Evaluation On Healthy City Project And Capacity Related To Health Promotion In Shanghai

Evaluation on Healthy City Project and Capacity Related to Health Promotion in ShanghaiRapid development of urbanization in the world provides many opportunities to improve people's life on one side, but it also meet great challenges of unhealthy factorson other side. Rapid urbanization created a series of serious environmental problems, for example, the city's climate change (such as the heat island effect) and environmental pollution (including water, air, noise, and solid waste contamination), social problems arising from significant increase in urban populations, chronic non-communicable diseases increased, social and psychological stress and mental disorders and health and safety of increased foreign population and so on. As Dr. Klezer said "rapid urbanization has posed serious challenges to human health, but human is lack of preparation." Facing the health challenges of urbanization, WHO advocated healthy city projects in 1986. Following pilot healthy city project in some cities and districtshealthy city project in China,Shanghai adopted healthy city project as new public health approach since 2003. Until now three waves of 3-year action plans of healthy city project have been implemented. It is necessary to evaluate its processes and outcomes under health promotion theory healthy city projecthealthy city project.The present study employed case study method evaluated organization system, action, process and outcome, health promotion capacity and model of Shanghai Healthy City project.The organizational system was constructed at the municipal and district levels. There were 14 government departments and 19 districts and counties governments involved in the system. In addition, some professional bodies and non-governmental organizations have joined it, such as Municipal Health Education Institute, the Tobacco Control Association. The actions of the healthy city project included the "four tasks" and "five-everyone skills "activities which focused on the public policy of promoting health, social participation, health services improvement and the development of personal skills, aimed to promote environmental health, social health and population health. Shanghai Municipal Government actively promoted healthy public policy and organizational support network. Healthy city plan was included in "11th Five-Year Plan of Shanghai Economic and Social Development " as well as the district and sectoral development plans. The establishment of municipal and district-level health promotion committee meet regularly to work regular meeting, to strengthen multi-sectoral communication system, to implement the technical steering group meeting and management by objectives.A variety of official and private media, governments at all levels and governmental departments, the general public, health self-management group and other associations, non-governmental organizations and units and so on were joined in the healthy city project. Awareness of activities were higher, ranging from 65% to85%; Participation rates varied according to activity content.. Satisfaction rates were high, about 90%. The main activities were "creating a healthy environment", "protecting the health food","promoting healthy behavior" and "eorienting health services". Of these activities, awareness rate on "cleaning home" was 80%, and participation rate was 38%. Activities on "protecting health foods" have a higher awareness rate (over 80%), and participation rate about 30%, satisfaction rate about 95%. Awareness rate of "tobacco control in public places" was 84.82%, participation rate 27.73%, satisfaction rate 87.21%; awareness rate of "resource conservation" activity was 80.02%, participation rate 32.75%, satisfaction rate 89.99%. Awareness rate of "healthy communities" was 77.32%, participation rate 30.59%, and satisfaction rate 94.42%. Awareness was of "building healthy units" 70.45%, participation rate 20.98%, satisfaction rate 92.63%. Reorienting health services included of "physical and mental health" and "hunyuxinfeng Households", and their awareness rate were 77.79% and 67.93%, and their participation rate were 26.05% and 17.58%, and satisfaction rate were over 92%.Among "five skills" activities, "everyone knows their own blood pressure" had the highest participation rate and satisfaction rate were 62.82%. Compared with other groups, the participation rate of students and migrant workers on the "everybody knows your blood pressure" was lower (about 36%).The awareness rate of "everyone master first aid skills" activities was 86.25%, participation rate 30.37%, satisfaction rate about 60%. The awareness rate of "everyone participate in fitness activities," was 90.56%; participation rate nearly 50%, and satisfaction rate about 60%." The awareness rate of "everyone has to understand food safety" was 89.03%, participation rate 41.91%, satisfaction rate about 57.23%. The awareness rate of "everyone has to develop healthy behaviors" was 89.70%, participation rate 46.80%, and satisfaction rate 55.33%. The results suggested that activities more close to public life and more simple in the form, more participation rates were more higher.Major environmental problems in the city have been improvement. Government put much source to increase the green. The city sanitations improved and vector density declined greatly. The residents satisfied with living environment including air quality, noise and green. Working conditions were improved too.Many uncivilized behavior has been improved. About 85.52% of people thoutht that the degree of civilization related to people behaviors have to improve in public places. About 85% of people believed that medical and health services have been improved, including that a "significant improvement" was "government departments concerned about the extent of health problems" (48.29%). About 18.23% of respondents were volunteers in the building of healthy cities. About 88.8% of people could feel to be supported from around friends and family.The percent of respondents which felt that their health is good or higher level were 67.34%. For health knowledge,90.96 percent of the respondents knew harm from hypertension and their dietary requirements. Awareness rate of first aid measures in electric shock was 88.68%, that of first aid measures in gas poisoning 56.41%. For health behaviors,56.40% of the respondents participated in the regular monitoring of blood pressure (intervals of not more than 3 months) and 86.26% of the respondents know their own blood pressure. The percent of active and highly active physical activity was 48.4%. The proportion of smokers was 22.42% and the male smoking rate was 44.31%, especially that among migrants, unemployed people, and workers in enterprises. Most respondents supported the tobacco control (73.72%). There was significantly different in in healthy behaviors between participation and non-participants on "five-everyone skills".Smoking and nutrition behavior rate were employed for evaluation of healthy school.13% of the students reflected that they often saw students smoking in schools. With 50.82 percent of the students said their schools have nutritious catering system. In the occupational settings, the percent of respondents which felt that their health was good or higher level were 74.33%. In term of the Physical activity, the rates meditation was 37.36%, inactive 11.50%, active 14.10%, and highly active 37.04%. Physical activity was significantly different in gender and age groups. Male smoking rate now was 49.09% and female smoking rate was 3.37%.89% of respondents felt support and encouragement from their family, friends, and colleagues.Four questionnaires from"Community Capacity Building Tool" and "A Workbook for Individual, Organizational, and Environmental Assessment" were translated into Chinese and adjusted for assessment tools on the capacity of health promotion in healthy city project in Shanghai. These questionnaires were subjected to analysis internal consistency reliability. Results showed that Cronbach's a values in person's capacity was 0.915 for total items, Cronbach's a values in organizational capacity was 0.928 for total items, Cronbach's a values in environmental capacity was 0.929 for total items, Cronbach's a values in community capacity was 0.956 for total items.Municipal and district and committees of health promotion were major components and major departments of healthy city network in Shanghai. It showed that their health promotion capacity were importment for healthy city project. The present results showed that total of person's capacity, sector organizational capacity and environmental capacity was 3.34 points for municipal committees of health promotion, 3.27 points for district committees of health promotion., the lowest was environmental capacity both in municipal and district level. Total score of health promotion capacitycovering person's, organizational, and environmental one was 3.22 points at community level and 3.28 points in occupational settings. The lower was environmental capacity at community level and organizational capacity in occupational settings. Community capacity of the total score was 2.72 points at community level and 2.36 points in occupational settings.Pearson correlation analysis showed that community capacity in leadership and external supports and total score were related with organizational skills, and community capacity in "Asking why" and "Sense of community" were related with organizations, environmental capacity(P<0.05).The present findings showed that person's, organizations, environmental capacity and the community capacity were influence factors for participation and related healthy behaviors.Based on the evaluation of Shanghai Healthy City project, the Healthy City model in Shanghai is characterized by government-led, multi-sectoral cooperation, community participation, health promotion capacity building.