The Pattern Of Three-Body-Interaction And The Effect Evaluation Of Health Promotion

The mainstreams of health promotion pattern in China includes:the doctor-patient one for one service pattern, the physicians-family team service pattern, expert-resident popular science pattern, and the patient-patient self-management pattern. These exist some disadvantages for all the four patterns in the following aspects:the coverage of health services, willingness of community residents on health service needs, timeliness of updateing health information and scientificity of information sources, supportability of health resources and development sustainability. In this study, drawing on domestic and international experience on development of health promotion pattern I intended to create a comprehensive, planned, purposeful, and organized process of health sintervention system for the promotion of community health practice patterns and to evaluate its effectiveness.PART I Feasibility analysis of the health promotion pattern of three-body-interactionA series of integrated quantitative and qualitative methods were applied to comprehensive analysis the characteristics of the organizations and communities residents which may be involved in the health promotion pattern of three-body-interaction. The results of quantitative analysis showed that medical treatment and public health are the mainly two parts of community health services in Yangjing Community. Residents' health-related lifestyles were unreasonable, and the prevalence of whole chronic disease was 49.2%, which must be paid enough attention. It impied that chronic disease was the focus of future interventions. In addition,39.7% of the surveyed population drank alcohol and 29.1% smoked, which implied that propaganda and education should be the priority of the later intervention. Based no the data of community residents initial clinical appeal and medical practice the community health care institutions were not fully used. Meanwhile, satisfaction surveys reflected the primitive community health services medical equipment, medical expenses not covered by the scope of medical insurance claims and insufficient propaganda were the three mafor factors that affected residents of the health service needs and utilization.This study was to create a "three-body-interaction" health promotion pattern, through using advantages of three-body's resources, long-term and repeated propaganda, combinning with necessary supervision and inspection systems and the establishment of long-term management mechanism, in order to promote community residents'health awareness and healp them master more health knowledge, develop good health habits and health behaviors.At the same time, this study was intended to support community residents to take effective action, to participate in related activities, to master the necessary skills and enhance their willing to pay a certain effort, and finally, to improve their health and life quality. Qualitative results showed that:all the leaders in charge of health promotion, preventive medicine experts, the street community workers and community residents had reach an consensus that the establishment of "three-body-interaction,"health promotion model is feasible. Therefore, in view of the attitudes and abilities of hospitals, communities and colleges, it is feasible to carry out "three-body-interaction" pattern of health promotion relying on the three of them.PARTⅡThe three-body-interaction to create health promotion patternIn this part, the pattern of health promotion was determined by literature review and audience analysi. Review of the literature showed that:the planning and design of three-body-interaction health promotion should be implemented in six stages and three steps-the first step, needs assessment phase; the second, planning and implementation; the third, the evaluation stage. Followed by six stages of the①community needs assessment;②Priority projects;③Overall goals and objectives;④Education strategies and intervention program development;⑤Planning and implementation;⑥Planning Assessment (short term effects assessment, mid-term evaluation; forward evaluation).Audience analysis is the concept of social marketing and its purpose is to understand consumer demand, thus creating products that meet consumer demand. Public health intervention project, although not a product, but must meet health service needs of residents and help residents solve their problems needed to be addressed. It is the only way to fully mobilize the enthusiasm and initiative of residents to devote themselves to disease prevention and health promotion. Therefore I took out focus group interviews to local residents in Yangjing Street Community as a qualitative survey to find out what they needed, demanded and which pattern of health promotion they needed.PART III The three-body-interaction pattern of the implementation of health promotionAccording to the principles of participatory research,we got the supports from leaders and brought the "three-body-interaction" health promotion pattern into regular affairs of relevant sections in clear responsibilities. Second, using a variety of ways to mobilize community residents and make them comprehensively know of the "three-body-interaction" health promotion pattern. Finally, trained the participator of this programme by a participatory training methods to master the methods of implementing health promotion and clear division of their own. Meanwhile, community workers and community residents negotiated about when the intervention carried out which made the intervention more acceptable to community residents, not only for meeting to their health service needs but also for their convenience. Through this broad mobilization, Yang Jing Street community residents had quite understood and cooperated with this programme. Among the total of 36 Community Committee and two preparatory Committee Groups and 34 formal Committee in Yang Jing,500 residents were sampled for intervention from 13 communities through stratified random method and other 500 were random sampled from rest community and served as controls.PART IV Evaluation of three-body-interaction health promotion pattern1.Effectiveness and efficiency evaluation of three-body-interaction pattern of interventionThree-body-interaction pattern is a health promotion with high effectiveness and efficiency, and the implementation of three-body-interaction health promotion pattern had achieved follows:①Changed health attitudes, enhanced health awareness, refrained from unhealthy behavior and improved health;②improved compliance of community residents in many aspects such as medication adiveces, adjust diet, exercise, smoking cessation and alcohol limit;③Improved people's social and psychological conditions and enhanced communication between doctor and patient;④Comparing with the traditional "doctor-patient one to one" pattern, the health service can save 6.3 minutes per resident and improve the efficiency of community health promotion.2. An exploratory study of the elderly of empty-nest houshold:a case of three-body-interaction pattern health promotionElderly people living alone are called "empty nest phenomenon."The elderly of empty nest in Yang Jing Community were relatively younger with mean age 67.53±6.46 year-old and most in their early old-age. Their health was in a good condition on the whole. Their demands for health services focused on health education, preventive health care services, and meanwhile those of technical service such as rehabilitative care were relatively less. Demands of health services were influenced by various factors such as age, education, chronic disease, functional aspects of health status. The problems of empty nesters should to be resolved rely on joint efforts of individual, family and society. In this system, family care took a role as the core, the community service network as supplement and pension system as guarantee.Much measures should be taken out to improve the quality of life and health literacy of empty nesters, so that they can enjoy their healthy aging.