Yasmin Williams - HEALTH-WISE
WHEN I last looked at the Medcaribe/Bireme network (for Latin America and the Caribbean), I saw documentation of only one worksite programme and a brief review of a national health promotion programme. The worksite programme was a pilot project of the Heart Foundation of Barbados (Hassel,1998) aimed at determining the feasibility of establishing the programme and its impact on the health practices of workers.
The project was conducted among the staff of a local professional services firm. It consisted of risk factor screening of staff members, teaching of and certification in Cardiopulmonary Resuscitation (CPR) and facilitating regular related activities.
Two years after the initiation of the project an anonymous knowledge/attitude/practice questionnaire was administered to participants. Sixty per cent of the 60 participants, who returned completed questionnaires, reported a change in lifestyle as a result of the programme. Among 63 per cent, there was an enhanced personal attitude to the company. Thirty-six per cent said that they would provide emergency assistance if needed. Sixty- our per cent of this 36 per cent expressed confidence in doing so and 58 per cent attributed their confidence to involvement in the programme.
The formation of a health club, active participation of employees in national lifestyle activities and the conducting of related seminars and activities on a regular basis were cited as evidence that the company developed an enhanced health consciousness and profile because of the pilot project. The national health promotion initiative (Roberts 2000), involved the development of a 10-week programme for Bahamians to incorporate into their lives, healthy lifestyle practices.
MASS MEDIA
The participants were 6,217 residents from 12 Bahamian communities. This included residents employed to 35 companies who registered for the healthy company award. Twenty-three of them were private companies on the Island of New Providence. The programme involved a mass media campaign, which included the publication of three newspaper articles, the airing of seven radio programmes, the production and airing of one TV programme, the broadcast of seven weekly health features and the placing of billboards.
Government agencies and non-govermental agencies co-ordinated and conducted weekly lectures, one health fair, health walks and a no-smoking programme. Ten designated parameters of good health were evaluated initially then at the end of the 10-week programme for the subset of 23 private companies on the island of New Providence. About 599 persons completed the 10-week programme.
An example of a North American worksite programme is the Treatwell worksite- nutrition intervention programme (Sorensen,1992). It focused on promoting eating patterns low in fat and high in fibre. Sixteen worksites from Massachusetts and Rhode Island were recruited to participate and randomly assigned to an intervention or a control condition. The intervention included direct education and environmental programming tailored to each worksite -- control work sites received no intervention.
Dietary patterns were assessed using semiquantitative food frequency questionnaire. Adjusting for worksite, the decrease in mean dietary fat intake was more in intervention than in control sites. Mean changes in dietary fibre intake between intervention and control sites did not differ.
Although the Caribbean and more specifically Jamaica, may be able to benefit from the North American experience, the development of appropriate programmes must take into account not only the scarce resources but the Jamaican culture and health status.
Dr. Yasmin Williams is a Family Doctor and Public Health Specialist.
