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PubMed2002

Reorienting health services with capacity building: a case study of the Core Skills in Health Promotion Project.

This paper presents a case study of the application of a framework for capacity building [Hawe, P., King, L., Noort, M., Jordens, C. and Lloyd, B. (2000) Indicators to Help with Capacity Building in Health Promotion. NSW Health, Sydney] to describe actions aimed at building organizational support for health promotion within an area health service in New South Wales, Australia. The Core Skills in Health Promotion Project (CSHPP) arose from an investigation which reported that participants of a health promotion training course had increased health promotion skills but that they lacked the support to apply their skills in the workplace. The project was action-research based. It investigated and facilitated the implementation of a range of initiatives to support community health staff to apply a more preventive approach in their practice and it contributed to the establishment of new organizational structures for health promotion. An evaluation was undertaken 4 years after the CSHPP was established, and 2 years after it had submitted its final report. Interviews with senior managers, document analysis of written reports, and focus groups with middle managers and service delivery staff were undertaken. Change was achieved in the three dimensions of health infrastructure, program maintenance and problem solving capacity of the organization. It was identified that the critically important elements in achieving the aims of the project-partnership, leadership and commitment-were also key elements of the capacity building framework. This case study provides a practical example of the usefulness of the capacity building framework in orienting health services to be supportive of health promotion.

Competency-Based Education↗
PubMedDate not supplied

Patient-provider communication in chronic illness: a health promotion window of opportunity.

As chronic illness takes its rightful place as an imperative for planners and policy makers globally, the obligation to provide appropriate self-care management support and promote optimal health among the chronically ill is attracting considerable attention. A generation of insider research into the chronic illness experience has yielded powerful evidence of the critical importance of communication between the chronically ill and those who provide their healthcare services. In this article, insights gained from the body of chronic illness research shape recommendations for attitudinal and structural adjustments that might steer our course toward promoting improved health for those affected by a chronic disease.

Chronic Disease↗
PubMed2000

[Health promotion. Concept development].

The development of health promotion in theory and practice is presented-from the Ottawa Charter in 1986, to the community based health promotion programmes, as the vision for the 21 Century. The historical mile stones in the process of change and the conceptualisation of health promotion are discussed with reference to the World WHO Conferences and documents from these conferences. These events and documents have been vital as guidelines for member countries, both for implementation of community based programmes, as well as for healthy public policy and for training, especially concerning evaluation. The paper also discusses the main trends in research; definitions of principal concepts are highlighted, concerning planning, implementation and evaluation of health promotion programmes.

Canada↗
PubMed2006

Reviewing health promotion in nursing education.

The [World Health Organisation, 2000. Nurse and Midwives for Health: A WHO European Strategy for Nursing and Midwifery Education. WHO Regional Office for Europe, Copenhagen] European Strategy for Nursing and Midwifery Education calls for the explicit inclusion and application of health promotion in all nursing curricula. Prior to this strategy, and subsequently, studies have explored the nature and extent of health promotion in nursing education. This article extensively reviews this body of literature. Overall, the literature, both included in this review and its supporting discussion, presents a picture suggesting that the call for effective inclusion of health promotion has in many cases gone unheeded. The literature also identifies that the educational delivery of broader elements of health promotion is muted in comparison to the 'traditional' constructs of health education. Considerations for wider reform, born out of the literature, are presented.

Clinical Competence↗
PubMedDate not supplied

The career paths of MHSc graduates in health promotion.

There is much support for health promotion in Canada, but not much is known about the various academic programs in this field or of their impact on the practice of community health. A census survey was conducted in 1991 to determine the career paths of graduates of the MHSc program in Health Promotion at the University of Toronto. Findings from the study indicate that the career paths of graduates change following completion of their degree. They are more likely to work in health organizations other than hospital or treatment settings, to have more responsibility and authority in their positions as reflected by changes in job titles and to utilize a wider range of health promotion strategies and methods in their work following graduation. The findings indicate that graduate training in health promotion has a positive effect on the planning, implementation and evaluation of community health programs.

Career Mobility↗
PubMed1998

Promoting breast cancer screening in rural, African American communities: the "science and art" of community health promotion.

Implementing community health promotion programs can be a daunting task for social workers. Aside from the practical skills necessary for engaging diverse groups, it requires an understanding of the complex interplay of several theoretical constructs. Using an eight-year breast cancer prevention project, the North Carolina Breast Cancer Screening Program, as a case study, this article describes both the "science and art" of community health promotion. The article provides examples illustrating the "art" of generating participation by both lay and professional communities and concludes with guidelines for social workers who plan to conduct their own community health promotion programs.

Black or African American↗
PubMed2006

[Opinion: prevention and health services research from the point of view of the German Forum on Disease Prevention and Health Promotion].

The article presents the point of view of the German Forum on Disease Prevention and Health Promotion that health promotion and prevention and health care research are not only similar as to their self-concept, structure and future tasks, but that health promotion and prevention need the systematic support of health care research to improve its policy impact. Furthermore, the article informs about the latest developments and the current state of disease prevention in Germany, presents a survey of the structure and work of the German Forum on Disease Prevention and Health Promotion and lists desirable topics for future studies in the field of health services research.

Biomedical Research↗
PubMed1997

The "social determinants" of practice? A critical analysis of the discourse of health promotion.

Developments in the practice of health promotion have centred on considerations of what clients bring to their encounters with professionals. This changes in the provider-client relationship marks a significant departure from practice models that relied on the professional giving the client expert health instructions. The literature that seeks to illuminate these more contemporary relationships with clients tends to ignore what practitioners bring to the health promotion encounter and, significantly, the social conditions that underlie the encounter. This paper, drawing on research gathered during an ethnographic study of practice in a public health clinic, critically analyzes health promotion with a view to challenging researchers, educators, and practitioners concerning the health-promoting possibilities in existing practice settings.

Adult↗
PubMedDate not supplied

Medicine for the twenty-first century: challenges in personal and public health promotion.

Over the last two decades, definitions of health and what creates health have changed dramatically. Health promotion concepts and practices have been in the forefront of that change and have had considerable impact on how health is viewed and what contributes to it. The fact remains, however, that, at this point, its true potential is largely unrealized. Canada has played a significant role in the development of health promotion internationally through cosponsorship of the First International Conference on Health Promotion in 1986, which produced the Ottawa Charter, and nationally through the release of Achieving Health for All: A Framework for Health Promotion in the same year. I review the background of health promotion from an international perspective, but I focus on the Canadian experience. Drawing on experience gained over many years of attempting to implement health promotion and analyze its impact, I present current issues and emphasize the need for strategic direction.

Health Promotion↗
PubMed1996

Preparing students for health promotion: the challenge for Australian nursing in the 90s.

Health promotion is increasingly recognized as a role to be taken up by all health workers, and nurses, in particular, have been recognized for their potential contribution in this area. Nurse educators around Australia are currently grappling with how best to reorient nurses towards health promotion, and how to prepare nursing students for a health promotion role. In this discussion paper, one university's preparation of their undergraduate students will be examined, as a means of stimulating further debate about how health promotion can be effectively incorporated into undergraduate nursing education. The Health Education and Promotion unit at University of New England, Armidale is offered in the third year of the Bachelor of Nursing. It incorporates traditional teaching strategies and a specific health promotion practicum. The practicum is vital in developing students' health promotion skills and helping them to integrate their theoretical learning into practice. It is argued that education in health promotion is vital if nurses are to prepare themselves for the challenge of promoting the health of their communities.

Australia↗
PubMedDate not supplied

The health promotion internship: a sponsor's perspective.

Health promotion internships are an essential link between the university classroom and the corporate or public service environment. A well structured internship experience will provide the future health promotion professional with an opportunity to transfer learned theory into practical application within a controlled and supervised environment. The success of the internship experience is contingent upon the mutual effort of the student, academic institution, and sponsoring organization working together to develop a model that will reflect the goals and objectives of each group with primary long-term benefit accruing to the future health promotion professional. The purpose of this article is to explore the components of a successful health promotion internship model developed from the perspective of a sponsoring organization.

Commerce↗
PubMed1996

Health-promoting nursing practice: the demise of the nursing process?

Health promotion is gaining widespread recognition throughout the world as the most efficacious practice in achieving health for all. In Canada, the philosophy of health promotion is driving both federal and provincial health initiatives. Such a philosophy is derived from a human science paradigm and is in direct opposition to the natural science paradigm from which the biomedical approach to health care emerged. There now exists a tension between these contrasting paradigms as health care shifts to embrace a health-promotion perspective. The nursing process is based in the natural science paradigm and on a biomedical approach to health care. In order for nurses to embrace health promotion fully, they must move away from the philosophy of the natural sciences and adopt a human science perspective. Such a shift requires a radical transformation in nursing practice as nurses move away from the 'top-down' approach of the nursing process and adopt a 'bottom-up' approach to health-promoting nursing practice. The purpose of this paper is to compare and contrast the nursing process with the principles of health promotion, and to challenge our use of the nursing process in current nursing practice. In particular, a framework for health-promoting nursing practice will be provided.

Behavioral Sciences↗
PubMed1998

Working with parents to promote health.

A cleft lip, with or without cleft palate, is the most common craniofacial malformation. The issue of whether health can be attained if the person has a physical defect is discussed. Health education can be considered as a means whereby individuals learn to maintain, restore and promote health. Consideration is given to health promotion and the prevention of ill health in relation to infant feeding. Skill teaching, if successfully completed, may be regarded as a fundamental cornerstone to health promotion.

Adult↗
PubMed2005

Health promoting hospitals: the role and function of nursing.

BACKGROUND: In 1986, the World Health Organisation's (WHO) Ottawa Charter for Health Promotion sought to create a framework that conveyed the notion of capacity building, related to specific settings, and a structured process for health promotion action. It provided the platform from which the health promoting hospital movement was later launched. Nearly two decades on, the health promoting hospital (HPH) movement has grown considerably and continues to expand, against the backdrop of having to adapt to the changing needs and demands of clients and the evolving social context of their communities. Many nurses, it is argued here, are often unaware of health promoting hospitals concepts or, when they are, do little to contribute to them. METHOD: A critical review of the available health promoting hospital and related literature has been conducted for discussion. FINDINGS: The literature revealed that hospitals are being urged to reject practices based purely on health-limiting and limited biomedical frameworks, in favour of moving towards models based on health promoting hospitals and public health-orientated hospitals. This requires radical reform that focuses on the social and health policy context of organizations, the socio-political empowerment of its employers and clients, and the personal/collective positive health and welfare of its employers and clients. Many health service agencies are beginning to emphasize population health within communities as part of a concerted move away from an original primary focus on acute inpatient hospital-based service provision. CONCLUSION: Hospitals need to adapt and expand their efforts to focus on health promotion activities, in collaboration with the ever-widening community networks of health and social agencies. This requires the commitment of all health care professional groups. Nurses who practice in the hospital setting should be aiming to initiate and promote radical health promotion reform as set out in the health promoting hospital movement. This paper argues that nursing per se could be making much larger inroads and efforts to affect and implement wide-ranging health promotion activities in hospital organizations. Nurses should view the HPH movement as another opportunity truly to embrace evolving broad-based health promotion concepts, as a means to forge and own their own health agenda, and also as a means to move beyond the traditional reliance of a limited health education role. RELEVANCE TO CLINICAL PRACTICE: Hospitals and their employees must be seen to advocate, support and implement wide-reaching social and community-based reform, as part of a necessary commitment to 'seamless' health care provision. The health promoting hospital movement represents a collective vehicle for enabling such activities. If nurses wish to be at the forefront of current health service strategies they must be seen to embrace the radical health promotion reforms that are emerging from the current literature and put forward in this article.

Health Care Reform↗
PubMed2006

The contribution of health discussion groups with students to campus health promotion.

Based on the idea of implementing health promotion in the university setting, this project is aimed at identifying determinants of health and well-being in the working and living environment of students and at developing targeted health interventions. The approach of health discussion groups is a well-established tool in workplace health promotion to enable participation and empowerment. This concept was innovatively applied and evaluated with the student body. There were seven sessions held at the University of Bielefeld with students from five different areas, a representative of the university management and a representative from the compulsory accident assurance. Process evaluation was done through standardized questionnaires and guided interviews with the participants while its impact was assessed in a follow-up period of 3 years by the amount of effects. Data included 11 distinct topics from the areas of study conditions, learning and their living environment with a total of 46 ideas for health-promoting actions. The process evaluation showed highly positive results, both in quantitative as well as qualitative approaches. Critical points were the resistances of students to participate in health discussion groups and the low confidence of students in the implementation of the proposed measures. The follow-up after 3 years showed that 11% of proposed actions could not be implemented, while 43% have resulted in recommendations for policy guidelines, 20% were fully implemented and 26% is still in progress. In conclusion, the health discussion group proved to be a useful instrument for student participation in university-based health promotion. Special emphasis should be given towards decreasing barriers for participation. The implementation of the proposed actions is highly depending on well-established structures of health promotion, such as a steering committee, and the commitment of the university management.

Communication↗
PubMed1989

A commentary on "Achieving Health for All: a Framework for Health Promotion".

In November 1986, the Minister of National Health and Welfare released a discussion paper called Achieving Health for All: A Framework for Health Promotion. The aim of this document is to present a new vision for health in Canada and to propose health promotion as a process to improve health for all Canadians. A framework of health challenges, health promotion mechanisms and implementation strategies is presented as a model to guide health programs and policies. Achieving Health for All builds upon the concepts and principles of health and health promotion that have been developing in Canada and other countries over the last 10-15 years. This article reviews the strengths and limitations of the framework and suggests its use in conjunction with the Ottawa Charter for Health Promotion, which was released in November, 1986. Implications of the framework for The Canadian Dietetic Association and dietitian/nutritionists are also presented. Dietetic and nutrition professionals are challenged to become familiar with the concepts and principles of Achieving Health for All and to assume a leadership role in promoting food and nutrition programs and policies as part of this new vision for health for all Canadians.

Canada↗
PubMed1998

Health promotion. Beating the bands?

A survey of health authorities in England to establish GPs' health promotion activities found that anti-smoking and heart disease prevention were the most common initiatives. Many HAs were dissatisfied with the current arrangements, feeling that they had little control of GPs' health promotion activities. Two-thirds of HAs reported problems with monitoring GPs' health promotion activities. Few health promotion initiatives addressed mental health, cancer or accident prevention.

Family Practice↗