
designed and delivered to the case group. Again, after two months of implementing the program, the data
were collected
Results and Conclusions: The respondents acquired 17.72% of total hypertension self-monitoring behavior
score, 47.03% of attitude, 12.37% of subjective norms, 33.46% of intention and 50.95% of enabling factors.
Attitude and subjective norms accounted for 22.6% of the variation of intention and enabling factors and
intention accounted for 57.7% of the variation of hypertension self-monitoring behavior. After intervention
there was not any significant difference in control group but in intervention group there were significant
increase in self-monitoring behavior (32.9%), attitude (20.39%), subjective norms (4.73%), intention
(44.65%) and enabling factors (26.77).The results of this study showed that the level of self-monitoring
behavior in the patients was low and there was a significant increase in its level after implementing the
educational program. Therefore, and considering that educational program based on the BAZNEF model
was effective in promoting behavior, we can conclude that educational programs, like what we implied in our
study, in order to improve self-monitoring behavior in patients with hypertension may be helpful and
necessary
Disclosure of Interest: "None declared"

TP-WED-022 CHANGES IN SMOKING, DIET AND WALKING FOR EXERCISE IN AFRICAN
AMERICANS
C. J. Berg* 1 , J. L. Thomas 2 , L. C. An 2 , H. Guo 2 , T. C. Collins 3 , K. S. Okuyemi 3 , J. S. Ahluwalia 2
1 Department of Behavioral Sciences and Health Education, Emory University School of Public Health,
Atlanta, 2 Department of Medicine, 3 Department of Family Medicine, University of Minnesota, Minneapolis,
United States
Background: Positive changes in one health behavior may be accompanied by positive changes in other
health behaviors.
Objectives: The current study investigated the association of smoking reduction and cessation to changes
in fruit and vegetable (FV) intake and engaging in walking for exercise among participants enrolled in a
smoking cessation intervention trial.
Underlying values and principles: Identifying critical periods for intervention is important in efficiently and
effectively promoting health and preventing disease, particularly in high-risk, underserved populations such
as the target population for the current study (i.e., urban African Americans who smoke).
Knowledge base/ Evidence base: Prior work (Costakis, Dunnagan, & Haynes, 1999; King et al., 1996;
Marcus et al., 1991) has documented that interventions targeting one health behavior may impact other
health behaviors; thus, intervening for smoking cessation may also impact nutrition and physical activity
among African American smokers.
Context of intervention/project/work: The current work was conducted in a Midwest U.S. city, and
participants were recruited through a community clinic largely serving an urban African American population.
Methods: This study examined 539 African American light smokers (≤10 cpd) enrolled in a 2 x 2 factorial
study (placebo vs. nicotine gum; health education vs. motivational interviewing) examining the effectiveness
of a smoking cessation intervention over the course of a 26-week period.
Results and Conclusions: At week 26, 17.1% (n=92) of the sample had cotinine-verified abstinence, 58.3%
(n=314) had reduced their smoking by at least one cigarette per day, and 24.7% (n=133) did not reduce their
level of smoking. The average number of FV consumed per day was 2.04 (SD=1.67) at baseline, with an
average FV intake of 2.25 (SD=1.90) per day at 26-week follow-up. At baseline, 44.4% (n=193) reported
walking for exercise, and 50.0% (n=230) reported walking for exercise at follow-up. In the ordinary least
squares regression model controlling for baseline FV intake, both reducers (Coefficient=0.47, CI=0.11, 0.82,
p=.02) and quitters (Coefficient=0.73, CI=0.27, 1.20, p=.003) had greater increases in FV intake compared to
those that did not reduce their smoking. In the binary logistic regression model controlling for baseline
walking status, reducing cigarette consumption (OR=1.82, CI=1.08, 3.07, p

TP-WED-023 A CHANGE OF THE LIFE STYLE AMONG INHABITANTS OF KOPER REGION
(SLOVENIA) 2004-2008
M. Sucic Vukovic* 1 , I. I. M. K. Majcan Kopilovic 2
1 public health, Regional Institute of public health Koper, 2 public health, Regional Institute of public health,
Koper, Slovenia
Background: Many researches about the connection between life style and health in different countries
were performed.
In the years 2001, 2004 and 2008 we were included in performing of national researches “The life style
connected to the health among inhabitants of Slovenia”
Objectives: Our objective is to present the results of analyse of acquired data in the field of tobacco and
alcohol use, nutrition and physical exercise habits among inhabitants of Koper region and change of them in
the period between 2004 and 2008.
Underlying values and principles: The life style is established as an important determinant of health. We
wanted to establish a change of the life style among our inhabitants in a period of 4 years and to connect it
with health indicators.
Knowledge base/ Evidence base: We collected the data with the questionnaires sent by post. We
processed data with computer programs SPSS, Microsoft Excel and Microsoft Word.
Context of intervention/project/work: The results of analyse will be used to estimate our performed health
promotion programs and as a background for our further planed activities.
Methods: The researches were performed on the representative sample of adult inhabitants of Slovenia
according to single regions in the years 2004 and 2008. We analysed and established statistical significant
differences into collected dates about the spread of tobacco and alcohol use, nutrition and physical exercise
habits among inhabitants of Koper region in the years 2004 and 2008.
Results and Conclusions: We established in year 2008 compared to year 2004 many favourable changes
in the field of smoking and nutrition habits and less favourable results on the field of alcohol use and physical
exercise habits among our inhabitants.
From analyse of collected dates arises that we achieved positive changes on the field of tobacco use and
nutrition habits.
We must direct the further planed programs to the fields of alcohol use and to the physical exercise
stimulation.
Disclosure of Interest: Non declared

TP-WED-024 BODY CARE AND CARDIAC REHABILITATION AMONGST UNDERPRIVILEGED MEN
SUFFERING FROM HEART DISEASE
A. Dumas* 1 , M. Savage 1 , C. Bergeron 1
1 School of Human Kinetics, University of Ottawa, Ottawa, Canada
Background: Self-responsibility is a core assumption of health promotion in liberal societies. In the context
of heart disease, individuals are expected to pursue a rehabilitative regimen after receiving heart surgery.
However, underprivileged groups, and particularly men, have been identified as being less receptive to such
measures. While much valuable research has been made to promote heart healthy behaviors, it has often
neglected the social mechanisms that influence bodily practices of vulnerable populations in the context of
social inequality.
Objectives: This study aims to understand the “dispositions” and commitments towards body care of 37
men suffering from cardio-vascular disease and experiencing difficult life circumstances in a context of social
inequality.
Underlying values and principles: This study draws on Pierre Bourdieu‟s socio-cultural theory of practice
and more directly on his concept of bodily habitus in order to understand the attitudinal and behavioral health
patterns of distinctive social classes.
Knowledge base/ Evidence base: In the Province of Québec, Canada, underprivileged men are more than
3.4 times more likely to die prematurely from heart disease than those of privileged groups, and 2.9 times
more likely to die from this condition than women of the same socioeconomic strata (Pampalon et al., 2008).
Although social class and gender have been highlighted as major determinants of cardiac rehabilitation
practices, few studies in this area have provided an in-depth account of class-based masculinities and
cardiac rehabilitation.
Context of intervention/project/work: The study was held in the urban areas of the Outaouais, a French
speaking region of Québec. This area was selected because of its high socioeconomic gradient in health and
higher rates of cardiovascular disease than the rest of Québec.
Methods: Participants were Francophone men aged between 25 and 79 years (average age of 53.6) and
who have had a medical intervention linked to heart disease. Qualitative data was collected through semistructured
interviews of an average duration of 90 minutes. A content analysis was performed based on
participants‟ perceptions, dispositions and appreciation of cardiac rehabilitation programs and heart healthy
lifestyles.
Results and Conclusions: Results highlight how social inequality and poor social living conditions shape a
view of the world (and bodily habitus) which is at odds with the lifestyle proposed by standard health
guidelines. Four major themes are highlighted for explaining underprivileged men‟s non-compliance to
cardiac rehabilitation: (a) lack of control over one‟s health (b) fear of losing social status (c) incompatibility
with life priorities and (d) resistance to the imposed lifestyle. The paper concludes with a discussion on the
socio-political character of health enhancement practices and its implications for cardiac rehabilitation.
References: Pampalon, R. Hamel, D. & Gamache, P. (2008). Évolution récente de la mortalité prématurée
au Québec selon la défavorisation matérielle et sociale. In Frolich, K, De Koninck, M, Bernard, P. & Demers,
A. (Éds.) Les inégalités sociales de santé au Québec. PUM, Montréal, (p.13-35).
Disclosure of Interest: None declared

TP-WED-025 IDENTIFYING AND TARGETING POOR CONTROL OF HYPERTENSION.
D. H. Wilson 1 , S. L. Appleton* 1 , R. E. Ruffin 1 , A. W. Taylor 2 , R. J. Adams 1
1 Medicine, University of Adelaide, 2 Population Research and Outcomes Study Unit, South Australian
Department of Health, Adelaide, Australia
Background: Identifying and preventing disease in populations with important biomedical risk factors are
important tasks of health promotion. This is especially the case with hypertension, which is not only a
primary risk factor in cardiovascular disease but is also a component of the metabolic syndrome which
contributes significantly other prevalent diseases, such as diabetes.
Objectives: To determine the prevalence of hypertension and its prognosis in a large representative
Australian biomedical cohort study and use this information to assist policy direction.
Underlying values and principles: A longitudinal cohort study permits the identification of factors
associated with hypertension and poor control. These populations can be targeted by health promotion
activities in order to improve the health of the population.
Knowledge base/ Evidence base: Hypertension is the leading cause of cardiovascular disease. Despite
advances in treatment, control rates continue to be suboptimal. Poor control is related to inadequate
treatment, poor adherence to treatment and patient-related and physician-related barriers.
Context of intervention/project/work: The primary purpose of this study is to identify factors associated
with poor control of hypertension in a population cohort. Studies have identified that programs targeting
hypertension prevention and improved control are urgently needed.
Methods: The North West Adelaide Health Study (NWAHS) is a longitudinal cohort study of randomly
selected adults aged at least 18 years and over that commenced in Adelaide, South Australia in 2000. At
baseline, 4060 participants completed questionnaires regarding demographics, health conditions and
behavioural risk factors. Medical assessment included measurements of blood pressure- average of two
recorded with a calibrated sphygmomanometer, five to ten minutes apart while participant was seated and
relaxed.
Results and Conclusions: The baseline prevalence of hypertension in the cohort was 28.4% (n=1154) of
whom 30.1% were receiving anti-hypertensive therapy, suggesting a large burden of undiagnosed
hypertension. After 3.5 years of follow-up, 786 subjects with baseline hypertension were available. Of these,
hypertension persisted in 61.3%, (n=481, untreated=25.8%, treated=35.5%) and resolved in 38.7 %, (n=304,
treated 16.8%, untreated=21.9%). Persistent untreated hypertension was associated with male sex, age 40
to 54, and 55+ years. Treated persistent hypertension was associated with exposure to primary care
providers. Baseline body mass index but not diabetes or current smoking was a strong predictor of persistent
(treated and untreated) hypertension. The importance of identifying specific sub groups with hypertension for
specifically targeted interventions and implications of these data for primary and secondary prevention
programs in primary care are discussed.
Disclosure of Interest: None Declared

TP-WED-026 EPIDEMIOLOGICAL STUDY OF HYPERTENSION IN AHMEDABAD
H. Nayak* 1 , S. Vyas 2
1 Community Medicine, Government, 2 Community Medicine, Corporation, Ahmedabad, India
Background: Ahmedabad is one of the growing metro city of India.People of Ahmedabad are more prone to
Hypertension & Diabetes because of their peculiar lifestyle.
Objectives: 1)To know the prevalence of hypertension in Ahmedabad municipal
corporation area.
2)To study the sociodemographic profile of study population.
3)To study various risk factors associated with hypertension
Underlying values and principles: Hypertension and other Noncommunicable diseases are increased
during last few decades.Study was planned to know the actual burden of Hypertension & Sensitize the policy
makers.
Knowledge base/ Evidence base: Its Knowledge and Evidence based study.
Context of intervention/project/work: Its Project work includes the all Municipal areas of Ahmedabad
Methods: It was Community based Cross sectional study. In which house to house survey was carried out
to include persons of >20 yrs of age from all the six zones of AMC. 904 people of above 20 yrs of age were
included by stratified random sampling from different wards of respective zones during April 2007-
March2008.Interview with questionnaire method and clinical examination was carried out. Data were
collected, compiled & Analyzed by suitable statistical methods.
Results and Conclusions: Total 904 persons were included in the study after going for stratified random
sampling. Maximum i.e.204 (22.6%) belongs to 30-39 years. systolic blood pressure≥120mmhg was found in
516(57.1%) parsons, however Diastolic blood pressure ≥80 was found in 441(48.8%) persons. Out of 904,
229(25.3%) already had Hypertension and on treatment. while 111(12.3%)were newly diagnosed
hypertensives , followed by 311(34.4%) were prehypertensives. majority 25(22.5%) hypertensives belonged
to age 40-49 yrs. However prehypertension was more prevalent (28.9%)among 30-39 yrs.188(39.4%)of
females had hypertension while152(35.6%)of males were hypertensives. Mean age of hypertensive was
54.57±15 & that of prehypertensives was 40.94±13.among the hypertensives mean duration of hypertensive
was7.8±6.9.Family history of hypertension and Hypercholesteremia was not significantly associated with
hypertension. Sedentary occupation was strongly associated with hypertension (p

TP-WED-027 CHALLENGES OF HEALTH PROMOTION FOR CVDS AMIDST CHANGING SOCIO-
CULTURAL SETTINGS IN DEVELOPING COUNTRIES: A CASE OF UGANDA, BY S. C. KABUKAIRE &
LEONARD MULEKWAH
S. C. Kabukaire* 1
1 Field Operations, Electoral Commission Uganda, Kampala, Uganda
Background: Socio-cultural settings are known to be among the other factors identified in The Ottawa
Charter which could highly influence the improvement of health. Health promoters are however facing a lot of
challenges posed by the changes in the societies' socio – cultural settings especially agnaist NCDs.There
are several NCDs but this study has considered only CVDs.
Objectives: 1.To establish the relationship between social settings and the prevalence of CVDs
2.To identify the main challenges for health promoters against CVDs.
Underlying values and principles: 1.Provide an understanding of the relationship between socio-cultural
settings and CVDs
2.Provide a better understanding of the challenges faced by health promoters in the field of CVDs
3.Strengthening approaches to health promotion
Knowledge base/ Evidence base: The study is based on evidence from information obtained from Uganda
Heart Institute
Context of intervention/project/work: All people are vulnerable to NCDs, however, they do not appreciate
their vulnerability until the prevalence thus making health promotion vital. There is need for new and
concerted approaches to raising peoples awareness, appreciation and adoption of preventive lifestyles
despite the changing socio-cultural settings.
Methods: i. Literature review
ii. Purposive sampling was used to select the hospital for purposes of obtaining the key informants and study
group.
iii. Interviewing of key informants; these included 3 medical doctors, 1 pediatrician cardiologist and 2 general
cardiologists who gave empirical information about the number of people they handled from each region in
the last six months identifying both the old clients and new clients.
Results and Conclusions: The study examined the prevalence of CVD‟s amongst people from different
social settings, which in Uganda vary according to ethnicity and geographical location. It was established
that acquired CVD‟s were highly prevalent among older people while congenital cases were prevalent
among the young children. Findings also indicate that much as people from all cultural backgrounds were
affected by CVDs, prevalence was high among the well to do class and those living in urban settings.
Literature revealed that the well to do class has a lifestyle that exposes them to the CVDs risk factors, which
include physical inactivity, obesity, poor dieting, smoking and or alcohol content.
In addition the collapse of the extended family system has further rendered such group inactive by spending
a lot of time watching television.
The study revealed that the main challenge for health promoters is lack of documented data to establish the
prevalence of CVDs and empirical evidence of their relationship with life style.
In conclusion, we recommend further research to facilitate health promotion.
Disclosure of Interest: None Declared

TP-WED-028 FORTIFYING DIETARY SALT REDUCTION TO PREVENT ÇARDIOVASCULAR
DISEASES:
B. Legetic* 1 , B. Legowski 2
1 Non communcable diseases, Pan America Health Organization, Washington ,DC, United States, 2 ,
Consultant in Public Health, Ottawa, Canada
Background: Common in the literature are conceptual frameworks to prevent chronic diseases that call for
interventions to be comprehensive, multisectoral and integrated. We apply one such framework by Brownson
et al to examine initiatives to reduce population-wide dietary salt intake.
Objectives: To assist policy and decision makers in three ways: offer a means to critique their current
policies or approaches regarding dietary salt;help them to conceive of a complete package of actions
operating across policy domains; and consider whether any efforts to reduce dietary salt operating in a
particular domain can be combined with or at a minimum complement interventions in that domain directed
at other diet-based risk factors for chronic disease.
Underlying values and principles: The ubiquitous nature of high salt foods calls for population-wide
interventions for the benefits of less dietary salt to be broadly and equitably distributed.
Knowledge base/ Evidence base: The framework by Brownson et al (2006) deconstructs the
characteristics (comprehensiveness, multisectorality and integration) into three tangible domains or
environments for policy - the physical, economic and communications.
Context of intervention/project/work: In high income countries, about 80% of dietary salt comes from preprepared
and ready-made foods. In lower and middle income countries, the nutrition transition is the
increasing consumption of commercially prepared food products that are highly salted, with children being
particularly affected.
Methods: Map into the Brownson et al framework the three pillars for national level interventions to reduce
dietary salt recommended in the 2006 WHO Forum and Technical Meeting Report for salt reduction. And
then map the interventions for salt intake reduction being applied now at population levels in three countries
in the Pan American region Argentina, Canada and Chile.
Results and Conclusions: In the three countries studied, there is a concentration of policies in the
communications environment, with information campaigns to increase consumer awareness of the hazards
of high dietary salt and mandatory information on on food labels. In the physical environment, understood to
be where people buy and consume food outside the home, the key activity underway is product reformuation
driven by voluntary actions of the food industry. Requiring research is whether there are policy instruments in
the economic environment that can effectively shift consumer and food producer preference away from high
salt food products.
References: Gaziano TA, Bitton A, Anand S, Weinstein MC for the International Society of Hypertension.
The global cost of nonoptimal blood pressure. J Hypertens 2009; 27:1472-1477.
Asaria P, Chisholm D, Mathers C, Ezzati M, Beaglehole R. Chronic disease prevention: health effects and
financial costs of strategies to reduce salt intake and control tobacco use. Lancet. 2007;370:2044–53.
Brownson RC, Haire-Joshu D, Luke DA. Shaping the context for health: a review of environmental and policy
approaches in the prevention of chronic diseases. Annu Rev Public Health. 2006;27:341-70.
World Health Organization. Reducing salt intake in populations: Report of a WHO forum and technical
meeting, 5-7 October 2006, Paris, France. Available at:
http://www.who.int/dietphysicalactivity/Salt_Report_VC_april07.pdf. Accessed November 11, 2009.
Wilson N. Salt tax could reduce population‟s salt intake. BMJ. 2004;329:918.
Jensen JD and Smed S. Cost-effective design of economic instruments in nutrition policy. Int J Beh Nutrition
and Physical Activity. 2007;4:10. Available at: http://www.ijbnpa.org/content/pdf/1479-5868-4-10.pdf.
Accessed on 5 November 2009.
Disclosure of Interest: None declared.

TP-WED-029 CHANGE IN CARDIOVASCULAR DISEASES RISK FACTORS AMONG THE EMPLOYED
POPULATION IN TANZANIA
H. I. Semu* 1 , R. R. Msumule 2
1 Community Health and Nutrition, Tanzania Food and Nutrition Centre, 2 Occupation, Pan African Energy,
Dar es Salaam, United Republic of Tanzania
Background: Cardiovascular Diseases (CVD) are attributed to common preventable lifestyle related risk
factors. Scientists have estimated that CVD and premature deaths from such diseases can be significantly
reduced if all known modifiable risk factors are addressed. However, not all strategies can contribute
significantly to change these risk factors.
Objectives: To determine change in Cardiovascular Disease risk factors among the employed population in
Tanzania by conducting a series of sensitization seminars
Underlying values and principles: Seminar was conducted to increase awareness on Cardiovasucular risk
factors and the improtance of health check to determine risk factors. Assessment was conducted three
months later and dissemination of results
Knowledge base/ Evidence base: In sub-Saharan Africa, CVD affect adult in their most economically
productive years. The average age of death from CVD is at least 10 years younger than in developed
countries (Steyn and Damasceno, 2006,WHO, 2006). CVD are attributed to common preventable lifestyle
related risk factors. These include tobacco, unhealthy diet, excessive alcohol consumption and physical
inactivity.
Context of intervention/project/work: Series of training every three months for one year
Methods: cross sectional study of all employees. Questionnaires were administered for self reporting and
physical measurements were taken by a trained nutritionist.
Results and Conclusions: A total of 39 (22) subjects with mean age 41.5 years were assessed. Past
medical history revealed that 16.2% (18%) were hypertensive and 10.6% (9%) had diabetes. None had
history of stroke or heart disease. Almost half of the subjects, (48.7%) (50%) were consuming alcohol the
amount above the recommended levels, 37% had consumed alcohol in the past only. Those using tobacco
were only 7.7% (5%) and 6.5% smoked in the past. Fruits and vegetables were consumed daily by only
44.4% (54%) and 39.5% (36) respectively. Subjects who were sedentary were 17.9% (27%) and those
performed moderate level of activity were also 20.5% (27%). The remained (23%) 43.6% were on feet much
of the day and further 17.9% (23%) performed manual work or regular vigorous exercises. Other findings
indicated that, 67.6% (63%) of the subjects were overweight and obese. However, when the subjects
requested to state their weight perception, only 17.9% (9%) thought were overweight, none thought was
obese and 82.1% (86%) thought had normal nutritional status. The actual subjects with normal nutritional
status were only 29.7% (32%). Further assessment on waist circumference showed 30% (14%) of the
subjects had substantial increased health risk. Other measurements taken revealed elevated blood
cholesterol above 5.2mmol/l was 23.1 and that of Triglycerides above 1.7 was 23.1%
The prevalence of risk factors for CVD was relatively high irrespective of availability of healthy lifestyle
choices. Also there is no much change in risk factors when comparing data from 2006 and 2009. Since the
employer has done his best to provide varied choices of foods and drinks to his employees as well as the
facilities for exercises, including sensitization seminars on CVD and associated risk factors, there is no much
improvement when comparing the results from 2006 and 2009 . This pilot study has also showed that,
improving knowledge by itself is not a very good strategy in improving health and nutritional status of
employees. A combination of knowledge and modification of environment could have worked out better as
many other recent studies have suggested.
(Note that the percentage in brackets is the findings from 2006 assessment)
References: Krisela Steyn and Albertino Damasceno, “Lifestyle and Related Risk Factors for Chronic
Diseases,” in Disease and Mortality in Sub-Saharan Africa, 2d ed., ed.D. T. Jamison, R. G. Feachem, M. W.
Makgoba, E. R. Bos, F. K. Baingana, K. J. Hofman, and K. O. Rogo (Washington, DC: World Bank, 2006):
247-65.
WHO Regional Office for Africa (WHO/AFRO), The Health of the People: The African Regional Health
Report (2006), accessed online at www.afro.who.int/regionaldirector/african_regional_health_report
2006.pdf, on June. 18, 2007.
Disclosure of Interest: None declared

TP-WED-030 A STUDY OF THE KNOWLEDGE ATTITUDE AND PRACTICE (KAP) OF FACULTY
MEMBERS OF YAZD UNIVERSITY REGARDING CARDIOVASCULAR DISEASES (CVD) AND ITS RISK
FACTORS (2009)
S. MAZLOOMY MHAMOOD ABAD* 1 , -. Jouzy 2
1 contral of disease, shahid sadoghi medical university, yazd, Iran (Islamic Republic of), 2 ,
Background: Cardiovascular diseases are the main cause of mortality and morbidity today. In Iran too, the
foremost and most common cause of mortality and morbidity in almost all the age groups and both sexes are
cardiovascular diseases. Most of the population have low levels of knowledge and practice about the
causative and etiological factors of cardiovascular diseases and therefore suffer from cardiovascular
diseases with irreversible damage and complications.
Objectives: Considering the fact that increased levels of awareness about risk factors and actions towards
removal or betterment of these factors makes it possible to prevent these diseases at the primary level with
the minimal of expenses and there are very few studies to date recognizing the levels of knowledge, attitude
and practice of university faculty members regarding the same, the authors decided to perform the study.
Underlying values and principles: ...
Knowledge base/ Evidence base: this study was knowledge base
Context of intervention/project/work: ...
Methods: This cross sectional descriptive study included 70 faculty members of Yazd University who were
selected randomly. SPSS software program was used for evaluating the data
Results and Conclusions: In the study, 88.6% were men and 11.4% were women with a mean age of 41
+/- 9.2 years. The knowledge level of the faculty members regarding cardiovascular diseases was relatively
good (mean score of 16.44 from total score of 27). The attitude of the participants was good (mean score of
32.70 from total score of 36) and their performance was also good (mean score of 27.57 from total score of
38). There was significant relationship between knowledge and performance (P < 0.000) and the relation
between attitude and performance was also significant (P < 0.003).
Conclusion: The results of the study showed that the knowledge, attitude and performance levels of
university faculty members regarding cardiovascular diseases is high and as they are in a good position to
relay information to students, university faculty members can play an important role in primary prevention of
cardiovascular diseases.
References: 1-Farhad M,Moazzzam E, Faghih imani E, Sarrafzadegan N. A study of the knowledge, attitude
and practice levels of general physicians of Isfahan regarding dangers of cardiovascular diseases. The
Medical Research Journal, Third Year; 4, 286-288.
2- http://www.who.int/mediacentre/fact sheets/en
3- Taghavi M. State of Death in 18 states of Iran in 2001, Tehran, Iran
4-Frontini M.G, srini rasan S.R, EL ksabany A,B erenson G.S.A wareness of nypertension and
dyslipidemiaina semirural population of younj adults:
The bogal usa heart study. Preven med 2003 , 36: , 3, 8 – 402
5- Angelicof , ben M.D, Franciosos , Hurtor m,liutia ,Baynaras ,Romano
D. Attitudes and approach to cardiorascular risk factors in Itali:
Resultsof electoronic questionnaire surrey: publc heath. July 2003
9117(4): 242 – 249
6- Adiyee F and co workers. Study of the levels of knowledge, attitude and practice of residents covered by
the population research center of Tehran Medical University regarding risk factors of cardiovascular
diseases. Diabetes and Lipid Journal of Iran, Winter, 2004, 5 (2), 176-184.
7- Habibullahzadeh H, Baghayee R, Abulfathi L, Ghassemzadeh P. Evaluation of causes of cardiac failure
and levels of knowledge, attitude and practice of patients regarding self care. Scientific Journal of Medical
Association of Iran, 2001, 190 (2), 85-89.
Disclosure of Interest: s.s mazloomy Paid instructor

TP-WED-031 IMPLEMENTATION, OUTCOMES, AND LESSONS LEARNED FROM A HEALTH
PERSONNEL'S COMPETENCY DEVELOPMENT IN AN EMPOWERMENT-BASED BEHAVIOR CHANGE
OF CARDIOVASCULAR DISEASE RISK GROUP IN BANGKOK METROPOLITAN
N. Pensirinapa* 1
1 School of Health Science, Sukhothai Thammathirat Open University, Nonthaburi, Thailand
Background: The National Health Security Office (NHSO), Bangkok Branch, set a policy to support health
services in Bangkok by empowering the population at risk to change health behaviors; and there was a need
to develop the capacity on an empowerment-based behavior change (EBC) of health personnel who were
responsible for providing this service.
Objectives: To evaluate and follow up the outcomes of the health personnel‟s competency development
program in an EBC of cardiovascular diseases (CVD) risk group in Bangkok metropolitan, and to identify
lessons learned from this program.
Underlying values and principles: CVD are increasingly a major cause of death and disability worldwide.
Lifestyle change strategies can play a significant role, not only in the reduction of risk factors but also in both
prevention and effective treatment of CVD.
Knowledge base/ Evidence base: Many studies have showed the association between empowerment and
self-care behavior, and found a favorable effect of empowerment-based intervention on patient‟s health and
well-being. Practicing within the empowerment philosophy requires a paradigm shift from provider-centered
care to patient-centered collaborative care. Within this model, health-care professionals‟ role is not to change
patients‟ behaviors, but to inspire, inform, support and facilitate their efforts to identify and attain their own
goals.
Context of intervention/project/work: The 3-day EBC training course for 5 groups was organized for 272
health service personnel from 107 primary care units and 35 hospitals in Bangkok at the end of 2007 by
Sukothai Thammatirat Open University (STOU) team. One month after trained, those personnel had to
attend a one-day project writing workshop to modify their projects to correspond to empowerment concept,
their target groups and health services. In 2008, 46 health services ran the EBC programs and were
supervised by the STOU team.
Methods: Data were collected by a questionnaire with reliability values of .67 and .96 for knowledge and
self-efficacy parts, to gather data before and after 3-day EBC training course. The follow up questionnaire
was sent to 142 participating health services in June 2008, with 60.5% response rate. An assessment of the
EBC program implementation of health services was done by a supervisor team, and 6 of them were
qualitatively evaluated. In August 2008, the EBC program knowledge management workshop was hold
among 38 participating health services to summarize their lessons learned from the implementation of EBC
program.
Results and Conclusions: The significant higher score of health personnel‟s knowledge and self-efficacy
on EBC program were found between baseline data and after 3-day training, and their satisfactions on the
training course and project writing workshop were at high levels. Regarding an assessment of an
empowerment handbook, they reported a high level of appropriate contents and usage proportion of 96% in
an empowerment-based lifestyle change part and 63% in a smoking cessation part. A supervision report on
the EBC program in 46 health services showed a high level of proper implementation. In the six-month follow
up, 55 units of the 86 responding health services reported having had an EBC project, but 53 of them
implemented. Key success factors learned were: building a team and strong supporting policy, tailoring
program activities suitable for the target group and focus on increasing their skills and concrete experiences,
beginning from voluntary persons having the same risks, setting empowerment learning group 4-5 times in 3-
6 months program period, and using behaviors and health outcomes for feedback. The qualitative data found
administrators' support and agreement with the EBC program; project teams reported a proper technical
support from STOU team, benefit from people behavior change and their improving capacities; the
participants reported the program suitable for them and fun, increasing their abilities to control behavior and
health outcomes. Therefore, to effectively changing health behaviors of the CVD risk group, health service
personnel should be trained in the EBC program and encouraged to self-design the suitable program.
Moreover, handbooks and guidelines for designing the EBC program‟s activities and evaluation, and
supervision on their first EBC project implementation should be available.
Disclosure of Interest: The National Health Security Office, Bangkok Branch, granted the program budget.

TP-WED-032 QUELLES STRATÉGIES DÉVELOPPER DANS LE CADRE DE LA PROMOTION DE LA
SANTÉ CARDIOVASCULAIRE : EXEMPLE DE LA COMMUNAUTÉ FRANÇAISE DE BELGIQUE
Y. Coppieters* 1 , C. Béduwé 1 , J. Collignon 2 , V. Hubens 3 , A. Levêque 1
1 Département d'Epidémiologie et Promotion de la santé, Université Libre de Bruxelles, ULB, Bruxelles,
2 CEP, Centre d'Education du Patient, Godinne, 3 Promo Santé & MG, Promotion santé et médecine générale
asbl, Bruxelles, Belgium
Historique / Origines: De récentes études analysent le poids des facteurs de risques cardiovasculaires et
le gain considérable en espérance de vie dans le cadre des actions de prévention pour des patients
présentant plusieurs facteurs de risque majeurs. Ces actions sont efficaces et elles l‟ont prouvé à travers les
programmes d‟interdiction de fumer dans les lieux publics ou des programme plus globaux comme en
Carélie du Nord (Finlande) ou aux USA (Minnesota Cardiovascular Health, etc.).
Objectifs: L‟objectif de cette étude est de présenter le cadre stratégique de la promotion de la santé
cardiovasculaire en Communauté française de Belgique, élaboré sur base d‟une approche systémique et
participative, et d‟analyser la place des stratégies préventives les plus efficaces dans ce programme.
Valeurs et principes sous-jacents: Les études épidémiologiques sur les facteurs de risque majeurs
cardiovasculaires sont importantes pour renforcer les stratégies préventives et confirmer le rôle de la
prévention primaire et secondaire comme facteur explicatif de la baisse de la mortalité cardiovasculaire
depuis plus de 20 ans. Cependant elle occulte auprès des professionnels de santé et des populations une
vision plus complexe et systémique de la santé cardiovasculaire.
Fondement de connaissance/Fondement de preuve: Une revue de la littérature préalable sur les
stratégies de promotion de la santé cardiovasculaire a entre autres montré l‟intérêt de développer la
responsabilisation citoyenne, communautaire et politico-sociale ; la multidisciplinarité des intervenants, les
collaborations et les synergies entre les différents secteurs en lien avec la santé cardiovasculaire, etc.
Contexte d'intervention/projet/travail: En Communauté française, un processus de mobilisation d‟acteurs
a été mis en place pour définir et mettre en oeuvre un Programme de promotion de la santé cardiovasculaire
et rechercher des stratégies d‟actions en lien avec les réalités de terrain, tout en essayant de toucher
l‟ensemble de la population et des acteurs concernés par cette thématique.
Méthodes: Neuf unités de concertation ont été constituées en lien direct avec un milieu de vie, un public
cible ou des groupes d‟acteurs. Chaque unité a analysé les déterminants environnementaux, sociaux et
personnels ainsi que les différents facteurs qui les influencent (avec l‟outil de catégorisation des résultats).
Résultats et Conclusions: Les stratégies et objectifs prioritaires sont entre autres l‟aménagement des
cadres de vie ; le développement d‟offres de promotion de la santé et des offres de suivi sanitaire et social
de proximité ; la mobilisation des responsables politiques et institutionnels et le soutien des professionnels
dans leurs actions envers les patients et la population. Des recommandations transversales pour les publics
fragilisés sont intégrées aux différentes stratégies. Plutôt qu‟une multitude de projets verticaux spécifiques,
ne visant qu‟un facteur de risque en particulier, c‟est une approche intégrée visant un ensemble de facteurs
de risque partagés par la population qui a été privilégiée. L‟action sur les déterminants de la santé est aussi
prioritaire et porte sur la création de milieux et de modes de vie favorables à la santé.
Conflit d'Interêt: Rien à déclarer

TP-WED-033 INTERVENCION COMUNITARIA PARA LA PROMOCIÓN DE LA SALUD Y PREVENCIÓN
DE ENFERMEDADES CARDIOVASCULARES
A. E. Alasino* 1 , L. Lazaro Cuesta 1
1 Universidad Nacional de La Plata, PROPIA Programa de Prevención del Infarto en Argentina, La Plata
Buenos Aires, Argentina
Antecedentes: Seleccionado por iniciativa de OPS NHLBI EEUU para apoyar propuestas en las Américas
en prevención de ECV
Guardacorazón es un programa de formación y construcción de capacidades individuales y colectivas con el
fin de desarrollar acciones de prevención y promoción de la salud PS a través de la implicación con la
comunidad y de la planificación de intervenciones comunitarias basadas en alimentación actividad física
antitabaco y entornos saludables
Objetivos: Contribuir a la construcción de conocimientos y habilidades de la comunidad del área de
intervención sobre los FRCV y promoción de estilos de vida saludables
Generar procesos de multiplicación de conocimientos y aptitudes por parte de los promotores de salud a
través de acciones de prevención y PS en comunidad
Promover articulación de instituciones y actores locales para desarrollar prácticas de salud desde la
integración de diferentes perspectivas
Valores y principios subyacentes: De característica poblacional basado en Líderes comunitarios como
agentes de cambio Progresivo escalonado y multinivel con acciones en diferentes niveles Participativo e
integrador articula esfuerzos y recursos existentes Multisectorial
Base de conocimiento / base de evidencia: Múltiples investigaciones demuestran que las raíces de las
Enfermedades No Transmisibles subyacen en los estilos de vida no saludables y en los adversos ambientes
físicos y sociales
Entre las principales enfermedades encontramos las ECV
Existe evidencia que es posible implementar proyectos para el logro de la disminución de la prevalencia de
FRCV de la población y aumento de niveles de salud individual
Contexto de la intervención / proyecto / trabajo: En Argentina las ECV y tumores son primeras causas
de muerte
6 de cada 10 ocurren por estas causas y muere una persona cada 8 minutos en Buenos Aire por ECV
La Encuesta Nacional de FRCV muestra la situación actual Sobrepeso 34,6% obesidad 14,8% Hipertensión
Arterial 34,4% colesterol elevado 30% Diabetes 12,7%Guardacorazón se desarrolla en Mar del Plata área
programática Santa Rita población de 21.500 habitantes pertenece a un sector de clase media y media baja
Métodos: Fase I junio 2007 diciembre 2008 Desarrollo y validación de los instrumentos y herramientas de
capacitación Desarrollo de programa de capacitación
Medición test antes después y metodología cualitativa
Fase II enero 2009 julio 2010 Desarrollo e implementación de programa modelo de prevención y control de
FRCV dirigido a grupos seleccionados de comunidad emplenado Promotores
Evaluación test antes después en proceso
Resultados y Conclusiones: Grupo capacitado de promotores no profesionales Manual para promotores
de Salud y Actividades diversas validadas
Materiales pedagógicos producciones gráficas juegos lúdicos
El involucramiento activo de la comunidad es indispensable para ayudar a modificar los estilos y modos de
vida de las personas en relacion a las ECV
Referencias: ENFR Ministerio de Salud Argentina, 2006 http:www.msal.gov.ar
Declaración de intereses: no declarado

TP-WED-034 DETERMINANTES SOCIOECONÓMICOS Y FACTORES DE RIESGO
CARDIOVASCULAR EN CANARIAS (ESPAÑA)
S. Darias-Curvo* 1
1 Salud Pública, Universidad de La Laguna, La Laguna, Spain
Antecedentes: El nivel de salud y/o de enfermedad de una población depende de diversos factores:
desarrollo económico, avances médicos, tipo de asistencia sanitaria, cualificación de los profesionales y
recursos sanitarios, entre otros. Probablemente estemos en una época en la que se ha producido un gran
avance en todos los niveles anteriormente mencionados; sin embargo, la reducción de las desigualdades en
salud no han sido a la par que estas mejoras por lo que cabe pensar que la salud no sólo está determinada
por esos aspectos más relacionados con el propio sistema sanitario sino, más bien, por otro tipo de
determinantes sociales entre los que se encuentran el tipo de trabajo desempeñado, las características de
ese empleo, el entorno ambiental y físico, la exclusión social, la situación económica, el nivel de estudios,
etc.
Objetivos: - Determinar el grado de asociación entre el consumo de tabaco, consumo de alcohol y
obesidad con nivel educativo.
Valores y principios subyacentes: La equidad en salud es un concepto ético fundamental en el estudio de
los determinantes sociales de la salud. El Departamento de Ética, Equidad, Comercio y Derechos Humanos
de la Organización Mundial de la Salud define la equidad como “la ausencia de diferencias injustas,
evitables o remediables en salud entre grupos de población definidos social, económica, demográfica o
geográficamente”. Las inequidades en salud son las diferencias en salud socialmente producidas,
sistemáticas en su distribución a través de la población, e injustas. Esto es una cuestión ética.
Base de conocimiento / base de evidencia: Para mejorar la salud de la población, fomentando la equidad
sanitaria, es necesario desarrollar nuevas estrategias de acción que tengan en cuenta estos factores
sociales que influyen en la salud.
Contexto de la intervención / proyecto / trabajo: El estudio ha sido realizado en Canarias, una de las
regiones más ultraperiférica de la Unión Europea. Para ello se ha analizado la Encuesta de Salud de
Canarias 2004 y la Encuesta sobre salud e ingresoso de Canarias 2004.
Métodos: Para el análisis estadístico, y en relación con nuestros objetivos realizamos un conjunto de
regresiones logísticas de cada factor de riesgo vascular considerado y de cada variable de carácter
socioeconómico por separado. Incluyendo en todas las regresiones logísticas la variable edad
Resultados y Conclusiones: Se observa una interacción entre el nivel de estudios y diversos FRC.
Presentan mayor probabilidad de consumir alcohol aquellos hombres que pertenecen al grupo de sin
estudios (OR 6,915, IC95% 2,087-22,907).
Presentan menor riesgo de consumo de tabaco las mujeres que poseen estudios secundarios (OR 0,609,
IC95% 0,375-0,989). Consumen más alcohol las mujeres sin estudios (OR 6,583, IC95% 1,938-22,368), con
estudios primarios (OR 3,027, IC95% 1,765-5,19) y secundarios (OR 2,21, IC95% 1,407-3,47.
Existe una desigualdad de género en los FRC especialmente para el consumo de tabaco y consumo de
alcohol.
A medida que descendemos en el nivel educativo los hombres y mujeres presentan mayor riesgo de
consumo de alcohol, lo cual implica la necesidad de establecer medidas que mejoren las condiciones de
vida, monitorizar la magnitud del problema, analizarlo y evaluar los efectos de las intervenciones específicas
en estos grupos sociales.
Declaración de intereses: No declarado

TP-WED-035 PATIENT PROVIDER GOAL SETTING, DECISION SUPPORT, AND CARDIOVASCULAR
RISK
S. M. Cohen* 1
1 Nursing, Asthma and Allergy Center of Roanoke, Roanoke, Virginia, United States
Background: Veterans are at high risk for cardiovascular disease. Patient provider goal setting and decision
support has shown success in promoting patient adherence to health recommendations, decreasing risk and
sustaining change among this population. It is applicable to other populations and diseases.
Objectives: The purpose of the study was to determine the prevalence of cardiovascular risk factors and to
examine the influence of patient provider goal setting and decision support on factors related to
cardiovascular disease risk among veterans receiving outpatient care.
Underlying values and principles: patient empowerment, shared decision making, adherence promotion
Knowledge base/ Evidence base: patient care clinical guidelines based on evidence based practice were
utilized in developing shared goals and decision support for patients
Context of intervention/project/work: 1,865 veterans, aged 18-89 years old, who received outpatient
primary care services between 2003-2007 at a Department of Veterans Affairs Medical Center in the United
States
Methods: Secondary data analysis of de-identified medical records. Descriptive statistics were used to
describe the prevalence of cardiovascular risk factors. The association among patient provider goal setting
and decision support on body mass index, HbA1c, and LDL cholesterol was examined using generalized
estimating equations with exponential regression.
Results and Conclusions: Veterans in this study were at high risk for cardiovascular disease. 1,579
(84.7%) veterans were 50 years or older in 2007, 22.9% had an existing diagnosis of cardiovascular disease,
26.2% had diabetes, and 6.6% had both cardiovascular disease and diabetes. Nearly 40% of the sample
was considered obese with a BMI ≥30. Twenty-eight percent had an LDL higher than recommended but risk
levels declined from 42.9% high risk cases in 2003 to 24.2% high risk cases in 2007. Over three-quarters of
the sample reported a smoking history. Patient provider goal setting and decision support was a significant
predictor of HbA1c and LDL along with educational class attendance, cholesterol medication prescribed,
age, and type of health care provider. Improved diabetic control and reduced LDL cholesterol levels were
sustained over the 5 year period. Future prospective studies are needed to further define the relationship
between patient provider goal setting and decision support and cardiovascular risk and develop culturally
sensitive and innovative programs.
Disclosure of Interest: None declared

TP-WED-036 DEVELOPMENT OF CARDIOVASCULAR DISEASE HEALTHY CITIES PLAN IN
GWANGMYEONG
K. Kim* 1 , S. Kam 1 , S. Lee 1 , J. Park 1 , S. Han 2 , J. Hwang 1 , J. Shin 1 , K. Kim 1 , N. Hong 1 , j. Hahm 3 , O. Pyo 3 , W.
Lee 3
1 Department of preventive medicine, School of Medicine, Kyungpook National University, 2 Department of
Public Health, Kyungpook National University postgraduate school department of Public Health, Daegu,
3 Department of health promotion, Gwangmyeong Public Health Cente, Gwangmyeong, South Korea
Background: The social burden of cardiovascular disease has increased in Korea and Gwangmyeong city.
As one of the top death causes, it causes lots of medical spending and often follows disability. Fortunately, it
is known that the disease is preventable and the prognosis becomes better corresponding to modifying risk
behaviors and early recognizing the disease. Gwangmyeong was announced as the AFHC healthy city in
2008, and to prevent and reduce cardiovascular disease, cardiovascular disease high-risk patients
registration have been undertaken.
Objectives: This study is aimed to development of Cardiovascular Disease Healthy Cities Plan in
Gwangmyeong.
Underlying values and principles: .
Knowledge base/ Evidence base: .
Context of intervention/project/work: .
Methods: Domestic and international examples were reviewed for benchmarking. Officials over many public
and private sectors which are directly or indirectly health-related were interviewed and their achievements
were collected. Besides, many documents of regional health status, public health schemes and development
strategy were reviewed, and experts and community opinion leaders were involved in this study.
Results and Conclusions: The death proportion caused by cardiovascular disease and its risk were
relatively high. Specific goals and activities were recommended for first/secondary/third level comprehensive
community-based and collaborative approaches. 1) To modify risky behaviors and promote healthy lifestyle,
walking or cycling courses as sports for all are constructed and a campaign called 'Active Living City" is
launched. To reduce risk factors, the community and risky groups are informed and educated of the risk of
smoking and high-sodium diet and others. 2) high-risk diseases like hypertension, diabetes mellitus and
metabolic syndrome are properly managed. 3) To early aware and treat cardiovascular disease, the
symptom awareness is improved, practical programs of cardiopulmonary resuscitation(CPR) are introduced,
automatic external defibrillators(AED) are equipped and utilized in public, interventions for the minority are
introduced and the emergency system is advanced. 4) To empower the community, comprehensive
approaches at the individual, local and environmental level are required. 5) The ten priority activities
recommended are walking city, promotion of sports for all, non-smoking supporters, low-salt consumption,
risky disease registration, early awareness of the cardiovascular disease symptoms, fast reaction to the
occurrence of cardiovascular disease, interventions for the old in hot days, musical therapeutic programs
and stress management.
It is concluded that some prerequisite conditions should be satisfied to accomplish the cardiovascular
disease healthy city project successfully, like local government willingness, priority decision, clear goal,
community participation, local acknowledge improvement, timing short/long-term evaluation, sustainable
structure and budget, and leader/human resource.
Disclosure of Interest: None declared

TP-WED-037 UNE APPROCHE ORIGINALE POUR LA PROMOTION DE LA SANTÉ ET LA
PRÉVENTION DES MALADIES CARDIOVASCULAIRES AU BÉNIN: LES GROUPES D'ENTRAIDE
H. F. Delisle* 1 , C. J. Sossa 1 , V. Agueh 2
1 Département de nutrition, Faculté de médecine, Université de Montréal, Montréal Qué, Canada, 2 Dép.
nutrition, Institut régional de santé publlique, Ouidah, Benin
Historique / Origines: Un problème nutritionnel préoccupant est celui de la progression rapide de l‟obésité,
du diabète et d‟autres troubles chroniques liés au mode de vie même dans les pays à faible revenu. Ces
maladies chroniques ne sont plus l‟apanage des riches et elles sont grandement favorisées par
l‟urbanisation.
Objectifs: Une étude de cohorte est menée au Bénin afin de suivre l‟évolution des facteurs de risque de
maladies chroniques chez des sujets ayant participé à des études transversales mettant ces facteurs en lien
avec le lieu de résidence, le niveau socio-économique, l‟alimentation et le mode de vie. Des groupes
d‟entraide sont constitués pour favoriser l‟auto-prise en charge et la prévention des facteurs de risque.
Valeurs et principes sous-jacents: L‟intervention préventive de nutrition communautaire est fortement
ancrée dans l‟approche de promotion de la santé. Les groupes d‟entraide comme moyen de prévention au
Bénin sont une expérience originale puisque de tels groupes ont surtout été créés dans les pays
industrialisés autour de problèmes de santé. L‟approche doit aider à prévenir les maladies chroniques
notamment par une meilleure alimentation, l‟activité physique et le dépistage de facteurs de risque comme
une tension artérielle élevée ou une hyperglycémie. Les groupes sont destinés éventuellement à s‟autogérer.
Fondement de connaissance/Fondement de preuve: Des études multicentriques de grande envergure
comme INTERHEART ont montré que les mêmes facteurs de risque cardiovasculaire étaient à l‟oeuvre
partout. Les études transversales que nous avons effectuées au Bénin ont montré que même chez des
sujets (n>500) apparemment bien-portants, 20% des hommes et des femmes étaient hypertendus, 15% des
hommes et 30% des femmes présentaient une insulino-résistance, précurseur de diabète, et 27% des
femmes étaient obèses.
Contexte d'intervention/projet/travail: L‟initiative est menée dans le cadre d‟un projet de développement
au Bénin d‟un pôle francophone africain sur le double fardeau nutritionnel (malnutritions et maladies
chroniques). Les activités de recherche-action doivent aider à réduire ce double fardeau notamment au
niveau des communautés.
Méthodes: Les 20 groupes d‟entraide (20 à 34 sujets) ont été constitués à partir des sujets des études
transversales. Les groupes ont nommé eux-mêmes leurs leaders. Pour l‟instant, ils sont visités plusieurs fois
par an par un médecin et un animateur qui expliquent l‟approche, orientent les discussions sur un sujetproblème,
font le suivi et servent de personnes-contact pour des conseils appropriés.
Résultats et Conclusions: Les premiers résultats sont prometteurs, car de nouveaux membres sont
recrutés, certains groupes ont entrepris de faire ensemble de l‟activité physique, et répondant à un besoin
évident d‟orientation pour les choix alimentaires, une ébauche de « guide alimentaire » béninois est en cours
d‟élaboration avec l‟appui de ces groupes. Nous évaluerons par la suite l‟évolution des facteurs individuels
de risque en fonction du degré de participation aux activités des groupes d‟entraide.
Références: Yusuf S, Hawken S, Ounpuu S, on behalf of the INTERHEART Study Investigators. Effect of
potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART
study): case-control study. Lancet. 2004;364:937-952
Conflit d'Interêt: Rien à déclarer

TP-WED-038 TRENDS IN SLEEP-DURATION IN 11- TO 15-YEAR-OLD SWEDISH SCHOOLCHILDREN
BETWEEN 1985/86 AND 2005/06
L. Eriksson* 1
1 Department Child and Youth Health, Swedish National Institute of Public Health, Östersund, Sweden
Background: Today, it is believed that children sleep less than before, but there is a need for studies
supporting this. Reasons for this declining sleep duration are said to be later bedtimes, changes in life style,
24-h availability of TV, Internet, and cell phones. Studies investigating changes in sleep patterns for school
children are scarce.
Objectives: This study aims to investigating whether schoolchildren sleep duration are shorter today than 20
yeas ago.
Underlying values and principles: If children sleep less this might lead to health issues. Children feeling
low or having problems concentrating, and overweight.
Knowledge base/ Evidence base: Sleep are said to be related to health outcomes such as obesity and
psychological functioning. If children sleep less, this might have health implications and problems
concentrating in school.Studies investigating changes in sleep patterns for school children are scarce.
Context of intervention/project/work: The Health Behaviour in School-aged Children (HBSC) provided
national data, Sweden, on children age 11-,13- and 15. Data gathered in schools in 1985/86 and 2005/06.
Methods: Data from 1985/86 (N=2921) and 2005/06 (N=4334) were used. WHO sponsored study, national
data from Sweden were used. A national representative random sample of 11-,13-, 15-year old school
children were drawn. Questionnaires were distributed through schools.
Sleep duration was measured by 2 questions “what time do you usually go to bed, when your going to school
the next day” and “what time do you usually get up when going to school?”.
Results and Conclusions: In 1985 children slept for 9 hours and 3 minutes (M=9,06: Sd= 0,642), In 2005
they slept for 8 hours and 50 minutes (M=8,84: SD=0,687). Counted in minutes, children sleep 13 minutes
less today than 20 years ago. The number of students sleeping less than 8 hours has increased from 2 % in
1985/86 to 6 % in 2005/06. This indicates that there has been a reduction in sleep duration for school-aged
children.
Naturally, 15 year olds sleep less than 11 year-olds. In the 1985 study, there is no difference depending on
gender, but in 2005 there is. Girls sleep less than boys in that sample (chisquare=21,74, df 7, p=0,03). Boys
usually goes to bed later than girls, and the trend is that more boys go to bed at 11pm or later.
Our findings suggest that during the last 20 years there has been a reduction in school-day sleep for 11-15
year-olds. This decline in sleep duration might cause health issues, but need further investigation.
Disclosure of Interest: None declared

TP-WED-039 ASSOCIATION OF CHILD HEALTH OUTCOMES WITH PRESENCE OF FATHER IN A
CAIRO SLUM
L. Benova* 1 , H. Gowayed 1 , Z. Khader 1
1 Social Research Center, The American University in Cairo, New Cairo, Egypt
Background: Children living in poor families in urban Egypt achieve lower health outcomes than children in
richer families. (1) This is an outcome of multiple factors, such as environmental risks, parent education,
income, food intake, health service utilization etc. Most health and social assistance interventions focus on
the mothers‟ capacities to improve child health outcomes, yet we have a limited understanding of the role of
fathers in the process of influencing child health.
Objectives: This study explores the association between the presence of a father in a family and child
health outcomes. The population of this study is children under 18 within 162 poor families living in a slum of
Cairo who are currently participating in a conditional cash transfer program (CCT).
Underlying values and principles: Children and adults in Ain es Sira suffer from a high burden of
preventable disease. (2) Any social program attempting to influence child health outcomes in the long term
must consider the immediate factors influencing these outcomes in order to suggest appropriate and
effective interventions.
Knowledge base/ Evidence base: The presence of a father living with children under 18 and its influence
on child health is a factor under-researched as well as under-utilized in social assistance interventions such
as CCTs. This is despite the literature suggesting that female-headed households raise children with better
health outcomes. In spite of the income that a father may bring to a family, negative behavioral patterns
(domestic violence, drug-use, limitations to mother‟s mobility) have also been reported within the poorest
families of Ain es Sira.
Context of intervention/project/work: In June 2009, the first CCT pilot in Egypt started in the slum of Ain
es Sira in Cairo. Families with school-age children were selected based on their poverty level to enroll in this
program. CCT programs aim to decrease the level of poverty in future generations by improving children‟s
health and education. The baseline evaluation uncovered that one third of children live without their own
father or no adult male head of household.
Methods: Children living in a household with their own father are compared to children living without an
adult male head of household in a sample of over 600 children living in CCT beneficiary families in Ain es
Sira. Factor analysis is used to assess the importance of several variables: stunting, wasting, BMI, anemia
levels, presence of intestinal parasites, as well as mothers‟ health-seeking behavior and self-reported
incidence of illness, especially RTI and diarrhea.
Results and Conclusions: Preliminary results indicate that children under 5 living with their own father are
less likely to suffer from stunting or wasting, but are equally likely to have anemia compared to children living
with no male head of household. A detailed analysis will show whether children living with their father have
any comparative advantage in regards to health status and which are the primary factors that explain
variations in health status. In conclusion, we discuss through which channels the presence or absence of a
father may influence child health outcomes, focusing on income and expenditure patterns, household
violence, and mother‟s agency in child health decision-making. We suggest social program components that
may ameliorate the health burdens associated with these influences.
References: (1) Egypt Demographic and Health Survey, 2008.
(2) Preliminary baseline analysis, Ain es Sira CCT.
Disclosure of Interest: None declared

TP-WED-040 FACTORS RELATED TO SOCIAL COMPETENCE DEVELOPMENT OF THIRTY-MONTH-
OLD TODDLERS: A LONGITUDINAL PERSPECTIVE
E. Tanaka* 1 , R. Shinohara 1 , Y. Sugisawa 1 , L. Tong 1 , E. Tomisaki 1 , M. Hirano 1 , K. Morita 1 , G. Amarsanaa 1 , Y.
Onda 1 , T. Watanabe 1 , Y. Mochizuki 1 , Y. Kawashima 1 , Y. Yato 2 , N. Yamakawa 3 , T. Anme 1
1 Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, 2 Depertment of
Psychology, Ritsumeikan University, Kyoto, 3 Sukusuku Cohort Mie Research Group, Mie-Chuo Medical
Center, Hisai, Japan
Background: Social development is one of the important outcomes in child care research. In addition,
factors related to parenting and the expanded rearing environment, which includes caregiver‟s mental health,
are hypothesized to contribute to children‟s social development, above all, in early childhood.
Objectives: The purpose of this study is to determine whether parenting satisfaction and caregiver stress
affect the social competence of toddlers.
Underlying values and principles: This study assumes that a long-term cohort study will be useful for
parenting support.
Knowledge base/ Evidence base: Many studies have suggested that daily emotional interactions between
a child and his/her caregiver play a significant role in his/her social development. Meanwhile, previous
studies have reported that parenting stress and satisfactions are related to mother-child relations.
Context of intervention/project/work: We conducted a prospective cohort study over 2 years as part of the
Japan Children‟s Study.
Methods: The study participants were 311 dyads of 9-month-old children and their caregivers. The
caregivers answered some questionnaires about rearing-related information, including parenting satisfaction
and stress when the child was 9 months old. Caregiver-child interaction was observed when the child was 30
months old, and the features of the interaction were examined using the Interaction Rating Scale (IRS) as a
measure of social competence.
Results and Conclusions: Regression analysis showed that the children‟s total score on the IRS was
significantly related to mother‟s satisfaction and parenting stress at 9 months. At the same time, the
caregiver‟s total score was also related to the children‟s total score on the IRS. Multiple regression analysis
controlling for genders of children was performed to analyze the association between the children‟s social
competence and the mother‟s satisfaction (eta = 0.12, p = 0.02) and parent-children interaction (eta = 0.41, p
< .001). The results of this study therefore suggest that mother‟s satisfaction in child rearing is an important
factor affecting the social development of children at 30 months of age.
Disclosure of Interest: This research was supported by the R&D Area “Brain-Science & Society” of JST
RISTEX and as a part of “Exploring the effect factors on the child‟s cognitive and behavior development in
Japan.” In addition, the study was funded by a Grant-in-Aid for Scientific Research (19330126).

TP-WED-041 LA VULNERABILIDAD INFANTIL EN LA LITERATURA BRASILEÑA
D. J. SOUZA 1 , C. M. L. Bittar Bueno* 1 , M. T. Cano 1
1 Programa de Maestría en Promoción de la Salud, Universidad de Franca - UNIFRAN, Franca, Brazil
Antecedentes: La atención a la salud de los niños en Brasil está sufriendo transformaciones, con
influencias de cada período histórico, de los avances del conocimiento técnico y científico, de las directrices
de las políticas sociales y de la participación de diversos agentes y sectores de la sociedad (1). Siguiendo
una tendencia en el mundo occidental, la infancia y la adolescencia deben ser vistas como una parte
esencial del desarrollo humano, que requiere una protección específica.
Objetivos: Identificar la producción de conocimiento científico brasileño sobre el tema de la vulnerabilidad
infantil en el período de 1992 a 2008.
Valores y principios subyacentes: discusión sobre el concepto de la vulnerabilidad en el contexto de la
Promoción de la Salud.
Base de conocimiento / base de evidencia: Promoción de la Salud
Contexto de la intervención / proyecto / trabajo: La literatura destinada a la comprensión de la
vulnerabilidad de la niñez.
Métodos: La pregunta que orientó la búsqueda de los artículos es:¿Qué ha presentado la literatura
científica nacional sobre la temática del niño vulnerable? Las fuentes fueron seleccionadas mediante
investigaciones en una base de datos de la Biblioteca Regional de Medicina (BIREME). Como descriptores
se utilizaron los términos de vulnerabilidad social + niños. El análisis de los datos se realizó mediante la
lectura del material bibliográfico, usando un enfoque cualitativo y registrando las principales similitudes
encontradas. El material fue analizado por un instrumento de recolección de datos del tipo ficha de catálogo,
que nos ha permitido identificar los datos sobre la distribución de los artículos por año en el período
estudiado, el origen de los autores, la naturaleza de los artículos, las revistas en las cuales se publicaron,
los objetivos, la metodología, la discusión y la conclusión.
Resultados y Conclusiones: La agrupación de temas similares nos ha permitido confirmar: a) El
desempleo como un factor relacionado con el aumento de la mortalidad infantil y de niños y niñas en
situación de calle, b) Las deficiencias en el entorno familiar y una mayor vulnerabilidad c) Las Políticas
Públicas como fuente de reducción de la vulnerabilidad, d) La reducción de la vulnerabilidad y el
mejoramiento del rendimiento escolar, e) La escuela como un lugar privilegiado para la discusión de temas
como la sexualidad, las enfermedades transmisibles y las diversas formas de intervención para la
prevención de HIV/SIDA; f) La influencia de las condiciones socioeconómicas como determinantes de los
trastornos nutricionales en la infancia. La relación entre la vulnerabilidad y los derechos de los niños
expresa la necesidad de crear las condiciones para su superación, sobre la base del ejercicio de la
ciudadanía enraizada en la idea de bienestar social.
Referencias: Figueiredo GLA, Mello DF. Atenção à saúde da criança no Brasil: aspectos da vulnerabilidade
programática e dos direitos humanos. Revista Latino Americana de Enfermagem. 2007. n. 15. v. 6.
Declaración de intereses: no declarado.

TP-WED-042 PROMOUVOIR LA SANTÉ DES TOUT PETITS ET SOUTENIR LES PARENTS
N. L. Houzelle* 1
1 Direction du développement de l'éducation pour la santé et de l'éducation thérapeutique, Institut national de
prévention et d'éducation pour la santé, Saint Denis, France
Historique / Origines: En France, même si les indicateurs de santé sont globalement bons pour les enfants
de moins de 6 ans, les gouvernements successifs ont développé des politiques en faveur de la santé des
enfants et de la natalité. Ces politiques permettent aux femmes d'exercer une activité professionnelle
rémunérée, ce qui est le cas de 82 % des femmes entre 25 et 49 ans. En 2007, on compte 816 500
naissances, et 4,6 millions d'enfants de moins de 6 ans, dont la moitié a moins de 3 ans.
Objectifs: Une variété de dispositifs est proposée aux familles d'enfants de moins de 6 ans, faisant
intervenir différents professionnels auprès d'elles. Pour les aider à développer un projet de promotion de la
santé (PS) un ouvrage méthodologique dans un langage adapté est proposé par l'Inpes.
Valeurs et principes sous-jacents: Réduction des inégalités sociales de santé
Partenariat
Modèle écologique
Fondement de connaissance/Fondement de preuve: Données de la promotion de la santé
Les données scientifiques confirment l'importance de la période de la petite enfance sur l'état de santé à
l'âge adulte.
Contexte d'intervention/projet/travail: Clarifier les différents niveaux d'intervention est utile pour que des
projets de PS avec les parents d'enfants de moins de 6 ans puissent gagner en cohérence.
La famille étant influencée dans son fonctionnement et son organisation par les différents groupes sociaux,
par les institutions et les politiques sanitaires et sociales, il apparaît judicieux de fédérer les acteurs du
social, de la santé et de l'éducation.
Méthodes: Pour mettre en oeuvre ce projet, l'Inpes associe les principales institutions soutenant la mise en
place de tels projets, en particulier des acteurs du champ social qui ont exprimé leur intérêt à ce projet, et
mobilise des experts sur ce sujet.
Différentes instances sont mises en place : comité de pilotage, groupe experts, comité de lecture.
L'édition et la diffusion est organisée par l'Inpes en s'appuyant sur les instances mises en place.
Résultats et Conclusions: Avec ce projet, nous voulons renforcer le rôle des professionnels de la petite
enfance en tant qu'acteur de la PS. En incitant les professionnels du social, de la santé et de l'éducation à
travailler ensemble sur un territoire au développement de projets de PS et de soutien aux parents, nous
espérons contribuer à la réduction des inégalités sociales de santé.
Références: Bronfenbrenner U., The ecology of Human develoment : experimented by nature and design,
Cambridge, Harvard University Press, 1979
Paquet G, Partir du bas de l‟échelle : Des pistes pour atteindre l‟égalité sociale en matière de santé, Les
Presses de l‟université de Montréal, 2005
http://www.insee.fr/
Conflit d'Interêt: Rien à déclarer

TP-WED-043 OFF LABEL PEDIATRIC USE OF ANTIBIOTICS IN A UNIVERSITARY HOSPITAL OF
BRAZIL
S. Santos* 1 , R. Arruda 2 , M. Cavalcanti 3
1 Pharmacy course, University of Pernambuco, 2 Pharmacy course, Faculty Mauricio de Nassau, 3 Program of
Postgraduation in Therapeutical Innovation, Federal University of the State of Pernambuco, Recife, Brazil
Background: According to UNICEF's estimate, over 9 million children under five years are expected to die
each year. More than half of these deaths have been caused by diseases which could be treated with safe
essential child-specific medicines.
Objectives: This paper has issued the evaluation of off-label use or unlicensed antibiotics prescribing to
children in a universitary hospital.
Underlying values and principles: The Pharmacokinetic process, in children, differs considerably from
these in adults, so extrapolation of adult to child data becomes a risk for several reasons: the influence of
growth, maturation and development on adsorption, distribution, metabolism and excretion of drugs.
Knowledge base/ Evidence base: Due to the lack of appropriate medicines, children are commonly given
medicines that have not been developed specifically for use in children, proven to be safe, effective and
licensed for their use only in adults. This practice can be unsafe and lead to potentially harmful side effects.
An increased risk of adverse drug reactions and ineffectiveness of particular drugs have been demonstrated,
due to the use of off-label or unlicensed drugs in children. At present, between 50 and 90% of daily
prescriptions for sick children use „off label‟ drugs, agents that have not been tested for safety and efficacy in
this population. Consequently, there is insufficient information about dosage, safety and efficacy.
Context of intervention/project/work: Creating a policy that requires inclusion of children in all human
subject clinical research, unless there is scientific or ethical reasons to exclude them.
Methods: This was a descriptive, quantitative and retrospective study with a random sample of pediatric
patient‟s prescriptions of a universitary hospital in the northeast of Brazil. It has analyzed the following
variables: age, medicines, doses, dosage, contraindicated medicines, Topographies of infection, therapeutic
subclasses. Drawing lots of a hundred twenty six prescriptions from January to October of 2008 was
performed and the gathered data was compared with the rules of The National Health Surveillance Agency
of Brazil. (ANVISA)
Results and Conclusions: The off-label use prevalence was 47,5%. The percentage of contraindicated
medicines was 3,8%.Topographies of the most frequent infection were on skin “soft parts” (50%)and
respiratory (27,5%). The four therapeutic subclasses most prescribed were: Cephalosporin 36,3%,
aminoglycoside 11,3%, Macrolides and Beta-Lactams 8%. The four most prescribed medicines were:
Cefazolin 16,3%, Ceftriaxone 13,8%, Amikacin and Erythromycin 11,3%.
Growth of drugs researches among pediatric population can provide information to support rational
pharmacotherapy improvement in this group.
Disclosure of Interest: S. Santos,Hospitalar Pharmacist, employee

TP-WED-044 PEDIATRIC SCREENING PROGRAMS AND EARLY INTERVENTION
R. Geene 1
1 Professor, University of Applied Sciences, Stendal, Germany
General description: The pediatric screening program for early detection of disease and developmental
problems in young children plays a key role in the discussion about prevention of child abuse and
developmental problems in socially disadvantaged children.
Rational: In order to develop a more thorough understanding of the factors that influence socially
disadvantaged mothers‟ utilization of this program, we conducted a qualitative study in Berlin, Magdeburg
and Stendal, cities and towns in the eastern part of Germany. Mothers of different SES and Familiy Adversity
index (FAI) were asked about their experiences with the screening program. In a second part, socially
disadvantaged mothers with a high FAI were asked in detail about their opinion about several early
intervention measures. Despite of the mother‟s difficult living conditions all mothers with low SES and high
FAI reported participation in the program. Analysis of the interviews yielded a paradox finding: Participation
in the pediatric screening program has a great subjective benefit for socially disadvantaged mothers which
can mainly be put down to its symbolic meaning. Use of the screening services allows a mother to feel that
she is in accordance with the societal expectations of the mother role. Hence, the fundamental shortcoming
of the pediatric screening program in its present form – its focussing on biological risk factors while
practically ignoring the psychosocial family context – becomes a subjective advantage for the mother: In the
office of the pediatrician who examines the child and not the living condition of the family, socially
disadvantaged mothers do not have to disclose their private sphere which they often feel ashamed and
embarrassed for. For the same reason they also disregard preventive services which are closer to their lifeworld
(such as mother – child groups, services of the youth welfare department and - in part – services of
midwives), while they highly regard video-feedback of educational performance. This high subjective benefit
of the pediatric screening examinations is in contrast to the equivocal objective benefit of the subsequent
child-based early intervention for the prevention of developmental problems in children raised in families with
a high psychosocial burden. The mothers‟ view should be taken into account when more appropriate, familybased
interventions are being developed.
Learning objectives: Mother's view on pedriatic screening programs
Mother's view n early interventions
Expected results: The mother's view should be taken into account when more appropriate, family-based
interventions are being developed.

TP-WED-045 WHY DO BOYS DIE BEFORE BIRTH? - AN ANALYSIS OF FOETAL DEATHS IN JAPAN
T. Masaki* 1 , K. Ogawa 2 , M. Sakamoto 3
1 President, Japanese Society for Development and Protection of Children, 2 Research Team for Social
Participation and Health Promotion, Tokyo Metropolitan Institute of Gerontology, 3 Vice, Japanese Society for
Development and Protection of Children, Tokyo, Japan
Background: Sex ratio of foetal death is the number of foetal death in boys per one hundred girls. Recently,
it has been dramatically increased in Japan. For example, the sex ratio of foetal death was 224.1 in 2006,
compared to the value of 110 in 1990's. Although the number of foetal death has been decreased by year in
Japan, sex ratio has been increased, showing that boys' foetal death has increased.
Objectives: The objective of the study is to determine the reason why foretal death in boys has been
increased in Japan.
Underlying values and principles: The mechanism liking such significant changes in sex ratio of foetal
death is unknown. Environmental hormones or electromagnetic waves might be one of possibilities in
multiple causes.
Knowledge base/ Evidence base: The significant increase in sex ratio of foetal death has been started
since 1975 in the analysis of changes in sex ratio of foetal death by year from 1900 to 2006.
Context of intervention/project/work: We analyzed the statistic data from Japanese government.
Methods: To explore the cause, an analysis of sex ratio of foetal death by pregnancy periods has been
performed. The data source of foetal death is the statistics of population kinetics by Statistics and
Information Department, Ministry of Welfare and Labor in Japan.
Results and Conclusions: During 1950-1973, the sex ratio of foetal death by 3 completed months of
pregnancy period were 190-290,the value was 300 in 1974, and the value was more than 1000 in 2001.
Compared to that trend, the values by 5 completed months of pregnancy period were attenuated 114-127
during 1950-2006. Therefore, the significant increases in sex ratio of foetal death has been started from
1968 to 1974 in 4 completed months of pregnancy period.
Disclosure of Interest: T Masaki, Reaseach and analysis
K Ogawa, support
M Sakamoto, support
None declared.

TP-WED-046 THE INFLUENCE OF BREAST FEEDING PRACTICES ON CHILDREN‟S SPEECH,
LANGUAGE, AND COGNITIVE DEVELOPMENT – A REVIEW LITERATURE
B. Chaimay* 1
1 Public Health, Faculty of Health and Sports Science, Thaksin University, Pattalung Campus, Pattalung
Province, Thailand
Background: Breast feeding appears to advance IQ/cognitive development. Children with cognitive
problems can show up in many ways, such as specific difficulties with language, academic and learning
problems, especially for psychiatric, neurological and/or behavioral problems in late life.
Objectives: To review systematically, on the existing literature, breast feeding that influence on speech,
language and cognitive development in children.
Underlying values and principles: none
Knowledge base/ Evidence base: none
Context of intervention/project/work: none
Methods: Databases of scientific literature were screened through the internet for publications that involved
breast feeding effecting speech, language and cognitive development in childhood. Hard copies of related
scientific journals were also sought for relevant topics by the authors, making use of reference lists of
publications, and citation search. Studies were included if they were published since 1984 and investigated
the effects of breast feeding that effect on speech, language and cognitive development in children. They
were excluded if they are not original research articles.
Results and Conclusions: Fourteen studies were included for this review – a case-control study and
thirteen longitudinal studies. Most studies demonstrated that breast feeding affect language and cognitive
development. However, the effect of breast feeding on cognitive development was controversy.It is
concluded that breast feeding influence language and cognitive development, but inconsistency for cognitive
development.
Disclosure of Interest: none declared

TP-WED-047 IMPLEMENTING EARLY INITIATION OF BREASTFEEDING PRACTICE: HOW FAR THE
JAKARTA URBAN COUPLES KNOWLEDGE AND PERCEPTION SUPPORT IT?
A. M. Septiari* 1 , J. Februhartanty 1 , S. Muslimatun 1 , B. Utomo 2 , R. Suradi 3
1 Community Nutrition, SEAMEO TROPMED Regional Center for Community Nutrition University of
Indonesia, 2 Biostatistic Faculty of Public Health, 3 Child Health Faculty of Medicine, University of Indonesia,
Jakarta, Indonesia
Background: Early initiation of breastfeeding is one of key behavior of breastfeeding since it serves as
crucial starting point of successful breastfeeding. It also reduce neonatal mortality rate. Effective
interventions to encourage early initiation of breastfeeding require an understanding of how parents‟ perceive
about it and how far their knowledge may enable them to practice it.
Objectives: The objective is to explore knowledge and perception toward early initiation of breastfeeding
among urban couples in Jakarta, Indonesia.
Underlying values and principles: Although early initiation of breastfeeding has significant role in
breastfeeding success and may reduce neonatal mortality rate, but in Indonesia currently it is hardly being
practice.
Knowledge base/ Evidence base: A recent study suggested that timely initiation of breastfeeding may
reduce neonatal mortality by 22%. Nevertheless, mother-infant separation post-birth is common in Indonesia,
including Jakarta.
Context of intervention/project/work: The study was designed cross-sectionally among couples having
infant aged 0-6 months living in South Jakarta.
Methods: The study consisted of mixed methods was carried out in 2 phases: (1) quantitative stage using
survey (n = 536 couples interviewed separately); and (2) qualitative approach using in-depth interviews (n =
11 coupled informants interviewed together). Pictorial aids were used during in-depth interview to trigger
couples‟ opinion in breastfeeding related issues including early initiation of breastfeeding. Univariate
analyses were performed to get proportions of categorical data, mean or median values of continuous data.
Listing of all important information and also preliminary analyses were performed right after each in-depth
interview. Data analysis was followed with confirming emerging themes by two analysts who worked
simultaneously to make sure completeness, clarity and coherence.
Results and Conclusions: Only 17.5% of infants were breastfed timely within 30 minutes after birth and
4.5% within at most half-hour after birth for at least 30 minutes. Interestingly, also only 17.5% of fathers knew
about early initiation of breastfeeding. Appealingly, most of the couples who were interviewed in-depth
perceived negatively toward this practice and did not know about it moreover the importance of this practice.
Most of them said this practice is weird and impossible as the condition of both mother and baby are still
weak and dirty. In-depth interviews also revealed that most of fathers did not know how it should be
performed, and what role he can provide during this period. The study also revealed that the health workers
never gave information toward the practice during antenatal care moreover gave supporting assistance for
the practice during delivery.
The study concludes that to be able to perform early initiation of breastfeeding, couples should have an
ample knowledge and positive perception of it. Supporting environments toward it should be created
especially from the health workers who help during delivery. Fathers are potential source to help this key
behavior of breastfeeding during labor.
Disclosure of Interest: None declared

TP-WED-048 MOTHER-INFANT WELCOMING ACTIONS AND MATERNAL CHARACTERISTICS
ASSOCIATED WITH THE INTRODUCTION OF TEA, WATER, AND JUICES IN THE FIRST SIX MONTHS
OF LIFE
R. P. Niquini 1 , S. A. Bittencourt* 1 , E. M. A. Lacerda 2 , M. I. C. de Oliveira 3 , M. C. Leal 1
1 Departamento de Epidemiologia e Métodos Quantitativos em Saúde da Escola Nacional de Saúde Pública,
Fundação Oswaldo Cruz, 2 Departamento de Nutrição e Dietética do Instituto de Nutrição Josué de Castro,
UFRJ, 3 Departamento de Epidemiologia e Bioestatística do Instituto de Saúde da Comunidade, UFF, Rio de
Janeiro, Brazil
Background: The introduction of water, tea, and juices to complement breast milk in the initial six months of
life is still highly prevalent in Brazil, despite initiatives to support exclusive breastfeeding.
Objectives: Determine maternal socioeconomic and demographic factors and mother-infant welcoming
actions associated with early introduction of liquids to infants.
Underlying values and principles: According to the Brazilian Constitution, health is a right of all and a duty
of the state, guaranteed through policies designed to reduce the risk of disease and other health problems.
Knowledge base/ Evidence base: The World Health Organization recommends that infants should be
exclusively breastfed during the first six months of life to achieve optimal growth, development and health.
Context of intervention/project/work: The mother-infant welcoming project was launched in the city of Rio
de Janeiro in 2003. This project consists in giving mothers, after delivery, information and a welcoming card
to visit a primary health care unit during the infant‟s first week of life, in order to receive early guidance on
breastfeeding.
Methods: In 2007, a cross-sectional study was performed with a representative sample of mothers of infants
under 6 months of age attending primary health care units in the city of Rio de Janeiro, Brazil. Multivariate
logistic regression models adjusted by children‟s age, with weighing and design effect were used to estimate
the association between explicative variables and the offer of liquids.
Results and Conclusions: Among the 1,057 mothers interviewed, 55% reported having introduced tea,
water, or juice in the first six months of life. Regarding mother-infant welcoming actions, 32% had not
received the welcoming card at the maternity hospital and 47% had not received guidance on breastfeeding
during their first contact with the primary care unit after the infant‟s birth. According to the multivariate
analysis, women that had not received guidance on breastfeeding during their first visit to the primary care
unit after their infant‟s birth had 58% greater odds (OR=1.58; 95% CI 1.18-2.12) of introducing tea, water, or
juice and those without prior breastfeeding experience had 57% greater odds (OR=1.57; 95% CI 1.16-2.13)
of introducing such liquids. Two significant interactions were observed. Offering liquids was positively
associated with adolescence among mothers who had a partner (OR=2.17 CI 95% 1.10-4.30) and negatively
associated with adolescence among mothers who did not have one (OR=0.31 CI 95% 0.11-0.85). Among
women with less than eight years of schooling, not receiving guidance on breastfeeding after the infant‟s
birth increased the odds of introduction of liquids (OR=1.80; 95% CI 1.05-3.09). These findings highlight the
importance of intensifying early breastfeeding guidance after the infant‟s birth. Maternal characteristics
should be considered when applying this strategy.
Disclosure of Interest: None declared

TP-WED-049 THE EFFECT OF TRAINING MOVIES ON EXCLUSIVE BREASTFEEDING
f. khayyati* 1 , M. Mansouri 2
1 public health, 2 pediatric department, Kurdistan University of Medical Sciences,, sanandaj, Iran (Islamic
Republic of)
Background: There have been a lot of studies about the interventions affecting breastfeeding, but the
efficacy of training and educational movies has not yet been proved.
Objectives: This survey compares the efficacy of training movies versus common method of face-to-face
training in health care centers.
Underlying values and principles: Providing an educational package into a film to facilitate and increase
exclusive breastfeeding among Iranian children
Knowledge base/ Evidence base: Contribution to evidence base to promotion exclusive breast feeding.
Context of intervention/project/work: Evaluate effects of interventional an educational package on
exclusive breastfeeding
Methods: This was a single blind randomized controlled trail. Participants were selected and allocated
randomly. In addition to the routine face to face trainings presented by health workers, the intervention group
members got a training movie including important breastfeeding points and the way of doing that. The
participants were evaluated by blinded investigator at sixth birth month.
Results and Conclusions: From all samples, 118 mothers (50.2%) were doing exclusive breastfeeding;
7(3%) didn‟t practice breastfeeding and 202 mothers (85.9%) at least had the experience of 6 months of
breastfeeding. There wasn‟t any difference in exclusive breastfeeding among these two groups (p>0.05).
Two hundred twenty five participants (95.7%) did overnight breastfeeding and there was not any significant
statistical difference in two groups (p>0.05).
This survey‟s findings and the conclusion of mentioned facts demonstrate that using training movies alone
can not help to increase exclusive breastfeeding and decrease its problems; however face to face training
can be very effective and training movies shouldn‟t replace live and direct counselling.
Disclosure of Interest: Employee
kurdistan university of medical sciences

TP-WED-050 SOCIAL SKILLS DEVELOPMENT AND PARENTING: ONE-YEAR FOLLOW-UP OF
YOUNG CHILDREN
Y. Onda* 1 , R. Shinohara 1 , Y. Sugisawa 1 , L. Tong 1 , E. Tanaka 1 , M. Hirano 1 , E. Tomisaki 1 , K. Morita 1 , A. G.
Yadam 1 , T. Watanabe 1 , Y. Motiduki 1 , Y. Kwashima 1 , T. Anme 1
1 Graduate School of Comprehensive Human Science, University of Tsukuba, Ibaraki, Japan
Background: Matters related child as typified by maladaptation, bullying, and mental health problems are
becoming more and more seriously in various contexts.
Objectives: The purpose of this study is to find out the factors effecting on the development of social skills in
young children focusing on the parenting by one-year follow-up.
Underlying values and principles: Understanding the development of child social skills requires a couple
of viewpoints, which are the impact from basic environment and long term effect.
Knowledge base/ Evidence base: Social skills are essentials for mature relationships with others. It is
known that social skills in preschool are the predicting factors of some problems, such as behavioral
problems and academic achievement in later stages. Even though, we have not so much known how social
skills develop in young children.
Context of intervention/project/work: We conducted a prospective cohort study over 2 years.
Methods: We used Social Skill Scale for Preschool Children (SSS) for evaluating social skills of children,
and Index of Child Care Environment (ICCE) for parenting. SSS constructs three factors, “cooperation”, “selfcontrol”
and “assertion”, which are the three dimensions often applied to sociability over the world.
Participants were 2-6 year-old 1,138 children evaluated with both SSS and the items of rearing environment.
Parents answered ICCE in 2006 and child care professionals evaluated children‟s behaviors with SSS in
2007.
Results and Conclusions: The results showed that girls marked higher score in “self-control” than boys at
all ages. “Cooperation” was affected by “support from partner” in 2-year-old children (eta=0.13), “selfconfidence
for parenting” in 4-year-old children (eta=0.15), and “playing with kids” in 5-year-old children
(eta=0.22). “Self-control” was influenced by “reading books to child” in 1-year-old children (eta=0.16) and in
5-year-old children (eta=0.15), “going to the park with child” in 2-year-old children (eta=0.15), and “selfconfidence
for parenting” in 2-year-old children (eta=0.15) and in 4-year-old children (eta=0.14). It was also
influenced by “slapping child” in 3-year-old children (eta=0.29) and 5-year-old children (eta=0.16), and
“playing with child” in 4-year-old children (eta=0.18). Finally, “assertion” was affected by “reading books to
child” (eta=0.18) and “self-confidence for parenting” (eta=0.16) in 1-year-old children, and by “playing with
child” (eta=0.15) and “having someone else to look after child ” (eta=0.22) in 3-year-old children.
The results indicate that the parent-child relationship, parents‟ skills to avoid punishment, and support for
parents from early childhood, those three played important roles to develop social skills of young children.
Disclosure of Interest: None declared

TP-WED-051 MATERNAL PRACTICES OF FEEDING THE CHILD: ETHNOGRAPHIC RESEARCH
M. A. Frota* 1 , A. R. Sales 1 , A. T. de Sousa 2 , C. F. Casimiro 2 , V. G. Silveira 1 , O. A. Sousa Filho 3
1 Public Health Master, 2 Nursing Graduation, Fortaleza University, 3 Nursing Graduation, Faculdade Integrada
da Grande Fortaleza, Fortaleza, Brazil
Background: Breastfeeding is biologically determined and sociocultural conditioned, consisting of an act
made up of ideologies and influences, arising from conditions and lifestyle, being the primary factor for
growth and development of the baby.
Objectives: The study aimed to investigate the causes of insertion of complementary feeding early in
primiparae of children in the age group 0 to 6 months, describing the food cultural practices used by mothers
of children aged 0 to 6 months; identify the difficulties faced by mothers in the process of breastfeeding and
see how the support networks affect the process of breastfeeding.
Underlying values and principles: The maternal beliefs regarding the feeding of infants from 0 to 6 months
has an effect over the life of the individual.
Knowledge base/ Evidence base: Ethnographic Approach; Culture
Context of intervention/project/work: The culture rooted in the community and to the complementary
feeding is directly associated with other nutrients to be healthy for the newborn, apart from problems related
to the aesthetics, comfort and leisure in front of exclusive breastfeeding.
Methods: The path had the methodological quality approach, with the use of ethnographic study, developed
during the months of March until August 2008. The informants of the research were eighteen primiparous
mothers of children 0 to 6 months, which were not exclusively breast fed attending the consultation of child
welfare in UBASFs of the Unit or the Joint Association of Jereissati III, in the Municipality of Pacatuba-
Ceara. For data collection, used a semi-structured and daily camp.
Results and Conclusions: The results were analyzed and reflected upon the principles that guide the
technical thematic analysis of Bardin, emerging categories: I use to calm the baby, because he not only
meets with the breast; Help to grow, develop and fatten the baby, preventing diseases; Difficulties
experienced in the process of breastfeeding; Foods that are not included in infant feeding and influence of
support networks for feeding. It was evident that the primiparous show insecure from of exclusive
breastfeeding and that the influence of the lifestyle cooperating for the decisions taken on the early weaning
because the individuality of each participant.
Disclosure of Interest: None declared

TP-WED-052 EARLY WEARNING FOCUS ON CHILD FEEDING
M. A. Frota* 1 , C. F. Casimiro 2 , P. O. Bastos 2 , O. A. Sousa Filho 3 , I. C. L. Oliveira 2 , C. M. Albuquerque 1
1 Public Health Master, 2 Nursing Graduation, Fortaleza University, 3 Nursing Graduation, Faculdade Integrada
da Grande Fortaleza, Fortaleza, Brazil
Background: Breast milk should be offered exclusively to the child in the first six months in order to provide
adequate nutrition to promote healthy living and acting in a beneficial way in child growth and development,
and thus have greater chances of survival.
Objectives: It was aimed to investigate the nutritional status and dietary habits in children up to six months
of age.
Underlying values and principles: It is common to come across situations where mothers introduce early
in children's diets foods other than breast milk that the nutritional point of view, it is disadvantageous.
Knowledge base/ Evidence base: Culture; Breastfeeding; Health Promotion
Context of intervention/project/work: Thus it is relevant to the performance of professionals in the health
education with a view to offer infant feeding to promote a healthy habit and prevent possible damage to
health.
Methods: This was an exploratory research with a qualitative approach with 16 mothers of children under 6
months of age who are in mixed feeding residents in a community located in Maranguape - Ceará. Data
collection proceeded with semi-structured interviews recorded in the field diary, from July to October 2009.
The data were organized a thematic analysis.
Results and Conclusions: From the results showed that mothers of children under six months to introduce
complementary foods because they believe the child is in need of substances other than breast milk, and
had no nutritional value. It could be inferred that parents have is passive in the face of choice and provision
of infant feeding, which contributes to the increase in consumption of these foods. Thus it is relevant to the
performance of professionals in the health education with a view to offer infant feeding to promote a healthy
habit and prevent possible damage to health.
Disclosure of Interest: None declared

TP-WED-053 NA
A. Trollvik* 1 , C. Silen 2 , K. Ringsberg 3
1 Faculty of Health and Sports, Hedmark University College, 2418, Norway, 2 NA, Nordic School of Public
Health, 3 NA, Karolinska Institut, NA, Sweden
Background: Asthma is the most common childhood disease and the most long-term medical condition
affecting children. The prevalence of asthma is increasing worldwide. Living with a chronic disease often
affects a child´s whole life; at home, in school and in free time playing. To increase the possibility for children
with asthma to live a healthier life they can participate in learning programs to learn how to cope with the
illness. When planning learning programs and approaching children, we should explore children‟s
experiences and needs so that new programs are optimally tailored to the target group. One method to reach
to the child‟s needs is that health care personnel (HCP) communicate and cooperate with the children during
the process of development of the learning program.
Objectives: The aim of the study was to develop a learning program for children with asthma based on
children‟s needs and perspectives and assess the influence on the children‟s learning and coping in a
salutogenic perspective.
Underlying values and principles: According to the Convention on the Rights of the Child, children have
the right to participate and to express their views freely in all matters and information must be adapted to the
qualifications of the individual recipient, i.e., age maturity, experience and cultural and linguistic background.
Knowledge base/ Evidence base: The study is evidence based.
Context of intervention/project/work: The co-operative inquiry research and took place in a paediatric
ward in Norway.
Methods: The study had a co-operative inquiry research approach Qualitative methods were used to create
data; interviews with children with asthma (7-10yrs old) before and after an asthma education program.
Focus groups with parents and health care personnel were performed. The data were analysed by content
analysis.
Results and Conclusions: The preliminary findings show that the children used different strategies in
coping with asthma. They strived to participate in activities and be like the others and enjoy life without
thinking about the consequences of the illness. It seems as if they lived with a health focus meaning that
they have a salutogenic perspective in life. Their daily activities influenced their own learning processes.
In the beginning of the planning process the health care personnel seemed to have a traditional health
education role in the dialogue with the children. During the inquiry process the HCP became more aware of
the children‟s perspective and participation; they listened to the children, they used a comprehensive
language and involved the children in the learning process in different ways.
References: Research - Support Hedmark University College, Innlandet Hospital Trust and Nordic School of
Public Health have funded the study. No other commercial funding is involved.
Disclosure of Interest: none declared

TP-WED-054 REFLECTION OF FAMILY SOCIOECONOMIC STATUS ON THE BIRTH WEIGHT OF
NEWBORNS: A NATIONALLY REPRESENTATIVE CASE-CONTROL STUDY USING NATIONAL
HEALTH INSURANCE DATA
V. C. R. Hsieh* 1 , T. Wu 1 , T. Chiang 2
1 Graduate Institute of Environmental Health, China Medical University, Taichung, 2 Institute of Health Policy
and Management, National Taiwan University, Taipei, Taiwan
Background: Although many studies may have discussed the importance of socioeconomic factors on
infant and reproductive health, a compelling set of empirical evidence and knowledge base linking social
determinants of health (SDH) to birth outcomes of infants in Taiwan is still absent.
Objectives: This study aims to examine the relationship between a family‟s socioeconomic status and the
birth weight of newborn infants.
Underlying values and principles: With the light to investigate inequities in health under current health
insurance, we aim to tackle the „equity from the start‟ aspect of action on SDH as described by the
Commission on Social Determinants of Health (CSDH) in their final report released in 2008 (CSDH, 2008).
Conditions in which individuals are born exert not only physiological, but also psychological impact later in
their lives throughout development, starting from early in life. One important marker at such stage is birth
weight.
Knowledge base/ Evidence base: It has been established worldwide that low income or social class is
associated with more adverse birth outcomes such as infant mortality and LBW (Moser et al, 2003). Despite
the consistency in results showing income inequality leads to LBW, there are great differences in the health
profiles of different countries - differences that must be first identified and measured, and then assessed
whether if they are indeed unnecessary, avoidable, and unjust. Moreover, causes to these disparities need
to be judged in the context of the society understudy before defining them as „inequitable‟ (Whitehead,
1992). Unfortunately, a lack of studies exploring the relationship between socioeconomic gap and birth
outcomes is observed here in Taiwan.
Context of intervention/project/work: Taiwan has a distinct medical infrastructure and social norm as
compared to other countries. It adopts a global-budget-supported NHI system providing universal coverage
to its people. Since its inauguration, the likelihood of using outpatient and emergency services significantly
increased with socioeconomic development of the geographic area (Liu, 2006). Statistics indicated increases
in health expenditures from 1994 to 1998 in all income classes, but the middle-income quintile had the most
observable growth of 64.1% (Chiang, 2006).
Methods: The National Health Insurance Research Database (NHIRD) is the main source of data. This
study adopted a case-control study examining the relationship between a newborn birth weight and his/her
family‟s socioeconomic status. Infants born between 2001 and 2005 with birth weight

TP-WED-055 HÁBITOS DE VIDA EN FUTBOLISTAS ADOLESCENTES FEDERADOS DE GRAN
CANARIA
C. Navarro Rodríguez* 1 , O. González Ramos 2 , P. Lainez Sevillano 1 , M. Marrero Montelongo 1 , M. Torres
García 3
1 Enfermería, Universidad de Las Palmas de Gran Canaria, 2 Enseñanza (Primaria), Consejería de
Educación, 3 Didácticas Especiales, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran
Canaria, Spain
Antecedentes: A pesar de ser la adolescencia, un periodo en el que se goza de buena salud, también es
un periodo en el que los jóvenes adquieren algunas conductas de riesgo para la salud. No sorprende que la
adolescencia sea la época más frecuente de experimentación con las drogas incluyendo el tabaco y el
alcohol, así como la adquisición de muchos y variados hábitos no saludables.
Objetivos: Identificar los hábitos de vida de los futbolistas adolescentes federados de Gran Canaria
Valores y principios subyacentes: La OMS plantea la promoción de la salud como la única herramienta
eficaz para conseguir que la población adopte hábitos sanos, siendo la adolescencia una etapa decisiva
para ello. Las intervenciones de promoción deberán estar fundamentadas, entre otros aspectos en el
diagnóstico de los hábitos.
Base de conocimiento / base de evidencia: En la adolescencia junto al inicio del consumo de tabaco,
alcohol y otros tipos de drogas, se produce un descenso de la práctica de actividad física y deportiva.
Los últimos estudios que relacionan la práctica de actividad física con otros hábitos, muestran una relación
directa con la alimentación sana, menor consumo de tabaco, alcohol y cannabis.
La evidencia científica ha puesto de manifiesto que los adolescentes físicamente activos, desarrollan un
estilo de vida más saludable que aquellos jóvenes físicamente inactivos siendo su percepción de salud más
positiva.
Contexto de la intervención / proyecto / trabajo: Realizado en todos los futbolistas federados (124
varones entre 14-16 años) de los equipos de la zona noroeste de la isla de Gran Canaria
Métodos: Diseño: Estudio observacional, descriptivo, transversal.
Método de recogida de datos: cuestionario auto-cumplimentado.
Análisis estadístico: listado de frecuencias de variables cualitativas y cálculo de medidas de tendencia
central y dispersión de variables cuantitativas. Análisis de posible asociación entre variables de estudio (Ji-
Dos). SPSS 14.1.
Resultados y Conclusiones: El 70,2% practicó actividad física 4 veces/semana, una media de 1,64 horas
día.
A lo largo de la temporada más de la mitad realizó otras actividades físicas, además de fútbol. Una vez
finalizada la temporada, sólo la mitad continuó realizando actividad física.
Casi el 60% realizó alguna otra actividad además del fútbol a lo largo de la temporada, siendo las más
practicadas el baloncesto, el tenis y la natación. Al finalizar la temporada, el 51,6% realizó actividad física,
siendo las más practicadas el fútbol, atletismo y natación.
Se observó que dedicaban menos de 1 hora diaria al estudio (46%), a leer (86,3%) y a jugar con
videojuegos (41,1%). Un máximo de 2 horas diarias de conexión a internet (66,1%), a ver la televisión
(62,1%), y a practicar otros deportes diferentes al fútbol (68,5%). El 62,9% dedicaba más de 2 horas diarias
a salir con los amigos. El 78,3% declaró dormir 8 o más horas al día.
Más del 90% declaró desayunar, almorzar y cenar diariamente. Más del 50% reconoció realizar cinco
comidas al día. Sólo un 35,8% declaró comer frutas y verduras a diario. Un 50% declaró consumir
diariamente o varias veces en semana bollería.
El 75,8 % ha probado el alcohol y un 56,5% reconoció beber en la actualidad. De los que un 21,8% declaró
haberse emborrachado.
El 91,9% declaró no fumar en la actualidad. El 95% declaró no haber'probado otras drogas.
El 72,6% declaró reaccionar pacíficamente ante derrotas y conflictos, no habiéndose peleado físicamente
con nadie en el último año (66,1%).
Un 36,3% declaró haber mantenido relaciones sexuales, y de ellos un 86,4% usó siempre el preservativo.
Declaración de intereses: No declarado

TP-WED-056 HEALTH PROMOTION IN RURAL CONTEXT: ENVIRONMENTAL AWARENESS IN THE
PERSPECTIVE OF ADOLESCENTS FROM ITAITINGA, CEARÁ, BRAZIL
A. A. G. M. C. Milhome Costa 1 , F. F. A. G. Gubert 1 , K. K. L. S. Silva 1 , P. P. N. C. Pinheiro 1 , N. N. F. C.
Vieira* 1
1 Nursing Department, Federal University of Ceará, Fortaleza, Brazil
Background: In the Brazilian Northeast, children and adolescents are considered part of the population in
most vulnerable situations, especially those who face the social problems such as poverty and lack of
access to basic services like education, health, sport, leisure and professionalization. Environmental
awareness is one of the least discussed topics in this population thus avoiding to promote health.
Objectives: to analyze the environmental rural health from adolescents‟ perspective based on the group
process of listening/speaking/thinking.
Underlying values and principles: The social context is a significant factor for the adolescents growing as
subjects and citizenships. The cultural values and attitudes are social determinants to their understanding of
health and the way they perceive and face the social vulnerability. Among the methodologies that promote
opportunity to raise adolescents‟ awareness about their social living condition, we highlight the use of
Photovoice and Community Based Research (CBR).
Knowledge base/ Evidence base: The framework of this research anchored upon the Paulo Freire‟s ideas
in which advocates that knowledge and critical thinking should be based on the experience and meaning of
each one gives to his world. We use the photography as resource to capture that world under adolescents‟
view and by means of group debate the adolescents revealed through images the political and social context
from their community
Context of intervention/project/work: Adolescent group who live in a rural area of Carapió, Itaitinga,
Ceará, Brazil
Methods: We adopted a qualitative study, using a Community Based Research. For data collection , we
used the photovoice method as proposed by Wang and Buris2 through fifteen group meetings and following
the steps to get knowledge of reality by images, critical analysis and dissemination of images to local health
improvement. The participants were 26 adolescents between of age 12 and 18 years old. The Project was
approved by the Ethical Committee of the Federal University of Ceará (09/09). The results showed 65
images and they derived two main themes: Beauty of Nature and Pollution.
Results and Conclusions: The adolescents‟ narratives stories present their concept of Beauty of Nature as
"green landscape, full of trees and plants. They feel outraged towards mankind‟s actions to destroy nature.
The second theme Pollution, the images denounced nature depredation such as grass fire, spread and store
garbage in inappropriate place. After the exposition of the images and group debate, adolescents
encouraged community union force to protect their rural environment. They also acknowledged the
community difficulties to make urgent changes due to their social conditions such as lack of knowledge, deempowering,
limited environment awareness. However, the adolescents showed their desire to overcome
those barriers and make a move of changes. In conclusion, we believe that the CBR and the use of
photovoice were important methods to raise adolescents‟ awareness about their social reality and to improve
their quality of life protecting the environment.
Disclosure of Interest: None declared

TP-WED-057 FACTORS THAT INTERFERE THE BREAST FEEDING OF CHILDREN IN RURAL AREA
SUPPLEMENTARY
M. A. Frota* 1 , C. F. Casimiro 2 , P. O. Bastos 2 , A. T. Sousa 2 , I. C. L. Oliveira 2 , O. A. Sousa Filho 3
1 Public Health Master, 2 Nursing Graduation, Fortaleza University, 3 Nursing Graduation, Faculdade Integrada
da Grande Fortaleza, Fortaleza, Brazil
Background: The exclusive breastfeeding is able to nurture and meet the needs of children aged 0 to 6
months. However, mothers introduce complementary foods at an early stage which renders vulnerable
children to disease.
Objectives: Thus, aimed to identify factors that influence the use of breastfeeding during the complementary
feeding period in infants under six months old.
Underlying values and principles: It is important that professionals pay attention to situations in which
mothers introduced complementary foods too early, trying to understand the reason for weaning by
harmonizing with their mothers, given the peculiarities and the scenario in which they operate, adjusting, so
the guidelines.
Knowledge base/ Evidence base: Health Promotion; Breastfeeding
Context of intervention/project/work: 16 mothers of children under 6 months of age who are in mixed
feeding residents in a community located in Maranguape - Ceará.
Methods: This was an exploratory research with a qualitative approach with 16 mothers of children under 6
months of age who are in mixed feeding residents in a community located in Maranguape - Ceará. Data
collection proceeded with semi-structured interviews recorded in the field diary, from July to October 2009.
The data were organized a thematic analysis, emerging categories: Maternal beliefs and external
interference that affect exclusive breastfeeding.
Results and Conclusions: From the results, it was noticed that, for mothers, breast milk did not satisfy the
hunger of the child, it brought with it the value that breastfeeding was useful to satisfy hunger and when the
situation did not occur, were taken by insecurity causing disability and early weaning. The mothers showed
little is confident it has claimed milk weak and does not meet the nutritional characteristics of the baby.
Associated maternal belief, you can add that the informants offered water in the sense that breast milk has
not quenched the thirst of the child. With regard to external interference, their relatives and friends were
stubborn in the introduction of other foods in a period that would be of exclusive breastfeeding and maternal
working hours, as well as domestic chores, was another factor that interfered with the natural process of
breastfeeding, so that if a woman works outside the home, the return end of the day, faced with the other
obligations of their own home, making it difficult to breastfeed. In this context, disruption of AME happened
upon beliefs that milk does not meet the child and the mother's employment interferes with the natural
process of breastfeeding, because of the many situations that arise, such as stress and lack of support from
employer to promote the well - being of mothers and children up to at least six months, which contributes to
the change in maternal perceptions of the importance of breastfeeding, discouraging them to the practice.
Disclosure of Interest: None declared

TP-WED-058 CHILDREN AND THEIR QUALITY OF LIFE
O. A. Sousa Filho* 1 , I. M. M. Alves 2 , A. T. Sousa 3 , I. C. L. Oliveira 3 , V. M. Vasconcelos 2 , M. A. Frota 2
1 Nursing, Conselho Federal de Enfermagem - COFEN, Brasília, 2 Public Health Master, 3 Nursing Graduation,
Fortaleza University, Fortaleza, Brazil
Background: The Spinal Muscular Atrophy (SMA) is a autosomal recessive neuromuscular disease that
affects the lower motor neuron. This occurs early weakness and degeneration of the muscles of the body,
causing atrophy and paralysis, and may at their most extreme forms (Type I and Type II) provide rapid
progression and weakness, in addition to severe respiratory impairment, which often leads to death.
Objectives: Aimed to evaluate the quality of family life of children with SMA type I and type II, seeking to
understand factors that influence and to identify relevant areas from the perception of parents.
Underlying values and principles: The impact of the disease and its treatment on family functioning has an
important role in the adaptation of children to chronic illness, and that the family's ability to relate to the
various sources of stress and uncertainty surrounding the diagnosis and treatment probably affects their
quality of life.
Knowledge base/ Evidence base: Quality of Life; Children; Health Promotion
Context of intervention/project/work: The study 8 families registered by the Brazilian Association of spinal
muscular (ABRAME), yielding a total of 12 informants.
Methods: Multimethodological research, carried out from January to May 2009 had the instruments to
collect data: a tool for assessing quality of life related to health (HRQOL) in Brazil validated for use with
relatives of patients with chronic diseases - PedsQL 2.0 module impact on the family, socioeconomic and
summary written by semi-structured . For quantitative data, analysis was performed descriptively to know the
areas most and least affected, they were used to support the qualitative analysis. In turn, the qualitative data
were analyzed using content analysis.
Results and Conclusions: The results showed that the domain relationships in the family is preserved and
obtained the highest mean score (59.58), it can be shown in both speeches, as in the PedsQL. The policy
concerns, was the most affected at the individual level (20.83), with its worst result in relation to the physical
functioning (27,78). The involvement of these two areas were cited in speeches. The emotional functioning
(42.08), communication (39.68) and cognitive functioning, have found variable results, showing that the
parents had different behaviors and feelings on the situations. Social functioning (32.81), found different
results, but was evidenced both in the implementation of the questionnaire and the statements of the
difficulty in finding time for social activities (83.33%). Within the area family relationship in the family had
been preserved, and the average score for this aspect was 59.58. This can be easily confirmed by means of
speeches, which talk about love and marriage in the family. The reverse was observed for the domain daily
activities, the most affected of all studied (score 4.17). Faced with a collective vision and seeking to promote
health, it is fundamental to the creation of strategies that are attentive to the needs of leisure, financial,
emotional, social and physical health of these families, since they were the most affected.
Disclosure of Interest: None declared

TP-WED-059 QUALITY OF LIFE OF CHILDREN WITH CEREBRAL PALSY
M. A. Frota* 1 , C. F. Casimiro 2 , P. O. Bastos 2 , O. A. Sousa Filho 3 , I. C. L. Oliveira 1 , C. M. Albuquerque 1
1 Public Health Master, 2 Nursing Graduation, Fortaleza University, 3 Nursing Graduation, Faculdade da
Grande Fortaleza - FGF, Fortaleza, Brazil
Background: Cerebral Palsy - CP is a predominantly sensorimotor dysfunction involving disturbances in
muscle tone, posture and voluntary movement, factors that, when they involve children, undermine the
development of activities of daily living, which can lead to significant changes in quality Life - QOL them and
their families and / or caregivers.
Objectives: It was aimed to evaluate QOL in children with CP treated at the Center for Treatment and Early
Stimulation - NUTEP; describe the socioeconomic profile of children with CP treated in NUTEP; identify
areas of PedsQL most affected QOL of children PC and know the parents' perception of the QOL of the child
with CP.
Underlying values and principles: It is common to come across situations where parents and health
professionals are unable to identify factors that may be interfering with the quality of life of children with
cerebral palsy.
Knowledge base/ Evidence base: Quality of Life, Children, Family, Health Promotion
Context of intervention/project/work: Propose strategies educational guidance to parents and
professionals who treat children with CP, aiming at improving the quality of life of children and their family
caregivers.
Methods: Descriptive study, quantitative data is qualitative assessment tools being used for this
methodological triangulation. Held in NUTEP, involved children aged 2 to 7 years. The instruments of data
collection were: (i) socioeconomic-item (ii) instrument for assessing quality of life related to health (HRQOL)
in Brazil validated for use with parents - PedsQL 4.0 and (iii) interview guide. Qualitative data were analyzed
based on Bardin (2008) and for the quantitative analysis was carried out using SPSS (Statistical Package for
Social Sciences) version 15.0.
Results and Conclusions: The average age of parents is 34.86, mothers have an average age of 31 years.
As they relate to parents' education, data show that these are predominantly in years 6 to 10 years (40.3%)
and mothers devoted more time studying, because most , 54.8%, had 11 to 16 years of study. Most parents
of children with CP, 43 (69.4%), living together. Regarding the occupation of parents of children, has the
most diverse professions possible, corresponding to 46.8% of the sample. The mothers, the majority, 69.4%
are home. Families live with an average income of R$ 1135.53. The majority of these families have between
one and three children (88.7%), living in the homes an average of 4.02 people. With regard to children, the
predominant age group was between 2 and 4 years (39). Of the children, most are male 35 (56.5%) and 46
(74.2%) have support elsewhere that not only NUTEP. With regard to the preferences of environments,
according to parents, has been highlighted to the room (40, 64.5%) and fourth (10, 16.1%), among the
reasons, the main thing is to be the environment that has a TV (36, 58.1%). Children were diagnosed at
different ages, ranging from birth to three years, with prevalence of diagnosed between the ages of 2 and 6
months (38.7%). Of the total sample, 53 (85.5%) have no other cases of PC in the family. In calculating the
average scores of QOL questionnaire used (PedsQL) data showed that the field school is the most affected.
After analyzing the qualitative data, the lines were grouped, the emerging categories: Routine child with CP,
Perception of QoL, QoL of the child with CP. To improve the QOL of children with CP are needed
educational strategies directed at family members and professionals who assist these children, with a focus
on health promotion, considering that the child with a disability has the same needs as any other, it needs to
be loved, valued and feel a participant in the family group, so it must be also in constant interaction with
society.
References: Bardin, L. Content Analysis. Lisbon: Edições 70, 2008.
Disclosure of Interest: No declared

TP-WED-060 CHANGES OF MORBIDITY INDICATORS IN 15-18 -AGED ADOLESCENTS DURING THE
FINAL STAGE OF GENERAL AND PRIMARY VOCATIONAL TRAINING
I. K. Rapoport* 1
1 Hygiene of children and adolescents, Research Institute of Hygiene and Health Protection of Children and
Adolescents, Moscow, Russian Federation
Background: The evaluation of health state indicators of students is necessary to carry out preventive and
sanitary work in educational institutions. In Russia the adolescents of 15-18 years old are examined every
year.
Objectives: To study morbidity indicators and determine the dynamics of
pathologic processes in students during the final stage of general and primary vocational training.
Underlying values and principles: 510 adolescents (256 boys and 254 girls) from senior classes
in schools and colleges were being observed for 3 years. They got professions of automechanicians,
seamstresses, accountants, operators of electronic technics.
Knowledge base/ Evidence base: Specialists from our institute participated in
the annual examinations: pediatricians, a neurologist, an
otolaryngologist, an oculist, an orthopedic surgeon, an instrumental-laboratorial examination was also
conducted.
Context of intervention/project/work: It was determined that schoolchildren's morbidity had increased by
17.9% among boys from grade 9 to grade 11; among girls - by 38%. In the group of vocational colleges the
indicators had increased by 11.7% and 15.4%, respectively. The prevalence of functional disorders of
cardio-vascular system and vision, neurotic disorders, diseases of alimentary and muscular-skeletal systems
were increased among adolescents. Only 15%-17% of boys and 25%-30% of girls have favourable course of
health disorders. It was revealed the worsening of
pathologic processes in 36%-44% of cases. More than 60% of students need for a regular observation of
medical specialists, drug therapy and physiotherapeutic procedures.
Methods: The annual examinations by medical specialists.
Results and Conclusions: The obtained data show the necessity of correction of
educational programs and improving students' nutrition. Sanitary work should be conducted in educational
institutions.
Disclosure of Interest: None declared

TP-WED-061 UNIVERSAL TECHNIQUE OF THE ESTIMATION OF SCHOOLCHILDREN‟S PHYSICAL
DEVELOPMENT
N. A. Skoblina* 1 , V. R. Kuchma 2
1 Department of complex problems of hygiene of children and adolescents, Research Institute of Hygiene
and Health Protection of Children and Adolescents, Moscow, Russian Federation, 2 ,
Background: Background and aims: A universal technique of the estimation of children‟s physical
development based on the use of the regional modified scales of the regression of body mass on body
length is presented.
Objectives: The estimation begins with the definition of the level of child‟s biological development.
Underlying values and principles: In junior schoolchildren the estimation is based on body length and
quantity of permanent teeth, in children of middle school age on body length and indicators of puberty, in
senior schoolchildren on indicators of puberty.
Knowledge base/ Evidence base: The level of biological development can correspond to the age, fall
behind the age and outstrip the age.
Context of intervention/project/work: Hereafter the harmonicity of child‟s physical development is being
estimated.
Methods:
The technique provides the following variants of the estimation:
1. Normal physical development - body mass within M-1σR up to М+2σR regarding body length.
2. Deficiency of body mass of the 1st degree.
3. Overweight.
4. Underweight of the 2nd degree.
5. Obesity.
6. Low body length.
7. High body length.
Results and Conclusions: Results and conclusions: A common conclusion of the child‟s physical
development is made based on the estimation of the level of biological development and the estimation of
harmonicity of physical development. If a child has a normal physical development his body length is
estimated as “average”, «below the average», «above the average».
Disclosure of Interest: None declared

TP-WED-062b SALUD INFANTIL DEL BARRIO GITANO DE TERUEL
P. Muñoz 1 , P. Sanchez 2 , A. Zaera 2 , P. Rodrigo 3 , V. Cañada 2 , D. J. Gallego Dieguez* 3
1 Salud y Consumo, Salud Pública, Teruel, Spain, 2 , Salud Publica, Teruel, 3 , Salud Publica, Zaragoza
Antecedentes: La salud es considerada como resultado de los factores que intervienen sobre la vida de los
individuos, entre otros, la etnia, marginación social, constituyen factores que inciden sobre la misma.
Analizar y cuantificar desigualdades es uno de los objetivos en Salud Pública a partir de la estrategia de la
OMS “Salud para Todos”, dirigida a conseguir una mayor equidad en salud entre las poblaciones. En este
marco se valorararon y analizaron las posibles desigualdades en salud de la población gitana infantil del
barrio Pomecia de Teruel, que planteasen futuras medidas de Salud Pública que mejoren sus condiciones
de vida, estableciendo a su vez vínculos de trabajo con otras entidades
Objetivos: Valorar y analizar las posibles desigualdades en salud de la población infantil gitana del barrio
Pomecia de Teruel,para plantear un proyecto de intervención multidisciplinar de acuerdo a las carencias
detectadas en el estudio
Valores y principios subyacentes: Capacitación. Equidad. Intervención multidisciplinar
Base de conocimiento / base de evidencia: Basado en el estudio nacional “Comunidad gitana y salud”
Contexto de la intervención / proyecto / trabajo: Diagnóstico de salud de una comunidad gitana en un
barrio de Teruel (Aragón –España)
Métodos: Estudio descriptivo. Se usó un cuestionario adaptado de la encuesta,“Comunidad gitana y salud”.
Población de Estudio: menores de 16 años. Elección de muestra mediante EPIDAT 3.1 de 30 individuos,
nivel de confianza del 95% y precisión del 5%. Algunos datos se comparan con los resultados obtenidos en
la Encuesta Nacional de Salud 2006.
Resultados y Conclusiones: Se encuestó al 47,6% de la población infantil, media de edad 7 años. En el
87% la percepción del estado de salud es muy buena o buena. El 23% limitó su actividad en las dos últimas
semanas por problemas leves de salud. El 23% sufrió algún tipo de accidente en el último año, y en un 43%
fueron quemaduras. El 27% ha acudido al dentista en los últimos 3 meses, nunca ha ido el 53%. El 17%
tiene caries. El 43% en los últimos doce meses ha utilizado el servicio de urgencias y han estado
hospitalizados el 23%, estancia media 5 días. El 29% ocupa su tiempo libre de forma sedentaria, el 7% de
los mayores de 1 año no desayuna, el 11% no consume fruta, y el 46% consume productos de Kiosco mas
de tres veces a la semana. El 63,3% tiene un IMC normal. 100% el calendario vacunal actualizado.
Problemas de salud habituales para su edad. Demandadores de los servicios de urgencias. Alimentación en
general buena, hábitos alimentarios mejorables, no sobrepeso y obesidad llamativos. Usan su tiempo libre
de forma sedentaria, limitan su actividad y sufren accidentes, hospitalización y caries, con más frecuencia
que los de la población general. Este estudio ha permitido identificar áreas de mejora en esta población,
motivos por los que se plantea colaborar con otras entidades reforzando a través del trabajo con las familias
los programas de salud existentes, para conseguir mejoras individuales y colectivas.
Declaración de intereses: no declarado

TP-WED-063 HEAT-PREVENTION NETWORK: A STRATEGY TO PREVENT HEAT-RELATED
MORBIDITY AND MORTALITY OF THE ELDERLY IN URBAN SETTINGS
M. Heckenhahn* 1 , B. Blättner 2 , D. Pfaffenberger 2 , S. Georgy 2 , A. Grewe 2
1 Department of Prevention and Health Promotion, Local Health Authority, Kassel, 2 Nursing and Health
Sciences, University of Applied Sciences, Fulda, Germany
Background: Heat is an environmental hazard for human health. During the heat wave in 2003, more than
35.000 excess deaths occurred in Europe, most of them in urban settings due to the local modification of
temperature. The elderly and persons with particular physical, social and environmental vulnerability were
identified to be at highest risk. Due to climate change more heat waves in Europe are expected for the
future, requiring effective community based prevention strategies to avoid heat-related ill health and death.
Objectives: To develop, implement and evaluate short, middle and long term measures to prevent health
risks of the elderly caused by high heat exposure in urban settings.
Underlying values and principles: The project acts multi-professional, across institutions and sectors, and
is committed to the participatory, empowerment strengthening approach of health promotion.
Knowledge base/ Evidence base: Heat warning systems and public health actions that focus the
population groups at threat due to high temperatures can reduce heat related mortality and morbidity.
International recommendations stress multi-agency and intersectoral approaches, thus covering short and
long term measures, as success factors. The reduction of the exposure to heat is the most effective
prevention strategy, thus requiring an adaptation of the built environment in the middle and long term.
Context of intervention/project/work: In consequence of the summer 2003 the Hessian government
established a heat warning system, thus local health authorities were sensitized to the impact of heat waves
onto health with beginning of the project.
Methods: High-risk-regions were identified through mapping microclimate and socio-demographic data. The
local health authority initiated workshops with experts to identify and discuss needs for action. A steering
group was established in each risk region to chair the network activities. The steering groups comprise
representatives from local authorities, the health care sector and the civil society, property developers and
town planners. A seniors committee advises the steering groups. Thematic work groups prepare short term,
middle term and long-term actions. In regular public conferences, further activities are discussed and
concluded. A monitoring system to assess heat-related morbidity in the community is being developed.
Results and Conclusions: A public-private heat-prevention network is established. Short, middle and long
term Network actions cover preventive home visits by the local health authority to assess individual heatrelated
health risks, neighbourhood based heat warning and support systems and activities to improve the
built environment. The commitment of housing cooperatives and property developers in the network activities
is a promising contribution to a sustainable development of healthy environments for the elderly in urban
settings.
Disclosure of Interest: "None declared"

TP-WED-064 THE DIFFERENCE OF LONG-TERM CARE NEED OF GERIATRIC INPATIENTS BY TYPE
OF FACILITIES IN KOREA
. Y. H. Cho* 1 , H. Kim 2 , Y. Jung 2 , H. Lee 2 , I. Yoo 3
1 Department of Nursing, Chodang University, Chunnam Province, 2 Department of Nursing, Daegu Hanny
University, Daegu, 3 School of Alternative Medicine and Health Science, Jeonju university, Jeonju, South
Korea
Background: A public long-term care insurance system was implemented in Korea in 2008, according to
which every senior citizen can avail of long-term care (LTC) services. These services were served multiple
setting areas.
Objectives: The purpose of this study was to investigate the difference of LTC need in geriatric patients by
facilities in Korea.
Underlying values and principles: We used LTC category instrument developed by the government, which
consists of 52 items, with 5 subscales, including physical function, psycho-cognitive function, nursing
treatment service, and rehabilitation domains.
Knowledge base/ Evidence base: This study was evidence based descriptive research.
Context of intervention/project/work: This project was R&D project of long-term care insurance system
was implemented in Korea in 2008
Methods: The subjects in this study were 2,521 institutionalized elderly of whole area in Korea . The data
collected by performing proportional stratified sampling between February 1, 2008, and March 31, 2008. The
institutionalized facilities divided 4 types of facility. The data were analyzed by descriptive statistics and LTC
category criteria using SAS version 9.1.
Results and Conclusions: Women comprised 70.4% of the sample, while men comprised 29.6%. The
average age of the subject was 77.7±7.6years old. The women of the subjects was institutionalized acute
hospital (57.1%), oriental medical hospital(63.6%), subacute hospital(71.0%) and LTC facilities(79.9%). The
physical function, psycho-cognitive function, nursing treatment service, and rehabilitation domains were
differenced significantly by type of facilities(p

TP-WED-065 THE DEVELOPING OF CHANGING HEALTH BEHAVIORAL MODEL IN HYPERTENSIVE
ELDERLY AT BAN MAIE-DANGE PUBLIC HEALTH CENTER, TUMBOL THARUEA, MUEANG
DISTRICT, NAKHON SI THAMMARAT
R. Palasuek* 1 , W. Sukkert 2 , K. Pintubtim 1
1 Boromrajonani College of Nursing, Nakhon Si Thammarat, Boromrajchanok Institute, Public Health of
Thailand, 2 Ban Maie-Dange Health Center, Public Health, Nakhon Si Thammarat, Thailand
Background: Thailand, like other countries, has been encountered with non-communicable disease e.g.
heart disease, hypertension.The study of Non-Communicable Disease(2008)reported that recently Thailand
has increased rate of hypertension, cardiovascular with the ratio of 708.74 and 901.31 respectively per
100,000 population. Because of those diseases they creates the mortality rate with the ratio of 3.64 and
55.29 respectively per 100,000 population. Most of hypertensive elderly people couldn't control their
appropriate self-care in pattern of nutrition,exercise,rest,and stress management.
Objectives: This participatory action research aimed to study the model of changing health behavior of
elderly who have hypertension.
Underlying values and principles: Apply the process of health behavioral model that is suitable for chronic
ill patients in rural area.
Knowledge base/ Evidence base: This knowledge based on theory of Planned Behavior and participatory
action research.
Context of intervention/project/work: 16 elderly with hypertension who received continually treatment and
nursing care from public health personnel at Ban Maie-Dange Health Center. Those patients requested for
assistance to be able to have effective self-management and control hypertension.
Methods: A purposive sampling technique was used to select 16 hypertensive elderlys who need to control
level of hypertension in Ban Maie-Dange Public Health Center,Tumbol Tharuea, Mueang District,Nakhon Si
Thammarat. Four focus group sessions were conducted along with indepth interviews. Data was collected
from February to May 2009 and then analyzed by using content analysis.
Results and Conclusions: The results revealed that health perception of the elderly regarding hypertension
consisted of headache, visual problem, edema, nausea and vomitting. Each factors had internal correlation
with health behaviors controlling including life styles,individual differences,occupation,family's roles,local
cultures,and other vascular diseases.So,the Development of Changing Health Behavioral Model in the
Hypertensive Elderly at Ban Maie-Dange Public Health Center,Tumbol Tharuea,Mueang District,Nakhon Si
Thammarat based on 5 steps in sharing, learning and evaluating comprising of 1) hypertensive elderly's
perception of signs and symptoms of hypertension, 2)finding out the sources of suffering, 3)seeking the best
practice to relieve suffering, 4)performing miracles in breaking down their barriers and evaluate
acchievement of new behaviors, and 5)taking action new behaviors.Therefore, the encouragement should be
initiated the perception process among family members and cummunity members to participate in the
appropriate cares of those who have hypertension.
References: Public Health of Thailand (2008). Practice Guidline for Healthy Thailand. Nonthaburi.
Disclosure of Interest: Non declared

TP-WED-066 MODERATION OF RELIGIOUS INVOLVEMENT ON THE RELATIONSHIP BETWEEN
ANXIETY, DEPRESSIVE SYMPTOMS AND QUALITY OF LIFE OF OLDER ADULTS
C. Huang* 1 , M. Hsu 1
1 Nursing department, I-Shou University, Kaohsiung County, Taiwan
Background: Older adults suffering from stress may consequently have anxiety or depressive symptoms,
and their quality of life is also influenced. The meanings of religious involvement are well documented, but
less is known about moderating characteristics that determine which older adults with psychological
problems are most likely to benefit.
Objectives: The aims of this study were to examine the relationships among religion, religious involvement,
anxiety, depressive symptoms, and quality of life in older adults with psychological problems, and whether
religious involvement moderated anxiety and depressive symptoms on the outcome of quality of life.
Underlying values and principles: Religion involvement may play a role to decrease depressive symptoms
and to enhance quality of life.
Knowledge base/ Evidence base: Evidence for the mechanism through which religious involvement exerts
its moderated effect on anxiety and depressive symptoms was provided.
Context of intervention/project/work: The subjects‟ frequency of attendance for religion involvement
ranging from never to more than once a week. The range of scores was coded from 2 to 12, higher scores
indicating a greater frequency.
Methods: A correlational, cross-sectional research study was conducted in 2007-2008 with a purposive
sample of 115 older adults who were 60 years of age or older at a psychiatric centre in Taiwan. Three
reliable and valid questionnaires and a demographic sheet were administered.
Results and Conclusions: About 75% of older adults had mild to severe anxiety; 76.5 % had depressive
symptoms; and 67.8% of participants who had depressive symptoms also had comorbid anxiety. Findings
indicated that there was a significant moderating effect for religious involvement on the quality of life
outcome. Religious involvement significantly moderated anxiety and depressive symptoms on quality of life.
Moreover, religious participants had a better quality of life, and had lower anxiety and depressive symptoms
than non-religious participants.
Testing for moderating effects provides important information regarding benefits of religious involvement.
The current study reveals that religious participants have lower levels of depressive symptoms and anxiety
and better quality of life than non-religious ones. Religious involvement plays a role in buffering the
relationship between psychological problems and quality of life.
Nurses can encourage individuals with health problems to participate in religious involvement, which may
help individuals to experience a feeling of support and enhance their quality of life.
Disclosure of Interest: no disclosure of interest has been declared by the authors

TP-WED-067 RELATIONSHIP BETWEEN LIFE STYLE HABITS AND DEMENTIA AMONG
COMMUNITY-DWELLING OLDER ADULTS
M. Hirano* 1 , R. Shinohara 2 , Y. Sugisawa 2 , Y. Kawashima 2 , R. Ton 2 , E. Tanaka 2 , T. Watanabe 2 , Y. Onda 2 , Y.
Ishi 2 , Y. Sawada 2 , S. Ito 3 , K. Morita 2 , A. Gan-Yadam 2 , Y. Mochizuki 2 , T. Anme 2
1 Graduate School of Conprehensive Human Sciences Doctoral Program in Nursing Science, 2 Graduate
School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, 3 Tobishima city, Tobishima
healthy center, Aichi, Japan
Background: In Japan, the percentage of the population aged 65 or over has increased to 22%, and the
average lifespan is 86.05 years for women and 79.29 years for men. Indeed, as of 2008, Japan had the
highest life expectancy in the world. However, this also means that serious health problems such as
dementia are prevalent among a large segment of the Japanese population.
Objectives: The purpose of this study was to explore the relationship between life style habits and dementia
among community-dwelling older adults by conducting a cohort study.
Underlying values and principles: Dementia makes daily life difficult for older adults because it is
accompanied by a broad range of severe symptoms.
Knowledge base/ Evidence base: According to previous studies, caring for a person with dementia can be
a heavy burden for the family and for welfare service workers. Therefore, it is essential to prevent the onset
of severe dementia. Although some intervention studies have begun to address the prevention of dementia,
little is known about the cause of the disorder.
Context of intervention/project/work: The research design is a prospective cohort study over 6 years.
Methods: The study was carried out in a farming community near a major urban center in Japan. The
sample consisted of 1,024 elderly adults aged 60 years or over. In 2002, they were administered a
questionnaire to assess their lifestyle habits on the basis of the following dimensions: breakfast, snacking,
care for salt consumption, care for nutrient balance, care for fat intake, drinking preference, smoking
preference, sleeping habits, and physical activity habits. In 2008, it was researched age of onset dementia
and public health nurses and doctors were surveyed the prodromes of dementia. Statistical tests included
chi-square tests and multivariate logistic regression analysis.
Results and Conclusions: According to the results, several dimensions of life style habits were associated
with dementia. There were significant relationships between snacking (p = 0.005), care for salt consumption
(p = 0.02), care for fat intake (p = 0.03), sleeping habits (p < 0.001), and amount of physical activity habits (p
= 0.04). The logistic regression, after adjusting for demographic variables, indicated that the probability of
dementia was 1.81 times higher (p = 0.04) among the participants who did not get sufficient sleep than
among those who did get sufficient sleep (OR = 1.81, CI = 1.11–2.95).
The results of the study indicate that not getting sufficient sleep could be a relative factor of dementia.
Indeed, several intervention studies have shown that dementia can be prevented by getting sufficient sleep.
Our findings furnish evidence to support the theory.
Disclosure of Interest: None declared

TP-WED-068 THE ELDERLY AND THE TRAUMA: A PROPOSAL OF RISK PREDICTION
J. Rodrigues* 1 , S. I. Ciosak 2
1 Escola de Enfermagem, Universidade de São Paulo, Curitiba, 2 Enfermagem, Universidade de São Paulo,
São Paulo, Brazil
Background: Brazil is becoming more and more a country of white hair and this process brings about
consequences in everyday life of Brazilian society. The increasing figure of the aged demands a new urban
organization and more suitable health services for their particularities.
Objectives: General objective: to develop a predictive rate of risk for trauma in the aged. Specific objectives:
to set the incidence of trauma in the aged; to verify the main types of trauma in the emergency medical
services for the aged; to assess the risk factors to the occurrence of the trauma in the aged.
Underlying values and principles: The issue on the aged assistance is surrounded by questions such: the
need for hospitalization more frequently, longer time of hospitalization and rehabilitation and higher costs for
health system, besides the increasing mortality in this range of age.
Knowledge base/ Evidence base: The issue on the assistance to the aged is surrounded by questions
such: the need for hospitalization more frequently, longer time of hospitalization and rehabilitation and higher
costs for health system, besides the increasing mortality in this range of age. It is known that one of the
biggest factors for these incidents is trauma and its prevention is one of the important focuses for diminishing
the damages in this age range.
Context of intervention/project/work: The findings of the research will be published on scientific articles as
well as to be informed to the Curitiba City Council, State of Paraná, for suitable intervention on the identified
problems.
Methods: The data were collected by structured interview. It was carried out an interview with 259 aged,
victim of trauma in the Emergency Medical Services of a reference hospital for trauma in the city of Curitiba.
As criterion of inclusion the aged should be 60 years older or over it, both genders, victim of trauma, that
accepted to be part of the research voluntarily or his/her carers and/or family, in case of auditory and/or
cognitive deficit.
Results and Conclusions: The findings reinforce the importance of making predictive rate of risk for
trauma, to advise and contribute in prevention of those damages.The damages most found were fallings
(75%), and, out of them 73% were from level falling. Out of the total patients that suffered falling, 60% had
some type of fracture.
Disclosure of Interest: None declared

TP-WED-069 THE RELATIONSHIPS AMONG SOCIAL SUPPORT, DEPRESSION, AND HEALTH
PROMOTION RELATED TO DIABETIC CARE AMONG THAI ELDERS
K. Phromjuang 1 , P. Phaungnak* 2 , N. Sirirat 3 , N. Leaudnakrob 4
1 Nursing administration and fundamental health nursing, Boromarajonani college of Nursing, Nakorn-
Lampang Praboromarajchanok Institute Ministry of Public He, Ampur Muang, 2 General education at
Boromarajonani college of Nursing, Uttaradit, 3 Director of Boromarajonani college of Nrusing, Uttaradit,
4 Fundamental nursing and general education at Boromarajonani college of Nursing, Uttaradit,
Boromarajonani college of Nursing, Uttaradit, Praboromarajchanok Institute Ministry of Public Health,
Uttaradit, Thailand
Background: In 1990, the elderly population share was 7.36 percent of the total population. In 2009, they
were increasing around 11%. They will represent 15.28 percent by 2020. Diabetic mellitus and hypertension
were causing a lot of problems among elders in Thailand.
Objectives: The study is to explore the correlation between social supports, depression, and health
promotion on diabetic care among Thai elders.
Underlying values and principles: The social support in Thai culture increased behavior regarding diabetic
care among elders. Depression and low income among elders from economic problems could lead to having
low on health promotion, causing poor quality of life.
Knowledge base/ Evidence base: The collaboration between volunteers in community and health care
professionals impacted on Thai diabetic elders for improving elders' health. The social support from elders‟
families and friends were important to improve and increase health promotion on diabetic problems and wellbeing.
Social determinant of health was utilizing on this study (Marmot & Wilkinson, 2006 & 2009).
Context of intervention/project/work: Subjected were explained by the researchers about the risk-benefit
ratio to participate on this study. The researchers, nurses, and volunteers interviewed elders on
questionnaires about 1 hour. Data were collected during January to November, 2009.
Methods: Diabetic dwelling elders (n=120) were collected from the primary health care units in Uttaradit
Province located in the Northern area of Thailand. Descriptive statistics and Pearson‟s Correlation
Coefficient tests were applied to address the research questions. The a=.05 and b=.95 were set for this
study.
Results and Conclusions: The average age in the sample was 68 years. Most of the subjects (72.5%)
were female. The mean of income was $197 per year. Economic crisis caused to having poor health among
diabetic elders. Findings showed that there were a statistically significant relationship between social
support, depression, and health promotion on diabetic elders. The correlation showed a minimal positive
relationship between social support and health promotion (r= .46, p < .01). Moreover, there was a statistically
significant association between depression and health promotion. The association revealed a minimal
negative correlation between depression and health promotion (r= -.46, p < .01).
References: Marmot, M. G. & Wilkinson, R. G. (1999 & 2006). Social determinants of health. Oxford; New
York: Oxford University Press.
Disclosure of Interest: None declared

TP-WED-070 PERCEPTIONS AND SELF-CARE OF KNEE OSTEOARTHRITIS FOR THE OLDER
ADULTS LIVING IN TAIWAN RURAL COMMUNITY
S. Y. Chen* 1 , F. Su 2
1 Graduate Institute of Elder Education, National Chung Cheng University, Chia-Yi, 2 Department of Health
Promotion and Health Education, National Taiwan Normal University, Taipei, Taiwan
Background: Osteoarthritis (OA) is the leading cause of pain and disability among the elderly. It is also the
third leading cause of life-years lost due to disability, seriously endanger the quality of life for older adults.
According to 2002 Taiwan National Health Insurance Statistical Annual Report showed that patients with
degenerative Arthritis taking non-steroidal preparations anti inflammation spent NT $ 2.3 billion. In addition, a
total of NT $ 1.7 billion, the second inpatient expense, were spent on nearly 12,000 patients that accepted
total knee replacement surgery. It is a heavy cost of country.
Objectives: The objective of this study was to understand the perceptions and self-care behaviors of Knee
OA of community people, as a basis to integrate hospital and community resources, to develop teaching
materials of knee OA, to design intervening planning and to develop training course for medical staffs in the
future.
Underlying values and principles: Taiwan is gradually aging. More people suffer from degenerative knee
OA. It is necessary to let people know about the causes, preventive strategies and proper treatment of
degenerative knee OA,. And through community early screening, let the patients accept medical care as
soon as possible; improve their self-care ability to slow the development of disease.
Knowledge base/ Evidence base: The semi-structured questionnaire of the perceptions of knee OA
,referring from common sense model include five factors, such as disease symptoms, pathogenic factors,
duration of the disease, result of the disease and disease can be treated or not. The self-care behaviors
include weight control, dietary adjustment, health supplement, exercise keeping, knee protection and consult
a doctor, etc.
Context of intervention/project/work: Chia-Yi is an agricultural county. The proportion of elderly is 15.35%
,the highest in Taiwan. About 60% of old people aged over 60 suffered from knee OA. Buddhist Dalin Tzu
Chi General Hospital in Chia-Yi County is a health promotion hospital of WHO, taking community health
works seriously. It sat up community health stores, actively provides simple detective services and health
promotion activities for community people with Hypertension, Hyperglycemia and Hyperlipidemia. Through
discussion, organization and action to format a bottom-up power let residents improve their own community
by themselves.
Methods: There were 60 cases aged over 45, coming from seven community health stores belong to Dalin
Tzu Chi General Hospital. Taking advantage of what the patients‟ waiting time, we interviewed them with
semi-structured questionnaire by qualitative method and recode the tape to verbatim words and analyzed the
content.
Results and Conclusions: 1. Although awareness of the existence of the disease for elderly is relatively
high, but knowledge about prevention, treatment or the disease severity is insufficient. 2. Community older
adults had strong awareness of the importance of calcium intake but poor knowledge of other risk factors,
such as hormonal changes, sex, obesity, poor muscle strength, race or heredity.3. Community people
thought knee OA is a natural phenomenon of ageing. It is too overly optimistic the effect of total knee
replacement to ignore the symptoms of OA and passive to take action to reduce their risks.4. They always
used many kinds of ways to control or reduce knee pain or inconvenience at first, until unable to release the
pain that they consider to see the doctor. 5. Generally the subjects reported few barriers of proper exercise,
rehabilitation and wish more medical information about OA.6. This study recommended that develop quantity
questionnaire of knee OA‟s perception to help people to take medical services as soon as possible and
provide simple community screening and health promotion activities for OA.
Disclosure of Interest: National Science Council

TP-WED-071 THE AFFECTING FACTORS FOR THERAPEUTIC ADHERENCE IN ELDERLY PATIENTS
WITH DIABETES MELLITUS
K. Park 1 , J. Kim 2 , B. Kim 2 , S. Kam* 3 , K. Kim 3 , S. Ha 4 , S. Hyun 5 , J. Shin 3 , J. Hwang 3 , N. Hong 3 , K. Kim 3
1 Department of Public Health, Graduate School, Kyungpook National University, 2 Department of Internal
Medicine, 3 Department of Preventive Medicine, School of Medicine, Kyungpook National University,
4 Department of Internal Medicine, Dr. Ha's Internal Medicine, 5 Department of Internal Medicine, Dr. Hyun's
Internal Medicine, Daegu, South Korea
Background: In Korea, the proportion of the aged has increased recently. Moreover elderly diabetic patients
have also increased rapidly. Especially in treatment of elderly diabetic patients, because of many cases that
have to take multi-drug as complex methods, medication adherence is more important than younger diabetic
patients.
Objectives: This study was conducted to examine the affecting factors for medication adherence of elderly
diabetic patients visiting diabetic outpatient department of tertiary hospital and internal medicine clinic.
Underlying values and principles: .
Knowledge base/ Evidence base: .
Context of intervention/project/work: .
Methods: The interview survey using a structured questionnaire was performed to 265 elderly diabetic
patients at a tertiary hospital and 2 internal medicine clinics. Data were analyzed using the Health Belief
Model, which adds item on self-efficacy. And medication adherence was measured by Morisky self-reported
questionnaire.
Results and Conclusions: The proportion of those who was adherent to medication measured by Morisky
self-reported questionnaire were 61.1% in tertiary hospital patients and 43.2% in internal medicine clinic
patients. The medication adherence proportion of tertiary hospital patients was higher significantly than that
of internal medicine clinic patients(P < 0.01). As the result of multiple logistic regression analysis, in tertiary
hospital patients when patients stored diabetic drugs well(odds ratio 5.401), when patients had higher selfefficacy(odds
ratio 13.114), medication adherence was significantly higher(P < 0.05), and in internal
medicine clinic patients, when patients had higher perceived severity(odds ratio 2.936) (P < 0.05) and higher
self-efficacy(odds ratio 4.040)(P < 0.01), medication adherence was significantly higher.
In consideration of above findings, in order to improve the medication adherence in elderly diabetic patients,
it would be necessary to educate method of diabetic drug storage and to increase self-efficacy for medication
for tertiary hospital patients. And it would be necessary to change perception for disease by health education
and to increase self-efficacy for medication in internal medicine clinic patients.
Disclosure of Interest: None declared

TP-WED-072 ATTITUDES TOWARDS URINARY INCONTINENCE AMONG CHINESE COMMUNITY
NURSES AND COMMUNITY-DWELLING OLDER PEOPLE
H. Yuan* 1 , B. A. Williams 2 , M. Liu 1
1 School of Health Sciences, Macao Polytechnic Institute, macao, Macao Special Administrative Region of
China, 2 Faculty of Nursing, University of Alberta, Edmonton, Alberta,, Canada
Background: Urinary incontinence is defined as involuntary loss of urine of sufficient severity to be a health
and /or social problem (Goldman & Ausiello, 2004). In China, the majority of individuals (90.6%) kept their
incontinence secret and received no treatment ( Duan et al., 2000). Attitudes of community nurses and older
people toward urinary incontinence can result in nurses‟ ignoring or avoiding the concern expressed by their
clients and older people‟s lack of understanding and hesitancy to seek professional help (Haslam, 2004).
Objectives: The purpose of this study was to describe the attitudes of community nurses and communitydwelling
older people towards urinary incontinence in China.
Underlying values and principles: The taboo nature of incontinence prevented discussion of problems in a
social setting. Urinary incontinence remains an underreported and embarrassing condition across all
countries and cultures (Haslam, 2004).
Knowledge base/ Evidence base: The barriers to seeking professional help include the belief that
incontinence is a minor problem, lack of awareness of available treatment, low expectations about the
effectiveness of treatment and shame and embarrassment about urinary incontinence (Margalith, Gillon &
Cordon, 2004).
Context of intervention/project/work: To assure the protection of human rights of the participants, the
study was explained and consent form was filled out before data collection.
Methods: A descriptive cross-sectional design was used to gather self-report data from the random samples
of 100 older people and 100 nurses in two communities in Shanghai, P. R. China.
Results and Conclusions: The response rate was 100% in both groups. The majority of respondents
considered UI as a time-consuming problem (81% nurses, 67% older people). Some of respondents
considered the first involuntary urine loss could be ignored (49% nurse, 41% older people). Older people
were unwilling to talk about incontinence (45% vs 17% nurses, P = .000), and considered it was not a
serious problem in need of treatment (29% vs 2% nurses, P = .000).
In conclusion, there are some negative attitudes towards urinary incontinence among nurses and older
people in China. Ways to alter attitudes towards urinary incontinence need to be explored,and effective
interventions for nurses and older people must be indentified.
References: Duan, J.H., Yang, Y., Wu, S.L., Pan, B.N., Na, Y.Q., & Xue, Zh.Y. et al. (2000). Investigation of
urinary incontinence in Beijin. Beijin Medical University Journal, 32(1):74-75.
Goldman, L., Ausiello, D. (2004). CECIL Text Book of Medicine (22 nd ed.). Philadelphia: Saunders An
Imprint of Elsevier.
Haslam, J. (2004). Nursing management of stress urinary incontinence in women. British Journal of Nursing,
13 (1): 32-40.
Margalith I, Gillon G, Cordon D. (2004).Urinary incontinence in women under 65: quality if life, stress related
to incontinence and patterns of seeking health care. Quality Life Research, 13(8):1381-1390.
Disclosure of Interest: 1. Negative attitudes towards urinary incontinence are found among community
nurses and older people in China.
2. Urinary incontinence is a prevalent cross-cultural condition, but it should be defined in a culturally
appropriate way.
3. Ways to alter attitudes towards urinary incontinence need to be explored.

TP-WED-073 HEALTH PROBLEMS OF THE GERIATRIC POPULATION OF NEPAL
S. Lamsal* 1
1 Community Health Nursing, B.P.Koirala Institute of Health Sciences, Dharan, Nepal
Background: Increasing geriatriac population growth has driven the health world towards the problem
exploration and appropriate intervantion for the solutions of the problems. Nepal being one of the least
developed country has progressed very less in the field and this study aims at making some effort for
exploring the geriatric health.
Objectives: To assess the physical health problems among the elderly population and to find out the
association of health problems with selected socio- demographic variables.
Underlying values and principles: Informed consent, Written permission from the municipality authority,
Respect to human dignity, confedentiality etc were the basic principles.
Knowledge base/ Evidence base: Evidence based.
Context of intervention/project/work: The study was conducted in one of the municipality in the Eastern
Region of Nepal.
Methods: A descriptive, cross-sectional study design was adopted. A total of 100 elderly people of Ward No.
19 of Dharan meeting the eligibility criteria were included as the samples. Systematic sampling technique
was chosen for selection of the samples. Data was collected by using self-developed tool. Pre-test of the
instrument was done in Ward No. 18 of Dharan with 10 samples. Data was analyzed by using appropriate
descriptive (percentage and frequency) and inferential statistics (Chi-square test).
Results and Conclusions: This study showed that Hypertension (30%) was the most common diagnosed
problem followed by Gastric problems (21%), Cataract (15%), Diabetes (13%), COPD (11%), Gout (11%)
and Heart Disease (11%). Regarding the other problems either perceived by the subjects or identified by the
investigators, diminished vision (89%), backache (76%), joint pain (60%), high BP (50%), insomnia (43%),
frequent headache (34%), hemi/ quadriparesis (30%), hearing impairment (28%), itchy skin (28%) and
abdominal pain (25%) were the most common problems identified. The study revealed that there was
significant association of hypertension with gender (P

TP-WED-074 THERMAL ENVIRONMENTS AND COMFORT OF ELDERLY PERSONS IN NEED OF
CARE
A. Grewe* 1 , C. Zink 1 , B. Blaettner 1
1 Nursing and Health Sciences, University of Applied Sciences, Fulda, Germany
Background: The concomitance of Climate change and demographic change requires efforts to provide
healthy thermal environments for the elderly even in regions with to date moderate climate. Lessons learned
from the European Heat wave in 2003 focus the vulnerability of aged people in need of care. As those
persons are exposed to a thermal environment that is mainly determined by the thermal characteristics of the
building, aspects of man-building-interaction come into interest. In contrast to international standards for
thermal conditions at workplaces, there is a lack of knowledge concerning thermal requirements for
retirement homes and nursing homes.
Objectives: To define thermal comfort criteria for elderly people in need of care with respect to their variety
of physiological conditions, behavioural adaptation capacities and side effects of their medication.
Underlying values and principles: All participants gave written consent; in case of dementia written
consent was obtained from the person‟s guardian.
Knowledge base/ Evidence base: The ability of thermal perception and of physiological responds to heat
declines with aging. Drugs impact on the physiological capacity of thermoregulation. Behavioural adaptation
capacity decreases due to limited mobility and cognitive impairment. In contrast to these findings, the current
concept of thermal comfort does not differentiate between age groups.
Context of intervention/project/work: The study was performed in two nursing homes for the elderly in a
German region at risk for heat extremes. Indoor and outdoor climate parameters of the buildings were
recorded over a 12 month-period. The survey included 62 residents of whom 42 persons were able to
respond to a questionnaire.
Methods: Persons able to rate their thermal situation were examined using a standardized instrument based
on EN ISO 10551, which was adapted to the target group. Persons with cognitive impairments were
investigated by structured observation, focusing criteria recommended by experts. The questionnaires and
observations were conducted twice a month at baseline and the frequency adapted to the actual weather
conditions. Clothing, medications, height and weight of the participants were recorded simultaneously.
Results and Conclusions: The indoor climate data show thermal situations that exceed temperature limits
for persons with sedentary work. Temperatures at night show ranges where sleep is disturbed. The ability to
physiological heat responds of the participants is reduced by drugs, e.g. by diuretics, antipsychotics and
sedatives. Furthermore, the latter impact on the ability to formulate thermal sensations and even to react on
heat. A stage of thermal comfort or discomfort of persons with cognitive impairment seems not to be
definable by observing caregivers. There seems to be a need of revising building regulations for retirement
and nursing homes considering indoor temperature limits for heat.
Disclosure of Interest: None declared

TP-WED-075 PERCEPTIONS AND COPING PROCESS OF OLDER ADULTS WITH KNEE
OSTEOARTHRITIS
S. Y. Chen* 1 , F. Su 2
1 Graduate Institute of Elder Education, National Chung Cheng University, Chia-Yi, 2 Department of Health
Promotion and Health Education, National Taiwan Normal University, Taipei, Taiwan
Background: Where degenerative osteoarthritis of knee is not only a common but also slowly progressive
diseases, seriously endanger the quality of life for older adults, especially people over 50 years. According to
2007 Taiwan National Health Insurance Statistical Annual Report showed that patients with Arthritis and
related disorders accounted for 12.1 % of the population and the aged 65 or above account for 30%.The
prevalence rate was 35.8%. The elderly with Knee OA is very popular. The accident rate of Knee
Osteoarthritis(OA)for man is 58%, the female is 68%. It brings pain and limits joint activities, seriously effects
the patient's vitality and quality of life, further develops depress and changes the patient's self-esteem.
Objectives: This studies objective was from the point of patients to understand their perceptions and coping
process of Knee OA in order to develop suitable health education strategies for older adults.
Underlying values and principles: At present, degenerative osteoarthritis of knee is an illness for
progressive deterioration and most of the patients are elderly. Its etiology and treatment is not very clear,
even though effects the communication between health care professionals and patients but also effects the
compliance with doctor.In order to apply the medical technology to improve the treatment of disease, we
need to understand the perceptions and coping process of the patients from their social context to develop
effective health education methods for keen OA.
Knowledge base/ Evidence base: The semi-structured questionaire of perceptions of knee OA ,referring
from common sense model include five factors, such as disease symptoms, pathogenic factors, duration of
the disease, result of the disease and disease can be treated or not. The coping process is an adoptive
method on the basis of the perceptions of knee OA to cope with the impact of disease, including self care,
the behaviors of seeking for medical care, emotion balancing and the life style reorganization.
Context of intervention/project/work: This studies target comes from one national teaching hospital which
located at south area in Taiwan. According to the percentage of the category of clinic, considering about sex,
age, sick time and kinds of treatments, we select interview cases from departments of orthopedics,
rheumatism, rehabilitation and family medicine. The cases aged 40 or over including 60 new outpatients,
their main symptoms are joint problems of knee and 100 follow-up patients.
Methods: Taking advantage of what the patients waiting time, we interview them with semi-structured
questionnaire by qualitative method and recode the tape to verbatim words and analyze the content.
Results and Conclusions: 1. Most of patients lacked full awareness of pathogenic factors and development
of disease. It will affect the coping behaviors for the disease and delay to see the doctors, owning to wrong
coping behaviors, sometimes the patient took a turn for the worse. 2. Patients thought pain problem is the
major symptom of knee OA. It is also an important judgment criterion of disease severity. Patients tolerance
of pain and the frequency of symptoms affect the wishes of seeking medical care. 3. Patients often
complained that pain and action limitation affected their quality of life, independence and dignity. 4. The
major strategies to balance emotion are to ignore the pain, learn how to transfer the attention on disease or
yield to fate. 5. Patients thought knee OA is a natural phenomenon of ageing. They always used many kinds
of ways to control or reduce knee pain or inconvenience at first, until unable to release the pain that they
consider to see the doctor. 6. Some patients heavily depended on the suggestion of others to select hospital
or clinic. 7. Some patients worried about the risk of total knee replacement surgery or it will increase the
dependence on their family, so they delay to see the doctor. 8. Patients got most of the information about OA
from their doctors. They looked forward to health care professionals can more clearly explain the severity of
disease, and teach them how to release the pain or take care by themselves.
Disclosure of Interest: National Science Council, Grant Research Support

TP-WED-076 THE EFFECT OF SAFE SPORT EDUCATING ACTIVITIES ON KNOWLEDGE AND
BEHAVIOR IN THE COMMUNITY ELDERS'
T. Chang* 1 , M. Chuang 1
1 Central Taiwan University of science and technology, Department of Nursing, Taichung, Taiwan
Background: Regular physical activity has many physical and mental health benefits, such as reduction in
all-cause mortality, prevention of cardiovescaular disease, Diabetes Mellitus, hypertention, anxiety and
depression. In seniors, regular physical activity has additional benefits, including increasing longevity,
reducing pain from arthritis, decreasing risk of falls and fractures, and increasing ability to maintain functional
independence.
Objectives: The purpose of this subject is to understand the importment of safe sport, the varieties of sport
and sport intervention, to understand the suitable safety field, and to empower the knowledge and practice of
safe sport for community elders. The elders may to realize and select safety environment on fitness health.
Underlying values and principles: physical activity is an important part of a healthy lifestyle as people age.
Knowledge base/ Evidence base: Recent evidence indicates that among older adults, low fitness is risk
factor for functional decline.Regular sport in older adults can facilitate healthy aging, improve functional
capacity and to prevent disease.They have emphasized the motivational orientations to sport of older adults,
within an orientation toward health benefits.
Context of intervention/project/work: This research project has been designed to be an safe sport and
education study on community elder in the Taichung region of central Taiwan.Subjects were participants at a
senior community. Intervention program was:1.the important of safe sport, 2.the suitable safety field, and
3.empower the knowledge of safe sport.
Methods: Activities design set up as a community park. Safe sport activities were designed and a record
was kept for the entire process, several sessions of education intervention were implemented from July 20 to
September 30, 2009. By inspect on the sport, the elders may understand and examine the riske of
environment. After activities implementing, questionaires were administered to subjects.
Results and Conclusions: From the result of questionaire that could found out the difference between
before and after test. To compare the difference in terms of knowledge significantly (t=-3.14, p

TP-WED-077 GYM FOR THE ELDERLY
A. O. l. i. v. e. i. r. a. P. o. l. e. t. t. o. Palácios 1 , A. A. C. F. Nardi* 1 , A. A. P. S. Salineiro 1
1 Secretaria de Saúde, Prefeitura de Maringá, Maringá, Brazil
Background: Maringá is located in Brazil, and has a population of 335,512 inhabitants, 12% of which are 60
years old or older. As far as public health is concerned, around 70% of the city‟s population is being served
through the Programa Saúde da Família (Family Health Program).
Objectives: With the objective of preventing complications with chronic, non-contagious diseases, mainly
among the elder, Academias da Terceira Idade –ATIs (Gyms for the Elderly) were installed all over the city.
These pieces of equipament, which are used for physical activities, are installed outdoors and made out of
metal.
Underlying values and principles: This project is based on emphasizing the value of the promotion of
good health and reverting the health care model, which usually prioritizes remedies instead of preventive
actions.
Knowledge base/ Evidence base: Ageing takes individuals to the progressive loss of their aptitudes,
augmenting the risk of becoming sedentary, which is a risk factor for most chronic diseases. Physical activity
reduces the risk of many chronic, non-contagious diseases, and can be associated to low morbidity and low
mortality.
Context of intervention/project/work: In Maringá, in 2008, 50.7% of deaths were caused by diseases of
the circulatory system and by cancer. Physical inactivity is a risk factor for these diseases.
Methods: Since 2006, 43 Gyms for the Elderly have been installed in Maringá, mostly nearby Unidades
Básicas de Saúde – UBS (Basic Health Outposts). They have been installed as a partnership between the
municipal government and private businesses. The professional teams at the Basic Health Outposts were
trained and learned that physical activities can promote good health, and thus started to direct the population
to the Gyms. In order to follow up the activities of the users, these gyms count on the help of physical
education and nutrition staff.
Results and Conclusions: Nowadays, in Maringá, there is a daily average of 1,500 people attending the
Gyms for the Elderly. A study done in 2008, with 401 users from 33 Gyms, revealed that 30% of them
improved their general disposition; 20% decreased their pain; 10% improved their sleep; 8% reported weight
loss; 40% reported that were totally sedentary before starting at the Gyms. Of the 242 users that were taking
medicine prior to using the Gyms, 41% reduced their medicine intake, under medical supervision, after
starting the physical activities at the Gyms. After the success experienced by Maringa‟s Gyms, 500 Brazilian
cities started the program. The Gyms for the Elderly allowed for an improvement in the quality of life for
Maringá‟s population, and emphasized the importance of physical activity in the promotion of good health.
References: CDC. Centers for Disease Control and Prevention. U.S. Department of Health and Human
Services. Phisical Activity Evaluation Handbook. Atlanta: Departamento de Saúde e Serviços Humanos,
2002.
Disclosure of Interest: None declared

TP-WED-078 TOOTH LOSS AND ITS INFLUENCE ABOUT THE ADULTS AND ELDERLY‟S QUALITY
OF LIFE IN THE NORTHEAST OF BRAZIL
C. C. Graça* 1 , E. L. A. Mota 1
1 Federal University of Bahia, Public Health Institute, Salvador, Brazil
Background: The adults and elderly‟s oral health presents as a serious public health problem in Brazil. The
advanced tooth loss is an outstanding feature on this condition, considered "natural" or even as inevitable
consequence of aging.
Objectives: To describe the characteristics of oral health, and to evaluate how the oral health quality of life
is perceived for a population group aged greater than or equal to 45 years
Underlying values and principles: Understand the phenomenon of edentulism is the first step towards
finding the solution to a problem of such magnitude in the country.
Knowledge base/ Evidence base: The oral health quality of life is perceived as positive when needs are
satisfied, whether through the maintenance of natural teeth or through the use of dental prosthesis.
Context of intervention/project/work: The urban zone of city named Alagoinhas, in the northeast of Brazil
Methods: It was made a cross-sectional study, with 902 individuals. Data were collected from home visits by
oral clinical examination and questionnaires.
Results and Conclusions: The results show a high prevalence of edentulism (27,7%) and high rate of
CPO-D (25,0) showing the precarious conditions of adults and elderly‟s oral health analyzed. It was
observed that women and the elderly showed greater proportion of edentulism, and that there is a need of
prosthesis around 90,0%. In this context, low schooling, low personal income, and the absence hygiene oral
guidance increased the prevalence of edentulism. The results show too that there isn‟t a relationship of
dependency between the number of teeth lost and the reference of good oral health quality of life. In logistic
regression analysis were associated as promote factors of quality of life, statistically significant, the selfperception
of oral health as excellent and good, the use of superior and/or lower prosthesis and being old.
Being female, having low income and black or brown skin don‟t contributed to a good oral health quality of
life. The discrepancy between the data about the perception and the oral health conditions shows the
singular way as adults and older people perceive their oral health. However, it‟s necessary to konw about the
people‟s perception, to help the development of public policy to elderly oral health attention, which are
appropriate to your profile, in order to promote health and well-being for all.
References: 1. PETERSEN, P.E., YAMAMOTO, T. Improving the oral health of older people: the approach
of the WHO Global Oral Health Programme. Community Dent Oral Epidemiol; 33: 81–92, 2005.
2.FDI (Fédération Dentaire Internationale), Global goals for oral health in the year 2000. International Dental
Journal, 32:74-77, 1982.
3. LOCKER, D., MATEAR, D., STEPHENS, M., JOKOVIC, A. Oral health-related quality of life of a
population of medically compromised elderly people. Community Dent Health, 19(2):90-97, 2002.
Disclosure of Interest: None declared

TP-WED-079 PROFILES OF ELDERLY PARTICIPANTS IN COMMUNITY-BASED REMINISCENCE
ACTIVITY
K. Chien* 1 , L. Liuhuang 2 , Y. Liou 3 , N. Tu 4
1 Geriatric Health Promotio, 2 International Labour and Development Research Centre, 3 Geriatric Habitation,
4 General Education Centerg, Kainan University, Taoyuan, Taiwan
Background: The elderly population currently constitutes 10.43% of the whole population in 2008, and is
expected to increase to 20.67% of the population by 2027 in Taiwan. Community senior center is the major
place to achieve the “aging in place” policy in Taiwan. It provides meal delivery, greeting by phone
(consulting and referral), home visiting and health promotion services. Health promotion activities include
health care lecture, physical activity, handcraft session, blood pressure management in the past. Elder group
is a special population. The activity design need consider participants characterizes.
Objectives: The purpose of this study was to investigate the profile of subjects who attend reminiscencebased
activity.
Underlying values and principles: There is limited information about application of reminiscence-based
activity in community now, especially relevant to government policy. The results of this study provide
important informatio for arrangement and management reminiscence activity in community.
Knowledge base/ Evidence base: Reminiscence is growth-oriented and helps older persons to feel more
confident about the present by reviewing past trials and accomplishments2. It is well known the positive
effects of dementia, depression, self-esteem in elderly by clinical trials.
Context of intervention/project/work: We survey the profile of particpants during 10-week programme.
Methods: Sixty-eight elderly, who come from four targeted local communities, attend the pilot run of
reminiscence-based activity under the sponsorship of Taoyuan County. They completed a questionnaire, 1)
background information (sex, language, race, age, and belief), 2) residence condition, 3) transportation, 4)
the resource of activity information and 5) motivation.
Results and Conclusions: The results of this study showed the average of age is 75.5 ±0.85. Seventy-five
percentages of participants were female. In terms of highest level of education received, the distribution was
20.3% illiteracy, 8.7% learning by self, 34.8% primary school, 31.9% high school, and 4.3 % superior
(university or technical institution). The participants were married (92.7%), with 45.6% widowed; 1.5%
divorced or separated, and 5.8% single. The average length of residence was 29.0 ±3.0 years. The question
of motivation was 44% make sense (or meaningful), 20% for social networking, 17.3% health promotion and
16% willing to learn. The resource of information was 50% human networking, 17.6% community ads and
17.6% community activity participation, 14.8 others. As for transportation, a high rate of 77.5% comes to the
community within 10 minutes of walking distance. This study suggests 1) the group leaders should be
attentive to the participant‟s education background in giving instructions; 2) The activity location is should be
consider. The time of transportation is within 10 minutes. 3) Intergenerational activities would be helpful in
enhancing positive image between grandparents and grandchildren. In addition, another high rate of 45%
participants was living with their descendants. Their life story books might play as a medium or topics in
ameliorating family relationships. 4) How to attentively tackle their feelings of loss would be important since
44 widows/widowers.
Disclosure of Interest: None declared

TP-WED-080 LIFESTYLE AND BODY COMPOSITION OF THE ELDERLY IN URBAN COMMUNITIES IN
ACCRA – TEMA METROPOLIS
D. K. COLLISON* 1 , W. B. OWUSU 1
1 NUTRITION AND FOODSCIENCE DEPARTMENT, UNIVERSITY OF GHANA, ACCRA, Ghana
Background: Lifestyle is a socially conditioned behavourial pattern involves in physiological changes and
may affect the body composition of the elderly.
Objectives: The objective of the study was to determine the association between lifestyle and body
composition of the elderly.
Underlying values and principles: Ageing is defined as the inevitable accumulation of changes with time
that are associated with and responsible for an ever increasing susceptibility to disease and death. It can
also be defined as a process of unfavorable progressive changes with the passage of time becoming
apparent after maturity and terminating invariably in death. The ageing process in an individual starts right
from conception and progresses throughout life till death [2].
Knowledge base/ Evidence base: Lifestyle is a socially conditioned behavioral pattern involves in
physiological changes and may affect the body composition of the elderly. Some of the behavioral patterns
or factors which are bad habits can be harmful. These include alcohol use, smoking and drug use. Healthful
lifestyle behavior should therefore be the cornerstone of disease prevention and health promotion [4]. As a
function of age, the health status of the elderly persons is related to their personal health practices. Never
smoking, moderate alcohol consumption or abstinence, regular physical exercise and weight maintenance
have been associated with lower mortality rates for all causes, as well as from specific diseases for which
certain practice carry a large relative risk. Although it is not clear (except for smoking among women) that
lifestyle practices among the elderly are associated (independent of age, health status and income) with
mortality, it is well established that these behaviours contribute to the overall quality of life and alter the
cause of various diseases and conditions among older adults [5].
Context of intervention/project/work: EPEDEMIOLOGICAL STUDY
Methods: This was a cross - sectional study adopting a purposive sampling technique to select 200 elderly
from one elderly people‟s home and two religious organizations. Relevant information was collected using
structured questionnaires and anthropometric measurements. Analysis was done using SPSS 16.0.
Results and Conclusions: Majority of the respondents were females (53%) and the mean age was 69 + 5.
About 18.5% smoked cigarettes whilst 54.5% took alcohol. The average BMI in kg/m3for the males was
26.12 + 5.40 and that of females was 27.98 + 5.74. There was an association between BMI and smoking,
BMI and alcohol intake, BMI and medication taken and BMI and nutrient supplements taken at p

TP-WED-082 GLOBAL WARMING AND OBESITY; WHAT ARE THE LINKS?
P. B. Mahler* 1 , E. Jeannot 2
1 Service de Santé de la Jeunesse, Département de l'Instruction Publiqe, 2 Institut de Médecine Sociale et
Préventive, Université de Genève, Genève, Switzerland
Background: Obesity is a major health concern in this rapidly evolving world as is Global warming and there
might be a correlation between the two. The hypothetical links go both ways; obesity leading to Global
warming(Edwards & Roberts, 2009) or the inverse. Concerns about high energy intake, high CO2 emission
to produce and deliver certain foods and extra fuel consumption to transport an overweight population
support the first hypothesis. Recent research on brown adipose tissue (BAT)(Farmer, 2009) has shown a
relationship between BAT activity and exposition to a cold environment. Intriguing observations like the
north-south gradient in obesity(Lobstein & Frelut, 2003) between north and south Europe despite the
"Mediterranean diet" could also be linked to temperature differences.
Objectives: See if there is a link between atmospheric temperature and overweight and obesity in 5 year old
children in Geneva.
Underlying values and principles: There might be a link between atmospheric temperature and obesity
and overweight.
Knowledge base/ Evidence base: The prevalence of overweight and obesity has increased among
children.
Exposition to cold can influence brown adipose tissue activity and body weight.
Global warming is increasing environmental temperatures
Context of intervention/project/work: Health of school children.
Environmental factors influencing health.
Methods: Weight, height and BMI of all 5 year old children (18,597) in the canton of Geneva were
measured, on admission to school, between 2001 and 2009. Prevalence of overweight (OW) and obesity (O)
were calculated using Cole's cutoff points. The prevalence of OW+OB was then compared to average
atmospheric temperatures, supplied by the national institute of meteorology. Trends were compared
between the prevalence of OW+OB and average annual temperatures and average winter temperatures
(Nov-Feb). The same procedure was also done with data from the Bordeaux(FR) area.
Results and Conclusions: Both Geneva and Bordeaux showed a significant drop in the prevalence of
OB+OW in 5yr old children between 2004-5 and 2005-6. When compared to the average annual
temperature no trend could be found. On the other hand, when comparing the prevalence of OB+OW with
the average winter temperatures, it was observed that the drop in the prevalence of OB+OW between 2004-
5 and 2005-6 was preceded by 2 unusually cold winters compared to the preceding years.
Just as much as it is believed that obesity could contribute to Global warming, Global warming might
contribute to obesity. Cold winters might stimulate BAT and thus contribute to increasing basal metabolism
and fat combustion. This could lead to a reflection about over warming our homes, overdressing and
overprotecting our children as well as the influence Global Warming might have on the future evolution of
OW+OB. This observation might also give some insight in to north-south differences in OW+OB prevalence
even though a multitude of other variables must be considered.
References: Edwards, P. & Roberts, I. (2009). Population adiposity and climate change. Int.J.Epidemiol.,
38, 1137-1140.
Farmer, S. R. (2009). Obesity: Be cool, lose weight. Nature, 458, 839-840.
Lobstein, T. & Frelut, M. L. (2003). Prevalence of overweight among children in Europe. Obes.Rev., 4, 195-
200.
Disclosure of Interest: None declared

TP-WED-083 HEALTH GAINS FROM SOLAR WATER DISINFECTION IN YAOUNDÉ, CAMEROON
S. T. Zebaze* 1 , J. Graf 2 , J. Gangoue Pieboji 3 , D. Niyitegeka 1 , R. Meierhofer 2 , N. Kemka 1
1 Faculty of Science, Unversity of Yaoundé I, Yaoundé, Cameroon, 2 Sandec, Eawag, Zürich, Switzerland,
3 Faculty of Science, Cameroonian Institute of Medecinal Research, Yaoundé, Cameroon
Background: In developing countries, the burden of diarrhoea is still enormous. One way to reduce
transmission of pathogens is by water quality interventions. Solar water disinfection (SODIS) is a low-cost
and simple method to improve drinking water quality on household level.
Objectives: The main objectives of the research were to assess the health impact of the intervention and to
identify some of the conditions favouring the adoption of the method by the households
Underlying values and principles: The principle was to link the SODIS promotion work done by the local
NGO Aquacare with the research work of the University of Yaoundé to support the advocacy work for
household water treatment at governmental level.
Knowledge base/ Evidence base: Water quality interventions focusing on point-of-use treatment have
proven to be effective in reducing diarrhoeal illness (Fewtrell et al. 2005; Clasen et al. 2007), but further
scientific investigations are required to determine whether the method is suitable for the wide range of
cultures in developing countries.
Context of intervention/project/work: This study evaluates a water quality intervention conducted in slum
areas of Cameroon‟s capital Yaoundé with 2911 households in four areas: Ntaba-Nlongkak, Briqueterie,
Carrière, and Melen. Community-based organisations carried out promotion campaigns with information
events followed by regular house visits.
Methods: Two surveys with randomly selected households were conducted before (N=2193) and after
(N=783) the intervention. Using a questionnaire, interviewers collected information on the health status of
children under five, on liquid consumption, hygiene and other issues.
Results and Conclusions: Data revealed a 34.3% diarrhoea prevalence among children before the
intervention. After the intervention, it remained stable in the control group (31.8%) but dropped to 22.8% in
the intervention group. Households fully complying with the intervention exhibited even less diarrhoea
prevalence (18.3%) and could reduce diarrhoea risk by 42.5%. Multivariate analyses revealed that the
intervention effects are also observed when other diarrhoea risk factors (hygiene,cleanliness of
environment)are considered. According to the data, adoption of the method was associated with marital
status. Findings suggest health benefits from SODIS use. Further promotion in low-income settings is thus
recommended.
References: Fewtrell, L., Kaufmann, R.B., Kay, D., Enanoria, W., Haller, L. & Colford J.M. 2005 Water,
sanitation, and hygiene interventions to reduce diarrhoea in less developed countries: a systematic review
and meta-analysis. Lancet Infect Dis. 5, 42-52.
Clasen, T., Schmidt, W.-P., Rabie, T., Roberts, I. & Cairncross, S. 2007 Interventions to improve water
quality for preventing diarrhoea: systematic review and meta-analysis. British Medical Journal 334(7597),
782-785.
Disclosure of Interest: none declared

TP-WED-084 ANALYSE QUALITATIVE DE L‟ACCES A L‟EAU DANS LES QUARTIERS PRECAIRES A
ABIDJAN
J. G. Sackou Kouakou* 1 , R. A. Attia 2 , S. Claon 2 , B. Ibrahima 2 , L. Kouadio 2
1 Sante Publique UFR Sciences Pharmaceutiques et Biologiques, Universite Cocody Abidjan, ABIDJAN,
Côte d'Ivoire, 2 ,
Historique / Origines: A Abidjan, mégalopole de plus de 3 millions d‟habitants, des quartiers précaires
émergent çà et là. On y retrouve 20% de la population, voire plus depuis la crise militaro-politique de
septembre 2002. L‟approvisionnement en eau y est mal maîtrisé.
Objectifs: Dès lors, analyser les modalités d‟accès à l‟eau et les réponses locales est essentiel pour orienter
les actions.
Valeurs et principes sous-jacents: En effet, fournir à ces habitants de l‟eau potable est un impératif
d‟équité et une problématique de développement durable car il s‟agit d‟assurer les besoins fondamentaux de
l‟homme.
Fondement de connaissance/Fondement de preuve: Une grande partie de la population défavorisée en
milieu urbain et périurbain utilise une eau insalubre ou en quantité insuffisante. Les plus vulnérables comme
les enfants en sont les premières victimes et se retrouvent sans défense face aux maladies notamment les
diarrhées.
Contexte d'intervention/projet/travail: L‟étude a été initiée dans le cadre de la politique de lutte contre la
pauvreté en Côte d‟Ivoire par la direction de l‟hydraulique humaine,
Méthodes: Cette recherche qualitative s‟est déroulée en 2007 et a concerné 21 quartiers précaires à
Abidjan. Des entretiens individuels approfondis avec les leaders communautaires ont été menés sur des
thèmes se rapportant à l‟importance de l‟eau dans la vie, les maladies rencontrées, les modalités et
difficultés liées à l‟approvisionnement en eau et les solutions envisageables.
Résultats et Conclusions: Nous avons interviewé 47 leaders dont l‟âge variait de 33 à 85 ans. Ils étaient
présents dans les quartiers depuis 7 à 55 ans. Ils ont tous évoqué le fait que les populations des quartiers
avaient triplé ou quadruplé ces dernières années. De façon unanime, pour eux, l‟eau était synonyme de vie.
Cette réponse est résumée par les propos d‟un enquêté: « L‟eau est tout. Sans l‟eau, il n‟ ya pas de vie. Elle
est au début et à la fin de la vie. Sans elle, le malade ne peut guérir et le bien portant ne peut vivre ». Les
maladies liées à l‟environnement étaient les plus fréquentes avec le paludisme en majorité. Chez les
enfants, on retrouvait en plus la diarrhée. Beaucoup ne faisaient pas de lien entre l‟eau consommée et la
fréquence des maladies. Certains expliquaient les cas de maladies par leurs conditions de vie à savoir la
pauvreté avec son corollaire de malnutrition. Les sources d‟approvisionnement en eau citées étaient les
revendeurs particuliers ou ambulants, les puits, les bornes fontaines et accessoirement l‟eau de pluie. La
collecte de l‟eau commercialisée était assurée par les femmes qui la transportaient du point de vente à leur
domicile. D‟autres ménages étaient directement servis chez eux par les revendeurs. Cette eau était
conservée dans des récipients de contenance allant de 50 à 200 litres et servait pour la boisson. Les coûts
pratiqués par les revendeurs variaient d‟un quartier à un autre (0,02 à 0,04 € les 10 litres). L‟accès à l‟eau
potable était difficile parce que la source était éloignée des quartiers (plus d‟un Km) et les bornes fontaines
étaient constamment en panne. La quasi-totalité des enquêtés a répondu qu‟elle voudrait bien contribuer
financièrement à l‟acquisition d‟eau potable à la condition que les taux de cotisation soient modérés.
D‟autres ont demandé l‟intervention de l‟Etat ou des communes pour viabiliser leurs quartiers ; ce qui
impliquerait la fourniture d‟eau potable. Il est nécessaire d‟améliorer durablement, dans ces quartiers, les
composantes de l‟environnement urbain dont la principale est l‟eau potable. Cela offrirait de meilleures
conditions de vie aux plus vulnérables à savoir les femmes et les enfants.
Conflit d'Interêt: Co auteurs
Stephane Claon, UFR Pharmacie, Consultant
Berthe Brahima, Direction de l‟hydraulique humaine, Employe

TP-WED-085 THE CHALLENGES OF POTABLE WATER SYSTEM IN GHANA: WATER POLICIES,
SHORTAGES, AND ATTEMPTS TO ADDRESS THEM
A. M. Sallar* 1
1 Ohio University, School of Health Sciences, Athens, United States
Background: Development of public water supply in Ghana started in 1920s with a pilot pipe-borne water
system in Cape Coast. In 1965 the Ghana Water and Sewerage Corporation (GWSC) was established by
Act of Parliament (Act 310) to provide, distribute, conserve and supply water for public, domestic and
industrial purposes.
Objectives: 1. Determine what accounts for the perennial water shortage in Ghana and developments of
policies to addressing them?
2. Discuss the health consequences of water shortage in Ghana.
3. To determine what are the current challenges in spite of these policy changes and make
recommendations.
Underlying values and principles: Having access to potable water is a human rights issue. People should
not pay any appreciable proportion of their earnings for good drinking water.
Knowledge base/ Evidence base: Current challenges relate to funding, pollution of water bodies, and poor
planning
Funding: In late 1970s and early 1980s, GWCL operational efficiency declined to very low levels due to
inadequate funding.
Pollution of water bodies: As a result of raw sewage, activities by mining and building construction
companies, and use of saline and mercury in some rivers.
Poor planning with regard to customer mapping: Only 400,0000 customers throughout Ghana have water
meters.
Context of intervention/project/work: Almost 50% of the population has no regular and safe water supply.
Women fill their buckets with water from dams they know are infested with guinea worm and it is common to
see women with babies on their backs carrying water on the head from ponds for long distances. In some
areas children have to walk long distances to fetch water before going to school.
The consequences of water shortages in Ghana can be viewed in terms of the prevalence of waterborne
diseases (cholera, burili ulcer, typhoid fever and diarrhea etc) are prevalent in Ghana. The water shortage
also negatively impacts on industrial developments which decreases job creation and affects poverty
reduction.
Methods: Interviewed personnel of Ghana Water Company, reviewed documents, newspaper reports, and
historical and legislative instruments relating to water in Ghana.
Results and Conclusions: Earlier attempts to charge user market rates led to a big outcry from citizens
leading to suspension of the idea. Other water sector reforms have since been implemented:
1. Build Operate and Transfer (BOT). BOT proposals are for 25 years and should approved by an Act of
Parliament.
2. Management contracts: pushed by the World Bank.
3. Building Boreholes by individuals, NGOs, and international funding agencies
4. Dug wells
5. Rainwater collection and other water harvesting methods into tanks
Even though the above may lead to improvement, it is hereby suggested that
1.The Government takes land and pay compensation to chiefs so that they don‟t sell land around water
bodies.
2.There must be laws to prevent land registration along water bodies.
3.Deregulate the water sector.
4.Increase metering, operational efficiency, effective custom identification, and mapping.
5.Prosecute illegal sale of water and make it national security offence.
6.The mushroom plumbers who do the illegal connections should face the full rigors of the law.
Disclosure of Interest: None declared

TP-WED-086 A PROGRAM TO PREVENT ASBESTOS RELATED DISEASES IN RESIDENTIAL
SETTINGS
P. A. Howat* 1 , G. Jalleh 1 , C. Lin 1 , A. Reid 2 , B. Musk 2 , N. deKlerk 2 , N. Olsen 2
1 Centre for Research in Cancer Control, Curtin University, 2 Population Health, Uni W Australia, Perth,
Australia
Background: Australia has among the world‟s highest rates of Asbestos Related Diseases (ARD). There is
an increasing proportion due to residential exposure by home renovators. A large proportion of pre -1987
Australian homes contain asbestos building materials.
Objectives: The aim of the project was to develop a community-based program to minimise exposure to
asbestos in residential settings.
Underlying values and principles: The next decade is likely to see unprecedented exposure by whole
families to asbestos fibres and dust due to home renovations and demolitions unless urgent steps are taken
to implement intervention programs.
Knowledge base/ Evidence base: This first national survey of asbestos exposure in the world identified a
large proportion of the population has been exposed to asbestos (80+%) . Both the national survey and
focus groups confirmed participants had taken minimal protection against residential exposure to asbestos
fibres and there was strong support for a program to protect home renovators. Specific intervention
strategies were recommended by the FG subjects who are the potential target group. Consultation with key
stakeholders confirmed the importance for interventions.
Context of intervention/project/work: This information was used to inform the development of the
community based program involving local media, a website, and hardware stores along with direct mail and
other supportive strategies.
Methods: The project consisted of three stages. Stage 1 involved a computer assisted telephone interview
(CATI) of a stratified random sample of 2800 Australian adults (18+years) from all States and Territories.
Stage 2 involved focus groups (n= 30) of a sample of these participants who have had significant exposure
to asbestos. Stage 3 involved consultation with key stakeholders and the preparation of the intervention
program.
Results and Conclusions: The large percentage of Australians exposed to asbestos especially in
residential settings is of concern for the development of future ARD. Programs aimed at the prevention of
such exposure are urgently needed. This is one of the first community wide asbestos awareness programs
to be developed worldwide and could be a model for national and international adoption.
Disclosure of Interest: "None declared"

TP-WED-087 TRANSFORMING INEFFICIENT HOTEL BUSINESS INTO CLIMATE FRIENDLY HOTEL
BUSINESS: HEALTH PROMOTION AND RESOURCE EFFICIENCY APPROACH
C. Sintunawa* 1
1 Faculty of Environment and Resource Studies, Mahidol University, Nakornpathom, Thailand
Background: Environmental problems and inefficient resource uses in hotels were analyzed in 1994. This
led to a need to motivate and work proactively with hoteliers to improve their resource uses. Environmental
education programs were launched by Green Leaf Foundation (GLF) in 1990s aiming to raise environmental
responsibility in hotel business. Environmental criteria in green hotel operations were created and used as
evaluating tools for participating hotels.
These evaluations were adapted and became green leaf environmental standards for hotels in 1998.
Achieving Green Leaf (GL) Standard helped hotels to market their services more effectively. GL
environmental standards became important levers for changes in hotels.
Objectives: This study was to comparatively evaluate environmental impacts and resource efficiency of GL
participating hotels in 1990s and 2000s. Improvements in hotel operations were to be identified and
analyzed.
Underlying values and principles: In 1990s, hoteliers were not directly and sufficiently exposed to
environmental knowledge and information and did not understand clearly how hotel business could
contribute to ecological restoration and protection of natural balance and attractions.
Knowledge base/ Evidence base: Resource efficiency and environmental conservation in hotel operations
would contribute to cost savings, green consumerism and business sustainability.
Context of intervention/project/work: Inter sectoral collaboration of organizations and partnerships
reinforced business transformation. GLF‟s interventions and environmental awareness activities triggered
change mobilization in hotels. GL environmental standard was a new approach to stimulate hotel
participation in environmental and tourism sustainability.
Methods: In depth interviews of hoteliers, quantitative measurements of resource utilization, and
environmental impact assessments were carried out to evaluate changes in hotels.
Results and Conclusions: Increasing recognitions of green leaf certificate raised incentives to hotels in
changing their practices. Resource uses per one room night services changed significantly, electricity use
declined from 4.6 kwh in 1996 to 1.6 kwh in 2009 while CO2 emission reduced from 2.3 kgs to 0.8 kg. Solid
waste generation decreased from 3.2 kgs per guest staying one night to 0.7 kg due to intensive waste
recovery and green procurements. Reduction of methane emission was also achieved from installations of
biogas digesters at hotel backyards. Untreated waste water of most hotels in 1990s was treated to
acceptable standards and treated water was increasingly reused in 2004.
Thai Health Promotion Fund supported health promotion program was an important driving force in
transforming waste generating menus, harshly chlorinated hotel pools, energy and chemical intensive
laundries and highly corrosive house keepings into climate friendly menus, salt chlorination health friendly
pools, ecological friendly and low carbon laundries and environmentally house keepings respectively.
Disclosure of Interest: None declared

TP-WED-088 GREENER ON THE OUTSIDE? PRISONERS AND ENVIRONMENTAL WORK
M. Baybutt* 1
1 Healthy Settings Development Unit, University of Central Lancashire, Preston, Lancashire, United Kingdom
Background: A pioneering programme of training and environmental outworking is taking place in prisons in
the North West of England as part of the Target: Wellbeing Pan Regional Prisons Programme.
Objectives: This presentation will provide an overview of an environmental project that aims to improve
wellbeing and quality of life, reduce health inequalities; have a positive impact on the drive to reduce reoffending;
and ensure equity and sustainability; concluding with a debate as to how true learning can be
captured in the programmes evaluation to ensure that what is measured is meaningful.
Underlying values and principles: Poor physical and mental health is strongly associated with offending
behaviour: as an excluded group, offenders generally fail to fulfil their potential and are denied opportunities
that most of us take for granted.
Knowledge base/ Evidence base: There is a growing body of evidence concerning the positive contribution
of green space and nature to health and well-being. Particularly that contact with natural places:
� supports physical and mental health
� aids social and psychological development by providing outlets for risk-taking and physical energy
� reduces stress and anti-social behaviour
� facilitates social interactions including team working and informal sociability
� provides visible and worthwhile achievements.
Key issues include the benefits of:
� viewing green space and nature – particularly for recovery and healing, mental health and self-reported
wellbeing;
� being in and having access to green space and natural environments – particularly for mental health,
cognitive development and functioning, emotional recovery and development of self-esteem;
� interaction with plants and animals – particularly in terms of mental health, reduced risk factors for
cardiovascular disease, social interaction, community cohesion and perceived wellbeing;
� green space and nature in terms of providing a setting for physical activity
Context of intervention/project/work: It is widely acknowledged that prisoners generally have poor skills.
For example, 80% have the writing skills, 65% the numeracy skills and 50% the reading skills at, or below
the level of an eleven year old child. Prisons can make a major contribution to improving the health and wellbeing
of some of the most disadvantaged and excluded individuals in our society – specifically by providing
opportunities for offenders to improve and develop skills that increase employability and reduce
worklessness, and by fostering family and social links that promote inclusion, thereby improving health and
wellbeing.
Methods: Whole systems evaluation of settings-based environmental work in prisons
Results and Conclusions: This presentation will explore the methods and discuss the complexities of
whole system evaluation and programme sustainability in the prison setting.
Disclosure of Interest: none declared

TP-WED-090 EVALUATION OF SCREENING TEST ON WEBSITE TO KNOW THE SUSCEPTIBILITY TO
SICK BUILDING SYNDROME - AS AN ATTEMPT OF PREVENTIVE MEDICINE
H. Nakaoka* 1 , E. Todaka 1 , M. Hanazato 2 , C. Mori 3
1 Center for Environment, Health and Field Sciences, 2 Center for Preventive Medicine, 3 Department of
Bioenvironmental Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan
Background: It has been concerned the adverse health effect by uncountable chemicals in the environment
to susceptible children and fetuses.
Objectives: The purpose of this paper is to introduce our screening test “Chemiless Necessity Test” and to
introduce our first attempt to see the result of it as a tool of preventive medicine in order to evaluate the
screening test on website to know the susceptibility to sick building syndrome as an attempt of preventive
medicine.
Underlying values and principles: The major causes of SBS are suspected to be volatile organic
compounds (VOCs) indoor air. However, SBS is not a health problem which occur to anyone and it is easily
overlooked as a cold or fatigue. It occurs to sensitive people to chemicals, and it is a preventable sickness. If
a person is sensitive, he/she should be careful to live in a way trying not to be exposed to chemicals to
prevent SBS. However, there was no way to know easily his/her sensitivity so far.
Knowledge base/ Evidence base: Currently, about 2-20% of Japanese population is reported to have
sensitivities or actually showing some symptoms such as headache, throat ache, dizziness in newly built or
remodeled buildings, that is called “Sick-building syndrome (SBS).”
Context of intervention/project/work: The health effect of indoor air chemicals are researched by
constructing a model town managed with fewer chemicals. It is named “Chemiless Town Project”.
Methods: For anyone to know his/her sensitivity to chemicals and take action to prevent SBS, we developed
software on the website to screen sensitive people. This software is called “Chemiless Necessity Test” and
anyone who accesses the website can know their sensitivity to chemicals by answering the questions. It has
been uploaded since April, 2009. Chemiless Necessity Test consists of two parts. One is condensed Quick
Environmental Exposure and Sensitivity Inventory (QEESI) by Miller and Prihoda (1999) to know his/her
sensitivity to chemicals and another is the questionnaire to ask his/her anamnesis about the occurrence of
SBS.
Results and Conclusions: As a result, the percentage of high-risk group to have SBS was 62% and lowrisk
group was 38%, respectively. Among high-risk group, female accounted for 55.2%. Regarding
anamnesis, 40.7% of people were diagnosed as SBS and 25.1% were diagnosed as Chemical Sensitivity.
The percentage of the group without anamnesis was 15.6%
Further, after knowing their own sensitivity, they are asked if they pay attentions in daily life not to be
exposed to unnecessary chemicals to prevent SBS. The results suggest that more than 79 % of people who
know their own sensitivity to chemicals answered that they will become more careful to chemical exposure. It
means that recognition is important to take actions to prevent SBS. By using this new software, the number
of people who will suffer from SBS is expected to decrease.
Disclosure of Interest: H.Nakaoka, None declared
E.Todaka, None declared
M.Hanazato, None declared
C.Mori, None declared

TP-WED-091 ASSESSMENT OF SOLID WASTE MANAGEMENT SERVICES IN OBAFEMI AWOLOWO
UNIVERSITY, ILE-IFE, SOUTH WEST, NIGERIA
C. A. Adegbenro* 1 , O. F. Oloruntoba 2
1 Community Health, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria, Ile-Ife, 2 Epidemiology,Medical
Statistics and Environmental Health, College of Medicine, University of Ibadan, Ibadan,Oyo State, Nigeria,
Ibadan, Nigeria
Background: The state of solid waste management practices is a serious concern in the OAU campus
community and is a reflection of what is obtainable in Nigeria at large. Apart from the magnitude of health
hazards associated with poor solid waste management practices, rotten and decomposed garbage make
neighbourhoods filthy, foul smelling and unhealthy. Flies, cockroaches and rodents thrive in such filth, and
they are the known vectors of many diseases. The incursion of vermin most especially rats on this campus
has been a subject of concern. In consequence, the growing problem of solid waste poses increasing threats
to the health and well being of its residents both on the short and long term.
Objectives: Objectives are to:
1) Assess the level of knowledge base of Obafemi Awolowo University undergraduates on solid waste
management.
2) Assesse the level of effectiveness of solid waste management services as well as identification of factors
influencing this effectiveness.
3)Applying data obtained from the study for future intervention programme to address this problem.
Underlying values and principles: This involve sensitizing undergraduates of OAU,Ile-Ife and the
University's solid waste management workers on the impact of poor solid waste management on the health
the health of the university community as a whole. this will in turn enable them to take positive steps in
addressing the problem.
Knowledge base/ Evidence base: The knowledge gained from the study will be used in designing future
intervention programme in addressing the problem of solid waste management on the university campus.
Context of intervention/project/work: The context of the work will involve the use two technique of data
collection which include the use of semi-structured questionnaire and interviewing/observational technique
Methods: The study was conducted in Obafemi Awolowo University Campus, a tertiary institution, located in
the ancient city of Ile Ife, Nigeria. The study population included both undergraduates and all managers and
workers at the environmental health unit of the university. Five hundred students were randomly recruited
from all the existing halls of residence for the study using non-probability sampling technique while all the
managers and the workers at the environmental health unit of the university took part in the study.
Data were collected from the students using semi-structured questionnaire while method of key informant
interview was used for managers and workers at the environment health unit .Participants‟ observation was
also used in getting to strategic location and important places of waste collections, transportation, disposal
and treatment procedure.
Results and Conclusions: The study also showed that the students have a good knowledge of solid waste
(51.6%). It also showed that the male students have a better attitude towards participating in effective waste
management. However, both sexes believed that the most effective ways are to engage in enlightenment
campaigns and discouragement of wrong waste management practices. Also the interviews and participant
observation revealed the problems of solid waste management ranging from inadequate manpower,
insufficient vehicles and other equipment.The study also concluded that factors that significantly influence
the solid waste management are: inadequate manpower and poor facilities.
Disclosure of Interest: None Declared

TP-WED-092 GOING GREEN: ASSESSING A COLLABORATIVE UNIVERSITY/COMMUNITY STATE-
WIDE MODEL USING INNOVATIVE DISTANCE TECHNOLOGY FOR LIFE-LONG TRAINING OF THE
PUBLIC HEALTH WORKFORCE
E. Mamary* 1 , A. Demers 1
1 Health Science, San Jose State University, San Jose, United States
Background: Today, we are faced with significant changes in the world and challenges to public health
including war, environmental racism, bioterrorism, global warming, globalization, health disparities between
rich and poor, and food security issues. Effective responses to these issues will require complex approaches
and strategies implemented by a qualified public health workforce. Many organizations including the Institute
of Medicine, National Board of Public Health Examiners, American Public Health Association, Society for
Public Health Education, Council on Education for Public Health (CEPH), Council of Accredited MPH
Programs, and National Commission for Health Education Credentialing have acknowledged the need to
provide additional training to ensure that the public health workforce is competent to respond to these
challenges effectively. Public health leaders recognize that an adequately prepared workforce requires longterm
development. While local health departments provide a significant amount of staff training, they have
limited financial and staff resources for providing continuing education for their staff. Although schools and
programs accredited by CEPH are required to provide continuing education to the public health workforce,
they are constrained by the lack of resources, geography, and limited time.
Objectives: 1. Describe a replicable model using a distance technology instructional delivery system for
offering ongoing continuing education opportunities that satisfy graduate education accreditation demands of
the Council of Education for Public Health.
2. Assess the technological aspects of the training mode of delivery.
Underlying values and principles: Collaboration, partnership, and sustainability through green technology.
Knowledge base/ Evidence base: Describes a successful model for an effective university and community
partnership in training the public health workforce using green technology.
Context of intervention/project/work: We initiated a state-wide collaborative project using an academic
and community partnership to increase public health training opportunities to both degreed, and non-degreed
public health workers throughout the State of California, USA.
Methods: Used a distance learning platform that offered the advantages of having several hundred
participants join a live session hosted by a moderator and guest speaker who presented on a timely public
health training topic. This technology allowed individuals to participate interactively in real time with two-way
audio capability using a headset with a microphone, regardless of whether they used a PC or Macintosh
computer platform.
Results and Conclusions: Collaboration was successful in delivering two major state-wide public health
trainings. The overwhelming majority of participants strongly agreed that this interactive distance mode of
training was very convenient and time efficient and that they would participate in future continuing education
programs using this format for future trainings.
Disclosure of Interest: Grant/Research - Support

TP-WED-093 ECOSYSTEM HEALTH APPROACH IN HEALTH PROMOTION GRADUATE PROGRAM,
BRAZIL
M. A. Morraye* 1 , M. Cesario 1
1 Mestrado em Promocao de Saude, Universidade de Franca, Franca, Brazil
Background: Environmental health promotion concept, has been used as awareness of physical
environmental stressors and exposures increased in communities.
Objectives: to describes a participative method for introducing the ecosystem health approach for graduate
students in an accredited multidisciplinary graduate program in health promotion, which is hold by UNIFRAN
(University of Franca), São Paulo State, Brazil.
Underlying values and principles: the role of ecosystems‟services and sustainable development in
promotion supportive environment for human health
Knowledge base/ Evidence base: ecology and health
Context of intervention/project/work: university
Methods: In the first meeting, the students‟ were asked about their concept of environment, and to describe
their daily routine and the objects used during it. Subsequently they had to identify the origin of objects
material (plant, animal or mineral), and is it is renewable or recyclable. In a second meeting, they were asked
to build a community in a remote area, using the natural resources. In a final discussion, they are able to
build a model of healthy cities.
Results and Conclusions: During the activities they start to understand the role of ecosystems‟ services
and that promotion of human health must be embedded in the wider pursuit of ecosystem health and being
aware that if ecosystems lose their capacity for renewal, society will lose life support services.
Disclosure of Interest: None declared

TP-WED-094 HEALTH, QUITY & SUSTAINABLE DEVELOPMENT
C. K. Gek* 1
1 Patient Education Library, Singapore General Hospital, Singapore, Singapore
Background: Health Promotion including integrated work-life health and wellness programs, help people
clear away the barriers to greater performance and well-being. Health Promotion and education help people
at all stages , to engage and lead healthy life-styles.
Objectives: Empowered individuals, become happier and more effective in their multiple life roles - as a
worker, spouse, parent. Often, there is a visible , tangible effect on their marriage and work-life activities.
They feel fulfilled and liberated, and the ability to balance their lives. there is alignment between individuals
and the organisations for which they work, the individual a healthier, happier & more productive employee.
Underlying values and principles: Health Promotion through Patient Education in hospitals and related
medical instituitions, promote better understanding, compliance to treatment, medications and reduce
unnecessary, repeated hospital admissions. Hospital facilities and utilisation of beds are maximised for acute
ill patients. Public health education to schools and community are promoted through mass media.
Knowledge base/ Evidence base: Annual utilisation statistics at Patient Education Library FY 2008 -
31,825 visitors ; walk-in consultations : 1,651 ; E-Nurse enquiries through Internet : 15,152 ; Health Glossary
( dedicated Patient Education Website ) : 81,916 hits ; Usage of Reference books : 26,477 ; Health
Education takeaway brochures : 15,152 ;
Context of intervention/project/work: It is a value-add service, complementing Post -Clinic Specialist
Outpatient consultations .
Methods: Patient Education Library provides personalised consultation to health education matters to walk
in or telephones. The Resource centre is equipped with referenxce books, brochures, videotapes on major
conditions
Results and Conclusions: Patient Feedback :
Verbal Appreciation : 106 ;
Written appreciation : 42
Health promotion help to enhance and promote awareness of Healthy Life-styles and nuture individuals to be
responsible for quality of life and higher productivity to sustain economy and environment
References: NA
Disclosure of Interest: None Declared

TP-WED-095 ARSENIC EFFECTS KNOWLEDGE IN RURAL AREAS IN DEVELOPING COUNTRY.
S. D. Joshi* 1 , R. Bhandari 2
1 Public Health, Primary Health Center, Kailali, 2 Community Health, Community Health and Environmental
Society Nepal, Kathmandu, Nepal
Background: Arsenic poisoning of tubewell water, which constitutes the primary source of drinking water,
has become the greatest health threat to the people of rural Nepal. While the government, non-government
organizations (NGOs), and bilateral and multilateral assistance agencies are involved in combating this
dreadful problem, all of their efforts to date have proceeded without having grassroots information about
arsenic poisoning
Objectives: The objectives of this study are to investigate the level of knowledge rural residents have
regarding arsenic poisoning and to identify the correlates of that knowledge.
Underlying values and principles: Ethical approval and consent taken
Knowledge base/ Evidence base: Evidence base
Context of intervention/project/work: Work
Methods: Questionnaire surveys administered among residents of four rural areas provided the major data
source for this study. Twenty villages were selected from moderate and low arsenic risk regions and a total
of 356 respondents, 177 from medium risk regions and 179 from low risk regions, were interviewed. The
data was edited and analyzed with the help of EPI info software.
Results and Conclusions: Analysis of the survey data reveals that arsenic awareness is currently not
widespread in the study villages, particularly in the low arsenic risk region. There are also gaps in arsenic
knowledge regarding the diseases caused by arsenic poisoning and mitigating measures available to
prevent contamination.
This study identified arsenic risk region, level of education, gender, and age as important determinants of
arsenic knowledge. The findings of this study will aid in making existing health education programs more
effective and in reducing the risk of developing arsenic-related illnesses
Disclosure of Interest: "None declared"

TP-WED-096 ENVIRONMENTAL EDUCATION WITH VIEW TO A HEALTHY TRANSIT
S. C. Oliveira* 1
1 Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, Brazil
Antecedentes: The constant and accelerated transformations through which the earth has been going have
significantly affected our world/ midst in its physical, biological, political and social aspects, jeopardizing both
the quality of life and the environment. Such fact demands, more and more, the development of effective and
articulated actions on the causes of the problems. The air pollution, caused by excessive automotive
vehicles circulating daily on the roads and highways as well as in the cities, is among these transformations.
Objetivos: Promote the use of shared transportation, which mediates the contact between drivers and
passengers, in such a way to make it safe for both parts.
Valores y principios subyacentes: Showing the importance of the sympathetic hitchhike/ ride for the
improvement of health and the environment.
Base de conocimiento / base de evidencia: The air pollution, caused by excessive automotive vehicles
circulating daily on the roads and highways as well as in the cities, is among these transformations.
Contexto de la intervención / proyecto / trabajo: The population under survey was comprised of 40
students in the Post Graduation Course “Interdisciplinary Specialization in Public Health,” 2009 group, from
the College of Public Health of the University of São Paulo, who drove from different areas in São Paulo city
twice a week.
Métodos: The method of research was the quali-quantitative one where an optional participation
questionnaire with opened and closed answers was used for enquiry.
Resultados y Conclusiones: Partial results: after the implemmentation of the Project, there was a change
of attitude by most part of the group who adhered to the” Eco-carroagem Sympathetic Ride” program and
reduced the use of their own car by sharing it with their colleagues not only for university hours. There was a
reduction of stress and improvement of interpersonal relationship by these people, who used to stay long
hours stand still and lonely in traffic, which in the end had a good indirect effect on both the quality of their
life and the environment.
Referencias: (Prefeitura de São Paulo, Projeto Ambientes Verdes e Saudáveis, pag 111, 2009)
Medina (2000, p.10),
Declaración de intereses: My interest in participating in the 20th IUHPE World Conference on Health
Promotion is a result of living in the project called "Eco-carroagem" which aims at exploring the sustainability
of an educational, causing people to change their attitudes towards use of motor vehicles jointly sharing the
ride.

TP-WED-097 MODEL OF PARTICIPATORY HEALTHY PUBLIC POLICY DEVELOPMENT IN A CASE
OF COMMUNITY BASED WASTE MANAGMENT IN SARABURI PROVINCE, THAILAND
N. Mathurapote 1 , S. Orathai* 2 , S. Boonthien 2 , J. Chairuk 2
1 Global Collaboration Development, 2 Health Assembly Development, National Health Commission Office,
Nonthaburi, Thailand
Background: Saraburi province is located in the central region of Thailand. One of the provincial policies is
to support the development of industry for export. With no appropriate plan responding to the impact of
industrial development, the public has encountered deteriorating health and environmental pollution caused
by hazardous waste. In 2008, the municipality of Saraburi initiated a plan for the construction of the transfer
station and disposal pond for industrial and chemical waste. The construction was planned to situate near a
temple and by Pasak River, the major river of the province. The construction plan was lack of public
involvement in a planning process and health impact assessment was not conducted. As a result, the conflict
between the municipality and the community has been provoked leading to objection of this plan from the
community.
Objectives: The model appropriate to solve this problem was studied. The approach for public policy
development and success factors in this situation were examined.
Underlying values and principles: Meaningful participation of 3 sectors in the society -
politician/government sector, academic/professional sector, civil society/ private sector – in the process of
developing public policy on community based waste management. The 3 sectors are considered as the
power of authority, knowledge and people respectively.
Knowledge base/ Evidence base: The result of public participation in the policy development process leads
to community initiatives in waste management for example waste recycle bank, HIA and etc. These
initiatives resulted in including community initiatives in the waste management plan of the Municipality and
halting the construction of the transfer station and disposal pond.
Context of intervention/project/work: Apart from conducting a participatory action research, the research
team facilitates the community to have dialogue among stakeholders on the way in which is able to solve
waste problem and ease the conflict in the community.
Methods: A participatory action research was conducted in 6 communities in the area of Saraburi
Municipality from January 2008 to September 2009.
Results and Conclusions: Commonly seen protests from the public when disapprove any state policies
and projects. The study proposes to have a neutral forum, which is called health assembly in Thailand, to
dialogue among stakeholders from 3 sectors in the society. Policy options derived from the public shall be
brought to the table Best practices of waste management from other areas shall be explored and shared. In
addition, monitoring and surveillance to policies is needed. The development of participatory healthy public
policy composes the following components; 1) leader and multisectoral mechanism 2) policy development
with knowledge base 3) networking 4) common goal setting 5) strategic planning with a participatory
approach 6) capacity building to nodes and networks 7) public communication 8) lesson distilled for
knowledge management. The success factors lie to 1) situation monitoring by leaders 2) Strength of
networks 3) Support of external factors 4) Opening of policy windows
Disclosure of Interest: None declared

TP-WED-098 CONSTRUCCIÓN DE POLÍTICAS PARA GESTIÓN DE RESIDUOS DE SALUD EN UNA
INSTITUCIÓN DE ENSEÑANZA SUPERIOR EN LA PERSPECTIVA DE LA EDUCACIÓN AMBIENTAL
L. B. CORREA 1 , V. L. Lunardi* 2
1 COORDENADORIA DE GESTÃO AMBIENTAL, UFPEL, PELOTAS, 2 ENFERMERÍA, FURG, RIO
GRANDE, Brazil
Antecedentes: Los residuos de salud resultantes de las diferentes actividades existentes em las
instituciones de la enseñanza superior – IES cuando gerenciados de manera inadecuada, causan riesgos a
la salud y degradación al ambiente. En este sentido, se torna necesario y urgente la construcción de
políticas de gestión integrada de los residuos en esos ámbitos.
Objetivos: Construir políticas para la gestión de los residuos de salud en una institución federal de la
enseñanza superior - IFES, a partir de su implementación en el Hospital de Clínicas Veterinaria – HCV na
perspectiva de la educación ambiental.
Valores y principios subyacentes: Vinculación a un proceso educativo en la perspectiva de la educación
ambiental.
Base de conocimiento / base de evidencia: Envolvimiento y participación de la comunidad universitaria
en la construcción de la sustentabilidad.
Contexto de la intervención / proyecto / trabajo: Institución federal de la enseñanza superior
Métodos: Estudio de cuño cualitativo, la modalidad de pesquisa-ación. A análisis temático de los datos
colectados de las reuniones con grupos focales – Grupo Desencadenador, 28 sujetos de diferentes sectores
de la institución y Grupo Constructor, 36 sujetos pertenecientes al HCV; del análisis documental acerca del
Estatuto, Regimiento, y Misión de la Institución y de la observación del ambiente institucional.
Resultados y Conclusiones: Emergieron dos categorías: a) “ La educación ambiental: la aparente
invisibilidad del proceso de construcción de políticas para la gestión de los residuos en la institución de
enseñanza superior” – enfocando la necesidad de conocer el todo y la parte: el contexto del ambiente de la
estructura institucional; la generación de residuos y situación de su manejo en la Institución; la realidad de
uno de los Campis de la Institución cuanto al manejo de residuos; el proceso de gestión de los residuos del
servicio de salud; vivencias en la propia institución y en otras, referentes a programas de gerenciamiento de
residuos de servicios de salud; y b) “ La educación ambiental: la visibildad presente del proceso de
construcción de políticas para la gestión de los residuos en la institución de eseñanza superior” – enfocando
el proceso de construcción de la política, el plano de gerenciamiento de residuos de servicios de salud en la
parte – HCV, pero de forma interelacionada con el todo, comprendiendo la Identificación de la problemática
de los residuos; la Planificación e implantación de metas y aciones; y el Programa de educación continuada.
La construcción de políticas para la gestión de los residuos en la IFES, mediante práctica pedagógica en la
perspectiva de la educación ambiental, potencializa la comunidad universitaria para la reforma del
pensamiento, posibilitando pensar la realidad institucional como un sistema complejo, integrado y articulado,
contribuyendo para un hacer ético, responsable y comprometido con la sustentabilidad del medio.
Declaración de intereses: No declarado

TP-WED-101 POLITICS AND POLICIES TO REDUCE SOCIAL INEQUALITIES IN HEALTH IN NORWAY
E. Fosse* 1 , M. Strand 1
1 Department of Health Promotion and Development, University of Bergen, Bergen, Norway
Background: Social inequalities in health have been high on European political agendas over a number of
years. In Norway, however, this issue has been at the focus of attention only for a few years. This
presentation addresses how this policy field has been developed in Norway over the last years.
Objectives: The development of the Norwegian policies is being described; and the development. is being
analysed and explained.
Underlying values and principles: The present research is based on health promotion principles, which
includes the principles of equity in studying social inequalities.
Knowledge base/ Evidence base: Kingdon‟s multiple streams model is useful for gaining insight into the
agenda setting process. The model identifies components necessary for a problem to rise on the political
agenda with a particular focus on the problem stream, the policy stream and the political stream. The
important role played by policy entrepreneurs is particularly emphasised.
Context of intervention/project/work: The present article follows the Norwegian policy making process on
social inequalities in health .The focus is process oriented following the development from little political
interest in the issue through to the introduction of a comprehensive, cross-sectoral strategy to tackle
socioeconomic health inequalities in Norway.
Methods: A case study design was selected, applying document analysis and personal interviews.
Results and Conclusions: The development of policies to reduce social inequalities in health in Norway
may be characterised as a development from indifference to the highest political priority. The current left
wing government has an overall aim of reducing the social inequalities in health by addressing the social
gradient. Policy entrepreneurs played an important role in placing the issues on the political agenda and
coupling the problem stream, the policy stream and the political stream.
References: Kingdon, J.W. (2003): Agendas, Alternatives and Public Policies. New York: Longman.
Disclosure of Interest: None declared

TP-WED-103 DEFINING THE DISCOURSE: COMMUNICATING RISK IN HEALTH PROMOTION AND
HEALTH EQUITY
G. P. Long* 1
1 Office of the Medical Officer of Health, Toronto Public Health, Ontario, Canada
Background: “Social injustice is killing people on a grand scale.” According to the WHO Commission on
Social Determinants of Health, the struggle to reduce health inequities is an ethical imperative. In its clarion
call to set a new global agenda for health equity, the final report of the Commission lays out a foundation for
what it calls “a new approach to development” through a “holistic” view of social determinants of health. This
view holds that the “unequal distribution of health-damaging experiences is not in any sense a „natural‟
phenomenon, but is the result of a toxic combination of poor social policies and programmes, unfair
economic arrangements, and bad politics.” In framing its report in these terms, the Commission has provided
a lead to health equity advocates everywhere by borrowing a lens from risk communications and applying
plain language to the complex political challenges associated with promoting “whole of government” healthy
public policy.
Objectives: The goal of this oral presentation is to reflect on the example offered by the Commission in its
use of evidence-based research to describe and explain the health risks associated with prevailing social
injustice. The presentation will review the current state of health promotion and health equity work in Canada
by examining the application of risk-themed language to health inequalities in the discourse by government
ministries and agencies at the federal, provincial and local levels.
Underlying values and principles: The underlying values in this presentation take as a given the precept
that health promotion work must actively engage the struggle for greater health equity by applying a “social
determinants of health approach”.
Knowledge base/ Evidence base: The knowledge base for this review of health equity discourse in Canada
will be generated by a survey of recent key documents and information materials produced by a sample of
agencies with mandates in population health and health promotion. The review will focus on the presentation
of these materials as they appear in online formats. As a comparator, the H1N1 influenza pandemic will
serve as a reference point in providing a recent case study in risk communications.
Context of intervention/project/work: The context for this project is set by the challenges posed in the
WHO Commission report, by the need to establish accountability measures for governments and their
agencies in the pursuit of health equity goals, and by the requirements for healthy public policy to follow a
strategic path of plain language and coherent discourse.
Methods: Methods will include a survey of key terms (and their variable usage by different agencies), such
as: health inequities, inequalities and disparities; social, socio-economic, environmental and just plain
determinants of health; health promotion as lifestyle change and health promotion as community
empowerment; marginalized, vulnerable, and other “at-risk” populations. The review will consider the
literature on risk communications and offer an analysis of the strengths and limitations of borrowing from its
practice in the fields of health protection and communicable disease control.
Results and Conclusions: The H1N1 influenza pandemic has served up the latest helpful reminder of the
critically important function of effective risk communications in enabling knowledge transfer across multiple
and diverse audiences. By drawing on this most recent and high-profile case study of lessons learned in
communicating risk to public health, the oral presentation will highlight the current state of health equity
discourse in the Canadian setting.
Disclosure of Interest: None declared

TP-WED-104 PROGRESS FOR EQUITY IN HEALTH PROMOTION EVIDENCE
L. J. Willenberg 1 , N. Priest* 1 , R. Armstrong 1 , L. Prosser 1 , E. Waters 1
1 McCaughey Centre, School of Population Health, University of Melbourne, Melbourne, Australia
Background: Improving health equity and reducing health disparities both within and between countries are
important health promotion priorities. There is also a critical need to increase the available evidence of
effective interventions for addressing health inequalities. „PROGRESS‟ is a conceptual tool that can be used
to appraise the extent to which inequalities have been considered within both primary research and evidence
syntheses, as well as to inform the design of primary intervention studies. „PROGRESS‟ incorporates seven
key components of equity: place of residence, race/ethnicity, occupation, religion, education, socio-economic
status and social capital.
Objectives: This project aimed to a) use ‟PROGRESS‟ to evaluate equity considerations in systematic
reviews and included primary studies on mental health promotion; and b) assess the „PROGRESS‟
statement in terms of its relevance and application to health inequalities research.
Underlying values and principles: There is overwhelming evidence of substantial and avoidable
inequalities in health outcomes within and between countries. Ensuring that the health promotion evidence
base appropriately considers issues of equity in the design, reporting and synthesis of research is a critical
priority.
Knowledge base/ Evidence base: Since its development in 2003, the PROGRESS tool has been
increasingly promoted in organisations such as the Cochrane Collaboration and the International
Epidemiological Network. However, little research exists appraising its use as an audit tool.
Context of intervention/project/work: This project was conducted by researchers within the Cochrane
Public Health Review Group (PHRG), based in Melbourne, Australia. Formerly the Health Promotion and
Public Health (HPPH) Field, the PHRG aims to work with contributors to produce and publish Cochrane
reviews of the effects of population-level public health interventions.
Methods: Systematic reviews on mental health promotion published on the Cochrane Library from Issue 1
2003 to Issue 3 2007 were identified. Data was extracted from reviews and included primary studies
regarding baseline and outcome reporting of the PROGRESS components. In addition, we identified whether
any of the interventions were aimed at low- or middle-income countries (LMIC).
Results and Conclusions: Twelve systematic reviews and 137 primary studies were assessed. Gender
was the only „PROGRESS‟ component reported at baseline in all systematic reviews and in 83% of the
primary studies. Only three systematic reviews and 31% of primary studies reported differences in
intervention effect across five of the PROGRESS dimensions. Of the 158 studies, only six (5%) were aimed
specifically at low- or middle-income countries. These results suggest that mental health promotion research
would benefit from the use of the PROGRESS statement in both the design and synthesis phase of studies
in order to increase consideration of health inequalities and build upon the existing evidence base.
Disclosure of Interest: None declared

TP-WED-106 UNE NOUVELLE VISION D‟APPLICATION TRANSFRONTIÈRES DES SAVOIRS
PROBANTS POUR UNE SANTÉ GLOBALE ET DES «MONDES DE LA VIE» ÉQUITABLES ET
DURABLES
V. A. Lapaige* 1
1 Santé communautaire, Université Laval, Québec, Canada
Historique / Origines: La globalisation, forme contemporaine de mondialisation, constitue aujourd‟hui un
défi majeur adressé au champ de la santé publique et à tous ses praticiens, soucieux d‟une santé éco-socioefficiente
ainsi que de l‟amélioration de la santé équitable et durable des populations (Lee, 2003). Ce défi
macro de globalisation incorpore lui-même de multiples enjeux transnationaux (ex. : H1N1, éducation pour
tous, changement climatique, etc.) en lien avec la promotion de la santé (Labonte et al., 2009).
Transversalement à toutes ces questions de santé supraterritorialisées, se profile un autre défi, celui de
mise en place d‟une vision adaptée de l‟application des connaissances.
Objectifs: Cette communication vise à présenter une nouvelle approche dite transfrontières de l‟application
des savoirs probants en santé, qui transcende six frontières, et qui répond à un positionnement d‟ouverture
cosmopolitique des agents (individuels, collectifs) qui l'adoptent. L‟auteur offre parallèlement de nouvelles
pistes de réflexion et d‟action pour le développement de compétences individuelles et collectives rattachées
à cette vision.
Valeurs et principes sous-jacents: Pareille vision véhicule des valeurs d‟équité, de durabilité et de
responsabilité partagée. Tenant compte du changement socio-culturel et environnemental global, elle
contribue à renforcer la capacité d‟adaptation des systèmes de santé pour des «mondes de la vie»
équitables et durables, pour tous (Kelly, 2006).
Fondement de connaissance/Fondement de preuve: Elle a émergé au Canada, suite à la mise à l‟essai
(2008-2009) d‟un modèle théorique appelé «La santé publique globalisée» (Lapaige, 2009).
Contexte d'intervention/projet/travail: Ce modèle prenait lui-même assise sur une recherche québécoise
(2004-2007) portant sur la transformation identitaire du champ de la santé publique en contexte sociohistorique
de globalisation.
Méthodes: Il reposait sur un devis méthodologique mixte séquentiel QUAL-quant.
Résultats et Conclusions: C‟est un outil de transfert de connaissances et de réflexivité, transdisciplinaire et
interactif (CD-ROM) destiné aux praticiens de la santé publique. Il leur permet d‟analyser, dans la nonlinéarité
de leurs interrelations, le changement social global, le développement durable et le nécessaire
repositionnement de la promotion de la santé globale. Il les introduit, secondement, à une vision renouvelée,
transfrontières, de l'application des savoirs probants.
Références: Lee, K. (2003). Globalization and health: An introduction. Basingstoke,UK: Palgrave Macmillan.
Labonte, R., Schrecker, T., Packer, C. & Runnels, V. (Eds.). (2009). Globalization and health: Pathways,
evidence and policy. London,UK: Routledge.
Kelly, M. (2006). Mapping the life-word: A future research priority for public health. In A. Killoran, C. Swann,
& M.P. Kelly (eds), Public health evidence tackling health inequalities (p. 553-573). Oxford, UK: Oxford
University Press.
Lapaige, V. (2009). La santé publique globalisée. Québec, Canada : Presses de l‟Université Laval.
Conflit d'Interêt: Rien à déclarer

TP-WED-107 LA DIMENSION EQUITÉ DANS LES DONNÉES ET ANALYSES DE SANTÉ AU BURKINA
FASO
A. MAIGA* 1
1 Université de Ouagadougou, Institut Supérieur des Sciences de la Population, Ouagadougou, Burkina Faso
Historique / Origines: Dans le processus d‟instauration d‟une culture statistique et l‟utilisation de
l‟information statistique à des fins de décisions, de planification et de suivi évaluation des politiques et
programmes, le Burkina Faso enregistre la réalisation de nombreuses opérations de collecte de données.
Enquête Démographique et de Santé (EDS), Enquête Intégrale sur les Conditions de Vie des Ménages
(EICVM), Enquête par Grappes à Indicateurs Multiples (MICS), Recensement Général de la Population et de
l‟Habitation (RGPH), etc. sont entre autres opérations de dénombrement fournissant des indicateurs
démographiques, socio-économiques ou sanitaires.
Objectifs: L‟objectif de cette étude est d‟analyser la prise en compte de la dimension "équité de santé" dans
les sources ou opérations de collecte de données. De façon spécifique, il s‟agit de :
Décrire les questions et variables explicatives susceptibles de s‟inscrire dans une perspective d‟analyse
d‟équité de santé ;
Décrire les variables à expliquer susceptibles de s‟inscrire dans une perspective d‟analyse d‟équité santé ;
Analyser la capacité d‟opérationnalisation du concept d‟équité par les indicateurs produits par les différentes
sources.
Valeurs et principes sous-jacents: Tout en se réjouissant de l‟existence la gamme variée et diversifiée de
sources de données, le regard critique ne peut tout de même s‟empêcher de s‟interroger ou de s‟inquiéter de
la place accordée à la question d‟équité dans ces différentes sources de données. Comparativement aux
questions d‟efficacité, d‟efficience ou d‟impact, l‟équité apparaît bien souvent comme le parent pauvre des
études, recherches et évaluations.
Fondement de connaissance/Fondement de preuve: Même si la notion d‟équité est souvent prise en
compte, il ne s‟agit d‟une considération partielle et restrictive se résumant à de simples et superficielles
différences entres des groupes ou catégories de personnes. Alors que l‟équité est un concept complexe et
recouvrant de multiples dimensions.
Contexte d'intervention/projet/travail: Ce travail s‟inscrit dans un projet de recherche global sur les
inégalités de santé au Burkina Faso.
Méthodes: Le résultats recensement général de la population et de l'habitation fournit des informations sur
les caractéristiques démographiques et socioéconomiques des ménages; les niveaux de mortalité générale
et dans l'enfance.
La série des enquêtes démographique et de santé réalisées depuis 1993 constitue une importante source
de données pour l'analyse des questions de santé.Ces enquêtes fournissent à l'image du RGPH'96
d'importantes données démographiques, socioéconomiques et sanitaires. Une attention particulière y est
accordée à la santé de la mère et de l'enfant, de même que les mortalités associées à ces deux populations.
Une méta-analyse de ces principales sources de données statistiques permettra d‟atteindre les objectifs
assignés à cette étude.
Résultats et Conclusions: Une telle étude s‟inscrit dans une perspective de démonstration de l‟importance
relative accordée à la dimension "équité" dans les opérations de collecte et d‟analyse des données dans le
domaine de la santé. Au même titre que les questions d‟efficacité, d‟efficience, etc. l‟équité doit faire l‟objet
d‟une attention particulière dans le processus d‟analyse et la promotion de la santé.
Conflit d'Interêt: Rien à déclarer.

TP-WED-108 HEALTH EQUITY: STRATEGIES FOR HEALTH PROMOTION ACTION
L. N. Signal* 1
1 Health Promotion and Policy Research Unit, University of Otago, Wellington, Wellington, New Zealand
Background: Equity in health is a key value of health promotion as evidenced by key documents such as
the Ottawa and Bangkok Charters. Despite this central concern there is limited evidence of success in
achieving health equity through health promotion action.
Objectives: This paper explores the challenge of promoting health equity and the strategies health
promoters can utilise to achieve it.
Underlying values and principles: Equity, fairness and social justice are the values that underpin this
paper.
Knowledge base/ Evidence base: Evidence suggests that it is the unequal distribution of the determinants
of health that drives health inequity. This poses the question, how can health promotion address the unequal
distribution of the determinants of health?
Context of intervention/project/work: Governments internationally have identified the importance of
addressing health inequities. There has been discussion amongst the health promotion community about
their role in achieving this goal. Yet, more thinking is needed to assist health promoters to act effectively if
the community is to maximise its contribution.
Methods: This paper is a commentary based on health promotion literature and practice, with a particular
grounding in the issue from a New Zealand perspective.
Results and Conclusions: This paper explores the challenge of addressing the unequal determinants of
health through health promotion action and identifies a range of strategies to achieve health equity through
this approach. First, leadership from health promotion in the political and policy-making processes in health
and other sectors, including Treasury, Trade and Tourism. People with health promotion skills and
experience need to become politicians and senior managers. Second, inequities suffered by indigenous
people must be addressed in culturally appropriate ways. In New Zealand, as with other colonial countries,
ways need to found to address the often huge inequalities between indigenous and non-indigenous peoples.
Third, an equity approach needs to be institutionalised into our health promotion institutions through their
mandates, their ways of working and the ideas upon which they draw. Fourth we need to end victim blaming
and act on the up-stream causes of health inequalities. Fifth we need to use appropriate tools such the
Health Equity Assessment Tool, equity-focused Health Impact Assessment and measures of area
deprivation. Improving health equity is challening work but work that health promotion is well equipped to
undertake. The paper concludes that health promotion needs to vigorously debate and research how to be
effective in achieving health equity and utilise the resources we have at hand and evaluate their
effectiveness. Health inequities are unfair, unjust and unecessary. Health promotion has a critical role to play
in addressing them.
Disclosure of Interest: None declared

TP-WED-109 ECONOMIC ARGUMENTS FOR ACTION ON HEALTH INEQUALITIES
T. Lavin* 1 , O. Metcalfe 1
1 Public Health, Institute of Public Health, Dublin, Ireland
Background: Health inequalities between different socioeconomic groups persist throughout Europe.
DETERMINE is a three year project(2007-2010) supported by the European Commission which brings
together a high level Consortium from 26 countries. Its objective is to support and enable policy makers and
practitioners in all policy sectors to place a higher priority on health and health inequalities when developing
policy.
Objectives: A frequent criticism of policy or action to address health inequalities and one that is particularly
relevant in a worsening macroeconomic climate is that there has been insufficient economic analysis or
inadequate adoption of an economic perspective in these areas. The DETERMINE project sought to address
this deficit in a discrete work package strand coordinated by the Institute of Public Health in Ireland.
Underlying values and principles: Supporting action on the social determinants of health inequalities.
Knowledge base/ Evidence base: Literature review. Analysis by project partners within 12 member states
of the European Union and at the EU level.
Context of intervention/project/work: The rationale for this is that where such work has been undertaken,
results should be disseminated to influence decision-making in favour of addressing health inequalities. If
such work has not been undertaken it is important to understand why this is the case.
Methods: Using a specifically designed data collection instrument, examples of economic evaluations
conducted on relevant policies and actions were identified and the benefits and barriers to using economic
arguments in this area were explored.
Results and Conclusions: This presentation will outline key findings which show that much work is
occurring and provide examples of good practice. It will identify the barriers and opportunities to progressing
work as described by project partners. Finally it will explore the complexity of establishing a framework by
which to examine the economic arguments for a social determinants approach to tackling health inequalities.
Disclosure of Interest: None declared

TP-WED-110 A REALIST SYNTHESIS OF EVIDENCE FOR THE EFFECTIVENESS OF COMMUNITY
EFFORTS TO REDUCE HEALTH DISPARITIES IN NORTH AMERICA
M. D. C. Hills* 1 , S. Carroll 1 , S. Desjardins 2
1 Human and Social Development, University of victoria, Victoria, 2 WHO CC, Public Health Agency of
Canada, ottawa, Canada
Background: This paper provides an analytical summary of the results of a review synthesis of the
effectiveness of community health promotion efforts in North America to reduce health disparities between
population groups, particularly those efforts that address the „social determinants of health‟ (SDOH).
Objectives: The research had three main objectives:
1) To inform policy-makers, researchers and practitioners of the best available evidence concerning effective
practice in community efforts to reduce health disparities.
2) To enhance collaborative relationships between researchers and policy-makers in the development,
conduct and use of systematic reviews to inform policy on reducing health disparities.
3) To test the coherence, practicality and scientific value of the realist synthesis methodology for conducting
systematic reviews of complex health interventions.
Underlying values and principles: This research responded directly to two research priorities identified by
the Canadian Institutes of Health Research‟s Institute of Population and Public Health (IPPH):
1) Understanding and addressing the impacts of physical and social environments on
health; and,
2) Analyzing and reducing health disparities
Knowledge base/ Evidence base: By conducting a systematic review of the effectiveness of community
efforts to reduce health disparities, the results of this research offer focused information on a neglected area
of research: complex community health interventions to reduce health disparities.
Context of intervention/project/work: North America
Methods: The researchers utilized a developing method of review synthesis (realist synthesis), which takes
into account the influence of complex, contextual factors, such as the impact of the social and physical
environment on health and the production of health disparities.
Results and Conclusions: The results will be described
Disclosure of Interest: None declared

TP-WED-111 HEALTH EDUCATION NEEDS ASSESSMENT:A COMPARISON BETWEEN DEVELOPED
AND LESS DEVELOPED DISTRICTS OF ISFAHAN PROVINCE - I.R IRAN
M. shiri* 1 , S. Aminiy 1 , K. Heidari 1 , A. Afghari 2 , F. Farhang 1
1 Vice-chancellory for health, 2 School of Nursing and Midwifery, Isfahan University of Medical Sciences,
Isfahan, Iran (Islamic Republic of)
Background: Needs assessment and determination of the important basic needs of the community will help
define clearly the goals of the health system plan and hence help organize other elements related to the
interventional programs. Health needs assessment is a systematic method for reviewing the health issues
facing a population, leading to agreed priorities and resource allocation that will improve
health and reduce inequalities.
Objectives: Objectives of this study were to determine the health education needs and their priorities in 8
health networks of the Isfahan province of Iran to compare the needs of developed districts with those of less
developed ones.
Underlying values and principles: We obtained the viewpoints of different groups regarding health
educational needs and their priorities of undercovered population.
Knowledge base/ Evidence base: The well-being of the community is influenced by many factors, such as
culture,education, genetics, nutrition, housing, empowerment, occupation, and income.Education enables
and empowers people to take personal and collective action to protect themselves from environmental
threats and to support the development of technology and the passage of legislation (Green and Potvin,
2002).The role of education (based on needs assessment) in preventing or treating health problems is widely
accepted. Community needs assessment is the first step of organizing effective curriculum development for
teaching target groups. Health education is based on a needs assessment (Breckon et al., 1994).
Context of intervention/project/work: This descriptive study used the consent-based technique of
needs assessment to determine health educational needs and priorities within such education in 8 district
health networks of the Isfahan province of Iran. It was conducted among following three groups in district
health networks: health experts at headquarters; health workers delivering health services; and people in the
community coverd by these networks.
Methods: An integrated consent-based technique (based on Delphi and Telstar) of needs assessment was
used to acquire the viewpoints of different stakeholders regarding health education needs.The following
groups participated in this study:health managers and experts of the headquarters of district health
networks.149 were selected by the needs assessment committees of the district health networks who were
mainly managers of networks and leaders of their technical units.The second group includes health service
workers of the district health networks who deliver health services to the people consists of health centers'
physicians(rural and urban); healthworkers (Behvarzan) of rural health houses; public health officers working
in health centers; physicians and nurses working in district hospitals.Total of 1184 persons were selected by
needs assessment committee in each district health network using a randomized sampling method.The third
group includes people in the community.They were randomly selected from different groups based on sex,
age and living place(urban and rural areas)(7159 individuals).An open questionnaire was used to collect
data.
Results and Conclusions: In more developed districts the first ,second and third priorities included
nutrition;non-communicable diseases;mental health;drug abuse;food stuff safety and finally communicable
diseases.While in less developed districts the first three priorities included environmental health;potable
water safety;sewage disposal,garbage disposal;drug abuse;nutrition;puberty health;oral health;noncommunicable
diseases;family planning and communicable diseases.Priorities in developed parts are
related to non-communicable diseases, where as in less- developed parts environmental health needs are
the priority concerns.
References: -Green LW, Potvin L. 2002. Education, health promotion, and social and life-style determinants
of health and disease. In Oxford Textbook of Public Health Volume 1. (4th edn), Detels R,Mcewen J,
Beaglehole R, Tanaka H. (eds). Oxford University Press: New York; 210–220.
-Breckon DJ, Harvey JR, Lancaster RB. 1994. Community Health Education. (3rd edn), Aspen publishers:
NY.
Disclosure of Interest: None declared

TP-WED-113 SOCIAL INEQUALITY AND ADOLESCENT HEALTH BEHAVIOUR IN TAIWAN
Y. Lin* 1 , I. Chiang 2 , Y. Huang 3 , H. Wang 1
1 Department of Education, National Taipei University of Education, 2 Department of Health Promotion and
Health Education, National Taiwan Normal University, 3 Institute of Life education and Health Promotion,
National Taipei University of Education, Taipei, Taiwan
Background: There are inconsistent findings between social inequalities and adolescent health behaviours.
Objectives: This study explored the association between four sets of social status indicators, and different
health behaviours in a general adolescent population of Taiwan.
Underlying values and principles: Social inequalities have been shown to be associated with key health
indictors in young children and adults, while the associations are less consistent among adolescents. Some
studies have found that higher social status is related to better health outcomes and behaviors among
adolescents, while others have not.
Knowledge base/ Evidence base: Traditionally, adolescent's social status has been measured using
information about parents‟ level of education, parents‟ occupation, or household income. It can be difficult for
some adolescents to answer questions on parents‟ socio-economic position. High levels of missing or invalid
data have been reported by previous studies using adolescents‟ self-reports.It is suggested to use multiple
indicators of social status in detecting health inequalities among adolescents.
Context of intervention/project/work: The data came from a 2009 school-based survey. 3368 students in
grades 6-10 in Kinmen County of Taiwan completed a modified WHO Health Behaviour in School-Aged
Children (HBSC) questionnaire.
Methods: Indicators of social status were parents‟ education, parental occupation, family affluence, and
adolescent‟s personal social position (measured as school performance). Logistic regression analyses were
used to investigate the independent effect of social status indicators on fruit and vegetable consumption,
physical activity, TV viewing, tobacco use and bullying behaviour.
Results and Conclusions: For tobacco use, a negative association was found with adolescent's personal
social position, while no relationship with other indicators of social status was observed. After adjustment for
age and gender, higher level of parents' education was associated with more vegetable consumption and
less time of TV viewing. Higher family affluence status was associated with greater participation of physical
activity and a decreased risk of being bullied. Adolescent's social position was strong independent predictors
for all health behaviours examined. Besides the traditional stratification indicators, family affluence and
adolescent's personal social position can be used to examine the impact of social strata on health
behaviours among adolescents.
Disclosure of Interest: Y.C.Lin,National Science Council in Taiwan
(NSC98-2410-H-152-010)

TP-WED-114 EQUITY IN HEALTH: A REVIEW WITH A VIEW TO HEALTH PROMOTION
M. A. Morraye* 1 , M. A. Furtado 1 , S. C. A. Silva 1
1 Masters Program in Health Promotion, University of Franca, Franca-SP, Brazil
Background: In Ottawa Letter, equity in health is pointed as a health promotion focus.
Objectives: Make a review of published scientific papers about equity in health, aim to check which issues
are most raised in studies and which one are most lacking in knowledge; which the direction of current
studies in area and what is the proportion of studies that aimed health promotion as a tool for achieving
equity in health.
Underlying values and principles: One of the principles defined by WHO to health promotion is equity, that
despite differences over its conceptualization, can be understood as the recognition of differences and the
treatment of these differences separately, corroborating with construction of justice and equality.
Knowledge base/ Evidence base: The actions of health promotion aim to reduce differences in health
status of population by ensuring equitable opportunities and resources, enabling all people to realize their
fully potential of health.
Context of intervention/project/work: If equity in health is a key focus to achieving health promotion, is
deduced that number of studies wich adress the two issues have increased in last years.
Methods: 557 abstracts found in Pubmed via National Library of Medicine database through descriptor
equity in health were analyzed, observing date of publication, place of production, indexing journals, issues
addressed on studies and relation of study with health promotion.
Results and Conclusions: The publications included the period between 1975 and 2009. United States
was the country with the largest number of publications, representing 20,8% of total, followed by United
Kingdom (13.8%) and Canada (6.8%). The papers were published in 213 different journals and the journal
Social Science & Medicine was the first in number of publications (7,9%), followed by Health Policy (5,7%)
and Reports in Public Health (4,1%). The issue most discussed in papers is public policy, representing 16%
of all studies, followed by access/use (15.4%) and socioeconomic status (12%). These issues are also more
frequent in studies published in the last two years, showing the direction of current studies about equity in
health. Publications that deal together equity in health and health promotion represents 1,98% of total
publications and were produced by eight countries: Australia, Brazil, Canada, Finland, Germany, Norway,
Pakistan, United States and also a publication without citation of country of origin. From these data, we
identified that health promotion is not yet much a theme explored in the articles dealing with health equity as
well as public policy or access to goods and services. Since equity is a key focus for health promotion takes
effect, these data suggest the need for deeper theoretical through empirical data analysis of interfaces
between equity and health promotion. The exploitation of these interfaces may contribute to expansion and
deepening of health promotion proposals and eventually increasing academic research about the theme.
Disclosure of Interest: None declared.

TP-WED-115 A HEALTH PROMOTION APPROACH TO ELABORATING EQUITY-FOCUSED CLIMATE
CHANGE ADAPTATION MEASURES
M. Shareck* 1
1 Médecine sociale et préventive, Université de Montréal, Montréal, Canada
Background: The adverse health impacts of climate change are distributed unequally, between and within
countries and cities. Climate change is associated with social inequities in health since socially-defined
groups such as the poor and indigenous populations are particularly vulnerable to its impact. Key documents
in public health recently mentioned the urgency of bringing together research and action agendas on climate
change and health equity. Several authors have suggested adopting a public health approach to climate
change mitigation. However, few have directly addressed the potential effects of climate change adaptation
strategies on health and the importance of equity in designing health-promoting adaptation measures.
Objectives: Systematic monitoring systems of climate change‟s impact on health are already in place in
selected cities around the world. In this presentation it will first be argued that such monitoring systems
would benefit from including socio-demographic and geographical data at different spatial scales so that
social inequities in health outcomes linked to climate change could be uncovered and vulnerable groups
identified. Such surveillance data could guide the elaboration and evaluation of equity-focused adaptation
strategies. Secondly, it will be suggested that revisiting the Ottawa Charter for Health Promotion (1986) can
help us devise and implement comprehensive equity-oriented adaptation strategies. A framework inspired by
this founding
document will be presented.
Underlying values and principles: The proposed framework builds on the values and principles of equity,
participation and a holistic view of health which should be considered when researching climate change and
health and when designing adaptation measures to climate change. Additionally, the five action pillars, as
found
in the Ottawa Charter, should serve as a basis for developing comprehensive adaptation strategies.
Knowledge base/ Evidence base: A critical analysis of the literature will be conducted.
Context of intervention/project/work: The present work was initiated during a doctoral seminar in health
promotion.
Methods: Relevant literature will be critically reviewed. Using selected climate change manifestations such
as heat waves and examples of adaptation measures taken from published literature as case illustrations, a
framework will be developed and presented which could guide the design of local adaptation strategies
tailored to the needs and resources of previously identified vulnerable groups.
Results and Conclusions: Equity-based adaptation strategies to climate change present the potential to
reduce social inequities in health in general as well as to reinforce populations‟ future adaptation capacities.
Systematic monitoring combined with a health promotion framework and interdisciplinary work between
researchers, practitioners and policy makers present great potential in addressing the challenges brought
about
by climate change on health equity.
Disclosure of Interest: None declared.

TP-WED-117 INEQUALITIES IN HOUSEHOLD FOOD SECURITY IN TEHRAN
M. Asadi-Lari* 1 , N. Kalantari 2 , B. Mohammadpour 3 , M. Abdollahi 4
1 Epidemiology, Iran University of Medical Sciences, 2 Associate professor of community nutrition,
3 Epidemiology, 4 Assistant Professor of Community Medicine, S Beheshti University of Medical Sciences,
Tehran, Iran (Islamic Republic of)
Background: Iran was among five countries which were assigned the mission of piloting cities equity
assessment by World Health Organisation. Health equity which could be assessed by a range of measures
including household food security is one of the key elements of parity.
Objectives: This cross sectional study was carried out to explore household food insecurity in 22 districts of
Tehran city, Iran.
Underlying values and principles: Urban-HEART measures inequalities in 6 policy domains which are
„physical and environmental infrastructure‟, „social and humanity development‟, „economic‟, „governance‟,
´health´ and ´nutrition´, with 65 indicators altogether.
Knowledge base/ Evidence base: na
Context of intervention/project/work: Urban Health Equity Assessment and Response Tool (Urban
HEART) which was developed by WHO Kobe Centre, as the knowledge hub of Commission of Social
Determinants of Health (CSDH) in „urbanisation‟, was employed in a population based survey in Tehran.
Various methods used to investigate the health and social determinants inequalities in districts of Tehran.
Methods: Using a valid 24 hour food recall, trained undergraduate nutrition students and nutritionists
interviewed families to collect dietary data in all the 22 districts of Tehran during 4 months (September-
December 2008). Sample size was figured out based on estimating calorie intake. Cluster sampling was
applied and sample size was modified considering design effect of 1.5. MS Access, SPSS 14.0, and EPI Info
2000 were applied to create data bank and to complete data entry and analysis. Data checking and cleaning
were completed prior to analysis.
Results and Conclusions: Mean intake of food groups in studied households (gram/person/day)
Household (N) Bread, rice and cereal Vegetables Fruits Meat Dairy Legumes Fat and oil
2347 336±135 307±226 384±317 111±89 296±251 52±45 41±37
Household food insecurity based on energy intake
The highest rate of insecurity (intake

TP-WED-127 USING THE DELPHI TECHNIQUE TO EXAMINE HEALTH PROMOTION/ HEALTH
EDUCATION IN NURSING PRACTICE, EDUCATION AND POLICY IN GREECE
P. Beletsioti-Stika* 1 , A. Scriven 2
1 Medical Oncology, 251 GENERAL HOSPITAL OF AIRFORCE, ATHENS, Greece, 2 Health Sciences, Brunel
University, London, United Kingdom
Background: Wide-reaching international legislative and recommended documentation has called for the
explicit inclusion and application of health promotion strategies in nursing practice (WHO 2000). Today, the
literature continues to suggest that this situation, while changed, has not changed in line with broader health
promotion reforms. The main reason for this relates to a lack of conceptual and contextual clarity.
(Whitehead 2006,2007).
Objectives: The purpose of the present study is to obtain consensus statements on the concepts of health
promotion and health education from a panel of Greek experts using a Delphi methodology. Where
consensus will be achieved this will be put forward as a defining means of contextualizing the current and
predicted health promotion role, for nursing. This will be in terms of health related practice, theory and policybased
positions.
Underlying values and principles: There is a need to clarify, refine and redefine health promotion in
nursing because the concept is partly non-specific and has not been used to identify a distinctive nursing
focus.
Knowledge base/ Evidence base: It is well established that nurses often use the paradigms health
promotion and health education interchangeably within the parameters of their practice (Irvine 2007).
Context of intervention/project/work: The survey will be conducted in Athens Greece in two Athenian
Primary Health Care settings as well with two General Public hospital settings in central Athens and will start
in winter 2009.
The number of eligible participants will be around 40 nurses and 40 health visitors randomly selected
following certain inclusion/exclusion criteria.
Methods: A two-round Delphi technique via post correspondence will be used in order to focus on nurses‟
perceptions concerning health promotion and health education.
The first round questionnaire will use open-ended questions for defining health promotion and health
education in order to structure the second –round questionnaire of the study.
Results and Conclusions: The findings of this survey will be a good indicator as to how Greek nursing
experts currently view health promotion and health education constructs. It will offer a useful form of
measuring against current and future clinical practice and will help structuring the form of a new stageplanning
nursing model for health promotion practice.
References: Irvine F (2007) Examining the correspondence of theoretical and real interpretations of health
promotion. Journal of Clinical Nursing 16, 593-602.
Whitehead D (2006) Health promotion in practice: a review of clinical issues. Worldviews on Evidence-Based
Nursing 3, 165-184.
Whitehead D (2007) A review of health promotion in nursing education. Nurse Education Today 27, 225-237.
World Health Organisation (2000) Munich Declaration. Nurses and Midwives. A Force for Health. The 2nd
WHO Ministerial Conference on Nursing & Midwifery in Europe. WHO, Munich.
Disclosure of Interest: NONE DECLARED

TP-WED-128 A PSYCHOEDUCATIONAL PROGRAM TO DEVELOP EFFECTIVE PHYSICIAN-PATIENT
COMMUNICATION AMONG MEDICAL RESIDENTS
M. Ando* 1
1 Department of Clinical Psychology in Education, Graduate School of Education, Okayama University,
Okayama, Japan
Background: Effective physician-patient communication has been associated with patient outcomes.
Therefore, communication skills training to physicians, especially to medical residents, is important not only
to improve the process and quality of patient care but also to foster confidence in a physician‟s career. To
date, psychoeducational programs which include communication skills training for medical residents have
been slow to be adopted, and no research has been conducted to assess the value of such programs in
Japan.
Objectives: The objective of this study is to develop a psychoeducational program for medical residents by
modifying an existing program called “Successful Self.” This educational approach to foster skills and social
competence through skills training is meant to prevent behavioral and mental problems, improve healthy
lives among adolescents, and to report the results of a pilot study.
Underlying values and principles: Developing an effective psychoeducational program to foster skills and
social competence among medical residents will improve their physician-patient relationships and build their
medical confidence as physicians.
Knowledge base/ Evidence base: This is a knowledge base study. As an initial evaluation, it demonstrates
a level of process evaluation. This study analyzes the feasibility as well as effectiveness of the new
psychoeducational program for medical residents.
Context of intervention/project/work: The current program participants meet weekly for thirty minutes over
a 5-week period. The objectives of this curriculum are to enhance skills and social competence through skills
training and to influence perceived physician-patient relationships. Each lesson introduces a new skill along
with activities that allow the participants to use that skill. Problem solving, self-management and self-control
skills, communication, and conflict resolution are emphasized. A typical session begins with the objectives
for the group, the introduction of a new skill, followed by activities using worksheets in which common
problems are presented. The participants practice problem solving and use new skills in various interactive
group activities. Through these lessons, staff responds to the participants in constructive supervision and
positive feedback.
Methods: To test the intervention‟s effect on the psychosocial mediators targeted by the intervention, (i.e.,
communication skills, self-efficacy, and mood status) the statistical analyses are performed comparing Time
1 (pre-intervention) and Time 2 (post-intervention) in the group. Questions to test the program‟s feasibility,
difficulty, usefulness, and impression are addressed in Time 2(post-intervention).
Results and Conclusions: RESULTS AND CONCLUSIONS:
A program to develop effective physician-patient communication among medical residents has been
developed. The results of the process analyses will be shown at the conference.
Disclosure of Interest: None declared

TP-WED-129 IMPROVING SMOKING CESSATION SUPPORT IN THE HOSPITAL SETTING:
EVALUATION OUTCOMES THREE YEARS POST IMPLEMENTATION OF THE QUEENSLAND HEALTH
SMOKING MANAGEMENT POLICY.
K. M. Pickering* 1 , J. Fischer 2
1 Preventative Health Directorate, Division of the Chief Health, 2 Centre for Drug and Alcohol Studies,
Queensland Health, Brisbane, Australia
Background: The Queensland Health Smoking Management Policy (QHSMP) was introduced in January
2006, comprising of three components, 1) a staff quit program, 2) provision of nicotine replacement therapy
(NRT) and brief intervention (BI) for inpatients, 3) smoking restrictions at Queensland Health facilities. An
evaluation of component 2 of the QHSMP was undertaken in 2009.
Objectives: Identify how component 2 has been implemented across Queensland, as well as identifying
barriers and enablers to implementation. Describe the implementation and maintenance of component 2 in a
selection of Queensland public hospitals and recommend future strategies for enhancement.
Underlying values and principles: Tobacco smoking is the leading preventable cause of death and illness
in Queensland (Queensland Health, 2000). Implementing healthy public policy and creating supportive
environments are cornerstones of effective behaviour change strategies.
Knowledge base/ Evidence base: There is recognition that hospital and health care facilities are well
placed to positively affect the smoking habits of employees, patients and visitors. In particular there is
evidence that NRT and BI can impact favourably on smoking cessation amongst inpatients (Rice and Stead
2008; Orleans 2006; Rigotti et al 2000; Rigotti et al 2008; Wolfenden et al 2003). However, translation of this
knowledge into practice has generally been less successful (Miller 2006; Freund et al 2005; Hajek et al
2002) due to the complexity of instigating and maintaining change within health care systems (Grol et al
2002).
Context of intervention/project/work: This evaluation was undertaken to determine the level of
implementation of component 2 in hospitals across Queensland since the Smoking Management Policy was
introduced in 2006. Anecdotal feedback suggested that provision of NRT and BI could be improved and
there were significant barriers for staff and hospitals to implement component 2.
Methods: Eight public hospitals were randomly selected to represent a range of hospital sizes and
geographic locations throughout Queensland. Semi-structured telephone interviews were conducted with a
representative from each hospital. An online survey of all acute care clinicians was undertaken and a postal
questionnaire was mailed to 10,000 randomly selected previous inpatients.
Results and Conclusions: Hospitals reported a variety of positive strategies to support implementation of
component 2. The clinician survey assessed the level of knowledge, implementation and satisfaction with
regard to component 2. 182 clinicians completed the online survey, with the majority responding they were
aware of their hospitals policies and procedures regarding component 2. However, only just over half
reported asking smoking status and providing quit advice and one-third assessed nicotine dependence.
Many barriers to delivering brief intervention and administering NRT were also identified.
2,111 (21%) completed the inpatient survey to assess awareness and experiences with component 2. 265
(13%) respondents self-identified as smokers, with the majority indicating they were pre-contemplative (39%)
or contemplative (43%) and 19% reporting being in the preparation or action stage of change. Just over half
(54%) reported being informed of the smoking management policy at admission. Disappointingly, only a
quarter reported being offered information or referral, just under a third were informed about quitting options,
and 37% were not offered NRT.
Strategies to address barriers and assist staff to increase the provision of brief intervention and NRT to
inpatients in Queensland Health hospitals are need to further assist patients to quit smoking.
References: Freund, M., Campbell, E., Paul., C et al (2005) Smoking care provision in smoke-free hospitals
in Australia, Preventive Medicine, 41, 151-153.
Grol, R., Baker, R., and Moss, F (2002) Quality improvement research: understanding the science of change
in health care, Quality and Safety in Health Care, 11, 110-111.
Hajek, P., Taylor, T. and Mills, P. (2002) Brief intervention during hospital admission to help patients give up
smoking after myocardial infarction and bypass surgery: randomized controlled trial, BMJ, 324.
Miller, N. (2006) Translating smoking cessation research findings into clinical practice, Nursing Research, 55
(46) 38-43.
Orleans, C., Gritz, E (2006) Helping Hospitalised Smokers Quit: New Directions for Treatment and Research
, Journal of Consulting and Clinical Psychology, 61 (5), 778-789.

Queensland Health (2000) Towards a smoke-free future: Queensland Tobacco Action Plan 2000/2001 to
2003/2004. Queensland Health: Brisbane.
Rice, V. and Stead. L (2008) Nursing Interventions for Smoking Cessation (review), Cochrane Collaboration.
Rigotti, N., Arnsten, J., McKool, K et al (2000) Smoking by patients in a smoke-free hospital: prevalence,
predictors and implications, Preventative Medicine, 31, 159-166.
Rigotti, N., Munafo, M., and Stead, L (2008) Interventions for smoking cessation in hospitalized patients
(review), Cochrane Collaboration.
Wolfenden, L. Camplbell, E. Walsh, R. et al (2003) Smoking cessation interventions for in-patients: a
selective review with recommendation for hospital-based health professionals, Drug and Alcohol Review, 22,
437-452.
Disclosure of Interest: None declared

TP-WED-130 BEYOND DIAGNOSIS AND TREATMENT: HOSPITALS AND CLINICS PROVIDE
ANOTHER SETTING FOR HEALTH PROMOTION AND EDUCATION
J. T. Fodor 1 , D. Obar* 2
1 Health Science, Professor Emeritus, California State University Northridge, Northridge, 2 Health Education,
Sansum Clinic, Santa Barbara, United States
Background: An increasing number of health care facilities throughout the country are providing a variety of
health and wellness education classes and activities, not only for patients but also for members of the
community at large. Some health care facilities have established special departments, such as the Health
Resource Center at the Sansum Clinic in Santa Barbara, to organize and coordinate a variety of health
promotion and education programs and activities.
Objectives: To increase the role of health care facilities in providing health promotion and education.
To identify ways health care facilities can and do provide health promotion and education services and
activities.
To Provide examples of hospital and clinic-based health promotion and education programs and activities.
Underlying values and principles: Health care facilities are proven settings for providing a variety of health
and wellness education programs and services that reach out to members of the entire community.
Their health promotion and education activities and outreach programs can literally reach hundreds of
thousands of individuals.
Knowledge base/ Evidence base: The knowledge base for this presentation comes from hands-on
experience by the co-presenters in providing health promotion and education activities and programs at a
specific health clinic (The Health Resource Center at the Sansum Clinic, Santa Barbara, CA) as well as
drawing from the experiences of others who are providing such activities and programs in local hospitals and
clinics.
Context of intervention/project/work: The context of the presentation focuses primarily on how hospitals
and clinics can move beyond diagnosis and treatment and increase their role in health promotion and
education.
Methods: Health promotion and education methods and programs illustrated include the use of pamphlets,
books, brochures, videos and CDs and VCRs; instruction on the use of the internet for online searches of
health information; health education workshops, seminars and classes on a variety of pertinent health topics,
such as Diet and Weight Control, Controlling High Blood Pressure, Heart Disease Control, Cholesterol
Management, Exercise and Fitness, Stress Management and Guided Meditation, as well as providing
outreach programs to other community agencies, schools and retirement communities.
Results and Conclusions: The essential conclusion of the presentation is that hospitals and clinics are
proven and needed settings for health promotion and education and that these settings can provide outreach
programs to other community agencies, schools and retirement communities.
Their health promotion and education activities and outreach programs can literally reach hundreds of
thousands of individuals.
Disclosure of Interest: None Declared

TP-WED-131 CARE HUMANIZATION OF CHILDREN WITH HEART DISEASE
O. A. Sousa Filho* 1 , L. A. Mota 2 , M. A. Frota 3 , V. G. Silveira 3 , C. F. Casimiro 4 , V. M. Vasconcelos 3
1 Nursing, Conselho Federal de Enfermagem, Brasília, Brazil, 2 Public Health Master, Fortaleza University, ,
3 Public Health Master, 4 Nursing, Fortaleza University, Fortaleza, Brazil
Background: Congenital anomalies are the second leading cause of mortality in children under 01 year in
Brazil, with a prevalence of heart disease between 08 and 10 children per 1000 live births.
Objectives: Aimed to understand how the mother experiences caring for a child with heart disease,
identifying their knowledge about the disease and ways of coping used.
Underlying values and principles: These disorders bring physical and emotional consequences for the
whole family, is essential to consider the action of the mother and the universe of social support networks
involved in caring for children with heart diseases.
Knowledge base/ Evidence base: Humanization; Health Promotion; Children with heart disease
Context of intervention/project/work: The education is a mediator of the stages of prevention, promotion
and restoration of health, in a process of constructing humanized able to promote the empowerment of the
individual, facilitating the experience of illness.
Methods: We adopted a qualitative methodology, descriptive and exploratory. Occurred at the Hospital of
Messejana Studart Carlos Alberto Gomes, from May to July 2009 with 20 mothers of children with heart
diseases, from zero to eight years, admitted for treatment, through observation, and structured interviews.
Carried out content analysis.
Results and Conclusions: The categories emerged: I was numb, my daughter has a heart condition!; Take
her, like taking care of a sentence so as not to fall, is hard to see your child in the operating room, my God
confirms that everything will be OK, We are afraid to sleep and not wake up. There was misinformation or
lack of understanding regarding the illness of the child, dedication to caring, protective instinct and strong
emotional and affective. Surgery was considered worrisome and faith proved to be emotional support,
encouraging prolonged stay in hospitals. The expression of what is being mothers of children with heart
disease indicates ambiguity, for the joy of motherhood is opposed by the difficulty, anguish, sadness that the
illness brings.
Disclosure of Interest: None Declared

TP-WED-132 AMÉLIORER LA QUALITÉ DES SOINS HOSPITALIERS POUR ATTEINDRE PLUS
RAPIDEMENT LES OMD
R. CHKOUNDALI* 1 , S. CHAOUACHI 2 , I. MEDDAH 3
1 Economie, Faculté des Sciences Economiques et de Gestion de Nabeul Tunisie, Nabeul, 2 , Institut
Supérieur de Gestion de Tunis, Tunis, 3 Economie, IESCAE, Bizerte, Tunisia
Historique / Origines: Parmi les huit objectifs du millénaire de développement, trois ont été consacré à la
santé. Il „agit de réduire la mortalité infantile, d‟améliorer la santé maternelle et de combattre le VIH/Sida.
Pour ces trois problèmes, la Tunisie a réalisé des progrès considérables grâce à une politique de
développement basée sur le planning familial, l‟éducation et la promotion de la femme. Cette politique a eu
pour conséquence le recul significatif de la mortalité infantile et maternelle comparativement aux pays à
revenus intermédiaires.
Objectifs: Dans ce travail de recherche, nous proposons une mesure de la qualité des soins publics côté
patient afin de cerner les goulots d‟étranglement qui empêchent l‟amélioration des indicateurs de santé en
Tunisie.
Valeurs et principes sous-jacents: La mesure de la qualité des soins publics peut être vue sous deux
angles : du côté offre et du côté demande. Du côté offre, c‟est l‟efficience économique, mesurée par les
coûts totaux de l‟hôpital. Il est souvent admis que la hausse des coûts par patient conduit à une bonne
qualité de soins. Du côté demande, c‟est le point de vue du patient qui compte, ce dernier évalue la qualité
des services de soins en fonction de ce qu‟il reçoit comme soins ou services médicaux.
Fondement de connaissance/Fondement de preuve: Qualité optique demande
Contexte d'intervention/projet/travail: Le contexte tunisien
Méthodes: Notre démarche consiste à élaborer une enquête auprès des patients de deux hôpitaux
importants en Tunisie. Les questions posées à ces patients concernent le degré de satisfaction des services
rendus par l‟hôpital ; Nous nous sommes intéressés principalement aux :
- services administratifs : le taux d‟attente ;
- services médicaux : efficacité des soins (chirurgie ou médicaments) et taux de réadmission ;
- services propreté : confort de la chambre ;
- services restauration : qualité des repas et
- services rendus par les infirmiers.
Résultats et Conclusions: Les résultants de cette étude permettraient de distinguer les services de soins
de santé publique qui convergent le plus avec les objectifs du Millénaire de Développement ; ces services
présentent un niveau de qualité élevé.
Références: - ARROW, J .K [1963] : “Uncertainty and the Welfare economics of medical care” American
Economic Review N°53
- Ashton et al. [1997] : “The Association Between the Quality of Inpatient Care and Early Readmission: A
Meta-Analysis of the Evidence.” Medical Care, Vol. 35(10): 1044-4059.
- BANQUE MONDIALE [2005] : “Améliorer les résultats en matière de santé”.
- Donabedian, A. [1966] : “Evaluating the Quality of Medical Care”, The Milbank Memorial Fund Quarterly,
Vol.XLIV, Number 3, July 1966, Part 2: 166-203.
302:414.
- GROSSMAN, M [1972] : “The demand for health: a theoretical and empirical Investigation”. NBER
occasional paper N°119
- Kjersti Helene Hernæs [2005] : Measuring the Quality of Hospital Services UNIVERSITY OF OSLO
Working Paper 2005: 10
- Nations Unies [Mai 2004] : Rapport National sur les Objectifs du Millénaire pour le Développement :
TUNISIE
- OECD [2007] : Quality indicators project 2006 : Data collection update report.
DELSA/HEA/WD/HWP(2007)4
Conflit d'Interêt: Rien à déclarer

TP-WED-133 INTERVENTION PROJECT: IMPLEMENTATION OF THE CENTER FOR PUBLIC HEALTH
IN THE BASIC HEALTH UNIT, BRAZIL
C. A. F. Audi* 1 , R. B. Paiva e Silva 2 , C. N. A. Pereira 2 , D. Montanini 2 , A. C. Cortez 2 , B. G. Ferreira 2 , C. D. P.
P. Fonseca 2 , C. Fudo 2 , M. M. Mukai 2 , M. S. E. Beck 2 , M. G. Moyses 2 , N. M. Oh Choi 2 , N. B. Campos 2 , T. Y.
Teruya 2 , T. A. Baldasso 2
1 Department of Preventive and Social Medicine, State University of Campinas, Campinas, 2 Department of
Preventive and Social Medicine, State University of Campinas, Itapira, Brazil
Background: Brazil‟s Unique Health System is a free and universal health system for any person in the
country, offering every and any kind of health assistance to anyone and for free.
Objectives: Development of an Intervention Project by the medicine students.
Underlying values and principles: It‟s based on the major underlying principles of SUS, which are
Universality – health care for everyone, anywhere, Integrality – total health care for anyone and entirely free
– and Fairness – more attention to those who need the most. The Intervention Project must bring freedom
and the improvement of the population‟s life conditions, and its results must remain even after the project is
concluded.
Knowledge base/ Evidence base: That work inserted of the first year of medicine the student in the health
of system, beginning for the basic attention. Making possible your first contact with the profissionias of
health, community and territory.
Context of intervention/project/work: There‟s an overwhelming need of health professionals which are just
a few -and health care in the community, which is damaging UBS‟ organization and logistics due to this large
amount of work.
Methods: The medicine students created center for puplic health (NSC) in the UBS, composed of its health
professionals (doctors, nurses, health agents), with weekly meetings where they should discuss the needs of
the community and organize data and exchange information to determine what are the actions and
interventions. The first intervention was about Tuberculosis. The medicine students went to schools to talk
about this subject with the children. At the same time, the NSC detected the need of a social worker (SW) in
the UBS. The students applied a questionnaire in the UBS to evaluate the need of the SW and how much
the UBS professionals knew about the government programs.
Results and Conclusions: The questionnaire showed need of the SW in the UBS and that health
professional were not able to properly inform the population about the government‟s social programs. The
folders distributed improved social conditions of some people because the information of how to take part in
some government programs and benefits was passed on to the population. The project about tuberculosis in
schools had very positive results due to the fact that information about the disease was passed on by the
kids to their families and friends and the bond between the school and its students with the UBS has gotten
stronger and the school has become open to new health interventions of the UBS.
References: Campos, G.W.S, 2003. Saúde Coletiva e o método Paidéia. Pp. 21-35. In: Saúde Paidéia, São
Paulo: Editora Hucitec.
Disclosure of Interest: None declared

TP-WED-134 CO-LOCATED MEDICAL AND PSYCHOSOCIAL SERVICES IMPROVE PATIENT CARE
D. P. Sendzik* 1
1 PATH, HIV Service, The Brooklyn Hospital Center, Brooklyn NY, United States
Background: PATH, the HIV service of Brooklyn Hospital, provides medical care along with three
psychosocial service agencies at one site. Many PATH patients have severe needs--poverty, mental health,
substance use.
Objectives: To determine if colocating HIV medical and psychosocial services results in better clinic
attendance (keeping HIV medical appointments), medication adherence (taking medications consistently),
and medical outcomes (HIV virus level under control.
Underlying values and principles: The colocated approach reflects the principles that quality patient care
can be improved through:
One-stop shopping for multiple services, making care convenient for patients with complex needs.
A collaborative, interdisciplinary approach by medical and psychosocial service providers who share
information (with patient consent), coordinate care, and support patients‟ receiving services and adhering to
care plans.
Knowledge base/ Evidence base: Integrated delivery systems, which allow multiple health services to be
managed by the same organizing entity, may improve coordination and ease patient navigation. Issue Brief 3
of 6, Navigating Health Care, R.W. Johnson Foundation, October 2007
Colocation generally leads to greater access to care and more patient/family satisfaction because services
are provided in a setting familiar to patients….The physical proximity of services and providers in collocated
practices appears to provide the basis for…improved access for patients and greater opportunities for
providers to interact and perhaps improve their skills and service to patients. Colocating Health Services,
Issue Brief, Commonwealth Fund, July 2008
Context of intervention/project/work: The study took place in PATH‟s clinic in Brooklyn, New York. The
colocated agencies provide intensive case management, home visits, escort to clinic, nutrition support, and
counseling. Staff of the agencies work as one team. With the patient‟s consent, they share information to
plan, implement and monitor care. They focus on, i.a., patients keeping their HIV medical appointments,
taking medications properly, and controlling HIV viral load.
Methods: Reviewed 100 randomly selected patients in care for all of 2008. Half chose to receive only
medical services; half received services from all four colocated agencies.
Results and Conclusions: Show-rate for HIV primary care appointments:
-Patients using only medical service: 78%
-Patients using colocated services: 84%
Taking HIV ARV medications on schedule:
-Patients using only medical service: 90%
-Patients using colocated services: 93%
Undetectable HIV viral load:
-Patients using only medical services: 58%
-Patients using colocated services: 52%
It appears that colocated services improve patients‟ keeping medical appointments and taking medications.
Patients using colocated services did not have a higher rate of HIV viral suppression. This may occur
because multiple-service patients are often those with severe psychosocial problems, who may enter care
with greater resistance to HIV medications. This requires future study.
Disclosure of Interest: None declared.

TP-WED-135 PUBLIC AND PRIVATE HOSPITALS – NEW MANAGERIAL PRACTICES AND CROSS
FERTILIZATION OPTIMIZING RESULTS AND MITIGATING DIFFERENCES – A POSITIVE APPROACH
N. P. Mascarenhas* 1 , Y. L. V. Bujdoso 2 , A. Cohn 2
1 Research, CEDEC, 2 Research, Cedec, São Paulo, Brazil
Background: In Brazil, the strong State ideology was observed in the reform of the governmental structure,
presented in 1995 by the Brazilian Government. One of the main strategies was the creation of the Social
Organizations legal statute allowing non profit institutions to develop social functions delegated by the State.
Since 1998, the Health Secretary of the State of São Paulo (HS) has transferred administration of public
hospitals to Health Social Organizations (HSO) based on performance contracts which establish qualitative
and quantitative goals to be reached in hospital services production. At the same time, Brazilian Constitution
states universal access to public health, although allows a private supplementary health system, which
currently assists over 41 million beneficiaries (21,6% of the population) where quality and access
differentiation compared to the public system are marketed by private health plans to attract customers to a
market that grew beneficiaries at 4.5% CAG, compared to a 1.4% CAG population growth for the last 4 years
(2004-08). Although a deeper analysis of both systems‟ characteristics indicate strong similarities.
Objectives: Analyze benchmarking practices adopted by both systems which reduce differentiation although
tend to improve operation.
Underlying values and principles: Optimization of public resources, addressing health and social needs,
developing managerial practices to improve results.
Knowledge base/ Evidence base: Public management practices, Supplementary Health Agency (ANS),
Heath Secretary of the State of São Paulo
Context of intervention/project/work: Comparison of management practices between public and private
hospitals - understanding differences and similities - benefits of cross fertilization.
Methods: Qualitative study conducted by open-ended interviews with main actors of the Supplementary
Health Chamber of the National Supplementary Health Agency (ANS), where the majority of the health
market actors are represented.
Results and Conclusions: Additional product coverage and financial guarantee requirements demanded by
the supplementary health regulation have successively increased since 1998, affected private health plan
companies' financial results, conducting them to seek for cost optimization opportunities like the adoption of
health prevention and promotion practices as chronic disease management and at the same time controlling
service access via a hierarchyzed organization as established for the public system. On the other hand
budget limitations on the public system and new public management practices have stimulated adoption of
performance indicators and cost controls utilized by the private sector as well as the offering by several
public and university hospitals of differentiated paid services, comparable to private health system products.
Practices cross-fertilization between public and private systems reduce their differentiation, challenging the
logic of their coexistence, the price justification of the private health plans and the government‟s capability to
maintain universality and equity which are basic principles of the public system.
Disclosure of Interest: None declared

TP-WED-136 PHYSICIANS‟ VIEWS ON SAFETY CULTURE AT GENERAL HOSPITALS IN
ALEXANDRIA
R. A. Mosallam* 1 , W. W. Guirguis 1 , M. R. Ahmed 2
1 Health Administration and behavioral sciences, 2 Biostatistics, High Institute of Public Health, Alexandria
University, Egypt, Alexandria, Egypt
Background: A safety culture is essential to minimize errors and adverse events. Its measurement is
needed to design activities in order to improve it.
Objectives: This paper aims at measuring safety culture dimensions at three general hospitals in
Alexandria.
Underlying values and principles: Instituting a safe culture in health care facilities is essential to prevent
patient harm.
Knowledge base/ Evidence base: The Questionnaire of assessing Safety Culture developed by the
Agency of Health Care Research and Quality is a validated tool for measuring safety cultute in hospital
settings
Context of intervention/project/work: The study was performed at three general hospitals at Alexandria
selected by simple random sampling technique to represent Health Insurance Organizations, Ministry of
Health and Population and University Hospitals.
Methods: Cross sectional surveys using Hospital Survey on Patient Safety Culture (HSOPSC). The survey
was applied to all physicians in three general hospitals after being translated to Arabic and pilot tested to
ensure understandability. The survey achieved a 65.4% response rate (317 out of 484). Composite
frequencies of positive responses were calculated (strongly agree and agree on positively worded items,
strongly disagree and disagree on reverse worded items) across 13 dimensions of patient safety culture and
the resulting number is the percentage of positive responses for that particular dimension.
Results and Conclusions: Results: The overall composite frequencies were found to be low to average in
all study hospitals. The highest percentage of positive responses were generated by the dimensions
"Supervisor/manager expectations & actions promoting safety" (70.9%), "Teamwork within hospital units"
(68.4%), and "Teamwork within hospital units" (67.5%). The lowest percentages were attributed to the
dimensions "No punitive response to error" (23.5%) and "staffing" (28.7%). Although percentages of positive
responses for most of the dimensions did not differ significantly by hospital, important variations between the
three hospitals were observed. MOHP hospital generated the highest percentages for the dimensions
"Hospital management support for patient safety" (71.9% for MOHP hospital versus 37.2% for University
hospital and 47.7% for HIO hospital) and "Organizational learning-Continuous improvement" (67.6% for
MOHP hospital versus 42.5% for University hospital and 49.1% for HIO hospital). On the other hand,
University hospital generated the highest percentages for the dimension "staffing" (42.9% for University
hospital versus 21.2% for MOHP hospital and 22.2 % for HIO hospital)
Conclusions: Safety culture dimensions are not well implemented in study hospitals. HSOPSC may be
helpful in fostering comparisons across hospitals, and identifying targets for interventions to improve patient
safety.
Disclosure of Interest: None declared

TP-WED-137 ESCUELAS HOSPITALARES – UN AMBIENTE FAVORABLE A LA PROMOCIÓN DE LA
SALUD PARA LOS NINÕS
E. V. Zombini* 1 , M. C. Focesi Pelicioni 1
1 Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, Brazil
Antecedentes: Escuelas hospitalares se llama el servicio-aprendizaje que produce en un entorno educativo
para el tratamiento de la salud y contribuye al proceso de desarrollo, aprendizaje y interacción social.
Objetivos: Analizar la contribución de un trabajo educativo-pedagógico en el aula del hospital para
promover la salud de los niños y sus familias.
Valores y principios subyacentes: Promoción de la salud se define como el proceso de empoderamiento
de la comunidad a actuar para mejorar su calidad de vida y la salud, incluida una mayor participación en el
control de este proceso. Las estrategias de promoción de la salud incluyen acción coordinada entre los
distintos sectores y segmentos de la sociedad para alcanzar condiciones propicias para salud.
Base de conocimiento / base de evidencia: El Ministerio de Salud del Brasil en 2001 creó el Consejo
Nacional de Atención Humanitaria del Hospital - PNH para promover nueva cultura de cuidado de la salud.
Esta forma de atención destaca la calidad técnica de la atención asociada con el reconocimiento de la
singularidad y la integridad de la persona. Entre las directrices de PNH es fomentar la práctica de la
Promoción de la Salud. La Sociedad Brasileña de Pediatría ha elaborado algunas recomendaciones para el
cuidado humano del hospital para niños y adolescentes que tratan de minimizar los efectos negativos de la
hospitalización. Entre ellos se encuentra el estímulo a la participación en actividades educativas durante
hospitalización. Estas actividades educativas pueden reducir ansiedad, miedo y desconfianza inherente en
el hospital, y dar a niños la oportunidad de actualizar sus necesidades de aprendizaje y vigilar lo que está
sucediendo en su escuela.
Contexto de la intervención / proyecto / trabajo: La creación de ambientes favorables para la promoción
de la salud es también una de las recomendaciones de la Carta de Ottawa elaborada a partir de la I
Conferencia Internacional sobre la Salud. Teniendo en cuenta los intereses de los niños hospitalizados,
hospitales deben buscar estrategias para mantener un espacio para el desarrollo de estas actividades.
Métodos: La simple observación del funcionamiento del hospital clase investigador, la formación continua
de los educadores a trabajar con temas de la educación y la promoción de la salud a través de juegos y
actividades lúdicas con los niños, el uso de multimedia en la enseñanza de recursos para el grupo de edad
de niños hospitalizados, la aplicación de cuestionarios a los maestros y los padres de niños hospitalizados.
Resultados y Conclusiones: El estudio demostro la importancia del trabajo como una contribución a la
construcción del conocimiento en el ámbito de la salud la educación para la promoción de la salud incluso
en breves períodos de hospitalización del hospital por una experiencia positiva en la vida de estos niños, la
mejora de su autoestima y sus posibilidades de relaciones humanas.
Declaración de intereses: no declarado

TP-WED-138 RE-ORIENTING HEALTH SYSTEMS TO A HEALTH PROMOTION APPROACH -
EXPERIENCE FROM PAKISTAN
M. Humble 1
1 Canadian Project Manager, Systems-Oriented Health Investment Program, Agriteam Canada Consulting
Ltd., Gatineau, Canada
General description: This symposium will bring together experiences of from Punjab Province in Pakistan
with re-orienting health services towards a health promotion approach. Papers will include perspectives on
working at a district and sub-district level, working in rural and remote communities through communitybased
health workers, and working at a provincial and policy level to ensure long-term sustainability of HP
initiatives and approaches. The examples all arise from the implementation of the Systems-Oriented Health
Investment Program, a four-year project of the Government of Punjab funded by the Canadian International
Development Agency (CIDA), with support and technical assistance from Agriteam Canada Consulting Ltd.
The project began in September 2006 and will be concluding in September 2010.
Objective(s): The objectives of the symposium are to present and discuss concrete examples of
mainstreaming health promotion at different levels within a developing country and South Asian context. The
discussion will include challenges inherent in integrating gender and poverty equity issues, expanding
beyond a highly medicalized model of primary health care, and promoting inter-organizational and multisectoral
approaches in partnership with government bureaucracies.

TP-WED-140 PROMOTING FOOD SECURITY THROUGH STUDENT NUTRITION PROGRAMS:
COLLABORATION WITH SCHOOLS AND PUBLIC HEALTH
R. Valaitis* 1 , R. Hanning 1 , I. Herrmann 2
1 Health Studies and Gerontology, University of Waterloo, Waterloo, 2 Chronic Disease and Inury Prevention,
Peel Public Health, Brampton, Canada
Background: The 2004 Canadian Community Health Survey found that 9.2% of households were
moderately or severely food insecure (1). Breakfast skipping is a concern for children and adolescents and
has been implicated in the high prevalence of poor nutrient intakes and overweight (2). Therefore, student
nutrition programs (SNPs) have been created to address these issues. In Canada, SNPs were created about
10 years ago. A large urban region offering over 100 breakfast programs sought academic partnership to
evaluate their programs.
Objectives: The purpose of this study was to evaluate SNPs in one region in Canada and determine how
public health (PH) staff can better support these programs.
Underlying values and principles: Universal access to SNPs can ensure that children at risk for poor
nutrient intake have access to safe, healthy foods, thereby promoting growth and development and
enhancing academic performance. However, programs are rarely standardized and differ greatly in how they
are implemented.
Knowledge base/ Evidence base: Access to nutritious food can have positive social, behavioural and
academic benefits. Students that attend SNP programs have shown improvements in psychological and
memory tests, and improvements in behaviour (3). Students consuming a regular nutritious breakfast have
better eating habits in general.
Context of intervention/project/work: Program coordinators of SNPs in a large, ethnically diverse urban
region in Ontario, Canada were surveyed and interviewed.
Methods: This mixed method evaluation included a quantitative survey (n=62; 76% RR) and qualitative
interviews with 22 program coordinators. The survey elicited a description of programs being offered.
Interviews with coordinators explored program strengths, weaknesses, opportunities, and threats. Current
and potential future partnerships between SNPs and health unit staff were also evaluated. All school levels
were well represented with community-based programs being under-represented.
Results and Conclusions: Survey results showed that teachers and volunteer program coordinators were
the most involved in planning and delivering programs. Also, more programs had public health inspectors
involved compared to public health nurses or dietitians. Public health involvement including health nurse
support, menu planning and nutrition support and food safety training, was positively received by those
respondents who had previously accessed the services (75, 60, and 53% respectively). Interview results
corroborated survey results and helped explain inconsistencies. SNPs varied in what and how they were
offered and their needs. Strengths included universality, the ability to reach needy students, and the social
aspect of the program. Weaknesses included attracting funding partnerships, lack of volunteers, scheduling
issues, and coordinator workload. Threats to delivering effective SNPs included: lack of sustainable funding,
complexity in tracking program use and food distribution, unreliable help from school staff, and conflicts with
school administration. Finally, opportunities for enhanced public health participation included assistance with
menu planning (finding healthy, affordable food options), expansion of program offerings, and assistance
with finding solid community partners. The research has identified a number of strategies for improving
support for SNPs. Public health staff can support menu planning and food safety training, help coordinators
find healthy food options, and build partnerships to increase collaborations.
References: 1. CCHS (2004). Canadian Community Health Survey - Nutrition (Rep. No. 0-662-43554-0).
Ottawa: Health Canada. Retrieved May 26th, 2009 from http://www.hc-sc.gc.ca/fnan/surveill/nutrition/commun/cchs_guide_escc-eng.php
2. Dubois, L., Girard, M., Potvin-Kent, M., Farmer, A., & Tatone-Tokuda, F. (2008). Breakfast skipping is
associated with differences in meal patterns, macronutrient intakes, and overweight among pre-school
children. Public Health Nutrition, 12(1), 19-28.
3. Florence, M., Asbridge, M., & Veugelers, P. (2008). Diet quality and academic performance. Journal of
School Health, 78(4), 209-215.
Disclosure of Interest: None declared

TP-WED-141 CHANGE IN COMMUNITY READINESS TO PREVENT OBESITY IN THE IT'S YOUR
MOVE PROJECT
M. de Courten* 1 , A. Simmons 2 , N. Robertson 2 , B. Swinburn 2
1 School of Global Health, University of Copenhagen, Copenhagen, Denmark, 2 Public Health Research,
Deakin University, Geelong, Australia
Background: Comprehensive community-based obesity prevention programs are heralded as having the
most potential to combat the public health threat from obesity. Assessing a community‟s readiness can assist
in evaluating the potential a community has to implement and sustain a comprehensive program required for
obesity prevention.
Objectives: To ascertain the readiness of school settings in an adolescent obesity prevention project to
undertake the promotion of healthy eating and physical activity environments and behaviours, and to
measure change after the 3 year implementation program.
Underlying values and principles: Assessing a community‟s readiness can assist in evaluating the
potential a community has to implement and sustain a comprehensive program required for prevention.
Schools can be regarded as a special set of communities for this purpose.
Knowledge base/ Evidence base: In theory, this assessment provides essential qualitative data to help
guide the community and or program toward development of effective prevention strategies and offers a way
to measure readiness before and after interventions. Based on information from baseline, interventions that
are appropriate to the community‟s level of readiness can be developed and implemented with a higher
potential of success and in a more cost effective manner than those ignorant of the level.
Context of intervention/project/work: We implemented the Community Readiness to Change Model in the
It‟s Your Move! adolescent obesity prevention project, in Victoria, Australia in five intervention and seven
control schools at baseline and 3 years later at the end of the project.
Methods: The Community Readiness Model was developed at the Tri-Ethnic Center for Prevention
Research at Colorado State University, USA and adapted with permission for our project.
Key stakeholders participated in one-on-one interviews answering 39 guided questions. A total of 112
interviews were conducted (4.6 per school per time period), audio taped and then transcribed. Scores were
determined from the transcription rather than audio tape. Six dimensions of readiness were scored:
community knowledge about the issue, existing community efforts, community knowledge of the efforts,
leadership, community attitudes and resources.
Results and Conclusions: The Community Readiness to change instrument was time consuming to
implement amongst the key informants as enthusiastic project coordinators, some key stakeholders
(partnership staff), principals and teachers contributed well over 60 minutes to complete whereas students
and parents felt more intimidated by the process reflected by shorter interviews.
On an ordinal scale from 1 – 9 ranging from „no awareness‟ to „high level of community ownership‟ at
baseline the intervention schools scored an average of 2 (denial/resistance) and control schools 3 (vague
awareness) which at the end of the intervention changed to 5 (preparation) in the intervention schools and
remained at 3 in the controls.
At the completion of our project, the Community Readiness assessment assisted in explaining changes in
the outcome variables of the project (reduced obesity rates in adolescents) and contributed to
recommendations for ensuring sustainability.
Due to the delay in obtaining results, the assessment did not arrive in time to allow the schools to determine
which dimension(s) they should address as priorities and begin the development of appropriate strategies
appropriate for moving them to the next level of readiness.
Disclosure of Interest: None declared

TP-WED-142 DO SCHOOL BASED LIFESTYLE INTERVENTIONS WORK IN INDIA ? EVIDENCE FROM
A RANDOMIZED TRIAL IN CHANDIGARH
T. PRABHUSHANKAR* 1 , J. S. THAKUR 1
1 COMMUNITY MEDICINE, POST GRADUATE INSTITUTE OF MEDICAL EDUCATION AND RESEARCH,
CHANDIGARH, India
Background: Non communicable diseases have their origins in childhood and childhood obesity has been
increasing in epidemic proportions. School based lifestyle intervention programs have had mixed results in
various parts of the world. But overall, there is an obvious dearth of methodological research regarding the
effects of a comprehensive lifestyle modification programs in India.
Objectives: To assess the effect of a short term 12 weeks school based lifestyle intervention program on
health behavior, anthropometric and biochemical measurements of school going adolescents.
Underlying values and principles: Childhood obesity is silently emerging as an epidemic and India is no
exception to this. About 75% of Indian urban adolescents have a sedentary lifestyle and bodyweight among
school going children has increased progressively over the last decade.School settings have long been
recommended as an excellent health promoting environment where promoting healthy eating can be an
integral and acceptable component of school curriculum.
Knowledge base/ Evidence base: Framework for health promoting schools by WHO India and Central
Board of Secondary Education in India, Review of various school based interventions like CATCH, PLANET
HEALTH, BE SMART etc
Context of intervention/project/work: The study was conducted in Chandigarh, a Union territory in north
India.
Methods: Design
Group randomized control trial
Setting
Eight schools in Chandigarh
Participants
384 children aged 13 to 15 years
Intervention
Situational analysis of schools at baseline was done. A stakeholder workshop where the tools and proforma
to be used were discussed and finalized. The intervention comprised of fortnightly Sessions on life skills
education for students, sensitization of parents, lifestyle diary to record children‟s diet and physical activity,
one physical activity period in school daily and introduction of healthier options in school canteen menu
Outcome measures
Health behavior, weight, BMI, biochemical parameters including fasting blood sugar and lipid profile
Results and Conclusions: The proportion of children who did some kind of regular physical activity
increased by 20% in the intervention group (p

TP-WED-144 SCIP SCHOOL - PROMOTING HEALTHY EATING HABITS, PHYSICAL ACTIVITY AND
SELF ESTEEM AMONG CHILDREN AGED 6-16.
A. Jälminger* 1 , L. Schäfer Elinder 1 , F. von Haartman 1
1 Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
Background: The alarming rise of childhood obesity prevalence calls for effective preventive and health
promoting methods. The SCIP-School was developed as a capacity building school intervention to facilitate
the uptake and long term use of health promoting practices and routines.
Objectives: The SCIP-School aims to improve healthy eating, physical activity and self esteem and to build
local school and community capacity on the issues. The objectives are; (1) local ownership among schoolstaff,
(2) health promoting physical and social school environment, (3) increased knowledge among teachers
and students on healthy eating, physical activity and measures to increase self-esteem and (4) local
evaluation systems put in place to promote sustainability and long term follow up.
Underlying values and principles: The intervention builds on the Social-Ecological model of health where
health behaviour and lifestyle are affected by knowledge and motivation, as well as external factors such as
the social and physical environment, national and international policy and regulations. To change the health
behaviour of an individual, the whole of society must support these changes. The intervention was based on
the PRECEDE-PROCEED framework and on the community capacity concept, designed to facilitate
knowledge translation on health promoting school activities.
Knowledge base/ Evidence base: Risk factors for developing overweight include sedentary behaviour,
irregular meals and a high intake of energy dense foods and sweetened drinks as well as socioeconomic
status. Low self-esteem, body dissatisfaction, weight related teasing and past eating disorders may also
increase the risk of developing overweight as well as underweight. By promoting healthy and regular eating
habits and adequate physical activity in combination with raising children's self-esteem and reduce
dissatisfaction with their own bodies it should be possible to promote a normal weight development and
prevent weight disturbances. Long term interventions have reported stronger preventive effects and more
sustainable effects are achieved if the implementation is carried out by existing staff, remaining within
existing economic frameworks and integrated into daily activities.
Context of intervention/project/work: The project was initiated by local officials and developed by the
research team in close contact with the officials and schools. No financial support was given too schools
during the project. Nine schools with students aged 6-16 years in a local community north of Stockholm
decided to participate, leaving the remaining 8 schools of the community as comparison schools.
Methods: A School Health team was formed at each school with 6-8 staff, including school health services,
teachers and school meal staff. School health promoting activities were assessed at a first workshop with a
self-assessment tool. A local “health action plan”, based on local needs and priorities, was set up by each
school to improve the health promoting activities. Support was offered as workshops, seminars, mail and
telephone contacts with the research team.
Results and Conclusions: A quasi-experimental evaluation plan has been set up to study the
implementation process and effects of SCIP-School in order to generate knowledge on the factors promoting
sustainable health promoting school environments. The implementation process will be monitored by staff
questionnaires, document analyses and interviews. The effects are measured by school environment
indicators and child health questionnaires at baseline and follow up. Useful indicators for assessing and
developing school health promoting routines at local community and national level will be investigated.
Disclosure of Interest: None declared.

TP-WED-145 REGIONAL FOODS AS A SOURCE OF SUPPLEMENTARY FEEDING: HEALTH
PROMOTION STRATEGY
O. A. Sousa Filho* 1 , M. C. Martins 2 , L. B. Ximenes 2 , M. A. Frota 3 , A. T. Sousa 4 , V. M. Vasconcelos 3
1 Nursing, Faculdade Integrada da Grande Fortaleza, 2 Nursing, Ceará Federal University, 3 Public Health
Master, 4 Nursing Graduation, Fortaleza University, Fortaleza, Brazil
Background: The child feeding from birth until the early years has repercussions throughout individual life,
and the breastfeeding essential for the proper growth and development of unique way to the six months,
when it should be complemented since period because of the child nutritional needs. Thus, the rural area
communities have foods with lower cost and easy access, and important basis for preparing the food
supplement.
Objectives: To understand the maternal perception about the child health, and eating habits in the period of
complementary feeding and use of food.
Underlying values and principles: The study shows that Children Promote Health in Supplementary
Feeding through the Regional Food Use, which has the basic features the high nutritional value, the easy
access and low cost, is a subject that should be disseminated, especially in the group of families suffering
with the social inequality in terms of social injustice.
Knowledge base/ Evidence base: Culture; Health Promotion; Child Care
Context of intervention/project/work: To promote the children health through Health Education has been
described as new knowledge, very important, know the why and how. Characterize social and economic
aspects of families who have children under six months, however, it was essential to understand the
coexistence of traditional values that influence so direct in the power of decision regarding the children
health and their food.
Methods: The methodological approach was qualitative, as use of quantitative tools to describe social and
economic data in the study developed during the months from February to August 2007. The universe of
search was of 150 families of children in the age group of 0 to 2 years, who resided in the District of
Sapupara - Maranguape - Ceará - Brazil. To data collect was used the semi-structured questionnaire and
focus group, and there are selected 13 mothers to integrate this group. The themes used to guide the groups
were: Children's Health, Nutrition and Food Supplementary Regional.
Results and Conclusions: The results were analyzed and reflected upon the principles that guide the
techniques of analysis issues, the meanings of mothers reports, emerging the following categories: Hygiene
habits; Food habits; Health Unit Support, Milk is essential; Food based on soup; Fruit characterizing the food
regionally. With support in the analysis, there was evidence that most of the families living in that district
survive with less income than a minimum wage. We understand that the perception on the children health
confined to the practice proper hygiene and healthy eating habits, but also to the search for the Health Unity
for healing of the child; in feed supplement, the predominant meal milk and soups, and two practices not
recommended by the Ministry of Health. Proving the regional food, the mothers did not know this issue,
leaving surprises during the explanation of revenue. The transcendence of that discussion shows that the
perception about the health of the maternal child presents jeopardize.
Disclosure of Interest: None declared

TP-WED-146 PRIMARY SCHOOL POLICIES FOR ADDRESSING NUTRITION AND PHYSICAL
ACTIVITY FOR OVERWEIGHT PREVENTION: AN INVENTORY
P. L. Kocken* 1 , J. Snel 2 , E. Dijkstra 3 , R. Bisseling 4 , L. Peters 1
1 Prevention and Health Care, TNO Quality of Life, Leiden, 2 Youth and education, Netherlands Nutrition
Centre, The Hague, 3 Youth department, NIGZ, Woerden, 4 Knowledge department, Netherlands Institute for
Sport and Physical Activity, Bennekom, Netherlands
Background: School health promotion programs preferably include or link to school health policy. Many
initiatives for overweight prevention through schools exist. International evidence suggests that
multicomponent programs (nutrition, physical activity, lessons, parent participation, school policy) have the
best chances for effectiveness. In the absence of such effective programs in the Netherlands, four national
institutes are collaborating to develop and evaluate such a program for primary schools (Extra Lekker Fit,
ELF).
Objectives: 1) To identify possibilities for addressing nutrition and physical activity in schools, using the
comprehensive, eight-component School Health Promotion Model of school policy. 2) To compare the ELF
program components with these possibilities. 3) To examine baseline nutrition and physical activity policies
and activities among schools participating in the ELF evaluation study.
Underlying values and principles: Systematic development, intervention mapping, collaboration, wholeschool
approach.
Knowledge base/ Evidence base: Reviews indicate that multi-component programs have the best chances
for preventing overweight through schools.
Context of intervention/project/work: Primary schools.
Methods: The multicomponent program was systematically developed using the intervention mapping
protocol. Methods like study of literature and consultation of school teachers and education specialists were
used. The options to address physical activity and nutrition for preventing overweight with the ELF program
were analysed using the School Health Promotion Model. These options formed the base for a questionnaire
for school principals to examine, as a baseline measurement, the existing policies and activities with respect
to nutrition and physical activity among the 40 schools that participate in the ELF evaluation study.
Results and Conclusions: The results indicate that, in theory, schools have many possibilities for
influencing nutrition and physical activity. The ELF program addresses many of these possibilities, but there
is room for improvement. First analysis of data from the baseline measurement of school policies indicate
that current implementation of policies is limited in many schools.
Insight into the current needs and practices of schools with respect to addressing nutrition and physical
activity and implementation of policies and activities is important for future implementation of the ELF
program.
Disclosure of Interest: None declared.

TP-WED-147 SCHOOL HEALTH APPRAISAL OF FEEDING PRACTICES OF PRE-SCHOOL CHILDREN
IN IBADAN NORTH LOCAL GOVERNMENT AREA (LGA) IN IBADAN, NIGERIA
O. E. Oyewole* 1
1 Health Promotion and Education, Lecturing, Ibadan, Nigeria
Background: The present economic situation in many developing countries has pushed many women to
engage in income generating activities outside the homes. This trend has resulted into the enrolment of 2
weeks old babies and children under-5 years into nursery and playgroup schools by working class nursing
mothers.
Objectives: This study investigated the feeding practices adopted by the nanny teachers of these
babies/children in the pre-school.
Underlying values and principles: A descriptive study of 32 schools with 157 pupils (61 babies and 96
under-5 children) was conducted in Ibadan North LGA, Ibadan, Nigeria
Knowledge base/ Evidence base: Not applicable
Context of intervention/project/work: Not applicable
Methods: Data were collected using interview with questionnaire, anthropometric measurement and
observation using a checklist. In most cases, the babies/children remained in these schools for between 6-8
hrs daily. The feeding entirely depended on the school nannies/class teachers.
Results and Conclusions: Only 40.2% of the babies under 6 months old had breast-milk expressed for
them in a warmer by their mothers while the others had infant formula prepared for them. The babies were
fed at specific times, unless when they cried. All the children one year and above had various foods packed
for them by their mothers and none had any fresh fruits packed with the foods. However, 56.5% of mothers
added artificial fruit juices with the packed foods. Under-5 children were fed at specific times regarded as
“break time” in all the schools. Sometimes, some mothers requested that the school should prepare the food
for their children and a fee would be charged. The most common food prepared was pasta (Indomie) in
many instances. Only 5.6% of 49 nannies assessed claimed that they had ever received formal training on
infant feeding. Among the under-5s, level of moderate stunting (-2SD) was 22.0%; wasting at -2SD was
6.5% while underweight was 18.5%. The level of environmental sanitation was better in the early hours of
mornings but was poor towards the afternoon. The refuse management was below average in 12 of the
schools assessed, as litters were observed because the refuse bins were either leaking or broken without
lids. All the schools had toilet facilities but only 67.0% of them can be considered good enough for use. Only
10 schools had source of water, which was from the well. Training of nannies on infant feeding becomes
very necessary as they can be a source of nutrition and health education to the mothers. Provision of basic
sanitary environment should be one of the basic requirements for granting a license to establish a preschool.
Government may set up a task force to ensure compliance with guidelines set for the operation of
pre-schools.
References: None
Disclosure of Interest: None declared

TP-WED-148 IMPROVING THE SCHOOL NUTRITION ENVIRONMENT IN U.S, SCHOOLS
C. J. Fisher* 1
1 Division of Adolescent and School Health, U.S. Centers for Disease Control and Prevention, Atlanta, United
States
Background: The prevalence of obesity among children in the U.S. aged 6 to 11 more than doubled in the
past 20 years, and the rate among adolescents aged 12 to 19 more than tripled. Schools offer nutritious
foods through the heavily regulated federal school lunch and breakfast programs; however, "competitive"
foods sold in vending machines, snack bars, and school stores are not seriously regulated. Schools typically
sell snack foods high in calories, fat, sodium, and sugar, as well as sugar sweetened beverages, in these
settings.
Objectives: 1.Describe recent developments in the competitive foods issue in U.S. schools.
2. Describe 3 uses of School Health Profiles, a system of surveys assessing school health policies and
programs.
3. Describe at least 3 strategies that have been employed to improve the school nutrition environment.
Underlying values and principles: Dietary behaviors of children are greatly influenced by the school
nutrition environment; promoting strong policies is a key health promotion strategy; children will make
healthy choices when the environments in which they live, study, and play support those choices.
Knowledge base/ Evidence base: In 2006: 89% of high schools and 71% of middle schools had either
vending machines or a school store, canteen or snack bar where students could purchase foods or
beverages. Junk food and sugar sweetened beverages bought at school account for, on average, among
students who consume them at school –177 calories / day; 31,860 calories / school year (9 lbs.).
Context of intervention/project/work: In the U.S. school policy is largely determined by states and local
communities with minimal federal regulation of competitive foods. There is a movement toward national
nutrition standards, supported by industry. In the meantime, states have passed nutrition policies, and
governmental agencies and NGOs have provided technical assistance to help schools improve nutritional
quality.
Methods: To estimate changes in the percentage of schools in which students could not purchase less
nutritious foods and beverages, CDC analyzed 2002–2008 survey data from its School Health Profiles for
public secondary schools.
Results and Conclusions: Substantial progress has been made across the United States in increasing the
percentage of secondary schools in which students could not purchase less nutritious snack foods and
beverages. Among the 34 states that collected data in 2006 and 2008, the median percentage of secondary
schools that did not sell soda or fruit drinks that are not 100 percent juice increased from 38 percent in 2006
to 63 percent in 2008. The greatest improvements were seen in states that have adopted strong school
nutrition standards and policies for foods and beverages outside school meal programs; however there is still
a long way to go to improve the quality of competitive foods in schools. State policies and a strong
commitment to school health can make a difference.
Disclosure of Interest: None declared

TP-WED-149 MOTIVATING SCHOOLS TO IMPLEMENT INDIVIDUAL HEALTHY NUTRITION
ACTIVITIES: RESULTS OF THE GERMAN PROGRAM “BEO‟S” (ACTIVITY AND FOOD IN
FRANCONIAN SCHOOLS)
L. Bodner* 1 , C. Eichhorn 1 , J. Loss 1 , U. Ungerer-Röhrich 2 , E. Nagel 1
1 Institut für Medizinmanagement und Gesundheitswissenschaften, 2 Institut für Sportwissenschaft, Universität
Bayreuth, Bayreuth, Germany
Background: In Germany, the number of overweight children and adolescents is alarming. The health risks
of overweight and obesity are well recognized. Apart from physical activity, healthy eating habits and a
balanced diet help children and adolescents prevent weight gain. Schools are important settings for
promoting healthy nutrition. In order to help schools implement nutrition and physical activity into daily school
life, the program “BEO‟S” (“Activity and Food in Franconian Schools”) was initiated in 2007. “BEO'S” is not a
standardized top-down concept, but it is based on a resource-oriented, systemic approach focusing on
school development processes. School staff and students are supported and empowered in order to identify
their school‟s strengths and weaknesses, and to develop tailored activities.
Objectives: The study aimed at analyzing whether the participating “BEO‟S” schools were successful in
implementing structures and activities to promote healthy eating.
Underlying values and principles: The project bases on empowerment and participation and the concept
of supporting environments for health.
Knowledge base/ Evidence base: Studies and literature concerning the effectiveness of participation,
empowerment and health promoting schools document the approach of this project.
Context of intervention/project/work: The interventions took place in the setting of primary and secondary
schools.
Methods: In order to identify changes in school structures, food supplies and activities between 11/2007 and
12/2008, data from the 14 participating schools were collected by (1) standardized questionnaires pre-post,
(2) comparison of food supply lists. Between 6/2008 and 6/2009, changes of 3 schools were documented by
photo documentation by the students pre-post.
Results and Conclusions: As each school could decide individually on the steps to be taken, the achieved
changes differed between schools. After one year, the food sale at morning breaks contained more fruit and
vegetables in 4/6 schools. School lunches were offered in 8 schools; among these, 37,5% (n=3) improved
the food quality, e.g. by abandoning the use of additives, e.g. flavor enhancers, or raising the proportion of
vegetables in meals. 7/14 schools established school water fountains. The awareness of integrated drinking
breaks into school lessons rose. 6/14 schools initiated one-off or regular activities on nutrition, e.g. the
preparation of healthy breakfast buffets with parents or the creation of health education materials on healthy
food. 8/14 schools started a co-operation with local restaurant industry and/or food retailers, e.g. cookery
courses for students.
The approach of BEO‟S, which consisted of empowering school staff and pupils to evaluate their resources
and to develop their own activities on healthy eating, was successful. The extent of the achieved changes
differed between schools, which might be due to missing funds and different engagement of principals and
teachers.
Disclosure of Interest: None declared

TP-WED-150 PROMOTION OF PURCHASE OF LOW CALORIE FOODS FROM SCHOOL VENDING
MACHINES
P. L. Kocken* 1 , J. Eeuwijk 1 , N. M. C. van Kesteren 1 , E. Dusseldorp 1 , G. Buijs 2 , Z. Dafesh 2 , J. Snel 3
1 Prevention and Health Care, TNO Quality of Life, Leiden, 2 Youth, NIGZ, Woerden, 3 Prevention and Health
Care, Netherlands Nutrition Centre, The Hague, Netherlands
Background: School-based interventions are a promising approach to the prevention of overweight and
obesity in children. Although more attention is drawn to school-based interventions focusing on changing the
availability and accessibility of foods in vending machines, few studies are known that have investigated a
combination of strategies to promote healthy nutritional vending machine choices.
Objectives: To investigate the effects of the strategies availability of lower calorie foods, labelling and price
reduction to promote the sale of lower calorie food products in vending machines in secondary schools.
Underlying values and principles: The intervention was directed at factors outside the individual which
could influence nutritional behaviour. It was hypothesized that total sales volumes would not increase,
because students would substitute high calorie products for lower calorie products.
Knowledge base/ Evidence base: Studies show that providing greater availability of healthy foods can
influence sales and consumption of healthy foods in a positive direction. Strategies such as labelling,
providing customers with information, reminders and reinforcements to guide them towards healthier
choices, positively influence purchasing behaviour.
Context of intervention/project/work: The practice of the food environment of secondary schools.
Methods: A school-based randomised controlled trial was conducted in 13 experimental and 15 control
schools in the Netherlands. Three strategies were tested within each experimental school: increased
availability of lower calorie products in vending machines, labeling of products, and price reductions for lower
calorie products. The experimental schools introduced consecutively the strategies in three phases. Phase 3
included all three strategies. The control schools did not change. The sales volumes of the vending
machines were registered. Products were grouped into 1. extra foods containing empty calories, e.g.
candies, sweets and crisps, 2. nutrient rich basic foods and 3. beverages, and were divided into favourable,
moderately unfavourable and unfavourable products.
Results and Conclusions: Total sales volumes for experimental and control schools showed no significant
differences for the extra and beverage products. A higher availability of lower calorie extra products resulted
in a higher proportion moderately unfavourable extra products purchased and a lower proportion of
unfavourable extra products. Availability, labelling and price reduction resulted in a higher proportion of
favourable beverages purchased and a lower proportion of unfavourable beverages. Basic products were
only sold in small amounts. The results of this study indicate that students make healthier choices when
there is an increased availability of lower calorie foods, without buying less or more products from the school
vending machines. Labelling and price reductions had no significant additional effect.
Disclosure of Interest: None declared

TP-WED-152 DEVELOPING AND EVALUATING NUTRITION EDUCATION PROGRAM FOR MID-LOW
INCOME ELEMENTARY SCHOOL CHILDREN IN AN URBAN AREA OF JAKARTA, INDONESIA
R. Kolopaking* 1 , A. Firmansyah 2 , J. Umar 3 , U. Fahmida 1
1 Community Nutrition, SEAMEO TROPMED University of Indonesia, 2 Child Health, Medical Faculty
University of Indonesia, Jakarta, 3 Developmental Psychology, Psychology Faculty University of Indonesia,
Depok, Indonesia
Background: A school-age year is a critical time for delivering nutrition education for the children, since
cognitive-motivational processes emerge as an important influence on their food choice. In fact urban
children from mid- to low-income would have the disadvantage due to instability of family income and poor
knowledge on nutrition which will affect their eating habits.
Objectives: The goal of this study is to design and evaluate a nutrition education program for 3rd and 4th
grades mid-low income children that promote healthy eating behaviors.
Underlying values and principles: Nutrition education will develop children self-regulation to choose
appropriate food from the available resources in their area and to perform sustainable healthy behaviors.
Knowledge base/ Evidence base: The nutrition education lessons are developed base on Social Cognitive
Theory and Self-regulation Approach which address the influence of social, psychological and cognitive
factors on health behaviors. In addition Ecological Framework was incorporated in design of the program
construct.
Context of intervention/project/work: Adapted from Indonesian food dietary guidelines, a culturallytailored
and age-appropriateness in-class lessons were designed for a mid-low income children in an urban
area of Jakarta. Students from 3rd and 4th grades received a 24 in-class sessions 45 minutes for each
session in a twice a week for a 12 weeks intervention, taught by the nutrition professionals.
Methods: In the formative study, environmental assessment was done to identify behaviors and
environmental characteristics of the community. Process and outcome evaluation was studied using a pre-
and post-evaluation which is combined with intervention (n=137) and control (n=120) groups, with three
assessment periods: baseline, post-intervetion, delayed-post (3 months after-post). Participants were
assessed for anthropometric status, self-evaluation for regulation on food choice, and dietary intake.
Results and Conclusions: The formative evaluation result included the suggestions for increasing intake of
fruits and vegetables, decreasing intake of empty-calorie snacks, and improving pocket money management
by the students. Process and outcome evaluation revealed that in-class lessons appear to have a positive
impact on the low-income elementary school students. The results suggest that the nutrition education was
successful in improving nutrition knowledge, food exploration, and healthy eating attitude.
Disclosure of Interest: None declared

TP-WED-153 ANDERS ESSEN - A MULITCOMPONENT COMMUNAL CATERING INTERVENTION IN
STYRIAN RESIDENTIAL SCHOOLS
D. Kuhness* 1 , S. Marchl 2 , S. Hollomey 2 , V. Rainer 3 , C. Pammer 4
1 Department of Health Promoting Schools, 2 Department of Nutrition Promotion, Styria vitalis - Styrian
Association of Health Promotion and Prevention, Graz, 3 Department of Nutrition Promotion, Ess.art, Vienna,
4 Evaluation, Health Consultant, Graz, Austria
Background: As in many European countries diet among adolescents in Austria is usually high in energydense
and low in nutrient-dense foods. Additionally, meals provided in residential schools do not meet
overall nutritional requirements. Therefore, Styria vitalis, the Styrian Association of Health Promotion and
Prevention (Austria), implemented a communal catering project in sixteen Styrian residential schools where
apprentices live for nine weeks a year.
Objectives: The objectives were to improve nutritional quality of offered food (e.g. less fat, more vegetables,
more wholemeal products), ecological quality (e.g. increased purchase of organic, regional and seasonal
products) and social quality of dining (e.g. design of dining rooms). The cost for the provided food must not
exceed the existing budget and the apprentices should be equally satisfied with it.
Underlying values and principles: According to the Ottawa Charter for Health Promotion, creating
supportive environments have a major impact on healthy living. Therefore, making the healthier choice
accessible and available was the main aim of this project.
Knowledge base/ Evidence base: The effectiveness of the intervention has been demonstrated in various
publications (French and Stables, 2003).
Context of intervention/project/work: A team of health promotion and communal catering professionals
accompanied each residential school for 18 months. The main emphasis was on the kitchen staff, as they
had to reach self-defined goals concerning nutritional, ecological and social quality in community nutrition.
The project implementation lasted from 2005 to 2009.
Methods: The needs assessment encompassed a workshop with the residential school staff, a tool
identifying costumer satisfaction and an analysis of meal components. Initiatives to reach self-defined goals
were planned and implemented (e.g. cooking courses, workshops, networking and exchange of information
with other kitchens). After one and a half year the same tools as in the beginning were used to evaluate the
project.
Results and Conclusions: In summary, 201 qualitative improvements could be reached in sixteen
residential schools, mostly nutritional and ecological achievements. Social quality improvements could be
reached in very ambitious schools. Kitchen staff now uses more vegetables and spices, cook less fatty
dishes and uses more wholemeal and organic/regional products and less convenience products. The
apprentices still enjoy the food as much as before and the motivation of the cooks and their staff for
continuing improvements is very high.
References: French, Stables (2003). "Environmental interventions to promote vegetable and fruit
consumption among youth in school settings." Prev Med 37(6 Pt 1): 593-610.
Disclosure of Interest: "None declared"

TP-WED-154 ASSESSING HEALTH FACILITIES' PREPAREDNESS FOR DISASTERS IN CITIES: A
CASE STUDY OF TWO HOSPITALS IN KOBE, JAPAN
J. M. Lapitan 1 , T. Ukai 2 , C. Steffens 3 , F. Armada* 3
1 Urbanization and Emergency Preparedness, World Health Organization Centre for Health Development,
2 Senior Consultant, Hyogo Emergency Medical Center, 3 Intern 2009, World Health Organization Centre for
Health Development, Kobe, Japan
Background: Health facilities are facilities exposed to natural hazards. Considering the critical need for
these institutions in the aftermath of disasters, priority should be put on identifying and reducing the
weaknesses of existing facilities and on improving the building standards for new construction.
Objectives: To assess conditions of hospitals in an urban setting and identify threats to them from disasters.
Underlying values and principles: The Hyogo Framework for Action 2005–2015, borne out of the UN
World Conference on Disaster Reduction, explicitly states that there is a need to promote the goal of
“hospitals safe from disaster”.
Knowledge base/ Evidence base: The World Health Organization Regional Office for the Western Pacific
(WHO/WPRO) published in 2006 a manual that would serve as an assessment tool for evaluating the
preparedness of health facilities in dealing with disasters.
Context of intervention/project/work: Resources allowed the assessment study to be done in two
hospitals in Kobe, Japan - the Kobe University Hospital (KUH) and the Kobe Red Cross Hospital(KRCH).
Methods: A standard questionnaire concerning the physical infrastructure and operations of hospitals was
adapted and given to two hospitals in Kobe, Japan in order to assess their capacities and challenges.
Results and Conclusions: Both KUH and KRCH can be considered as health facilities safe and prepared
for disasters. KUH has a reasonably-sized number of qualified staff with diverse specializations. It
experienced and responded to the Great Hanshin-Awaji Earthquake in 1995, and has been considered
prepared for and responsive to disasters with a few challenges. KRCH is a modern, state-of-the-art health
facility and considered as structurally and functionally sound benefiting from lessons learned that can
withstand earthquakes, though it may not be well prepared for tsunamis and/or flooding.
KUH and KRCH have seriously planned for emergencies and disasters; and how to continue effective
healthcare delivery during such events. Some non-structural and functional issues (less on structural issues)
were brought to light that can well be addressed strategically. More hospitals in Kobe and elsewhere would
do well to assess their facilities using a standard questionnaire.
References: 1. Disaster risk reduction and the preparedness of health facilities. Kobe: World Health
Organization Centre for Health Development; 2007.
2. Field manual for capacity assessment of health facilities in responding to emergencies. Manila: World
Health Organization Regional Office for the Western Pacific; 2006.
3. Report of the World Conference on Disaster Reduction. Kobe, Hyogo: UN International Strategy for
Disaster Reduction; 2005.
4. Ukai, Takashi. Report on the assessment of urban disaster measures prepared by healthcare facilities
(unpublished) submitted to the WHO Centre for Health Development, Kobe, December 2007.
Disclosure of Interest: None declared

TP-WED-155 PROMOTING HEALTH IN THE LINE OF FIRE; SOCIAL ORGANIZERS IN NORTHERN
PAKISTAN
S. Khan* 1
1 Health Systems, Health Services Academy Ministry of Health, Islamabad, Pakistan
Background: In the northern parts of Pakistan, recent rise in militancy and resulting armed conflict resulted
in displacement of population-groups and disruption of health services in most parts of the Northern
Pakistan. Vaccine and drug supplies are disturbed, health workers are unable to attend the health centers
and there is widespread violence and unrest.
Objectives: This study aimed to explore the role of social mobilizers in special population groups in conflict.
Underlying values and principles: Social mobilization for health promotion in conflict.
Knowledge base/ Evidence base: Exploring a component of a country level program for primary health
care in Pakistan, with special emphasis on conflict area.
Context of intervention/project/work: In 2005, successful piloting of management contracting of basic
health units in one district, Pakistan expanded grass root level Peoples Primary Healthcare Initiative”
(PPHI)and it now has management control of 3100 basic health facilities in 80 districts. PPHI has hired social
organizers in intervention districts for community mobilization. The social mobilizers of PPHI in North West
Frontier Province (NWFP) are facing daunting challenge in social mobilization for primary health care
services uptake. They made local level health management committees having broad membership from
village based organizations. This include local leaders, teachers, religious scholars, and some voluntary
workers. They organize session in the health facility and also arrange sessions in the community at regular
intervals.
Methods: This study takes only one aspect of a program/intervention and scope of this work is limited to a
special health promotion workforce of population in conflict. The methods used are 20 indepth interviews,
three focus group discussion and use of secondary data.
Results and Conclusions: OPD in most areas have doubled and even tripled; vaccination coverage even in
conflict areas is improved; there is problem with ANC coverage, but percentage deliveries by skilled birth
attendants have shown improvements. People are now more attentive to these social organizers and even
the militants give access to them, primarily owing to their local nature, appearances, gestures and the use of
local language. There are issues with branding of medical supplies and equipment (with logos of
international agencies engraved) but these social organizers use their communication skills in making even
hard core militants to let them use services and distribute these supplies from donors to population. There is
enough reasons for exploring and studying this intervention in greater details, to make a case for evidence in
health promotion of special population groups and in areas of conflict.
Disclosure of Interest: "None Declared"

TP-WED-156 THE NUTRITIONAL AND HEALTH STATUS OF CHILDREN IN FLOOD AND NON FLOOD
EXPOSED AREAS IN TWO DISTRICTS IN INDIA
B. van den Oever 1 , P. C. Joshi* 2
1 na, Centre for Research on the Epidemiology of Disasters, Brussels, Belgium, 2 , University of Dehli, Dehli,
India
Background: Malnutrition plays a part in more than a third of all child deaths in developing countries.
According to figures from the United Nations Children's Fund (UNICEF) 1 in 4 children under the age of 5 in
developing countries is underweight.
A child's dietary condition is threatened by the recurrence of climate related disasters such as tsunamis and
floods. Their impacts on human populations are especially dramatic in developing countries of south and
south-east Asia. The international child rights and development organization Save the Children estimates
that around 175 million children a year will be affected by climate related disasters over the next decade.
Most children, however, do not die due to the disaster as such, but rather due to the consequence of
inadequate health care, malnutrition and poor water and sanitation.
Floods are the most common reported natural disaster worldwide, with important impacts on health. ,
According to historical EM-DAT data on floods, India is the second country in the world in number of persons
affected (total affected, see Criteria and Definition section in EM-DAT website). The Indian state of Orissa,
for instance, is vulnerable to multiple disasters, like tropical cyclones, storm surges and tsunamis. Its densely
populated coastal plains are the alluvial deposits of its river systems. These rivers, with heavy load of silt,
have very little carrying capacity, what results in frequent floods. Another example is Bahraich the least
developed and most flood-affected district in Uttar Pradesh (UP), India. It is located on the Saryu River, 125
km North-east of Lucknow, the capital state. At the local level, the most flood-exposed blocks are:
Kaisarganj, Fakharpur, Mahsi, Shivpur and Mihinpurwa. Fakharpur was the most affected flood area in the
district of Eastern UP with 173 villages being affected in 2007 and 183 villages in 2008. Out of the 74 Gram
Panchayats (GPs) in Fakharpur 12 were severely affected by floods while the rest remained less or nonaffected.
Ensuring that high-level policy commitments are translated into improved outcomes for the poorest remains
a challenge. A key element for effective policy includes sound data in order to measure outcomes and
provide quantifiable risk profiles for action.
Objectives: The objective was to assess and compare the nutritional and health status of children living in
flood exposed and un-exposed areas. Further, economic and social household characteristics were
examined in order to get a broader understanding of the survey setting.
Underlying values and principles: Despite the economic growth that could be observed in India over the
recent years, crushing poverty and malnutrition are unforgiving realities for millions of women and children.
According to UNICEF malnutrition is more common in India than in Sub-Saharan Africa with 1 in every 3
malnourished children in the world living in India. Infant mortality remains as high as 63 deaths per 1,000 live
births.ii This shows that there is a great need to translate the economic growth into improved healthcare,
health promotion and specifically nutritional programmes. The situation becomes even more urgent when
taking into account the increasing threat of natural disasters and their potentially devastating impacts on the
poor in particular.
Knowledge base/ Evidence base: According to UNICEF, malnutrition increases dramatically in
emergencies because livelihoods and food crops are lost, food supplies are interrupted, diarrheal diseases
break out resulting in mal-absorption and nutrient losses, and infectious diseases suppress the appetite
whilst increasing the need for micronutrients to help fight illness.ii A recent review has pointed out a limited
evidence base about the health effects of floods in controlled epidemiological studies, particularly of
morbidity. iii Despite relevant studies have focused on mortality, disease and mental health, there is little
research on the association between floods and children‟s nutritional health.
Context of intervention/project/work: This paper is based on the research results and experiences of two
studies undertaken in India within the framework of a European Commission Research Study funded under
the Sixth Framework programme in Asia and Europe called MICRODIS (www.microdis-eu.be). MICRODIS
field studies have been conducted in nine sites in India, Indonesia, the Philippines, Vietnam, UK, China and
Italy by a consortium of 16 different institutions. The objectives from the studies were to measure the social,
economic and health impacts of climate disasters - and the interplay amongst these thematic areas. This
paper is analyzing and comparing the nutritional and health data of children aged between 6 and 59 months
in two MICRODIS sites in India – Bahraich and Jagatsinghpur.

Methods: A cross-sectional study was conducted in Jagatsinghpur, a coastal district of the state of Orissa by
a research team of the Voluntary Health Association of India (VHAI). The field survey was conducted in
October/ November 2008. Another cross-sectional study was undertaken by a research from the University
of Delhi in Bahraich in 2009. In both sites anthropometric measurements were obtained for children aged
between 6 and 59 months living in flood-exposed and non-exposed households.
Additional information was collected on demographics, socio-economic, food security and child health
collected at the household level.
Both studies estimate the prevalence of malnutrition and morbidity (such as cough and diarrhea) in children.
Multivariate analyses were performed with the purpose of exploring the possible confounding effect of
background variables on the relationship between child malnutrition and morbidity and the exposure to
recurrent flooding. Before performing a multivariate analysis, co linearity for continuous predictors was
assessed using variance inflation factor (VIF) function as well as Pearson correlation coefficients.
Results and Conclusions: All in all the health and nutritional status of the youngest as well as the
household economic status - especially of those families living in exposed areas- are of great concern.
Knowing that floods will geographically spread and are most often than not reoccurring events, they can
transform acute health impacts to long term problems and long lasting economic damages to chronic
situations.
References: UNICEF, 2009. Available at: http://www.unicef.org/nutrition.
Rodriguez J, Vos F, Below R, Guha-Sapir D. Annual disaster statistical review 2008: The numbers and
trends. Brussels: CRED; 2009.
Save the Children UK (2009), News". Available at: http://www.savethechildren.org.uk/en/41 499.htm.
EM-DAT: The OFDA/CRED International Disaster Database. www.emdat.be - Université Catholique de
Louvain - Brussels – Belgium. Created on: Oct-7-2009 - Data version: v12.07.
Ahern M, Kovats RS, Wilkinson P, Few R, Matthies F. Global Health Impacts of Floods: Epidemiologic
Evidence. Epidemiol Rev 2005, 27: 36-46.
EM-DAT: The OFDA/CRED International Disaster Database. www.emdat.be - Université Catholique de
Louvain - Brussels – Belgium. Created on: Nov-3-2009 - Data version: v12.07.
MICRODIS (2009), Bahraich (India)". Available at : http://www.microdis-eu.be/content/bahraich-
India.
UNICEF (2009), India - Children‟s issues - Nutrition",http://www.unicef.org/india/children 2356.htm.
Choudhury AY, Bhuiya A. Effects of biosocial variables on changes in nutritional status of rural Bangladeshi
children, pre- and post-monsoon flooding. J Biosoc Sci 1993; 25: 351-7.
Disclosure of Interest: None declared

TP-WED-157 A COMPREHENSIVE HEALTH PROMOTION PROGRAM FOR DISASTER
RECONSTRUCTION FAMILIES IN TAIWAN
L. Chang* 1 , S. Chen 1 , H. Ho 1 , C. Cheng 1 , S. Chang 2
1 Nursing, 2 Geriatric Care, National Tainan Institute of Nursing, Tainan, Taiwan
Background: August 8, 2009, Typhoon Morakot slammed into Taiwan Island. The southern people faced
unleashing floods, mudslides and misery. At Tainan County, Sha-Ying Elementary school surveyed their
students. It reported that those students two third of houses suffered from flood. Although Typhoon Morakot
has disappeared, many students and their family still suffered from panic and damaged resident
environments.
Objectives: In order to helping disaster families to reconstruct as soon as possible, the program would like
to develop many competences of parents & child on health care and environment reconstruction.
.
Underlying values and principles: We believe that with the caring and health promotion concepts,
connecting the social and environmental resources, even disasters might happen anytime and anywhere, the
suffered families might have a health, equity and sustainable development under a comprehensive health
promotion programs.
Knowledge base/ Evidence base: In the program, we will apply the concepts of caring and health
promotion to care these disaster families. Also, we use the method of empowerment to increase the
competences of parents and children on health care and environment reconstruction.
According to Morse et. al. (1990) reported that caring as a human trait; caring as a moral imperative or ideal;
caring as an affect; caring as an interpersonalship; caring as a therapeutic intervention. Further, the
definition of “Health Promotion” (WHO) is a process of enabling people to increase control over their health
and its determinants, and thereby improve their health.
Context of intervention/project/work: The program consists of two parts. The first part for children that
focused on assisting students' academic problems, learning the concepts of life science & nature
environmental science and engaging in physical fitness activity. The second part for parents, it includes
learning physical health care knowledge and skill, conducting psychological consulting, promoting spirit
development, and learning how to reconstruct resident environments.
Methods: The project would be implemented from January 2010 to December 2010. At the first six months,
the activities of would be held once a month. Second, during the summer time, the program will open 3-day
Health & Medical Learning camping and one visiting activity.
Results and Conclusions: During the project implementation, we will conduct the process and outcome
evaluation to assess the impact of the comprehensive program. The project may be a reference for other
conutries to apply on assising disaster families in the future.
References: Morse JM; Solberg SM; Neander WL; Bottorff JL; Johnson JL.,Concepts of caring and caring
as a concept. Advances in Nursing Science, 1990 Sep; 13 (1): 1-14
WHO (n.d.), Definition of Concepts: Health Promotion. Retrieved November 4, 2009, from
http://www.searo.who.int/en/Section1174/Section1458/Section2057.htm
Disclosure of Interest: none declared

TP-WED-158 TRENDS OF HEALTH DISPARITIES BETWEEN RURAL AREAS OF PROVINCES OF
IRAN (1993-2008)
M. Moradi-Lakeh* 1 , B. Bijari 1 , A. R. Olyaeemanesh 2 , A. Khosravi 3
1 Department of Community medicine, Iran University of Medical Sciences, Tehran, Iran, 2 Office of social
determinats of health, 3 Council of applied research, Deputy for health, Ministry of Health, Tehran, Iran
(Islamic Republic of)
Background: Iran started implementation of Primary Health Care network(PHC) in 1980s and reached an
almost complete coverage for rural areas in early 1990s (1,2). Since then, many reports have been
emphasized on the improvements of health indicators at national (or provincial) level, however there are few
reports about the distribution of health and its trends.
Objectives: We performed this study to assess the trends of health disparities between rural areas of Iran
provinces in a 15 years period between 1993 to 2008.
Underlying values and principles: Social justice has been one of the key principles in running the PHC of
Iran.
Knowledge base/ Evidence base: Running the PHC in Iran has decreased the gap between the health
indicators of rural and urban areas at national level (3). A previous study compared the inequalities of health
between rural areas of Iran provinces during two periods of time (1996-2000 vs. 2001-2005) but a
quantitative index to be assessed as a sequential trend was not reported (4).
Context of intervention/project/work: We performed this study as an academic project based on the
routine data collected by the PHC in rural areas of Iran.
Methods: We used the data extracted from vital horoscopes or 'Zij' of rural areas (a national tool for
registeration of key health data)(5) which are being covered by the 42 universities of medical sciences and
health services; currently, there are more than 20 millions people in these rural areas. We estimated the
annual index of disparity (IDisp) for 12 selected health indicators and assessed their trends. The indicators
included: Neonatal mortality(NMR), Infant mortality(IMR), Under-5 mortality(U5MR), Maternal mortality
(MMR), Crude death rate(CDR), Dependency ratio(DR), Population growth(PG), Skilled attendance of birth
(SAB), In-hospital deliveries (IHD), Percent of weighted neonates (WN), Neonates with under 2.5Kg
weight(U2.5N) and Modern family planning coverage (FP).
Results and Conclusions: Overally, the largest amounts of IDisp were related to MMR and SAB. Trends of
IDisp for FP, IHD and WN were decreasing from 1993 to 2008. The other way around, trends of IDisp for
SAB, PG and CDR were increasing. According to the other selected indicators (DR, U2.5N, NMR, IMR,
U5MR and MMR), there were no regular pattern for trends of IDisp.
In spite of improvemvents in national levels of almost all health indicators, trends of health disparities are not
as good as the same. We conclude that new policies and programs are required to decrease health
disparities between provinces. Also, the impact of new interventions on health disparities should be
assessed as an essential part for the acceptance process.
References: 1. Brarzagar MA, Djazayery A: Evaluation of Rural Primary Health Care Services in Iran:
Report on Vital Statistics in West Azarbaijan. Am J Public Health 1981; 71: 739-742.
2. Pileroudi C: The district primary health care networks in Iran. UNICEF, Tehran, 2002.
3. The World Health Organization: The World Health report 2008: Primary Health Care now more than ever.
World Health Organization, Geneva, 2008.
4. Movahedi M, Hajarizadeh B, Rahimi A, Arshinchi M, Amirhosseini K, Haghdoost AA: Trends and
geographical inequalities of the main health indicators for rural Iran. Health Policy Plan, 2009; 24(3): 229-37.
5. Khosravi A, Motlagh ME, Emami Razavi SH: The Iranian Vital Horoscope; Appropriate Tool to Collect
Health Statistics in Rural Areas. Iranian J Publ Health, 2009, 38 (Suppl. 1): 74-80.
Disclosure of Interest: A.R. Olyaeemanesh, the Office of social determinants of health (Iran MOH), the
head and responsible person

TP-WED-159 CHALLENGES FOR HYGIENE AND HEALTH PROMOTION- A STUDY IN FLOOD
AFFECTED AREAS OF JAGATSINGHPUR DISTRICT IN ORISSA, INDIA
S. R. Dash* 1 , I. Kanungo 1
1 Disaster Management and Health Promotion, Voluntary Health Association of India, Bhubaneswar, India
Background: Disasters are causing enormous harm to individuals, families and communities affecting their
life and livelihood. It is evident from the previous research works that flooding is one of the most wide spread
climatic hazards and poses multiple risks to human health. It severely challenges the public health
infrastructure and behavior of personal hygiene. In this context, the present paper based on case-control
study observing health impacts of flooding in Jagatsinghpur District of Orissa.
Objectives: To assess the health impact of disasters particularly recurrent flood.
To observe the morbidity pattern and analyse the changes in the context of recurrent floods.
Underlying values and principles: During the study certain principles and values were observed. Consent
of the respondents was taken before taking detailed information from them. Response from women
respondents and presence of women enumerators in the study team were ensured. The study was
conducted in both affected and non affected areas.
Knowledge base/ Evidence base: A detailed study has been conducted in the flood affected areas of
Jagatsinghpur district covering 758 respondents from affected areas and 816 respondents from non affected
area. Focus group discussions were also organised to discuss on various issues.
Context of intervention/project/work: The flood in Orissa in September 2008 was due to heavy rainfall in
the upper as well as lower catchments of the Mahanadi River System resulting out of the effect of a deep
depression in Bay of Bengal from 16th to 21st September 2008. VHAI captured the health impact of this
disaster on the community under a research project supported by European Commission under the 6th
Framework Programme.
Methods: In order to establish empirical evidence the study has adopted exploratory research design and
concurrently collected data both by qualitative and quantitative method. The sample was selected with the
Probability Proportion to Size (PPS) method. An interview schedule was administered among 758
respondents from test group and 816 from control group drawn from sampling
Results and Conclusions: It is observed that most of the respondents in the exposed area are attributed
some physical health effects to the flood. A comparative study of morbidity pattern in the exposed and non
exposed area shows that there is a high rate of disease prevalence among affected community. The
sanitation and Hygiene conditions in post disaster situation decorated to a great extent. Study shows that
before disaster 93.54% of people were using tube well/bore well water during pre disaster for drinking and
cooking purpose. The usage decreased to 49.76% after disaster as most of the tube wells were inundated in
flood water and were defunct Nearly 23.75% of people used private bath rooms before disaster and
decreased to 10.42% after disaster. Before flood 72.56% people preferred for open defecation. It even
increased to 90.61% after disaster.
Disclosure of Interest: Funding for this research was made available by the European Commission under
the 6th Framework Programme- Contract No. GOCE-CT-2007-036877.
European Commission, A Grant Research Support.

TP-WED-161 FRUIT AND VEGETABLE CONSUMPTION: POSSIBILITY TO OBTAIN APPROPRIATE
QUANTITY OF FIBER AND SUGAR FOR THAI PEOPLE
P. Edson* 1 , K. Sranacharoenpong 1 , S. Charoenkiatkul 1 , W. Kriengsinyos 1
1 Institute of Nutrition, Mahidol University, Nakhon Pathom, Thailand
Background: The Thai Food Based Dietary Guidelines(Thai FBDGs) has suggested adults to eat at least
five rice serving spoons of vegetables and four servings of fruits daily since 1999 in order to obtain adequate
amount of dietary fiber, minerals and vitamins. However, based on food consumption survey in 2003, Thai
adults are consuming fruit and vegetable remarkably less than the recommendation. In addition, it was also
noted that currently Thai adults tended to consume more fruits than vegetables (ratio of 3 to 1).
Objectives: To determine the appropriate, flexible and practical portions of vegetable and fruit for Thai
people based on recommendation of fiber and sugar
Underlying values and principles: The practical and appropriate guidelines of vegetable and fruit
consumption are needed to promote Thai people to increase their vegetable and fruit intake to obtain 25 g of
dietary fiber per day. Categorizing vegetable and fruit based on their fiber and sugar contents help people
have a better picture of how to eat for better health.
Knowledge base/ Evidence base: The combination consumption of a variety of fruits and vegetables
obtains enough dietary fiber a day that can prevent and reduce risks of chronic diseases.
Context of intervention/project/work: Only fruits and vegetables that are available in Thailand with known
dietary fiber and sugar contents were categorized in this study.
Methods: Dietary fiber (DF) and sugar content of fruit and vegetable items were compiled from three
sources of Thai nutritive databases. The total of 122 items of raw and cooked vegetables and 75 items of
fruits including fresh or dried fruits were selected. Goal of dietary fiber was set up at 80% and 100% of 25 g
of the recommended intake. Sugar contents in fruit were considered for optimal daily sugar intake not higher
than 10% of total energy. To categorize high to low fiber groups, one serving size was determined as 1 cup
(2 rice serving spoons, RSSs) for vegetable and a serving size of fruit was based on Thai FBDGs.
Reasonable combination and proportions of fruit and vegetable were calculated to reach goal of fiber.
Results and Conclusions: The fiber classification groups are six for vegetable(very
high(V1),high(V2),medium(V3),low(V4),very low(V5) and lowest(V6))and five for fruit(very
high(F1),high(F2),medium(F3), low(F4),and very low(F5)).Twenty-three combinations (18%) of vegetable
and fruit groups were satisfied with dietary fiber and sugar goal of 144 combinations in total (FiVn, where,
F=fruits, V=vegetable i=1 to 5 group of fruits and n=1 to 6 group of vegetables). Only four-eight RSSs of
vegetable in very high dietary fiber group(V1) could provide appropriate amount of fiber(108% of 25 g DF
,and 31,25-35 median, min-max ,respectively) and sugar (median, min-max:17.56,7.36-35.12,),when they
combined with 1-3 portions of fruit in very high fiber group(F1),or 1-2 portions of high fiber
group(F2),medium(F3), low(F4)or a portions of or very low(F5).It is possible to obtain appropriate quantity of
dietary fiber and sugar for Thai people to consume a variety of fruits and vegetables in combination a day.
Disclosure of Interest: The authors declare that they do not have any competing interests.

TP-WED-162 COMMUNITARIAN VEGETABLE GARDENS
A. A. P. S. Salineiro 1 , A. O. l. i. v. e. i. r. a. P. o. l. e. t. t. o. Palácios 1 , A. A. C. F. Nardi* 1 , J. J. O.
Albuquerque 2
1 Secretaria de Saúde, 2 Secretaria de Serviços Públicos, Prefeitura de Maringá, Maringá, Brazil
Background: Brazil has invested in the formulation, implementation and concretion policies for the
promotion, protection and rescue of good health, by placing a great emphasis on the construction of a health
attention model that prioritizes actions for the improvement of the quality of life for the individuals and for all.
(Brazilian Ministry of Health, 2006)
Objectives: In 2006 the communitarian vegetable gardens project started in Maringá, by presenting
initiatives for the cooperation and sustainable production of food for self-consumption and commercialization,
with the objective of improving the quality of life, promoting social and productive inclusion for the citizens
that are in vulnerable economic and feeding insecurity situation.
Underlying values and principles: The promotion of good health works through integrated and intersectorial
policies, building a network of commitment and co-responsibility for the population‟s quality of life,
so that everyone becomes a participant in health care. The central part of this process is the empowerment
of the community – the possession and control of their own efforts and destiny.
Knowledge base/ Evidence base: The communitarian vegetable gardens´ experience have bases in
national policies of food and nutrition, what previous intersectoriality actions, with views at universal foods´
access.
Context of intervention/project/work: The communitarian vegetable gardens were created by the
municipal government of Maringá, through its many Secretariats, and started by means of discussion
workshops with the community, where the problems and solutions were identified in order to improve the
quality of life of the population. This was accomplished based on the proposed strategies presented by the
Rede de Municípios Potencialmente Saudáveis (Network of Potentially Healthy Municipalities), from which
Maringá is a member since 2005.
Methods: The program is coordinated by the Municipal Secretariat of Public Services, which is responsible
for the infrastructure, land patch preparation and the acquisition of inputs. The Municipal Secretariat of
Health, Eletrosul, Universidade Estadual de Maringá (State University of Maringá), as well as other private
businesses are also partners in the project. The community handles the production and maintenance
activities of the gardens.
Results and Conclusions: Today, there are 13 communitarian vegetable gardens that produce 120 tons of
produce per year. Around 250 families (1,000 people) are involved in the project. All of the production is free
from pesticides and abide by the highest standards of quality and hygiene. The populations of the various
parts of the city have requested to start the gardens in their neighborhood. There were reports of physical
and mental health improvements and increase of sociability among the participants of the project.
References: Análise da Atenção em Saúde em Maringá, Relatório anual, Secretaria de Saúde, 2006.986
Brasil. Ministério da Saúde. Secretaria de Atenção à Saúde. Política nacional de promoção da saúde.
Brasília: Ministério da Saúde, 2006. 60 p. – (Série B. Textos Básicos de Saúde)
Primeira Conferência Internacional Sobre Promoção da Saúde, Ottawa, novembro de 1986. (Apostila
Cidades Saudáveis – Carta de Ottawa – Primeira Conferência Internacional Sobre Promoção da Saúde,
Ottawa, novembro de 1986).
Disclosure of Interest: None declared

TP-WED-163 DÉTERMINANTS DE L‟INTENTION DE LA CONSOMMATION DE LÉGUMES ET DE
FRUITS CHEZ DES COLLÉGIENS
D. Boucher* 1 , F. Côté 2 , C. Gagné 2
1 Département des sciences infirmières, Université du Québec à Rimouski, Lévis, 2 Faculté des sciences
infirmières, Université Laval, Québec, Canada
Historique / Origines: Une alimentation délétère constitue un facteur de risque quant à l‟augmentation de
surpoids, d‟obésité et du développement de maladies chroniques, notamment chez de jeunes adultes. Ces
menaces ont attiré l‟attention non seulement des chercheurs en promotion de la santé, mais également des
professionnels de l‟éducation qui interviennent auprès de ces étudiants. C‟est sur cet intérêt partagé qu‟a
pris naissance la présente collaboration université/milieu qui s‟est concrétisée à travers un projet de
recherche.
Objectifs: L'objectif de cette étude est d'identifier les déterminants de l‟intention de consommer au moins
cinq portions de légumes et de fruits chaque jour chez des collégiens.
Valeurs et principes sous-jacents: Accroître l‟efficacité d‟interventions en promotion de la santé, faire
montre de rigueur scientifique via l‟utilisation d‟un devis rigoureux et d‟un cadre théorique, agir en partenariat
pour favoriser la mise en œuvre de l‟étude puis le partage des connaissances.
Fondement de connaissance/Fondement de preuve: En dépit de nombreuses données probantes qui
supportent les bénéfices pour la santé de la consommation d‟au moins cinq portions de légumes et de fruits
chaque jour, plusieurs jeunes en présentent toujours une prise insuffisante. C‟est pourquoi, la mise en place
d‟interventions pour améliorer cette condition est si importante. Or, il s‟avère nécessaire de bien connaître
les déterminants de l‟intention d‟un comportement avant d‟agir. Pour ce faire, la théorie du comportement
planifié (Ajzen, 1991) est reconnue fort efficace.
Contexte d'intervention/projet/travail: La présente étude s‟insère à l‟intérieur d‟une recherche pour
élaborer, mettre en place et évaluer une intervention ciblée auprès de collégiens pour favoriser la
consommation de légumes et de fruits. Dans cette première phase, il s‟est agi d‟élaborer un questionnaire
qui doit nous permettre de mieux comprendre les facteurs qui peuvent influencer l‟intention des étudiants
d‟adopter ce comportement. Elle se déroule avec la collaboration des professeurs et de la direction et sert à
valider l‟instrument de mesure.
Méthodes: Un devis corrélationnel a été utilisé pour identifier des déterminants de l‟intention de consommer
au moins cinq portions de légumes et de fruits chaque jour chez des collégiens (N = 34). Une analyse de
régression hiérarchique avec les données du questionnaire a été effectuée en entrant d‟abord les
déterminants de la théorie. L'ajout d'une variable externe à cette théorie "la norme descriptive" pourrait
fournir une information additionnelle en ce qui a trait à l‟influence sociale.
Résultats et Conclusions: Les résultats indiquent que 73 % de la variance de l‟intention [F (1,32)= 88,11,
p

TP-WED-164 PROMOTING THE CONSUMPTION OF WHOLE-GRAIN FOODS IN SINGAPORE
M. Yeo* 1 , M. T. Lim 2
1 Corporate Marketing, 2 Nutrition Department, Health Promotion Board, Singapore, Singapore
Background: Data from the 2004 National Nutrition Survey (NNS) showed that carbohydrates consumed by
Singaporeans were largely contributed by refined grains.
Objectives: The Health Promotion Board (HPB) embarked on a nationwide initiative aimed at encouraging
Singaporeans to increase their consumption of whole-grain foods.
Underlying values and principles: There is strong evidence that a diet rich in whole-grains reduces the risk
of coronary heart disease and Type 2 diabetes, which are among the main causes of death in Singapore.
Some studies also suggest that whole-grains may help in weight management and protect against certain
cancers.
Knowledge base/ Evidence base: A literature review was conducted to determine the quantity of wholegrains
which is likely to confer significant health benefits. Based on this research, HPB established an
updated recommendation to consume 50g of whole-grains daily. This amount translates to about 2-3
servings of whole-grain foods. Results from the 2004 NNS found that the average intake of whole-grain
foods was only 0.2 serving. Focus group discussions revealed that barriers to whole-grain food consumption
include the lack of knowledge, relatively high cost, perceived bland taste and low availability.
Context of intervention/project/work: An integrated marketing campaign was launched to communicate to
the public about the importance of incorporating whole-grains into their daily diet. It encompassed messages
on what whole-grain foods are, their benefits, recommended amounts to consume, and where they can be
found.
Methods: The Singapore Healthy Diet Pyramid graphic was revised to reflect that half of the total servings
from the Rice and Alternatives food group should be whole-grains. A “Higher in Whole-grains” logo for
packaged products was introduced to help consumers make informed purchases. HPB also worked with
food retailers and food outlets to make whole-grain foods more accessible and affordable. Marketing
strategies included the creation of a “hero” mascot made out of whole-grain foods to educate the public on
eating whole-grains to protect their health. HPB also collaborated with media partners to ensure strategic ad
placements in the press, radio and supermarkets, and launched a series of highly visible advertorials
featuring information on whole-grains and restaurants which serve whole-grain dishes. This campaign was
further supported by culinary classes in community clubs, as well as online recipes and cooking demos.
Results and Conclusions: The whole-grain campaign was estimated to have reached 76% of the
population and 72% of female grocery buyers. Major supermarkets reported a 20-35% increase in sales of
whole-grain products during the campaign period. Even after the campaign, the average sales were higher
than usual. This initiative also generated great media interest and numerous free coverage. An assessment
on the intake of whole-grain foods will be carried out next year in conjunction with the 2010 NNS.
Disclosure of Interest: None declared

TP-WED-165 MIGRATION EFFECTS ON FOOD CONSUMPTION IN AN INDIAN SAMPLE
N. Khandpur* 1 , A. Satija 1 , D. Bansal 1 , L. Bowen 2 , S. Kinra 2 , D. Prabhakaran 3 , S. Ebrahim 4
1 Chronic disease, The Public Health Foundation of India, New Delhi, India, 2 Epidemiology, London School of
Hygiene and Tropical Medicine, London, United Kingdom, 3 Chronic disease, Centre for Chronic Disease
Control, 4 Chronic disease, South Asia Network for Chronic Disease, New Delhi, India
Background: The epidemiological transition underway in India is characterized by increasing chronic
disease burden, changes in food patterns and increasing urbanization, one reason for which is migration (3).
There have been increases in the consumption of fats, sugars and processed foods – a trend seen more
commonly in the larger cities where access to these foods is greater (2).
Objectives: To study the role of rural to urban migration in food consumption.
Underlying values and principles: The role of environmental factors in determining food consumption is
underestimated by the common assumption that food choices are decisions made by individuals (4).
Studying this in populations living in different environments therefore becomes important - finding differences
in consumption would imply that environmental factors (availability and accessibility of food) play a role in
determining food choices. It then becomes the responsibility of the government to create policies to promote
healthy eating in populations.
Knowledge base/ Evidence base: The 1970s and 80s saw an increase in per capita calorie intake in the
Indian population - attributed to increased cereal consumption(1). There was an increase in the consumption
of milk & milk products, animal products and fats & oils in the following decades - possibly fueled by the
economic spurt in the country.
These findings cannot explain variations between urban and rural populations or the role of rural to urban
migration in influencing dietary change. Food patterns of urban and rural groups are different, with vegetable
& fruit consumption being lower in urban than rural groups and fats & oils being lower in rural populations.
Context of intervention/project/work: The study was conducted in urban settled factory workers in 4
Indian cities. Given the high rate of migration at these sites, migrant workers at the factories were also
recruited. Rural dwelling siblings of these migrant workers formed the rural sample.
Methods: Cross-sectional food consumption data from urban, rural and migrant groups (4124 men and 2944
women) was got using a food frequency questionnaire. Frequency of consumption of 184 foods was
examined by migration status, controlling for age and sex.
Results and Conclusions: Traditional foods were consumed most frequently (daily) by a majority of the
sample. Western foods were mostly consumed on a weekly basis. Migration significantly affected the
consumption of traditional foods examined. The most common pattern was an increase in the proportion of
individuals consuming phulka (Indian bread), tur dal (lentil) with vegetables, potato, tea and ghee (saturated
milk fat) on a daily basis, from rural to migrant to urban groups. For instance 57.3% of the urban, 50.1% of
the migrant and 45.9% of the rural group consumed phulka everyday (p

TP-WED-166 TRADITIONAL AND MODERN TRENDS IN FOOD CONSUMING BEHAVIOUR – RESULTS
OF A TRANSNATIONAL EMPIRICAL RESEARCH (HUNGARY, POLAND, CZECH REPUBLIC,
SLOVAKIA)
Z. Benko* 1 , K. Tarko 2
1 Institute of Applied Health Sciences and Health Promotion, University of Szeged, Szeged, Hungary, 2 ,
Background: The Institute of Applied Health Sciences and Health Promotion at the University of Szeged,
together with research groups from Poland, Czech Republic and Slovakia has performed a transnational
empirical research into studying the lifestyle elements of families in the Visegrad Countries.
Objectives: One aim was to study the nutrition related consumer behaviour of participants with the help of
12 questions including cooking habits, vegetable, fruit, bread, liquid, spice and meat consumption and
shopping habits. The above variables were analysed along the tradition and modernity axis created on the
basis of participants‟ subjective self-categorisation and the transnational professional team‟s objective
definition.
Underlying values and principles: Food consumption and nutrition is an important element of lifestyle
largely affecting the health state of a population. Unhealthy nutrition and insufficient lifestyle would lead to
heart and coronary diseases and diverse types of cancers.
Knowledge base/ Evidence base: People have similar physiological needs, though the nutrition related
customs are not universal, but social constructs. Nutrition has a central role in social life, so related
sociological, political, economic and philosophic questions should also be studied.
Context of intervention/project/work: Working out the empirical part of the research project was based on
a thorough analysis of relevant professional literature from the area of Sociology, Psychology and Economy.
Methods: The large sample (500-500 families/households per country) research was performed with the
help of structured assisted questionnaire interviews.
Results and Conclusions: The results indicated that the use of animal fat for cooking was considered to be
traditional, while oil consumption was regarded as an element of modernity. In terms of bread consumption,
white bread characterised traditional consumers, while brown bread was a value in modernity. Modern
consumers preferred mineral water (65,4%), green and herb tea (38,5%) and fruit juices, considered to be
scientifically up-to-date and modern by nutrition professionals also. Traditional consumers preferred
refreshments with bubbles, and drinks with caffeine and alcohol content. Modern people chose the
consumption of chicken (90,9%), fish (48,7%) and turkey (41,9%) meat, while traditional consumers
preferred pork (63,2%) and beef (23,3%). Decision making on buying a food product has also varied along
the tradition and modernity axis: in modern decisions calorie content (16,3%), fat content (24,1%), and sugar
content mattered (8,9%) and also the extent to which the given product was in global terms healthy (61,6%).
Traditional consumers based their decisions more on tradition and family customs (36,1%), and brand-name
(35,0%).
Though both along subjective (traditional: 68%; modern: 32%) and objective factors nutrition was dominated
by traditional elements, as a conclusion it seems, that modernity comes together with a strive for healthy
nutrition.
Disclosure of Interest: None declared

TP-WED-167 FAST FOOD CONSUMPTION AND PERCEPTION OF VULNERABILITY TO NON-
COMMUNICABLE DISEASES AMONG NIGERIAN UNDERGRADUATE STUDENTS
M. O. Owolabi* 1 , O. S. Arulogun 1
1 Department of Health Promotion and Education, University of Ibadan, Ibadan, Nigeria
Background: Fast food consumption has gradually become a common lifestyle in Nigeria especially in
urban areas despite the associated adverse health consequences. In Nigeria, university undergraduates'
consumption and perception of fast foods as a risk factor for non-communicable diseases (NCDs) have not
been fully explored.
Objectives: This study assessed fast food consumption and perception of vulnerability to noncommunicable
diseases among Nigerian undergraduates.
Underlying values and principles: Behavioural change in the consumption of fast foods towards healthy
nutritional diets for the prevention of NCDs.
Knowledge base/ Evidence base: It has been well documented that fast foods are a contributing factor in
the etiology of NCDs such as hypertension and cardiovascular diseases. The President, Blood Pressure
Foundation, Nigeria reported that junk foods were major causes of diabetes and obesity-related diseases.
He suggested the consumption of healthy foods such as fruits, vegetables and peas to reduce the risks of
having these problems.
Context of intervention/project/work: Descriptive cross-sectional survey.
Methods: A 3-stage sampling technique was used to recruit 400 undergraduates from halls residence in the
university. Data was collected using a validated self-administered semi-structured questionnaire. The data
were analyzed using descriptive and Chi-square statistics.
Results and Conclusions: The mean age of respondents was 22.0 (s.d.3.3) years with 57.3% being males.
Most of the respondents were single. Many (69.5%)of the respondents were of the opinion that fast foods
can be taken as breakfast, lunch or dinner. The frequency of fast food consumption among respondents
included: once in a week (19%), twice weekly (15.6%), thrice weekly (10.3%), four times weekly (3.4%),
everyday (8%) and occasionally (28.9%). The frequency of fast food consumption was higher among male
(57%) than the females (43%). More respondents (83%) perceived themselves to be vulnerable to
developing NCDs. Out of these; those with high knowledge about NCDs (41.8%) perceived themselves to be
vulnerable to developing diabetes (p

TP-WED-168 L‟ INTERVENTION MAPPING, UN MODELE DE PLANIFICATION POUR APPLIQUER LES
THEORIES DE PREDICTION ET DE CHANGEMENT COMPORTEMENTAL DANS LE DEVELOPPEMENT
D‟UN PROGRAMME DE PROMOTION DE LA CONSOMMATION DE FRUITS ET LEGUMES
L. Guillaumie* 1 , G. Godin 1 , J. Manderscheid 2
1 Chaire de recherche du Canada sur les comportements et la sante, Universite Laval, Quebec, Canada,
2 Laboratoire de psychologie EA 3188, Universite de Franche-Comte, NA, France
Historique / Origines: La consommation de fruits et légumes permet de prévenir les cancers, de réduire les
risques d‟accidents vasculaires et la prise de poids. Le programme Passalact est un programme visant
l‟augmentation de la consommation de fruits et légumes et est destiné aux personnes qui ont l‟intention de
suivre les recommandations de consommation de fruits et légumes mais qui ne le font pas. En effet, s‟il
existe une forte corrélation entre l‟intention et le comportement, les personnes ayant l‟intention d‟adopter un
comportement peuvent ne pas y parvenir.
Objectifs: Cette présentation décrit le développement du contenu du programme Passalact basé sur le
cadre de planification « Intervention Mapping » et plus particulièrement l‟utilisation concrète des théories de
prédiction et de changement comportemental.
Valeurs et principes sous-jacents: inspiré du modèle de Donabidian: 1) efficacité, 2) effectivité 3)
efficience, 4) optimalité, 5) acceptabilité, 6) légitimité et 7) équité.
Fondement de connaissance/Fondement de preuve: Les revues de la littérature ont permis de démontrer
que les interventions basées sur des théories ont plus de chance d‟atteindre leurs objectifs.
Contexte d'intervention/projet/travail: Promouvoir l‟utilisation concrète des théories dans le
développement de projets dans le domaine de la promotion de la santé
Méthodes: L‟ « Intervention Mapping » est un modèle de planification d‟interventions dont la caractéristique
principale est de permettre de combiner l‟utilisation de théories et les données empiriques. Alors que de
nombreuses théories en promotion de la santé sont disponibles, leur réelle utilisation dans le développement
de programmes de promotion de la santé reste encore un enjeu.
Résultats et Conclusions: Après avoir réalisé une évaluation des besoins et identifiés les objectifs du
programme, nous avons sélectionné des cadres théoriques, des méthodes et des stratégies pour finalement
les intégrer dans le programme d‟intervention. Consommer au moins cinq portions de fruits et légumes par
jour a été identifié comme le comportement-cible. Les théories de prédiction du comportement nous ont
permis d‟identifier les déterminants du comportement-cible : la connaissance, l‟intention, le sentiment
d‟efficacité personnelle et l‟habitude. Les théories du changement comportemental nous ont permis
d‟identifier le développement de l‟efficacité personnelle et l‟activation des intentions comme les principales
méthodes pouvant réaliser un changement comportemental. L‟efficacité de ce programme a été évaluée en
mesurant le comportement-cible et les variables psychosociales. L‟ « Intervention Mapping » s‟est révélé
être une méthode prometteuse pour développer rapidement des interventions taillées sur mesure et basées
théoriquement.
Conflit d'Interêt: rien a declarer

TP-WED-169 PROMOTING EDIBLE WILD PLANTS TO COMBAT HIDDEN HUNGER
H. D. y. a. h. Patria* 1 , A. Pitoy 1
1 Research Institute for Edible Wild Plants, Mantasa, Gresik - East Java, Indonesia
Background: Micronutrients deficiencies can exist in populations even where the food supply is adequate in
terms of meeting energy requirements. In these situations, people are not considered “hungry” in the
classical sense, but their diets may be grossly deficient in one or more micronutrients. People often
unnoticed the presence of this deficiency in spite of their insidious effects on immune system functioning,
growth and cognitive development. It is for these reasons that micronutrient deficiencies have been referred
to as “hidden hunger”.
Micronutrient deficiencies are most prevalent in areas where the diet lacks variety, as is the case for many
individuals in developing countries. When people cannot afford to diversify their diets with adequate amounts
of fruits, vegetables or animal-source food that contains large amounts of micronutrients, deficiencies are
inevitable.
Indonesia is mega-biodiversity country which means it has plenty species of animals and plants. The main
cause of hidden hunger in Indonesia is the dependency in only little kind of foods while actually plenty of
food sources could be found around them. Many reasons why people are no longer use edible wild plants in
their daily diet, one of it is prestige. While actually these edible wild plants provide more micronutrients than
domesticated food plants. Besides, these species also important for social, economic, biodiversity and
cultural aspect.
Objectives: 1. To understand the cause of micronutrients
2. To understand edible wild plants as alternative to tackle hidden hunger problem
Underlying values and principles: Edible wild plants are easily found around rural area. Some decades
ago people use them in their diet daily basis. But with globalization, the diet habit has changed and rural
people more preferred to buy their food. While actually, after some studies, these wild plants contain high
nutrition value, even higher than vegetables in market.
Knowledge base/ Evidence base: One example of edible wild plants that commonly grow in rural area is
MOringa olifiera. It contains vitamin A that seven times higher than carrot, vitamin C that four times higher
than orange and other minerals. This plant also useful in cultural context as people used to use the fruit of
this plant to wash dead body.
Context of intervention/project/work: Mantasa is trying to promote the use of edible wild plants among
rural communities. The area of research is in East Java and include some villages around Mount Arjuna. In
these villages found that the children suffering from malnutrition and hidden hunger. Mantasa then try to
educate the mothers/women about nutrition and try to find local resources to fulfill the nutrition needs for their
children and family.
Methods: Anthropometry measurement
Interview
Laboratory analysis for nutrition content in wild plants
Focus group discussion
Results and Conclusions: After 3 months joined discussion about food and nutrition and able to identify
edible wild plants, the mothers now have confidence to process edible wild plants for daily menu. Although
until now there is no evidence yet show that edible wild plants can contribute decrease the number of
malnutrition as it need more time to see the result.
Disclosure of Interest: None declared

TP-WED-170 HOME GARDENING (HORTA DO LAR) AS AN ECO-SUSTAINABILITY CONTRIBUTION
TO TACKLE DEPRIVATION
L. A. Saboga Nunes* 1
1 Seccao de Saude Publica e Comunidade, Escola Nacional de Saude Publica, Universidade Nova de
Lisboa, Lisbon, Portugal
Background: Financial crises set difficult conditions for the survival of a number of families, that can be
seen (e.g.) in quality of food intake. Processed foods become the preference with negative consequences
(e.g. child obesity). Accessibility to vegetables and fruits decreases, even with natural resources to counter
this. City eco-sustainability (CES), which includes home gardening HL (horta do lar), deserves special focus
since it enhances healthy life styles.
Objectives: In order to apprehend local government planning and inclusion of CES solutions (e.g. HL), an
assessment was done in Portugal in a period of political change (prior to 2009 general elections).
Underlying values and principles: Millions of lives (up to 2.7) could be spared with increase of vegetable
and fruit intake (FAO, 2001). Millennium Development Goals focus on reducing poverty and hunger in cities
(MDG 1) and ensuring environmental sustainability (MDG 7) (UN, 2009).
Knowledge base/ Evidence base: Several benefits of urban and HL are clearly established (FAO, 2007),
emphasizing the important role of leadership from local governments in this process.
Context of intervention/project/work: Local authorities have a contribution to give in the context of MDG
implementation. By setting a clear policy of development and support of CES, local governance can enhance
citizens capacity to build solutions to overcome adversity in critical periods. HL is a tracer of such an
endeavor.
Methods: A web questionnaire was set at www.infohorta.net and information to fill it in was disseminated in
a regular meeting of the Healthy Cities project in Portugal. All municipalities were invited to answer the
survey that was planed to establish a base line of CES HL.
Results and Conclusions: Nine municipalities answered the web survey. Two had specific strategies at
local government level to support and sustain HL. Plans were being made by three municipalities to start
such projects in the near future. Results show a deficit of awareness of CES HL solutions that can empower
citizens in the context of financial and social crises. Increase of physical activity as well as vegetables and
fruit intake, or contribute to better mental health outcomes, are some of the positive results that could be
induced by public policies in the present context when focusing on CES.
References: FAO, (2001). Cities of the future: urban agriculture in the third millennium. Geneva: Nutrition
and Consumer Protection
UN, (2009). Millennium Development Goals Report
FAO, (2007). Profitability and sustainability of urban and peri-urban agriculture. Agricultural management,
marketing and finance occasional paper. Rome
Disclosure of Interest: None declared

TP-WED-171 FRUITS AND VEGETABLES OF COLLABORATION: SHOWCASING THE OUTCOMES
OF THE OUR CULTURES FOR A GOOD LIFE PROJECT, LOGAN, AUSTRALIA
M. A. Sandor* 1 , N. Harris 2
1 School of Life Sciences, University of Skövde, Skövde, Sweden, 2 School of Public Health, Griffith
University, Logan, Australia
Background: The Our cultures for a good life project was a collaborative project between a university and
two non-government community organisations that work at the grass roots level with communities in Logan,
Australia. The project was focused upon physical activity and nutrition of children 0-8 years in Pacific
Islander and African migrant communities as significant and growing communities in the region.
Objectives: The goal of the project was to increase access to and participation in physical activity and
healthy eating in Pacific Islander and African children aged 0-8 years in the Logan-Beaudesert region. The
objective of this paper is to discuss and present the resources developed as outputs of the project.
Underlying values and principles: The practice of health promotion emphasises a process based
partnership approach and , at times, seemingly neglects the importance of achievement or outputs and
outcomes. Yet, it is the very product of the work that is often seen by funders and supporters as representing
the real value of an intervention.
Knowledge base/ Evidence base: There is a need within these communities for interventions to enable
them to improve nutrition and physical activity and thereby the long term health of these communities.
Research has shown that after arrival in Australia, migrants from so-called developing countries often gain
weight, somewhat overwhelmed by the accessibility of fast food and the discontinued use of walking as a
major means of travelling (Burns et al, 2000; Renzaho & Burns, 2006).
Context of intervention/project/work: The Pacific Islander and African communities of the Logan-
Beaudesert region are recognised as communities with social and health needs. At an operational level, this
is evident in the services oriented to these communities on the ground in locations such as Logan Central.
With regard to the evidence of need relating to nutrition and physical activity of these populations, adverse
health outcomes such as diabetes associated with poor nutrition and lack of physical activity is significantly
higher in people born in the Pacific Islands and parts of Africa than that of Australian-born (AIHW, 2006).
Methods: The Our cultures for a good life project was a collaborative undertaking between three
organisations. Sub-projects were implemented around physical activity and nutrition focusing on dance and
games, cooking and information resources. These outputs have been completed and a process evaluation of
the project has been undertaken. The intent of this paper is to review and present the outputs of the project.
Results and Conclusions: The project was successful in producing three products:
• A recipe book, Feasting with Logan‟s Global Family: Sharing African and Pacific Islander Food
Experiences, containing nutritional information and traditional recipes from the communities;
• A games and dance resource kit, Let‟s Learn, Let‟s Play, Let‟s Dance!: African and Pacific Islander Games
and Dance Activities, that presents cultural games and dance activities for primary schools and child care
centres; and
• An information resource, Living a Healthy Life in Logan: Information for Food and Exercise Choices, which
contains a DVD and booklet with information on nutrition and physical activity for people in the target
communities in Logan. These products have been distributed within the target communities and to service
providers to these communities. Feedback from the community is very positive with the resources being
actively used and appreciated.
References: Australian Institute of Health and Ageing (AIHW) (2006). Australia‟s health 2006. AIHW Cat.
No. AUS 73. Australian Institute of Health and Ageing: Canberra.
Burns, C., Webster, K., Crotty, P., Ballinger, M., Vincenzo, R., & Rozman, M. (2000). Easing the transition:
Food and nutrition issues of new arrivals. Health Promotion Journal of Australia, 10, 230-236.
Renzaho, A. M. N., & Burns, C. (2006). Post-migration food habits of sub-Saharan African migrants in
Victoria: A cross-sectional study. Nutrition & Dietetics, 63, 91-102.
Disclosure of Interest: None declared

TP-WED-172 ON THE ROAD TO EMPOWERMENT, PART 2: FROM SIDE DISH TO MAIN COURSE
L. Pilotto* 1 , R. Moro 2 , A. Cacitti 3
1 Health Promotion Consultant, ASS 4, 2 Associazione, Diamo Peso al Benessere, 3 Mental Health
Department, ASS 4 Medio Friuli, Udine, Italy
Background: For the last 8 years the Eating Disorders clinic of the mental health department in Udine (Italy)
has been conducting a successful program for overweight/obese people, based on a process of
empowerment, both at personal and at group level. A couple of years after the program begun, a group of
“graduates” formed an association to initially provide some support to the people ongoing the therapeutic
process and to raise funds for the needs not met by the health department. Over the years the non-profit
association “Diamo Peso al Benessere” has taken on a role of advocacy
Objectives: Mission empowerment: the Association will put into action the members‟ newly acquired skills
by creating a supporting environment outside the health services and promoting a positive image of
overweight/obese people
Underlying values and principles: Empowerment, networking, and advocacy
Knowledge base/ Evidence base: Based on empowerment work of Bruscaglioni (2007) and Gheno (2002),
on Bandura's social cognitive theory (1986), on community organizing theory (Francescato,1992), on social
marketing (Kotler & Zaltman,1971), and on Freire's educational theory (2005).
Context of intervention/project/work: The association was created to support obese and overweight
people undergoing a process of empowerment to regain control of their lives.
Methods: •Advocating and lobbying at the political level for recognition of the problems faced by obese
people, especially in terms of health care
•Partnering with community businesses and other associations to promote a positive image of
overweight/obese people
•Create an answering service in different locations to give information about the program
•Sponsor the empowerment program in other locations
•Support its members by establishing "maintenance" groups
Results and Conclusions: Since 2004 about 400 persons have joined the association, which now
publishes a regular newsletter, holds social gatherings and participates with a booth to the most important
events in the city of Udine and surroundings;
as a result of its lobbying has obtained regional and local funds for its programs, in particular for the
“maintenance” groups for those who have already finished the initial program; has established MoUs with the
city‟s Farmers Market to promote healthful eating also involving local restaurants, and with the University‟s
Health, Fitness and Exercise Studies program to establish supervised walking groups; has organized
residential long week-ends at the beach where the members get together, have fun, and also work in groups
to improve their life skills.
The Association has now become a power to be reckoned with, a voice for a segment of the population
usually either ignored or criticized, a partner in community development and a co-sponsor and advisor to the
therapeutic process of empowerment. In fact, from being the offshoot, the daughter of the program, it has
now become the “mother” in so far as it contributes to the dissemination and strengthening and overall
success of the project.
References: Bandura, A. (1986). Social foundations of thought and action: A social cognitive theory.
Bruscaglioni M. (2007). Persona Empowerment.
Francescato, D. (1992). Psicologia di comunità.
Freire, P. (2005). Education for critical consciousness.
Gheno,S.(2002). L'uso della forza.
Kotler, P. & Zaltman, G. (1971). Social marketing: an approach to planned social change.
Disclosure of Interest: None declared

TP-WED-173 EVALUATION OF COLLABORATIVE PROCESSES AND STRUCTURES IN THE OUR
CULTURES FOR A GOOD LIFE PROJECT IN BRISBANE, AUSTRALIA
K. Nissen* 1 , A. Seibt 2 , N. Harris 3
1 Health Sciences, HAW Hamburg, 23714, 2 Health Sciences, HAW, Hamburg, Germany, 3 Public Health,
Griffith University, Brisbane, Australia
Background: After settling in Australia, migrants often acquire food habits and physical activity levels of
their new home country with the negative consequences of overweight and obesity. The community-based
project 'Our Cultures for a Good Life' addressed this issue aiming to improve the nutrition and physical
activity of African and Pacific Islander migrant children in Australia. The present evaluation study
investigated those project key components that contributed to implementation effectiveness. It adds to the
evidence-base of health promotion and evaluation literature.
Objectives: 1.To describe and investigate collaborative processes and structures 2.To examine the
involvement of the project stakeholders and target population 3.To determine the appropriateness of
activities and resources 4.To develop recommendations for partnerships for future projects
Underlying values and principles: Contemporary health promotion advocates a partnership-based
approach to planning, implementing and evaluating interventions. The Our Cultures for a Good Life project
adopted such an approach. The evaluation study examined theses processes thereby meeting health
promotion principles of evaluating practice.
Knowledge base/ Evidence base: The literature highlights the need for community-based partnerships to
design interventions to tackle overweight and obesity in migrant children. However, there is a paucity of
knowledge on evaluations of collaborative health promotion projects in socially disadvantaged migrant
communities.
Context of intervention/project/work: The Our Cultures for a Good Life project was investigated according
to theory-based process evaluation principles.
Methods: For the present study, evaluation research was chosen as the study design. The process
evaluation was underpinned by interpretive social science and the primary data collection method was semistructured
interviews supported by document analysis and observation.
Results and Conclusions: Major findings of the study suggest that project management, relationships and
communication are important components for successful community-based partnership programs. Limited
funds, the relatively short timeframe,a prior history of competition between the partners, the communication
flow as well as different structures and processes of the various organisations created challenges. Overall,
the Our Cultures for a Good Life project was perceived as a successful program with a potential for
sustainability when integrated and linked with other programs and with a longer time frame. The insights
gained will assist service providers to have a better understanding of what kind of processes and structures
facilitate collaboration in implementing preventive health projects in disadvantaged migrant communities.
Disclosure of Interest: "None declared"

TP-WED-174 PROGRAMME TO COUNTERACT CHILD OBESITY IN THE ALGARVE
T. S. o. f. i. a. Sancho* 1
1 Department of Nutrition, Regional Health Authority - Algarve, Faro, Portugal
Background: The Algarve strategy on healthy weight consists in a comprehensive approach, which is a
multisectorial and multidisciplinary. There is a health policy developed both regionally and locally. The
Programme to Counteract Child Obesity in the Algarve is being developed between 24 institutions in
partnership, the Regional Health Authority, the University of the Algarve, the Regional Education Authority,
theFaro‟s Central Hospital, the Barlavento‟s Central Hospital, the Municipalities Association, the 16
Municipalities of the Algarve, Parents‟ Representatives and Regional Sports Authority.
Objectives: The general objective is contradict the growth rate of childhood obesity in the Algarve, with a
more efficient and effective prevention and treatment.
Underlying values and principles: The underlying values and principles are the promotion of the health
through the improvement of the habits of healthy eating and of the habits of physical regular activity, though
the target be free of options.
Knowledge base/ Evidence base: A prevalence study on overweight and obesity on a regional level
showed that these problem affect 30,2% of the algarvian children, so high as in Portugal (31,56%), one of
the highest percentages in Europe.
Context of intervention/project/work: The study of childhood obesity in the Algarve is currently in its
second phase - the community intervention – which is made in schools, health care centres and hospitals, in
collaboration with health and education professionals.
The children need to adopt a healthy lifestyles (healthy diet and physical activity) and the adults (families)
need to create the conditions to make this possible. Counteracting obesity develops itself through prevention
and treatment based on a community intervention, with a multidisciplinary and intersectorial approach
centered in the family, to promote healthy eating habits and regular physical activity habits.
The priority approach is targeted at infants, children and adolescents. At the health programs level the
priority starts during the pregnancy and it is developed at the following levels: oral hygiene, school health
and family health.
Methods: The methodology of the communitary intervention consists in:
• Training sessions with health primary care professionals;
• Training sessions with school professionals;
• Developing projects in local context;
• Developing regional initiatives.
The Programme to Counteract Child Obesity in the Algarve has also a communication plan for pupils,
families and the community. At the pupils level the communication is accomplished with flyers, with
notebooks of physical activity and with games. At the families level the communication plan includes
newsletters, flyers and parental advice with technicians and leaflets. At the community level the plan is
accomplished though public events, the internet and media.
Results and Conclusions: The Programme to Counteract Child Obesity in the Algarve contemplates a final
evaluation of the impact in 2012.
References: http://www.arsalgarve.minsaude.pt/site/index.php?option=com_content&view=article&id=665&Itemid=114
http://www.youtube.com/watch?v=xtTr2Y_1H5E
Disclosure of Interest: There is no conflict of interest to declare.

TP-WED-175 MOBILISATION RÉGIONALE ET LOCALE SUR LES SAINES HABITUDES DE VIE, LE
POIDS ET LA SANTÉ
A. Royer 1 , M. Turcotte 1 , L. M. Manceau 1 , S. Dugal 1 , M. Beauchemin* 1
1 Direction régionale de santé publique, Agence de la santé et des services sociaux, Québec, Canada
Historique / Origines: Dans la foulée des taux croissants de maladies chroniques et d‟obésité observés au
Québec, la Direction régionale de santé publique de Québec a amorcé une stratégie de mobilisation
régionale et locale sur les saines habitudes de vie, le poids et la santé dans le but de ralentir la progression
de l‟obésité et d‟améliorer les habitudes de vie de la population.
Objectifs: Cerner les facteurs favorables et défavorables à l'égard d'une stratégie de mobilisation régionale
et locale sur les saines habitudes de vie, le poids et la santé.
Valeurs et principes sous-jacents: La Mobilisation vise à promouvoir la création d‟environnements
favorables pour soutenir la population dans l‟adoption et le maintien de saines habitudes de vie, et ce, en
accordant une attention particulière aux familles vivant en contexte de vulnérabilité ou de pauvreté.
Fondement de connaissance/Fondement de preuve: Le cadre de référence utilisé pour faciliter le
déploiement des activités est l‟approche 0-5-30 COMBINAISON PRÉVENTION. Ce cadre mise sur
l‟intégration de trois mesures autour d‟un message unifié pour promouvoir les saines habitudes de vie et
prévenir l‟apparition des maladies chroniques. Les trois mesures sont: « 0 » pour la non-consommation de
tabac et la non-exposition à la fumée de tabac dans l‟environnement, « 5 » pour la consommation d‟au
moins cinq fruits et légumes par jour et « 30 » pour la pratique d‟au moins trente minutes d‟activité physique
par jour. Pour introduire ces mesures, la combinaison de deux stratégies est proposée: des actions
éducatives auprès des individus et des actions environnementales dans les milieux de vie (Dugal et coll.,
2004)
Contexte d'intervention/projet/travail: L'évaluation de l‟implantation de la démarche de mobilisation s'est
effectuée dans le contexte des planifications gouvernementales régionales et locales pour améliorer les
saines habitudes de vie, le poids et la santé de la population de la région de Québec.
Méthodes: Des entrevues ont été effectués auprès des 21 partenaires de la Mobilisation. L‟évaluation est
fondée sur une analyse systématique de la littérature scientifique, une analyse qualitative des entrevues
ainsi que des documents écrits (comptes rendus et documents accompagnateurs, rapports, bilan,
documents de planification et plan d‟action). Les documents analysés couvrent la période de 2004 à 2007.
Résultats et Conclusions: Les résultats font état de problèmes organisationnels (leadership,
communication, partenariat, financement), individuels (rôles, intérêt) et environnementaux (contexte
politiques et économiques, connaissance du milieu). L‟analyse des résultats montre que la Mobilisation doit:
1.Clarifier la vision commune.
2.Réviser le plan d‟action et obtenir du financement.
3.Favoriser la permanence des partenaires et reconnaître la nature de leur organisation et leur rôle dans la
Mobilisation.
4.Revoir la composition et la structure de la Mobilisation ainsi que ses modes de fonctionnement.
Les quatre défis ciblés dans le cadre de cette évaluation sont liés à des conditions de réussite qui, si elles ne
sont pas intégrées, pourront influer sur la pérennité de la Mobilisation.
Références: DUGAL, Sonia, et coll. (2004). Programme intégré de prévention des maladies chroniques
2002-2012 dans la région de la Capitale nationale, population adulte, Beauport, Agence de développement
de réseaux locaux de services de santé et de services sociaux de la Capitale nationale, Direction régionale
de santé publique, 76 p.
Conflit d'Interêt: rien à déclarer

TP-WED-176 CAPTURING HOW WEIGHT GOALS ARE ASSOCIATED WITH WEIGHT-RELATED
BEHAVIORS AMONG A REPRESENTATIVE POPULATION-BASED SAMPLE OF QUEBEC (CANADA)
TEENAGERS
M. Roy* 1 , L. Gauvin 2
1 Médecine sociale et préventive, Université de Montréal, CRCHUM–Centre de recherche du Centre
Hospitalier de l‟Université de Montréal, 2 Médecine sociale et préventive, Université de Montréal, CRCHUM–
Centre de recherche du Centre Hospitalier de l‟Université de Montré, Montréal, Canada
Background: Adopting and maintaining a weight management strategy is important for reaching a healthy
body weight which is in turn linked to better outcomes. Weight management strategies contain at least two
dimensions: a pursued weight goal and different behaviors used to reach this weight goal. There are four
weight goals which can be pursued. People can try to lose, gain, maintain, or do nothing concerning their
weight. Weight goals are not, in and of themselves, healthy or unhealthy. Their potential to promote or
undermine health depends of the actual weight status of the individual who tries to reach them. For example,
losing weight is an appropriate weight goal when someone has excess weight whereas gaining weight is
appropriate for underweight people and maintaining weight or doing nothing concerning weight is appropriate
for normal weight people. Conversely, weight goals that mismatch weight status are inappropriate because
they are not directed toward a healthy body weight and this can lead to unhealthy outcomes. To reach
weight goals, there is an array of weight-related behaviors which can be used with varying frequency. By
opposition to weight goals, behaviors used to reach weight goals are inherently healthy, unhealthy, or
disordered.
Objectives: The objective of this study was to examine associations between both dimensions of a weight
management strategy that is, between matched vs. mismatched weight goals and the frequency of use of
different behaviors aimed at weight goals.
Underlying values and principles: The underlying principle of this study was to identify determinants of
health behaviors to promote health and protect vulnerable groups of young people.
Knowledge base/ Evidence base: Psychosocial determinants of human behavior
Context of intervention/project/work: Doctoral thesis of the first author
Methods: Measures included an indicator of whether weight goals matched or mismatched the individual‟s
weight status and self-reported frequency of use of different behaviors among a representative populationbased
sample of Quebec (Canada) teenagers (n = 2346, 51% female; 93.3% complete data). Genderspecific
multilevel logistic and ordinal regression models were conducted to examine associations between
weight goals and frequency of use of weight-related behaviors.
Results and Conclusions: Results suggest that pursuing a mismatched weight goal increases the
likelihood of using unhealthy behaviors among both sexes. This association is statistically non significant for
the other types of weight-related behaviors (healthy and disordered). We conclude that there is an
association between mismatched weight goals and the use of unhealthy behaviors.
References: ESSEA, © Gouvernement du Québec, ISQ, 1999.
Disclosure of Interest: None declared

TP-WED-177 « C‟EST PAS QUE POUR LES BOBOS !» L‟ALIMENTATION DURABLE POUR TOUS, UN
OBJECTIF STRATÉGIQUE DE LA PROMOTION DE LA SANTÉ EN HAINAUT.
M. DEMARTEAU* 1
1 Prévention et Promotion de la santé, Observatoire de la santé du Hainaut, Mons, Belgium
Background: L‟observatoire de la santé du Hainaut est une institution publique de promotion de la santé
financée par la collectivité territoriale « Province de Hainaut ».
Sa mission principale est de réduire l‟inégalité sociale et territoriale de santé qui se traduit par environ 1.500
décès excédentaires au regard des données nationales. Pour ce faire, elle agit en particulier pour
promouvoir une alimentation favorable à la santé.
A la faveur des enjeux climatique et énergétique de nouvelles thématiques sont apparues ces dernières
années dans le champ de l‟alimentation se référant au développement durable : commerce équitable,
souveraineté alimentaire, production locale, impact environnemental… qui touchent les secteurs de la
production, de la transformation, de la distribution et de la consommation. Mais cette alimentation locale bio
éthique et diététique ne concernerait encore qu‟une petite frange de la population : les plus riches, les plus
instruits, les plus conscients des enjeux sociétaux. Comment tenir compte de ces enjeux et les rendre
accessibles à tous dans le cadre de notre institution ?
Objectives: Intégrer le développement durable dans la démarche de l‟observatoire de la santé du Hainaut.
Underlying values and principles: Inégalités sociales et territoriales de santé
Knowledge base/ Evidence base: Approche par milieux de vie
Context of intervention/project/work: Participation au réseau régional wallon de promotion de
l'alimentation durable
Methods: Utiliser la planification stratégique pour adapter les programmes afin de tenir compte et d‟anticiper
les modifications de l‟environnement externe.
Results and Conclusions: Une démarche d‟équipe au sein de l‟institution est en cours pour une analyse
interne et externe pour confronter notre mission, nos compétences avec ses forces et ses faiblesses aux
opportunités et menaces portés par l‟alimentation durable.
Quelles sont les positions de la population, des mandataires politiques, des professionnels ?
Comment les faire évoluer ? Avec quel mandat du point de vue de la promotion de la santé ? Quels sont les
alliances à créer ? Quels sont les opposants potentiels ? Pour quelles raisons ? Avons-nous les
compétences nécessaires ? Comment les rassembler et/ou les développer ? Quels moyens rassembler ?
Quelles sont les priorités ? Avec qui et pour qui travailler ?
Les réponses apportées seront présentées au moment du congrès.
Disclosure of Interest: none declared.

TP-WED-178 EATING BEHAVIOUR, OVERWEIGHT AND OBESITY IN POLISH SECONDARY SCHOOL
STUDENTS
E. Wierzejska* 1 , M. Biskupska 1 , J. Wysocki 1 , J. Bajerska 2 , M. Zielke 2 , B. Bilski 2 , J. Jeszka 2 , J. Twardowska-
Rajewska 3
1 Department of Preventive Medicine, Poznan University of Medical Sciences, 2 Department of Human
Nutrition, University of Life Sciences, 3 Faculty of Educational Studies, Adam Mickiewicz University, Poznan,
Poland
Background: In European countries, overweight affects approximately 20% of the population of children and
young people, a third of whom suffer from obesity. In this respect, a growing tendency has been noted for a
long time. According to WHO reports, in various regions of Europe obesity is responsible for as many as 2-
8% of health expenditure and for 10-13% of deaths.
Objectives: The main objective of the project was to find out whether there is a connection between eating
behaviours and the incidence of overweight and obesity in the population of secondary school students.
Underlying values and principles: The research was conducted with the respect of study subjects
(informed consent signed by students or by parents in case of underage subjects). Researchers declare
objectivity and honesty.
Knowledge base/ Evidence base: Studies carried out by the Polish Instytut Zywnosci i Zywienia (The
National Food and Nutrition Institute) in the population of schoolchildren and youths in the years 1994/1995
and 2000 show that the proportion of young overweight and obese people is growing also in Poland.
Context of intervention/project/work: The study group comprised 620 schoolchildren (307 girls and 313
boys) aged from 16.0 to 20.0 years, from randomly selected secondary schools of the city of Poznan.
Methods: Three questionnaires were employed: Eating Inventory (TFEQ), FFQ – Food Frequency
Questionnaire, and a questionnaire designed by the researchers, containing questions about demographic
data and the organisation of the complementary meals school programme.
In anthropometric study the subjects‟ height and weight was measured, and their weight and height
percentile and Body Mass Index and was calculated. To determine the distribution of adipose tissue around
the body, Waist-Hip Ratio (in cm) was used. Bodyfat (%FM) was estimated on the basis of the thickness of
skin folds using Harpenden Skinfold Calipers.
Results and Conclusions: It was concluded that the average BMI was 21.9 ± 3.1 kg/m2, with 22.4 ± 3.2
kg/m2 among boys and 21.5 ± 2.9 kg/m2 among girls. The average thickness of skin and fat folds in the
whole population was 14.9 ± 5.8 mm. The results might suggest that the overweight and obese people,
realising that one of the factors contributing to overweight is bad eating habits (such as consuming a lot of
high-calorie low-nutrition products – “fast food”,) intentionally declared a lower intake of such foods. As
expected school setting was found to be also a strong determinant of eating habits and behaviour.
Disclosure of Interest: None declared

TP-WED-179 EATING BEHAVIORS AMONG PRISTINA PRIMARY SCHOOL CHILDREN: CROSS-
SECTIONAL STUDY
R. Hoxha 1 , M. Berisha 2 , S. Gashi 1 , D. Zajmi 2 , N. Berisha* 3 , I. Begolli 2
1 Health Information System, 2 Social Medicine, National Institute of Public Health of Kosova, 3 Dentistry,
Medical Faculty, University of Prishtina, Prishtina, Albania
Background: Healthy and balanced eating has significant impact on physical development and mental
health in school children. There are many factors that play a role in the matter of making healthy foods by
children of this age in the first place: the culture of family, the country's culture, and norms, access to these
products, prices, domestic policies which regulate or support in relation to food issues, schools and
educational programs. Healthy eating and positive habits are preventive factors for many diseases.
Objectives: Aim of this study has been to analyze the habits of school children aged 12-15 years in relation
to healthy food.
Underlying values and principles: Information about eating behaviors of school children will help us to
design programs for creating positive habits among children about healthy eating and prevent the obesity
among this group in the future.
Knowledge base/ Evidence base: Primary school children in Pristine region; 12-15 years old
Context of intervention/project/work: Identify differences in eating behaviors according to age, gender,
dwelling place and mother‟s education.
Methods: This study is the cross sectional study and data was conducted through a survey which has
adequate content questions about this topics. Study was realized with children aged 12-15 years in primary
schools of Pristina in October-November period 2008.
Results and Conclusions: Results shows that 69.5% of interviewed primary school children in Pristina
answered that fruit and vegetable consumption positively affects health, with significant difference (p

TP-WED-180 PROMOTING HEALTHY FOOD BEHAVIORS AMONG STUDENTS BY RECIPE
COMPETITION?
M. Lomazzi* 1 , B. Borisch 1
1 IMSP, University of Geneva, Geneva, Switzerland
Background: The scientific literature frequently reports the epidemic status of obesity. Several interventions
on both regional and national level to change food behaviour have been carried out.
Objectives: We set out to initiate a communication process related to everyday nutritional practices in the
student population.
Underlying values and principles: This activity should further sustain the word-of-mouth communication
among students.
Knowledge base/ Evidence base: Everyday problems of specific groups, i.e. university students, are less
the focus of health promotion interventions.
Context of intervention/project/work: This project was launched on the occasion of the 450th anniversary
of the University of Geneva. The project was community-based.
Methods: Students were asked to submit balanced healthy suggestions for food derived from their practice
and lifestyle. They had to take into account time and money constraints and this happened in form of an
open contest. The intervention was mainly internet-based, with flyers and posters in the university buildings
as supplementary means of communication.
The entries were judged by a multidisciplinary jury and answers analyzed for content/origin. Moreover,
participants answered to an on-line survey test to determine their profile.
Results and Conclusions: Out of 30 recipes, 26 corresponded to the nutrition requirements. Most recipes
derived from mediterranean (38.6%) or middle-east areas (34.6%). Students participating in the competition
were already concerned and deeply involved in the nutrition theme. They had either cooked for a long time
(58.8%) or since they started living independent from family. Main motivations were the pleasure of cooking
(82.4%), health aspects (58.8%) and budget (47.1%). This intervention will be concluded by publishing all
recipes in a booklet and on the net.
Our preliminary results suggest that recipe competition represents an innovative approach to be exploited for
wider actions on health nutrition habits. University students are a good target-group as they present a kind of
“open-window opportunity” for food-related message.
Disclosure of Interest: None declared

TP-WED-181 EATING HABITS, LIFESTYLE FACTORS, AND BODY WEIGHT STATUS AMONG
ETHIOPIAN GOVERNMENTAL EDUCATIONAL INSTITUTION STUDENTS
N. T. Wabe* 1 , S. S. Suleiman 2 , w. W. bededa 3
1 Toxicology and Therapuetics, jimma university, Jimma, Ethiopia, 2 , , 3 Pharmacy, jimma university, Jimma,
Ethiopia
Background: Overweight or obesity is a major public health problem. The identification of factors associated
with obesity, weight gain as well as weight maintenance will in turn enable the development of programs to
promote health among college students and other at risk populations.
Objectives: To assess the prevalence of underweight, overweight, and obesity and to evaluate the effects of
eating habits, lifestyle, and sociodemographic characteristics on students' weight.
Underlying values and principles: The population of our study has equal opportunities in health
sustainability, almost same obligations and shared responsibility for health avoiding damage, fairness
transparency and accountability health sustainability & health promotion.
Knowledge base/ Evidence base: The study subjects of our study are university and high school student.
Other study among Turkish private educational institution students shows,about 70% of the students were of
normal weight; 25.7% were underweight; and 4.4% were overweight/obese students, with just 0.6% being
obese. Girls(13) had more accurate habits than boys(7)in this study. Compared with those
underweight/normal weight, special meals prepared at least once daily at home (P < 0.05), and not selecting
fast food such as hamburgers at meals (P < 0.01)unan ayranci et al.
Context of intervention/project/work: A formal letter written from Jimma University to Student Research
Program & permission was obtained. Verbal consent was obtained from the respondents and brief
explanation of aim of study was provided with the questionnaire. Only those who were volunteer were
included in the study.
Methods: This cross-sectional study was carried out from April to May 2009 in the city of Jimma, Ethiopia. A
total of 1500 students 15-25 y of age (820 boys and 680 girls) were examined. The questionnaires, including
items related to eating habits, lifestyle, and sociodemographic characteristics, were completed by the
students. The data were evaluated using chi-square test, percent ratios & t_ test was employed to test the
reliability of the questionnaire scale.
Results and Conclusions: RESULTS: About 85% of the students were of normal weight; 5% were
underweight; and 5.4% were overweight/obese students, with just 4.6% being obese. Accordingly, girls(15)
had more accurate habits than boys (9). Compared with those underweight or of normal weight, the
proportion of those overweight/obese was smaller for those having milk or juice at breakfast (P < 0.05),and
special meals prepared at least once daily at home (P < 0.05) CONCLUSION: The result suggest that the
prevalence of overweight and obesity is much lower than the prevalence of underweight in Ethiopia schoolbased
adolescents, important data that merit consideration. Health professionals, teachers, and family
environment may play a key role in the promotion of a healthy lifestyle.
Disclosure of Interest: Sultan S, jimma Universtity, consultant

TP-WED-182 EFFECT OF EXPERIENCE OF A DIETARY SURVEY ON THE AWARENESS OVER
NUTRITIONAL HABIT AMONG JAPANESE COLLEGE STUDENTS
T. Yoshizawa* 1
1 Health Sciences, Kagawa Nutrition University, Saitama, Japan
Background: While the relationship between better nutrition and health appears well understood, behavioral
as well as life-style change are often hardly achieved. Participation to a dietary survey might a good tool to
change one‟s nutritional habit.
Objectives: The present study was designed to evaluate how the experience of a dietary survey can
influence person's nutrition habits.
Underlying values and principles: Knowing the opinions of people who experience a dietary survey is
vital,especially because its is very difficult to change people's life style behavior. If the experience of a
dietary survey affords the possibility to change human behavior,dietary surveys would become significant
contributors to human health especially as relates to dietary habits.
Knowledge base/ Evidence base: Much research on dietary surveys has been published all over the world.
However only a few researchs have used the technique of detailed dietary surveys. Mostly research has
used simple and easy dietary surveys (for example FFQ:Food Frequency Questionnaire). This study use the
detailed dietary survey(direct observation) to examine a change of the nourishment awareness among
Japanese college students.
Context of intervention/project/work: 428 college students from five independent departments of a single
college were participated in this study.
Type1(n=122,students of applied nutrition) Type2(n=105,students of health and nutrition, division of nutrition
sciences) Type3(n=71,students of health and nutrition, division of health and school nursing)
Type4(n=94,students of food culture and nutrition) Type5(n=36,students of health and nutrition)
Methods: The contents of the detailed dietary survey method
・record all the meal types which participant ate during the investigation period
・breakdown participant meals to the level of the cooking ingredients
・record all the weight of each cooking ingredient
・record the precise of weight of ingredients such as seasoning or oil
・breakdown meal ingredients in a similar fashion for the following cases : eating out, ready-made meals
and meals cooked food for oneself
・calculate nutrient quantities from cooking ingredient weights using food composition table
・Record all meals taken over three day investigation period(include snacks)
At the end of the survey, participants were asked to provide free responses regarding their opinions of the
survery and whether it had influenced them in any way. These responses were analyzed to identify common
themes as well as check whether the survey had encouraged the participants to improve their dietary habits.
Results and Conclusions: Many student participants felt that this investigation was a chance to for them to
review their own actual eating habits. In addition, after the survey many students expressed in interest in
changing and improving their eating habits. However, a difference was observed in the food groups used by
the type of the department. What was observed was that attitudes towards dietary habits differed according
to future professional carreer paths. The research showed that experience of a detailed meal record resulted
in people reviewing dietary habits and seeking improvement of the future dietary habits. However, it should
be noted that this study recorded people's intentions to change after the initial investigation. It will be
necessary to conduct a follow-up study to confirm whether people actually do change and continue to
improve their dietary habits.
References: Evidence-Based Nutrition & Nutritional Epidemiology
Disclosure of Interest: None declared

TP-WED-183 HEALTH PROMOTION THROUGH ORGANISATIONAL DEVELOPMENT: CREATING
SUPPORTIVE EATING ENVIRONMENTS WITHIN A NEW ZEALAND UNIVERSITY
A. Crocket* 1 , E. Rush 1 , G. Dickson 1
1 Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand
Background: Encouraging the development of environments that support health and wellbeing is a
cornerstone of health promotion. Within commercial eating environments, such as those at universities, high
fat and/or sugar foods tend to be easily available. These obesogenic environments contribute to the high
levels of obesity in New Zealand. Organisational development using financially sound and evidence-based
strategies is needed so these environments can become supportive of a healthy diet and lifestyle.
Objectives: The aim of this participatory action research (PAR) is to create a healthier eating environment at
a university by integrating environmental changes in the foodservice (such as availability, labelling or pricing
strategies) with a social marketing campaign. This presentation will show how PAR is being used to develop
and implement a strategy for organisational development within a commercial foodservice.
Underlying values and principles: Using PAR within an organization allows for greater collaboration with
stakeholders and focuses on empowering people to find solutions to meet their needs. Collaboration
underpins all stages of this PAR and is essential when endeavouring to create supportive environments.
Compared to individual behaviour change strategies, supportive environments encourage equity as all
stakeholders have equal opportunity to benefit from changes.
Knowledge base/ Evidence base: Empirical evidence shows PAR and collaboration are successful
strategies to create positive organizational change within an eating environment1.Furthermore, changing the
eating environment within a workplace, results in improved eating behaviour and is a successful and costeffective
strategy at a population level.
Context of intervention/project/work: AUT University has 30,000 culturally diverse students and staff,
there are 6 cafes spread over 3 campuses, which are operated internally by AUT on a not-for-profit basis.
Like similar operations within New Zealand there was minimal availability and promotion of healthier food
and beverages prior to this initiative.
Methods: Consultation and collaboration are included in all stages of this PAR (needs assessment,
development, implementation and evaluation) to encourage sustained organisational development. Planning
and consultation meetings with the foodservice management team and staff have been integral to
collaboration throughout this PAR. In addition, focus groups and an online discussion forum with end users
and consultation with an advisory group to look for collaboration opportunities with other university
departments have also contributed to the PAR process.
Results and Conclusions: This program has successfully used PAR to create positive organisational
changes such as using lower fat recipes, selling fruit at cost price, and labelling and displaying healthier
choices more prominently. These changes have been incorporated into the organisational makeup of the
university foodservice operation and created a healthier eating environment on campus.
References: 1) Matson-Koffman, D. M., Brownstein, J. N., Neiner, J. A., & Greaney, M. L. (2005). A Sitespecific
Literature Review of Policy and Environmental Interventions that Promote Physical Activity and
Nutrition for Cardiovascular Health: What Works? American Journal of Health Promotion, 19(3), 167-167.
Disclosure of Interest: A. Crocket, Healthy Living Trust Ltd, Grant/Research support
A. Crocket, Tertiary Education Commission, Grant/Research support

TP-WED-184 ENVIRONMENTAL ASPECTS SHAPING FOOD PREFERENCE AND CHOICES AMONG
ADOLESCENT GIRLS IN SOUTH SULAWESI, INDONESIA
R. Indriasari* 1 , E. Schubert 2 , G. C. Marks 2 , K. Long 2
1 Faculty of Public Health, Hasanuddin University, Indonesia, School of Population Health, The University of
Queensland, 2 School of Population Health, The University of Queensland, Brisbane, Australia
Background: Food choice is affected by factors related to food, the person, and the economic and social
environment as well as the interactions among the factors (1). Nevertheless, literature explaining food choice
focuses predominantly on people in industrialized countries or in Western cultures (2). Therefore, the models
that developed to understand food choice in Western world may or may not be applicable in different cultural
setting. Research is needed to identify factors shaping food choice in a non-Western cultural context,
particularly in more specific population group.
Objectives: to explore environmental concepts shaping adolescent girls‟ food preference and food choice
and to understand how these concepts are interrelated
Underlying values and principles: Understanding environmental factors influencing the development and
changes in food selection are considered important for assisting the successful translation of
nutritional/health messages in promoting eating behavior change that is relevant to, and targets priority
nutrition problems in a target population.
Knowledge base/ Evidence base: Dietary factor is one of the key determinants of iron deficiency anemia
(IDA) that affects many population groups including young adolescents (3). One of dietary change strategies
to control IDA is changing eating behavior by improving the consumption of foods important for iron status
(4). However, negligible attention has been placed for promoting dietary change in preventing IDA among
adolescent girls in Indonesia that might be due to the lack of data on eating behavior in this population.
Besides the importance of personal aspects, the recognizable roles of environmental aspects in determining
food choice have been considered in tailoring nutritional interventions to facilitate dietary modification, and
efforts to change behavior benefit from a supportive environment (5).
Context of intervention/project/work: Young female adolescent population in a country with Asian cultural
background that experiencing developing economic condition.
Methods: A qualitative methodological approach, utilizing in-depth interview technique, was employed as
part of a larger study involving a mixed method design. A purposive sample of 20 female students aged 12-
14 years was recruited from secondary schools in the South Sulawesi province. Nineteen mothers who had
teenage girls enrolled in the same schools were also recruited. Thematic analysis was performed to capture
broader concepts that emerged from the data.
Results and Conclusions: Cultural tradition, parent and peer influences, financial issues, accessibility and
availability of food, and the existence of food vendors and restaurants in surrounding neighborhood,
appeared to play important roles in shaping food preference and choices among young adolescent girls.
Promoting consumption of foods important for iron status should not only target the girls individually but
should include changes in home, school, and neighbourhood environment.
References: 1.Shepherd, R 2005, 'Influences on food choice and dietary behaviour', in I Elmadfa (ed.), Diet
Diversification and Helath Promotion, Karger, Basel, vol. 57, pp. 36-43
2.Cox, DN & Anderson, AS 2004, 'Food Choice', in MJ Gibney, BM Margetts, JM Kearney & L Arab (eds),
Public Health Nutrition, Blackwell Science, Oxford, UK ; Ames, Iowa
3.WHO 2006, Adolescent Nutrition: A Review of the Situation in Selected South-East Asian Countries, World
Health organization
4.UNICEF/UNU/WHO/MI 1998, Preventing Iron Deficiency in Women and Children: Background and
Consensus on Key Technical Issues and Resources for Advocacy, Planning and Implementing National
Programmes, 1-894217-07-1, International Nutrition Foundation (INF) and Micronutrient Initiative (MI),
Boston
5.Butriss, J, Stanner, S, McKevith, B, Nugent, AP, Kelly, C, Phillips, F & Theobald, HE 2004, 'Successful
ways to modify food choice: lessons from the literature', Nutrition Bulletion, vol. 29, pp. 333-43
Disclosure of Interest: R.Indriasari,Neys-van Hoogstraten Foundation,Grant Research Support

TP-WED-184b A STUDY OF PARENTAL INFLUENCE ON UNHEALTHY EATING BEHAVIOR IN
ADOLESCENTS OVER A SEVEN YEAR PERIOD: GROUP-BASED TRAJECTORY MODELING
W. Wu 1 , L. Yen 2 , H. Chang 3 , Y. Chiang* 4 , C. Wu 5
1 Department of Nutrition and Health Sciences, School of Health Care Management, Kainan University,
Taoyuan, 2 Institutions of Health Policy and Management, College of Public Health, Naitonal Taiwan
University, Taipei, 3 Institute of Population Health Sciences, National Health Reseach Institute, Miaolo Couny,
4 Department of Public Health, Chung Shan Medical University, Taichung, 5 Institute of Public Health
Sciences, National Health Reseach Institute, Miaoli County, Taiwan
Background: Unhealthy eating behavior in adolescents has been proved to be one of the predictors of
obesity. The stability of, or change in, the course of unhealthy eating behavior has an important influence on
adolescent obesity. The eating behavior of adolescents is usually nurtured in the home environment. It is
valuable to investigate the various trajectories and related parental influences of adolescents‟ unhealthy
eating behavior.
Objectives: This study aims to identify the trajectories of unhealthy eating behavior among adolescents and
to identify related parental influence on adolescents displaying heavy or increasing unhealthy eating
behavior.
Underlying values and principles: There may be clusters of distinctive developmental trajectories in
adolescents' unhealthy eating behavior. Understanding the related factors of instances of heavy or
increasingly frequent unhealthy eating behavior is very important for obesity prevention.
Knowledge base/ Evidence base: Unhealthy eating habits are positively associated with body weight and
with waist and hip circumference. Persistent unhealthy eating will lead to deteriorating health. Parental
attitudes towards eating are related to the development of obesity in children. Hence, paying attention to the
influence of parents on unhealthy eating behavior in adolescents is important.
Context of intervention/project/work: Child and Adolescent Behaviors in Long-term Evolution (CABLE) is
a longitudinal study based on the ecological model, analyzing personal, family, school, and community
influences on the health and lifestyle of individuals. This project was carried out from 2001 to 2008. The
participants from selected schools were first and forth graders in 2001, and were eighth graders and eleven
graders in 2008. The CABLE project collected data using an independently-developed instrument that has
been carefully refined for reliability and validity. This project was approved by the Institutional Review Board
of National Health Research Institute in Taiwan.
Methods: Questions about unhealthy eating behaviors were first included in the 2002 survey of the CABLE
study. Therefore, we used 2002-2008 survey data of the CABLE project, and only included only included the
cohort of students who were fifth graders in 2002. Students' sex, residential area, parents‟ marriage status,
social economic status and unhealthy eating behaviors were included as covariates and were measured in
2002. Group-based trajectory modeling was used to identify the types of distinct trajectories in the
development of unhealthy eating behavior and to clarify the related parental factors. SAS version 9.1 (Proc
Traj) was used to conduct the statistical analysis.
Results and Conclusions: A total of 2251 students were included in the final analysis. The results of the
group-based modeling established five different trajectories of unhealthy eating behavior, namely: low
desisters (7.6%), moderate desisters (52.9%), moderate declining (19.2%), rising (12.4%), and high stable
(8.1%). Adolescents living in the country side were more likely to be classified in the moderate declining
trajectory. Students with fathers who frequently displayed unhealthy eating behavior were more likely to be
classified into the moderate declining trajectory and high stable trajectory. Mothers‟ unhealthy eating
behavior were significantly related to all trajectories apart from the low desisting trajectory. Parents‟
unhealthy eating behavior had significant long-term effects on the development of adolescents‟ unhealthy
eating behavior. The results of this study further our understanding of factors associated with the
development of unhealthy eating habits at a young age and hence may be used to assist in the development
of early preventive programs.
Disclosure of Interest: None declared

TP-WED-185 HEALTH PROMOTION AND PREVENTION, DIRECTED TO VULNERABLE
POPULATIONS TO HIV/AIDS: CONSTRUCTION AND CO-VALIDATION
S. Dias* 1 , S. Trindade 2 , R. Rosa 2 , G. Cohen 2 , L. Mendão 2
1 Public Health, Institute of Hygiene and Tropical Medicine, 2 , Association for the Development of Tropical
Medicine, Lisboa, Portugal
Background: The interventions at vulnerable groups as men who have sex with men (MSM) and
commercial sex workers (CSW) are sporadic, and monitorization and evaluation of the activities are
restricted in Portugal. Furthermore, the impact is not in accordance with the strategic objectives outlined in
the National Plan for Prevention and Control of HIV/AIDS infection. There is limited information available
regarding the prevalence of HIV, social and behavioral factors among groups of MSM and CSW.
Objectives: The PREVIH project aims to reduce the overall incidence of infection and the transmission
rates. This national project, programmed for 2009-2013, has the collaboration and partnership of
organizations from the Portuguese civil society, already working with theses population. PREVIH is counting
on their participation at the implementation, monitoring and co-validation levels. We intend to present the
process of planning and evaluation of the project, describing the logic behind the coherent intervention,
consisting of technical and structural components with specific activities, materials produced and expected
results.
Underlying values and principles: In this project it is intend to identify, raise awareness and empowerment
the participation of the civil society already working with these two groups. The main goal of this presentation
is to report on the participatory approach used as the starting point once the partners were identified.
Knowledge base/ Evidence base: Evidence have shown that projects are more likely to have success
when a participatory approach is chosen.
Context of intervention/project/work: The intervention integrates 4 distinct components: the Baseline
Study seeks to meet the needs of knowing the prevalence of the virus in these groups, as well as the access
to knowledge, attitudes and risk behavior in order to obtain information for action and effective prevention
planning; the IEC/prevention campaigns aim to co-validate, adapt and disseminate educational material for
HIV and other STIs; the Peer Education aims to develop skills to negotiate safe sex, increase knowledge
about transmission and prevention of STIs, as well as to raise awareness about the access to health
services; the Capacity Building/Participatory Monitoring and Evaluation seeks to develop skills for monitoring
and evaluation, sharing experiences and networking with civil society partners.
Methods: A Logical Model construction and participatory evaluation.
Results and Conclusions: The participation of a diversity of actors is important, not only to facilitate the
building of new knowledge, but also to extend the decision-making process, promotion of collective reflection
and ensure their control in the evaluation process, and working together to establish the planning, judgments
and decisions to make in the future. Taking this into account, PREVIH does not end when the
implementation starts, and the evaluation will not be the last phase of a program, but a cross-cutting result
and continuously present, where each activity is reviewed and evaluated after each step.
Disclosure of Interest: None declared

TP-WED-186 PHYSICIAN ATTITUDES REGARDING HIV COUNSELING DURING ROUTINE CARE:
RESULTS FROM A QUALITATIVE STUDY IN GERMANY
J. Loss* 1 , A. Wolf 1 , S. Taubert 2 , E. Nagel 1
1 Institute for Health Care Sciences and Management in Medicine, University of Bayreuth, Bayreuth,
2 Deutsche Aidshilfe (German Aids Support), Federal Office, Berlin, Germany
Background: Physician advice can significantly influence preventive health behavior (e.g. physical activity).
Therefore, it has been suggested to enhance preventive HIV counseling in private physicians' offices. In
Germany, it has not been analyzed yet which barriers to a communication about HIV risks and prevention
exist, and which facilitators might help incorporate HIV counseling into medical routine care.
Objectives: The study aimed to explore perspectives and problems of patient-physician communication
about HIV. It focused on the target group of male patients who have sex with men (MSM), as this group has
the highest incidence of HIV in Germany.
Underlying values and principles: The idea of office-based HIV prevention is based on the concept of
patient-centered counseling. This approach is meant to help patients explore their individual risks and
resources and set specific risk-reduction goals.
Knowledge base/ Evidence base: U.S. studies could show that physician advice on HIV prevention could
reduce unprotected sexual behavior among their patients. It was also shown that only a minority of U.S.
physicians routinely offer HIV counseling. It has not been studied yet if German physicians regularly perform
risk assessment and risk reduction counseling in their (MSM) patients, and what the reasons for their
counseling behavior are.
Context of intervention/project/work: The study pertained to preventive interventions in private physicians'
offices.
Methods: In a metropolitan area (Berlin), 3 focus groups with 6-8 physicians were performed. The
physicians were specialized in HIV (2 groups) or were trained in general practice, urology and/or
dermatology (1 group). In addition, 7 physicians (HIV specialists as well as GPs or urologists) were
interviewed in a rural area (Franconia).The discussions were recorded, transcribed and underwent content
analysis.
Results and Conclusions: Some physicians regard HIV prevention as a genuine professional
responsibility, whereas others do not consider themselves the paramount contact persons for this issue;
those would prefer to leave the principal part of HIV prevention to mass media. The participants do not trust
the influence they might have on the patient. They all have experienced that patients of theirs were not
compliant with the recommended protective behavior; patients got infected with HIV despite repeated and
intense counseling. The resulting frustration seems to be a major barrier for incorporating HIV counseling
into routine care. It was also pointed out that successful prevention remains „invisible“. Patient-physician
communication about HIV risk can be awkward; physicians also fear to offend their patients, e.g. when
asking about sexual practices. Others describe that intense communication on HIV can be a gratifying
experience if the patient can be motivated to open up. Time constraints, however, render patient-centered
counseling difficult.
In conclusion, positive consequences of HIV counseling should be made more „visible“ to physicians. A
special training in patient-physician communication on HIV risks is needed.
Disclosure of Interest: None declared

TP-WED-188 OBSERVANCE AU TRAITEMENT ARV PAR LES PERSONNES VIVANTS AVEC LE VIH
T. PIMA* 1 , O. Diabaté 1 , T. Tiemtoré 2
1 Ministère de la santé, Fonction Publique, ZINIARE, 2 Ministère de la santé, Fonction Publique, Zorgho,
Burkina Faso
Historique / Origines: Avec la décentralisation de la prise en charge des Pv/VIH, la Région du Plateau
Central a instauré sa file active . Le constat est que certaines Pv/VIH sous ARV ne viennent pas chercher
leur médicament. Ce qui pose un problème d‟observance du traitement. La situation régionale est de 28
Pv/VIH sur 142 qui ont raté leur rendez-vous au moins une fois. Cette situation pourrait aboutir à long terme
à une élévation des risques d‟échecs thérapeutiques aux ARV, et les décès des malades sous ARV seraient
importants. D‟où la nécessité d‟explorer les raisons qui expliqueraient le manque d‟observance par certains
patients.
Objectifs: I-Objectif général de recherche
Quelles sont les raisons qui expliquent le manque d‟observance par certains patients aux traitements par les
ARV dans l‟aire sanitaire du Plateau Central ?
II- Objectifs spécifiques de recherche
1) Quelle est la perception des Pv/VIH sous traitement ARV sur le traitement ARV?
2) Quelles sont les difficultés rencontrées par les Pv/VIH sous ARV?
3) Quel est le profil des Pv/VIH sous ARV observants et non observants ?
Valeurs et principes sous-jacents: L‟étude a utilisé une technique d‟échantillonnage exhaustif. Les Pv/VIH
sous ARV ont été incluses dans l‟étude jusqu‟à une saturation d‟informations avec leur consentement.
Fondement de connaissance/Fondement de preuve: Toute la file active a été prise comme cible de notre
étude. Deux enquêteurs ont été recrutés pour la collecte des données. Les enquêteurs chargés
d‟administrer le questionnaire sont les responsables chargés de la file active et ont été formés.
Contexte d'intervention/projet/travail: La confidentailité des propos a été strictment respecté et
l'anonymat des enquétés.
Méthodes: Etude qualitative à visée analytique. Elle a ciblé les Pv/VIH adultes sous ARV. L‟interview
individuelle et le focus groupe semi structurés ont été utilisés avec un échantillonnage exhaustif jusqu‟à
saturation d‟informations
Résultats et Conclusions: De nos enquêtés, 51,11% des patients ont reconnu que le respect des heures
permet aux médicaments de bien agir, 20% ont répondu que le respect des heures de prise permet de
soulager la maladie ; 3,33% des patients ont déclaré ne pas respecter les heures de prise, car le respect des
heures n‟a pas d‟impact sur l‟efficacité du traitement et 23,8% ne savent pas pourquoi les agents de santé
leur demandent de respecter régulièrement les heures de prise. Les raisons de la non observance :
grossesse, peur des agents de santé (3,33%) ; éviction des effets secondaires (13,33%) ; absence de
confidentialité (6,67%) ; perte de la carte (6,67%) ; travaux champêtres (6,67%) ; voyage (17,00%) ; manque
de nourriture (3,33%) ; oubli (10,00%) ; sommeil (6,67%). Les résultats des focus groupes ont rapporté que
le fait de vouloir cacher le statut sérologique influence négativement sur l‟observance du traitement.
La préoccupation actuelle est de savoir quelle alternative trouvée pour prévenir le développement de
résistance du VIH aux médicaments.
L‟étude a montré que les Pv/VIH ne sont pas observants et les principales raisons ont été dégagées. Elles
sont dominées par les problèmes sociaux et ceux liés au personnel de santé.
Conflit d'Interêt: "Rien à déclarer"

TP-WED-189 EMPOWERMENT ET VIH/SIDA : ADAPTATION DU CADRE CONCEPTUEL
D‟EMPOWERMENT DE NINACS POUR L‟ANALYSE DU PROCESSUS DE RENFORCEMENT DU
POUVOIR D‟AGIR POUR LA PRÉVENTION. ÉTUDE DE CAS SUR L‟INITIATIVE PRIVÉE ET
COMMUNAUTAIRE DE LUTTE CONTRE LE VIH/SIDA AU BURKINA
k. kadio* 1 , P. A. Somé 2
1 Programme OEV, Initiative Privée et Communautaire contre le VIHSIDA, Ouagadougou, 2 Pôle Régional
d'Appui Technique de l'Alliance Internationale, Initiative Privée et Communautaire contre le VIHSIDA,
Ougadougou, Burkina Faso
Historique / Origines: L‟étude fut réalisée en décembre 2007, pour l‟obtention du master professionnel en
population et santé. Le programme de prévention de l‟ONG Initiative Privée Communautaire contre le
VIH/SIDA vise le renforcement du pouvoir d‟agir des communautés à produire des réponses locales à
travers une approche de prévention participative. Malgré la pertinence de l‟approche participative ou
communautaire, les interventions s‟inspirant d‟elle présentent souvent des incohérences et des insuffisances
liées au processus de mise en œuvre. C‟est pourquoi nous voulons comprendre l‟approche prévention
participative de l‟IPC pour voir si elle est susceptible de renforcer le pouvoir d‟agir des individus et des
communautés
Objectifs: L‟Empowerment se défini comme le pouvoir d‟agir de manière autonome selon ses propres
préférences et en ayant le contrôle sur sa destinée. Une personne ayant le pouvoir d‟agir a la capacité de
transformer ses choix en décision et d‟agir en conséquence. I‟ objectif de la recherche est d‟analyser une
approche de prévention participative du VIH/SIDA basée sur les discussions de groupes homogènes pour
voir si elle est susceptible d‟investir les acteurs impliqué de pouvoir d‟agir
Valeurs et principes sous-jacents: empowerment et équité
Fondement de connaissance/Fondement de preuve: recherche qualitative
Contexte d'intervention/projet/travail: intervention d'ONG
Méthodes: La mise en contexte du cadre conceptuel d‟empowerment de
Ninacs à servi de cadre d‟analyse. Des entretiens approfondis (individuels et en groupe) avec un échantillon
raisonné de 45 personnes, ont permis de vérifier si l‟approche est susceptible de permettre aux acteurs
impliqués d‟évoluer sur les quatre dimensions (Ninacs, 2000) pour l‟empowerment individuel et
communautaire.
Résultats et Conclusions: Une approche visant l‟empowerment est « centrée sur le développement du
pouvoir d‟agir se concrétisant par une démarche centrée sur l‟élimination progressive des obstacles
individuels et collectifs qui se dressent devant la personne ou le groupe qui désire changer sa situation ….. »
Le Bossé, 2002. L‟application du cadre d‟analyse de Ninacs a offert l‟occasion d‟identifier des indices qui
témoignent de la prise en compte des dimensions de l‟empowerment dans l‟approche de prévention
participative. Ceci au niveau des individus et des groupes vulnérables. les personnes ayant participé aux
séances de discussion ont développé leur compétence à pouvoir identifier les obstacles socioculturels à
d‟adoption de comportement à moindre risque. Ils ont acquis une capacité et le désir d‟adopter des
comportements et habitudes nouvelles constituant la voie la mieux indiquée pour réduire la propagation du
virus du SIDA dans leur communauté. l‟analyse a permit d‟identifier de nombreux changements au niveau
des individus et des groupes qu‟on pourrait attribuer au pouvoir d‟agir. L‟étude a renforcé notre opinion
concernant la pertinence d'une approche d‟intervention participative habilitante ou émancipatrice visant à
investir les groupes vulnérables de pouvoir d‟agir (donner la capacité de transformer leurs choix et décisions
en action). Dans un contexte où les normes et valeurs socioculturelles sont des facteurs influençant les
comportements sexuelles, elle est susceptible de modifier ces dits comportements pour réduire l'adoption
d'attitude sexuelle à risques.
Références: Le Bossé, 2002
Ninacs, 2000
Conflit d'Interêt: rien à déclarer

TP-WED-190 ACTIVITES DE PREVENTION DES IST/VIH/SIDA CHEZ LES FEMMES COMMERCANTES
DANS CINQ PAYS DE LA SOUS REGION « LA GUINEE – CONAKRY, LE SENEGAL, LE MALI, LA
MAURITANIE, LA COTE D‟IVOIRE ET LA GAMBIE »
M. s. a. l. i. o. u. SOWM* 1
1 Santé, Programme de lutte contre le sida, Conakry, Guinea
Historique / Origines: La mise en œuvre du projet de Prévention pour la réduction du risque d‟infection à
VIH/SIDA parmi les femmes commerçantes en Guinée initié par MIDA et financé par OSIWA a commencé
par une réunion de restitution et de sensibilisation après des associations des femmes commerçantes et des
responsables des marchés de Conakry suite à l‟atelier de Dakar.
Objectifs: - Plaider après des partenaires de développement et des femmes commerçantes en faveur de
leur plus grande implication dans la lutte contre le VIH/SIDA en Guinée
- Prévenir l‟infection à VIH/SIDA en milieu du commerce en Guinée
Valeurs et principes sous-jacents: Nouvelles connaissances et Adoption de comportement nouveau
Fondement de connaissance/Fondement de preuve: - Approche participative de prévention VIH/SIDA
- Les infections sexuellement transmissibles
- La transmission du VIH de la mère à l‟enfant
- Facteurs de propagation des IST/VIH/SIDA et les moyens de prévention
- Les violences faites aux femmes et le VIH/SIDA
- Les défis de la féminisation de l‟infection à VIH/SIDA
- Le VIH/SIDA et réponse communautaires
- Le dépistage du VIH et les centres de prestation de services
Contexte d'intervention/projet/travail: Un plan a été adopté en collaboration avec le partenaire de
financement et les activités ont été planifiées au cours d‟une rencontre qui a réunie les participants de
l‟atelier de Dakar des différents pays concernés.
Méthodes: JOURNEE DE PLAIDOYER,FOCUS GROUPE ET DE L‟INTERVIEWS
FORMATION DES PAIRS FACILITATRICES, ACTIVITES DE SENSIBILISATION
Résultats et Conclusions: Résultats enregistrés des activités de sensibilisation :
1- Personnes formées:20 Femmes relais formées
2- Groupes de discussions
Nombre de femmes touchées : 569
Nombre de Hommes touchés : 54
3- Conférences:Nombre de conférence réalisées : 5
4 – Thés débats : 25 séances
Ces résultats permettent de constater l‟intéressement des bénéficiaires et apprécient les activités de
sensibilisation dans leurs sites. Quelques hommes ont été également touchés par les activités de
sensibilisation pour leur information sur les IST/VIH/SIDA.
Conclusion
L‟importance des questions soulevées lors de cette première phase dénote la pertinence de l‟initiative et
interpelle tous les acteurs pour son rayonnement en Afrique, en général et en Guinée particulièrement.
L‟engagement des autorités et les concernés est un bon présage à la suite du projet.
La note majeure est intégration des activités des femmes commerçantes du plan stratégique la lutte contre
les IST/VIH/SIDA en Guinée, ce qui représente un atout majeur.
Références: - MIDA "Mouvement Intrenational pour le developpement en Afrique"
- OSIWA
Conflit d'Interêt: Rien à déclarer

TP-WED-191 ASSESSMENT OF QUALITY OF LIFE OF HIV-POSITIVE PEOPLE RECEIVING ART IN
ORISSA, INDIA
D. Pahwa* 1 , S. Puri 1 , M. Mathew 2
1 Department of Nutrition, Institute of Home Economics, 2 Programme Unit, World Food Programme, New
delhi, India
Background: Progression of HIV/AIDS affects the quality of life of the individual (Penedo etal. 2003).
Lipodystrophy and other body composition changes which are commonly seen among HIV positive patients
receiving ART also affects the quality of life (Blanch et al. 2002). Quality of life is identified as a useful
medium to determine the efficacy of treatment or interventions like dietary interventions (Echeverria et al.
1999).
Objectives: To evaluate anthropometric parameters and the quality of life (QOL) of people living with
HIV/AIDS (PLHA) receiving ART.
Underlying values and principles: ARV drugs have revolutionized the treatment of HIV/AIDS by increasing
the average life span of an individual. Increase in diseased life span and burden of lifestyle modification is
bound to affect the quality of life. Therefore, it is important to investigate the quality of life of PLHA.
Knowledge base/ Evidence base: Evidence Based
Context of intervention/project/work: Community based study
Methods: Data on socio-demographic profile, BMI, CD4 and quality of life using WHOQOL-HIV BREF scale
was gathered from 153 HIV positive subjects (96 males and 57 females). Informed consent forms were taken
before the enrollment.
Results and Conclusions: Heterosexuality was found to be the major route of HIV transmission. Half of the
study population had monthly income less than Rs. 2000 (

TP-WED-193 CAN WE REWORK NGO ACTIVITIES TO MEET THE COMPREHENSIVE NEEDS OF
PEOPLE LIVING WITH HIV IN SOUTH AFRICA?
A. N. Parsons* 1
1 School of Public Health, University of Western Cape, Cape Town, South Africa
Background: There is general awareness amongst non-governmental organizations (NGOs) that People
Living With HIV (PLWH) usually face a number of challenges in their daily lives. Examples include
insufficient nutrition, domestic or community violence, poor sanitation and housing, and unemployment. But
HIV-related activities by NGOs in South Africa are typically grouped into treatment, care or prevention and
rarely expand across these constraints, let alone beyond them. Global funding for health in South Africa has
focused in the last six years on community-level access to antiretroviral therapy (ART). This has provided
much-needed health personnel to government clinics and helped to expand access to ART. Access to ART
is often presented as an important step in giving PLWH the physical and emotional capacity to address daily
concerns, but the focus remains on the individual taking advantage of known resources. Many of the PLWH
worst affected by these problems are unable to do so as they lack knowledge of such resources or simply
lack the transport to access said resources. Though NGOs recognise that the basic determinants of health
are also a daily challenge for PLWH, they typically expect government to provide such related services.
Government programmes on issues such as nutrition and employment generation are increasingly limited by
funds and scale.
Objectives: The paper aims to identify the constraints on NGOs in taking action on known issues around
comprehensive care for PLWH, and describe a potential means to address said constraints.
Underlying values and principles: Political decisions by government and non-government actors on
resource allocation should be guided by evidence on people‟s need.
Knowledge base/ Evidence base: This paper arises out of a broader study that aims to understand the
impact of Global Health Initiatives (GHIs) on the South African health system. The paper reflects preliminary
work in a South African province with the highest level of HIV infection in the country.
Context of intervention/project/work: GHIs provide large amounts of money to South Africa in support of
its ART programme. Such funding is a reflection of global concerns with HIV and AIDS. PEPFAR and the
Global Fund alone fund roughly the equivalent of a quarter of comparable government expenditure on HIV
and AIDS, mostly through NGOs. NGOs‟ stated aims do not necessarily reflect the broader health concerns
of PLWH.
Methods: Data collection involves primary and secondary data, namely document analysis and individual
interviews at national, provincial, district and facility levels.
Results and Conclusions: NGO funding is usually linked to given targets and outputs, which in turn
constrain the willingness of NGOs to expand beyond their known abilities. Funding for HIV and AIDS in
general reflects global concerns with HIV as an infection and not as a life condition. NGOs working in
localised communities provide an ideal means of comprehensively addressing the problems faced by PLWH
as they have the capacity to identify such issues and bring resources to the communities. GHI funding
structures should be reworked so that NGOs can form consortiums of care related to need. This would mean
that individual NGOs could maintain their focus as per funder requirements, but would work together with
NGOs targeting the same people in the same area in complementary ways. This would improve the ability of
NGOs to address the social determinants of health amongst PLWH.
Disclosure of Interest: None declared.

TP-WED-195 WORKING TOGETHER: FOSTERING COLLABORATIVE RELATIONSHIPS BETWEEN
HIV SERVICE PROVIDERS AND FAITH COMMUNITIES TO ADVANCE AND TO SUSTAIN HIV
PREVENTION AND HEALTH CARE EFFORTS
C. O. Tyrell* 1 , S. M. Gieryic 2 , B. Justiniano 1 , J. M. Tesoriero 1 , A. R. Candelas 1 , D. A. O'Connell 3
1 Division of HIV Prevention, 2 Office of Program Evaluations & Research, 3 Executive Office, New York State
Department of Health - AIDS Institute, Albany, United States
Background: The New York State Department of Health (NYS DOH), AIDS Institute (AI) coordinates NYS‟
response to HIV/AIDS. The Faith Communities Project is a component of this response.
Surveys conducted between 2000-2007 evaluated goals of the FCP related to increasing the involvement of
the faith community involved in the project, which have demonstrated success; these surveys did not focus
on the HIV/AIDS service provider perspective of partnership development. Recognizing the importance of
the role of HIV/AIDS service providers in developing and sustaining effective partnerships with faith
communities, a survey was developed and administered in 2008 to 1) to determine the current level of HIV
related activities with faith communities 2) to assess the willingness of HIV/AIIDS service providers to
collaborate with faith communities, and 3) to determine challenges to successful collaborative efforts.
Objectives: Present results of the survey of HIV service providers;
Compare results of survey conducted with HIV/AIDS service providers to the statewide survey of faith
institutions;
Discuss challenges to collaboration between HIV service providers and Faith Communities; and,
Propose best practices to enhance and sustain collaboration/partnerships.
Underlying values and principles: •Partnership building activities between faith communities and
HIV/AIDS service providers are essential to reach vulnerable communities most impacted by HIV and AIDS;
•Collaboration fosters greater understanding of issues and best practices for a successful HIV prevention
and care services framework.
Knowledge base/ Evidence base: •Community level intervention based on the following models/theories:
Diffusion of Innovation, Peer Influence and Social Norms. Supportive and additional data gathered through
evaluation activities and surveys
Context of intervention/project/work: The FCP is a community level intervention designed to advance HIV
prevention efforts in communities of color and was created in 2002. A framework inclusive of all faith
communities and traditions was adopted in recognition of the extent of the HIV/AIDS epidemic and the fact
that communities of color embrace various religious and spiritual traditions.
Methods: In 2008, surveys were completed by 171 (60.0%) of the 283 HIV/AIDS service agencies
contacted. The majority of statewide surveys returned were from urban areas (84%) with only sixteen
percent from rural areas. A little more than half of all agencies (52.3%) provided HIV-related
education/prevention services to faith-based organizations.
Results and Conclusions: Partnerships between HIV/AIDS service providers and faith communities can
advance HIV prevention efforts.
HIV/AIDS service providers and faith communities share commonalities including knowing the needs of the
community and advocating for vulnerable and marginalized populations.
Disclosure of Interest: "None delared"

TP-WED-196 BUILDING CAPACITY AND COMMITMENT OF THE BUSINESS SECTOR EVERYWHERE:
HIV PREVENTION TARGETING MEN WHO HAVE SEX WITH MEN (MSM) IN 8 EUROPEAN COUNTRIES
N. Sherriff 1
1 Senior Research Fellow, University of Brighton, Brighton, United Kingdom
General description: The overarching aim of this workshop is to enable participants to critically explore and
debate whether businesses that provide opportunities for men to have sex with men (MSM) have a social
responsibility to support HIV prevention initiatives.
Rational: HIV continues to be a major public health issue across Europe, with recent evidence suggesting
that the annual rate of newly reported infections has nearly doubled between 2000 to 2007. MSM account for
the largest number of new diagnoses in a number of European countries. They are vulnerable populations
worldwide and are amongst the most hidden, stigmatised, and at risk from HIV infection. Some European
cities have included attempts to involve actively entrepreneurs from MSM businesses in HIV prevention and
harm reduction activities. However, given the mobility of this collective and the magnitude of gay tourism,
such strategies have yet to enjoy visible success at a European level. To address this issue, the EU cofunded
EVERYWHERE project aims to develop and validate a European model of good practice of HIV
prevention in MSM. This model or way of working will be developed by creating and testing a series of
activities designed to articulate an effective, sustainable, and appropriate methodology for reaching venues,
spaces and activities linked to men who have sex with men.
Learning objectives: In the first instance, EVERYWHERE is focusing on four MSM business types
including websites, hotels, sex venues, and travel agencies. Participants will therefore have the opportunity
to debate innovative ideas and address challenging questions around key themes relating to these business
types including:
• Social responsibility and what it means for MSM businesses in European countries with regards disease
prevention and promoting health.
• Developing a common language around social responsibility and HIV prevention across different: cultures,
health discourses, business types, infrastructures and economies (e.g. What and who compromises? What
values do we need to share and not share? What values do we need in common with businesses?)
• Consumer power and individual choice in supporting social responsibility initiatives.
Expected results: This workshop will identify areas for EVERYWHERE further action and collaboration
(particularly around partnership working and sustainability). Participants will consider how these ideas could
potentially be implemented in practice through the EVERYWHERE network.

TP-WED-197 COMMUNITY COLLECTIVEEMPOWERMENT TO ASSIST WOMEN TO REALISE THEIR
HUMAN RIGHTS TO PREVENT HIV TRANSMISSION
K. Dube* 1
1 HIV, CONCERN WORLDWIDE, HARARE, Zimbabwe
Background: The African culture has diverse cultural background and in modern-day Zimbabwean culture,
traditional customary practices have a strong foothold and remain a fundamental part of everyday lives of
many Zimbabweans .Chifambe, ward 2, Nyanga, North is one such area where women are still vulnerable to
some entrenched customary practices despite legal prohibitions. Victims are restricted their access to
education or marriage and leave them at risk of contracting HIV.
Objectives: It is against this background that Concern Worldwide (CWW) through a partner organization
Family AIDS Caring Trust (FACT) is implementing the Community Empowerment and Services Project to
prevent transmission and mitigate the impact of HIV. One strategy used was to roll out of activities that would
ensure duty bearers demonstrate understanding of their responsibility to protect and uphold the rights of
communities to safety from harmful cultural practices fuelling the spread of HIV.
Underlying values and principles: Ingrosi Ngoma is the second village head in Chifambe community and a
STAR circle facilitator, he highlighted that before (CWW) intervention, women and girls were offered as
compensatory payment in inter-family disputes as well as in the appeasement of avenging deceased spirits
(kuripa ngozi).An avenging spirit is appeased by offering a young woman in a spiritual marriage covenant,
and any male member of the family being compensated can be sexually involved with the offered girl,
increasing the risky of HIV transmission. The offered girl is deprived of safety and rights to protect herself
from HIV infection in sexual relationships, the ability to decide when and whether to have sex, and whether
to use contraception. There are laws aimed at enhancing rights and countering certain traditional practices
that discriminate against women, however systematic problems and lack of education often mean that
people do not report matters to police. In Chifambe; on average the avenging spirit would demand ten herd
of cattle and a young girl.
Knowledge base/ Evidence base: Currently if the deceased spirit demands a girl and cows, arrangements
are made in consultation with the spirit to add more cows in replacement of the girl, recently a spirit
demanded seven cows and a young woman but after wide consultations, the spirit accepted seven more
cows instead of the girl. STAR also empowered the community to engage the police for services in extreme
cases where a consensus is not reached. The community liaison office of the police is currently making a
follow up on a reported case of child appeasement.
Context of intervention/project/work: Ingrosi says „Dai pasina Concern wana wedu wangadai wakapera
kuripiswa ngozi.‟ (Without Concern intervention many of our young girls would have been offered to appease
avenging spirits).After the training Ingrosi is now taking every village gathering as an opportunity to sensitize
villagers against offering girls to appease spirits. The poor and excluded are also targeted and organized at
village levels in what are called STAR circles, to deal with the issue and formulate joint action. Through the
star circles the community was empowered to enable marginalized people especially women to attain
knowledge and skills that enable them to claim their rights.
Methods: FACT embarked on training and supporting of traditional leaders to strengthen their capacity to
give correct information and promote safe practices around HIV and AIDS .Local stakeholders were also
trained on the legal framework to advance gender equality and reduce women‟s vulnerability to HIV and
AIDS.Local police also is rolling out crime awareness campaigns throughout the community with emphasis
on human rights protection, discouraging negative traditional practices and encouraging reporting through
suggestion boxes or in person
Results and Conclusions: Village head Ingrosi is one example of many other traditional leaders in Nyanga
North who have spoken out and acted against negative traditional customary practices. From this
intervention we can deduce that collective community empowerment is an effective tool in discouraging
negative cultural practices. CWW has gone a long way in reducing traditional negative cultural practices,
however they is still need for wider coverage of the program and continuous education of duty bearers to
ensure sustainability
References: CWW baseline survey
Disclosure of Interest: None declared

TP-WED-198 EL COMPORTAMIENTO DE RIESGO DE ETS / SIDA ENTRE LOS ESTUDIANTES DE LA
SALUD
G. A. de Paula Neto* 1 , L. B. Martens 1 , E. M. Lemos 1 , M. M. C. Graciano 1
1 Faculdade de Ciências Médicas, UNIFENAS, Alfenas, Brazil
Antecedentes: Una vez que los estudiantes de la salud serán futuros proveedores de cuidado y promotores
de salud de la población, se asume que el conocimiento que han adquirido en su formación sean suficientes
para el desarrollo de actitudes de auto-protección.
Objetivos: Investigar la adopción de comportamiento de riesgo y prácticas de prevención en las ETS/SIDA
entre universitarios de el área de la salud.
Valores y principios subyacentes: El Comité de Ética de la universidad aprobó el estudio. Los datos
fueron tratados con secreto, preservandose la identidad de los sujetos de la investigación.
Base de conocimiento / base de evidencia: Adopción de medidas preventivas ha sido identificado como
la más eficazes para controlar las enfermedades infecciosas. Educación para la salud, a su vez, es una
herramienta esencial para la información y sensibilización, con consecuente generación de hábitos
salutares. Sin embargo, la información no es suficiente, pues no se traducen automáticamente en
conocimiento ni este conduce necesariamente a la adopción de nuevos estilos de vida. De hecho, incluso ni
la decisión por una actitud lleva a la misma. Por lo tanto, es esencial que la información sea seguida del
desarrollo de un sentido de responsabilidad individual y colectivo para lograr cambios de comportamiento.
Contexto de la intervención / proyecto / trabajo: Este trabajo fue realizado en una universidad con treinta
y siete años de tradición y vocación en la área de la salud, en la cual se realizan anualmente, simposios y
seminarios sobre las ETS/SIDA. Además, el municipio en enfoque es un centro regional para la
administración de la salud y sede de una importante ONG dedicada a la prevención de EST/SIDA.
Métodos: Tratase de una encuesta con muestra aleatoria estratificada por curso y semestres de los cursos
de pregrado en salud, eso es: medicina, odontología, enfermería, farmacia, nutrición, fisioterapia, psicología
y biomedicina, con un nivel de significación del 5%. Cuestionario estructurado de auto-llenado se aplicaron a
638 estudiantes. Los datos fueron introducidos en Excel y tabulados para análisis en el SPSS versión 13.0.
Hubo análisis frecuencial y calculo del odds-ratio.
Resultados y Conclusiones: Entre los métodos anticonceptivos utilizados, la retirada es el método de
elección para el 10% de los estudiantes de la salud, en general, y el 16% de los de medicina. El 31,4% de
los encuestados indicaron que nunca havian utilizado condones, siendo que cerca de 8% declaranse
virgenes. Los hombres son más promiscuos que las mujeres, ya que el 52,4% de ellos afirman haber tenido
más de una pareja sexual en los últimos seis meses, en comparación con el 9% de las mujeres, y el 13,3%
van a fiestas con propósito sexual, en comparación con 1,6% de las mujeres que declaran hacerlo. El uso
de alcohol antes de tener relación sexual es 5,11 veces más probable entre los hombres que entre las
mujeres (p = 0,000). Entre los estudiantes de medicina de todos los semestres 63,7% no sabe cuál es la
serología para VIH de sua pareja y el 58% siquiera conoce su propio serología. El uso de condones, a su
vez, en el 86% de los casos, es para evitar un embarazo no deseado.
Referencias: FRANCA, C, COLARES, V. Estudo comparativo de condutas de saúde entre universitários no
início e final do curso. Rev. Saúde Pública, 2008, 42(3): 420-427.
GIR, E et al. Medidas preventivas contra AIDS e outras doenças sexualmente transmissíveis conhecidas por
universitários da área de saúde. Rev. Latino americana de enfermagem, 1999, 7(1): 11-17.
BERQUO, E, BARBOSA, RM, LIMA, LP et al. Uso do preservativo: tendências entre 1998 e 2005 na
população brasileira. Rev. Saúde Pública. 2008, 42(1): 34-44.
Declaración de intereses: No declarado

TP-WED-199 FEMALE CONDOM USE IN HIV/AIDS PREVENTION AND CONTROL AMONG
COMMERCIAL SEX WORKERS IN NIGERIA - A GEOGRAPHICAL PERSPECTIVE
E. C. Onyenechere* 1
1 Geography and Environmental Management, Imo State University, Owerri, Nigeria
Background: One of the primary concerns of the Millennium Development Goals is to combat and reverse
the spread of HIV/AIDS. About three million people in Nigeria now live with AIDS, and current research
suggests that unprotected sex accounts for about 90 per cent of the infections among adolescent girls,
economically disadvantaged women and commercial sex workers who constitute the high risk group
Objectives: The paper considers effective and equitable ways to contain the spread of the virus among the
socially excluded female commercial sex workers in Nigeria.
Underlying values and principles: The paper advocates greater care and consideration for the socially
excluded groups like commercial sex workers, to enable them to have access to modern devices for aids
prevention.
Knowledge base/ Evidence base: The paper draws theoretical and comparative insights from a wide
variety of secondary sources, as well as interviews with governmental officials. The surveys I conducted are
referred to under "Method"
Context of intervention/project/work: The study fits into the ongoing national and international campaigns
to combat and reverse the spread of HIV/AIDS
Methods: About 1,500 brothel based commercial sex workers responded to a questionnaire designed to
elicit information on the extent of AIDS infection among them, and on current attitudes and measures to
control the spread of the pandemic in four major geographical zones of Nigeria selected for the study.
Government officials and health representatives were also interviewed on the legal and social protection of
CSWs, and the programmes of government, donor agencies and NGOs on female condom use, and AIDS
control in general. Secondary sources were consulted for theoretical and comparative insights on the spatial
and behavioral aspects of disease and health. Maps and charts are used where necessary to illustrate
spatial variations.
Results and Conclusions: Female commercial sex workers suffer discrimination and neglect, and have
limited access to information on the new devices and other resources available to reduce and treat HIV
infections. Since women are in a subordinate position in sexual relations with men, the female condom, over
which the women have greater control, is the only safe-sex method available, and should be an essential
component of any strategy for contraception, microbicides and AIDS prevention. There is need for well
designed and properly targeted government interventions that would subsidize the high cost of female
condoms, and promote its accessibility to commercial sex workers.
The geographer can contribute to public policy through a better understanding of the spatial incidence and
spread of disease, and the optimal location of health interventions.
Disclosure of Interest: NONE DECLARED

TP-WED-200 ACQUIRED IMMUNODEFICIENCY SYNDROME AND PERCEIVED HUMAN IMMUNE
VIRUS INFECTION IN GERONTOLOGICAL SEXOLOGY IN NIGERIA.
K. O. Odor* 1 , I. O. Olaseha 2
1 Health promotion and Education, University of Ibadan, Nigeria, 2 Health promotion and education, University
of Ibadan, Ibadan, Nigeria
Background: BACKGROUND/SIGNIFICANCE
As HIV/AIDS continues to pose a public health challenge globally, the pandemic is without boarders. It
affects all the age groups including the geriatrics, however, little attention is paid to this population in
mitigating HIV/AIDs pandemic. There is limited Sexual and Reproductive Health (SRH) intervention designed
for them. However, the use of condom is unknown.
Objectives: This study examined the condom use and perceived HIV/AIDS infection among the geriatrics in
Nigeria.
Underlying values and principles: little attention is paid to the geriatrics in mitigating HIV/AIDs pandemic.
There is limited Sexual and Reproductive Health (SRH) intervention designed for them.
Knowledge base/ Evidence base: There is limited Sexual and Reproductive Health (SRH) intervention
designed for them.
Context of intervention/project/work: Engagement in risky sexual activities among the old people is a
growing public health challenge and the use of contraceptives is misconstrued probably due to knowledge
gap. However, without urgent measure to enable geriatrics to protect themselves, there will be problem of
achieving optimal health
Methods: METHODOLOGY
The study was cross-sectional in design. A multi-stage sampling procedure was used to randomly select 400
geriatrics in four locations in the southwest Nigeria. A pre-tested questionnaire, which was developed, using
information obtained from 10 Focus Group Discussion (FGD), was used to collect information from the
respondents. The FGD data were analyzed thematically, while the questionnaire data were analyzed using
descriptive and chi-square statistics.
Results and Conclusions: FINDINGS
Respondents mean age was 71.8 years. Slightly more than half (50.5%) were males, while 49.5% were
females. Twenty-five percent of the participants had extra-marital sex since they attained the geriatric age.
However, among this subgroup that had extra-marital sex, only few (6.8%) used a condom. There was no
significant difference between gender and condom use, hence more males (5.3%) than females (1.5%) used
a condom during the last episode of extramarital sex (p

TP-WED-201 HIV/AIDS KNOWLEDGE, ATTITUDES, AND SEXUAL BEHAVIOR AMONG
ADOLESCENTS IN SEOUL, KOREA
A. Sohn* 1 , S. Ko 2
1 Health Management, Sahmyook University, 2 Health Management, Hyupsung University, Seoul, South
Korea
Background: The first case of HIV in South Korea was reported in 1985. The Government responded
immediately and made infectious disease control policies. The government presently conducts education
programs and information campaigns to minimize the disastrous impact of HIV/AIDS on society.
Nevertheless, there are few studeis on HIV/AIDS.
Objectives: The aim of this study was to describe HIV/AIDS knowledge, attitudes (discrimination towards
HIV/AIDS and lives with HIV-infected persons), and HIV/AIDS-related sexual behaviors among middle
school and high school students in Seoul, Korea.
Underlying values and principles: It was also the goal of the present study to seek variables that greatly
affect discrimination towards HIV/AIDS and lives with HIV-infected persons.
Knowledge base/ Evidence base: The purpose of the present study was to assess HIV/AIDS knowledge,
attitudes (discrimination towards HIV/AIDS and lives with HIV-infected persons), and HIV/AIDS-related
sexual behaviors
Context of intervention/project/work: This study was to determine whether Education Intervention
Programs could help increase HIV/AIDS knowledge and decrease attitudes (discrimination towards
HIV/AIDS and lives with HIV-infected persons).
Methods: Eight junior high schools and eight senior high schools were randomly selected in Seoul City. Two
thousand nine hundred ninety-six responses from 16 schools were analyzed (59 responses were excluded).
A self-administered questionnaire measuring socio-demographic variables, knowledge of HIV/AIIDS, as well
as the degree of involvement, self-esteem, and self-control of HIV/AIDS was utilized.
Results and Conclusions: The level of HIV/AIDS knowledge was low and the levels of discriminatory
attitudes were high. Results indicated that students held considerable misconceptions about HIV
transmission, as well as stigmatizing attitudes of HIV-infected persons and lives with them. The incidence of
sexual intercourse was 1.3 % for middle school students and 7.7% for high school students. Only 30.7% of
current sexually active subjects reported condom use during the last episode of sexual intercourse. The
HIV/AIDS-related risk-taking behaviors were predicted by gender, school type, parental marital status,
reported academic performance, and attitudes toward homosexuals.
It is important to design HIV prevention strategies that increase the knowledge of HIV transmission for
adolescents in Korea.
Disclosure of Interest: This poster presentation will be helpful to develop Education Intervention Programs
for prevention of HIV/AIDS.

TP-WED-202 THE EFFECT OF PISEN (PAQUET INTEGRE DE SERVICES ESSENTIELS DE
NUTRITION) ON THE NUTRITIONAL STATUS OF PEOPLE LIVING WITH HIV AND AIDS (PLWHA) IN
DAKAR AND ZIGUINCHOR IN SENEGAL
D. K. COLLISON* 1 , D. CISSE 2 , M. NDOME 3 , C. TENDENG 2
1 NUTRITION AND FOODSCIENCE DEPARTMENT, UNIVERSITY OF GHANA, ACCRA, Ghana, 2 , HELEN
KELLER INTERNATIONAL, 3 NUTRITION, CATHOLIC RELIEF SERVICES, DAKAR, Senegal
Background: PISEN is a collection of vital nutritional educational services targeted at improving nutritional
status of the PLWHA.
Objectives: This study evaluated the impact of the inclusion of PISEN on the nutritional status of the
PLWHA.
Underlying values and principles: PLWHA are generally classified as at-risk or highly vulnerable group as
a result of the interplay between raised metabolic requirement and malabsorption of nutrient intake [1].
Knowledge base/ Evidence base: Adequate nutrition is the fundamental part of the care and support for
PLWHA. Nutritional support is therefore an efficient means of ensuring that PLWHA live an optimum and
positive life [2]. The PISEN is therefore targeted at improving the nutritional status of the PLWHA.
Context of intervention/project/work: NUTRITIONAL INTERVENTION
Methods: This quasi – experimental study adopted a sampling technique to select 374 PLWHA from six
health facilities in Dakar and Ziguinchor. The baseline study was done in July, 2005 and was repeated after
an intervention with the PISEN was implemented for 2years. After the 2years a post - intervention study was
done between July and September, 2007. The post intervention study used a similar structured
questionnaire to collect information on nutritional services received by the PLWHAs and 24 hours dietary
recall. Anthropometrics measurements were also taken to determine body composition. Analysis was done
using SPSS 16.0, descriptive and inferential statistics were generated to test for associations.
Results and Conclusions: Over two thirds (72%; 73%) of the respondents for both pre and post
intervention studies were females. The prevalence of under nutrition amongst the PLWHA respondents had
reduced to about half (12.3%) the baseline estimate (21%). The over nutrition estimate had reduced from
28% of the baseline to 22% in the post - intervention study. However, the proportion of respondents with
normal nutritional status increased slightly by 6.3%. These services received by the respondents also had a
significant association with their BMI at p

TP-WED-204 INFLUENCE OF EDUCATION IN PROMOTION OF KNOWLEDGE ABOUT HIV/AIDS IN
COUPLES WHO ATTENED IN PREMARRIAGE COUNSELING CENTER IN AHWAZ,IRAN 2004
S. Nouhjah* 1 , s. Fayazi 2
1 public health, school of health, 2 nursing, school of nursing and midwifery, Ahwaz, Iran (Islamic Republic of)
Background: All of couple had to participate in premarriage counseling class before reception the results of
routine laboratory exams in Iran .Marriage for many couple especially for girls is the first experience of
sexual contact in Iran.
Objectives: Assessment influence of education on promotion of knowledge related to HIV/AIIDS
Underlying values and principles: Reduce cost of treatment by education and prevention program
Knowledge base/ Evidence base: Acquired Immunodeficiency Syndrome (AIDS) has become an important
public health hazard in Iran.
Context of intervention/project/work: Different methods of education(lecture, film, group
discussion,pamphelet or cassette were used. A questionnaire before education and after that were filled by
couple separately
Methods: In a semi experimental study 350 women and 200 men who attending for premarriage routin
laboratory exams participated in this study. Different methods of education(lecture, film, group
discussion,pamphelet or cassette were used. A questionnaire before education and after that were filled by
couple separately. After education 1 box condom gave to them. We used general linear model, ANOVA and
pair T test for analysis of data.
Results and Conclusions: Multivariate tests showed that a significant difference between knowledge
before and after education(p

TP-WED-205 KNOWLEDGE, ATTITUDES AND PRACTICES CONCERNING HIV/AIDS AMONG MEN
WHO HAVE SEX WITH MEN (MSM) AND SEX WORKERS (SW) IN PORTUGAL: A PARTICIPATORY
APPROACH.
R. Rosa 1 , S. Dias* 2 , G. Cohen 1 , S. Trindade 1 , L. Mendão 1
1 , Association for the Development of Tropical Medicine, 2 Public Health, Institute of Hygiene and Tropical
Medicine, Lisboa, Portugal
Background: Portugal has one of the highest general population HIV prevalence rates in Europe (0.5%).
Moreover, due to the vulnerability of the target groups, it is expected that their HIV prevalence is higher than
that of the general population. Despite a lack of scientific data to prove this view, this assumption is very
relevant because both groups often keep their sexual orientation and sexual liaisons secret due to fear of
discrimination.
Objectives: This study aims to provide, information about knowledge, attitudes and practices related to
HIV/AIDS, which is particularly important because it is the first time that is being conducted in Portugal.
Furthermore, the goal is for it to serve as an instrument that will be used in the monitoring and evaluation of
interventions in the area of prevention, promotion of sexual health and access to health services in the target
groups.
Underlying values and principles: The main goal of this paper is to report the participatory approach used
as the starting point once the partners were identified.
Knowledge base/ Evidence base: Gay sex remains highly stigmatized; few men admit to having sex with
other men. On the other hand while the activity of SW is not a crime, it is not recognized by the Portuguese
state as a profession. As such SW does not have any rights, particularly health benefits which contribute to
their vulnerability. This may increase MSM and SW risk as they know less about prevention and are less
likely to seek health care, when necessary.
Context of intervention/project/work: This project has a community perspective as it will capacitate ONGs
to be able to better intervene in the target groups.
Methods: Different techniques of data collection (Snowball Sampling, RDS, through the users of the
proximity structures and Internet) will be used to allow for the comparison of the obtained results. Two
questionnaires were conceived taking into consideration the UNGASS indicators.
Results and Conclusions: The participatory approach will be used to build a shared methodology including
NGOs and community based organizations that have been actively participating in all phases of the study:
the questionnaire design (a face to face interview also available on-line using the social network of carefully
chosen seeds), data collection and an intervention plan promoting capacity building and peer education
actions to guarantee the feasibility of the project. Brief, this research will generate the necessary data to
create the conditions for sustainable partnership policies by the Portuguese Government and NGOs, in the
field of health promotion among MSM and SW.
Disclosure of Interest: "None declared"

TP-WED-206 POPULATION-SPECIFIC HIV/AIDS STATUS REPORTS: IMPLICATIONS FOR CANADIAN
POLICY, PROGRAMS AND RESEARCH
C. V. Jackson 1 , J. Arthur 1 , A. Houde 1 , M. R. Smith 1 , J. Guay 1 , M. Trubnikov 1 , K. Beausoleil 1 , B. Ellis 1 , S.
Mehta* 1
1 HIVAIDS Policy, Coordination and Programs Division, Public Health Agency of Canada, Ottawa, Canada
Background: The Federal Initiative to Address HIV/AIDS in Canada identifies eight populations within
Canada that are particularly affected by HIV/AIDS: Aboriginal peoples, women, youth, gay men and other
men who have sex with men, people who inject drugs, people in prison, people from countries where HIV is
endemic, and people living with HIV/AIDS. The Public Health Agency of Canada is developing populationspecific
HIV/AIDS status reports to provide a comprehensive analysis of the state of HIV within these
populations.
Objectives: The reports are part of efforts to develop discrete approaches to addressing HIV/AIDS within
the eight populations and will be used to inform future directions in HIV/AIDS policy, programming and
research in Canada.
Underlying values and principles: The reports incorporate the Principle of the Greater Involvement of
People Living with HIV/AIDS (GIPA). The reports were developed in collaboration with population
representatives, including people living with HIV/AIDS.
Knowledge base/ Evidence base: The reports use a determinants of health lens to examine the underlying
factors that influence the vulnerability of the eight populations to HIV infection, including: social
environments; social support networks; culture; gender; income, education, employment; physical
environments; health services; personal health practices and coping skills; healthy child development;
biology and genetic endowment.
Context of intervention/project/work: In Canada, approximately 2,500 individuals are diagnosed with HIV
each year. As in most high-resource countries with low HIV incidence, HIV/AIDS in Canada is most
entrenched among the populations which are the focus of the status reports.
Methods: National expert working groups were established comprising population representatives, people
living with HIV/AIDS, researchers, policy and program experts. Peer-reviewed and grey literature published
from 2002 to present on the following topics was included: HIV/AIDS epidemiology; determinants of health;
currently funded research; current program and policy responses. Information was also gathered from the
Public Health Agency of Canada; Health Canada; Correctional Service of Canada; Canadian Institutes of
Health Research; provincial and territorial governments.
Results and Conclusions: HIV/AIDS among vulnerable populations in Canada is closely linked to
determinants of health that influence each population‟s resilience against and vulnerability to infection. These
factors include HIV-related stigma and discrimination, racism, homophobia, low income and poverty, social
exclusion, unstable housing and homelessness, problematic substance use, lack of access to culturally
appropriate services, and gender inequalities. The status reports provide evidence to support coordinated
efforts among governments and civil society to address the broader health inequities that influence the
vulnerability of key populations to HIV infection.
Disclosure of Interest: None declared

TP-WED-207 PERSPECTIVES OF LOW-INCOME NIGERIANS ON HIV/AIDS: IMPLICATIONS FOR
SPREAD AND PREVENTION IN SOUTHWEST NIGERIA
I. B. Oluwatayo* 1
1 Agricultural Economics and Extension Services, University of Ado-Ekiti, Nigeria, Ado-Ekiti, Nigeria
Background: There is no gainsaying the fact that HIV/AIDS infection and its attendant problem have
become an issue of urgent public concern in Nigeria. This is because HIV/AIDS pandemic already
constitutes a drainpipe to the dwindling resources available especially in this era of global financial
meltdown. In other words, available meager resources that ought to have been used for developmental
programmes are now being used to curtail its spread through investments into campaign and sensitization
programmes, treatments and provision of antiretroviral drugs to those living with the disease just to mention
a few.
Objectives: This paper therefore examines the perspectives of low-income Nigerian on HIV/AIDS with a
view to understanding how best to curtail the spread and its eventual implications on their wellbeing.
Underlying values and principles: -
Knowledge base/ Evidence base: -
Context of intervention/project/work: -
Methods: The study relied on primary data collected from a random sample of 340 respondents in
southwest Nigeria using a multi-stage sampling technique. Data collected were analysed using descriptive
statistics, poverty measures and regression model.
Results and Conclusions: The results of the analyses revealed that about 57 percent of the respondents
were young with an average age of 45 years. Farming was found to be the main source of livelihood
providing employment for over two-third, about 43.8 percent of the respondents had household size of more
than six members with income per head of less than one dollar a day. Respondents‟ distribution by poverty
indices showed that over 61.7 percent of them were poor living on less than one dollar a day using the twothird
mean consumption per-capita. However, it was also revealed that awareness on the magnitude of
HIV/AIDS infection was very low especially among those residing in rural/peri-urban areas. The low level of
awareness was attributable to the fact HIV/AIDS is perceived to be the disease/ailment of the rich and elites.
Again, there was a significant correlation between respondents‟ perception about HIV/AIDS and location.
Thus, those living very close to local government headquarters (peri-urban and urban) were found to be wellinformed
and had significant correlation with the poverty status of respondents. Based on the findings, it is
recommended that efforts should be intensified at increasing the earning capacity of respondents through
education (capacity building) and sensitization on family planning techniques and the use of contraceptives
to check population growth. This is because as household size increases, income per-capita declines and
this invariably translates to increased poverty and hence increased vulnerability of respondents to HIV/AIDS
infection.
References: None
Disclosure of Interest: None declared

TP-WED-208 THE PERCEIVED IMPACT OF GOVERNMENT “KNOW YOUR STATUS” CAMPAIGN IN
MITIGATING HIV/AIDS PANDEMIC IN LESOTHO
J. O. Osiki* 1 , T. T. J. Ralenkoane 1
1 Theology and Religious Studies, National University of Lesotho, Roma, Lesotho
Background: Lesotho is among the worst HIV/AIDS affected countries in the world, with the prevalence rate
of 23.3% in a population of 2.2 million (UNAIDS; 2004). Ever since the existence of this virus in the 1980s
the infection rate have been growing in an alarming rate in the country. Lesotho is countered as the third
country with the greatest burden of HIV and AIDS in the world while among the southern African countries, is
the second, with Botswana being highest (Kimaryo et al,2004).
Objectives: The study explored the extent to which the Government‟s „Know Your Status‟ campaign (KYSC)
impact on those who have gone for HIV testing and counseling. It investigated some of the traditional
alternatives for halting and reversing the spread of HIV and AIDS in the country while concomitantly
examined the general attitudes of the people to KYSC.
Underlying values and principles: Individual attitudes have corresponding impact to their general lifestyles
and behaviour. Attitudes and beliefs hardly die and are reinforcing to how human behaviours are developed,
nurtured and modified.
Knowledge base/ Evidence base: To mitigate endless death toll among the Basotho (i.e. people of
Lesotho) as result of HIV/AIDS, „Know Your Status‟ campaign was expanded to involve all people from age
12 upward to go for voluntary counseling and testing. Involvement of young people while conducting HIV test
is a better strategy to be used for halting and reversing the spread of HIV infection (Government of Lesotho,
2005). That is why information, education and communication about HIV/AIDS is more beneficial if it is first
done to the youth, since the youths are the leaders of tomorrow for any country.
Context of intervention/project/work: The study setting was Maseru, Lesotho with 130 participants
(males=66 or 50.8% and females=64 or 49.2%) selected both from the Ministry of Health and Social Welfare,
Lesotho and the general public in Maseru through a simple random sampling technique.
Methods: The simple random sampling technique was used to pick 130 participants (i.e. Males=66 or
50.8%, and Females 64 or 49.2%) in the study. The Perceived Impact of Know Your Status Scale (PIKYSS)
was the research instrument used in eliciting the respondents‟ views. Participants‟ age range was between
18 and 37 years (Mean age = 27.06years; SD=6.04).
Results and Conclusions: Adopting the ANOVAR at the 0.05 alpha levels, the findings showed that the
participants marital, religious affiliations and educational statuses influenced how they perceived the
Government Know Your Status Campaign in Lesotho. The findings were statistically significant with Fishers
value [F(1,88)=0.604;P

TP-WED-218 THE RIGHT TO HEALTH, INTERNATIONAL MENTAL HEALTH LEGISLATION AND
POLICY, AND HEALTH PROMOTION AND CARE PRACTICES FOR PEOPLE WITH MENTAL ILLNESS
IN SOUTH AUSTRALIA
S. J. Battams* 1 , J. Henderson 1
1 Southgate Institute for Health, Society and Equity, Flinders University, Adelaide SA, Australia
Background: This paper will consider the right to health for people with psychiatric disabilities. It will
examine the potential impact of the recent UN Convention on the Rights of People with Disabilities on
Australian and South Australian legislation and policy, with a particular focus on the „right to health‟ for
people with a psychiatric disability.
The significance of this paper is supported by evidence on the poor physical health of people with a
psychiatric disability. The President of the World Psychiatric Association has recently declared that the poor
physical health of people with mental illness is emerging as a great public health and ethical concern
worldwide (Maj, 2009). For example, based on an analysis of 20 studies, it was found that the overall
increased risk of mortality is 1.6 times higher for people with schizophrenia than that of the regular
population and the mortality rate of deaths from „natural‟ causes was 1.4 times more than expected,
accounting for 62% of the excess deaths (Harris & Barraclough, 1998). Another study into the overall
increased risk of mortality for people with depression showed that the rate was 1.4 times that expected in the
general population, with deaths from „natural causes‟ accounting for 16% of excess deaths (Craig, 2008).
Objectives: The aims of this research were:
- To review current mental health and guardianship legislation affecting people with mental illness in
Australia/South Australia in regard to their rights, particularly the right to health
- To consider the impact of the new Convention on the Rights of People with Disabilities upon mental health
and guardianship legislation and practices regarding rights, health promotion and care
- To ascertain the views of key stakeholders on best practice regarding the rights, health promotion and care
of people with mental
Underlying values and principles: Equity in health
Knowledge base/ Evidence base: Policy and research review, qualitative interviews
Context of intervention/project/work: UN Convention on the Rights of People with Disabilities
Methods: This paper is based on a policy/article review as well as qualitative interviews (n=10) with
health/disability/justice professionals and consumer advocates in Australia/South Australia.
Results and Conclusions: TBA
References: Craig, T. J. (2008). "Evidence Based Mental Health." British Medical Journal 11(9).
Harris, C. E. and B. Barraclough (1998). "Excess mortality of mental disorder." British Journal of Psychiatry
173: 11-53.
Maj, M. (2009). "Physical health care in persons with severe mental illness: a public health and ethical
priority." World Psychiatry 8(1): 1-2.
Disclosure of Interest: None declared

TP-WED-219 STRESS AND COPING MECHANISMS AMONG MOTHERS OF MENTALLY
CHALLENGED CHILDREN IN SCHOOLS FOR THE HANDICAPPED IN IBADAN, NIGERIA
O. E. Omotayo 1 , O. S. Arulogun* 1
1 Department of Promotion and Education, University of Ibadan, Ibadan, Nigeria
Background: The mentally challenged [MC] are people with condition of sub average intellectual functions
combined with deficits in adaptive behaviour. Therefore, management is required throughout the child's life.
These demands constitute a continuing source of stress conditions on their caregivers especially their
mothers. There is a dearth of research in Nigeria regarding mothers'managerial role and coping skills in
relation to the burden they encounter in the care of their MC children.
Objectives: This study assessed the level of stress, type of stressors and coping mechanisms among
mothers of MC children in Ibadan, Nigeria.
Underlying values and principles: Mothers usually play both supportive and maintenance roles, especially,
in a disabled child. A relationship has been found between stress and neurosis, cancer and cardiovascular
disease. While the results of stress have been amply documented in research on the male population, less is
known about what happen when women experience stress.
Knowledge base/ Evidence base: Mothers bear most of the burdens and subsequent demands in their
multiple roles elicit more stress. Stress experiences of 95 women who were simultaneously occupying the
roles of caregivers, mother and wife were examined and findings indicated that multiple role experiences
could either detract from or enhance their mental and physical health. It has also been observed that
mother's stress cause kids to become stressed too which could lead to insulin resistance which may trigger
diabetes-related autoimmune reactions in genetically predisposed children.
Context of intervention/project/work: This is a cross-sectional survey which sought to document stressors
among mothers of MC children and their coping mechanism
Methods: All the 250 mothers of mentally challenged children in the eleven schools for the handicapped in
Ibadan, Nigeria who consented to participate were recruited into the study. The instrument for data collection
was a standardized semi-structured questionnaire. Mothers‟ stress scores was measured with a four-point
[nature of disability; burden of child‟s disability; financial; family and community; and psychological] typology
of stressors. Descriptive and Chi-square test were used to analyze the data.
Results and Conclusions: The respondents' mean age was 45.5 ±18.5 years; 31.6% while 45.2%, 42.0%
12.8% had high, low and moderate stress levels respectively. The highest and lowest mean stress score
were child (24.4±6.6) and disability related (8.6±3.4) respectively. Age and educational level were
significantly related to stress level (p

TP-WED-220 YOUNG PERSONS' PERCEPTION AND ATTITUDINAL DISPOSITION TO PERSONS
WITH MENTAL ILLNESS IN A RURAL LOCAL GOVERNMENT AREA IN SOUTH-WEST NIGERIA
O. M. Aina* 1 , O. S. Arulogun 1
1 Department of Health Promotion and Education, University of Ibadan, Ibadan, Nigeria
Background: The stigma associated with mental illness has been in the increase in Nigeria and of public
health importance. Stigmatization does not only affect social relationship with people but also
psychological,physical and mental well-being of an individual. Few studies however have explored the
perception and attitudinal dispositions of young persons towards people with mental illness in Nigeria.
Objectives: Assessment of young persons' level of knowledge, perception and their attitude to people with
mental illness in a rural local government area in South West Nigeria.
Underlying values and principles: Behavioral change in perception and attitude of young persons towards
people with mental illness.
Knowledge base/ Evidence base: The stigma and deprivation of the basic human rights faced by those
with mental disorders has attracted attention all over the world and is becoming a serious issue for debate
and concern.
Context of intervention/project/work: Descriptive cross-sectional survey.
Methods: A 4-stage sampling technique was to select 500 young persons (10-24 years) from the local
government area. Data was collected using a validated semi-structured questionnaire and FGD guide.
Quantitative data were analyzed using descriptive and Chi-square statistics while the FGD data were
transcribed and analysed using thematic approach.
Results and Conclusions: Respondents' mean age was 16.6(s.d 3.5) years with 52.4% males, 85.7%
Yoruba and 62.0% Christians. More(66.4%) respondents had secondary education. Majority of the
respondents (87.6%) attributed the cause of mental illness to evil spirit. Mean knowledge score was 12.3(s.d
3.3). Forty five percent of the respondents claimed that a mentally ill person should be kept locked up in a
room and 73.6% expressed a positive perception that mental illness is preventable. Most
respondents(71.0%) would not dare to make friends with someone who has mental illness, while 70.4%
would be upset to be in the same class or workplace with such.Only 26.6% in-school respondents reported
that mental illness is contagious compared with 3.8% who are out of school (p

TP-WED-221 ADOLESCENTES CON DISCAPACIDAD MENTAL: UN EJERCICIO PARA LA
BÚSQUEDA DE LA CIUDADANÍA.
C. T. Maria Aparecida 1 , B. P. Cléria Maria 1 , A. Iara* 1
1 Promoção de saúde, Universidade de Franca, Ribeirão Preto, Brazil
Antecedentes: Durante siglos, las personas con discapacidad fueron sometidas a un proceso continuo de
exclusión social. Perjudicadas por supersticiones y creencias, las personas con discapacidad fueron
segregadas y durante mucho tiempo consideradas peligrosas, violentas y nocivas para la sociedad. Cuando
se buscó la reversión de esta situación, fueron consideradas incapaces de explicar sus ideas e indicar sus
necesidades. Pasaron entonces a la supervisión de los padres y de los profesionales, que han captado la
voz de este grupo de personas y se auto eligieron sus representantes, o más bien los representantes de sus
deseos y expectativas. Para tanto, los jóvenes con discapacidad mental deberán ser empoderados para
luchar por su ciudadanía, buscando recibir lo que más necesitan: el respeto como seres humanos. Esta
necesidad de conocimientos específicos nos lleva a preguntar: ¿los jóvenes con discapacidad mental
disponen de autonomía para realizar actividades en la escuela, en la familia y en la esfera social?
Objetivos: Identificar y analizar la autonomía de los jóvenes con discapacidad mental que asisten a una
escuela para discapacitados mentales en la ciudad de Guaxupé-Minas Gerais, Brasil.
Valores y principios subyacentes: Salud Mental y promoción de salud.
Base de conocimiento / base de evidencia: Promoción de salud.
Contexto de la intervención / proyecto / trabajo: escuela para discapacitados mentales
Métodos: Este es un estudio descriptivo, basado en los datos del cuestionario entregado a veinte jóvenes
con discapacidad mental, sin otras patologías asociadas, de 10 años a 20 años.
Resultados y Conclusiones: Se analizaron los datos en tres ámbitos: 1 - casa 2 - institución especial y 3 -
otras esferas sociales. En casa, los encuestados indicaron que la participación en las tareas domésticas:
lavar los platos, limpiar la casa, cocinar, con diversos grados de participación, dependiendo de lo que se
requiera o permita. En la institución, los sujetos comentan sobre actividades relacionadas con los programas
desarrollados en el aula, “capoeira” y educación física. Al respecto, hablan en términos que sugieren la
aceptación de las actividades ofrecidas. En la esfera social, hay muchas oportunidades para la vivencia:
bailar, ir a restaurantes, ir al cine, viajar, salir con alguien y encontrarse con los amigos. Sin embargo, estas
experiencias siguen siendo, en parte, vinculadas a la escuela o la familia. Las manifestaciones de los
encuestados indican que sus relaciones personales y actividades son, en general, fuertemente controladas,
sobre la base de un complejo entramado de cuidado, protección y subestimación subyacentes a las
acciones de los demás hacia ellos. Así, los jóvenes tienen actividades e interacciones en otros ámbitos más
allá del hogar y de la institución, pero son oportunidades limitadas y, con raras excepciones, con sujeción a
la autorización y presencia de la familia y la institución especial, que, aunque no exclusivamente, son los
motores sus vidas.
Declaración de intereses: No declarado.

TP-WED-222 PSYCHIATRIC PATIENTS PARTICIPATION IN COMMUNITY BY SELF HELP GROUP
V. Nitipong* 1 , J. Sompoo 2 , M. Jumnian 3
1 Community Health and psychiatric nursing, 2 Adult and elderly nursing, 3 Community health and psychiatric
nursing, Boromarajajonani College of Nursing, Ratchaburi, Ratchaburi, Thailand
Background: The number of psychiatric patients has been increasing in Thai society. This stigma and
psychosocial problems result in patients‟ lack of self-care. Once the patients are recovered from their
psychiatric problems and returned home, the majority of patients had continued psychosocial problems such
as lack of self esteem and poor social interaction. Therefore, this study was carried out to demonstrate how
self-help group would empower the psychiatric patients to take care of themselves.
Objectives: The purpose of this research is to study participation by the psychiatric patient in self help
group. The specific objectives were to examine : 1) The processes 2) The supporting and hindering factors in
self-help group as well as 3) The benefits that the psychiatric patient gain from participation in self-help
group.
Underlying values and principles: Self help groups include patients with similar experiences who help and
encourage each other, volunteer to join in the group, benefit from exchanging experiences, get important
information, think and learn from their actions.
Knowledge base/ Evidence base: There are not enough government support rehabilitation centers to
provide psychiatric patients once they have been recovered from the hospital. Patients are in the stage of
adjusting themselves to society after treatment one more time. They lack self motivation and skill to improve
their cognitive processes well enough to be independent and there is stigma for these patients in the
community.
Context of intervention/project/work: The 12 volunteered psychiatric patients joined in the self help group
in Pongsawai community, Ratchaburi, Thailand. They learned and shared their experience freely among the
group. They encourage each other to give any opinions and make comments such as what already
happened to them, how they have done, and what they should do.
Methods: The researcher served as facilitator of the group. Relationship was then created among the
patients by building up rapport, faith, trust and good relationship among group members. The qualitative data
were collected by participatory observation and in-depth interview
Results and Conclusions: The findings suggest 6 steps in self-help group process : 1) setting for the selfhelp
group 2) psychiatric patient group meeting 3) active learning, sharing ideas and experiences 4)
application of relevant methods for problem solving 5) reflecting on the result of problem solving and 6)
evaluating benefits gained from group participation. The facilitating factor were the members‟ potential in
group participation, regularly attending group meetings, active participation in sharing ideas and
experiences, helping each other, satisfaction with being group members, and social support, especially from
family. The hindering factor was health problem. The benefits gained from the participation included
enhancing physical and psychosocial health, especially their self-esteem.
Based on these finding it is recommended that the government should have a policy to continuously support
networking among small groups of the psychiatric patient. To enable psychiatric patient self-help group
process to be sustainable, members needed to actively participate in the self-help group including planning,
making decision, group implementation, and evaluation.
Disclosure of Interest: none declared

TP-WED-223 SCHIZOPHRENIA AND STIGMA IN DEVELOPING COUNTRY
S. D. Joshi* 1 , R. Bhandari 2
1 Public Health, Primary Health Center, Kailali, 2 Community Health, Community Health and Environmental
Society Nepal, Kathmandu, Nepal
Background: Stigma is a social devaluation of a person because of personal attribute leading to an
experience of sense of shame, disgrace and social isolation.
Objectives: To know about stigma and discrimination towards mental health patients.
Underlying values and principles: Ethical approval
Knowledge base/ Evidence base: Knowledge base
Context of intervention/project/work: Work
Methods: The nature of stigma in schizophrenia and its relationship to attribution was studied in one
hundred and fifty-nine urban and rural patients who fulfilled DSM-IV criteria for schizophrenia(2006-2007).
The response of the primary care givers to fourteen questions on stigma and 14 on what they thought
attributed to the illness was elicited. Based on the mean stigma score, the entire sample was divided into two
groups- those with high and low stigma.
Results and Conclusions: Marriage, fear of rejection by neighbour, and the need to hide the fact from
others were some of the more stigmatising aspects. Many care givers reported feelings of depression and
sorrow. Discriminant function analysis showed that female sex of the patient and a younger age of both
patient and caregiver were related to higher stigma. Among attribution items, having no explanation to offer,
and attributions to faulty biological functioning, character of life style, substance abuse and intimate
interpersonal relationship discriminated between the two groups. The relevance of stigma in the cultural
context is increasing due to illiteracy, poverty, superstition and lack of awareness in developing country like
Nepal and India.
Disclosure of Interest: "None declared"

TP-WED-224 ANALYZE OF UNLAWFUL ACTS COMMITTED BY PATIENTS WITH MENTAL
DISORDERS IN GEORGIA
N. Naneishvili* 1 , T. Silagadze 1
1 Psychiatry, Tbilisi State Medical University, Association of Sinergetic Medicine, Tbilisi, Georgia
Background: The public opinion, that mental ill patients represent danger is a widely spread in the
population. That cause: high probability of hospitalization of mentally ill patient‟s instead of treatment in outpatient
clinic, long term hospitalization of patients, deepen of stigmatization.
In addition the process of mentally ill patients‟ integration in society is more complicated Because of lack and
not relevant distribution of funding psychiatric care rehabilitation, mental disorders prevention (especially
indicated prevention) and re-socialization for mentally ill patients in Georgia are not comprehensive. That is
why the first stage of mental health institutions do not work properly which leads to committed crime by
patients increase.
Objectives: Study of unlawful acts committed by patients with mental disorders in Georgia and elaborating
of relevant recommendations for psychiatric institutions - out and in patient clinic, law machinery who have
contacts with mental health problem persons , psychiatric department of penitentiary system, relevant NGO‟s
and Ministry of Labor, Health and Social Affairs
Underlying values and principles: Elaborated recommendations are to be implemented
Knowledge base/ Evidence base: The numbers of samples are statistically reliable.
Context of intervention/project/work: Scientific work.
The target group were Patients with mental disorders who committed unlawful acts in 1990 – 2005 and on
the basis of the forensic psychiatric expertise‟s decision were recognized insane by court verdicts.
Methods: 1329 sick persons‟ medical history documents were examined in total. Tbilisi State Medical
University specialists carried out research which was held in the city of Poty in special Psychiatry hospital
with strict regime for imprisonment patients and in the Tbilisi forensic psychiatric department. Results were
process by SPSS software program.
Results and Conclusions: 0.6 % out of all unlawful acts in Georgia is committed by persons with mental
disorders. It was discovered that patients with schizophrenia, organic delusional disorders, mental
retardation, chronic alcoholism, epilepsy, personlogical disorders, involution paranoid are mostly declined to
commit unlawful acts in Georgia. The most dangerous and widely spread crime behavior, committing by
mentally ill patients is: murder, body mutilation, larceny, as well as it were statistically defined reasons of
crimes and groups of victims.
References:
Kolutskaia E. "Typology of OCD during Schizophrenia
Smulevich A. "Continuous sluggish schizophrenia"; "Nevrology Psychiatry" 2002- N 102(2) P 27-33
2003- N 103(1)P 4-10 Russian
Cooper I. ICD-10; Mental disorders chepter of the international classification of diseases
A century of psychiatry.-London: 1999-P. 302-306.
Dawson J.H. Sussams P. Grounds A.T. Assocations of self-reported past psychotic phenomena with
features of personslity disorders//Comprehensive Psychiat.-2000-N41(1)-P 42-48
Disclosure of Interest: Prof. Z.Beria Tbilisi State Medical University, Consultant

TP-WED-225 REPORTS OF STIGMA: MENTAL HEALTH SERVICE USERS' PERSPECTIVES
C. London* 1
1 Faculty of Society and health, Buckinghamshire New University, Uxbridge, United Kingdom
Background: Evidence suggests that people with mental illness experience discrimination by being
stigmatised both by the general public and by health professionals. The experience of stigma may result in a
delay in seeking professional help, loss of self-esteem and is a serious inhibitor to recovery and social
inclusion. Stigma and discrimination is pervasive and despite a number of campaigns, there appears to have
been little reduction in prevalence.
Objectives: This research aimed to identify the perceptions of stigma by mental health service users, to
quantify these perceptions alongside reported accounts of being stigmatised and to make recommendation
for strategies to reduce the stigma experienced by people with mental illness.
Underlying values and principles: The perception of actual stigmatisation or an expectation of
stigmatisation can precipitate mental illness or impact service users‟ to the point where they self-stigmatise,
become isolated and socially excluded
Knowledge base/ Evidence base: Previously, the evidence base on the stigma of mental illness relied
primarily on public attitudes towards mental illness. This research adds to the evidence base by eliciting
mental health service users‟ perspectives.
Context of intervention/project/work: To highlight sources and mechanisms of stigmatisation, as reported
by mental health service users.
Methods: A cross-sectional survey was undertaken between June 2007 and April 2008, involving the use of
a 35-item attitude scale employed with self-selecting service users, together with semi-structured interviews
with a smaller sample of fifteen service users. Qualitative data was analysed using an interpretative
phenomenological approach. Quantitative data was analysed using inferential statistical tests. Measurement
of stigma was derived from the attitude scale by which a maximum score of 140 was possible. Lower scores
indicated a higher perception of stigma.
Results and Conclusions: Results show an experience of relatively high degree of stigma, with males
reporting higher levels. Education was the highest statistically significant factor. The public and mental health
professionals were identified as sources of stigma.
Conclusions include i) service users perceive stigma as a barrier to social inclusion ii) being stigmatised by
healthcare professionals act as an obstacle to care iii) higher levels of education lower the perception of
stigma and iv) longer periods of in-patient care increase stigma and inhibits recovery.
Recommendations include i) continuing to addressing the causes of stigma to facilitate the social inclusion of
people with mental illness, and ii) professionals should examine their own attitudes, and empower service
users.
Disclosure of Interest: None declared

TP-WED-227 EXPLORING THE ROLE OF MULTIDISCIPLINARITY IN THE DEVELOPMENT OF CLIENT
VOICE
A. Vitale* 1 , P. M. McNamara 1
1 Education and Professional Studies, University of Limerick, Limerick, Ireland
Background: This paper reports an empirical study on clients‟ views on receiving multidisciplinary care and
building their capacity to shape their treatment care in community-based mental health services in Ireland. It
contributes to recent trends in mental health promotion which suggest listening to clients‟ voices and
empowering them in choosing a treatment care related to their specific needs.
Objectives: Research objectives include:
1) To explore clients‟ experience of the multidisciplinary care at their community mental health service;
2)To investigate clients‟ involvement in choosing their treatment care;
3)To assess improvements of clients‟ wellbeing as result of their treatment;
4)To examine the empowerment potential of multidisciplinarity for mental health promotion.
Underlying values and principles: Reorienting of health services to provide more holistic and client based
services is a key principle of health promoting practice. Clearly there is need in metal health to implement
policy in this area.
Knowledge base/ Evidence base: In Ireland, previous empirical work (e.g., Dunnes, 2006 ) indicates that
mental health services are not able to meet clients‟ needs to be actively involved in their treatment, and to
provide the full range of multidisciplinary treatment care.
Context of intervention/project/work: Recent National and European mental health policy document (e.g.,
The European Green Paper for Mental Health, 2006) identifies the need to improve clients‟ wellbeing through
multidisciplinary, community based care in which they play an active role. So far little empirical work has
been conducted to verify if, from the clients‟ perspective, this is effectively happening, or the empowerment
potential of such an approach.
Methods: Selected users from ten community mental health services participate in the study. All users were
surveyed individually at their local community mental health service. A questionnaire was designed ad hoc
for this study.
Results and Conclusions: Contrary to national policy there was little evidence of multidisciplinary care in
participants‟ treatment. Participants were seen individually by medical staff. The contribution of the allied
health professionals was extremely low. Participants‟ involvement was extremely low. Participants suggested
improving the quality of the care of their community mental health service by providing a more effective
holistic approach, reducing waiting times and improving the layout of the service, in building their capacity to
choose and their treatment care. These findings support the belief that mental health promotion should work
towards empowering users in choosing treatment care that is related to their needs and that facilitates their
role of client‟s voice in shaping mental health service provision.
References: Dunne, E. (2006) The Views of Adult Users of Public
Sector Mental Health Services. Mental Health Commission.
European Commission, Health & Consumer Protection Directorate-General. Green Paper. Improving the
mental health of the population: towards a strategy on mental health for the European Union. Luxembourg:
EC, 2005.
Disclosure of Interest: None declared

TP-WED-228 SOCIAL INTEGRATION AND HOUSING FOR PEOPLE WITH SEVERE MENTAL
DISORDER IN SANTO ANDRE, BRAZIL
E. Nakamura* 1 , A. Tugny 2 , C. Generoso 3 , A. Guerra 4 , F. Campos 5 , S. Kapp 2 , J. Furtado 1
1 Health, Education and Society, Federal University of Sao Paulo, Santos, 2 Architecture, Federal University of
Minas Gerais, Belo Horizonte, 3 Department of Health, Municipal Health Secretary, Betim, 4 Psychology,
Catholic University of Minas Gerais, Belo Horizonte, 5 Health Sciences, Federal University of Sao Paulo,
Santos, Brazil
Background: People with severe mental disorder in Brazil have two perspectives considering their housing
needs: if they had lived a long history of psychiatric hospitalizations they can try to enter into a Therapeutic
Residential Services (Supported Housing); if not, they should consider their housing needs alone or
supported by their families or the mental health network (SUS – National Unified Health System), among
others. Supported Housing is a single option for long term patients from psychiatric hospitals as it counts
with state funding, but very little is known about the social integration of these people.
Objectives: The aim of the project is to understand how people with severe mental disorder live in
Supported Housing and how they are social integrated or not, by identifying structural elements of housing
(shelter, privacy, safety and comfort) and social and cultural support (social relationship, network and social
services).
Underlying values and principles: Social integration of people with severe mental disorder should be
considered in mental health promotion policies, as it involves social inclusion for a disadvantaged group.
Knowledge base/ Evidence base: Social integration can be understood from an anthropological approach,
as it is related to cultural concepts of housing and involves the relationship amongst people living in a same
place: people with mental disorder, health professionals and local community.
Context of intervention/project/work: The research was conducted in Supported Housing located in Santo
Andre (670,000 people), a city in the metropolitan area of Sao Paulo, Brazil.
Methods: Qualitative research with participant observation of 2 Supported Housing, focusing on their
structural elements and the relationship established amongst patients, health professionals and local
community.
Results and Conclusions: Supported Housing was conceived as housing for people with severe mental
disorder who leaved psychiatric hospital, but it still remains as mental health services. People living there are
treated as “patients” with little privacy and comfort, as they can‟t decide much about staying alone when they
want to, choosing their own furniture or even cooking. But they mention that Supported Housing is a place
where they can live safe, because if they were not there they would live in the streets. Social relationship
between “patients” and health professionals is based especially on health care, “patients” have little contact
with local community. In this study social integration seems to be in contradiction with the idea of autonomy,
thus a question that must be taken into account in mental health policies remains on social inclusion of
disadvantaged groups.
Disclosure of Interest: None declared

TP-WED-229 STRESS, BURNOUT AND COPING STYLES AMONG HOSPITAL MANAGERS IN THE
REGION OF GREAT POLAND.
E. Wierzejska* 1
1 Department of Preventive Medicine, Poznan University of Medical Sciences, Poznan, Poland
Background: Stress experienced by staff is reflected in the functioning of the whole organisation, and is
manifested by: the decreased productivity, increased number of accidents, greater turnover and
absenteeism and finally costs of diseases induced by distress. Organisational culture and workplace health
promotion depends, to a great extent, on the managers and it is them who being stressed or burned out
more than their inferiors can distress the whole hospital. Because of that it is crucial to tackle the problems of
this group first.
Objectives: The main aim of this study is the evaluation and analysis of the levels of stress and burnout, as
well as diagnosis of the coping styles among hospital managers in region of Great Poland.
Underlying values and principles: The research was conducted with the respect of study subjects
(informed consent). The results are ready to be used for the benefit of the healthcare environment it was
conducted in, primarily through the exchange of knowledge and promotion of healthier work settings in
expert publications. The researcher declares honesty, verifiability and truthfulness.
Knowledge base/ Evidence base: There are some previous studies of stress in healthcare personnel
(nurses, doctors) and social workers (e.g. Borrill et al., 1998; Caplan, 1994; Firth-Cozens, 1999), but there
are very few dealing with healthcare managers and there are no (to the knowledge of the researcher) studies
employing three standardized instruments used in this work.
Context of intervention/project/work: The study was conducted as a PhD project in Poznan University of
Medical Sciences. 20 hospitals were selected and 165 managers working there have taken part in the study.
Methods: The quantitative study was conducted with the use of a survey questionnaire consisting of a
demographic part and three standardized questionnaires: GHQ -12 (General Health Questionnaire) and
CISS (Coping Inventory for Stressful Situations) and MBI (Maslach Burnout Inventory). The qualitative study
was based on the open, structured interview.
Results and Conclusions: The level of stress in the study group is relatively high (23,6%) and comparable
to the results of foreign studies, the most frequent coping style is task-oriented (47,9%). All the studied
dimensions correlate with each other and coping style was found to be a mediator between stress and
burnout. That means that the managers who employ task-oriented coping style, even if they show high levels
of stress, are not likely to burn out.
References: 1. Borrill C. S., Wall T. D., West M. A., Hardy G. E., Shapiro D. A., Haynes C. E., Stride C. B.,
Woods D., Carter A. J.: Stress among staff in NHS trusts. Final report. August 1998, Institute of Work
Psychology, University of Sheffield.
2. Caplan R. P., Stress, anxiety, and depression in hospital consultants, general practitioners, and senior
health service managers. BMJ, 1994;309:1261-1263.
3. Firth-Cozens J.: Stress in health professionals. Psychological and organisational causes and
interventions. John Wiley & Sons Ltd, Chichester 1999.
Disclosure of Interest: None declared

TP-WED-230 FROM THE INSTITUTIONAL TO COMMUNITY-RESIDENTIAL CARE: A JOURNEY
TOWARDS CLIENTS‟ EMPOWERMENT IN MENTAL HEALTH CARE.
A. Vitale* 1 , P. M. McNamara 1 , E. Carew-Eichholz 1
1 Education and Professional Studies, University of Limerick, Limerick, Ireland
Background: This paper reports an empirical study on clients‟ experience of moving from institutional to
community residential care in Ireland. It contributes to recent trends in mental health promotion which
suggests that listening to clients‟ voices promotes better mental health services that are more responsive to
clients needs.
Objectives: Research objectives include:
1)Comparing clients‟ experience of institutionalised and community residential care;
2)Assessing improvements of clients‟ wellbeing as result of their move the community residence;
3)Listening to clients‟ view in improving the quality community residential care.
Underlying values and principles: Empowerment has to do with gaining mastery over one‟s own health
(WHO, 1998). This is related to individuals‟ control over their environment, in order to enhance their
wellbeing and health related abilities (Tengland, 2007). In mental health promotion, these principles are
achieved through listening to clients‟ voice and supporting them in building their capacity to shape their
treatment care.
Knowledge base/ Evidence base: Previous empirical work (e.g., Dunnes, 2006 ) indicates that much needs
to be done in order to promote clients‟ involvement in Irish mental health services.
Context of intervention/project/work: Recent European mental health policy document (e.g., The
European Green Paper for Mental Health, 2005) identifies to ensure that clients‟ voice influence practice. So
far there is little empirical in Ireland on clients‟ view on community residential care.
Methods: Ten clients from two Community Residences were interview through in depth structured
interviews. All clients had experience of both, being in institution and in the community residence care.
Results and Conclusions: The themes and domains emerged from the analysis were clustered in a
manner that could facilitate the comparison between clients‟ experience of being in the institution and in the
residential care. The comparison between these two experiences was done through multiple levels, starting
from the individual‟s own experience, to the relations with other clients and staff members, and the way the
organization and the „outside community‟ were perceived. The overall findings indicate that, at all different
levels, participants experiences of being within an institution was correlated as „powerless‟; while their
experience of residential care was described by all as „empowering‟.Still, they felt there were areas of
improvement in the residential care, such as having more therapeutic support or being more integrated in
their community. Overall it can be concluded that clients‟ experiences of residential care are more
empowering and potentially health promoting than being in institution. There are key insights from mental
health promotion practitioners here.
References: Dunne, E. (2006) The Views of Adult Users of Public Sector Mental Health Services. Mental
Health Commission.
European Commission, Health & Consumer Protection Directorate-General. Green Paper. Improving the
mental health of the population: towards a strategy on mental health for the European Union. Luxembourg:
EC, 2005.
Tengland, P., A (2007) Empowerment: A goal or a means for health promotion?, Medicine, Health Care and
Philosophy, Vol 10 (2), 197-207.
WHO: 1998, Health Promotion Glossary. Geneva: WHO
Disclosure of Interest: None declared

TP-WED-231 THE RELATIONSHIP BETWEEN SOCIAL CAPITAL AND MENTAL HEALTH OF WOMEN
REFERRAL TO HEALTH CENTERS OF QAZVIN CITY 2008
l. sabzmakan* 1 , A. moosavie 2 , M. morowatisharifabad 3 , l. bahramkhani 4
1 health Education Department, yazd Shahid Sadoughi university of medical scince, 2 health Education
department, yazd university of medical scince, 3 health Education department, yazd Shahid Sadoughi
university of medical scince, yazd, 4 medical school, Qazvin university of medical scince, Qazvin, Iran (Islamic
Republic of)
Background: Social capital represents the degree of social cohesion which exists in communities. It refers
to the processes between people which establish networks, norms and social trust, and facilitate coordination
and co-operation for mutual benefit .Mental health promotion uses strategies that foster supportive
environments and individual resilience, while showing respect for culture, equity, social justice,
interconnections and personal dignity.
Objectives: The purpose of the study was to investigate the relationship between social capital and mental
health of women referral to Qazvin city Health Centers
Underlying values and principles: Social capital(social trust, social participation and social support) has
been linked to a number of positive outcomes, including for mental health
Knowledge base/ Evidence base: Systematically review studies exploring the association between social
capital and mental health in order to provide an estimate of the effect of social capital on mental health.
Context of intervention/project/work: With a clustered sampling of 8 Qazvin city health centers, 523
women complet two questionnaire of GHQ-28 and social capital.
Methods: 523 women in the Qazvin City Health Centers participated in this cross-sectional study with a
clustered sampling of 8 health centers in the year 2008. The data collected using with two questionnaire.
GHQ-28 was used for measurement of mental health status, and for measurement of the social capital, three
indicators were used: social trust, social participation and social support. Validity and reliability of the
questionnaire was examined and approved Data were analyzed with SPSS software and were used for
access to goals of research from Pearson Correlation Coefficient , ANOVA test and Multiple Regression test
by using of Stepwise method.
Results and Conclusions: Participant‟s age mean was 28.91±9.24 years .the mean score of mental health
in women was 61.45±11.2 (total score=84), mean score of social capital was 77.58±14.61(total score =125) ,
mean score of social trust was 45.25±14.61, mean score of social participation was 4.01±2.61 and social
support 28.96±6.54 .The Pearson Correlation Coefficient showed a significant correlation between mental
health and social trust (p=0.00), mental health and social support (p=0.03) ,mental health and social
participation (p=0.00) .Analyze variance test showed a significant correlation between educational level
(p=0.03) and job (p=0.03) with mean score of mental health . Multiple Regression test by using of method of
step by step showed the importance rate of independent variable ( social trust, social participation, education
)to predict the variance of dependent variable(mental health) ,totally the three variable predicted %8 of
mental health variance (R=%9). The results show significantly higher level of correlation between social
capital and mental health of women referral to Qazvin city Health Centers .The findings of this thesis have
implications for existing policies aimed at strengthening social capital with the intention of improving mental
health .we suggest to engage in empowering community development(enabling people to interact with each
other in a cooperative, beneficial and self-determined way to achieve common goals at a local level.
Disclosure of Interest: None declared

TP-WED-232 ASSESSMENT OF RISK MANAGEMENT TRAINING TO PREVENT VIOLENCE AGAINST
HOSPITAL WORKERS
A. MIKI* 1 , Y. Ishibashi 1
1 Psychiatric and Mental Health Nursing, Graduate School of Comprehensive Human Sciences, University of
Tsukuba, Tsukuba, Japan
Background: In recent years, the violent acts of patients directed toward hospital workers have become a
serious problem, with an increasing number of reports of severe injuries and adverse effects on their mental
health. In response to this situation, the original Comprehensive Violence Prevention and Protection
Program had developed by Japanese researchers. However, the training program is designed for nurses
working in psychiatric hospitals or wards, and not those in general hospitals and hospital workers.
Objectives: We provided violence risk management training for hospital workers, and asked them to assess
the training program.
Underlying values and principles: The present study received approval from the institutional ethics
committee at the University of Tsukuba.
Knowledge base/ Evidence base: There have been some studies examining the efficacy of the training
program(CVPPP), including changes in the recognition of psychiatric nurses.
Context of intervention/project/work: The first training program
- The current status of violence in hospitals
- Awareness of violence
- Response to verbal violence
The second training program
- Care for victims of violence
- Response to physical violence
- Development of prioritized preventive measures
Methods: Between September and October 2009, we provided violence risk management training for the
workers of General Hospital A, and conducted questionnaire surveys. In the first questionnaire, the
participants were asked about their recognition of violence by patients, and the second questionnaire asked
about secondary victimization. We asked them to assess the two training programs on a ten-grade scale and
provide comments, focusing on their satisfaction with the contents of the programs and their significance, to
examine changes in their thoughts.
Results and Conclusions: Thirty-nine participants responded to the first questionnaire (response rate:
86.7%), and thirty-six to the second one (94.7%).
A total of 89.5% of the participants were aware of violence by patients, whereas 62.2% thought that
measures to protect hospital staff were insufficient. Regarding preventive measures for secondary
victimization, 100% responded accurate answers to 12 of 22 question items, and 72.2 to 94.4% answered
correctly to the remaining questions. The mean average score for satisfaction with the first and second
programs were 8.9 and 9.1, respectively, and 9.0 and 8.8 (respectively) for their significance.
Changes were observed in the options of most participants: from 'Violence by patients may be tolerated to
some extent' and 'It is difficult to prevent violence by patients.' to 'Any form of violence should not be
allowed.' and 'It is possible to prevent violence by patients'.
The participants positively evaluated the training program, which helped them acquire accurate knowledge
and skills. It is important to further promote risk management to prevent violence in hospitals based on what
has been learned from the training sessions.
Disclosure of Interest: This study was conducted with financial aid from the Japanese Society for the
Promotion of Science (19659562).

TP-WED-233 “DEVELOPMENT OF MENTAL HEALTH PROMOTION SERVICES FOR SMALL AND
MIDDLE COMPANIES FROM SIBIU COUNTY AT THE MENTAL HEALTH CENTRE LEVEL WITHIN
PSYCHIATRIC HOSPITAL GH. PREDA SIBIU”
M. Hãrãtãu 1 , E. C. Bratu* 2 , T. Hãrãtãu 1
1 , 2 Public Health, Romtens Foundation, Bucharest, Romania
Background: Mental health is a basic component of our life, health and wellbeing. It is a necessary support
in managing our lives successfully and providing us with the emotional and spiritual resources which allow us
to enjoy life. The WMHP 1 activities contribute to companies productivity and to societys smooth functioning.
This abstract presents the methods used to develop and implement a WMHP project in Sibiu County,
Romania.
Objectives: The general objective of the project was to increase the organizational and operative capacity of
the County Mental Health Centre in to providing WMHP services to SMEs 2 . The specific objectives included
needs evaluation of MHP 3 services within the Sibiu county enterprises and increasing the operational
capacity of the mentioned Centre to offer services tailored to the identified needs.
Underlying values and principles: The main principles outlined in the project were to put emphasis on
supporting the integration of different background specialists into a multidisciplinary team and to prepare the
team to communicate with various companies and employees about WMHP.
Knowledge base/ Evidence base: The project tried to create a model of how MHP at Workplace
Interventions can be designed and implemented using the transfer of expertise from EU countries in different
stages of the project.
Context of intervention/project/work: Taking into account that people spend more than half of their active
time at the workplace it seems obviously to pay attention to those factors associated with the workplace
which can influence the mental health of people. Also, it is important to see how specialists can work in an
effective way to design those interventions which are tailored to the specific needs identified in the target
populations.
Methods: In the project were used quantitative and qualitative research methods (survey using as tool a
Questionnaire for employees, focus group for companies‟ representative) to identify and evaluate the specific
needs.
The educational approach to health promotion was used for intervention: to provide information to help
clients make an informed choice about their health behavior. A series of trainings, health education and
information sessions were provided by a multidisciplinary team to the county companies‟ representatives and
employees in order to increase the level of information, awareness and the ability to manage mental health
issues at the level of workplace.
Results and Conclusions: One of the main results obtained was the developed an innovative Model of
Good Practice in providing Services of WMHP based on the specific employees‟ needs related to the
identified MHP services.
Other useful results obtained were the materials developed:
• WMHP Guide, which describes the teams that will provide the training of the companies‟ representatives
and employees and the materials used during the training,
• Website with information for companies and enterprises regarding the importance of WMHP and its
inclusion in the occupational health and safety policies,
• Informative materials for employees.
References: 1)WMHP: Workplace Mental Health Promotion
2)SME: Small and Medium Enterprises
3)MHP: Mental Health Promotion
Disclosure of Interest: None declared

TP-WED-234 THE EFFECT OF COSMETIC INTERVENTION PROGRAM ON PSYCHO-SOCIAL
FUNCTION IN INSTITUTIONALIZED ELDERLY PEOPLE
Y. Hayakawa* 1 , I. Shoji 2 , T. Arao 3 , H. Kumon 4 , M. Tokita 1 , M. Kamata 4 , S. Watanabe 5 , Y. Ohno 5
1 Aesthetics and Health science, Yamano, College of Aesthetics, Tokyo, 2 Graduate School of Sports
Sciences, 3 Sport Sciences, Waseda University, Saitama, 4 Aesthetics and arts, 5 Aesthetics and Welfare,
Yamano, College of Aesthetics, Tokyo, Japan
Background: Muscle strength training is wildly conducted as one of the major health care programs to
preventive long-term care in aged people in Japan as well as the other developped and developping
countries. It is, however, too difficult for the elderly people with low mental and/or physical functional capacity
to implement and continue such health care programs.
Objectives: The objective of this study was to examine the effect of cosmetic intervention program on
psycho-social function in institutionalized elderly people.
Underlying values and principles: It needs to develop a new health care program that is interested and
attractive for the elderly people with low functional capacity. Therefore, we developed a cosmetic intervention
program to improve mental health in frail female elderly.
Knowledge base/ Evidence base: Evidence base
Knowledge base/ Evidence base: Evidence base
Context of intervention/project/work: This is the first well-designed intervention study using cosmetic
program for the improvement of the psycho-social function in the frail female elderly people.
Methods: Forty-eight elderly people from two nursing homes volunteered as a subject in this study. They
were allocated in either cosmetic(28 subjects;81.7±9.5age) or light exercise(17 subjects;80.4±5.6 age)
intervention group based on their home. The subjects in both intervention groups received 5 classes during 5
weeks. Questionnaire consisted of 10 items concerning with psychological health status (Geriatric
Depression Scale:GDS, a definite aim in life:DAL), social health status ( range and frequency of going out,
social support and network) , and physical activity (daily walking steps) was applied for the assessment. The
effectiveness of each intervention program was examined using Wilcoxon signed rank test for intra-group
changes in questionnaire items. The difference of the program's effectiveness was examined as an intergroup
difference of intra-group change, using an analysis of covariance with baseline values of each
measurement as covariates. For all analyses, significant level of alpha error was set at P

TP-WED-236 PHYSICAL ACTIVITY FOR PSYCHIATRIC INPATIENTS: AN INTERVENTION STUDY
LEADING TO THE FORMULATION OF NATIONAL RECOMMENDATIONS
B. Hjalsted* 1
1 Centre for health promotion and disease prevention, National Board of Health, Copenhagen, Denmark
Background: People with mental illness have substantial excess mortality due to noncommunicable
diseases and an underlying more unhealthy lifestyle compared to other population groups. Psychiatric
patients often have a long-standing contact to the health care system which can be used as an entry point
for health promotion activities. The Danish health policy ”Healthy throughout Life” focuses on the prevention
of noncommunicable diseases and the promotion of healthy living, including an increase in physical activity.
The Danish national strategy for psychiatry emphasizes the need for a health supporting inpatient
environment for this patient population.
Objectives: To promote and systematize the integration of physical activity as part of the treatment of
psychiatric inpatients.
Underlying values and principles: A set of underlying values for health care work with psychiatric patients
were formulated in 2005: respect, professionalism, responsibility. These cross sectoral principles guide the
described intervention.
Knowledge base/ Evidence base: Physical activity (PA) has a well-described potential related to the
prevention and treatment of non-communicable diseases. There is moderate evidence supporting a
preventive and rehabilitative effect of physical activity in relation to certain mental illnesses. Very limited
knowledge exists about systematic implementation of physical activity in psychiatric inpatient care.
Context of intervention/project/work: The National Board of Health in Denmark initiated a one year pilot
study of integrating physical activity in four psychiatric wards in 2005. Experiences from the pilot study were
the foundation for an implementation study in 21 psychiatric wards throughout the country in 2007-8. Both
studies were systematically evaluated. A number of supporting tools were developed during the studies.
Methods: All ward staff including management were offered a 1-1½ days training resulting in the formulation
of action plans for enhanced physical activity in each ward. A team of specially trained PA consultants
facilitated the cultural change process in the wards. The physical environment of the wards was screened for
adjustment possibilities to further support activity. Staff applied interview and assessment tools to motivate
patients for PA. Patients were involved in planning activities and staff and patients were physically active
together.
Results and Conclusions: In general psychiatric inpatients were motivated for and viewed PA as a
meaningful part of treatment. The social aspects and the physical and mental wellbeing related to the
activities were motivating for the patients. According to the ward staff, PA benefitted patients‟ mental
wellbeing and contributed to a reduction of their medication. Staff themselves became more physically active
as a consequence of the intervention and some experienced a better relationship with patients. It was
possible to integrate physical activity systematically in the everyday life of psychiatric wards with small
means. In conclusion the studies showed that integrating physical activity into the treatment of psychiatric
patients can provide good results for few additional means. These results led to the formulation of national
recommendations for integration of physical activity in treatment plans for psychiatric inpatients in Denmark
(1).
References: (1) Website with national recommendations in English www.sst.dk/psykiatriogfysiskaktivitet
Disclosure of Interest: None declared

TP-WED-237 HEAT FOR CYCLING: ENVIRONMENT-ORIENTED PHYSICAL ACTIVITY PROMOTION
USING A HEALTH ASSESSMENT TOOL
S. Kahlmeier* 1 , B. Martin 2 , N. Cavill 3 , H. Rutter 4 , F. Racioppi 1 , P. Oja 5
1 European Centre for Environment and Health, WHO Regional Office for Europe, Rome, Italy, 2 Physical
Activity and Health Work Unit, Institute of Social and Preventive Medicine, Zurich, Switzerland, 3 3British
Heart Foundation Health Promotion Research Group, 4 4National Obesity Observatory England, Department
of Public Health, University of Oxford, Oxford, United Kingdom, 5 European Centre for Environment and
Health, UKK Institute, Tampere, Finland
Background: Physical activity promotion is recognised as an important public health issue and the evidence
on the effects of the environment on physical activity behaviour is growing. However, there is only limited
experience in working with other sectors that may have better possibilities for influencing the environment
than health promotion has. Transport is such a sector in which economic appraisal is an established
planning practice. However, but health effects are rarely taken into account.
Objectives: To develop a Health Economic Assessment Tool (HEAT) for cycling, as a simple, transparent
and practice-oriented tool for estimating the economic savings resulting from reduced mortality due to
regular physical activity from cycling, i.e.: if x people cycle y distance on most days, what is the economic
value of the improvements in their mortality rate?
Underlying values and principles: Changing the environment may change behaviour.
Knowledge base/ Evidence base: Improving infrastructure for cycling implies investment but also potential
return on investment from improved health status of cyclists.
Context of intervention/project/work: Collaborative European effort under the guidance of the WHO-
Europe office.
Methods: A systematic review of economic valuations of transport projects including a physical activity
element was carried out. Based on the results, draft guidance on the identified key methodological questions
and a draft HEAT for cycling were developed. The products were finalized taking into account the feedback
from an international expert consensus workshop.
Results and Conclusions: The calculations are based on the results of a prospective cohort study
[Andersen et al, 2000] which allowed deriving a relative risk for reduced mortality from regular commuter
cycling. HEAT for cycling is primarily intended to be used in comprehensive economic analyses of transport
interventions or infrastructure projects, but it can also serve to assess the current situation or investments
made in the past.Since its informal presentation in autumn 2007 and its official launch in early 2009 HEAT
for Cycling has been used in Austria, the Czech Republic, Sweden, England, Scotland and New Zealand. It
has been judged as a useful tool by transport planners and efforts are underway to develop a version for
walking infrastructure and interventions, to develop a version adapted for the use in North America, and to
include reductions in both mortality and morbidity in the estimations. Such tools illustrate the importance of
considering health in transport policy and infrastructure planning, putting “Health in All Policies” into practice.
References: Andersen LB, Schnohr P, Schroll M, Hein HO. All-cause mortality associated with physical
activity during leisure time, work, sports and cycling to work. Arch Intern Med. 2000;160:1621–1628.
Disclosure of Interest: None declared.

TP-WED-238 ON THE PHYSICAL STRENGTH MEASUREMENTS FROM INFANTS TO OLDER ADULTS
K. Terasawa* 1 , W. Koichi 1 , Y. Kenjirou 1 , Y. Akitaka 1 , S. Kikunori 1 , K. Toshie 1 , T. Saiki 1 , F. Satomi 1 , M.
Tomio 1 , S. Taito 1 , N. Kouki 1
1 Faculty of Education, Shinshu University, Nagano, Japan
Background: The measurements of the same physical strength items performed on infants through older
adults are hardly reported.
Objectives: The purpose of this study is to obtain and compare data of the performance of the physical
strength measurements for older adults carried out on infants through older adults in order to help future
health education.
Underlying values and principles: We can draw up a plan for future health promotion adequately by
understanding the physical strength measurements of infants through older adults.
Knowledge base/ Evidence base: In the past, there were no continuous data from infants to older adults
using the same measurements. Only separate ones of the age groups of 6-12, 11-19, 20-64, and 65-79.
Context of intervention/project/work: A project was carried out by 11 staff members.
Methods: We performed the physical strength measurements on 1384 subjects (male: 524, female: 859,
and ages from 3 to 77). We adopted the measurement used by the Japanese Ministry of Education, Culture,
Sports, Science and Technology for people of ages 65 through 79. The measurement items were grip
strength, sit-up, sit-and-reach flexibility, eyes-open-single-leg stance, ten-meter obstacle and six-minute
walk.
Results and Conclusions: The value of the grip strength which shows muscular strength increases with
age until the age of 20 and decreases after that. That of sit-ups which show muscle stamina increases with
age until the age of 17 and decreases after that. That of sit-and-reach flexibity increases until the age of 17
and decreases after that. That of eyes-open-single-leg stance increases until the age of 10 and maintains it
until 50 but decreases sharply at the age of 60. That of ten-meter-obstacle which shows walking ability
increases until the age of 10 and maintains it until the age of 60 but decreases at 70. That of six-minute walk
which shows stamina increases until the age of 7, maintains it until 18 but gradually decreases after that.
Disclosure of Interest: none declared

TP-WED-239 NEIGHBORHOOD ENVIRONMENT FACTORS AS CORRELATES OF PHYSICAL
ACTIVITY AND WALKING AMONG NIGERIAN YOUNG ADULTS
A. L. Oyeyemi* 1 , B. O. A. Adegoke 2 , A. Y. Oyeyemi 3
1 Physiotherapy, University of Maiduguri, Nigeria, Maiduguri, 2 Physiotherapy, University of Ibadan, Nigeria,
Nigeria, Nigeria, 3 Physical Therapy, Hunters College, City University of New York, New York, United States
Background: There is growing interests in the assessment of the built environment for physical activity
behaviors. However, Africa is the only continent for which empirical findings on the association between the
environment and physical activity is lacking. Evidence from studies on environmental determinants of
physical activity conducted in Western developed countries may not be applicable to guide intervention in
Africa.
Objectives: The objective of this study was to examine associations between perception of the
neighborhood environment and health related physical activity and walking in a population of Nigerian young
adults.
Underlying values and principles: The socio- ecological model recognizes the multiple level of influence
on health behaviors vis social system, public policies and the physical environment, and has potential for
facilitating better understanding of the influence of the environments on physical activity behavior than
individual focus oriented model.
Knowledge base/ Evidence base: Models that explain behavior- environment relationships can play a key
role in shaping research agenda and in linking research, policy, and practice.
Context of intervention/project/work: Representative sample of undergraduates living in a Nigerian
university hostels.
Methods: A cross sectional survey was conducted with a representative sample of 1006 undergraduates of
a Nigerian university. Data were collected on walking and physical activity with the short International
Physical Activity Questionnaire, and on 16 perceived neighborhood environmental variables using a reliable
instrument. Perceived neighborhood environmental variables were categorized as “agreed” or “disagreed”,
while outcomes were meeting health related guidelines for physical activity and walking. Separate logistic
regression analysis was used to examine the associations between neighborhood environmental variables
and outcomes.
Results and Conclusions: After adjusting for demographics, proximity of bus/transit stop (OR= 1.41), traffic
as not a problem (OR= 0.48; unexpected direction) and not many four-way intersections (OR= 0.70) were
significantly associated with sufficient physical activity. Low crime rate at night (OR= 1.56), many interesting
thing to look at (OR= 1.87) and seeing many people active (OR= 0.59; unexpected direction) were
significantly associated with sufficient walking.
Conclusion: Neighborhood environment attributes were inconsistently related to physical activity of Nigerian
young adults. There appear to be some similarities and some differences between patterns of association
found in Africa and other world regions. Future research utilizing objective measures and prospective
designs is needed to confirm these findings in the African environment.
Disclosure of Interest: None declared

TP-WED-240 COMMUNICATING THE RESULTS OF THE SURVEILLANCE SYSTEM ON CHILDREN‟S
BMI, EATING HABITS AND PHYSICAL ACTIVITY TO THEIR FAMILIES AND PAEDIATRICIANS
C. Cattaneo 1 , V. Possenti* 1 , B. De Mei 1 , A. Perra 1 , G. Fontana 2 , A. Lamberti 3 , G. Maggio Cavallaro 3 , A.
Spinelli 3
1 Unit of Training and Communication, National Centre for Epidemiology, Surveillance and Health Promot,
Istituto Superiore di Sanità, Rome, Italy, 2 Public Health, University of Washington, Washington DC, United
States, 3 National Centre for Epidemiology, Surveillance and Health Promot, Istituto Superiore di Sanità,
Rome, Italy
Background: In 2008 the Ministry of Health initiated the national research project PInC- Programme of
Information and Communication- to enable the population to make informed choices for healthy lifestyles.
This supports the Italian version of Gaining Health (Eu Strategy for the Prevention and Control of
Noncommunicable Diseases). Information and communication activities and initiatives have been planned,
considering that for effective communication, it is crucial to translate technical-scientific information into
understandable language so that messages are clear and meaningful for their audience, whose involvement
in the production is important. First informative materials were developed for the data collected by the Italian
surveillance system OKkio alla SALUTE. This concerns children‟s Body Mass Index (BMI), eating habits and
physical activity.
Objectives: Because the data, collected on 45,590 children attending primary school, showed a high
prevalence of overweight and obesity (36%), bad eating habits and sedentary lifestyles, and low parental
perception of the problem, two target populations were considered: parents and paediatricians.
Underlying values and principles: Effective communication with stakeholders
Knowledge base/ Evidence base: Youth overweight/obesity
Context of intervention/project/work: Surveillance System on children‟s behavioural risk factors
Methods: An informative leaflet for parents and an informative chart for paediatricians were produced. Both
present the main results; the leaflet contains general advice for the parents, the chart emphasises the role of
paediatricians. They were presented to the regional representatives of OKkio alla SALUTE for a first review.
They were evaluated with respect to their contents, graphics and development using two questionnaires: one
for parents and the other for paediatricians.
Results and Conclusions: 16 of the 18 Regions participating to OKkio alla SALUTE evaluated the
materials. Questionnaires were delivered to 813 parents of children in 49 primary-schools and 176
pediatricians. Parents evaluated the leaflet positively, but criticised the language and suggested to underline
essential messages, and better explanation of what should be done to improve the overall health and the
well-being of their children (increased by using clear graphics). Paediatricians suggested that the written part
should be more concise leaving more space for graphs and charts. To better communicate health risks and
information to the public for promoting healthy lifestyles, the opinions and comments of the recipients of
informative materials should be used to improve the drafts produced by communications professionals.
Disclosure of Interest: None declared

TP-WED-241 EFFECTIVENESS OF WORKSITE PHYSICAL ACTIVITY INTERVENTIONS. A META-
ANALYSIS.
M. Zinsmeister* 1
1 Departement of Sport and Exercise Science, University of Stuttgart, Stuttgart, Germany
Background: A physically active lifestyle has a positive impact on many health related conditions. Worksites
are an important setting to promote physical activity through interventions.
Objectives: The objectives were to conduct research on the effectiveness of physical activity interventions in
worksite settings in order to find out if physical activity is enhanced at all, how effective the interventions are
and if variation of the calculated mean effect can be explained by moderators.
Underlying values and principles: As employers share responsibility for protecting and enhancing
employee´s health it is important to know if and what kind of interventions work in this setting.
Knowledge base/ Evidence base: Expert reviews show contradictive results about the effectiveness of
physical activity interventions in worksites. Quantitative data show only little or no effect while narrative
reviews claim that worksite interventions are effective and classify physical activity interventions as a
relevant strategy to worksite health promotion.
Context of intervention/project/work: Meta-analytic methods bear well-known challenges in observing
interventions in human behavior such as physical activity. Therefore calculations and integration procedures
were caluated as conservative as possible to avoid overestimation.
Methods: After a systematic literature analysis quantitative and qualitative data were integrated using
studies with randomized and quasi-experimental designs. Studies with pre-post designs were excluded. The
integrated primary studies were rated according to their level of quality with a self-developed scale. Metaanalytic
methods were used to integrate quantitative data in a randomized effect model to quantify a mean
effect expressed as Hedge's g. Variation was analysed through several moderators.
A separate outlier-analysis was calulated to adjust variation in primary data and to test the impact of extreme
primary effects on the mean effect. Quality of the integration model and validity of the statistical findings were
tested within an a posteriori power analysis.
Results and Conclusions: Fourty-nine studies with overall 16508 subjects reported 218 effects.
The mean effect was medium g=0.56 (95% CI, 0.32 to 0.86), heterogenous and revealed a binomial
treatment effect of 28,4% for subjects in the intervention group. Two moderator variables, setting and study
design, showed homogenous effects. Adjustment for outliers did not change significance of the mean effect
but turned it homogenous and reduced the mean effect to g=0.27 (95% CI, 0.21 to 0.32).
Findings of this Meta-analysis confirm results of former quantitative reviews. Despite of three decades of
research in this topic, poor scientific quality of literature prevents a sound judgement on worksite physical
activity interventions. Studies that fulfilled scientific quality criteria (sample size, randomized-controlled
design, valid outcome measures) yielded a small and statistically insignificant effect leading to the conclusion
that effectivity of worksite physical activity interventions still remains to be demonstrated.
Disclosure of Interest: None declared

TP-WED-242 PHYSICAL ACTIVITY MEASUREMENT AND PATTERNS AMONG AN AUSTRALIAN
POPULATION
T. K. Gill 1 , M. Smith 2 , A. W. Taylor* 1
1 Population Research and Outcome Studies Unit, 2 Health Promotion Branch, SA Health, Adelaide, Australia
Background: Levels of physical activity are an important issue in public health with lack of physical activity
associated with increased levels of chronic disease and higher levels of obesity. Monitoring of physical
activity is a significant part of a population health focus and the development of health promotion programs.
Objectives: To describe the methods used to monitor physical activity over a period of over ten years and to
highlight differences between socio-demographic groups which may provide areas for targeting programs.
Underlying values and principles: There is an increased emphasis on using surveys and ongoing
surveillance systems as a means of identifying associations between chronic diseases, risk and sociodemographic
factors in order to define and address health inequities that may exist.
Knowledge base/ Evidence base: Self reported prevalence of chronic diseases and risks factors has an
important place in public health and health promotion. While there are acknowledged limitations using
telephone surveys, the information provided by these surveys is important for targeting priority groups.
Context of intervention/project/work: Physical activity is monitored in order to determine changes in the
proportion of the population who undertake sufficient physical activity to obtain a health benefit. Addressing
health inequities is a priority for government and as a result strategies are developed aimed at encouraging
the population to be more active and also prioritise those groups that require specific support and
intervention.
Methods: Self reported physical activity has been measured as part of an ongoing surveillance system
conducted using Computer Assisted Telephone Interviewing (CATI) since 2002. It has also been assessed
every three years using a specific survey undertaken during spring, in September/ October. This information
provides the ability to monitor physical activity across all seasons and at a specific time of year using a
consistent methodology. Analyses of data were undertaken to reveal trends in the proportion of adults
achieving sufficient physical activity defined as 150 minutes or more per week, together with information on
demographic factors and health status.
Results and Conclusions: The prevalence of physical activity among adults aged 18 years and over has
ranged between 50% and 57% each year since 2003. For the single surveys, 2007 showed an increased
proportion of adults participating in sufficient physical activity (58.1%) compared to 52.7% in 1998. Sufficient
physical activity varies across population groups, quintiles of social disadvantage, educational and income
status. The findings indicate that over recent years, participation in physical activity appears to have
increased across the population and may reflect a positive impact of physical activity campaigns. This
provides support for continuing an approach which focuses on not only physical activity but associated
factors and health inequities.
Disclosure of Interest: None declared

TP-WED-243 A COMPARISON OF EDUCATIONAL AND COUNSELLING APPROACHES TO
INCREASING, RETENTION, ADHERENCE AND PHYSICAL ACTIVITY IN A 6-MONTH HOME-BASED
PHYSICAL ACTIVITY PROGRAM FOR OLDER ADULTS: THE MOVES STUDY
K. L. Cox* 1 , V. Burke 1 , E. N. Kane 1 , L. J. Beilin 1
1 School of Medicine and Pharmacology, University of Western Australia, Perth, Australia
Background: Finding strategies to promote physical activity is a challenge. Motivational interviewing has
been used successfully to change other lifestyle behaviours but few have evaluated its effect on physical
activity.
Objectives: To evaluate the effect of educational and counselling approaches on retention, adherence and
physical activity in a 6-month home-based physical activity program for 50-80 year olds.
Underlying values and principles: The Stage of Change model was used as a basis for behaviour change.
A behavioural education (BE) program was developed from this model. Motivational interviewing (MI) was
used alone and in combination with BE.
Knowledge base/ Evidence base: Successful methods and resources from our and others previous studies
were modified after focus group input.
Context of intervention/project/work: Healthy sedentary men and women (n = 149) were recruited from
Perth, Western Australia for a 6-month home-based physical activity program.
Methods: Participants were randomised to receive either a standard (SE) or behavioural education program,
with or without standard (SC) or motivational interviewing counselling. All participants attended a workshop
specific to their intervention program and the counselling was delivered via 4 phone calls over a 6-month
period. They were asked to complete three 50-minute sessions of moderate walking per week, these were
recorded on exercise diaries returned each fortnight. Exercise self efficacy and perceived barriers to exercise
were assessed by questionnaires, health and fitness tests were completed and pedometers worn for 7-days
were used to assess physical activity at baseline and 6 months.
Results and Conclusions: After 6 months 119 were still in the study. Each group received similar numbers
of telephone counselling calls, 3.98 (0.01). There was no significant difference between groups in retention
rate (77% for standard versus 82% for behavioural education; 82% for standard counselling versus 79% for
motivational interviewing). Adherence rates were similar across the groups (63% and 66% for standard
versus behaviour education and 66% and 63% for standard versus motivational interviewing). Mean increase
in fitness after 6 months was 4.8% with no difference between groups. Further, after 6 months there was no
significant difference between groups in exercise self efficacy or perceived barriers to physical activity.
In a linear regression model, only a reduction in perceived exercise barriers predicted adherence to the
physical activity program (P

TP-WED-244 PROMOTION AND EVALUATION OF HAPPY 10 PROGRAM
Y. Li* 1 , S. Du 1 , A. Liu 1 , Q. Zhang 1 , H. Pan 1 , X. Hu 1 , G. Ma 1
1 Department of Student Nutrition, China National Institute for Nutrition and Food Safety, Beijing, China
Background: With more than 25% of Chinese adults overweight, China is facing a major epidemic of
obesity. Increasing physical activity is considered an important strategy for prevention of childhood obesity.
Objectives: In order to increase the physical activity and prevent childhood obesity, Happy 10 Program was
promoted and its effectiveness was evaluated.
Underlying values and principles: The Happy 10 activities are designed to be implemented in the
classroom. As such, they address the issue of limited sports space (a main reason cited by 38.7% of the
children for lack of activity).
Knowledge base/ Evidence base: Theoretically, decreasing energy intake or increasing energy
expenditure by 45 kcal each day could offset weight gain in roughly 90% of the population in China.
Therefore, with energy expenditure of 43-50kcal per day, Happy-10 should have the potential to maintain
body weight in a normal range for the long term.
Context of intervention/project/work: Happy 10 program provided a variety of safe, moderate, age- and
space-appropriate exercises. Teaching materials included activity cards, video demonstrations, tracking
posters, and stickers. Each activity card introduced one exercise and explained how to perform it. The videos
showed students from the pilot study performing the activities. Teachers could either demonstrate the activity
or show it on a video. The tracking poster and stickers were used to illustrate the progress of each class. .
Methods: One year cluster randomized controlled trial was developed to evaluate the effectiveness of
Happy 10 on physical activity, body composition, blood lipid and metabolic profiles, with a subsequent 1-year
follow-up.
Results and Conclusions: Happy 10 was a physical activity promotion program, which was developed in
2003, then promoted in 6 cities during 2006-2007 and another 7 cities during 2008-2009. The estimated
number of students reached 100 thousands.
The average energy expenditure of Happy 10 program was 25.0-35.1 kcal and its metabolic index was 4.8-
6.2 kcal/kg/h. The daily physical activity energy expenditure and physical activity time changes among
students in intervention school were significantly higher than those in control school (3.1 kcal/kg vs -9.6
kcal/kg, P

TP-WED-245 AN EVALUATION OF THE IMPACT OF PARTICIPATION IN A PHYSICAL ACTIVITY
MENTORING PROGRAM ON MENTOR SELF-EFFICACY.
K. L. Cox* 1 , A. K. Stewart 2 , V. Burke 1 , L. J. Beilin 1 , I. B. Puddey 3
1 School of Medicine and Pharmacology, University of Western Australia, 2 School of Exercise Biomedical and
Health Sciences, Edith Cowan University, 3 Faculty of Medicine and Dentistry, University of Western
Australia, Perth, Australia
Background: Mentoring has been shown to be effective in changing behaviours. Little is known about the
impact of the mentoring process on the self-efficacy and perceived effectiveness of the mentors. The PATH
(Physical activity Time for Health) study was a 6-month supervised walking versus a self-managed physical
activity program for 60-80 year olds. The supervised program included a behavioural education component
incorporating mentoring.
Objectives: To evaluate the impact of participation in a physical activity mentoring program on self-efficacy
and perceived effectiveness of trained older mentors.
Underlying values and principles: On a community level the greatest benefits to health are attained by
moving the „inactive‟ to the „active‟ stage of physical activity. Mentoring self-efficacy was considered to be the
belief that the mentor could be an effective mentor under certain conditions.
Knowledge base/ Evidence base: A validated measure of self-efficacy modified for mentoring skills and the
mentoring process were used. The Stage of Change model was used as basis for the intervention program
to facilitate change in the mentees physical activity.
Context of intervention/project/work: The project was conducted in community recreation centres in
metropolitan Perth, Western Australia.
Methods: Physically active potential mentors (n = 117) were recruited from community groups. Sixty two
completed an 8-hour physical activity mentor training course and were assigned participants (mentees) from
the supervised centres in the PATH program. Each participant was mentored for 6 months. Mentors were
involved for 2 years. After training the mentors completed a mentoring self-efficacy questionnaire. After
mentoring they repeated this questionnaire and a self evaluation of their mentoring.
Results and Conclusions: Ten mentors withdrew from the program. Mentors were assigned between 1 and
9 mentees each. Ninety-seven per cent thought the training adequately prepared them as mentors. On a
self-rating scale 97% said they had a satisfactory to excellent relationship with their mentee with 69% rating
their mentoring as satisfactory. However, 53% indicated that they encountered some resistance to
mentoring, 75% noting that this resulted from the mentees perception that they did not need a mentor. At
baseline self-efficacy for effective mentoring was 86.9 (12.8)% and at the end of the program this was not
significantly different 79.1 (39.6)%. Self-efficacy to motivate the mentee to attend sessions was significantly
reduced from 78.2 (15.6)% to 59.4 (31.2)% after the program (P

TP-WED-246 DOSE-RESPONSE CONSIDERATIONS IN THE PROMOTION OF PHYSICAL ACTIVITY
J. F. Konopack* 1
1 Nursing and Health Studies, Monmouth University, West Long Branch, United States
Background: Physical inactivity is recognized by the World Health Organization as a global health problem,
and the promotion of physical activity (PA) is an essential component of health promotion efforts in sedentary
populations. Recommendations from the 2008 Physical Activity Guidelines for Americans, developed by the
U.S. Department of Health & Human Services, reported a linear dose-response relationship between PA and
health benefits. Thus, recommendations suggested that more PA is always desirable. However, the extent to
which this relationship holds for psychosocial health under extremely high doses of PA remains to be
determined.
Objectives: One objective was to examine the dose-response relationship between PA and psychosocial
health in the context of an extremely high dose of aerobic exercise. Another objective was to describe
motivational themes underlying participation in extremely high-volume running events.
Underlying values and principles: This research is part of an effort to empower individuals toward healthy
behavior change. The dissemination of sound, healthy public policy with respect to physical activity is
needed.
Knowledge base/ Evidence base: Previous research has provided a wealth of evidence suggestive of a
linear dose-response relationship between PA and various health outcomes, but the nature of this
relationship for extremely high doses of PA is unclear and may vary by which health outcome is under
consideration. Extremely long-duration exercise bouts, as seen in ultra marathon competition, may well be
physiologically detrimental (e.g., increased oxidative damage), but the mental health outcomes and
motivating psychosocial factors of this activity remains to be examined.
Context of intervention/project/work: Participants completed questionnaires and semi-structured
interviews within 30 minutes following their attempts to complete up to 150 miles (80.47 kilometers) of
running. All interviews were conducted in an isolated, private environment in order to ensure confidentiality
and thereby encourage open discussion.
Methods: Male (n = 10) and female (n = 10) participants (M ± SD age = 40.8 ± 10.3 years) were interviewed
immediately following participation in a 50-mile (80.47-km), 100-mile (160.93-km), or 150-mile (241.40-km)
trail race. Interviews were digitally recorded, transcribed, and analyzed for emergent themes.
Results and Conclusions: “Challenging personal limits” and “socialization” emerged as dominant themes
describing motivational factors for participation. “Addiction” and “weight loss” were mentioned, but
infrequently. Participants, as a whole, did not demonstrate high levels of exercise addiction and, instead,
demonstrated sound psychological well-being. These results provide evidence for the benefits of extremely
high doses of PA with respect to psychosocial health, in support of recent recommendations adhering to a
linear dose-response relationship. Future research on the multidimensional consequences of high-dose PA
is warranted.
Disclosure of Interest: None declared

TP-WED-247 USING LOGIC MODELS AS ITERATIVE TOOLS FOR PLANNING AND EVALUATING
PHYSICAL ACTIVITY PROMOTION PROGRAMS IN CURITIBA, BRAZIL
I. C. Ribeiro* 1 , A. Torres 2 , D. Parra 3 , R. Reis 4 , C. Hoehner 3 , T. Schmid 2 , M. Pratt 2 , L. Ramos 5 , E. Simoes 6 ,
R. Brownson 3
1 NCEH, 2 NCCDPHP, CDC, Atlanta, 3 Department of Surgery and Siteman Cancer Center, Washington
University, Saint Louis, United States, 4 Physical Education, Pontiff Catholic University of Parana, Curitiba,
5 Department of Preventive Medicine, Federal University of Sap Paulo, Sao Paulo, Brazil, 6 Prevention
Research Centers Program, CDC, Atlanta, United States
Background: The Guide for Useful Interventions for Activity in Brazil (GUIA) and Latin America, a
systematic review of community-based physical activity (PA) interventions in Latin American literature,
selected the city of Curitiba, Brazil, for a comprehensive program evaluation.
Objectives: To describe the process of and lessons learned from developing LMs for evaluating PA
community interventions in Curitiba.
Underlying values and principles: Various PA interventions coexist in the city of Curitiba. These are
conducted by different key players from the public sector, making the evaluation of these interventions very
challenging.
Knowledge base/ Evidence base: Describing a program or intervention in detail is one essential piece in
the evaluation process, which can be developed using the logic model tool. Logic models (LMs) provide a
common language among stakeholders and help to identify important variables that should be measured
when conducting evaluations.
Context of intervention/project/work: Curitiba has been nationally and internationally recognized for its
creativity in facing severe problems associated with dense urban development, such as traffic congestion,
loss of public space, and adverse environmental impacts. The PA programs began to be implemented in
1998 in response to the burden of chronic diseases among the local population.
Methods: The year-long process included engaging individuals or organizations involved with the promotion
of PA in the city (stakeholders); developing a clear description of all programs (i.e., definition of the problem
addressed, program activities, resources, expected outcomes, and context; and finally, developing two LMs
encompassing the various ongoing PA interventions in Curitiba.
Results and Conclusions: The process of developing the LMs provided program managers with a clearer
picture of the resources used to sustain the activities, such as personal, infrastructure, funding, and
partnerships, information recognized as very useful for sustaining their programs. The better understanding
of the program‟s elements enhanced teamwork and may have had a positive effect in the way the staff
planned and managed the programs. It also helped to frame evaluation questions, identify data sources,
describe realistic outcomes, establish evaluation goals and objectives and reinforce the importance of
intersectoral alliances for public health impact.
The evaluation of the PA programs in Curitiba was greatly enhanced by the process of developing LMs. The
process proved to be feasible in the Latin American context, and could be very useful for other PA promotion
programs in Latin America.
Disclosure of Interest: None declared

TP-WED-248 APPLICATION OF THE TRANSTHEORETICAL MODEL TO EXERCISE BEHAVIOR
AMONG FEMALE EMPLOYEES IN YAZD, IRAN
S. MAZLOOMY MHAMOOD ABAD* 1 , m. Mohammadi 1 , m. Morowatisharifabad, 1
1 contral of disease, shahid sadoghi medical university, yazd, Iran (Islamic Republic of)
Background: In spite of exercise benefits on health, more than 60% of adults do not exercise sufficiently
during their life span. Many studies on a wide range of populations have shown a significant relationship
between exercise behavior and Transtheoretical model constructs. Considering the most previous studies
carried out in western countries, it seems that a similar study in developed countries like Iran is necessary
Objectives: The study objective was to examine weather specific constructs from the Transtheoretical
Model regarding regulate physical activity are applicable to Iranian female employees.
Underlying values and principles: ..
Knowledge base/ Evidence base: knowlede base
Context of intervention/project/work: ..
Methods: The data collection occurred in 2008. A total of 68 offices employee with age mean 30.06±6.37
selected from all the administrative offices in Yazd city. The study was quantitative analytical, with data
gathered through standardized self-report questionnaires. These questionnaires examined the exercise
behavior of offices employees and the TTM constructs relating to exercise behavior.
Results and Conclusions: Stage of exercise behavior change distribution overall are represented in table1.
According to this tables, pre-contemplation (n=14, 20.6% ), contemplation(n= 33,48.5% ), preparation
(n=7,10.3% ), action(n=7,10.3% ), maintenance(n= 7,10.3% ).
this study, showed that significant differences between self efficacy in stage of change (p=0.001) as Efficacy
increased in stages and were the most in maintenance stage and very low in precontemplation stage.
Significant differences in both pros and cons emerged across stages of exercise behavior change too
(p=0.00). Individuals in the precontemplation stage had significantly lower perceived pros associated with
exercise in comparison with those in the other maintenance stages.
Process of change increased in stages and the most in maintenance stage and very low in precontemplation
stage.
The results of study indicated that transtheoretical model may be used as a conceptual framework for
exercise promotion.
References: 1. Juarbe T, Turok X. P., 7& Perez- Stable, E. J. (2002). Perceived benefits and barriers to
physical activity among older Latina women. Western Journal OF Nursing Research, 24, 868-886.
2. United State of Health and Human Services, Physical Activity and Health: A Report of the Surgeon
General. Atlanta, GA.1996.1-3
3. Miilunpalo Seppo, Evidence and theory based promotion of health-enhancing physical activity, Public
Health Nutrition: 4(2B), 725-728.
4. Faulkner G, Biddle S, Mental health nursing and the promotion of physical activity, Journal of Psychiatric
and Mental Health Nursing 2002;659–665.
5. United State Department of Health and Human Services (2000). Healthy people 2010: Understanding and
improving Health. p1-5.
6. Garrett NA, Brasure M, Schmitz KH, Schultz MM, Huber MR6. Physical inactivity: Direct Cost to a Health
plan. Am J Prev Med, 2004; 4: 304-309.
7. Caspersen CJ, Christenson GM, Pollar RA. Status of the 1990 physical fitness and exercise objectiveevidence
from NHIS 1985; Public Health 1986; 10:587-592.
Disclosure of Interest: Paid instructor

TP-WED-249 EVIDENCE AND BEST PRACTICE IN PROMOTING HEALTHY DIET AND PHYSICAL
ACTIVITY
C. Hollemann Pedersen* 1 , K. Norman 1 , T. Curtis 1
1 National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
Background: Health professionals, policymakers and decision makers need evidence to guide health
promoting initiatives and interventions. A comprehensive and evidence based engagement is needed, to
ensure that interventions have a positive impact on core health measures. But evidence on promoting
healthy diet and physical activity on community level is sparse.
Objectives: The project aimed to strengthen the work of community health professionals, by the
dissemination of current best knowledge on how to promote healthy diet and physical activity. This was
achieved in the form of a set of recommendations and examples of best practice. For usability purposes this
also included detailed information and guidance on how to implement the recommendations.
Underlying values and principles: Dietary habits and physical activity affects mortality and morbidity. And
therefore play an important role in the current health status of the population. If the influence from lifestyle
habits is to be challenged, there is a need to act even though evidence is sparse. Until more comprehensive
evidence on promoting healthy diet and physical activity on a community level is present, best practice
should be included in determining which interventions are expected to promote health.
Knowledge base/ Evidence base: The views on the international literature on evidence on promoting
healthy diet and physical activity have focused primarily on findings from randomized controlled trials.
However, to create a contextualized platform for evidence based practice, this project has also included the
experiences of selected local health professionals in Denmark.
Context of intervention/project/work: The Healthy Settings Approach is an ecological model of health
promotion. It facilitates the use of local health professionals‟ experiential knowledge of best practice. And
enables a comprehensive inclusion of members of communities.
Methods: A review of the international literature was conducted and information on health professionals‟
experiences of best practice was collected in order to obtain knowledge on effective interventions. Findings
from the literature and best practice experiences were discussed with the Danish Healthy Cities Network.
Results and Conclusions: The main findings suggest a need to place an emphasis on structural health
promotion. This involves completion of policies relating to main settings such as childcare centers, schools
and workplaces.
Disclosure of Interest: None declared

TP-WED-250 THE STUDY OF THE EFFECT OF EDUCATIONAL INTERVENTION THROUGH THE
THEORY OF PLANNED BEHAVIOUR ON THE PHYSICAL ACTIVITIES OF KERMAN HEALTH
CENTER‟S STAFF
V. Ahmadi Tabatabaei* 1 , M. Hossein 1 , T. Nozar Nakheei 1 , F. Balali 1
1 kerman university of medical science ,deputy of health, kerman health center, Kerman, Iran (Islamic
Republic of)
Background: It has been estimated that physical inactivity causes around 2 million deaths in the world each
year.
Objectives: This study is carried out based on determination of the effect of educational intervention through
the theory of planned behavior on the physical activities of Kerman Health Center‟s staff.
Underlying values and principles: this study is based on theory of planned behaviore
constructs:(behavioral intention,attitude,subjective norm,perceived behavior control and behavior)
Knowledge base/ Evidence base: today, theory and model based health promotion and education
interventions are mandatory.so this study is a theory based intervention.
Context of intervention/project/work: theory of planned behavior intervention(an experimental study)
Methods: In this interventional study, 149 persons of Kerman province and city Center‟s staff in two groups
of intervention and control come under investigation. Through a questionnaire with approved validity and
reliability, the knowlege, attitude, behavioral intention, subjective norm and behavior were measured before
intervention. They were planned and performed on the same basis of educational intervention. After six
weeks, the effect of the intervention on the constructs of theory was examined and the results were analyzed
with statistic test of Man-Whitney, paired t test, chi-square and Wilcoxon.
Results and Conclusions: The findings reveal that both groups don‟t have any significant difference before
intervention based on demographic characteristics (p>0/ 05). Also, in the beginning of the study, there was
no significant difference between the grade point average of both groups of constructs of theory. In
intervention group, only the grade point average after and before knowlege had demonstrated the significant
increase (p=0/003) and perceived behavioral control had demonstrated significant decrease (p=0/003) but
the other constructs didn‟t have demonstrated the significant difference and in mean difference of grades
constructs of theory didn‟t have revealed any significant difference between groups of intervention and
control before and after intervention.
Disclosure of Interest: none declared

TP-WED-251 DO HEALTH PROMOTION ORIENTATIONS AND RELATED ACTIVITIES CONTRIBUTE
TO EACH OTHER IN YOUTH SPORTS CLUBS?
S. P. Kokko* 1 , L. Kannas 1 , J. Villberg 1
1 Research Center for Health Promotion, University of Jyväskylä, Jyväskylä, Finland
Background: Although, sports clubs have been recognised as potential health promotion settings for
children and adolescents, international research in this area is limited. In a Finnish case, it was found that
youth sports clubs were fairly health promoting by their orientations, but variation between clubs was wide
(Kokko et al. 2009). There are also signs that these orientations have not been changed into practical
actions to the same degree.
Objectives: The purpose of this research was to examine whether youth sports clubs health promotion
orientations have lead to practical actions by the clubs, and whether there were differences between the
clubs that value health promotion high and those less.
Underlying values and principles: Settings-based approach, organizational development, equity in health
for children and adolescents.
Knowledge base/ Evidence base: research-based knowledge and evidence.
Context of intervention/project/work: The data was collected in 2007 by a postal survey, and it consisted
of 273 club officials from 97 clubs.
Methods: The respondents evaluated their clubs health promotion orientation through 22 single claims,
which as a total constituted a Health Promoting Sports Club Index (HPSC Index). It is also possible to
examine single claim as index-based (range 0-1.00, the higher the value the better), which was done here.
Practical actions were examined under three sub-domains i.e. substance-related regulations, cooperation in
health-related issues and clubs internal education. Both basic descriptive and multivariate analyses were
used.
Results and Conclusions: Single claim values for examined sub-domains were .63 for substance-related
regulations, .30 for cooperation and .38 for internal education. As to practical actions, more than two thirds
(69%) of the clubs had written regulation concerning substances in general. Specific substances were
mentioned infrequently. Most of the clubs did not cooperate with any external parties (70%) nor arranged
internal education (74%) with relation to health promotion.
Club-based health promotion orientations associated strongly with practical actions. Those clubs whom had
higher health promoting orientation by HPSC Index (single claim values) had notably more often written
regulations on substances (OR varying 4.80-6.37). Similarly cooperation with other parties was more active
for higher orientation clubs (OR varying 2.20-10.00). Clubs orientation was significant factor under internal
education concerning coaching (OR=2.34) and trainer (OR=2.77) educations.
Finnish youth sports clubs health promotion orientations were moderate, but differed concerning single
claims; substance-related regulations were clearly better recognised, than cooperation and internal
education. Similar kind of differences were discovered when practical actions were examined. Sports clubs
health promotion orientations seem to contribute to practice; when the clubs with higher orientation had also
been notably more often active in practice. Thus, the development work in youth sports clubs should be
started at orientation-level. These results, at the same time, strengthen the reliability of HPSC Index as good
measurement of health promotion in youth sports clubs.
References: Kokko S., Kannas L. and Villberg J. (2009) Health promotion profile of youth sports clubs: Club
officials‟ and coaches‟ perceptions. Health Promotion International, 24, 26-35.
Disclosure of Interest: None declared.

TP-WED-252 UNDERSTANDING MEDIA‟S IMPACT ON INTENTIONS TO ENGAGE IN PHYSICAL
ACTIVITY: AN APPLICATION OF THE THEORY OF PLANNED BEHAVIOR INCLUDING MEDIA
MESSAGES AS A BACKGROUND FACTOR
C. Rossmann* 1 , A. Vlasic 2 , H. Brosius 1
1 Department of Communication Science and Media Research, Ludwig-Maximilians-University of Munich,
München, 2 Medien Institut, Ludwigshafen, Germany
Background: Type 2 Diabetes has become a major public health problem in Germany. It can be prevented
by motivating people to engage in physical activity. This requires behavior change, but campaigns aimed at
changing behavior often fail. One reason is that the campaign messages to deal with are not identified
carefully enough. Further, campaigns are not the only source of information: People face numerous health
messages via mass media and other channels each day often countering campaign messages.
Objectives: The present study seeks to …
(1) examine media messages about physical activity people derive from several media channels,
(2) find out how these media messages influence people‟s beliefs about physical activity,
(3) understand the antecedents of intentions to engage in physical activity.
Underlying values and principles: One of the main challenges of public health is developing best practices
for prevention campaigns. Integrating different scientific perspectives, such as health psychology and
communication science, is the key to a better understanding of effective health behavior change.
Knowledge base/ Evidence base: Fishbein and Ajzen‟s Theory of Planned Behavior (TPB) has gained
wide empirical evidence within the health domain and has been proven to be fruitful in developing diabetes
prevention campaigns (Montano & Kasprzyk 2008). Further, media effects theories, especially cultivation
theory (Gerbner 2002), indicate that media influence people‟s real world beliefs.
Context of intervention/project/work: The study is conducted as formative research for a diabetes
prevention campaign initiated by the German Diabetes Foundation. Results will be used to identify the key
contributors to physical activity to be addressed in diabetes prevention campaigns.
Methods: A quantitative content analysis of television programs, print magazines, and web pages is being
conducted to identify media messages. Qualitative interviews are being conducted to identify people‟s beliefs
about physical activity. Standardized telephone interviews will be conducted with a netto-sample of 1000
respondents representative for German adults aged between 30 and 60 years.
Results and Conclusions: Data collection runs from November 2009 to February 2010. Thus, we are not
able to describe results at this stage. We will discuss the practical implications of our results for campaign
development and the theoretical implications of media as a crucial background factor of planned behavior in
the health domain.
References: Gerbner, George (2002). Against the mainstream: the selected works of George Gerbner. New
York: Peter Lang Publishing.
Montano, D. E. & Kasprzyk, D. (2008). Theory of reasoned action, theory of planned behavior, and the
integrated behavioral model. In K. Glanz, B. K. Rimer & K. Viswanath (Hrsg.), Health behavior and health
education: Theory, research, and practice (S. 67-96). San Francisco, CA: Wiley & Sons.
Disclosure of Interest: None declared

TP-WED-253 EFFECTS OF THE PHYSICAL FITNESS PROGRAM IN A WOMEN'S UNIVERSITY
S. Ueda* 1
1 Department of Education, University of the Sacred Heart, Tokyo, Shibuya-ku, Japan
Background: In spite of evidence that regular physical activity promotes health, participation rates have
been shown to decrease over the life span. The steepest decline occurs in adolescence and early adulthood.
Furthermore, inactivity appears to be a bigger problem in females; they tend to be less active than males.
Objectives: The purpose of this study was to examine the efficacy of one-semester physical fitness program
in a university for women.
Underlying values and principles: Universities/colleges are important settings for reduction of health risk
behaviors in young adults, such as physical inactivity.
Knowledge base/ Evidence base: Some report significant improvements in exercise behavior among
students after physical activity programs, but other have reported that interventions are not effective.
Context of intervention/project/work: The efficacy of university- or college-level exercise programs has
not been confirmed because results vary.
Methods: The participants were seventy-eight first-year students of two classes who chose the physical
fitness program class from required health and physical education courses. The students worked on the
program for 90 minutes each week over a period of 13 weeks, in one semester in the spring. The program
included lecture on health and physical fitness, posturing, static stretching, stretching with stretch pole, basic
PNF stretching, walking, balance ball exercising, and self-massage. Exercise self-efficacy and exercise
behavior before the program and after the program were surveyed. Exercise self-efficacy was assessed on a
12-item scale. The measure used was a 5-point Likert-type scale ranging from 1 (no confidence) to 5
(complete confidence). Exercise behavior was assessed using the Stage of Exercise Change Scale.
Students identified with one of five stages of exercise behavior (precontemplation =1, contemplation =2,
preparation =3, action =4, or maintenance =5). Seventy-six students were surveyed and data analyzed.
Results and Conclusions: The mean exercise self-efficacy score, after the program was 2.77 (SD=.75),
compared to 2.33 (SD=.79) before the program (t=5.40, p

TP-WED-254 SANTÉ, PAUVRETÉ ET DÉVELOPPEMENT DURABLE : MULTIPLIER OU INTÉGRER
LES ÉVALUATIONS PROSPECTIVES D‟IMPACT ?
F. Gagnon* 1 , J. Turgeon 2
1 Unité enseignement et recherche, TÉLUQ-UQAM, 2 Direction enseignement et recherche, ÉNAP, Québec,
Canada
Historique / Origines: En moins d‟une décennie, le gouvernement du Québec (Canada) a adopté des lois
qui comportent des clauses d‟impact sur la santé (Québec, 2001, Loi sur la santé publique, art.54), la
pauvreté (Québec, 2002, Loi visant à lutter contre la pauvreté et l‟exclusion sociale, art. 19 et 20) et le
développement durable (Québec 2006, Loi sur le développement durable, art.15). Trois clauses d‟impact,
trois ministères concernés, trois stratégies différentes. Des études de cas sur l‟évaluation d‟impact sur la
santé font ressortir les difficultés que présentent pour les policy-makers la prise en compte des impacts sur
la santé (Gagnon et al. 2008). L‟intégration des évaluations prospectives est-elle une voie à privilégier? Les
avis des experts sont partagés.
Objectifs: Cette présentation vise à contribuer à la réflexion analytique sur le développement d‟évaluation
intégrée d‟impacts. À travers le cas du Québec, nous apporterons un éclairage sur les avantages et
inconvénients que posent la multiplication des évaluations prospectives (scénario 1) et l‟intégration de ces
évaluations (scénario 2).
Valeurs et principes sous-jacents: Par l‟adoption des évaluations d‟impact, les gouvernements, les
administrations publiques et les experts souhaitent une action publique mieux coordonnée et plus cohérente.
L‟objectif ultime serait de créer un environnement social et physique favorable à la santé et au bien-être des
populations.
Fondement de connaissance/Fondement de preuve: Nos travaux s‟appuient sur des méthodes d‟analyse
qualitative rigoureuses et systématiques (Huberman & Miles, 2003). Le portrait de la mise en œuvre des
clauses d‟impacts à l‟étude s‟appuiera sur une analyse de données primaires et secondaires et une analyse
critique.
Contexte d'intervention/projet/travail: Cette étude s‟inscrit dans le cadre des travaux de recherche que
mène le Groupe d‟étude sur les politiques publiques et la santé (GÉPPS).
Méthodes: Diverses sources de données seront utilisées:recension des écrits (Larochelle & Turgeon, 2009);
données d‟entrevues; étude sur les conditions de succès de dispositifs interministériels (Bourgault & al.
2008). Une matrice sera développée afin d‟analyser et de comparer les tenants et les aboutissants de
chacune des clauses d‟impact et la pertinence de leur intégration. Seront considérés comme
facteurs:définition des termes santé, pauvreté, développement durable; acteurs concernés; ressources;
outils; indicateurs.
Résultats et Conclusions: Cette analyse basée sur une expérience concrète permettra d‟alimenter la
réflexion actuelle et d‟illustrer les avantages et les difficultés que pose la réalisation des évaluations d‟impact
prospectives dans le contexte de l‟administration publique, à partir de scénarios d‟évaluations prospectives
sectorielles ou intégrées.
Références: Huberman, M.A. & M.B.Miles (2003). Analyse des données qualitatives. Bruxelles, de Boeck.
Conflit d'Interêt: Rien à déclarer

TP-WED-255 VIVRE MIEUX DANS UN MONDE MEILLEUR: UNE APPROCHE ÉCOSYSTÉMIQUE
POUR DÉVELOPPER LA QUALITÉ DE VIE
A. F. Pilon* 1
1 École de Santé Publique, Université de São Paulo, São Paulo, S.P., Brazil
Contexte: La qualité de vie, les environnements naturels et construits, le bien-être physique, social et
mental sont actuellement sapés par de multiples agressions et risques; les structures politique, économique,
sociale et culturelle normalisent des conduites destructrices et disséminent la violence à travers le monde.
Les politiques publiques, le procédures légales, les formatages académiques, les media et les intérêts du
marché tiennent compte des bulles de surface (les conséquences) et ignorent les problèmes au cœur d‟un
"pot en ébullition”.
Objectifs: Développer les capacités de compréhension et d'action en vue d'un approche eco-systémique,
tout en développant un modèle eco-systémique de culture où les quatre dimensions de l'être dans le monde
ont des rapports mutuels, en vu d'un équilibre dynamique: la dimension intime (les liens sujets-objets, la
cognition et l'affection), la dimension interactive (la dinamique des groupes), la dimension sociale (la culture,
la politique, l'économie) et la dimension biophysique. (la dotation biologique et l'environnement naturel et
construit).
Valeurs et principes sous-jacents: Les problèmes concernant l'environnement, la santé, la culture,
l'éducation, la société et la qualité de vie demande l'analyse de la qualité de l'enchevêtrement, comme
donatrices et récipiendaires, de les quatre dimensions constitutives de l'être dans le monde. La qualité de
vie est considérée comme le résultat d'un modèle eco-systémique de culture où la singularité de chaque
dimension et la réciprocité parmi elles sont revalorisées.
Base de connaissance/Base de preuve: Les évènements sont considérés comme des configurations
résultant d'un champ dynamique tenant compte des connections et des ruptures parmi les différentes
dimensions constitutives de l'être dans le monde (Pilon).
Contexte d'intervention/projet/travail: Le projet de changement considère les configurations dynamiques
au cœur du «pot en ébullition» et non les simples «bulles de surface» (les faux problèmes). Dans les niches
socioculturelles, le diagnostic de situation considère les liens et les ruptures par rapport à toutes les
dimensions avec le but de renforcer les liens et de renouer face aux ruptures.
Méthodes: Une approche multidimensionnelle, théorique et pratique, et un modèle pour la planification sont
posés en vu du développement d'un modèle eco-systémique de culture, enchevêtrant, comme donatrices et
receveuses, les quatre dimensions d'être dans le monde: intime, interactive, sociale et biophysique. Des
expériences heuristiques et herméneutiques dans les niches socioculturelles dévoilent l‟arrière plan culturel
et épistémique qui soutient les rapports sujets-objets (cognitifs et affectifs). Les événements sont évalués en
différents lieux et contextes en vue du rôle d'ensemble des quatre dimensions de l'être au monde, en
provoquant les événements (défauts et avantages), en faisant face aux conséquences (désirées ou non
désirées) et en contribuant aux changements.
Résultats et Conclusions: L‟évaluation et la gestion des projets porte sur des stratégies d‟intervention
fondées sur une recherche pluridisciplinaire à étudier les problèmes dans une perspective holistique et à
présenter des propositions de recherche faisant appel à une approche écosystémique pour analyser les
liens entre la culture, l'éducation, la societé, l‟environnement, la santé humaine et le développement de la
qualité de vie.
Références: PILON, A.F. Experience and Learning
http://www.comminit.com/files/ExperienceandLearningintheEcosystemicModelofCulture.pdf
Conflit d'Interêt: Rien à déclarer.

TP-WED-256 FORMATIVE DIALOUGE RESEARCH; AN APPROPRIATE STRATEGY IN COMMUNITY
HEALTG PROMOTION?
G. E. Rønningen* 1
1 HENÆR Faculty of Health science, Vestfold University College, Tønsberg, Norway
Background: Background: Formative dialogue research (FDR) is an approach that evaluates ongoing local
and community work while it is being developed and improved (Baklien 2004). The evaluation is based on
dialogue between the researchers, members of the local project, staff members as well as people from the
local settings. FDR is closely related with process – evaluation, but differs from the weight it gives the
dialogue and the formative aspect. In addition, FDR has many similarities to action - research, but the main
difference is that the FD – researcher does not take part in the project or intervention, and is not responsible
for the development or result of the project. The FD – researcher facilitates conditions for process – learning
and helps the locals to visualize what decisions lead to which consequences and goals. The FD – researcher
assists the community or local organisation to facilitate the dialouges. The FD-reseacher iso responsible for
scientific standards on how to do relevant and good research, and for analysing, summing up and
disseminating this in a way that reaches people who have interest in it. The main intension in addition to
providing evidence in HP, is that communities become empowered and take control of the project (op.cit).
Objectives: To discuss whether and how experiences from FDR may support the idea that FDR has
potential to become an appropriate HP community strategy and also provide evidence to strengthen the HP
knowledge base.
Underlying values and principles: The FDR approach to HP supports the ideological principles that HP
activities should be empowering, participatory, holistic, intersectoral, equitable, sustainable and multi –
strategic
Knowledge base/ Evidence base: The World Health Organisation, together with Health Promotion (HP)
experts and professionals, have long called for methods of evaluation that both will provide evidence within
HP and be formative for the local HP processes. These methods should also support the ideological
principles in HP (WHO 1998, IUHPE 1999, Springer et al, Tones and Tilford 2001; Tones and Green 2004).
Context of intervention/project/work: Data are based on HENÆRs (t.i. Research centre for health
promotion in local setting at Vestfold University College in Norway) experiences from 5-8 FDR community
projects.
Methods: Qualitative data were collected during and after the project periods, using multiple methods such
as interviews, questionnaires, focus groups, and repports.
Results and Conclusions: Results: The analysis will be completed January 2010, but results so far, imply
that FDR under certain conditions may be both an adequate approach in HP-evaluation and an appropriate
strategy in community HP.
Conclusion: The results so far demonstrate that it is possible to reach project goals, stimulate community HP
based on HP values (WHO 1986) and empowerment, through FDR. Carried out under certain conditions,
FDRs may also contribute to the evidence base in HP. One important condition for doing so, is to clearly
define the roles and responsibilities of researchers and local stakeholders from the very start.
References: Baklien 2004
IUHPE 1999,
Tones and Green 2004
Tones and Tilford 2001
Springer et al,
WHO 1998,
Disclosure of Interest: None declared

TP-WED-258 CULTURAL AND LINGUISTIC VALIDATION INTO ITALIAN OF ANTONOWSKY‟S LIFE
ORIENTATION QUESTIONNAIRE/SENSE OF COHERENCE SCALE
L. Andrissi* 1 , A. Mereu 1 , C. Sardu 1 , A. Sotgiu 1 , P. Contu 1
1 Public Health, University of Cagliari, Cagliari, Italy
Background: The SOC scale has been used in many international studies in public health sectors but no
validated version of the SOC questionnaire is available in Italian.
Objectives: To present the translation and cultural validation into Italian of the short-form(13 items)of
Antonowsky‟s Sense of Coherence Scale(SOC).
Underlying values and principles: To make available a unique tool for the Italian researchers.
Knowledge base/ Evidence base: The SOC scale, measures the individual level of Sense of Coherence,
defined as a steady way of perceiving and interpreting life events.
Context of intervention/project/work: The English version of SOC translated into Italian by a number of
bilingual translators.
Methods: Each of the translators prepared his/her own translation individually.Than they met to produce a
first common draft. Subsequently a translator who had never read the original English version produced a
back translation. After the comparison between the two English versions, the questionnaire was submitted to
a group of volunteers, men and women aged from 20 to 73 years and of different educational levels who
were asked to discuss understandability and clearness of the questions.
Results and Conclusions: After a meeting among all the experts involved, the Italian version of SOC scale
was slightly modified according to the suggestions and queries from the group of volunteers, producing the
following linguistically and culturally validated Italian version.
Senso di Coerenza/questionario di orientamento per la vita
Ha la sensazione che non le importa realmente ciò che
accade intorno a lei?(spesso/raramente o mai)
Le è capitato in passato di essere sorpreso dal comportamento di persone che pensava di conoscere
bene?(mai/sempre successo)
E‟ capitato che le persone su cui contava la abbiano deluso? (mai/ sempre successo)
Fino a questo momento la sua vita ha avuto:(obiettivi e scopiper niente chiari/obiettivi e scopi molto chiari)
Ha mai la sensazione di essere trattato ingiustamente? (Spesso/raramente o mai)
Ha mai la sensazione di trovarsi in una situazione poco familiare e non sapere cosa fare? (molto spesso/
molto raramente o mai)
Fare le cose che fa ogni giorno è: (fonte di profondo piacere e soddisfazione/Fonte di dolore e di noia)
Ha sensazioni ed idee molto confuse ? (molto spesso/raramente o mai)
Le capita di provare dentro di sè sensazioni che preferirebbe non provare?(molto spesso/raramente o mai)
Molte persone, anche quelle con un carattere forte, a volte si sentono dei perdenti in certe situazioni. Quante
volte si è sentito così in passato. (mai/ molto spesso)
Quando è capitato qualcosa, generalmente ha trovato che : (ne aveva sopravvalutato o sottovalutato
l‟importanza/aveva visto le cose nelle giuste proporzioni)
Quanto spesso ha la sensazione che ci sia poco senso nelle
cose che fa tutti i giorni ? (spesso/ molto raramente o mai)
Quanto spesso prova sensazioni che non è sicuro di poter
tenere sotto controllo? (spesso/ molto raramente o mai)
Disclosure of Interest: none declared

TP-WED-259 TESTING THE APPLICABILITY OF THE COMMUNITY DIRECTED APPROACH TO
DELIVERY OF HEALTH INTERVENTIONS OF DIFFERENT LEVEL OF COMPLEXITY
O. A. lawanson 1 , O. S. Arulogun* 2 , J. D. Adeniyi 2
1 Department of Economics, 2 Department of Promotion and Education, University of Ibadan, Ibadan, Nigeria
Background: A gap exists between major health interventions developed and their implementation at the
community level. This called for an urgent need to develop and scale up strategies that can ensure improved
access of poor populations to existing, efficacious health interventions.
Objectives: This three-year study determined the extent to which the community-directed intervention (CDI)
process can be used for the delivery of other health interventions with differing degrees of complexity.
Underlying values and principles: CDTi is based on the principle of active, structural community
participation. In this study, the concept was shared with the community through structural participation in
which the community members play an active and direct role in project development. This was ensured
through introductory meetings with community leaders by health staff, planning meetings with entire
Community where decisions on how to implement, selection of volunteers for implementation takes place,
training of volunteer community implementers by health staff, community implementation of the Interventions
and community reports back to health system
Knowledge base/ Evidence base: The evidence on which this research was based was the successful
application of the Community Directed Treatment with ivermectin (CDTi) at the community level which
ensured sustained high treatment coverage and advancing the process of disease elimination.
Context of intervention/project/work: This is a community directed intervention
Methods: Implementation of CDI involved addressing six major processes [stakeholder processes, health
system dynamics, engaging communities, empowering communities, engaging CDI implementers and
broader system effects] which were regarded as having relatively equal importance to outcomes
Standardized survey research techniques were employed to assess the effectiveness of the CDI intervention
by estimating effects on key coverage indicators.
Results and Conclusions: At the end of the three years, the CDI approach was shown to be much more
effective than currently used delivery approaches for all studied interventions except DOTS. More than twice
as many children with fever received appropriate antimalarial treatment in CDI study districts a proportion
which exceeded the Roll Back Malaria target of 60%. Possession and utilization of ITNs was two times
higher in the CDI districts, despite shortages of ITNs in most research sites. Vitamin A coverage was
significantly higher in the CDI districts with 90%, on average, of eligible children receiving the supplements in
the CDI districts. At least four to five interventions could effectively be implemented through CDI strategies.
The coverage with the different interventions generally increased over time in the CDI districts, reflecting
“maturation” of the CDI process. With respect to costs CDI was also more efficient than conventional delivery
systems.
Disclosure of Interest: None declared

TP-WED-260 APPLIED HEALTH TECHNOLOGY- A NEW RESEARCH DISCIPLINE
E. M. Olander* 1 , L. A. Nilsson 2
1 School of Health Science, Blekinge Institute of Technology, Karlskrona, Sweden, 2 ,
Background: For society as well as health promotion and health services there are huge challenges to meet
future needs of new technologies in a more complex context for promoting health and preventing diseases.
Since spring 2008 is Applied Health Technology a new research discipline at Blekinge Institute of
Technology (BTH), Karlskrona, Sweden. Focus is on human context in relation to technical opportunities and
limits to facilitate and maintain well being and health, and relieve suffering. The integration of these
disciplines could open up for more inclusive designs in research and development health technology
projects. A challenge is to make values and foundations in public health, nursing sciences and clinical
medicine obvious and apparent in a synthesis of health and technology.
Objectives: The purpose with the development of Applied Health Technology is to shape a supportive
scientific environment for research and development in a more complex technology depending society.
Underlying values and principles: Applied Health Technology corresponds to increasing national and
international stated societal needs of technology development in health promotion and prevention efforts as
well as in health care and social services.
Knowledge base/ Evidence base: A comprehensive investigation was carried out focusing initiatives and
research fields in the interface between health and technology, and analysis of the concepts used at
universities in Europe. A number of researches were found in the border of health and technology and did
not give a distinct view of the research fields or a uniform meaning in the used concepts.
Context of intervention/project/work: BTH is one of the most distinctly profiled institutes in Sweden, with a
clear focus on Applied IT and Sustainable Development of Industry and Society. BTH is also a broad-based
institute of technology with a wide range of growing research in engineering, spatial planning, humanities,
business administration, public health and health care.
Methods: Applied Health Technology is evolved in collaboration between researchers in technology and
health disciplines. Parallel is a development of supporting environments for the new discipline on going; one
research-lab, aimed to be a meeting place for reflexive dialogues, investigations, modeling and experiments,
one working process model for cooperation with organizations and communities as well as individual
professionals and inhabitants.
Results and Conclusions: The formation of research teams and third-cycle study programs in Applied
Health Technology are in progress with the main principle that the doctoral students‟ accomplish their
research studies in research teams with competences in technology as well as in public health or clinical
medicine. Already today some research projects have their resident in Applied Health Technology. Inter- and
multi scientific meetings, research and development processes seem to be necessarily. The synthesis of
health sciences and technology, and establishment of common values for Applied Health Technology could
provide a proper foundation for such processes.
Disclosure of Interest: none declared

TP-WED-261 ASSESSING THE IMPACT OF MASS-MEDIA PRODUCTS IN CHANGING BEHAVIORS
F. A. Khan* 1 , A. I. Butt 1
1 Center for Communication Programs, Johns Hopkins University, Islamabad, Pakistan
Background: Pakistan Initiative for Mothers and Newborns (PAIMAN), a USAID funded project in Pakistan,
has undertaken a holistic approach for improving maternal, newborn and child health. The behavior change
communication (BCC) and community mobilization component of the PAIMAN has been working to improve
families‟ awareness and promote positive maternal, newborn and child health (MNCH) behaviors.
PAIMAN has recently conducted an impact evaluation focusing on select media activities of the PAIMAN
project that were designed to reach a national audience ~ the 13 episode TV drama series, the television
commercials (TVCs) and the PAIMAN music video, which has brought forward an array of encouraging
findings.
Objectives: The main objective of the evaluation was to assess the success of national televised massmedia
products of PAIMAN in terms of its reach, acceptability and understanding and, mainly, impact in
improving specific behaviors associated with MNCH.
Underlying values and principles: At national and provincial levels, mass media is used to reinforce
messages for all audiences. Radio and TV spots are developed and broadcasted for various audiences. A
13-episode TV drama series has been produced each discussing a distinct issue highlighted by PAIMAN
formative research that affects MNCH in Pakistan.
Knowledge base/ Evidence base: The data used for this report comes from a content analysis of scripts of
the TV drama series, viewer group discussions with currently married women of reproductive ages
(CMWRA) after each episode of the drama series was aired. In addition, a population based survey with
some 1,873 CMWRA in three districts ~ Rawalpindi, Sukkur and Jafferabad was also conducted.
Context of intervention/project/work: One of the strategic objectives of PAIMAN is to increase awareness
and promote positive MNCH behaviors. PAIMAN, in this regard, has developed a strategy that aims to create
awareness, mobilize the community, and establish links with community health workers and ultimately fully
functional health facilities.
As part of its BCC strategy and within mass-media component, PAIMAN has so far developed a television
drama, five television commercials and a music video which were broadcast at national level to create
awareness on selected MNCH issues in Pakistan.
Methods: A complete list of rural and urban Union Councils in each district was first obtained. Union
Councils were then stratified for urban and rural areas and randomly selected according to their listed
proportion. In each selected Union Council, a village was sampled as a PSU in which 25 households were
randomly selected for survey. One currently married woman between 15-49 years of age was interviewed in
each eligible household whereas one husband and one mother-in-law were interviewed in every 3rd
household.
Results and Conclusions: Exposure information reveals vast differences by districts, while, as a whole, the
drama series show diminishing levels of exposure over time. One of the critical elements of the success of
entertainment education programs has been that long running formats allow for improved audience
involvement over time and therefore allow these shows to retain if not boost viewership.
The impact on knowledge and behaviors based on comparisons of those exposed and those not exposed
shows that exposed CMWRA were significantly more likely to report on the importance of skilled care for
antenatal care and their personal approval of women seeking skilled antenatal care.
Disclosure of Interest: None declared

TP-WED-262 THE EVALUATION PROCEDURE OF THE HEALTHY STADIA PROGRAMME
M. T. Tenconi* 1 , W. Drygas 2 , F. Lloyd Williams 3 , N. Lanati 1 , M. Philpott 4 , F. Roncarolo 1
1 Preventive Medicine, University of Pavia, Pavia, Italy, 2 social and preventive medicine, university of Lodz,
Lodz, Poland, 3 Division of Public Health, University of Liverpool, 4 Preventive Medicine, Heart of Mersey,
Liverpool, United Kingdom
Background: The evaluation procedure is mandatory along the realization of a Public Health Programme in
order to assess if its specific objectives are met and to monitor its advancement.
Objectives: The Authors describe the methodology of the process evaluation of the Healthy Stadia (HS)
Programme, a European public health programme (financed by the EPHA), started in 2007 and ended in
2009. It aims to address healthy messages to staff, players and visitors in public/private Stadia.
Underlying values and principles: The evaluation procedure was planned in order to explore the feasibility
of the HS programme, the participation and the community involvement, the reaching of the prefixed
outcomes and outputs.
Knowledge base/ Evidence base: The process evaluation was planned taking account of the indicators
chosen for each specific objective.
Context of intervention/project/work: It was made within the nine Associated Partners of the programme,
who played a major role, and the 24 Collaborative partners, engaged as supporters.
Methods: Structured questionnaires were administered to partners by e-mail at different times (6-12-18-24
months) from the beginning of the HS programme. The mean frequencies of the answers to the questions
concerning, beyond others, the number and type of stadia involved and those who adopted healthy practices
allowed to assess its development in time.
Results and Conclusions: The mean response of the associated partners was 77.8% to the 1st and 3rd
questionnaires, 88.9% to the 2nd and 4th. The collaborative partner‟s response was very low (15%).
The evaluation procedure allowed to assess the feasibility, the programme diffusion as well as its visibility. It
was also worthwhile in discovering the challenges and the difficulties encountered during its development,
the reaching of outcomes set by the protocol.
In conclusion the procedure was useful to monitor the programme development and to assess its quality.
Disclosure of Interest: none declared

TP-WED-264 CIVIL SOCIETY AND DESTINY: IS IT WRITTEN?
M. Johnson* 1
1 Catchment Health, Glenelg Hopkins Catchment Management Authority, Hamilton, Australia
Background: Understanding the communication between civil society and various levels of government is
going to be critical to enable reasoned responses to global climate challenges impacting communities. The
relationships are diverse, complex and beset with an interrelatedness of issues, people and politics.
Objectives: This paper examines how discourse analysis can reveal the opportunities, barriers and
strategies used by government, regional agency and civil society for achieving their respective goals.
Underlying values and principles: Potential tensions between government and civil society may constrain
the ability of the latter to influence their own destiny.
Knowledge base/ Evidence base: One method to reveal hidden or unseen meaning is through Discourse
Analysis. Critical qualitative analysis of texts can reveal self-contradictions, essentialist assumptions,
absences, the existence of multiple voices, metaphors, taken-for-granted constructions and rhetorical
devices that uncover multiple meanings (Forbes 2000).
Context of intervention/project/work: In Australia the relationship between civil society and government is
evident in the problems of the Murray Darling Basin. This area, the food bowl of Australia, has serious water
delivery problems as a consequence of drought and over allocation of water. The result has been a
significant loss of biodiversity and profound social and economic implications for the reliant communities and
wider Australian public.
Recent research using satellite technology has shown that while drought is shrinking the visible surface
water, ground water losses are a staggering 80% of total water lost. That is, the vast groundwater aquifers,
unseen and difficult to measure, may be the bell weather that presages the future of water use in Australia.
The importance of understanding what lies beneath has parallels to the communication between civil society
and government.
Methods: The PhD research project, still in progress, has examined official communiqués between a
regional catchment authority (responsible for managing the community response to environmental change)
and the federal Department of Environment, Heritage, Water and Arts. The benefit of this method is that it
captured the text and the intention in the official communiqué as well as the reaction of participants in both
departments.
Results and Conclusions: Preliminary analysis reveals that the pressures imposed by the community
based approach is conflicted by the rhetoric around implementing government policy and initiatives. The
result is a weakening of community voice and ownership of regional decisions in favor of government.
This method offers others that are engaged with any level of government and from any discipline, a means of
revealing the whole picture not just that surface rhetoric that usually informs government communications.
References: Forbes D (2000) Reading text and writing geography, in Hay I (ed) Qualitative Research
Methods in Human Geography. Oxford University Press Oxford
Disclosure of Interest: None declared

TP-WED-265 ASSESSMENT OF THE QUALITY AND EFFECTIVENESS OF (LIFESTYLE)
INTERVENTIONS
D. v. a. n. Dale* 1 , S. S. Dijk van 1 , M. M. Leurs 1
1 Centre of Healthy Living, National Institute of Public Health and Environment, Bilthoven, Netherlands
Background: In the Netherlands there is growing demand for insight into evidence based practice and
„what‟ works in health promotion, particularly in the area of lifestyle interventions. Many interventions are
performed, but there is very little information about the quality and effectiveness of these interventions. For
that reason, the Dutch Institute for Youth Interventions and the National Institute for Public Health and
Environment have started a quality assessment system for youth and lifestyle interventions.
Objectives: The aim is to provide professionals, policymakers and researchers with usable information
about the quality and effectiveness of youth and lifestyle interventions.
Underlying values and principles: The assessment system is developmental process: From practice
based to evidence based interventions.
Knowledge base/ Evidence base: The Assessment System is based on a developmental model
concerning the evidence of effectiveness. This implies a tentative recognition of the intervention, based on a
comprehensive description and theoretical and practice-based evidence (Veerman and Yperen 2007). The
model is meant to form a stimulus for those working in the field to obtain more insight into the effectiveness
of the interventions they develop and use, and invites scientists and practitioners to work together to improve
the quality of health promotion and youth care.
Context of intervention/project/work: Context
The assessed interventions are within the policy domain of the Ministry of Health, Care and Sports and the
Ministry of Youth and Family. It is the policy of the ministries to increase the use of effective interventions by
professionals in the field. A central system like the Assessment Committee is one way of encouraging the
use of more effective interventions.
Methods: This system consists of an Assessment Committee, a website and databases for lifestyle
interventions (www.loketgezondleven.nl) and youth interventions www.nji.nl/jeugdinterventies), where
professionals can find information about effectiveness and quality of these interventions.
The Assessment Committee works with a set of established criteria and procedures. Based on these criteria
the Assessment Committee can classify interventions under four categories: a solid theoretical basis,
probably effective, proven effective, cost effective (2011). In the presentation, the criteria for these categories
will be clarified.
We have performed several strategies to support the professional to improve the development and
description of interventions. This resulted in a tendency towards increasing quality of the submitted
interventions at the end of 2009.
Results and Conclusions: We see a growing interest among professionals and policymakers in the results
of the Assessment Committee. The challenge now is to realize more interventions on the level of proven
effective and the use of these effective interventions in the Netherlands.
References: Veerman,JW& Yperen,TA. Degrees of freedom and degrees of certainty. A developmental
model for the establishment of evidence-based youth care.Evalution and Program Planning, 30 (2),212-221.
Disclosure of Interest: none declared

TP-WED-266 HEALTHCARE ASSESSMENT METHODOLOGY IN DEVELOPING COUNTRY
S. D. Joshi* 1 , R. Bhandari 2
1 Public Health, Primary Health Center, Kailali, 2 Community Health, Community Health and Environmental
Society Nepal, Kathmandu, Nepal
Background: Health care assessment system in Nepal is still taking long time and high cost. Collection of
data about prioritization of community health problems by the community is essential for planning and
monitoring of programs and interventions for improving community health status. Scientific Rapid Community
Health Assessment Methodology needs to be validated in rural community developing country like Nepal
which is economic and less time consuming.
Objectives: To validate the Rapid Community Health Assessment Methodology (RCHA) for prioritization of
community health problems in a rural community including Tobacco control programs.
Underlying values and principles: Ethical approval
Knowledge base/ Evidence base: Evidence base
Context of intervention/project/work: Work
Methods: STUDY AREA: 14 Villages of rural areas. STUDY POPULATION: 34 Primary School Teachers
from 10 randomly selected Primary Schools in above villages. (One Teacher each from Class I to V, in each
School). VALIDATION: Heads of households from 500 Households (50 per village, systematically sampled).
DATA COLLECTION TECHNIQUE: Self-Administered Questionnaires for Teachers, Interview Schedules for
Heads of Households. DATA ANALYSIS: with the help of EPI info program.
Results and Conclusions: RESULTS: There was significant correlation between the responses of the
school teachers and heads of households on community health problems viz., (a) the prioritization of ten
village problems(r=+0.77, p

TP-WED-268 DESARROLLO DE HERRAMIENTAS Y CAPACIDADES PARA LA EVALUACIÓN DE
IMPACTO EN SALUD EN ANDALUCÍA (ESPAÑA).
J. Venegas-Sánchez* 1 , J. Bolivar-Muñoz 2 , L. López-Fernández 1 , C. Artundo-Purroy 3 , A. Rivadeneyra-
Sicilia 4 , A. Daponte-Codina 2
1 Área de Salud Pública. Promoción y Prevención, 2 Área de Salud Pública. Protección de la Salud, Escuela
Andaluza de Salud Pública, 3 Consultor externo, 4 Consultora externa, Granada, Spain
Antecedentes: Apenas existen en nuestro país experiencias en aplicación de la metodología de Evaluación
de Impacto en Salud (EIS). La experiencia en países del entorno ha puesto de manifiesto el potencial de la
herramienta para el abordaje de las desigualdades sociales en salud, la acción intersectorial y la
formulación de políticas públicas más saludables. En este sentido, la EIS está siendo cada vez más utilizada
por administraciones regionales y locales en paralelo al interés creciente por incorporar la salud en las
agendas políticas.
Objetivos: (1) objetivo de carácter estratégico: sensibilizar en torno al potencial de la EIS y facilitar su
apropiación entre decisores políticos, gestores y profesionales implicados en el proyecto; y(2) objetivo
técnico-operativo: elaborar y validar una batería de herramientas de EIS para avanzar en su aplicación en
coherencia con la nueva estrategia en salud/salud pública del Gobierno Andaluz.
Valores y principios subyacentes: En Andalucía estamos asistiendo a un proceso de reforma de la Salud
Pública. En este contexto la EIS ha sido destacada como una herramienta estratégica tanto en los nuevos
desarrollos legislativos, como en los marcos estratégicos de acción en Salud, de acuerdo con su
compromiso con la estrategia Salud en todas las Políticas. En este ámbito, la experiencia que proponemos
viene a rellenar un vacío en cuanto a experiencias en nuestra comunidad, generando, de paso,
herramientas y capacidades para la aplicación de la metodología de EIS en los próximos años.
Base de conocimiento / base de evidencia: Basada en el modelo de los Determinantes Sociales de
Salud, la EIS se ha definido como un conjunto de herramientas con las que puede ser juzgada una política,
un programa o un proyecto, en relación a sus potenciales efectos en la salud, y acerca de la distribución de
esos efectos dentro de la población.
Contexto de la intervención / proyecto / trabajo: Andalucía, España. La experiencia se aplica sobre
varios planes y programas de ámbito regional y local. Cuenta con la participación de decisores políticos y
gestores del gobierno autonómico, profesionales y expertos-as de Salud Pública.
Métodos: Partiendo de un enfoque “learning by doing”, se ponen en marcha dos experiencias piloto en
materia de EIS. La primera consiste en el diseño y validación de una herramienta de cribado y su aplicación
a una muestra seleccionada de planes y programas intersectoriales de ámbito autonómico. La segunda
experiencia corresponde con la aplicación de una EIS sobre un plan de desarrollo local de ámbito municipal.
Resultados y Conclusiones: Entre los diversos productos del proyecto destacamos: herramienta de
cribado validada y de aplicación en un ámbito autonómico; informe de la evidencia disponible recogida;
informe EIS completo, incluyendo los impactos en salud y las recomendaciones establecidas; batería de
herramientas validadas para la aplicación de la EIS en ámbito local. Se crea igualmente una Plataforma
virtual como espacio de encuentro en torno a la EIS en Andalucía y como un banco de recursos en EIS.
Declaración de intereses: Este trabajo responde al encargo de la Secretaría General de Salud Pública y
Participación (SGSPP) de la Consejería de Salud de la Junta de Andalucía

TP-WED-269 DECIPHERING SUBTEXT: UNDERSTANDING THE POWER OF WORDS IN A
SUSTAINABLE FARM PROJECT
c. a. wagg* 1
1 Sustainable Farming, Department of Primary Industries, Warrnambool, Australia
Background: The promotion of sustainable farming has necessitated the use of multiple practices and
techniques. One technique that can be deployed in a reflective learning environment is discourse. When
practitioners, scientists and sponsors are drawn into collaboration, multiple discourses emerge to mediate
their exchanges and involvement. Such an interplay is a contest over ideas; a transformative process.
Sustainability lies within this transformation as an „agenda of good questions, practical questions….. that are
essentially contestable‟ (Davison 2001).
Objectives: When the task at hand defies a simple „cause and effect‟ explanation and is comprehended as
messy or hard-to-define the mien of the collaboration becomes more important as ideas are leveraged on
the strength of sub-text or unspoken signals.
Underlying values and principles: Learning to navigate the contestable world requires us to hear what is
being said and decipher how it is being said. Reading the unspoken signals is the work of discourse.
Knowledge base/ Evidence base: Much work has been conducted on articulating environmental
discourses at national and global scales. More recently there has been increasing interest in applying
methods of discourse analysis that will articulate at a program scale. This presentation will describe one
such example; a sustainable farming program that desired to convert people to a more environmentally
nuanced practice of farming.
Context of intervention/project/work: This presentation will describe one such example; a sustainable
farming program that desired to convert people to a more environmentally nuanced practice of farming.
Methods: A transparent and hierarchical discourse analysis technique was developed using excerpts of text
that grapple with „what must be done‟ and „how it should be done‟. This establishes radical and reforming
categories of data which are further characterised by interpreting the metaphors they contain.
Results and Conclusions: The result is a program scale articulation of discourses that, by including all
agents, can overcome the power imbalances inherent discourse. The method is sequential and transparent
allowing others to examine the evidence at each level. Such a technique may prove a valuable tool for
groups engaged in a reflective review of their practice change program.
References: Davison, A.(2001)'Technology and the Contested Meanings of Sustainability'. State University
of New York Press. New York
Disclosure of Interest: C. Wagg -Employee of the Department of Primary Industries

TP-WED-270 TRAINING MODEL FOR RESULT BASED MONITORING AND EVALUATION IN HEALTH
ORGANIZATION
K. Ashjaei* 1
1 National Public health Management Centre, Tabriz University of Medical Sciences, Tabriz, Iran (Islamic
Republic of)
Background: Developing countries usually are facing pressures to reform the policies and practices of their
public sector such as health sector. It is now widely recognized and accepted that an effective efficient health
system is one of main components to achieving the desired result and goals of health system. As health
system in general and developing countries in particular begin to address the challenges of working within
result based orientation, they face the necessity of being able to document their performance in order to
monitor the process and also evaluate the results to follow system objectives.
Objectives: to develop training model to design and implementation of RB-M&E
To build competency among health manger in order to use RB-M&E tool in management of health
organizations and health programs or projects
Underlying values and principles: Credible answer to the “ so what “ question address responsibility
concerns of stakeholders, give health sector information on progress towards achieving stated targets and
goals and also provide substantial evidences as the basis for any necessary mid-term correction in policies,
programs, projects and activities to get better results. Therefore creating a system that produce information
on the result of health program or project actions and on the effect of health polices within organization and
as well as community is key element in system management
Knowledge base/ Evidence base: Effectively delivered M&E results often provide the basis for improved
decision making. So M&E is one of important managerial skills. Our experiences through conduction Health
Management & Planning courses for health manger and interacting with them through monitoring and
evaluation the courses and getting feedback (Kazem Ashjaei, Maye Omar, 2007) has been showed that
monitoring and evaluation is one of important needs of health manger and as well as their weakness as a
health manger
Context of intervention/project/work: Based on the expectations from the package in order to cover needs
of health manger, it seems that the training package should have some characteristics like: Skilled Based,
Process Oriented, Practical in action and adapted with health context.
Methods: Following activities conducted by project manager:
•Organization a professional team (Co-workers & Consultants)
•Literature and context review
•Developing the model of training material on M&E
•Testing developed training material on M&E in a pilot course
•Finalizing the training material on M&E as a training package on M&E
Results and Conclusions: To developing Training materials for the model of result based monitoring and
evaluation two aspects have been considered: Content and Dynamic. The content will cover knowledge
materials of the model and Dynamic aspect will cover practical and application dimension (Building a system
for RB- M&E) the model. In order to clarify these aspects the diagram in figure 2 illustrates component of
each aspects of the model
Disclosure of Interest: None declared

TP-WED-271 ENHANCING LOCAL VOLUNTEER MONITORING AND EVALUATION CAPACITY: FOR
PROGRAM SUSTAINABILITY AND LOCAL EMPOWERMENT
G. Lamaro* 1
1 School of Health and Social Development, Deakin University, Geelong, Australia
Background: Peer education models are often used to deliver community based programs in resource poor
settings. Local volunteers are often recruited as peer educators (PE‟s) to implement programs. Concurrently,
there are great demands on organisations to collect rigorous evidence to inform and justify program delivery.
However, it is widely contended that volunteer PE‟s capacity to conduct M&E is limited, but little is known
about current training for M&E, or the support needed to develop M&E capacity. This needs to be addressed
to inform program delivery and sustainability, and to empower local communities.
Objectives: This study investigates current capacity and training of volunteer peer educators to undertake
M&E in order to develop a model of best practice to enhance M&E capacity.
Underlying values and principles: The research aligns with principles of empowerment, equity,
sustainability, evidence-based practice, and ensuring quality standards.
Knowledge base/ Evidence base: There is wide acknowledgement that capacity of volunteer PE‟s in
community health and development programs is generally lacking and needs to be enhanced and prioritised
(Mayberry et al 2009; Holt-McKenzie et al 2006; Birdsall & Kelly 2005; Atkinson et al 2005).Some key
challenges to volunteers conducting M&E have been highlighted in literature (Adamchak 2006; Birdsall &
Kelly 2005), yet training needs to address these challenges are yet to be properly investigated. Enhancing
training in M&E among local volunteers enhances sustainability (Birdsall & Kelly 2005) and is also important
to develop capacity and empower local communities (Holt-McKenzie et al 2006).
Context of intervention/project/work: The research is based on peer-education models of health and
community development programs operating in resource poor settings in South Africa.
Methods: Qualitative methods (literature review, document analysis and interviews) were used to map
current training content and methods. Interviews were conducted to explore volunteers‟ experiences and
capacity in M&E, and priorities for training and capacity building. Inductive thematic coding and concept
mapping was used to analyse data.
Results and Conclusions: Interim results reveal key issues including the perceived value of M&E; use of
data; challenges to engaging in training and practice; training needs; and ideas for training development.
This study contributes evidence about capacity and support needs of volunteers for M&E practice.
Challenges to engagement and capacity in M&E are discussed, and opportunities to meet these challenges
highlighted. A role for researchers and donors in supporting M&E training is highlighted.The findings provide
insights for the development of new models of volunteer training to enhance M&E capacity. Results will be
used to inform the development of a new volunteer training model to enhance M&E practice and thereby
program delivery, sustainability, and community empowerment. Updated progress toward this will be
provided.
References: Adamchak, S.E. (2006) Youth Peer Education in Reproductive Health and HIV/AIDS: Progress,
Process, and Programming for the Future, Arlington: Family Health International, YouthNet Program.
Atkinson, D.D., Wilson, M. and Avula, D. (2005) A participatory approach to building capacity of treatment
programs to engage in evaluation, Evaluation and Program Planning, 28: 329-334.
Birsdall and Kelly (2005) Community responses to HIV/AIDS in South Africa: findings from a multicommunity
survey, Johannesburg: CADRE.
Holte-McKenzie, M., Forde, S. and Theobold, S. (2006) Development of a participatory monitoring and
evaluation strategy, Evaluation and Program Planning, 29: 365-376
Mayberry, R.M., Daniels, P, Yancey, E.M., Akintobi, T.H., Berry, J., Clark, N. and Dawaghreh, A. (2009)
Enhancing community-based organizations‟ capacity for HIV/AIDS education and prevention, Evaluation and
Program Planning, 32: 213-220
Disclosure of Interest: None declared

TP-WED-272 MAKING THE MOST OF WHAT YOU HAVE IN PAPUA NEW GUINEA: MAXIMIZING THE
USE OF DATA
H. E. . S. .. Ashwell* 1 , L. M. Barclay 1
1 Northern Rivers University Department of Rural Health, University of Sydney, Lismore, Australia
Background: Papua New Guinea‟s health care system consists of community aid posts, rural health centres
and provincial hospitals. The national health information system provides the framework for monitoring
health sector performance.
Objectives: To identify innovative ways of evaluating community interventions or local service performance
using take-out reliable village data to assess changes in health status across rural and remote communities
in Papua New Guinea.
Underlying values and principles: A national policy dictates village-level aid post data is excluded from
health centre statistics. Aid post data is considered inaccurate and inappropriate for inclusion in the national
health information system.
Knowledge base/ Evidence base: Healthy community settings in Papua New Guinea are impacting on the
health of the population, especially maternal and child health.
Context of intervention/project/work: Project-led community interventions were implemented in all
provinces of Papua New Guinea between 1999 and 2004. These included a national community health
development program and a village health volunteer program.
Methods: An outcome evaluation of community interventions in 2006 covered ten provinces (50 percent) of
Papua New Guinea. Health worker interviews (175), community group discussions (77) and observations
provided qualitative data. A review of national census population figures and analysis of community use of
health services over a seven year period provided quantitative data.
Results and Conclusions: The evaluation identified sustainable improvements in health were achieved
through community-led and maintained activities. New health knowledge initiated changes to lifestyle
practices, improved physical health and social and economic well-being in villages where health volunteers
had been trained. However, village claims of improved physical health, increased use of health services and
reduced maternal and child mortality could not be substantiated statistically. The national health information
system does not allow reporting of villages separately or tracking of changes in health status over time
across identifiable villages despite the project finding this data could be useful. Innovative ways of evaluating
community interventions or local service performance can and should provide reliable village-level data to
assess changes in health status across rural and remote communities in Papua New Guinea.
Disclosure of Interest: None declared

TP-WED-274 HEALTH NEEDS & BASIC CARE: VALIDATION OF COLLECTION INSTRUMENTS
E. Y. Egry* 1 , P. Hino 2 , S. I. Ciosak 1 , R. M. G. S. Fonseca 1
1 Collective Health, Nursing School- University of S, S, 2 Collective Health, Nursing School- University of S,
São Paulo, Brazil
Background: The organization of a health system based on the dialectics of need satisfaction expresses the
viewpoint of the universal protection of health, based on the premise of social wellbeing. Health needs
cannot be considered mere medical needs, nor can health problems be considered diseases, suffering or
risks. Instead, they also refer to lacks or vulnerabilities that express ways of life and identities, expressed in
the question about what is necessary to be healthy and involving the conditions needed to enjoy life to the
full(2). The complexity of these Collective Health practice objects requires that health professionals be
equipped so as to adequately respond to its collective nature.
Objectives: This study aimed to validate instruments to get to know health services‟ practice and the tools
health professionals use to recognize the health needs and vulnerabilities of the population in a given
territory.
Underlying values and principles: Needs can function as “analysts” of health practices, as recognizing and
coping with health needs is linked with the principles of the Unified Health System (SUS), which implies that
health teams need to make efforts to translate and respond to the needs the population presents(4). When
they get organized with a focus on the population‟s needs, it is believed that health services can or tend to
be more efficient, in the sense of greater capacity to listen and respond to the health needs.
Knowledge base/ Evidence base: Adopting instruments that can recognize the needs of different social
groups can contribute to recognize health practices, so that these are put in practice in response to the
needs that originated them, in a circular relation between health needs and health work. At the same time, by
permitting the complementariness between objective aspects of reality and the population‟s subjective
conceptions, this also values the possibilities of expression the involved subjects have at their disposal and
the meanings attributed to their ways of life, health and sufferin.
Context of intervention/project/work: The instruments proposed in this study were elaborated based on
the experience of the researchers involved in this investigation and on the qualitative script to capture the
objective reality, adapted to the realities of the research areas, aimed at characterizing the health services
and family health teams, and complemented by questions related to the recognition of health needs and
vulnerabilities, as mentioned. Starting from the script to capture the objective reality, two instruments were
elaborated, one for health teams and the other for health service managers.
Methods: This methodological development study focuses on the elaboration, assessment and
improvement of instruments and methodological strategies. To verify the validity of the proposed
instruments, they were submitted to the assessment of “judges” who are considered specialists on the theme
of health needs. As a methodological study, we built tools based on a guide adopted to characterize primary
care services and their family health team. We established a minimum percentage agreement of 85% among
the 11 peers who participated in the study. It comprehended two phases: first was general validation and
second the validation of items that didn‟t reach agreement score.
Results and Conclusions: Fourteen “judges” received the material to participate in the study, 11 of whom
responded. The results allow to considerer validated the Tools to assess how primary care services and
family health team recognize health needs of territory population. The researchers believe that the validated
instruments can facilitate and support decision making, to the extent that they systematically permit the
collection of data that recognize the population‟s health needs, and also contribute to cope with these needs
in the practice of family health teams.Finally these Tools will contribute to best practice in primary care
services to qualify health assistance.
Disclosure of Interest: None declared

TP-WED-275 HEALTH OBSERVATORY: A PRACTICE TO REFLECTION OF ITS DETERMINING
ELEMENTS IN A REGION IN BAHIA, BRAZIL.
R. Nascimento* 1
1 Instituto de Saude Coletiva, Universidade Federal da Bahia, Salvador, Brazil
Background: The cities can represent positive opportunities, unequal negative impacts related to the lack of
social organization, precarious urban and labor conditions. On the other hand, the lack of government,
opportunities and the capacity to develop policies tend to widen the adverse effects over people‟s health
living in urban communities.
Objectives: Aiming at getting to know how the students of Collective Health in the Nursing Course at UNIRB
perceive the health problems that affect the collectivity in the region of Alagoinhas, Northeast of Bahia/Brazil.
Underlying values and principles: Thus, a health observatory is a strategy that aims at understanding
influences from biological, social and environmental on the health and well-being of people living in the cities,
as well as conducting studies with multidisciplinary and intersetorial characteristics.
Knowledge base/ Evidence base: In this path, it focuses on how urbanization influences health, sanitary
matters and the health agenda.
Context of intervention/project/work: The professor of this subject has promoted the making of an
experimental health observatory in that region through the observation actors, students, taking as reference
the dimensions: environmental and health care, supported by the widened concept of health according to the
Lalonde Report, 1974.
Methods: The 25 students grouped each other into 04 teams, from which 03 lived in Alagoinhas and 01
formed with students who lived in cities of Rio Real and Catu. The local news sections acted as information
sources on the positive and negative points about the population‟s health, having been classified through an
observation list of dimensions observation: health care (political-institutional, technical-operational and infrastructure
aspects) and environmental (soil, water, air, resonant pollution aspects, others – urbanization,
accidents). The period of observation, recording and entailing of data happened between the months of
August and December of 2008 in the chosen cities.
Results and Conclusions: The environmental issue was more frequently observed (75%) with a distinction
to the water pollution aspects (18%), resonant pollution (16%), air pollution (14%), traffic accidents (14%),
and inadequate urbanization (13%). As for the facts regarding the health care, those classified as technicaloperational
were more frequently observed (69%): health care model, medical technologies, access;
followed by those classified as political-institutional (25%): management capacity, social participation and
those as infra-structure (6%): human resources, equipments, health units.
We believe to have instigated the students to the critical comprehension phenomena associated to the
health determiners in the collectivity in urban centers, which may contribute to the reinforcement of the social
participation, focusing the equity reach, integrality, the health services quality and the environmental
conditions control in the region.
References: Lalonde M 1974. A new perspective on the health of Canadians: a working document: health
and Welfare Canada. Ottawa.
Disclosure of Interest: R. Nascimento, ISC/UFBA, None declared

TP-WED-276 DEVELOPMENT OF A HEALTH COMMUNICATION KNOWLEDGE AND RESOURCE
CENTRE: AN ECDC INITIATIVE FOR EVIDENCE-BASED HEALTH COMMUNICATION
N. Cartwright 1 , A. Wurz 1 , P. Wysocki 1 , P. Moreira* 1
1 Health Communication Unit, European Centre for Disease Prevention and Control, Stockholm, Sweden
Background: Health communication is a cross cutting issue in public health and fundamental to all health
promotion activities. Health communication with respect to communicable diseases in the European Union
(EU) poses both major challenges and opportunities.
One challenge in applying health communication best practices is the resource requirements needed to
review and keep up to date on emerging evidence. A second challenge is that there is currently relatively
limited research on health communication and its related topics from the EU (Kondalis 2005, 2008) and,
consequently, there is limited knowledge on how to effectively target diverse European audiences in a
contextually specific way.
One of the major opportunities within the EU is the potential for synergy and resource pooling to optimize
health communication.
Objectives: It is with these challenges and opportunities in mind that the European Centre for Disease
Prevention and Control (ECDC) has created a Health Communication Knowledge and Resource Centre
(KRC) with the below objectives.
Underlying values and principles: 1) To provide current and evidence-based information on health
communication and related topics, with a particular focus on communicable diseases within the EU
2) To facilitate the sharing of health communication best practices and lessons learned between
stakeholders in EU Member States and EEA/EFTA countries
3) To promote and develop communication competencies for persons undertaking health communication
activities in EU Member States and EEA/EFTA countries
Knowledge base/ Evidence base: KRC is meeting these objectives by developing a number of knowledge
and evidence based resources to be available in an online platform.
Context of intervention/project/work: First, KRC is compiling evidence-based information on health
communication and related topics including health promotion, health education, health literacy and social
marketing. KRC has also begun to make available regular updates on new health communication research.
KRC can distil and update Member States on general health communication advances thus leaving more
resources for application of health communication activities as well as research into the local contexts.
Second, KRC is developing a database of health communication campaigns undertaken by Member States.
This will facilitate the online sharing of communication campaigns as well as lessons learned. Furthermore, it
allows people undertaking health communication initiatives within the EU to identify groups doing similar
work, thus facilitating networking and partnerships.
Lastly, KRC also provides pertinent links and a regular bulletin that includes conference and training
opportunity information.
Methods: ECDC has identified a team, located within the Health Communication Unit, to undertake these
tasks.
Results and Conclusions: During this oral presentation, ECDC will present some of its outputs on
generating evidence for public health communication research and practice in the field of communicable
diseases.
References: Kondilis BK, Soteriades ES, Falagas ME. Health literacy research in Europe: a snapshot.
European journal of public health 2006;16:113.
Kondilis BK, Kiriaze IJ, Athanasoulia AP, et al. Mapping Health Literacy Research in the European Union: A
Bibliometric Analysis. PLoS ONE 2008;3:e2519.
Disclosure of Interest: None declared

TP-WED-278 STATISTICS OF A HOME ARE SERVICES UNDER NURSING PERSPECTIVE
E. R. Gameiro* 1 , V. V. T. Telheiro 2 , S. S. T. I. Izidoro 2 , A. A. C. V. Vianna 2 , R. R. B. S. Santos 2
1 Enfermagem Médico-Cirurgica, Escola de Enfermagem Anna Nery UFRJ, 2 Enfermagem Médico- Cirurgica,
Escola de enfermagem Anna Nery -UFRJ, Rio de Janeiro, Brazil
Background: The nursing facilitate the promotion of home care by giving information transcribed into quality
indicators based on users conception. We contribute to the instrumentalization of care aimed at a more
effective action to nursing.
Objectives: - Present and analyze indicators for the implementation of the Protocol under nursing
perspective.
Underlying values and principles: The analysis was based on quality indicators of Home Care Services,
namely Mortality Rates (number of deaths for all users who was attended), Hospital Admission after Home
Care (service users who required hospitalization for who was attended), Infection in Home Care (infection of
users in attendance for who was attended), and High Support Services (high occurring for who was
attended).
Knowledge base/ Evidence base: It was observed: 70 deaths (39 elderly, 17 cancers, 12 HIV-infected and
2 out of criteria), mortality rate 75.26%, 22 hospital admissions (14 elderly, 3 cancer, 3 out of criteria and 2
HIV-infected), rate of 23.65%; 19 infections (2 elderly, 2 cancer, 3 out of criteria, and 12 HIV-infected), rate of
20.4%, 22 released home (9 elderly, 2 cancer, 8 out of criteria, 3 HIV-infected), with a rate of 23.65. Due to
gain autonomy translated by mortality rates, home care, home care after interaction and discharged home,
HIV positive´s users and Out of Criteria reflect the promotion of adherence to treatment and improved quality
of life in relation to the cancers users and the elderly who came to the program at the end of life.
Context of intervention/project/work: The indicators of home care services help to visualize the effect of
the Assessment Protocol of Home Care by nursing. From the survey of user´s' data evaluated by the
Protocol of Home Care (DAP), was possible to further the care system, resulting in the findings that have
affected the quality indicators.
Methods: Quantitative study with data collected from 93 users attended between 2002 and 2007, from the
medical register and specific forms. Data collection took place between June and July 2008. To this, was
used a spreadsheet software XLSTAT for Excel.
Results and Conclusions: The oncology´s users, proportionally, had higher number of deaths, when we
consider the total of calls received (34%, 17/50), in contrast to the elderly (22.29%, 39/175), the outside
criteria (1,94%, 2/103) and those infected by HIV (16,90%, 12/71), as they were at the end of life and need
support to face death with dignity and quality of life, while users with AIDS and Outside Criteria reflect
adherence to treatment, and quality of life, to gain autonomy. It was common denominators: be carrier of a
disorder or injury, chronic disease and dependency to self-care.
References: SANTOS, R.B. Protocolo de Atenção Domiciliar em enfermagem e a substitutividade.
Enfermagem Brasil. Maio/Junho, 2009;8(3): 152-159.
Disclosure of Interest: Not declared

TP-WED-279 IL EST PLUS FACILE DE CONSTRUIRE UN HOPITAL OU CENTRE DE SANTÉ QUE DE
CHANGER LES INDICATEURS DE SANTÉ DANS LES PAYS AFRICAINS: QUEL RÔLE POUR LA
PROMOTION DE LA SANTÉ
A. M. HOUNSA* 1
1 Service de Promotion de la sante, Ministere Sante Benin, Cotonou, Benin
Historique / Origines: Dans les pays africains, il existe un engouement pour la construction
d'infrastructures sanitaires et hospitalières qui n'arrive pas à produire les résultats escomptés. Au Bénin, on
assiste à une stagnation de la fréquentation des formations sanitaires malgré une bonne couverture
géographique en infrastructures.
Objectifs: Contribuer au changement de paradigme dans les politiques d'investissements en infrastructures
sanitaires
Valeurs et principes sous-jacents: La non prise en compte des déterminants de santé et des besoins des
populations limite l'impact escompté des constructions d'infrastructures sanitaires dans les pays africains
Fondement de connaissance/Fondement de preuve: En 2008, pour un taux de couverture géographique
de 89%, la fréquentation est de 45%, niveau atteint depuis les cinq dernières années avec un niveau plus
bas de couverture physique.
De plus, pour les soins néonataux par exemple, les populations sont prêtes à utiliser des hôpitaux éloignés
de leurs domiciles quand elles ont la garantie d‟une qualité meilleure des soins par rapport à l‟offre de
l‟établissement proche.
Contexte d'intervention/projet/travail: Le contraste entre la fréquentation et la couverture géographique
est illustré dans la région septentrionale du pays où les populations préfèrent utiliser un hôpital
confessionnel éloigné de 30 km de leurs domiciles mais réputé pour des soins de qualité avérée au
détriment de l'hôpital public plus proche en cours de réhabilitation.
Méthodes: Analyse des données statistiques, entretiens avec les prestataires de santé et le personnel
administratif hospitalier et réalisation de deux discussions de groupe. Le thème central débattu est la qualité
des soins néonataux et les facteurs d'influence
Résultats et Conclusions: Le facteur géographique n'est pas toujours le plus déterminant de la
fréquentation des infrastructures sanitaires même pour des bâtiments neufs ou réhabilités. Parmi les
facteurs d'importance, il y a (i) la présence de spécialistes, (ii) l‟accueil par le personnel soignant; (iii) la
disponibilité et l‟abordabilité des coûts des prestations et des médicaments, et (v) la satisfaction des soins
reçus selon la population. Les prestataires ont évoqué la motivation, le cadre et les conditions de travail. De
toutes les approches de développement sanitaire connues, la promotion de la santé offre un avantage
comparatif dans la prise en compte de tous les facteurs d'importance dans les changements d'indicateurs de
santé.
Dans les pays africains, on ne peut plus espérer avoir de bons résultats sanitaires en développant de façon
isolée une politique de construction d'infrastructures sanitaires sans tenir compte des autres paramètres. La
promotion de la santé apparaît donc comme une alternative d‟efficacité et d'accompagnement des
investissements immobilers du secteur de la santé pour des changements notables des indicateurs
sanitaires
Références: Bénin/Ministère de la santé. Annuaire statistique, 2008.
Conflit d'Interêt: Rien à déclarer

TP-WED-280 LINKING PUBLIC HEALTH SURVEILLANCE AND PRACTICE IN PREVENTIVE WORK
AIMED TO REDUCE THE USE OF TOBACCO, ALCOHOL AND ILLICIT DRUGS AMONG
ADOLESCENTS IN TEN MUNICIPALITIES THROUGH MONITORING, EDUCATION, CAPACITY
BUILDING AND EVALUATION
L. Östlund* 1 , S. Persson 2
1 Department of Public Health Medicine, 2 Dep of Public Health Medicine, County Council of Gävleborg,
Gävle, Sweden
Background: In the County of Gävleborg (middle of Sweden, 275 000 inhabitants) the 10 municipalities
together with the County Council have since 1996 monitored the use of alcohol, tobacco and illicit drugs
among adolescents ages 16 and 18. Altogether it makes nine surveys between 1996 and 2008. The
questionnaire is national which gives local, regional and national data as a reference. In the county it‟s a total
study which makes it possible to produce health profiles for each school in the county.
Objectives: We work with several methods to link the survey results to theory on preventive work, on how to
increase dissemination and use of survey data, and to practice. The purpose is to get the results to affect the
practice on the field.
Underlying values and principles: Key issues in this concept are:
• Monitoring the situation
• National survey questionnaire
• Time series
• Data processing and analysis
• Educational meetings
• Strategies in preventive work
• Network of municipality coordinates whose strategic work aim to affect preventive work in all the
municipality areas, including politicians.
• Capacity building
• Local plans for dissemination and use of the results
• Evaluation of the work
Knowledge base/ Evidence base: Epidemiology
Social science
Theory on dissemination of public health surveillance
Theory and best practice on preventive work
Theory on evaluation
Context of intervention/project/work: Ongoing regional work to support the public health work on a local
level in ten municipalities.
Methods: Monitoring
Data analysis
Educational meetings
Capacity building
Disseminition of results
Evaluation
Results and Conclusions: Implications for public health work:
• Structure of the local work important
• Local work groups
• Networks over municipalities
• Competence of the municipality coordinates
• Reference data from local, regional and national level
• Educational meetings
• Capacity building
• Evaluation with a theoretically based questionnaire
• Results: The municipality coordinates think that the educational meetings are useful to them. It gives them
an opportunity to interpret their own results, to discuss explanations and tools on different levels in
preventive work, to reflect together with others on their own work, to work with dissemination and practical
use of public health surveillance, and to change experiences with other municipality coordinates.
Disclosure of Interest: "None declared"

TP-WED-281 LINKING SURVEILLANCE SYSTEMS WITH POLICY MAKING AND EVALUATION:
EXAMPLES FROM CANADA
B. Choi* 1
1 Centre for Chronic Disease Prevention and Control, Public Health Agency of Canada, Ottawa, Canada
Background: In health promotion, a central question is how to enhance effective evidence-informed
decision making.
Objectives: This study examines ways to better link public health surveillance to the development and
evaluation of public health policies and programs.
Underlying values and principles: It is believed that public health policies and programs that are informed
by evidence from public health surveillance will better serve the population.
Knowledge base/ Evidence base: Ways to improve the science-policy interface do exist. But they need to
be systematically summarised, disseminated and marketed to become general knowledge and practice in
public health.
Context of intervention/project/work: A group of 17 investigators at the federal, provincial and local
government level in Canada worked to identify ways to improve the linkage of surveillance to policies and
programs. The investigators came from various fields including chronic disease, infectious disease, health
promotion, environmental health, product safety, nutrition and public health surveillance. They include both
research scientists and policy makers.
Methods: Investigators from the Public Health Agency of Canada, Health Canada, Statistics Canada, as
well as provincial and local health authorities collected stories and examples from their work that are
considered to be able to enhance effectiveness of using surveillance information leading to public health
action. These examples were then grouped into a number of major ways.
Results and Conclusions: Several ways can improve linkage of surveillance to policy and programs: (1)
surveillance at the local level, (2) surveillance of high risk groups, (3) surveillance to address policy needs,
(4) surveillance to develop policy and programs, and (5) surveillance to evaluate policy. Ample examples are
available to illustrate the ways. It is concluded that seven themes can improve the science-policy interface,
as summarised in the acronym SCIENCE – Strategy, Collaboration, Information, Education, Novelty,
Communication and Evaluation.
Disclosure of Interest: None declared

TP-WED-283 IMPLEMENTATION OF TOTAL QUALITY MANAGEMENT IN DISTRICT HEALTH
SYSTEMS: DESIGNING THE EFFECTIVE MODEL OF QUALITY IMPROVEMENT IN HEALTH
ORGANIZATIONS
Y. Hamidi* 1
1 Health Management, Hamadan University of Medical Sciences, Hamadan, Iran (Islamic Republic of)
Background: TQM (total quality management) is a managerial philosophy that covers all health system
activities, estimates all the needs and expectations of the customers and society, and helps achieve
organizations‟ objectives in a cost-effective manner by continuously maximizing the capabilities of all
employees.
Objectives: The objective of this research were to assess the impacts of quality management on health
centers in eight cities with a focus on process-related aspects and to design an appropriate and effective
model of the main element of total quality management (TQM) for health systems.
Underlying values and principles: - Designing a new model of quality management with integrating
strategic planning and total quality management that it‟s named: Strategic Total Quality Management
(STQM)
- Proposing effective model of process quality improvement in health services
- Providing appropriate model of employee‟s participation in health services
Knowledge base/ Evidence base: the results of implementation of quality management and process quality
improvement activities in eight health centers can be:
1- Providing necessary knowledge of quality management for health managers and policymaking
2- Designing Practical strategies for health promotion
3- Providing appropriate strategies to improve productivity and enhance the quality of health services
Context of intervention/project/work: context of intervention includes service process in health and
hospital organizations. In implementing the proposed model of quality improvement, the following steps were
taken: situational analysis to define the mission, vision, and quality policy; the establishment and
organization of quality improvement teams; and the provision of workshops on quality improvement. After
organizing and training the teams and problem-solving committees, the projects for the quality improvement
of key processes were defined and implemented. Finally, a year after the model implementation, the
researchers analyzed the data and presented the results.
Methods: This research was an interventional study related to pre-test and post-test shots in eight health
centers in Hamadan, Iran. Primary survey data about the implementation of quality management and
process quality improvement activities were collected in 2000-2002, and 2006, and these data were
combined with information on quality management outcomes of health organizations in selected countries.
Results and Conclusions: The findings showed that the process capability ratio (PCR) was dramatically
increased in some processes, resulting in improvements in PCRs for issuing health cards (from 0/82 to
1/71), child care (from 0/5 to 1/3), and health center reports (from 0/24 to 1/5). The major driving forces that
affect the success of quality management were 1) a committed and supportive management (87%); 2)
continuing education (85%); and 3) strategic planning (73%). The important tools and techniques that were
stressed for implementation of TQM in selected countries included quality promotion projects, reengineering
of the process, team work, research related to customers‟ expectations and preferences, and training the
managers and staff.
The design and use of a strategic model for total quality management (STQM) improved productivity and
process performance and created positive culture change.
Disclosure of Interest: None declared

TP-WED-284 TOWARDS IMPROVED MEASUREMENT OF HEALTH-INFLUENCING
NEIGHBOURHOOD FACTORS
M. Shareck* 1 , K. L. Frohlich 1 , C. Dassa 1
1 Médecine sociale et préventive, Université de Montréal, Montréal, Canada
Background: Neighbourhood and health research has been gaining increasing momentum over the last
decade. Moving beyond an individual-based approach to health to one focused on settings, health promotion
researchers have been attempting to identify contextual factors as intervention targets. Various methods,
including direct observation, have been used to measure area attributes thought to influence social
inequalities in health at the local level.
Objectives: The objective is to discuss the design and reliability of a new neighbourhood observation grid
developed to study social inequalities in smoking in Montreal.
Underlying values and principles: Social inequalities in smoking are a matter of equity. It is essential to
identify contextual factors contributing to unequal smoking rates across Montreal neighbourhoods in order to
allow the design of health promotion programs focused on the settings where social groups live, work and
play.
Knowledge base/ Evidence base: The grid was designed by adapting items from existing grids, synthesis
of literature and focus group material with Montreal residents. For the reliability study, four socially
contrasted Montreal neighbourhoods were observed in June 2009.
Context of intervention/project/work: This presentation is the result of pilot work performed with funding
from the Canadian Tobacco Control Research Initiative in 2008-2009. The goal was to assess the reliability
and validity of our measurement tool.
Methods: Three raters followed a week-long training including detailed review of the grid and site visits.
Fifteen street sections were randomly chosen from each neighbourhood for a total of 60 street segments and
rated on two occasions by each rater. A reliability study was performed for each item separately with
generalizability analyses based on one-facet (raters) and two-facet (raters and occasions) crossed designs.
Resulting ICC were computed with EduG 3.04 and are presented at the conference. Test-retest Kappa
coefficients for the three raters and preliminary inter-rater one-facet intra-class coefficients (ICC) based on
the first occasion were computed for 69 individual items using SPSS 13.0. These results are reported below.
Results and Conclusions: 61% of test-retest Kappa coefficients showed moderate to good agreement
(values between 0.4 and 0.8), and 14% showed very good agreement (values higher than 0.8). 54% of ICC
coefficients indicated acceptable to good reliability (values between 0.6 and 0.9), and 13% indicated
excellent reliability (values higher than 0.9). Developing a reliable observation tool tailored to the Montreal
reality is a step towards improved measurement of neighbourhood attributes by health promotion
researchers and the identification of contextual factors that contribute to social inequalities in smoking across
neighbourhoods. Practitioners and policy makers can also benefit from such a tool since it may lead to the
identification of relevant neighbourhood factors on which health promotion programs can focus.
Disclosure of Interest: None declared.

TP-WED-286 PUTTING POPULATION DATA TO EFFECTIVE USE
K. Price* 1 , A. Taylor 2 , T. Gill 2
1 School Nursing and Midwifery, University of South Australia, 2 Population Research Outcome Studies Unit,
SA Health, Adelaide, Australia
Background: Cohort studies have the potential to be more than an epidemiological study of a group of
people as evidenced by developments within the North West Adelaide Health Study (NWAHS). NWAHS is a
successful epidemiological population-based cohort study established in 1999 with over 4,000 randomly
selected participants.
Objectives: NWAHS is about identifying and describing specific population groups with chronic conditions,
at risk of developing or with undiagnosed chronic conditions, together with health-related risk factors and
socio-demographic factors along a chronic disease continuum. The study focuses on priority health
conditions such as asthma, diabetes, chronic obstructive pulmonary disease, arthritis, osteoporosis, and
cardiovascular disease. Stage 1 of the study established baseline self-reported and biomedically measured
information on those who were at risk of these conditions; previously undiagnosed with these conditions; and
diagnosed with these conditions.
Underlying values and principles: Demonstrating how to connect population health research to primary
health care is for us a purposefully linked knowledge-translation process. In this paper we explore the
relevance that summarising NWAHS findings from 2000 - 2008 has to assist in maximising the effectiveness
of strategies for the prevention, early detection, and management of chronic conditions.
Knowledge base/ Evidence base: Major stages of the study have been held approximately every four
years: Stage 1 in 2000 and 2002–03 and Stage 2 in 2004–06. Stage 3 commenced in June 2008 and is due
for completion in May 2010 (please see Grant et al. 2008).
Context of intervention/project/work: Evidence-based policy and practice are fundamental to a primary
health care system. Health promotion and education strategies should be underpinned by data-driven
research to ensure relevance and sustainability.
Methods: The participants in the NWAHS are a representative sample aged 18 years and over who
participate in a telephone interview, self-completed questionnaire and biomedical examination at a clinic.
During the clinic visit, height, weight, waist and hip circumference, and blood pressure were measured. Lung
function and allergy skin prick tests were conducted, and a fasting blood sample was taken to measure
glucose, triglycerides, total cholesterol, high density lipoprotein (HDL), low density lipoprotein (LDL), and
glycated haemoglobin (HbA1c). Consent was obtained from participants to link to their publicly provided
health service and pharmaceutical usage.
Results and Conclusions: In this paper, we show how longitudinal datasets from a successful
epidemiological population-based cohort study can be effectively utilised to inform health promotion and
health education strategies.
References: Grant JF, Taylor AW, Ruffin RE, Wilson DH, Phillips PJ, Adams RJT, Price K and the North
West Adelaide Health Study Team 2008 „Cohort profile: The North West Adelaide Health Study (NWAHS)‟,
International Journal of Epidemiology, Oxford University Press, Oxford.
Disclosure of Interest: Grant/research - support

TP-WED-287 BUILDING CAPACITY IN HEALTH IMPACT ASSESSMENTS: AN OPPORTUNITY TO
SHIFT HEALTH SYSTEM THINKING
J. J. Smith* 1 , D. F. Schmitt 1 , P. P. Harris 2
1 Health Promotion Strategy Unit, Department of Health and Families, Casuarina, 2 Centre for Health Equity
Training, Research and Evaluation, University of NSW, Sydney, Australia
Background: Health Impact Assessments (HIAs) can be defined as a combination of procedures, methods,
and tools by which a policy, program, or project may be judged as to its potential effects on the health of a
population, and the distribution of those effects within the population.1 Their use has grown in popularity over
the last decade and ranges from desk-based HIAs through to comprehensive HIAs. It is likely their growth
will continue in Australia given they have received a special mention in the recently released National
Preventative Health Strategy.
Objectives: The following presentation will describe a recent training partnership between the Northern
Territory (NT) Department of Health and Families (DHF) and the Centre for Health Equity Training, Research
and Evaluation at the University of New South Wales to build the capacity of the NT public service to conduct
HIAs in both operational and policy settings.
Underlying values and principles: The opportunity to build health equity through HIAs is particularly
relevant for the NT population (approximately 30% of this population are Aboriginal and Torres Strait
Islanders, with many living in remote communities). Both indigenous and remote populations are considered
as priority populations in Australia. DHF is interested in the application of HIAs to support these priority
populations. Additionally HIA application provides an opportunity to enhance collaborative work between
DHF Health Promotion Strategy Unit and Environmental Health Branch.
Knowledge base/ Evidence base: At present, little is known about the effectiveness of capacity building in
relation to HIAs.
Context of intervention/project/work: The Northern Territory has a population of approximately 220,000
people, spread over a large geographical area. It is estimated that 30% of the NT population are Aboriginal
and Torres Strait Islanders with many living in remote communities. Poor health and social outcomes among
Aboriginal and Torres Strait Islanders in the NT, indicate that HIAs, are a particularly important tool for the
assessment of policies and projects implemented in these communities
Methods: We will describe three different HIA capacity building workshops held in the NT throughout 2009
and identify associated outcomes based on participant observations and evaluative feedback.
Results and Conclusions: Our results show that the training extended far beyond the skills staff developed
to conduct HIAs. Indeed, the HIA training provided an opportunity to influence the broader organisational
culture with the Department of Health and other government department with respect to health system
thinking, particularly for staff in decision-making roles. Further HIA training is subsequently being scheduled
for 2010.
References: ECHP (1999) Health Impact Assessment: Main concepts and suggested approach
(Gothenburg Consensus Paper), European Centre for Health Policy. Brussels
Disclosure of Interest: None declared

TP-WED-289 PUT RESEARCH INTO PRACTICE : EXPERIENCE OF NATIONAL PUBLIC HEALTH
MANAGEMENT CENTER
n. tajaddini* 1
1 education, NPMC, tabriz, Iran (Islamic Republic of)
Background: Based on philosophy of HSR, in recent years health organizations focused on running
researches. While it is generally understood that research can have a positive impact on health statues, the
potential influence of it on health policy is not clear enough .
Tabriz University of Medical Sciences and Health Education (TUMS) is one of the oldest universities in Iran
with powerful educational and research background .
For instance 210 research proposals approve annually in TUMS which are involving an expense about
1000000$. Although most of these proposals are done by the university members , the results rarely used in
policy and decision making. .
Objectives: to build capacity in staff through short term training programme in order to promote evidence
based decision making at work setting .
Underlying values and principles: One of the most critical resources at health systems in the accessibility
to capable and complete human resources who take the role at researchers . Although any health systems
may have sufficient and adequate hardware ,but they may run into trouble. For lack of evidence based
decision making . in order to equip the staff with necessary techniques in reaching profound decisions ability
of staff in conducting HSR is a must ,thereby a training programme in HSR was designed to build HSR
capacity in health staff to be able to identify , analyze and implemented evidences based on solutions .
Knowledge base/ Evidence base: it includes 6 models which were conducted in the forms of workshops
each with the two to three weeks duration.
Context of intervention/project/work: medical universities of IRAN
Methods: 1- nominating board of trustees based on their educational and job experiences
2- setting the educational content based on boards‟
3- approve the content based on experts‟ opinions
4- call for entrance examination
5- accomplishment of examination
6- declaration of results
7- disposed of interview
8- student selection
9- implement the course
10- evaluation
Results and Conclusions: we conclude that trainees have gained enough skills in doing protocol research
which was evident from their final project . the content of their project indicates that they were able to identify
the problems and conduct research and suggest an evidence based solutions
References: A. Muir Gray, Evidence-based policy making In: A. Haines and A. Donald, Editors, Getting
research findings into practice (2nd ed.), BMJ Books, London (2002), pp. 154–161.
[2] A. Haines and A. Donald, Getting research findings into practice: making better use of research findings,
BMJ 317 (1998), pp. 72–75. View Record in Scopus | Cited By in Scopus (102)
Disclosure of Interest: reza goli vahidi , grant research support

TP-WED-289b HEALTH PROMOTION AGENDA-SETTING: INNOVATIVE RESEARCH FOR
ADVOCACY, AND POLICY DEVELOPMENT FOR HEALTH PROMOTION PRACTITIONERS
C. T. Kozel* 1 , A. P. Hubbell 2 , M. T. Hatcher 3 , S. Thompson 4 , F. G. Pe'rez 5 , M. Goodman 6
1 Health Science, 2 Communication Studies, New Mexico State University, Las Cruces, 3 Environmental
Medicine and Education Services, Agency for Toxic Substances and Disease Registry, Atlanta, 4 Health
Promotion, University of Texas, El Paso, 5 Communication, University of Texas. El Paso, El Paso, 6 Bingaman
Senate Office, U. S. Senate, Las Cruces, United States
Background: Health promotion practitioners must continuously address health promotion issues using the
most innovative strategies and research. Agenda-setting theory postulates that mass media do not
determine what people think but do influence what they talk about. Agenda-setting offers understanding of
how issues move from relative unimportance to the forefront of supportive action among the media, public,
and policymakers. Health Promotion Agenda-Setting (HPA-S), a subset of agenda-setting research, has
identified four factors that influence health promotion policy agendas. These factors are characteristics of
agenda-setters, HPA-S design and mechanism factors, and mass media content .
Objectives: Health Promotion Agenda-setting (HPA-S) provides practitioners a theoretical framework to
guide environmental change and achieve sustainable courses of practice for advocacy, and policy
development. HPA-S is used to specify and prioritize health problems and alternative solutions by influencing
the efficacy of the above factors in policy development.
Underlying values and principles: Shared vision, synchronicity, salience and social justice
Knowledge base/ Evidence base: Uses the cross cutting agenda-setting theoretical research basis. Offers
a sustainable innovation in health promotion research for global health promotion advocacy, practice and
policy development.
Context of intervention/project/work: The crucial link between agenda-setting and processes of
establishing effective legislation, policy, and programs has been researched. However, many health
promotion practitioners do not understand what agenda setting is, nor how to apply it to advocacy and policy
development.
The project described was supported by a grant from the Paso del Norte Health Foundation through the
Center for Border Health Research located in the U.S.-Mexico border region. Its contents are solely the
responsibility of the authors and do not necessary represent the official views of the Paso del Norte Health
Foundation or the Center for Border Health Research.
Methods: Using point-in-time interview surveys and mass media content analysis an interdisciplinary binational
research team examined how public health agendas are determined within the Paso del Norte
region of the U.S.-Mexico border.
Results and Conclusions: Health Promotion Agenda-setting findings offer practitioners professional
development opportunities to gain new knowledge, skills, and methods to reshape and strengthen health
promotion advocacy and policy development practices. This research identifies knowledge and cultural gaps
in how mass media, public health and policy agendas foster innovative global health advocacy and policy
development opportunities for health promotion.
References: References are available from authors upon request
Disclosure of Interest: none declared

TP-WED-290 A LASTING PARTNERSHIP FOR QUALITY PROJECTS IN HEALTH EDUCATION
N. L. Houzelle* 1 , E. Collet 2 , C. Gerhart 1 , D. Jourdan 3
1 DDESET, INPES, Saint Denis, 2 Education a la sante, Reseau IUFM, 3 Education a la sante, University
Blaise Pascal, Chamalieres, France
Background: INPES is the national public agency of the Ministry of Health, in charge of prevention and
health education. A partnership was formed between INPES, the Ministry of Education and the Network of
teachers‟ colleges, who are affiliated with the Ministry of Higher Education.
The focus of this partnership is to work on teachers‟ skills so that they can legitimately treat health education
(HE) topics.
Objectives: To develop training modules in HE for teachers using a participative approach.
Underlying values and principles: Equity and participative approach, working in partnership
Knowledge base/ Evidence base: Data regarding health promotion in a school setting (ST Leger et al. In
Mc Queen and Jones 2007), teachers‟ involvement (Jourdan et al. 2002) and partnerships (Mérini et de
Perretti 2002).
Context of intervention/project/work: Different professions and diverse professional cultures are
represented in this work group yet were able to establish a practice to permit the development of common
productions. The Network recruited heath education professionals and INPES worked at integrating cultural
elements of the education environment.
Methods: Trust grew progressively from mutual recognition during work group meetings, contract signing,
participation in each others‟ events, as well as joint event planning. Signing contracts favoured a
formalisation of the partnership. With different professional cultures and stakes, some tensions appeared
occasionally between partners but were overcome through dialogue.
Results and Conclusions: The training guide that was produced thanks to 5 years of partnership and
implicating more than 150 people involved in teacher training exhibits their increasing interest in HE. The
evidence of this ongoing partnership is seen in publications released from both INPES and the education
sector. Research on HE in school settings has allowed to increase knowledge on this topic. To accompany
HE training for teachers, the Network and INPES are working on a distance education course to be included
in masters of education programmes.
There is a real opportunity for INPES in the evolution of teacher training. In accompanying this social and
cultural change and by collaborating on work tools, the objective is that health education will find a
recognised place in teacher training. In training teachers and in working in a partnership to join visions of HE,
methods are evolving in the classroom.
With a certain maturity, this partnership is demonstrating its impetus. It is now legitimate to question what the
next steps will be for the three ministries involved. Should the current partnership be renewed? Is it
necessary to develop new projects together? How can we make sure that the different parties continue to
move forward and spur each other on?
Disclosure of Interest: None declared

TP-WED-291 STUDENT TEACHERS‟ WAYS OF EXPERIENCING LEARNING IN HEALTH EDUCATION
L. Paakkari* 1 , P. Tynjälä 2 , L. Kannas 1
1 Department of health sciences, 2 Finnish Institute for Educational Research, University of Jyväskylä,
Jyväskylä, Finland
Background: Health education (HE) became an independent school subject in Finnish basic education in
2004 and in general upper-secondary education in 2005. Health education teacher training began at the
University of Jyväskylä in 2002. From the perspective of health education teacher training, studying student
teachers‟ understanding of pedagogical matters is essential. In order to change student teachers‟
understanding of HE in a more complex and complete direction, it is important to gain insight into the way the
student teachers experience the target phenomenon and to find out the critical aspects of learning.
Objectives: The aim of this study in progress is to identify ways of experiencing learning in health education,
and to discover the aspects that are educationally critical to gaining a more complex and more complete
understanding of learning.
Underlying values and principles: This research aims to produce knowledge that will support the
development of health education teacher training and health education teaching in schools. The research is
grounded in literature which is directly relevant to the topic. It has a sound research design and is ethically
appropriate.
Knowledge base/ Evidence base: The research is based on accurate, original empirical data, collected
using methods appropriate to the research questions. It includes knowledge which supports new ideas in the
field.
Context of intervention/project/work: The research context is health education teacher training in the
University of Jyväskylä, Finland.
Methods: Qualitative data (written essays, semistructured interviews) were gathered twice during health
education teacher training from students of physical education who were specializing in health education
(n=20). The data were analyzed using phenomenographic techniques (Marton, Pong 2005; Åkerlind 2005a,
2005b).
Results and Conclusions: According to our preliminary findings, five qualitatively different ways of
experiencing learning in HE can be discerned. Learning was experienced as:1. acquisition of health
knowledge 2. application of health knowledge and skills to everyday life3. relational thinking on health4.
transformation of thinking related to health issues5. personal growth.The categories seem to form a
hierarchically-ordered outcome space where the first category represents the least complex way of
understanding learning in health issues, and the fifth category the most complex way. In the first two
categories the focus is on knowledge and skills, in the third and fourth meaning, and in the fifth category
growth. In relation to the aim of promoting meaning and growth aspects in the learning of health issues,
questions arose concerning reflection, and the problematic nature of knowledge. These were related to the
ability to link and evaluate health issues from one‟s own experiences and health habits, and also to the ability
to create one‟s own opinion on health topics and to grow as a person. The results can be used in evaluating
how students are able to discern meanings related to learning health issues, and in planning learning
experiences aimed at enhancing student teachers‟ understanding in a more complex and complete direction.
References: Marton F, Pong WY. 2005. On the description unit of phenomenography. Higher Education
Research & Development 24; 3: 335-348.Åkerlind G. 2005a. Learning about phenomenography:
Interviewing, data analysis and qualitative research paradigm. In: Bowden JA, Green P (eds). Doing
developmental phenomenography. Melbourne: RMIT University Press, 63-73.Åkerlind G. 2005b.
Phenomenographic methods: A case illustration. In: JA Bowden, P Green (eds.). Doing developmental
phenomenography. Melbourne: RMIT University Press, 103-127.
Disclosure of Interest: none declared

TP-WED-293 UNDERSTANDING THE RELATIONAL ASPECTS OF LEARNING WITH, FROM, AND
ABOUT THE OTHER: IF IT WERE ONLY THAT EASY!
R. B. Hovey* 1 , W. Yen 1
1 Applied Health Research, The Michener Institute, Toronto, Canada
Background: Frequently heard among health care providers, administrators, students and educators,
especially within the context of interprofessional collaboration, is the phrase-as-mantra: learning with, from
and about others. The purpose of this article is to explore and invite mindful consideration about the words
used in this popularized notion of learning. Upon reflection, the sequence of learning with, from and about
does not seem to accurately describe how people come together for collaboration, partnerships, or personcentered
planning. A reconfigured sequencing of the words may offer a more realistic model for
interprofessional collaboration whereby health care practitioners, colleagues and patients learn about, with
and from each other. Collaborators begin by first learning about one another, then progress to learning with
that person within some common context. Learning with another person opens up the possibility of learning
from the Other when the participants are willing and open to share new perspectives, knowledge and
experiences. This reconfigured sequencing provides health care promoters a more realistic model for
interprofessional collaboration that supports a progression from transactional practices of gaining knowledge
(learning about) toward a transformational shift in attitude, identity and practice, which promotes learning
with and hopefully learning from the Other.
Objectives: To discuss the complexities of learning about, with and from the Other through an exploration of
the fundamental relational requirements to achieve effective interprofessional collaboration with individuals
and community.
Underlying values and principles: A careful and critical reflection on the words and relational constructs
implied by with, from and about suggest a meaningful collaborative outcome from a deep understanding of
these words as knowledge-into-action. Attention to these details may appear trite or insignificant, but each
word suggests a type or quality of relationship with the Other. It is through an understanding of these words,
their meaning, and their relational implications that we are able to determine why some relationships fail to
constitute, remain inadequate, and why people may be resistant to learning.
Knowledge base/ Evidence base: Social constructionist perspective: In daily life, we rarely ask one another
to specifically define the words we are using. We use words like “poverty” and “obesity” without thinking.
Constructionist perspectives encourage us to take words seriously because even the most simple of words
(particularly the simple words) are categories for entire systems of meaning. (Loseke 2005, p.16)
Context of intervention/project/work: Development of effective interprofessional / interpersonal
collaboration which is authentically person or community centered.
Methods: A philosophical and social constructionist exploration into commonly used words which may have
lost their humanistic and tacit meaning and relevance in practice.
Results and Conclusions: We are reminded of the complexity of simple words used to describe systems of
meaning and that merely showing up to collaborate is not sufficient to learn from another especially when the
Other is not like ourselves. To do so, this perspective argues that learning from the Other is not something
that can be learned through transactional communicative exercises, simulation or the application of a set of
rules alone. These are not transformative encounters because to open up to an affective mode of being with
and learning from the Other requires a significant transformative change of perspective.
References: Loseke, D.R. (2005). Thinking about social problems: an introduction to constructionist
perspectives. 2nd ed. New Brunswick, NJ: Transaction Publishers.
Disclosure of Interest: None Declared

TP-WED-294 CONCEPTOS ASOCIADOS A LA SALUD DESDE LA PERSPECTIVA DEL DESARROLLO
SOSTENIBLE
W. A. Salas Zapata* 1 , L. Rios Osorio 1 , X. Alvarez Del Castillo 2
1 School of Microbiology, University of Antioquia, Medellin, Colombia, 2 Catedra Unesco de Sostenibilidad,
Universidad Politecnica de Cataluña, Barcelona, Spain
Background: La salud es un concepto implícito en el marco conceptual del desarrollo sostenible. Sin
embargo, como parte de su construcción histórica producto de la evolución conceptual su abordaje ha
estado signado por la ambigüedad de su definición, y por su utilización indiscriminada para tratar temas
como el bienestar del individuo, la sociedad, los ecosistemas, la tierra, las fuentes de recursos, y de la
economía.
Objectives: De esta manera el concepto salud–enfermedad ha sido privado de su carácter objetivo para ser
reducido a la función de calificativo de los hechos objeto del discurso del desarrollo sostenible, y en
consecuencia, en el discurso oficial del desarrollo sostenible, en el cual se hace alusión al concepto de
salud, la falta de claridad conceptual impide reconocer en dichos discursos la concepción de salud que
orienta a los analistas y hacedores de políticas para el desarrollo sostenible.
Underlying values and principles: Este documento es el resultado de una investigación secundaria
realizada desde el método histórico hermenéutico, por el cual, se interpretaron los diferentes estudios
realizados sobre las categorías: salud – enfermedad, y desarrollo sostenible/sostenibilidad, a partir de los
contextos sociales, culturales, políticos y filosóficos de los conceptos de salud–enfermedad y su relación
con el desarrollo sostenible.
Knowledge base/ Evidence base: Resultados
La salud en el desarrollo sostenible se debate entre tres frentes conceptuales; en primer lugar se encuentra
la salud biológica, operacionalizada e instrumentalizada de acuerdo a las necesidades de su adaptación al
discurso sostenibilista de Occidente, que la circunscribe a teorías biológicas de las enfermedades, y la
enmarca en el contexto ambiental cómo factor determinante tanto para el análisis de su problemática cómo
para la búsqueda de soluciones.
Context of intervention/project/work: En segundo lugar se encuentra la salud institucional, según la cual
la salud es un estamento, de carácter público o privado, local o regional, nacional o internacional, que vela
por la salud de las personas, y en consonancia con el discurso, la problemática de la salud se relaciona con
el acceso a y la calidad de los servicios de salud que regulan u ofrecen estas instituciones
Methods: En tercer lugar se encuentra la salud percibida en sentido abstracto, asociada a factores
culturales de trascendencia individual y colectiva, y que se relaciona con la idea del bienestar percibido
desde los estándares de vida occidental.
Results and Conclusions: Como complemento, estas tres visiones de la salud entremezcladas en el
discurso se matizan con la idea de la pobreza, asociada a la carencia de recursos económicos; las
necesidades, asociadas a las materialidades y los modelos de consumo insostenibles, como factores
determinantes en la solución de la problemática de la salud.
Finalmente, en el discurso sostenibilista sobresale la idea de la salud como objetivo intermedio en la
búsqueda del desarrollo sostenible. A veces ponderable, con la utilización de indicadores que describen y
representan ese lado asible de la salud, como la morbimortalidad, el acceso a servicios de salud, los
factores ambientales de riesgo; la renta per capita; y la mayoría de veces imponderable, con ese sentido
abstracto que la caracteriza y la asocia con aspectos igualmente difíciles de cuantificar como lo cultural,
social, político y sicológico.
Disclosure of Interest: No declared

TP-WED-296 PROFESSIONALIZATION VERSUS CERTIFICATION: WHAT IS NEEDED TO
STRENGTHEN THE QUALITY OF HEALTH PROMOTION INTERVENTION?
K. D. Pluemer* 1
1 Health Promotion and Management, Academy for Public Health, Düsseldorf, Germany
Background: The Galway Consensus Conference Statement from last year launched a new global initiative
to discuss and outline "Domains of Core Competencies for Building Global Capacity in Health Promotion".
On national level there are debates about Competencies for Health Promoters (e.g. Canada) as to read in
the HPO-commissioned report "Towards the Development of Competencies for Health Promoters in
Canada" or the list of "Core Competencies of Healthy Cities Coordinators" as discussed by a proposal from
Esther Mok, Sai Kung District of Hong Kong, both in 2008. The quality of health promotion is also discussed
in terms of evidence and „model of good practice‟ criteria and content of tool kits for health promoters in
Germany.
Objectives: Health promotion as profession
Professionalization: expert skills and quality
Professionalization: soft skills and leadership
Professionalization: attitudes and codes of ethics
Certification: quality standards versus diversity management
Instead of norms creative diversity and variety
people before structure
Underlying values and principles: Professionalization and Certification is not to understand as opposite
but as counterpart. In the pursuance of a profession one can say professionalization constitutes the quality
level (skills and abilities) of a certain work which can be credited by a certificate, e.g. in trade this is the
craftsman‟s diploma which combines theory and practice.
Knowledge base/ Evidence base: Certification is the to understood as a particular proceeding
(methodological approach) which is accepted and declared (mostly by experts) as norm, a certain quality
standard, e.g. RCT‟s by EBM, EFQM as quality management model or the participatory research and action
approach in health promotion. But in applying these specified methods it is by no means guaranteed that this
approach will work in practice and succeed too, e.g. in an health promotion intervention project.
Context of intervention/project/work: It is not only a matter of suitability of theoretical knowledge and
methodical know-how in practice but first of all how successful their application is in terms of desirable
results, to reach the set goals and objectives of an intervention. It is a matter of effectiveness of professional
work and performance. In short: effectiveness constitutes quality or utility creates success – but for whom?
And what does this mean for health promotion practice and health promoters in the field.
Methods: Critical reflection about theory and practice of profession driven health promotion. The quality of a
profession gets its expression in knowledge about its object, the material and environmental condition as
well as in the craftsmanship and methodological expertise in realising its concept, plan or project, e.g. in their
health promoting practice.
Results and Conclusions: In my oral presentation I want to focus from the German perspective on
following questions: What core competencies should health promoters have? Is there a need for an ethical
code of health promotion? Do health promoters need a ethical codex? What is needed that certificates of
quality contribute to improve the performance and evidence of health promotion? Are empowerment and
participation means and/or end of health promotion and what the consequences for health promotion
practice are. It is very clear that participation and empowerment are key terms of the concept of health
promotion but they are representing not already quality in itself.
References: HPO-Report "Towards the Development of Competencies for Health Promoters in Canada"
Esther Mok: Core Competencies of Healthy Cities Coordinators, Hongkong 2008
BZgA: Criteria for Models of Good Practice, Cologne
Disclosure of Interest: None declared

TP-WED-297 CREENCIAS DE LOS FUTUROS EDUCADORES Y PROMOTORES DE LA SALUD ANTE
LA OBESIDAD
M. Torres García* 1 , D. Vallespín Toro 1 , M. Marrero Montelongo 2 , C. Navarro Rodríguez 2
1 DIDÁCTICAS ESPECIALES, 2 ENFERMERÍA, UNIVERSIDAD DE LAS PALMAS DE GRAN CANARIA, LAS
PALMAS DE GRAN CANARIA, Spain
Antecedentes: El objetivo 18 de Salud 21 dirigido a desarrollar los recursos humanos para la salud declara
que “todos los estados miembros deben garantizar que los profesionales sanitarios y de otros sectores han
adquirido los conocimientos, las actitudes y las cualificaciones necesarias para proteger y promover la
salud”, por ello es imprescindible la formación de grado orientada a la capacitación profesional inicial, en
titulaciones como Magisterio y Enfermería.
Objetivos: Identificar las percepciones que poseen los futuros maestros y enfermeros de la ULPGC sobre:
• las personas obesas y los métodos que emplean para adelgazar.
• su papel como promotor de hábitos saludables en relación con la obesidad.
• los conocimientos populares sobre dieta y hábitos saludables.
Valores y principios subyacentes: La OMS plantea la promoción de la salud como la única herramienta
eficaz para conseguir que la población adopte hábitos de vida saludable. Para ello, es imprescindible la
formación y capacitación de profesionales.
Dos de los escenarios más importantes para el desarrollo de la promoción de la salud son los servicios
sanitarios y el medio escolar. El papel de los profesionales en promoción de salud consistirá en desarrollar
intervenciones eficaces en estos escenarios
Base de conocimiento / base de evidencia: Según la OMS, la obesidad y el sobrepeso constituyen una
epidemia mundial. En España, el índice de obesidad en adultos se sitúa en el 14,5%, mientras que el
sobrepeso asciende al 38,5%. La obesidad infantil y juvenil se sitúa en el 13,9%, y la de sobrepeso en el
26,3%. España presenta una de las posiciones más altas de Europa. La preocupación creciente por este
problema ha puesto en marcha estrategias de promoción de la salud.
Actualmente muchos estudios ponen de manifiesto que los futuros promotores de salud presentan creencias
que determinarán la calidad de sus intervenciones en el ámbito de la promoción de la salud.
Contexto de la intervención / proyecto / trabajo: Trabajo realizado en estudiantes del primer y último
curso de las titulaciones de Magisterio y Enfermería (1º y 3º) de la ULPGC
Métodos: Diseño: estudio descriptivo e interpretativo (metodología cualitativa).
Método de recogida de datos: grupos de discusión, formados por estudiantes de 1º de Magisterio, 3º de
Magisterio, 1º de Enfermería y 3º de Enfermería.
Método de análisis de información: se realizó un sistema de categorías, tras la transcripción literal de los
grupos de discusión siguiendo la modalidad de codificación abierta. Posteriormente se realizó la
triangulación de los datos.
Resultados y Conclusiones: Los estudiantes de Magisterio y Enfermería perciben que tienen un
importante papel como promotores de salud, y se sienten motivados y preparados para ello (“Si aprendes y
estás perfectamente cualificado, me veo capaz…”).
Las creencias de los estudiantes acerca de las dietas de adelgazamiento podrían condicionar su papel en
sus intervenciones (“Yo creo que una dieta debería estar puesta o impuesta por un profesional, enfocada a
un problema de salud….”)
Los estudiantes poseen una visión negativa de las capacidades de una persona obesa para seguir una dieta
de adelgazamiento o para cumplir las recomendaciones que se les haga. Estas creencias podrían ser una
importante barrera en sus actividades de promoción de la salud ("Una persona obesa o con obesidad no
está motivada a bajar de peso, y menos si te ponen a las niñas monas en la tele”).
Los estudiantes consideran que los conocimientos de la población acerca de la influencia de los hábitos de
vida en la obesidad son erróneos e insuficientes (“Mucha gente está mal informada, que se piensa que una
dieta o hacer deporte es sufrimiento”; “La gente asocia dieta a no comer”).
Declaración de intereses: No declarado

TP-WED-298 INNOVANDO EN EL APRENDIZAJE COMUNITARIO
A. M. Palmar 1 , O. Martínez* 2 , A. Pedraz 3 , A. García 4 , D. Rubiales 5
1 Enfermería, Escuela Universitaria de Enfermería. Universidad Autónoma de Madrid, 2 Enfermería, Área 1 de
salud, 3 Enfermeria, 4 Enfermería, Escuela Universitaria de Enfermeria de la Comunidad de Madrid.
Universidad Autónoma de Madrid, 5 Enfermeria, Esucela Universitaria de Enfermería de la Comunidad de
Madrid. Universidad Autónoma de Madrid, Madrid, Spain
Antecedentes: La adquisición de competencias en promoción de Salud en la formación pregrado de
enfermería, habilitarán al profesional a llevar a cabo estrategias eficaces para trabajar con la comunidad.
Así lo reconoce el Consejo internacional de Enfermería (CIE) y la OMS que considera en el perfil del
profesional de enfermería un trabajo que incluya la promoción de la salud como una de sus principales
funciones (1). La EUE de la Comunidad de Madrid en esta línea de trabajo y en sintonía con el Espacio
Europeo de Educación Superior, mantiene un programa docente teórico-práctico que posibilita esta
formación de forma eficaz e innovadora.
Objetivos: Facilitar la adquisición de conocimientos, habilidades y actitudes para la intervención
comunitaria en los estudiantes de enfermería para alcanzar las competencias en promoción de la salud y
habilidades en liderar proyectos (2)
Valores y principios subyacentes: Competencias; habilidades búsqueda en la comunidad, trabajo en
equipo, conocimiento de necesidades de la población
Base de conocimiento / base de evidencia: La formación pregrado debe dotar para el desarrollo de las
actividades comunitarias. Es relevante generar un clima de motivación favorable a lo “comunitario” y una
sensibilización dirigida a la acción para favorecer la implementación de proyectos, la disminución de las
resistencias y colabore a la creación de equipos que permita desarrollar con eficiencia el trabajo en la
comunidad(3,4)
Contexto de la intervención / proyecto / trabajo: Estudiantes del último curso de la titulación de
enfermería en la Escuela de enfermería de la Comunidad de Madrid.
Métodos: Programa docente de la asignatura de Enfermería Comunitaria II de la titulación de Enfermería de
España. La metodología de aprendizaje en técnicas de habilidades. Se articula en la elaboración de un
proyecto comunitario trabajado en grupos de 8 estudiantes en áreas sanitarias diferentes de la Comunidad
de Madrid. Fases:
Exploración de territorio;Exposición del mapa de recursos; Diagnóstico de necesidades de
salud;Planificación de participación;Entrevistas con protagonistas comunitarios: administración/población
/técnicos;Priorización de los problemas;Planificación de la intervención;Memoria y exposición del proyecto
comunitario.
Evaluación mediante la valoración del aprendizaje en participación comunitaria continua y final, de proceso
y resultado
Resultados y Conclusiones: Adquisición de competencias profesionales en Promoción de la Salud a
través de la elaboración de un proyecto comunitario. Los alumnos valoraron satisfactoriamente el resultado
de su aprendizaje con la superación de la materia de forma continua del 95% de los alumnos matriculados.
Los responsables asistenciales reconocen que los resultados resultan de gran interés para los
profesionales.
Referencias: 1. World Health Organization. WHO human resources for health minimum data set. World
Health Organization, 2008.
2. Agencia Nacional Española de Evaluación de la calidad y acreditación. Título de grado de Enfermería.
Junio 2005.
3. Direccion General de Atención Primaria. Papel de la Enfermería en Atención Primaria. Madrid. Enero
2009.
4.Boletín Oficial del Estado. Ley de Ordenación de las profesiones sanitarias. 2003.
Declaración de intereses: A. Palmar, "no declarado"
O. Martínez "No declarado"
A.Pedraz "No declarado"
A. Garcia "No declarado"
D. Ruabiales "No declarado"

TP-WED-300 USO DE LOS DETERMINANTES SOCIALES DE LA SALUD EN LA CARRERA DE
PROMOCIÓN DE LA SALUD
E. Alfaro* 1
1 Escuela de Salud Pública, Universidad de Costa Rica, San José, Costa Rica
Antecedentes: La Escuela de Salud Pública en los últimos quince años ha creado una serie de espacios de
discusión para mejorar la calidad de vida de la población costarricense.
En el año 2007 esta escuela inicia con la carrera de Promoción de la salud en la cual el enfoque
desarrollado aborda el concepto de salud más allá del nivel medicalizado en su lugar se plantea una salud
integral en la que los enfoques de determinantes sociales de la salud y otros elementos se vean reflejados
en la misma.
Objetivos: Mostrar la lectura desde los determinantes sociales de la salud de lo que es la nueva salud
pública y la estrategia de la promoción de la salud.
Explicar algunos cambios relacionados con los determinantes sociales de la salud en la sociedad
costarricense.
Valores y principios subyacentes: Valor de la salud como derecho
Solidaridad con poblaciones vulnerables
Responsabilidad social
Base de conocimiento / base de evidencia: Se trabajo con el planteamiento teórico de la Comisión de
Determinantes sociales de la salud.
Metodológicamente se trabajo con el diseño de investigación acción participativa integrando elementos de la
complejidad.
Contexto de la intervención / proyecto / trabajo: Se contextualiza en comunidades urbanas y rurales en
Costa Rica, y con enfoque de derechos, en poblaciones vulnerables.
Métodos: El método específico es el cualitativo desde el enfoque de los determinantes, pero se trabajo con
una serie de técnicas cualitativas: análisis de contexto.
En el proceso de antecedentes se trabajo con el Análisis de situación en salud
Resultados y Conclusiones: La integración de los determinantes sociales de la salud da al traste, con una
serie de desventajas sociales que viven las poblaciones más vulnerables tanto en zonas urbanas como
rurales.
El valor de la salud como derecho es importante en la integración de los determinantes de la salud en las
nuevas concepciones de salud pública que se discuten a nivel mundial.
El desarrollo humano debe mediarse por una construcción social de la salud en la cual el acto humano es lo
más importante, sin descuidar los determinantes sociales, ambientales, entre otros.
Declaración de intereses: No declarado

TP-WED-301 "CUENTO CONTIGO":CIUDADANIA Y ENFERMERIA
F. Espejo 1 , O. Martinez* 1 , L. repeto 1 , J. Rodriguez 1
1 SEMAP, Sociedad de Enfermeria Madrileña de Atencion Primaria, Madrid, Spain
Antecedentes: La enfermería de Atención Primaria es una profesión relativamente nueva y no todas sus
funciones son conocidas por los ciudadanos. El papel de la enfermera es clave en el desarrollo de servicios
de prevención y promoción de la salud(1). La Sociedad de Enfermería Madrileña de Atención Primaria
(SEMAP) quiere dar a conocer a la ciudadanía los cuidados que las enfermeras pueden prestar en los
Centros de Salud, para fomentar su utilización y accesibilidad, con el objetivo último de mejorar los servicios
que se prestan y con ello la salud de la población. La participación de los ciudadanos se ha considerado
fundamental en este proceso.
Objetivos: Desarrollar un documento de consenso que defina los servicios de enfermería básicos de la
Atención Primaria pública de la Comunidad de Madrid, mediante la colaboración de profesionales de
enfermería, y de representantes de asociaciones ciudadanas relacionadas con los principales programas de
salud de atención primaria(2)
Valores y principios subyacentes: La visión integral de la salud. La promoción de la salud en atención
primaria. La visibilización de los cuidados enfermeros en atención primaria. El trabajo en equipo
multidisciplinares. La participación ciudadana.(3)
Base de conocimiento / base de evidencia: Existe un desconocimiento relativo de los servicios y las
funciones de la enfermería en Atención Primaria por parte de la población. El enfoque biomédico sigue
teniendo mucho peso y dificulta el desarrollo de la Promoción de la Salud en atención primaria(4)
Contexto de la intervención / proyecto / trabajo: Asociaciones ciudadanas y profesionales de enfermería
de la Comunidad de Madrid.
Métodos: Elaboración de un documento base por parte del grupo dinamizador. Reuniones de consenso con
profesionales expertos y con representantes de las asociaciones ciudadanas. Síntesis y redacción final del
documento de consenso. Edición de un folleto de difusión
Resultados y Conclusiones: Elaboración de una Carta de Servicios y Cuidados de Enfermería básicos y
edición de un folleto que se difundirá en la Comunidad de Madrid. El título del folleto es “¡Cuenta con tu
enfermera!” e incluye el papel de la enfermera en atención primaria, a quién se prestan los servicios, cómo
se solicitan, dónde se prestan, qué servicios hay y para qué sirven.(5)
Referencias: 1.Papel de Enfermería en Atencion Primaria-Servicio Madrileño de Salud-Enero 2009.Madrid
2.La satisfacción de los pacientes. Manuel de la Peña. Instituto Europeo de Salud y Bienestar Social. 2007
3.Marco Estratégico para la mejora de la Atención Primaria en España: 2007-2012. Proyecto AP-21.
Ministerio de Sanidad 2007
4.Informe sobre el estado de salud de la población. Comunidad de Madrid, 2007.
5.Informe sobre el estado de salud de la población. Comunidad de Madrid, 2007.
Declaración de intereses: F.Espejo,Vocal participacion ciudadana/Semap-Enfermera
O.Martinez,Vocal participacion ciudadana/Semap-Enfermera
L.Repeto,Consultora/Semap
J.Rodriguez ,Presidente Semap-Enfermero

TP-WED-302 PERCEPCION DE LOS DILEMAS ÉTICOS QUE PRESENTAN LOS PROFESIONALES DE
LOS EQUIPOS DE SALUD DE ATENCIÓN PRIMARIA
Z. R. Franco* 1 , S. M. Franco 1 , P. A. Restrepo 1
1 Caldas, Universidad de Caldas, Manizales, Colombia
Antecedentes: La presente investigación surge de la preocupación de los autores frente al manejo de los
dilemas éticos en Atención Primaria en Salud, por parte de los profesionales que laboran en el nivel básico
de acceso de los usuarios al sistema de salud.
Objetivos: Comprender los dilemas eticos que se presentan en los profesionales de los equipos de salud
de atención primaria
Valores y principios subyacentes: aplicación de metodologías pedagógicas interactivas que brinden
elementos para iluminar la reflexión acción critica
Base de conocimiento / base de evidencia: La unidad de trabajo la constituyeron tres médicos generales,
cinco enfermeras y cuatro trabajadoras sociales,pacientes, la familia, los colegas y otros miembros del
equipo
Contexto de la intervención / proyecto / trabajo: centros de atención primaria en Manizales, Anserma,
Risaralda, Chinchina y Palestina, municipios del departamento de Caldas en Colombia
Métodos: estudio de tipo cualitativo comprensivo mediante entrevistas semiestructuradas se indago sobre
las percepciones de los participantes con relación a lo que significa para ellos un dilema ético; dilemas
éticos más frecuentes en su práctica profesional respecto a los pacientes, la familia, los colegas y otros
miembros del equipo, así como dilemas frente a la disponibilidad de recursos y los manejos a nivel
institucional, igualmente la existencia de espacios de debate para su resolución
Resultados y Conclusiones: los resultados sugieren vacios significativos no solo desde los cognitivo si no
desde la sensibilización, concienciación y compromiso activo para afrontar debidamente la problemática de
salud que afecta a los colombianos incluyendo los mismos profesionales de la salud enfrentados a la
frustración y a la impotencia en la toma de decisiones éticas para salvaguardar la dignidad y los derechos
de los usuarios como ciudadanos en ejercicio. Como conclusión urge la necesidad de concienciar a todo
nivel sobre el horizonte ético que debe orientar las decisiones gubernamentales, institucionales y
profesionales para evitar vulnerar la dignidad y los derechos de las personas en el Sistema de Salud.
Declaración de intereses: No declarado

TP-WED-304 LA TERAPIA COMUNITARIA COMO ESTRATEGIA DE FORMACIÓN EN LA
PROMOCIÓN DE LA SALUD
F. A. C. .. FARIA 1 , M. C. ABDALA 2 , M. A. MORRAYE* 1
1 Mestrado Promoção de Saúde, UNIFRAN, Franca, 2 Psquiatria, Universidade Federal do Ceará, Fortaleza,
Brazil
Background: La terapia comunitaria (TC) es um abordaje terapéutico realizado en grupo, que da prioridad
al reparto de experiencia de vida en um espacio solidario, valorando las competencias del individuo. En él,
los participantes se ayudan en la superación de seus conflictos, ya que la comunidad tiene problemas, pero
tiene también sus proprias soluciones. En la promoción de la salud, toda la comunidad debe tener um,
interconectando saberes advindos de los más distintos contextos socioculturales y ampliando las redes
solidarias de la ciudadanía.
El terapeuta comunitario se construye en la relación dialógica con los otros. No es necesario que sea un
experto, pero sí, que conozca su propia historia, que haya vivido sus dolores y encontrado la superación de
ellos.
Objectives: •Señalar la TC como estrategia de formación en promoción de la salud.
•Demostrar la sistemática de la formación en Terapia Comunitaria
Underlying values and principles: La TC se basa en cinco ejes: antropología cultural, teoría de la
comunicación, concepto de resiliencia, pedagogía de Paulo Freire y en el pensamento sistémico. Posee
como valores y principios: dejar la dependencia hacia la autonomía, mirar más allá de la falta para valorar la
competencia, creer en el potencial de uno, moverse del unitario hacia el comunitario, ir del privado al
público, rescatar la identidad cultural e integrar el saber popular al saber científico
Knowledge base/ Evidence base: La TC fue creada por el psiquiatra y antropólogo Adalberto Barreto, en
1987, en la comunidad de Pirambu, en la cuidad de Fortaleza – Ceará – Brazil. La principal unidad
formadora, Proyecto 4 Varas – Movimiento Integrado de Salud Mental Comunitaria (MISMEC-CE), se ubida
en esta comunidad. Hoy existen otras 36 unidades formadoras en todo Brazil, donde ya fueron entrenadas
más de 15 mil personas. En 2008, empezó a integrar la Política Nacional de Prácticas Interactivas
Complementares, del Departamento de Atención Básica, del Ministerio de la Salud
Context of intervention/project/work: La formación del terapeuta comunitario posee 360h/a, distribuídas
en 80h/a para aspectos teóricos, 80h/a vivencias terapéuticas, 120h/a prácticas en TC, 80h/a intervisión.
Trás la formación, que deve ser concluída en lo máximo de 2 años, el alumno recibe el diploma de terapeuta
comunitario por la Universidad Federal de Ceará
Methods: La formación del terapeuta puede ser realizada en cualquier unidad formadora de Brasil y posee
una programación que incluye: los ejes de la TC, la prácticas de vivencias terapéuticas que contextualizan
la dimensión humana del participante
Results and Conclusions: La TC puede ser considerada una estrategia para la formación en Promoción
de la Salud, pues valora las competencias del individuo, que se apodera de sus descubiertas y se vuelve
capaz de modificar los determinantes de la salud en beneficio de la propia cualidad de vida
References: BARRETO, A.P. Terapia Comunitária passo a passo. Fortaleza:Gráfica LCR, 2008
Disclosure of Interest: None declared

TP-WED-305 HEALTH EDUCATION AND PREVENTION. INCREASE HEALTH PROFESSIONALS
AWARENESS AND PLAN ACTION RESEARCH INTERVENTIONS
S. Lingua 1 , E. Coffano* 1 , L. Lazzari 2 , G. Corni 3 , A. Fossati 4 , G. Muscolo 5 , F. Furioso 6 , P. Lemma 7 , C. Fiore 8 ,
C. Ronci 8
1 Regione Piemonte, DoRS Centro regionale di documentazione promozione salute, grugliasco, 2 USP
Verbania, Ufficio scolastico provinciale, Verbania, 3 USP Torino, Ufficio scolastico provinciale, Torino, 4 USP
Vercelli, Ufficio scolastico provinciale, Vercelli, 5 Istituto Scolastico, scuola superiore II grado, Mondovì,
6 Istituto Scolastico, Istituto Comprensivo, 7 igiene e sanità pubblica, Università degli studi, 8 USR Piemonte,
Ufficio Scolastico Regionale, Torino, Italy
Background: School must represent a community, taking care of the health status of all its members, even
though the health projects are often episodic. Therefore, a new methodological and organisational
framework is needed for health education/promotion interventions in school, in order to develop actions
implementing the most updated recommendations based on the evidences of effectiveness. These
evidences conceive them as an integral part of the training plans.
The Ministry of Health e and the Ministry of Education, through an Agreement, committed themselves to
define common strategies and to realize an intervention program involving education and health systems in
preventing chronic diseases and facing typical youth phenomenons.
Objectives: To raise the awareness of figures identified as referees for health education by the Regional
and Provincial Offices of Education and by the equivalent figures of the National Health Service, through the
start-up of a specific joint course of information, examination and action- research, aimed at sharing and
disseminating good practices in mutual local realities.
Underlying values and principles: Intersectoral cooperation and network
Instruments sharing
Acknowledgment of skills
Knowledge base/ Evidence base: The start-up of a specific joint course of information, examination and
action- research, aimed at sharing and disseminating good practices in mutual local realities, is based on
evidences of effectiveness taken from national and international scientific literature.
Context of intervention/project/work: The choice of a joint educational course reply to the need of
encouraging the integration health/school for health promotion in the school setting and for the cooperation
of the school in the community setting, through a process of joint action research at local level.
Methods: Educational course divided into three training modules:
1. residential phase (5 days): knowledge and experiences sharing and integration
2. project work (2 months): e-learning and counselling for the implementation of projects in the specific local,
regional and provincial realities.
3. residential phase (2 days): projects sharing and assessment and strengthening of the integrated net for
the following phases of process and outcomes monitoring and check.
The residential phase takes place in several editions, closed to each other, in order to keep down the
number of participants, to promote the interaction and to grant the development of a unit program.
Integrated computer systems are available since the beginning of the course, in order to grant a systematic
update on the information about the project.
Results and Conclusions: During the meeting session, the results will be discussed and they will be
available since June 2010.
Disclosure of Interest: none declared

TP-WED-307 PARTICIPATION IN PLANING AND HEALTH PROMOTION
R. W. Norborg* 1
1 HSE, risk assesment and emergensy prepareness, Norconsult AS, Horten, Norway
Background: Both planning and health promotion, have in common that they treat complex overall
community structures and development conditions (Amdam, R. 2007). Planning and health promotion meet
through national documents and regulations. The meeting take place because of reciprocity benefits. One
meeting point is a common subject to promote participation.
Objectives: The main objective of this study was to investigate the correspondence between ideals and
reality in consideration to participation in planning.
Underlying values and principles: Empowerment planing and health promotion
Knowledge base/ Evidence base: I have been studying two planed cases. I have selected two plan cases
from two different municipals in two different counties. The cases are represented with land use plans.
Context of intervention/project/work: This dissertation has become as a direct result from a co-operation
whit Møreforskning. I have participated in Møreforskning evaluation of the two projects; “Helse i plan” og
“Partnerskap for folkehelse”
Methods: As a part of this case-study it is used qualitative research interview of planners and chief
municipal medical officer. It‟s also done a document study connected to the cases.
Results and Conclusions: Experience from this study can justify that it is a challenge to achieve ideals on
participation in planning. Its a challenge to achieve those communicative rationalities that should be superior
instrumental rationalities in community planning (Friedmann, J. 1987).
This dissertation has demonstrated that it is a challenge to achieve genuine participation in questions that
interfere with either national or local interests.
This dissertation has demonstrated that the ideals of an interdisciplinary planning do not always confirm with
reality.
This dissertation has shown that the wish of effective planning processing can be sacrificed for the ideals of
participation among the population.
Experience indicate that the participation processes is not applicable to a critical analyse or transmission of
knowledge. But participating in planning can be seen as a tool to secure acceptance for the plan and to
decrease later time consuming conflicts.
A settings approach to health promotion may be an appropriate proposal for planning as an instrument for
public health and health promotion. This kind of approach will require that community planning must be
specific for the setting that the plan affects. This entails that a planning process must be based on locale
requirement, conditions, resources and boundaries, and how the community will be affected by this plan.
When embracing this approach, every municipality or local community must be accommodated in this plan.
Local development must be based on opportunities, resources and local knowledge. In this matter, it is
necessary for an empowerment approach, which gives local communities the opportunity to accomplish
these tasks.
In this kind of process, it is important to discuss the plans long-term goal and give opportunity to a critical
discussion of the plans structure and content (Pløger, J. 2002).
References: Amdam, R. (2007) Empowerment evaluation in regional planning and public health. Notat
11/2007. Høgskulen i Volda. Volda. Norway.
Friedmann, J. (1987): Planning in the Public Domain– From Knowledge to Action.
Princeton: Princeton University Press
Pløger, J. (2002) Kommunikativ planlegging og demokrati - nye perspektiver i planforskningen.
NIBR-rapport 2002:17. Oslo. Norway.
Disclosure of Interest: None declared

TP-WED-308 UNE DÉMARCHE PARTICIPATIVE POUR CONCEVOIR UN OUTIL ORIGINAL :
PROFÉDUS «PROMOUVOIR LA FORMATION DES ENSEIGNANTS EN ÉDUCATION À LA SANTÉ »
E. C. I. Collet* 1 , N. Houzelle 2 , D. Jourdan 3
1 Education à la santé, Reseau des IUFM, Chamalières, 2 DDESET, INPES, Paris, 3 Education à la santé,
University Blaise Pascal, Chamalières, France
Background: Réalisé par le Réseau des IUFM pour la formation en éducation à la santé et prévention des
conduites addictives et l‟Institut national de prévention et d‟éducation pour la santé, l‟outil Profédus a
mobilisé, au cours de ses cinq années de conception, près de 190 contributeurs. Destiné aux formateurs
d‟enseignants en éducation à la santé, il renferme des contenus modulaires et variés. Sa diffusion à l‟échelle
nationale est prévue pour 2010. Elle sera accompagnée de formations à son utilisation.
Objectives: Présentation de la méthode d'élaboration partenariale mise en œuvre pour élaborer cet outil de
formation national.
Underlying values and principles: Démarche participative, approche promotion de la santé
Knowledge base/ Evidence base: Cet outil est basé sur les apports bibliographiques relatifs à l'efficacité
de la promotion de la santé en milieu scolaire (par exemple St Leger et al. in D. Mc Queen and C. Jones
2007 ou bien S. Steward Brown 2006).
Context of intervention/project/work: Outil en faveur du développement des compétences des acteurs de
l'éducation à la santé en milieu scolaire.
Methods: La dynamique ayant conduit à la production de l‟outil Profédus a connu trois étapes successives.
La première étape a consisté en la production de ses contenus. De 2004 à 2007, des groupes de travail
composés de formateurs de l‟Education nationale et d‟acteurs issus des secteurs mutualiste, associatif et
sanitaire ont élaboré des contenus pour le 1er et le 2nd degrés utilisables en formation initiale et continue. A
partir de 2007, une seconde étape a permis la validation des éléments produits. Elle a reposé sur l‟activité
de trois comités : un comité de rédaction, un comité de lecture et un comité de test. La troisième et dernière
étape du processus fut caractérisée par le maquettage de l‟outil. Elle a permis, dès 2008, de fixer son
organisation et de mettre en synergie contenus et supports.
Results and Conclusions: Ce processus collectif et complexe a conduit à la naissance d‟un outil appelé
Profédus pour « Promouvoir la formation des enseignants en éducation à la santé ». Il se présente sous la
forme d‟un classeur partagé en quatre supports principaux : un ouvrage présentant des éléments de fond
sur les enjeux de la formation des enseignants en éducation à la santé ; des fiches incluant des exemples de
formations et d‟activités de classe en éducation à la santé, des techniques d‟animation et des outils d‟aide à
l‟élaboration de projets ; un DVD présentant des fiches imprimables, des ressources documentaires et des
séances filmées de formations, d‟activités de classe et de témoignages de professionnels de l‟Education
nationale ; et, enfin, un photoformation.
Profédus est le premier outil complet destiné aux formateurs d‟enseignants en éducation à la santé. Sa
principale spécificité est liée à son mode d‟élaboration qui sera discuté au cours de la communication.
References: St Leger, L., Kolbe, L., Lee, A., Mc Call, D. et Young, I. (2007). School health promotion :
achievements, challenges and priorities. Dans D. Mc Queen et C. Jones (Dir.) : Global perspectives on
health promotion effectiveness. New York, New York : Springer Science and Business Media.
Stewart-Brown, S. (2006). What is the evidence on school health promotion in improving health or preventing
disease and, specifically, what is the effectiveness of the health promoting schools approach. Proceedings of
the WHO Regional Office for Europe, Health Evidence Network. Copenhagen, Denmark : World Health
Organization.
Disclosure of Interest: none declared

TP-WED-309 EDUCACION PERMANENTE COMO ESTRATEGIA DE MONITOREAMIENTO DE LA
FORMACION TECNICA DE ACS EN UNA MACROREGION DE SALUD DEL ESTADO DE BAHIA,
BRASIL.
R. Nascimento* 1
1 Instituto de Saude Coletiva, Universidade Federal da Bahia, Salvador, Brazil
Background: La regionalización es un proceso social que compromete la participación de todos debiendo
producir efectos en la descentralización del Sistema Único de Salud (SUS) en Bahia.
Objectives: Este estudio contribuye a la evaluación de los cursos técnicos de los ACS descentralizados
desarrollados por la EFTS tomando la EPS como estrategia de monitorización de los mismos en el cotidiano
de trabajo de los ACS.
Underlying values and principles: Para fortalecer ese proceso, la Escuela de Formación Técnica de Salud
Profesor Jorge Novis (EFTS) organizo la monitorización los cursos técnicos de forma descentralizada,
conforme al Plan Director de Regionalización, y con base en la Educación Permanente en Salud (EPS).
Knowledge base/ Evidence base: Esta modalidad de organización tiene por fin conocer las
particularidades locales y regionales para dar énfasis al acompañamiento de la formación profesional en
esos cursos, dirigidos al aumento de la escolaridad de los trabajadores, la educación técnica, la
transformación de la práctica de atención y fortalecimiento de la promoción de la salud, buscando la
autonomía de las personas en la producción de salud.
Context of intervention/project/work: En esta dirección, la EPS fortalece el aprendizaje apoyando el
protagonismo de las personas en la construcción de los conocimientos, habilidades y actitudes.
Methods: El locus del estudio es la macro región sudoeste con setenta y tres municipios y seis direcciones
regionales de salud (DIRES). El trabajo conjunto con las DIRES promovió espacios de EPS, dialogando con
los gestores y coordinadores locales de los cursos para la identificación y análisis colectivo de los nudos
críticos enfrentados por los cursos técnicos de los ACS, discutiendo las atribuciones y competencias de
cada esfera protagonista de la acción. Posteriormente fueron programados las capacitaciones a los
docentes locales y el acompañamiento de los cursos en las dimensiones técnico-pedagógica, políticoadministrativa
y ética.
Results and Conclusions: Fueron capacitados 162 docentes de 22 municipios y se dio inicio a 8 cursos
con 140 grupos de ACS en total en el año 2009 representando el 30% del total de municipios, superior al
porcentaje alcanzado en el 2008. Se percibe el potencial de la EPS en la monitorización de los cursos
descentralizados de técnicos de ACS, en cuanto al análisis de los nudos críticos este proporciona la
identificación colectiva de posibilidades para la construcción de estrategias para enfrentar las dificultades, lo
que permite cambios en la monitorización de los cursos, calificación del trabajo de los ACS revirtiéndose en
mayores resultados para la comunidad.
Solamente es posible cambiar la forma de cuidar la salud de la población si cambia también los modos de
enseñar y aprender tomando el trabajo como eje del proceso educativo. En ese contexto la EPS está en el
cotidiano de las personas y organizaciones, se presenta como un excelente dispositivo para monitorear la
formación técnica, para ampliar la capacidad local y regional, en la perspectiva de la promoción de la salud.
References: CECCIM, R. B.; ARMANI, T. B. Educação na saúde coletiva. Divulg. Saúde Debate, n.23,
p.30-56, dez.
2001.
CECCIM, R. B.; FEUERWERKER, L. O quadrilátero da formação para a área da saúde: ensino, gestão,
atenção e controle social. Physis - Rev. Saúde Coletiva, v.14, n.1, p.41-65, 2004.
FREIRE, P. Educação como prática da liberdade. 19.ed. Rio de Janeiro: Paz e Terra, 1989.
Disclosure of Interest: R. Nascimento, ISC/UFBA, None declared

TP-WED-310 MODÉLISER LA COMPLEXITÉ DES PRATIQUES D'ÉDUCATION THÉRAPEUTIQUE
A. Le Rhun* 1 , P. Lombrail 1
1 Pôle d'Information Médicale et d'Evaluation en Santé Publique, CHU de Nantes, Nantes, France
Historique / Origines: Le développement récent des programmes d‟éducation thérapeutique a généré des
tensions chez les soignants en lien avec la mise en œuvre de nouvelles pratiques éducatives.
Objectifs: Cette recherche visait à comprendre la nature de ces nouvelles tensions et à modéliser les
interactions entre les représentations et les pratiques des soignants en jeu dans ces tensions.
Valeurs et principes sous-jacents: Cette recherche s‟est inscrite dans les courants de pensées
cognitiviste, phénoménologique et socioconstructiviste.
Fondement de connaissance/Fondement de preuve: Il s‟agit d‟une recherche exploratoire qualitative.
Contexte d'intervention/projet/travail: Ce projet multicentrique (Nantes, Paris, Bruxelles) a été mené par 3
équipes de recherche impliquées par ailleurs dans la formation et l‟accompagnement des équipes
soignantes pour le développement de l‟éducation thérapeutique. Cette communication présente uniquement
les résultats de la recherche « nantaise ».
Méthodes: Des entretiens semi-directifs de 2 heures ont été réalisés auprès d‟un échantillon varié de
soignants participant à un programme d‟éducation thérapeutique, suivis d‟une analyse qualitative
thématique. A Nantes, 27 professionnels impliqués dans 20 programmes éducatifs différents, dont une
majorité de femmes infirmières et médecins, travaillant en milieu hospitalier, ont été interviewés d‟avril 2008
à mars 2009.
Résultats et Conclusions: Le modèle qui s'est dégagé montre l‟importance des facteurs psychosociaux, en
sus des représentations des soignants sur leurs rôles et objectifs en éducation thérapeutique, et notamment
les facteurs suivants: la balance bénéfices/inconvénients attendus d‟une pratique, le sentiment
d‟autoefficacité du soignant et la faisabilité perçue du changement, les tensions ressenties du fait de
l‟absence de cette pratique et les nouvelles tensions vécues suite à sa mise en place.
Ce modèle s‟inscrit dans un paradigme de complexité (E. Morin), par deux caractéristiques:
- le principe de rétroactions : la pratique « expérimentée » influe les anciennes représentations qui influent à
nouveau la pratique, etc.
- le principe dialogique : ce modèle intègre les contradictions, les tensions perçues nées de l‟existence de
plusieurs logiques co-existantes chez un même soignant-éducateur.
Ce modèle exploratoire, en tant qu‟outil de réflexion sur les facteurs influençant les pratiques
professionnelles, peut servir de base aux échanges entre chercheurs et praticiens afin de pouvoir penser,
dialoguer et négocier avec une réalité complexe. Une recherche complémentaire est en cours pour valider
ce modèle.
Références: Edgar Morin,Introduction à la pensée complexe. Points Essais, Editeur Points, 2005.
Conflit d'Interêt: "Rien à déclarer"

TP-WED-311 TRAIN-THE-TRAINER APPROACHES: WHAT ARE THE CRITICAL SUCCESS
FACTORS?
E. H. Howze* 1 , J. Fonseka 2
1 Coordinating Office for Global Health, Centers for Disease Control and Prevention, Atlanta, United States,
2 Division of Cancer Prevention and Control,
Background: Since its inception in 1992, the Sustainable Management Development Program at the
Centers for Disease Control and Prevention (CDC) has used a train-the-trainer (TTT) approach to build
training capacity for public health management in low and middle income countries. In 2009, we undertook a
review of the evidence related to training-of-trainers interventions as part of a larger program assessment
and strategic planning process.
Objectives: 1. What is the evidence associated with the effectiveness of TTT intervention strategies?
2. What are the critical success factors that TTT interventions should employ?
Underlying values and principles: 1. The CDC is committed to employing and recommending evidencebased
practices in building public health capacity.
2. Country ownership and sustainability are key.
Knowledge base/ Evidence base: This presentation reviews the evidence base for TTT and defines critical
success factors identified through a review of the literature. TTT is an educational model where an
organizing institution that houses content and training expertise identifies potential trainers with ties to
institutions or communities. The trainers are provided with the content, instructional tools, and guidelines to
train others.
Context of intervention/project/work: TTT approaches have been widely used for the purpose of
extending the reach of health and other programs. In public health TTT approaches are used to help assure
that populations have access to prevention, detection, treatment programs.
Methods: We searched the public health, health, business, and education literature for "train-the trainer"
programs and approaches. We asked 5 questions:
1. Did TTT increase knowledge of trainees in the subject matter and in their perceived ability to impart
knowledge and skills to others?
2. Did the trainees implement training programs,i.e., what happened after the training?
3. What was the quality of the training conducted by the trainees and to what degree did they maintain
fidelity to the original training they received?
4. What effects did the training by the trainers have on the recipients of the training, i.e., KAB, organizational
changes?
5. How cost effective was the TOT approach?
Results and Conclusions: Reports in the literature varied widely in how TTT approaches were described
and evaluated. Evaluations often relied on self-reports by trainers and trainees. Trainers and those they
trained reported KAB gains. There was wide variance (from 10%-90%) in the percentage of trainers who
actually went on to train others. There was limited evidence about the extent and quality of trainings the
trainers provided to others. The literature provided examples of the impacts of TOT from changing provider
practices to prevent perinatal HIV transmission to improved access to HIVAIDS counseling and testing. We
identified critical success factors in 4 areas - training and curriculum delivery, trainer selection, institutional
characteristics, and technical assistance and support.
Disclosure of Interest: E Howze, Centers for Disease Control and Prevention, employee, none declared
J Fonseka, Centers for Disease Control and Prevention, employee, none declared

TP-WED-312 ISSUES OF PERSONAL AND PROFESSIONAL PREPARATION FOR FUTURE HEALTH
PROMOTION AND HEALTH EDUCATION PROFESSIONALS
Z. Yager* 1
1 Faculty of Education, La Trobe University, Bendigo, Australia
Background: The dual rise in eating disorders and obesity has meant that the general population in
developed nations are more aware of weight than ever before. A range of health promotion professionals,
including school health and physical education teachers, are given the difficult task of implementing health
promotion programs in this area, yet several issues may impair their abilities in this role.
Objectives: This paper aims to discuss the issues of personal weight loss behaviours (including dieting and
disordered eating and exercise problems) and the potential for weight bias among university students in the
fields of health promotion and health education.
Underlying values and principles: Individuals in health promotion are in a unique position in that their
professional competence is often judged by their personal appearance. In addition, individuals with existing
body image and eating problems may be attracted to careers in health due to their own preoccupation with
food and exercise (Kinzl et al., 1999). The social norms present in groups of undergraduates interested in
health may also reinforce and worsen disordered behaviours (Crandall, 1988).
Knowledge base/ Evidence base: Those enrolled in food and exercise related university programs have
been found to have significantly higher levels of dieting, disordered eating and exercise disorders than the
general population (Kinzl et al., 1999; Yager & O'Dea, 2009). In addition, training in health promotion does
not protect these individuals against weight bias, and the nature of their profession may increase this stigma
(Teachman & Brownell, 2001).
Context of intervention/project/work: If health promotion professionals possess a combination of these
personal behaviours and weight bias, they may not be successful in the design and implementation of
programs to promote healthy weight.
Methods: The author implemented two versions of a combined self esteem, media literacy and cognitive
dissonance intervention programs to trainee physical and health education teachers and compared the
results to a control group.
Results and Conclusions: It was found that the internalisation of body ideals and disordered behaviours in
the intervention groups were reduced at post test and held at follow up. Several options for expanding the
focus of these programs, and including weight bias interventions also exist. It is imperative that health
education and health promotion staff are personally and professionally prepared for their role if we are to
move forward in promoting healthy weight and preventing obesity and eating disorders.
References: Crandall, C. S. (1988). Social contagion of binge eating. J Pers Soc Psychol, 55, 588-598.
Kinzl, J., et al. (1999). Dieticians: Are they a risk group for eating disorders? Eur Eat Dis Rev, 7, 62-6.
Teachman, B. A. & Brownell, K. (2001). Implicit anti-fat bias among health professionals: Is anyone immune?
Int J Obesity Rel Metabol Disord 25: 1525-31.
Yager, Z., & O‟Dea, J. (2009). Body image, dieting and disordered eating and activity practices among
teacher trainees. Health Education Research, 24(3), 472-482.
Disclosure of Interest: None declared

TP-WED-313 MEASURING EMPOWERMENT OF STUDENTS ENGAGED IN COMMUNITY OF INQUIRY
IN HEALTH
B. Beric* 1 , M. Troiano 1
1 Marjory K. Unterberg School of Nursing and Health Studies, Monmouth University, West Long Branch,
United States
Background: Community of inquiry as a discussion method of engaging students has been introduced in
health education classes. It is a five-step discussion method, modeled after the inquiry in philosophy for
children (P4C). Evaluating the effectiveness of this teaching/learning method may present a challenge to
teachers who subscribe to this method in their classes.
Objectives: 1. define community of inquiry, by identifying the five steps in developing one
2. identify three separate scales within the instrument for measuring students‟ perceptions
3. discuss reliability and validity of the instrument Classroom Experiences: Student Questionnaire
4. discuss implications for community of inquiry teaching/learning method in health promotion globally
Underlying values and principles: The instrument is designed to measure constructs of Psychological
Empowerment theory applied in health education classes: intrapersonal (e.g., learning style), interactional
(e.g., perceived control), and behavioral manifested in action (e.g., participation in class discussion),
therefore, measuring empowerment in college health classes.
Knowledge base/ Evidence base: Studies conducted in undergraduate general student population, and in
undergraduate and graduate nursing student population, employed the Classroom Experiences: Student
Questionnaire, an instrument to measure students‟ perceptions about participation in class discussion,
perceived control and learning in health education classes.
Context of intervention/project/work: Undergraduate and graduate college health classrooms.
Methods: Cross-sectional survey, Chronbach Alpha and Delphi Method.
Results and Conclusions: Results: The relationship between Perceived Control (PC) and Participation in
Class Discussion (PCD) has been consistent throughout, with Pearson correlation positive and statistically
significant, varying between 0.26 and 0.39. Reliability of the PCD Scale, measured by Cronbach Alpha has
been steadily above 0.8 for all undergraduate and graduate groups of participants, while Chronbach Alpha of
the PC Scale varied between 0.69 and 0.71. The content validity of the PCD scale was determined
employing the Delphi Method with four experts in the field. The authors of the original PC Scale did not
report validity of the scale.
Conclusions: 1. Discussion in community of inquiry is empowering method in learning about health. 2. The
Classroom Experiences: Student Questionnaire, is a reliable instrument for measuring empowerment in
college classes. More studies are needed to complement validity of the scales in the instrument.
3. Discussion in community of inquiry about health is a democratic process that appears to be the least
oppressive and most effective in reaching the health promotion outcomes manifested in voluntary behavior
change by individuals and groups of people, allowing all to attain optimum health as a basic human right.
Disclosure of Interest: None declared

TP-WED-314 TEAM LEARNING AND GROWTH INDICATORS FOR THAI HEALTH-PROMOTING
TEAMS: A CASE STUDY OF SWEET ENOUGH NETWORK
P. Chatiketu* 1
1 Department of Family and Community Dentistry, Faculty of Dentistry, Chiang Mai University, Chiang Mai,
Thailand
Background: The revolution of health promotion concepts at the global level and the changing of Thai
national health policies had impacted on health organizations and health personnel in Thailand. Thai Health
Promotion Foundation (ThaiHealth) was established to react to these changes. ThaiHealth managed and
organized its structures through team-based work structure. The indicators for measuring team performance
may reflect the organizational management. It is a challenge to create team performance indicators that
were unique, formalized and usable.
Objectives: This study identifies, develops and verifies team learning and growth indicators for Thai healthpromoting
teams.
Underlying values and principles: The balanced scorecard was used as a measurement approach to team
performance and knowledge management.
Knowledge base/ Evidence base: The performance-based budgeting system was set to indicate and
measure performance specifically for the ThaiHealth organizational level; however, there were no indicators
for measuring performance at the team level
Context of intervention/project/work: This study selected provincial health-promoting teams from the
Sweet Enough Network as samples. Teams in this study managed themselves autonomously as selfdirected
teams. Each provincial team generated practical knowledge on how to work with the different
partners. They volunteered to promote health and to launch the program.
Methods: Qualitative methods were selected to collect data from six health-promoting teams of the Sweet
Enough Network. These teams had joined the network for 3 years and team leaders worked in the Public
Health Provincial Offices. The balanced scorecard used in non-profit organizations was modified as a
guideline to develop team performance indicators. Data were collected from in-depth interview of 16 team
leaders and 17 team partners, 16 participant observations and documentary analysis. The indicators were
verified by using peer review via the questionnaire, interview and focus group discussion. According to the
balance scorecard, there were five perspectives for team performance. This study selected only team
learning and growth perspective which included indicators to present for reflecting team performance.
Results and Conclusions: Team learning and growth indicated through team leaders‟ skill improvement,
information technology system and knowledge management for team. The indicators included: number of
academic papers created by leaders, number of training days for leaders, percentage of team members
using knowledge sharing through IT system, number of best practice model and number of learning forum at
team level. These indicators revealed that each team learned and grew differently. The indicators in this
study linked to the teams‟ strategies and were systematically developed. However, these indicators were
quantitative and the quality of team performance required intense confirmation in detail.
Disclosure of Interest: None declared

TP-WED-316 OTOP GROUP WORKSITE INVESTIGATION: A CASE STUDY OF PARTICIPATORY
ERGONOMICS INTERVENTION IN KHANGKOI DISTRICT, SARABURI PROVINCE, THAILAND
P. Hongsranagon* 1 , Y. Samana 2 , B. Charum 3
1 College of Public Health Sciences, Chulalongkorn University, 2 Occupational Health, Rajaprachasamasai
Institute, Ministry of Public Health, Bangkok, 3 Industrial Engineering, Faculty of Engineering, Rajamangala
University of Technology Lanna, Chiangmai, Thailand
Background: This project investigated the prevention of injury in a small-scale community-based enterprise,
One Tambon One Product (OTOP). The major health problems recorded by OTOP workers are
musculoskeletal ones giving rise to pain and absenteeism.
Objectives: : The aim of the project was to establish a health promotion scheme to develop workers‟
awareness of prevention of pain. The project was phase one of an investigation of work-related
musculoskeletal disorders (WMSD) among OTOP workers using the principle of Occupational Safety and
Health (OSH) by the United States National Institute of Occupational Safety and Health (NIOSH).
Underlying values and principles: Health promotion involving local organizations sought to improve
workers‟ physical, mental, and social health at the workplace. Local stakeholders from the public sector were
involved to achieve the fulfillment of “yielding support to and promotion of good quality of life among local
residents.”
Knowledge base/ Evidence base: At the beginning of the project, the workers‟ WMSD status was
assessed and a knowledge-attitude-practice (KAP) survey was administered to managers and workers to
monitor the effects of risk-reduction measures on workers‟ health. An investigation of the workplace was
made by a check-list of improvement activities and an analysis of the groups‟ workflow providing data related
to the groups‟ history, physical environments, and work physiology.
Context of intervention/project/work: The study site was located in Khangkoi in Saraburi province.
Twenty-six groups participated in the project, their products including handicrafts, food and drink, garments,
bricks, and stoves. Data collection took place in October-November 2009 (ethical review COA no. 115/2552).
Methods: Inspections, observations, interviews, and questionnaires were used to collect data related to
WMSD. Also, a KAP survey was completed by managers and workers to gauge understanding of OSH in
general and OSH practices in particular.
Results and Conclusions: Saraburi OTOP groups‟ labor is of a low intensity and about 15% of the workers
reported WMSD at a moderate level. They complained about lower back and shoulder pains due mostly to
lengthy periods of time sitting. The KAP survey demonstrated the managers‟ good understanding about
ergonomics principle in general and ergonomics practice in particular and the workers‟ good knowledge and
attitudes on ergonomics. However, their practice regarding ergonomics and OSH required improvement. The
second phase will focus on the identification of WMSD risk factors and workers‟ physiology in terms of
posture, repetition, force, and duration, providing the groundwork for future intervention, evaluation, and
establishment of guidelines for ergonomics program management of each OTOP production line.
Disclosure of Interest: None declared.

TP-WED-317 THE RELATIONSHIP BETWEEN JOB SATISFACTION AND WORKERS MENTAL
HEALTH: AN INTEGRATIVE REVIEW.
V. V. Silva 1 , I. A. Nascif Junior 1 , C. M. L. Bittar Bueno* 1
1 Programa de Maestría en Promoción de la Salud, Universidad de Franca - UNIFRAN, Franca, Brazil
Antecedentes: Many and increasing are the existing and available scientific studies on workers health,
however, these studies provide a range of information that need to be transformed into a knowledge course,
organized and synthesized.
Objetivos: To achieve this goal, was held an integrative literature review of studies that establish the
relationship, published in the Virtual Health Library (VHL) in Portuguese, English and Spanish, from crosses
between the descriptors job satisfaction and occupational mental health, workers mental health and job
satisfaction, in the years 1997 to 2007.
Valores y principios subyacentes: In this scenario, the challenge is to seek, analyze and synthesize the
scientific evidence on the relationship between job satisfaction and Brazilian workers mental health, which
can be justified by the importance that this relationship appears to be in the context of health promotion.
Base de conocimiento / base de evidencia: It is believed that the quest for workers health promotion must
be guided in a "look" at the organizational elements constituents of satisfaction at work, because of its
impact on workers mental health.
Contexto de la intervención / proyecto / trabajo: The search in workers‟ health promotion is still a field of
knowledge in construction, where there is shortage of researchers in the field.
Métodos: There were 152 (one hundred and fifty-two) studies, while only 26 (twenty-six) met the criteria for
inclusion set. Of these, 16 (sixteen) studies are repeated in more than one database and/or in the two
searches conducted, and one (1) study was not available after contact with the authors. So were included 8
(eight) studies.
Resultados y Conclusiones: From the data found, it appears that there is a statistically significant
association between job satisfaction and workers mental health. Clearly the fact that situations of pleasure /
job satisfaction, are related to good capacity for work, and the best tables of health, particularly with regard
to mental health. In contrast, situations where the work leads to suffering / dissatisfaction, increase to the
negative impacts on the mental health of the worker (with emphasis on the Burnout Syndrome, depression
and anxiety).
In this sense, it is believed that organizations that seek to promote the health of their workers, should
consider the practical knowledge of workers and, through the practice of empowerment, to develop more
autonomy and involvement in the process of work and with their own quality of life and health, and, from then
you can talk about promoting workers health.Therefore, it is suggested the holding of longitudinal studies on
the subject not found, in multidisciplinary teams, to investigate the causal direction of the associations found.
In addition to research, it is believed that there will only be able to intervene and change the reality in the
quest for promoting workers health from the effect of such knowledge in practice achieved in searches.
Declaración de intereses: no declarado.

TP-WED-320 HEALTH RELATED QUALITY OF LIFE AMONG HOSPITAL PERSONNEL OF THE
HELLENIC NETWORK OF HEALTH PROMOTING HOSPITALS
D. Triantafyllou* 1 , C. Tzavara 1 , F. Filippidis 1 , A. Prokopi 1 , S. Schoretsaniti 1 , E. Giannopoulou 1 , Y. Tountas 1
1 Center for Health Services Research, Medical School, University of Athens, Athens, Greece
Background: The investigation of the Health Related Quality of Life among among hospital personnel is
important in order to design and implement effective health promotion programs.
Objectives: To assess Health Related Quality of Life (HRQoL) among a representative sample of Greek
hospital employees and to explore its association with socio-demographic characteristics.
Underlying values and principles: The study is the first to test Health Related Quality of Life (HRQoL)
among Greek hospital personnel in order to recognize significant issues that affect Health Related Quality of
Life (HRQoL), to reduce inequalities among different personnel categories and to guide efforts for improving
hospital personnel health.
Knowledge base/ Evidence base: In the last two decades researchers have paid much more attention to
important aspects like health related quality of life. Studies have shown that socio-demographic
characteristics have an important impact on health related quality of life.
Context of intervention/project/work: This cross – sectional study was conducting within the framework of
Health Survey of hospital personnel of the Hellenic Network of Health Promoting Hospitals (HNHPH).
Methods: The validated Greek version of SF-36 questionnaire was administered to a stratified random
sample of 720 employees of 13 Health Promotion Hospitals (HNHPH).
219 (31,1%) of the sample were men, whereas 486 (68,9%) were women. Data analysis, using SPSS based
on SF-36 Interpretation Guide, examined differences by age, sex and personnel category (medical,
administrative, nursing, technical and auxiliary personnel).
Results and Conclusions: The mean score for Physical Functioning was 84.3, for Role Physical 75.2, for
Bodily Pain 69.6, for General Health 66.7, for Vitality 62.3, for Social Functioning 69.7, for Role Emotional
74.7 and for Mental Health 66.7.
As far differences in HRQoL between male and female sex are concerned, women reported significantly
(p

TP-WED-322 PSYCHO-SOCIAL STRESS / MOBBING AND HEALTH PROMOTION
K. Schiller-Stutz 1
1 Geschäftsleiter, PPP, Hedingen, Switzerland
General description: Reintegration of a sick employee suffering from a mobbing-situation
Method
In the Workshop you will learn to analyze the „psycho-social stress and mobbing dyna-mics“ in a team, and
what's to do to reintegrate a sick employ in a team. So it's necessary to organize a „team coaching in health“
that the employees are able to develop more constructive coping mechanisms, and working more productive
and effective – and the sick employe had to leave the victim role behind (Schiller-Stutz, IZA, 2007).
Thesis
In Europe the biggest challenges in the areas of workplace safety and health are stress at work, resulting in
adverse health effects, as well as the increase of violence and mobbing at work (see the report oft he
European Agency for Workplace Related Safety and Health, 1/30/2008). The EU-report (Andersson, 2001)
states that deficiencies in business organiza-tion, information and management,as well as unsecure
employment and longtime unsolved organizational deficiencies, all lead to the main reasons for mobbing and
relating to individuals as scapegoats for organizational problems.
It is a win-win situation for those affected, as well as companies and our society in general, to reintegrate
employees in their workplace, who fell sick because of psychosocial stress or a mobbing situation. Affected
individuals often get diagnosed with a maladjustment diso-der and are given sick notes for an extended
amount of time. Senior employees (from 45 years old) are more often affected by mobbing than others, and
as a consequence, take the early retirement route more often (Meschkutat et al., 2002). In Switzerland, right
now, we see more frequent reports about health damages and illnesses, as a result of the overall increase of
workplace related to psycho-social stress and mobbing. This leads to more days of absence from work, more
use of prescription and other drugs, and more consultations with physicians (Swiss Bureau for Economy,
seco, 2002). Mobbing gives rise to substantial costs for employees, companies and the society because of
missed time at work, sickness, decreased performance, interrupted work flow and may be a damaged image
for the company. Projections for Switzerland show that the economic costs for mobbing are between 8 to 13
billion Euro.
Rational: Conclusions
Psycho-social stress and mobbing can be overcome with the help of a health professional, and those
affected can learn how to cope in a constructive way in order to be integrated back in their original
workplace. The sooner the early detection of mobbing occurs and the sooner an individual consults a health
professional (physician or psychologist), the better the chances for a successful reintegration. The attitude
and outlook of superiors and the management will make all the difference.
Learning objectives: To Analyze psychosocial stress and mobbing dynamics and how to manage health
promotion in a team
Expected results: Participants learn a constructive way to manage psychosocial stress and mobbing in
teams

TP-WED-323 VALIDATION OF AN ITALIAN QUESTIONNAIRE FOR WORK RELATED-STRESS RISKS
ASSESSMENT: STUDY PROTOCOL AND PRELIMINARY RESULTS
I. Carosi* 1 , M. Scatigna 1 , I. Corradini 2 , S. Chirilli 2 , V. Martinez 1 , M. Pericoli 2 , A. Fiorenzani 2 , L. Fabiani 1
1 Internal Medicine and Public Health, University of L'Aquila, L'AQUILA, 2 Themis s.r.l., ROMA, Italy
Background: The recent studies at international level demonstrated that the stress can have a considerable
effect in term of workers‟ suffering besides of production and health sector costs. In Italy the work-related
stress became an important issue within the work-place safety and health assessment from 2008 (D.Lgs
81/2008).
Objectives: The study is aimed at validate a questionnaire for work related stress risks in Italian workers,
named P.R.I.S.M.A. an acronym for the five dimensions to assess: Person, Resources, Integration, Safety,
Motivation, Environment.
Underlying values and principles: Holistic approach to the individual and community health, involving all
the potential areas of quality of life and health, specifically the work-site wellness and its health
consequences. The study start from setting-based health promotion, but needs intersectorial approache and
competencies: psychological, medical and statistical.
Knowledge base/ Evidence base: Recently, the specific questionnaires, scales and inventories have been
created and applied in different countries with the aim to define risk-indicators.
The UK Health Safety Environment Authority identified six factors determining the stress in work experience:
demand, control, support, interpersonal relations, role and changes.
Context of intervention/project/work: Work-site setting, both public and private sectors, in relation to
public health approaches, aims and potential interventions.
Methods: The validation consists in psychometric properties and stability evaluation, by means of test-retest
design administration.
The questionnaire is composed of 100 questions, in form of Likert scales. Two drafts were tested (originallyform
and parallel form) differing for general organisation and order of questions, with the aim to verify the
true dimensionality of scales regrouping single items.
The statistical analyses consist in the multi-items scales dimension evaluation by means of: the Explorative
Factorial Analysis (EFA) to detect the different dimensions and corresponding items; the internal consistency
analysis (i.e. Cronbach alpha, item-scale correlation) to measure the coherence into different scales; the
Confirmatory Factorial Analysis to test the applicability of dimension structure of the questionnaire between
different sub-groups of workers (i.e. by gender, by age, by different kind of employment).
The test-retest correlation will make us able to assess the stability, one of the reliability components useful to
test if the questions are clear, univocal and coherent with the contents.
Results and Conclusions: 105 workers, in all, filled the two drafts of questionnaire in the November 2009,
105 at test and 100 at the retest. The administration was anonymous and the linkage of two questionnaire
(test-retest) for the each subject has been performed by means of a secret code.
The data are inputting in a electronic database and will be analysed with STATA and SPSS software.
This experience, starting from a scientific approach, provides useful instruments and methods in the field of
work related health determinants, that is one of the major basis of setting-based Health Promotion both in
terms of reliable monitoring and in terms of right interventions‟ programming.
Disclosure of Interest: None declared

TP-WED-324 DIFFERENCE IN JOB STRESS AND SOCIAL SUPPORT BETWEEN SMOKERE AND
NON-SMOKERS IN JAPANESE WORKSITES
K. Tomiyama* 1 , A. Saruyama 1 , Y. Haruyama 2 , T. Muto 2
1 Health Manegement, Departmentstore Health Insurance Association, Tokyo, 2 Department of Public Health,
Dokkyo Medical University of Medicine, Tochigi, Japan
Background: With the Health Promotion Law in 2003 and joining the Framework Convention on Tobacco
Control in 2005, “Guidelines for tobacco use in business organizations” were promulgated by the Ministry of
Health, Labour and Welfare in Japan. These guidelines suggest that there is a need to systematically act
from the perspective of ensuring the health of workers and facilitating the creation of pleasant working
environments. Recently, the smoking prevalence in Japan has decreased slightly; however, it is still high
among developed countries; this rate is 40% and 13% among males and female. In addition, the smoking
prevalence among employees is higher than that among community residents in Japan.
Objectives: To assess the association between smoking behaviors and job stress and offer evidence of
smoking cessation, a cross-sectional study was implemented.
Underlying values and principles: Orientation towards smoking cessation
Knowledge base/ Evidence base: Knowledge based on a cross-sectional study
Context of intervention/project/work: Legal bases
Methods: A self-reported questionnaire survey was conducted among 2903 employee at three worksites of
Departmentstore Health Insurance. Of the 1916 (66%) respondents, 1849 (64%) responses were considered
valid after excluding those with missing values for gender, age, smoking state and job stress. The subjects
comprised of 839 (45.4%) males and 1010 (54.6%) females, and the average subject age was 39.9 (SD11.7)
yr. for males and 44.9 (12.2) yr. for females, respectively. Job stress and social support were assessed using
job stressors (17 items), psychological distress (18 items), physical complaints (11 items), superiors (3
items) and co-workers (3 items) on the Brief Job Stress Questionnaire (BJSO). The items were rated on a 0-
1-2-3 point Likert scale, ranging from 0=strongly disagree to 3=strongly agree. Binary variables were divided
by the median of each subscale. After adjusting for gender, age, work-related factors, associations with the
variables of job stress and smoking status were analyzed by a multiple logistic model.
Results and Conclusions: Smoking prevalence was 35.0%, 49.0%, and 23.5% for respondents overall,
males, and females, respectively. The highest smoking prevalence was 53.5% in the 30s and 58.9% in the
40s for males, and 28.3% in the 40s and 27.0% in the 50s for females. These findings indicate that smokers
showed significantly higher scores for job stressors (quantitative and qualitative demand, physical load, and
poor human relations and environment), psychological distress (irritability, fatigue, anxiety, depression), and
physical complaints compared to those of non-smokers. Furthermore, smokers had lower scores for
superiors and co-workers. Individuals who are smoking have 1.53 times the odds for high job stressors
compared to the odds of those who do not smoke, after adjusting for gender, age, employment, shift, work
position and hours. In conclusion, job stress reduction would likely be important for smokers in smoking
cessation programs.
Disclosure of Interest: None declared

TP-WED-325 MULTIPLE ROLES AND LEISURE-TIME PHYSICAL ACTIVITY AMONG WORKING AGE
WOMEN: TESTING ROLE STRAIN AND ROLE ATTACHMENT THEORIES.
M. Chao* 1 , T. Chiang 1 , F. Pai 2
1 Institute of Health Policy and Management, College of Public Health,, National Taiwan University, Taipei,
2 Graduate schools of material science., National Yunlin University, Yunlin, Taiwan
Background: In tradition point,natural role for women is wife and mother
employee is unnatural women's role. Now,more and more women have multiple roles. Many study showing
cultural value are related to multiple role‟s,and role combinations related to women's health.
Objectives: This research aimed to assess associations between leisure-time physical activity variations
and different role combinations among working age women in Taiwan. Secondly, I tested the applicability of
two theories: the multiple role strain hypothesis and the multiple attachment hypothesis to explain women‟s
physical activity.
Underlying values and principles: Definition of multiple role is women have both job and family role.Family
role included marriage or parenthood.
The definition focus on the combination of roles in two domain not on the number of roles people have.
Knowledge base/ Evidence base: Previous studies suggest that marriage is supportive of
good health. This is likely to be due to social supports and material advantages of marriage. Poorer health of
unmarried women may relate to the selection in the „marriage market‟ since women with poor health may be
less likely to marry. Employment status as well as the material and socioeconomic position vary between
different societies, and this is likely to contribute to the variations in the health status of women with different
family and parental statuses. Non-employed women, including housewives and unemployed, may have
difficulties finding a job if their health is poor.The reason for multiple roles linked with good health:first,social
active people may experience fewer health risks overall than non-active people;Secondly,people with job or
family responsibility may become less sensitive to symptom and less curative care;Finally,healthy people
may be more willing and able to engage in the roles- a social selection effect.
Context of intervention/project/work: Multiple roles included role combination, the role of daughter-in-law,
and number of children. Role combinations were categorized into eight groups: “married, with children,
employed”, “married, with children, unemployed”, “married, without children, employed”, “married, without
children, unemployed”, “Lone mother, employed”, “Lone mother, unemployed”, “Single, employed”, “Single,
unemployed”. Leisure-time physical activity was measured by engagement in any leisure-time physical
activity in the past two weeks.
Methods: Data came from the 2001 National Health Interview Survey, with 4,357 working age women (20-
49 years) participating in the study. Data were analyzed by description statistics and multivariable
regression.
Results and Conclusions: The result of demographic statistics showed that women‟s LPA increased with
age, education and income, and decreases with increasing ADL difficulties. In terms of marital status and
family type, single women tend to be employed while married women prefer being housewives. Women,
whether married or not, tend to be housewives when they have more children. The multivariate regression
analysis indicated that compared with women married, with children, and employed, groups of “married with
children, unemployed” and “married, without children, employed” tended to have higher LPA; compared with
women without children, increased LPA prevalence was found among women having two or more children.
However, when analyzed in role combination situation, having children became an interfering factor. In role
combination analysis, employment had a stronger effect than parenthood role. There was no correlation
between the role of daughter-in-law and women‟s LPA.
This study concluded that multiple roles strain hypothesis was associated with women‟ s LPA. Therefore, to
enhance women‟s LPA, policies can be oriented to (1) create a LPA-friendly working environment and (2)
support working women with child care services.
Disclosure of Interest: None declared

TP-WED-326 INTEGRATING THE WORKFORCE OF COMMUNITY HEALTH WORKERS AS
ESSENTIAL PARTNERS IN EFFECTIVE HEALTH PROMOTION, HEALTHCARE UTILIZATION, AND
COST REDUCTION
G. G. McCray* 1
1 Department of CHPM, Morehouse School of Medicine, Atlanta, United States
Background: The history of Community Health Workers (CHWs) has been rooted in self-preservation and
self-reliance the world over for centuries. CHWs are known by over 60 names including promotoras de
salud, client navigators, and Health Outreach Workers. In the United States, for at least the past four
decades, CHWs have played a major role in bridging gaps between healthcare providers and
underserved/uninsured/underinsured populations.
Objectives: (1) To discuss how Community Health Workers (CHWs)have been shown to be an important
asset in reducing unnecessary suffering from chronic diseases, and reducing and controlling healthcare
costs and (2) To discuss our rationale, process, outcomes, challenges, and successes in establishment of a
statewide Network of CHWs in the USA .
Underlying values and principles: Healthcare costs in the U.S. surpassed $2.2 trillion annually in 2007,
eight times more than the $253 billion in 1980 (KFF, 2009). In 2003, than two-thirds of Americans over age
65 with insurance received the insurance through their employers, but that number is declining as the costs
skyrocket. During difficult economic times, the weaknesses in the U.S. system of healthcare are exposed,
and the need for the contributions of CHWs is made clear. More people have become unemployed, reaching
its highest rate in more than 25 years. The number of CHWs grew 41% from 2000 to 2005, and there is still
no formal recognition of this valuable workforce. CHWs can help to reduce costs through encouraging better
decision-making, more engaged self-management of disease, and more effective utilization of resources.
Knowledge base/ Evidence base: CHWs are well-trained to provide health information and connections to
medical and social services. They serve as a "safety net" or support for patients between medical visits and
to control chronic diseases and to provide health information and information on related issues, such as
emergency preparedness. Unfortunately, there is no formal recognition of CHWs, no permanent funding for
their positions, and therefore no sustainability for their employment.
Context of intervention/project/work: CHWs have been employed by health promotion and research
programs in a variety of disease areas, and on temporary funding. Employers were frustrated with attrition
and re-training on limited funds. CHWs were not aware they were part of a wider Network of workers, but
often left work they enjoyed for higher pay and benefits at other jobs.
Methods: In the past 24 months, we convened a panel of local and national expert/stakeholders for the
CHW workforce. We conducted a statewide reconnaissance and focus groups of CHWs. In 2008, we
conducted the first statewide conference of CHWs, and there were three inventories of CHWs from
interested stakeholders during 2009.
Results and Conclusions: Through targeted meetings, we have been able to develop an organization of
over 200 stakeholders, including CHWs, employers/potential employers, grantwriters, physicians, nurses,
and volunteer agencies/organizations. This presentation will describe the process for organizing CHWs into
a formal statewide network, called the Georgia Community Health Workers' Network (GA_CHWN). This
Network facilitates communication, the sharing of experiences, and the development of a standardized
curriculum with core competency areas, defining a career lattice for CHWs, and developing an advocacy
group to establish policy for the CHW workforce.
References: Kaiser Family Foundation. Accessed November 29, 2009.
http://www.kaiseredu.org/topics_im.asp?imID=1&parentID=61&id=358.
Health Resources and Services Administration, Bureau of Health Professions. Accessed November 29,
2009. http://bhpr.hrsa.gov/healthworkforce/chw/default.htm#preface.
Disclosure of Interest: None declared.

TP-WED-327 WORKPLACE HEALTH PROMOTION (WHP) IN OLD AGE CARE AS A CONTRIBUTION
TO SUSTAINABLE HEALTH
G. Faller* 1
1 Social and Health Sciences, University of Applied Sciences of Magdeburg-Stendal, Magdeburg, Germany
Background: In regard of the challenges of an ageing society in Europe (Eurostat 2009), and due to a
forecasted increase of elderly people in need of care (BGW 2007), the workload in this line of business will
intensify. Concurrently the workforce grows older and has to deal with chronic health problems. So health
equity is not only an issue, concerning social strata of the population – it also affects differences between
lines of business and professions. High physical and emotional demands, tight schedules, shortages of staff,
financial restrictions and effort-reward imbalances (ERI) seem to be relevant impacts on the health of elderly
care nurses as well as on their disposition to leave the job (Küsgens 2005; Hasselhorn et al. 2005; Simon et
al. 2005; Zimber et al. 2000).
Objectives: (1)Implementation of a participatory WHP-process in a residental old age care home in order to
improve working conditions on an organisational level. (2)Identifying promoting forces and obstacles of an
organisational development project in a line of business which is confronted not only with many health
problems, but also with organisational restrictions. (3) Examination of changes, taking place in the course of
the intervention on an individual and on an organisational level.
Underlying values and principles: The project is geared to the basic principles of the Ottawa Charter
emphasizing active involvement of the people concerned by giving them the possibility to explain their
wishes in order to initialize a process of health promoting organisational development in a setting.
Knowledge base/ Evidence base: The implementation of WHP is orientated towards the workplace-health
promotion management process, including survey of demand, goal setting and the design of structural and
procedural interventions (Faller 2010). The theoretical approach is based on the model of organisational
development considering the workplace as a social system with a relevant impact on the health and
wellbeing of employees (Becker/Langosch 2002; Grossmann/Scala 1996).
Context of intervention/project/work: Maintenance of a sufficient, satisfying and affordable care for the
elderly in a situation of demographic change is a significant societal challenge. Creative models are needed,
which inter alia involve workplace health promotion of elderly care nurses.
Methods: Implementation and evaluation of the process decidedly follow a participatory approach, involving
different representatives of the enterprise. It draws upon the concept of Action Research of Lewin, which is
considered to be a root of participatory research and evaluation (Halkow 2004: 181; Trojan/Legewie 2001:
70). Possible changes in the course of the project are evaluated by quantitative data at the beginning and at
the end of the project (Nübling et al., 2005; Badura et al. 2008).
Results and Conclusions: In the face of an ageing society and increasing workloads the need of
improvement of health, job satisfaction and commitment in old age nursing care is urgent. The presented
project shows, that the implementation of structures and processes of health promotion on a company level
in residential old age care is possible.
References: (1) Badura B. et al. (2008). Sozialkapital. Berlin.
Becker H., Langosch I. (2002). Produktivität und Menschlichkeit. Stuttgart. (2)BGW (2007). BGW-
Pflegereport 2007. Hamburg. (3) Faller G. (Ed.). (2010). Lehrbuch Betriebliche Gesundheitsförderung. Bern.
Grossmann R., Scala K. (1996). Gesundheit durch Projekte fördern. Weinheim. (4) Halkow Anja (2004). Mut
zum Dialog! In: Luber E., Geene R. (Hrsg.). Qualitätssicherung und Evidenzbasierung in der
Gesundheitsförderung. Frankfurt a.M., 176-196. (5) Hasselhorn H.M. et al. (2005). Berufsausstieg bei
Pflegepersonal. Bremerhaven. (6)Küsgens I. (2005). Krankheitsbedingte Fehlzeiten in Altenpflegeberufen.
In: Badura B. et al. (Hrsg.). Fehlzeiten-Report 2004. Berlin, 203-219. (7) Nübling M. et al. (2005). Methoden
zur Erfassung psychischer Belastungen. Dotmund. (8) Simon M. et al. (2005) Auswertung der ersten
Befragung der NEXT-Studie in Deutschland. Wuppertal. (9) Trojan A., Legewie H. (2001). Nachhaltige
Gesundheit und Entwicklung. Frankfurt a.M.(10) Zimber A. et al. (2005). Die Beanspruchungssituation in der
stationären Altenpflege. Pflege aktuell (5): 272-275.
Disclosure of Interest: G. Faller, University of Applied Sciences Magdeburg-Stendal, Consultant

TP-WED-329 SANTE DES OUVRIERS DU SECTEUR INFORMEL DU BATIMENT AU CAMEROUN
A. Nguenda* 1
1 -, UNIVERSITE YAOUNDE II, -, Cameroon
Historique / Origines: Les statistiques de la BEAC(2008) montrent que la Contribution du secteur du
Batiment à la croissance économique au cameroun a augmenté ces dernières années : (2,2%, 2001) ; (5,4%
,2004) ; (10% ,2007). Ceci s‟explique en partie par la libéralisation du secteur du batiment. Mais, cette
libéralisation a aussi favorisé le développement d‟un secteur privé faiblement structuré, caractérisé par un
très faible nombre d„agences immobilières, pour la plupart du secteur infomel. le secteur informel se définit
comme l‟ensemble des unités de production (UPI) dépourvues de numéro de contribuable et ne tenant pas
une comptabilité écrite formelle au sens du plan comptable . de manière générale , le secteur informel
camerounais connaît, en effet, une forte prépondérance des travailleurs individuels (63,3 % de l‟emploi
total), un faible taux de salarisation des employés du secteur(6,6 %) et une quasi absence de relations
contractuelles des employés (seuls 2,5 % des employés bénéficient d‟un contrat écrit avec leur employeur,
les autres sont sans contrat (68 %) ou ne bénéficient que d‟un contrat oral avec leur employeur (29,2 %).
Seule la moitié des employés sont permanents et l‟ensemble de la main d‟œuvre ne bénéficie pratiquement
d‟aucune prestation sociale. Dans ce cadre de travail informel de plus en plus marqué part la précarité, les
risques se multiplient et, il devient important de s‟interroger sur la nature du rapport entre les conditions de
travail et la santé des travailleurs dans ce secteur d‟activité. Concernant particulièrement les ouvriers du
secteur informel du batiment,l‟étude suivante recherche donc la réponse à la question suivante:quels sont
les déterminants de l‟accroissement des risques de maladies professionnelles ou d‟accidents de travail dans
le secteur informel du batiment au cameroun?
Objectifs: L‟objectif de ce général est de montrer que le milieu de travail (secteur informel) accroit les
risques d‟accidents de travail ou de maladie chez les ouvriers du batiment au cameroun. Spécifiquement ,il
s‟agit de montrer l‟existence des facteurs déterminant l‟accroissement de risques d‟accident des ouvriers du
batiment du secteur informel.
Fondement de connaissance/Fondement de preuve: I- les manifestations de la précarité dans le secteur
informel du bâtiment au Cameroun
I-1 la précarité de l‟emploi Dans ce secteur d'activité comme d'ailleurs dans l'ensemble des secteurs
économiques, la précarité d‟emploi renvoie au degré de stabilité de la situation professionnelle des salariés,
stabilité définie par la nature du contrat de travail et la politique économique de l‟entreprise. La précarité se
définit et se mesure à l'aune des incertitudes issues d'éventuelles menaces qui pèsent sur l‟emploi du salarié
(durée limitée du contrat de travail, facilité pour l'employeur de se séparer de l'employé selon des critères
prédéfinis). Un emploi précaire se caractérise donc à la fois par une forte vulnérabilité économique et par
une limitation des droits sociaux, car ces derniers sont d'autant plus protecteurs pour le salarié que le degré
de stabilité de son emploi est élevé. À ses propres yeux comme à ceux des organisations qui l'emploient, le
salarié précaire occupe une place inférieure dans la hiérarchie des statuts sociaux définis par l'État
Providence (Paugam, 2000). Dans ce cadre, il devient évident que les ouvriers du secteur informel du
bâtiment au Cameroun font figure de travailleurs précaires par excellence. Le niveau des rémunérations
versées aux ouvriers (le manœuvre gagne 1500fcfa la journée tandis que le maçon bénéficie de 2500fcfa ;
ces taux incluent la ration) ; l‟absence de sécurité sociale et d‟assurance en cas d‟accident ou de maladie ;
une forte rotation de la main d‟oeuvre ; pour gagner un peu plus les maçons et manœuvres par exemple
sont obligés de travailler à la fois sur plusieurs chantiers
I-2 la précarité du travail La précarité du travail s‟analyse quant à elle à travers l‟antagonisme
satisfaction/frustration éprouvé par le salarié dans l‟exercice de ses fonctions. Elle renvoie à une série
d‟indicateurs tels que : pénibilité des conditions de travail, bas salaires, non intérêt de l‟activité de travail ,
relations tendues avec les supérieurs et les pairs, absence de perspectives de promotion, inexistence de
revendications collectives (Paugam 2000). Parmi les difficultés auxquelles est confronté l‟ouvrier, l'une des
plus importantes est son accueil effectif sur le chantier (Trinquet 1996). Au début de sa mission, il ignore
l‟organisation du chantier, il ne connaît pas ses collègues de travail ni ses supérieurs hiérarchiques, il n‟est
pas familiarisé avec les règles et les arrangements informels qui régissent les relations entre les ouvriers
alors que ces connaissances peuvent s‟avérer cruciales pour sa santé et sa sécurité. Le respect des règles
de sécurité requiert une connaissance générale de ces règles mais aussi et surtout une familiarisation
spécifique avec la géographie, l‟outillage et les dangers du chantier. Pour les ouvriers du secteur informel du
bâtiment au Cameroun, cet apprentissage se fait directement sur le tas. On observe particulièrement une
faible qualification des ouvriers : on recrute parfois les membres de la famille ou les enfants en vacances

sans aucune formation préalable sur le métier qu‟ils seront appelés à exercer. L‟augmentation des accidents
de travail (brûlure du ciment, chute sur échafaudage, grue manipulée par un manœuvre..), et l‟expansion
des maladies professionnelles (inhalation des poussières amiantes, affections causées par les ciments,
affections causées par les liquides divers et substances chimiques, atteinte auditive….) en sont les
conséquences immédiates. Légalement, tout nouvel ouvrier doit être informé des contraintes de sécurité sur
le chantier. (Code du travail camerounais). Pratiquement, cela ne se fait jamais : l‟entreprise la plus
scrupuleuse se contentera de faire signer à l‟ouvrier un document indiquant qu‟il a bien pris connaissance de
ces contraintes. Ainsi les pratiques réelles des entreprises ne sont pas toujours en accord avec des prescrits
législatifs jugés comme trop normatifs et éloignés de la réalité du travail sur les chantiers, c'est-à-dire des
considérations de production.
Contexte d'intervention/projet/travail: lutte contre la précarité dans l‟emploi.
Méthodes: problème L‟analyse des atteintes à la santé liées au travail pose de délicats problèmes
méthodologiques dans la mesure où les relations entre travail et santé ne sont ni univoques, ni instantanées
(Gollac et Volkoff, 2000). Les affections peuvent relever de plusieurs risques professionnels différents et de
facteurs non professionnels.
Résultats et Conclusions: La précarité des conditions physiques de travail : environs 57 % des ouvriers
interrogés dans le secteur informel contre 10% seulement dans le secteur formel du bâtiment expliquent les
risques de blessures et l‟état de fatigue générale par des conditions de travail rudes : postures douloureuses
ou fatigantes(10%) ; manutentions de charges lourdes(20%) ; vibrations mécaniques(3%) ; bruits
intenses(5%) ; chaleur inhalations de substances dangereuses(9%) ; contacts avec des substances
dangereuses(10%). Les charges lourdes exposent le plus les ouvriers du secteur informel du bâtiment aux
accidents à cause de l‟absence des grues dans la plupart des chantiers ; l‟insécurité de l‟emploi est un autre
facteur de risque : 18.5% pensent que le stress lié aux faibles revenu (11%) et l‟absence de sécurité sociale
(7.5%), peut occasionner certaines blessures sur le chantier ; la faible formation explique également le
risque d‟accident sur le chantier : environs 45% des ouvriers du secteur informel contre 13% dans le secteur
formel, justifient leur blessure par l‟ignorance des règles élémentaires de sécurité.
Conflit d'Interêt: rien à déclarer

TP-WED-330 UTILITY OF TELEWORK FROM DISABILITY WORKERS STUDY.
M. NISHINA* 1
1 Occupational Health, Nishina Occupational Health Consultant Office, Kawanishi-City, Hyogo-Pref., Japan
Background: Employing for each different kind of handicapped workers with keeping their securities are
difficult for the employers from the point of view of economical and risky problems. And if it is possible to
work, the most biggest problem for them is how these persons can go to the office in safety.
Objectives: I would like to introduce here two case studies of both physically handicapped workers who can
not go to the offices for themselves, but working at home as the employees of company, which are not
common yet.
Underlying values and principles: We sometimes find the working styles which have only duties of
required outcomes, but are not so important for the places and their times in their works.
Knowledge base/ Evidence base: We also notice they have many risks for their safeties and health while
they are working because of nothing under the supervision. Now, these following cases are all working under
the supervision and we can find many merits which we do not notice for working styles using teleworks, and
we notice they can apply to the other ways of life-style.
Context of intervention/project/work: These cases show we can get many merits for the persons who can
not move around for themselves using to connect each placed computers.
Methods: First case is a male employee who has been with a disease of progressive muscular dystrophy.
He can not move around for himself but is possible to use a computer with his hands barely. He has a skill of
CAD (Computer Aided Design). And he has been working as an employee of CAD engineer in Kokuyo
Group Company (Total office supplies one), and his real working hours are accounting by the time of
connecting each placed computers. Second case is a male employee who suffered from a traffic accident.
And he has a paralysis of right side body now. His skill of CAD and his working style and condition are same
as the first case except for the name of disease.
Results and Conclusions: Merits of these cases are following.First, we do not worry about traffic accidents
because of no needs of coming to the offices most of cases. That means nothing needs of communicating
time except few cases. And, they make cost down and the time may be used for another possibility. And it is
also good for environments not using traffic communications. Second, they don not need to mind worrying
about the difficulties of social associations. Oppositely, it makes loneliness for them, but it is possible to ask
their present situations using connections of cables during their working time. And, it is possible to go out
calculatedly with other workers asking their wishes. The demerit can be possible to change to merit.Third, we
can easily understand they work so hard or not, and possible give the advices for them. Once there was a
happening one of them was working without taking rests. Immediately, one gave him to take a rest. We can
also notice and help him as soon as possible if something happens there.
Disclosure of Interest: None declared

TP-WED-331 EFFECTS OF BLOOD PRESSURE SELF-MANAGEMENT IN WORKPLACE
H. Lin* 1 , A. Chiu 1 , C. Lu 2 , L. Yu 2 , S. Hour 2
1 Department of Health, 2 Health Promotion Division, Department of Health, Taipei City Government, Taipei
City, Taiwan
Background: Asymptomatic hypertension can be detected only by periodic measurement and monitoring of
blood pressure levels for early treatment.
Objectives: The aim of this program is to raise employees' awareness of health self-management and help
them establish the habits of measuring blood pressure routinely.
Underlying values and principles: Since the workplace is an interactive environment, underlying
symptoms of hypertension and related health issues of workers can be spotted early, so that success can be
achieved in both the prevention and control of hypertension.
Knowledge base/ Evidence base: The nature of office work added to the fact that daily routines are carried
out in the same location, may be factors which help make it possible for blood pressure measurement to be
routine. Such a routine may also be an opportunity for employers to demonstrate their concern over worker‟s
health and to create cohesion in the office.
Context of intervention/project/work: The program was implemented on nearly all 70,000 employees from
a total of 403 departments and schools in Taipei City Government.
Methods: The program consisted of three stages. In the preparatory stage, one inter-departmental
consensus conference was arranged, and objectives and methods of this program were presented in the
municipal meetings. A convenient, secure, and interactive blood pressure self-management information
system was put in place, to measure physical health indicator data (Measure), to sign-in the system
(System) and to key in the data. The information system then completed an individual health assessment
report, followed by a full list of the 12 District Health Centers for health promotion and advisory services
(Nursing-care). This program provided 2 training seminars conducted by workplace health promotion
experts, which attracted a total audience of 250 and offered employees tools for measuring physical health
levels. In the implementation stage, the program officially began with an announcement made by the mayor.
12 District Health Centers toured the various departments to counsel blood pressure control and to explain
the benefits of such routine checks. The means used for spreading the information on the program were
posters, mobile phone texts, field visits to departments for measurement of blood pressure, joint health
promotion activities, affidavits signing, a database listing department coordinators as well as various
windows of personal consultation. In the evaluation stage, questionnaires were distributed to all
governmental employees via email to assess their awareness of cardiovascular disease prevention and
control, as well as to judge their level of satisfaction with this program. Distribution of various health
indicators such as blood pressure and BMI were analyzed to explore how this program had improved
worker‟s health.
Results and Conclusions: This program won the support of all departmental managers who consented to
lead colleagues to measure blood pressure. By November 6 2009, 10,724 people had signed in the blood
pressure self-management system (among which 7,862 people had abnormal readings in physical health
indicators). Analysis suggests 54.2% of the employees have Pre-hypertension, 14% have Stage 1 and Stage
2 Hypertension while more than 70% of men and over 50% of women have waist measurements that are
above average and those slightly overweight or obese by BMI values accounted for 54.9%. In conclusion,
this program applies strategy of workplace health promotion to help employees establish the habits of
measuring blood pressure routinely.
Disclosure of Interest: None declared

TP-WED-332 HEALTH PROBLEMS AMONG CONSTRUCTION WORKERS IN SELECTED AREAS
N. Yasmin* 1 , S. Lahiry 2 , A. Hossain 1
1 Department of Public Health, State University of Bangladesh, 2 Institute of Health Economics, Dhaka
University, Dhaka, Bangladesh
Background: Construction workers face various types of health hazards owing to unfavorable atmosphere
in work place.
Objectives: This cross-sectional study was undertaken to explore the health problems among construction
workers.
Underlying values and principles: Health of construction workers is a neglected issue in Bangladesh
though ILO defines it as a priority.
Knowledge base/ Evidence base: No published study on construction workers are found.
Context of intervention/project/work: State University of Bangladesh encourages public health research.
Methods: The study was carried out at Mirpur in Dhaka City from September to December 2008 among
people who worked at least one year in construction sector. The sample size was 384 and the respondents
were selected purposively. An interviewer-administered semi-structured questionnaire was used for data
collection.
Results and Conclusions: The mean age of the respondents was 29.6±12.3 while 41.5% young workers
aged 15-24 years and range was 15-72 years. According to monthly personal income Mean was
5013.5±1670 (range: 1200-10000) with 16.5% low income grade from Tk.1200-3000. A satisfactory number
of the respondents (75.7%) used ORS when excessive sweating occurs. Majority of the respondents (66.5%)
were found with tobacco consumption habit. It was found that 63% respondents work 9-10 hours per day. A
large number of respondents (88.3%) did not use PPE owing to supply from recruiting company. Most of the
respondents (88.5%) claimed some diseases happen owing to work at construction sector with 30.5% fever
and 22.6% jaundice. It was found that 42% respondents noticed of having sickness within last one month
with 54.8% fever. Among the respondents 82% faced different types of injury during work. A considerable
number of respondents (78%) were found taken health care from medicine sellers. A significant association
was found between work duration and idea about PPE (p

TP-WED-333 „LOSE TO WIN‟– A NATIONAL WORKPLACE WEIGHT MANAGEMENT PROGRAMME
K. R. Vasquez 1 , S. Thilagaratnam 1 , H. Amin* 1 , L. Choo 1 , E. Tan 2
1 Healthy Ageing Division, 2 Corporate Marketing and Communications Division, Health Promotion Board,
Singapore, Singapore
Background: In Singapore the prevalence of obesity among adults increased from 5.1% in 1992 to 6.9% in
2004 while the prevalence of overweight increased from 21.1% in 1992 to 25.6 % in 2004. In 2009, the
Health Promotion Board's (HPB) annual event, National Healthy Lifestyle Campaign, focused on obesity. As
part of the campaign, a 12-week weight management programme called 'Lose to Win‟ was held. A reality TV
programme was produced in conjunction with the challenge.
Objectives: To implement a sustainable national workplace health programme on weight management
Underlying values and principles: „Lose to Win‟ was designed as a team-based challenge for workplaces.
This setting encouraged the use of peer support to foster and sustain behaviour change. All interventions
(fitness assessment, nutrition workshops & boot camp-style exercises) were evidence-based. Incentives
such as cash prizes, trophies, recognition and time-off from work to attend the sessions were also used.
Knowledge base/ Evidence base: Studies have shown that a well-planned workplace health promotion
(WHP) programme contributes both directly and indirectly to a company‟s bottom-line by boosting
productivity, improving presenteeism, improving health-related behaviour and staff morale while reducing
healthcare costs and absenteeism.
Context of intervention/project/work: The participants were selected based on their BMI, which was set at
25 and above. A WHO-validated Asian BMI was used with 18.5 to 22.9 classed as being in the healthy
range. BMI of 25 and above was classed as being in the medium to high risk category for developing chronic
disease(s). With 60% of the population in the workforce, this setting was ideal for this challenge.
Methods: „Lose to Win‟ comprised 5 members per company. The workplace health facilitators screened staff
for eligibility and readiness to participate.
Participants went through 3 Fitness Assessments, 3 Interactive Nutrition Workshops and 21 Boot Camp style
exercises (11 Aug to 31 Oct 09). Follow-up activities and evaluation will be conducted at 6 and 12 months.
Results and Conclusions: Results of the 12-week programme showed positive outcomes. Paticipation rate
was 86.3% of which 94% reported weight loss and 88% reported body fat loss. All participants reported
increased fitness level from the first to final assessment. Results on the pre & post challenge questionnaire
as well as the follow-up evaluation will be available at the conference.
The average ratings for the reality TV show ranged from 2.7%-8.1% and reached more than 1.6 million
viewers. Compared to similar health-related reality TV programmes, „Lose to Win‟ achieved higher ratings of
1.4%-3.5% more viewers. In addition, healthy lifestyle activities featured in the TV show saw increased
participation at local community centres.
Disclosure of Interest: None declared

TP-WED-334 FOOD (FIGHTING OBESITY THROUGH OFFER AND DEMAND) A WORKPLACE
HEALTH PROMOTION PROGRAM
G. M. Masanotti* 1 , N. Renaudin 2
1 Public Health, University of Perugia, Perugia, Italy, 2 Direction des Relations Institutionnelle, ACCOR
Services, Bruxelles, Belgium
Background: 53% of the European population is overweight! Obesity-related expenses alone account for
between 75 and 130 billion euros and causes 10%-13% of deaths according to the EU.
Objectives: -sensitise employees in order to help them to improve their nutrition habits; improve the
nutritional quality of the offer by working with restaurant owners, cooks and waiters.
Specific objectives; evaluate the needs and expectations regarding nutrition information of the two targets;
collect experts‟ recommendations after the understanding of the needs; adapt the recommendations into
practical communication tools.
-adapt the offer to the demand of the consumers
-organise useful trainings according to the countries
-enable a large access to detailed information to the targets
Underlying values and principles: Having lunch at work has become common; it is a sign of our
contemporary lifestyle and an ordinary occurrence implying a definite change in eating habits. Employees
who do not have a company restaurant are often confronted with complex offerings as well as plenty of
temptations and they must rely on their own discernment to make rational choices.
Knowledge base/ Evidence base: FOOD actions will be led through original networks that are often
forgotten but essential: restaurants and companies. Pedagogical guides, trainings, conferences and a
dedicated DVD to raise awareness among restaurant owners, give them the means to act, inform employees
and give them access to balanced menus. Developed a strong analysis and adapted recommendations,
while maintaining a scientific line.
Context of intervention/project/work: Cross-sectoral (public/private) and integrated approach to address
the issue from the supply of healthy and balanced food for employees in the restaurants, outside the working
place.
Methods: 1.Inventory of the existing programmes to know and understand better the needs; 2.Surveys have
been designed and sent to employees and restaurants. The results of the inventory and the surveys have led
to recommendations; 3. Pilots in restaurants on the one hand and companies on the other, 4.Evaluation of
the pilots (in 2010); 5. Dissemination of best practices in Europe and beyond.
Results and Conclusions: Identification of a list of current programmes that share common objectives and
to develop synergies with them. A data base has been created with the collection of the main
programmes/projects. Two surveys have been conducted: restaurants and employees (5.000 restaurants
and 52.000 employees have been reached), we can lay the accent on different issues: from the lack of
information and false ideas encountered, a common recommendation was identified as a priority, i.e. to
clarify the messages and information towards professionals. The information should also be personalized so
that the restaurant‟s owner/chef can feel that healthy cooking is a concern. Moreover, we discovered that
culture is not a hurdle but an ally. What the meetings enlightened is also the strong link between restaurants
owners‟ information and customers‟ information because they all insisted that the offer will follow the
demand.
Based on the findings have been developed simple tools adapted to each target to raise awareness among
restaurant owners, give them the means to act, and to inform employees and give them access to balanced
menus. In common within all the countries there is: a website: www.food-programme.eu.; a blog function that
provides information on a regular basis; DVD presenting the rules decreed by the experts, whose
recommendations are illustrated by demonstrations performed by six national chefs and a flyer giving a
general introduction to explain the project.
Each country will also have communication tools designed and adapted specifically for their needs (posters,
practical manuals, training sessions and workshops, depending on the case).
The road shows took place in October 2009 with the aim to exchange directly with employees and
restaurants and to provide them with the guides DVD and any other material produced or collected
nationally. Currently we are evaluating the national initiatives.
Disclosure of Interest: None declared

TP-WED-335 GUIDELINES FOR THE PREVENTION OF OBESITY AT THE WORKPLACE - THE GPOW
PROJECT
P. Karnaki* 1 , D. Zota 2 , A. Linos 3
1 on behalf of the GPOW consortium - www.gpow.eu, 2 Health promotion, 3 Epidemiology, Institute of
Preventive Medicine Environmental and Occupational Health, Marousi, Athens, Greece
Background: Studying the workplace is important in understanding part of the etiology of the obesity
epidemic especially since a large part of the population spends a significant part of their days at work.
Modern workplaces have become increasingly obesogenic both because of the changing nature of work with
more sedentary type jobs and because of working conditions such as overtime or shift work. GPOW sought
to examine the workplace and determine its obesogenic nature in relation to obesity outcomes. The project
was co funded by the EU with its consortium comprising research institutions and universities from 10 EU
countries. More details about the consortium can be found at www.gpow.eu
Objectives: Identification of the obesogenic factors in several workplaces and the development of evidence
based guidelines and best practice for the prevention of obesity at the workplace were the main objectives of
the project.
Underlying values and principles: The principles of comprehensive workplace health promotion and the
settings approach guided the project. The way work is organized, working conditions and management are
independent determinants of obesity outcomes at the workplace and were studied as such. Workplaces were
also approached as ideal settings to address personal determining factors of obesity such as an unhealthy
diet and inadequate physical activity.
Knowledge base/ Evidence base: Implementing diet and physical activity interventions while changing
aspects of management and the occupational environment have the potential of improving the health status
of workers, contributing thus to a positive and caring image of the company. Evidence has also shown that
such changes improve staff morale, reduce staff turnover and absenteeism, enhance productivity, and
reduce sick leave.
Context of intervention/project/work: The workplace and involved stakeholders comprised the context of
the project work targeting in particular how and to what extent the workplace affects obesity outcomes.
Organizational and environmental aspects of the workplace were examined as where individual determining
factors of obesity.
Methods: Development of evidence based guidelines through original research, critical analysis of existing
data and assessment of best practice through a purpose made assessment tool were the methods used.
The assessment tool evaluated components of the identified interventions examining and assessing the
planning, implementation and evaluation phases.
Results and Conclusions: A number of workplace environmental and organizational factors influence
obesity outcomes including occupational stress, long working hours, continuous sedentary work, shift work
and lack of food storing facilities. Best practice for preventing obesity at the workplace must include:
comprehensive and targeted needs assessment; combination of physical activity and nutrition methods;
environmental and organizational change, implementation during work hours, activities lasting for over one
year, self monitoring of progress, the use of simple language and visuals, incentives for employees and
employers, and continuous evaluation. The produced guidelines include: an outline of the most prevalent
obesogenic factors per work sector; practical recommendations on specific evidence-based strategies per
workplace sector; the stages of comprehensive workplace health promotion planning, implementation and
evaluation.
Disclosure of Interest: The project was co-funded by the EU
The project was kindly supported by Titan Cement Company

TP-WED-336 OCCUPATIONAL HEALTH RELATED PROBLEMS AND SAFETY PRACTICES AMONG
SMALL-SCALE GOLD MINERS IN THE WASSA WEST DISTRICT OF THE WESTERN REGION OF
GHANA
G. DORGBETOR* 1
1 SCHOOL HEALTH EDUCATION PROGRAMME, GHANA EDUCATION SERVICE, ACCRA, Ghana
Background: Small-Scale Mining employs over 13 million people globally with between 80 million and 100
million people depending on it for their livelihood. The sector attracts people particularly in rural areas of
developing countries and thus checking rural-urban migration and contributes to employment for the lower
poor.
Small-Scale gold mining in Ghana employs between 100,000 and 1,000,000 workforce of men and women
with extended families directly or indirectly benefiting.
Objectives: The study tries to identify the occupational health related problems and safety practices among
small-scale gold miners in the Wassa West District of Ghana. Thus identify the common occupational
accidents, causes of diseases and injuries, health hazards confronting the miners and to ascertain the type
of safety and protective equipment used among the small-scale miners.
Underlying values and principles: Involvement of small-scale miners in issues which affect their lives
based on health, safety and environment, their right to good health, safety and environment.
To recognizing the skills, knowledge and expertise that small-scale miners contribute and develop by taking
action to tackle Health, safety, and environmental problems.
Cooperate with government agencies and other organizations, to identify and implement action on health,
safety and environment, based on mutual respect of diverse cultures and contributions.
cultures and contributions.
Knowledge base/ Evidence base: Small-scale gold mining in Ghana excessively degrade the land making
farming and its related activities very difficult. Occupational lung disease, TB, Silicosis, STIs, HIV/AIDS,
widespread prostitution and alcoholism, and occupational injuries were some common health problems
affecting the miners and their entire community.
Context of intervention/project/work: Major causes of occupational diseases and injuries among the
small-scale miners were; exposure to chemicals, metallic poisoning, poor ventilation, over-exertion, falling
stones or rocks, cave-in, slipping and flying objects.
Mining and processing involve simple hand-held tools such as; chisel, pick axes, hoes, for digging, shovels
for lading and sacks, pans and wheelbarrows for transporting the ore. The small-scale miners were exposed
to mercury, nitric acid, dynamite (nitrous fume), carbon monoxide and dust (free crystalline silica)
Methods: The study involved a cross-sectional descriptive study spanning August 2004 to June 2005. The
strategies were using participant observation and Focus Group Discussion, and five years (2000 – 2004)
hospital records of small-scale gold miners reviewed at ABA hospital. Structured questionnaire was used to
collect data from the small-scale gold miners.
Results and Conclusions: Almost all of small-scale miners (97.8%) had reported malaria over the last one
year. 85.9% and 42.2% of the respondents had suffered from back pain and skin diseases respectively.
Tuberculosis (2.2%), Asthma (5.2%), Hernia (2.6%), Sprain and Strain (18.5%). Other diseases include;
rheumatism, cough, headache and flea infection.
88.1% of the miners do not wear safety boot, and only 12.6% wear Gloves, 10.4% wear helmet with raincoat
(3%).
87.4% of the miners use mercury and 54.8% use Nitric acid everyday. 135(100.0%) are exposed to dust
(free crystalline silica) and 135 (100.0%) expose to noise with a period of between 8 and 24 hours.
The miners were exposed to free crystalline silica which has the potential of causing silicosis and
silicotuberculosis and other respiratory diseases,
References: Yelpaala, Kaakpema (2000) Mining, Sustainable Development, and Health in Ghana. The
Akwatia Case Study
Ghana Minerals Commission (2000.
World Health Organization/International Labour Organization, (2003).
Disclosure of Interest: "None declared"

TP-WED-337 PRECEDE-PROCEED MODEL-BASED SAFETY EDUCATION: ITS EFFECT ON
M. Rezai-Rad* 1 , F. Fazlollah Ghofranipour 2 , H. Sanaeinasab 3 , R. Tavakoli 4 , A. Khavanin 5 , A. Kazemnejad 6
1 Dept. of Management, IRI Police University, 2 Health Education Department, Faculty of Medical Sciences,
Tarbiat Modares University, 3 Dept. of Health Education, School of Health, Baqiyatallah University of Med.
Sci., 4 Dept. of Health Education, Baqiyatallah Univ, of Medical Sci., 5 Dept. of Occupational Health, 6 Dept. of
Biostatics, Tarbiat Modares Univ., Tehran, Iran (Islamic Republic of)
Background: One of the main causes of accidents in worksites is unsafe behaviors. One of the most
important and basic methods for the reduction of such unsafe behaviors is occupational safety and health
education.
Objectives: This study aims to determine the effects of safety education using the PRECEDE-PROCEED
model.
Underlying values and principles: Health Behavior Modification
Knowledge base/ Evidence base: Evidence base
Context of intervention/project/work: The health education was implied on two groups (experiment and
control) by using group discussion. Each group was observed by 2 exports and the researchers.
Methods: This Randomized Control Trial (RCT) study was conducted in Razi Petrochemical complex in
Mahshahr, Iran. Data was gathered from 91 experiment and 91 control workers through a researcher-made
questionnaire and a behavior observation form (�=0.85).
Results and Conclusions: One month after educational intervention, unsafe behaviors score mean of
experimental group was significantly decreased while this was not the case in the control group (p

TP-WED-338 INVESTIGATION OF WORKERS CARRYING OUT OUTDOOR ACTIVITIES IN
ENVIRONMENTALLY CONTAMINATED AREAS
T. C. S. NERY* 1
1 Company of Sanitation for the state of SP – SABESP and, Epidemiological Surveillance Center, SÃO
PAULO, Brazil
Background: Changes caused by industrial processes in the world today are factors of changes across
several environments, including soil, air, and water. Across the planet there are areas identified as
contaminated. In the state of São Paulo -Brazil, there are more than 2,000 areas identified as contaminated
by various chemicals. In the study and identification process of the impacts of these contaminated areas
there are concerns with the populations which are directly exposed: workers of the company or residents.
Workers with high levels of exposure or working in the maintenance of gas, water or sewer infrastructures,
as well as in civil construction, are never considered. Thousands of workers throughout the world are
involved in the described situations by conducting their activities without having information of the risks
present in the soil or water, and consequently without the benefit of specific prevention.
Objectives: This study was conducted due to a concern in evaluating the health of workers in sanitation
activities in the city of São Paulo, who work in areas identified as contaminated
Underlying values and principles: Ethics, performances with various relevant institutions, seeks to
promote health, ensure the principles UNIFIED HEALTH SYSTEM
Knowledge base/ Evidence base: To conclude, it is necessary to identify risks arising from contaminated
areas, evaluate the health of the workers exposed to these areas, and provide guidance on the risks that
may be present in addition to the traditional risks associated with the occupation.
Context of intervention/project/work: The soil surface layer generally defined as the earth's crust has
been, or was sometimes considered, an endless recipient of substances often harmful to the environment
and health. The concentration of industrial parks and population density in the main metropolitan regions of
Brazil, especially Sao Paulo, has caused the emergence of environmental liabilities causing the
contamination of soil and underground water. Commercial activity using harmful substances of the industry
and trade, for example, deposits of chemicals, metal industries, and distribution of fuel, may or will impact
the soil and ground water. A contaminated area can be defined as an area, place or land where there is
known contamination or pollution.
Methods: We evaluated 300 workers, which were subjected to laboratory tests and clinical examination after
completion of specific procedures. The analyses are described where changes were found in AST, ALT and
GGT.
Results and Conclusions: To conclude, it is necessary to identify risks arising from contaminated areas,
evaluate the health of the workers exposed to these areas, and provide guidance on the risks that may be
present in addition to the traditional risks associated with the occupation
Disclosure of Interest: none declared

TP-WED-339 LACKING SUPPORT FOR WELLBEING OF OVERWORKED SELF-EMPLOYED
J. Muckenhuber* 1
1 Sozial Medicine and Epidemiology, Medical University Graz, Graz, Austria
Background: In Austria self-employed are the group of people with the longest working hours, according to
the data of the micro census.
Long working hours constitute a stressing factor to peoples wellbeing. This can be stated following results of
most studies on work and wellbeing in general and following the results of a completed project on demands
and resources of wellbeing of overworked small entrepreneurs in Austria.
The salutogenetic theory allows to look for ressources of wellbeing despite stressing environments.
But is there anyone who cares about working conditions and ressources to improve wellbeing of overworked
small entrepreneurs?
Objectives: Thus the aim of the research project has been to answer the following research questions:
- Are special interest groups aware of the decline of quality of life small entrepreneurs face due to long
working hours?
- Do they offer the support small entrepreneurs express to need to improve their wellbeing?
Underlying values and principles: The central aim of the presentation is to focus on problems selfemployed
are facing in order to enhace understanding and support for better wellbeing for them.
Knowledge base/ Evidence base: The evidence base is the data which has been colltected for a qualitative
oriented empirical study. It is described more in detail in in the methods section:
Context of intervention/project/work: The empirical study has been carried out as a part of my PHDproject.
Methods: To answer the research questions there have been applied the following methods:
- A qualitative content analysis has been undertaken of homepages of special interest groups (unions,
employers' federations and NGOs dealing) and
- Interviews with representatives of the special interest groups have been conducted and analysed using
qualitative text-analysis supported by ATLAS-ti as tool of analysis.
Results and Conclusions: Results:
Special interest groups in general are not aware of the decline of wellbeing small entrepreneurs face due to
their long working hours.
Therefore there is not enough support offered to small entrereneurs.
More in detail, special interest groups can be divided into two groups. Whereas the economy-oriented do not
regard long working hours as problem influencing wellbeing of self-employed, employee-oriented groups
emphasise the picture of exploited quasi-employees who should be employed to reach regular working hours
and thus better health conditions.
Research has shown most self-employed not to fit into this dichotomy and to require support to enhance
their wellbeing despite of long working hours.
Thus none of the special interest groups, that have been investigated, show an understanding of this
situation or provide strategies to improve wellbeing by reducing working hours or in spite of long working
hours.
Conclusions:
More research should be done on special needs of self-employed and micro-entrepreneurs.
Special interest groups should be aware of health problems of self-employed because of their long working
hours.
Special health promotion programs need to be developed to adress needs of self-employed.
These programs will need to take into account gender issues, as women with caring responsibilities face a
different situation than men do.
Disclosure of Interest: none desclared

TP-WED-340 HARCÈLEMENT SEXUEL : ATTEINTE À LA SANTÉ ET OBSTACLE À L'ÉGALITÉ
B. Berthouzoz* 1 , V. Ducret 2 , F. Saunier 2
1 Recherche et formation, 2 , le deuxième Observatoire, Carouge, Switzerland
Historique / Origines: Le deuxième Observatoire, institut de recherche et de formation sur les rapports
sociaux de sexe, travaille entre autres sur le harcèlement sexuel en entreprise.
La prévalence et les conséquences de ce phénomène mériteraient une attention particulière. La récente
étude suisse mandatée par le SECO et le BFEG le démontre.
Objectifs: Nous voulons attirer l'attention sur les effets néfastes que subissent les pesonnes harcelées.
L'objectif visé est d'encourager les entreprises à prendre les mesures préventives adéquates, mesures qui
sont une obligation légale en Suisse.
Valeurs et principes sous-jacents: La valeur première de notre activité, et de notre poster, est le respect
des personnes. Le harcèlement sexuel est une violation de cette valeur puisqu'il est une atteinte grave à la
dignité humaine et à l'égalité.
Plus pragmatiquement, en Suisse, la prévention du harcèlement sexuel est une obligation légale des
employeurs.
Fondement de connaissance/Fondement de preuve: Le travail du deuxième Observatoire s'est
développé à partir d'une recherche faite en 1993 qui a révélé que plus de la moité des femmes rencontrées
avaient été confrontées au harcèlement sexuel au cours des deux années précédentes. L'étude du SECO et
du BFEG déjà mentionnée démontre que près de 30% des femmes et 10% des hommes interrogés par
téléphone avaient été confrontés à un tel comportement au cours de l'année précédant l'enquête.
D'autre part, notre pratique nous permet de rencontrer des victimes de harcèlement sexuel et nous pouvons
en mesurer les conséquences.
Contexte d'intervention/projet/travail: Le deuxième Observatoire est mandaté par des partenaires
sociaux, patronat et syndicats, pour intervenir dans les entreprises à divers titres : conseil sur des mesures
préventives, formation des cadres et des employés, supervision de personnes de confiance internes ou rôle
de personnes de confiance externes. Nous sommes également appelées à mener des enquêtes sur des
situations dans d'autres entreprises.
Le deuxième Observatoire a produit un film "Agir pour prévenir, Harcèlement sexuel en entreprise".
Méthodes: Lors d'entretiens individuels et confidentiels, nous entendons les personnes victimes, à l'aide
d'une grille que nous avons élaborée nous essayons de décrire le plus concrètement possible ce qu'elles
vivent et si possible, nous leur demandons d'écrire un résumé de leur histoire. Nous élaborons ensuite avec
elles les solutions les plus satisfaisantes possibles pour mettre un terme à la situation de harcèlement.
Toutes les démarches que nous entreprenons ne se font qu'avec leur accord.
Résultats et Conclusions: Les conclusions qui figureront sur le poster sont d'une part les atteintes à la
santé constatées, qui peuvent également servir d'indices pour détecter les situations à risque et prendre des
mesures de correction, et d'autre part les effets discriminatoires sur la place des femmes dans le monde du
travail.
Références: - BFEG & Bureau de l'égalité des droits entre homme et femme, Genève : "Harcèlement
sexuel, la réalité cachée des femmes au travail", Berne, mars 2003.
- SECO & BFEG : "Risque et ampleur du harcèlement sexuel sur le lieu de travail", Berne, janvier 2008
- Véronique Ducret, Christian Fargues : "Agir pour prévenir, Harcèlement sexuel en entreprise", DVD 32',
premier prix du 7e festival international du film et du multimédia, Congrès mondial sur la sécurité et la santé
au travail, Séoul, juillet 2008.
- Véronique Ducret, "Pour une entreprise sans harcèlement sexuel, un guide pratique", Georg 2008, Genève
Conflit d'Interêt: Rien à déclarer