Ideal and actual involvement of community pharmacists in health promotion and prevention: a cross-sectional study in Quebec, Canada.

BACKGROUND: An increased interest is observed in broadening community pharmacists' role in public health. To date, little information has been gathered in Canada on community pharmacists' perceptions of their role in health promotion and prevention; however, such data are essential to the development of public-health programs in community pharmacy. A cross-sectional study was therefore conducted to explore the perceptions of community pharmacists in urban and semi-urban areas regarding their ideal and actual levels of involvement in providing health-promotion and prevention services and the barriers to such involvement. METHODS: Using a five-step modified Dillman's tailored design method, a questionnaire with 28 multiple-choice or open-ended questions (11 pages plus a cover letter) was mailed to a random sample of 1,250 pharmacists out of 1,887 community pharmacists practicing in Montreal (Quebec, Canada) and surrounding areas. It included questions on pharmacists' ideal level of involvement in providing health-promotion and preventive services; which services were actually offered in their pharmacy, the employees involved, the frequency, and duration of the services; the barriers to the provision of these services in community pharmacy; their opinion regarding the most appropriate health professionals to provide them; and the characteristics of pharmacists, pharmacies and their clientele. RESULTS: In all, 571 out of 1,234 (46.3%) eligible community pharmacists completed and returned the questionnaire. Most believed they should be very involved in health promotion and prevention, particularly in smoking cessation (84.3%); screening for hypertension (81.8%), diabetes (76.0%) and dyslipidemia (56.9%); and sexual health (61.7% to 89.1%); however, fewer respondents reported actually being very involved in providing such services (5.7% [lifestyle, including smoking cessation], 44.5%, 34.8%, 6.5% and 19.3%, respectively). The main barriers to the provision of these services in current practice were lack of: time (86.1%), coordination with other health care professionals (61.1%), staff or resources (57.2%), financial compensation (50.8%), and clinical tools (45.5%). CONCLUSIONS: Although community pharmacists think they should play a significant role in health promotion and prevention, they recognize a wide gap between their ideal and actual levels of involvement. The efficient integration of primary-care pharmacists and pharmacies into public health cannot be envisioned without addressing important organizational barriers.

Moving forward in fall prevention: an intervention to improve balance among older adults in real-world settings.

OBJECTIVES: We investigated the effectiveness of a group-based exercise intervention to improve balancing ability among older adults delivered in natural settings by staff in local community organizations. METHODS: The main component of the intervention consisted of biweekly group-based exercise sessions conducted over 12 weeks by a professional, coupled with home-based exercises. In a quasiexperimental design, 10 community organizations working with older adults offered the intervention to groups of 5 to 15 persons concerned about falls, while 7 organizations recruited similar groups to participate in the control arm of the study. Participants (98 experimental and 102 control) underwent balance assessments by a physiotherapist at registration and 3 months later. RESULTS: Eighty-nine percent of participants attended the 3-month measurement session (n=177). A linear regression analysis showed that after adjusting for baseline levels of balance and demographic and health characteristics, the intervention significantly improved static balance and mobility. CONCLUSION: Structured, group-based exercise programs offered by community organizations in natural settings can successfully increase balancing ability among community-dwelling older adults concerned about falls.

[The habits and perceptions of participants in water and other outdoor activities in terms of risk behaviors]. / Comportements et croyances des amateurs d'activités nautiques et de plein air. Etude sur les comportements et les perceptions des risques à la santé.

OBJECTIVE: The objective of this study was to explore the habits and perceptions of participants in water and other outdoor activities in terms of health risk behaviours. METHOD: A survey was undertaken of 1,200 users of a river in the Greater Montreal area. RESULTS: Only about 30% of respondents used some form of protection against the sun during every outing. Fewer respondents who used some form of motorized water craft wore personal flotation devices (PFDs) compared with those who used non-motorized water craft (63% vs. 83%). Almost half of the respondents avoided all contact with water unfit for swimming, and this was the only instance of behaviour influenced by a perception of serious health risks. The data also indicate that men and respondents under 25 years of age are not inclined to practise the safe behaviours studied. INTERPRETATION: These results suggest that effective interventions must be developed for the population in general and for certain sub-groups in particular in order to promote the adoption of safe behaviours during water and other outdoor activities.

[Behavior and beliefs in amateur open water activities. Study of beliefs and attitudes with respect to health risks]. / Comportements et croyances des amateurs d'activités nautiques et de plein air. Etude sur les croyances et les attitudes vis-à-vis des risques à la santé.

OBJECTIVE: The objective of this study was to explore beliefs, attitudes and suggestions concerning effective interventions to promote the use of sun protection, the use of personal flotation devices (PFDs) and the avoidance of contact with water unfit for swimming. METHOD: Interviews were conducted with 36 users and 2 river park activity coordinators on a river in the Greater Montreal area. RESULTS: The respondents recognized the existence of a certain number of negative beliefs and barriers associated with the adoption of safe behaviours, in particular the pointlessness and inconvenience of means of protection against the sun and the wearing of PFDs, the negligible effects of polluted water on health and the thrill of defying bans. To help change beliefs, attitudes and behaviours, the respondents suggested legislative, organizational and individual interventions. INTERPRETATION: The data gathered during this study will help to determine intervention strategies and to set up programs promoting behavioural change among the target population.