Most professional health publications and presentations are not about health, but about how to avoid, prevent, or treat disease or infirmity. Better health cannot be attained by simply avoiding, preventing, or treating problems. Health efforts, therefore, should be directed toward creating physical, mental, and social wellbeing. To guide these efforts, salutogenesis, a theoretical framework about the origins or creation of health, is needed to complement the traditional pathogenesis framework that focuses on the origins and causes of disease. Salutogenic strategies are necessary to help health professionals promote positive health enhancement by making their practices about health.
Background
Approximately 1% of U.S. women may have an undiagnosed bleeding disorder, which can diminish quality of life and lead to life-threatening complications during menstruation, childbirth, and surgery.
Purpose
To understand young women’s knowledge, attitudes, and perceptions about bleeding disorders and determine the preferred messaging strategy (e.g., gain- versus loss-framed messages) for presenting information.
Methods
In September 2010, a web-assisted personal interview of women aged 18–25 years was conducted. Preliminary analyses were conducted in 2011 with final analyses in 2013. In total, 1,243 women participated. Knowledge of blood disorders was tabulated for these respondents. Menstrual experiences of women at risk for a bleeding disorder were compared with those not at risk using chi-square analyses. Perceived influence of gain- versus loss-framed messages also was compared.
Results
Participants knew that a bleeding disorder is a condition in which bleeding takes a long time to stop (77%) or blood does not clot (66%). Of the women, 57% incorrectly thought that a bleeding disorder is characterized by thin blood; many were unsure if bleeding disorders involve blood types, not getting a period, or mother and fetus having a different blood type. Women at risk for a bleeding disorder were significantly more likely to report that menstruation interfered with daily activities (36% vs 9%); physical or sports activities (46% vs 21%); social activities (29% vs 7%); and school or work activities (20% vs 9%) than women not at risk. Gain-framed messages were significantly more likely to influence women’s decisions to seek medical care than parallel loss-framed messages. Findings suggest that the most influential messages focus on knowing effective treatment is available (86% gain-framed vs 77% loss-framed); preventing pregnancy complications (79% gain- vs 71% loss-framed); and maintaining typical daily activities during menstrual periods.
Conclusions
Lack of information about bleeding disorders is a serious public health concern. Health communications focused on gain-framed statements might encourage symptomatic young women to seek diagnosis and treatment. These findings and corresponding recommendations align with Healthy People 2020 and with CDC’s goal of working to promote the health, safety, and quality of life of women at every life stage.
Health measurement tools typically assess indicators of poor health by identifying the absence, or presence, of disease and risk factors. This article describes development and validation of the first instrument for measurement of adolescent engagement in positive health promoting actions from a salutogenic approach. This cross-sectional study of 406 youths 14-16 years old tested the validity and reliability of the Salutogenic Wellness Promotion Scale for Adolescents (SWPS-Adol) and examined the extent to which SWPS-Adol positively correlated with and was able to predict perceived health among this population. Findings indicated that SWPS-Adol had good internal consistency ( α = 0.84, subscales α = 0.70), a multi-dimensional structure (physical, emotional, social, vocational and spiritual), and was positively correlated with perceived health ( r = 0.37, p < 0.001). The SWPS-Adol total score also showed significant positive correlations with the physical ( p ≤ 0.001), emotional ( p < 0.001), social ( p < 0.001) and vocational ( p < 0.039) dimensions. The more adolescents engaged in positive behaviors, the better their perceived health. The SWPS-Adol tool provides positive health data to guide adolescent health programs and health curricula, to inform health professionals and policy makers about how positive health actions enhance health and community wellness.
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