A WHO-HPH operational program versus usual routines for implementing clinical health promotion: An RCT in health promoting hospitals (HPH)

Jeff Kirk Svane, Shu Ti Chiou, Oliver Groene, Milena Kalvachova, Mirna Zagrajski Brkić, Isao Fukuba, Tiiu Härm, Jerneja Farkas, Yen Ang, Mikkel Østerheden Andersen, Hanne Tønnesen

Research output: Contribution to journalJournal articleResearchpeer-review

Abstract

Background: Implementation of clinical health promotion (CHP) aiming at better health gain is slow despite its effect. CHP focuses on potentially modifiable lifestyle risks such as smoking, alcohol, diet, and physical inactivity. An operational program was created to improve implementation. It included patients, staff, and the organization, and it combined existing standards, indicators, documentation models, a performance recognition process, and a fast-track implementation model. The aim of this study was to evaluate if the operational program improved implementation of CHP in clinical hospital departments, as measured by health status of patients and staff, frequency of CHP service delivery, and standards compliance. Methods: Forty-eight hospital departments were recruited via open call and stratified by country. Departments were assigned to the operational program (intervention) or usual routine (control group). Data for analyses included 36 of these departments and their 5285 patients (median 147 per department; range 29-201), 2529 staff members (70; 10-393), 1750 medical records (50; 50-50), and standards compliance assessments. Follow-up was measured after 1 year. The outcomes were health status, service delivery, and standards compliance. Results: No health differences between groups were found, but the intervention group had higher identification of lifestyle risk (81% versus 60%, p < 0.01), related information/short intervention and intensive intervention (54% versus 39%, p < 0.01 and 43% versus 25%, p < 0.01, respectively), and standards compliance (95% versus 80%, p = 0.02). Conclusions: The operational program improved implementation by way of lifestyle risk identification, CHP service delivery, and standards compliance. The unknown health effects, the bias, and the limitations should be considered in implementation efforts and further studies.

LanguageEnglish
Article number153
JournalImplementation Science
Volume13
Issue number1
ISSN1748-5908
DOIs
Publication statusPublished - 2019

Fingerprint

Health Promotion
Compliance
Health
Health Services
Hospital Departments
Documentation
Medical Records
Smoking
Alcohols
Organizations
Diet
Control Groups

Keywords

  • Clinical health promotion
  • Fast-track implementation
  • Health promoting hospitals
  • Hospital staff
  • Lifestyle risk
  • Patients
  • Quality improvement
  • Strategic implementation

Cite this

Svane, Jeff Kirk ; Chiou, Shu Ti ; Groene, Oliver ; Kalvachova, Milena ; Brkić, Mirna Zagrajski ; Fukuba, Isao ; Härm, Tiiu ; Farkas, Jerneja ; Ang, Yen ; Andersen, Mikkel Østerheden ; Tønnesen, Hanne. / A WHO-HPH operational program versus usual routines for implementing clinical health promotion : An RCT in health promoting hospitals (HPH). In: Implementation Science. 2019 ; Vol. 13, No. 1.
@article{59d0e6489d374036b51f0d535913fe7c,
title = "A WHO-HPH operational program versus usual routines for implementing clinical health promotion: An RCT in health promoting hospitals (HPH)",
abstract = "Background: Implementation of clinical health promotion (CHP) aiming at better health gain is slow despite its effect. CHP focuses on potentially modifiable lifestyle risks such as smoking, alcohol, diet, and physical inactivity. An operational program was created to improve implementation. It included patients, staff, and the organization, and it combined existing standards, indicators, documentation models, a performance recognition process, and a fast-track implementation model. The aim of this study was to evaluate if the operational program improved implementation of CHP in clinical hospital departments, as measured by health status of patients and staff, frequency of CHP service delivery, and standards compliance. Methods: Forty-eight hospital departments were recruited via open call and stratified by country. Departments were assigned to the operational program (intervention) or usual routine (control group). Data for analyses included 36 of these departments and their 5285 patients (median 147 per department; range 29-201), 2529 staff members (70; 10-393), 1750 medical records (50; 50-50), and standards compliance assessments. Follow-up was measured after 1 year. The outcomes were health status, service delivery, and standards compliance. Results: No health differences between groups were found, but the intervention group had higher identification of lifestyle risk (81{\%} versus 60{\%}, p < 0.01), related information/short intervention and intensive intervention (54{\%} versus 39{\%}, p < 0.01 and 43{\%} versus 25{\%}, p < 0.01, respectively), and standards compliance (95{\%} versus 80{\%}, p = 0.02). Conclusions: The operational program improved implementation by way of lifestyle risk identification, CHP service delivery, and standards compliance. The unknown health effects, the bias, and the limitations should be considered in implementation efforts and further studies.",
keywords = "Clinical health promotion, Fast-track implementation, Health promoting hospitals, Hospital staff, Lifestyle risk, Patients, Quality improvement, Strategic implementation",
author = "Svane, {Jeff Kirk} and Chiou, {Shu Ti} and Oliver Groene and Milena Kalvachova and Brkić, {Mirna Zagrajski} and Isao Fukuba and Tiiu H{\"a}rm and Jerneja Farkas and Yen Ang and Andersen, {Mikkel {\O}sterheden} and Hanne T{\o}nnesen",
year = "2019",
doi = "10.1186/s13012-018-0848-0",
language = "English",
volume = "13",
journal = "Implementation Science",
issn = "1748-5908",
publisher = "BioMed Central",
number = "1",

}

Svane, JK, Chiou, ST, Groene, O, Kalvachova, M, Brkić, MZ, Fukuba, I, Härm, T, Farkas, J, Ang, Y, Andersen, MØ & Tønnesen, H 2019, 'A WHO-HPH operational program versus usual routines for implementing clinical health promotion: An RCT in health promoting hospitals (HPH)' Implementation Science, vol. 13, no. 1, 153. https://doi.org/10.1186/s13012-018-0848-0

A WHO-HPH operational program versus usual routines for implementing clinical health promotion : An RCT in health promoting hospitals (HPH). / Svane, Jeff Kirk; Chiou, Shu Ti; Groene, Oliver; Kalvachova, Milena; Brkić, Mirna Zagrajski; Fukuba, Isao; Härm, Tiiu; Farkas, Jerneja; Ang, Yen; Andersen, Mikkel Østerheden; Tønnesen, Hanne.

In: Implementation Science, Vol. 13, No. 1, 153, 2019.

Research output: Contribution to journalJournal articleResearchpeer-review

TY - JOUR

T1 - A WHO-HPH operational program versus usual routines for implementing clinical health promotion

T2 - Implementation Science

AU - Svane, Jeff Kirk

AU - Chiou, Shu Ti

AU - Groene, Oliver

AU - Kalvachova, Milena

AU - Brkić, Mirna Zagrajski

AU - Fukuba, Isao

AU - Härm, Tiiu

AU - Farkas, Jerneja

AU - Ang, Yen

AU - Andersen, Mikkel Østerheden

AU - Tønnesen, Hanne

PY - 2019

Y1 - 2019

N2 - Background: Implementation of clinical health promotion (CHP) aiming at better health gain is slow despite its effect. CHP focuses on potentially modifiable lifestyle risks such as smoking, alcohol, diet, and physical inactivity. An operational program was created to improve implementation. It included patients, staff, and the organization, and it combined existing standards, indicators, documentation models, a performance recognition process, and a fast-track implementation model. The aim of this study was to evaluate if the operational program improved implementation of CHP in clinical hospital departments, as measured by health status of patients and staff, frequency of CHP service delivery, and standards compliance. Methods: Forty-eight hospital departments were recruited via open call and stratified by country. Departments were assigned to the operational program (intervention) or usual routine (control group). Data for analyses included 36 of these departments and their 5285 patients (median 147 per department; range 29-201), 2529 staff members (70; 10-393), 1750 medical records (50; 50-50), and standards compliance assessments. Follow-up was measured after 1 year. The outcomes were health status, service delivery, and standards compliance. Results: No health differences between groups were found, but the intervention group had higher identification of lifestyle risk (81% versus 60%, p < 0.01), related information/short intervention and intensive intervention (54% versus 39%, p < 0.01 and 43% versus 25%, p < 0.01, respectively), and standards compliance (95% versus 80%, p = 0.02). Conclusions: The operational program improved implementation by way of lifestyle risk identification, CHP service delivery, and standards compliance. The unknown health effects, the bias, and the limitations should be considered in implementation efforts and further studies.

AB - Background: Implementation of clinical health promotion (CHP) aiming at better health gain is slow despite its effect. CHP focuses on potentially modifiable lifestyle risks such as smoking, alcohol, diet, and physical inactivity. An operational program was created to improve implementation. It included patients, staff, and the organization, and it combined existing standards, indicators, documentation models, a performance recognition process, and a fast-track implementation model. The aim of this study was to evaluate if the operational program improved implementation of CHP in clinical hospital departments, as measured by health status of patients and staff, frequency of CHP service delivery, and standards compliance. Methods: Forty-eight hospital departments were recruited via open call and stratified by country. Departments were assigned to the operational program (intervention) or usual routine (control group). Data for analyses included 36 of these departments and their 5285 patients (median 147 per department; range 29-201), 2529 staff members (70; 10-393), 1750 medical records (50; 50-50), and standards compliance assessments. Follow-up was measured after 1 year. The outcomes were health status, service delivery, and standards compliance. Results: No health differences between groups were found, but the intervention group had higher identification of lifestyle risk (81% versus 60%, p < 0.01), related information/short intervention and intensive intervention (54% versus 39%, p < 0.01 and 43% versus 25%, p < 0.01, respectively), and standards compliance (95% versus 80%, p = 0.02). Conclusions: The operational program improved implementation by way of lifestyle risk identification, CHP service delivery, and standards compliance. The unknown health effects, the bias, and the limitations should be considered in implementation efforts and further studies.

KW - Clinical health promotion

KW - Fast-track implementation

KW - Health promoting hospitals

KW - Hospital staff

KW - Lifestyle risk

KW - Patients

KW - Quality improvement

KW - Strategic implementation

UR - http://www.scopus.com/inward/record.url?scp=85058925700&partnerID=8YFLogxK

U2 - 10.1186/s13012-018-0848-0

DO - 10.1186/s13012-018-0848-0

M3 - Journal article

VL - 13

JO - Implementation Science

JF - Implementation Science

SN - 1748-5908

IS - 1

M1 - 153

ER -