A digitalized methodology to strengthen health equity: control, influence and participation

Abstract

Abstract Problem Angered Hospital is situated in the northeast of Gothenburg, Sweden, serving municipalities with high prevalence of ill health. Dedicated to increase health equity, the hospital has established a Public Health Unit (PHU) to support residents to healthier lives. PHU found that lack of transparency concerning strategies, reflections and results hindered knowledge-exchange between public health practitioners. Also, information from the execution of public health interventions and programs needed to be more accessible for policy-makers and researchers. Description PHU developed a digitalized methodology for systematic steering. It draws on control, influence and participation, using Social Cognitive Theory to plan for strategies. The evaluation build on norm-critical reflections of structured reports. Themes include: How to improve efforts on the structural level? What measures do we plan for and conduct to enhance participation from residents? Quantitative goals were set. Results 222 activity reports were launched and discussed by team members, leading to professional development. Strategies to support self-efficacy were used throughout. The strategy “reciprocal determinism” was planned for more than used, due to giving floor to participants to raise their issues. Methods that draw on transparency, sound evidence and continous collaboration allow for residents to rethink their lifestyle and strive for change. Issues for future development included the importance og giving time for trust and shared values to emerge. Quantitive goals were reached. Lessons Quality assurance of public health work enables formative and summative evaluation, increases potential to close the health gap, provides policy-makers with valuable knowledge and opens for research. Trust and shared values are vital at all levels. The methodology allows for organizations to develop their health literacy in order to include and give voice to people in underserved areas. Key messages Public health units aiming at health equity should use tailored evidence based methods, including norm-critical reflections. Digitalizing a methodological instrument increases accessability and transparency which enables common knowledge development.