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Objective: Although teachers are the key participants in health-promoting schools (HPS) programme delivery, it is still unknown whether teachers are appropriate health information resources and role models for students with respect to healthy diets. The present study aimed to investigate the effects of implementing HPS programmes on teachers' nutrition knowledge and diets. Design: One HPS programme aiming at dietary intervention (HP-D) and one HPS not aiming at dietary intervention (HP-ND) were selected, along with two nonhealth-promoting (NHP) schools matched for school size and urbanization level with the two HPS. All 361 teachers in the four schools were invited to participate, yielding a 78?4 % overall valid response rate. A structured, self-reported questionnaire was administered, with regression models used for statistical analysis. Results: Teachers in the HP-D group had a mean score of 21?1 on a range of 0-30 for nutrition knowledge, which was significantly higher than the mean scores of 18?5 in the HP-ND group and 19?1 in the NHP group (P , 0?001). Better dietary behaviours were also observed among HP-D teachers. Further, being a 'health education' course instructor was associated with significantly higher scores on nutrition knowledge (b 5 2?6, P , 0?001) and vegetable and fruit consumption (b 5 1?4, P 5 0?02) in the HP-D group than in the NHP group. The HP-ND and NHP groups exhibited similar patterns of non-significant differences compared with the HP-D group. Conclusions: Implementation of a coordinated HPS framework on nutrition and diet was positively correlated with schoolteachers' nutrition knowledge and dietary intake. Inadequate diet and nutrition can slow growth in childhood and increase the risk of health conditions such as obesity, hypertension and certain cancers in adulthood (1,2) . Many children exhibit intakes of food and nutrients below the recommended levels, both internationally and in Taiwan (3)(4)(5)(6)(7) . Educators have recognized the importance of promoting a healthy diet and various nutrition-education programmes have been implemented in schools (8)(9)(10) . In these school-based programmes, teachers play a central role in providing accurate nutrition information to students and responding to students' concerns about diet, nutrition and weight control. In order for schoolteachers to be a valuable source of health information, however, they must be equipped with adequate knowledge (11) . Teachers' knowledge of nutrition affects their willingness and confidence to teach a course on healthy diets (12) , which could influence the implementation of a nutritioneducation programme in their schools. In addition, teachers' unhealthy eating behaviours at school may make them inappropriate role models for students. In a study reported by Kubik et al. (13) , 62 % of teachers reported purchasing beverages from vending machines. In addition, 54 % of teachers did not consume five servings of fruits and vegetables daily. Among physical education teachers, 20 % of women and 13 % of...

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HRRP to reduce payments to hospitals with excess readmissions had a significant effect on the inpatient readmissions for PN, AMI and HF in US Hospitals.

BackgroundHealth care resource allocation is key towards attaining equity in the health system. However, health professionals’ perceived impact and attitude towards health care resource allocation in Sub-Saharan Africa is unknown; furthermore, they occupy a position which makes them notice the impact of different policies in their health system. This study explored perceptions and attitudes of health professionals in Kenya on health care resource allocation mechanism.MethodWe conducted a survey of a representative sample of 341 health professionals in Moi Teaching and Referral Hospital from February to April 2012, consisting of over 3000 employees. We assessed health professionals’ perceived impact and attitudes on health care resource allocation mechanism in Kenya. We used structural equation modeling and applied a Confirmatory Factor Analysis using Robust Maximum Likelihood estimation procedure to test the hypothesized model.ResultsWe found that the allocation mechanism was negatively associated with their perceived positive impact (-1.04, p < .001), health professionals’ satisfaction (-0.24, p < .01), and professionals’ attitudes (-1.55, p < .001) while it was positively associated with perceived negative impact (1.14, p < .001). Perceived positive impact of the allocation mechanism was negatively associated with their overall satisfaction (-0.08) and attitude (-0.98) at p < .001, respectively. Furthermore, overall satisfaction was negatively associated with attitude (-1.10, p <.001). On the other hand, perceived negative impact of the allocation was positively associated with overall satisfaction (0.29, p <.001) but was not associated with attitude.ConclusionThe result suggests that health care resource allocation mechanism has a negative effect towards perceptions, attitudes and overall satisfaction of health professionals who are at the frontline in health care. These findings can serve as a crucial reference for policymakers as the Kenyan health system move towards devolving the system of governance.