Abstract
BackgroundThe concept of health promotion rests on aspirations aiming at enabling people to increase control over and improve their health. Health promotion action is facilitated in settings such as schools, homes and work places. As a contribution to the promotion of healthy lifestyles, we have further developed the setting approach in an effort to harmonise it with contemporary realities (and complexities) of health promotion and public health action. The paper introduces a modified concept, the supersetting approach, which builds on the optimised use of diverse and valuable resources embedded in local community settings and on the strengths of social interaction and local ownership as drivers of change processes. Interventions based on a supersetting approach are first and foremost characterised by being integrated, but also participatory, empowering, context-sensitive and knowledge-based. Based on a presentation of “Health and Local Community”, a supersetting initiative addressing the prevention of lifestyle diseases in a Danish municipality, the paper discusses the potentials and challenges of supporting local community interventions using the supersetting approach.DiscussionThe supersetting approach is a further development of the setting approach in which the significance of integrated and coordinated actions together with a participatory approach are emphasised and important principles are specified, all of which contribute to the attainment of synergistic effects and sustainable impact of supersetting initiatives. The supersetting approach is an ecological approach, which places the individual in a social, environmental and cultural context, and calls for a holistic perspective to change potentials and developmental processes with a starting point in the circumstances of people’s everyday life. The supersetting approach argues for optimised effectiveness of health promotion action through integrated efforts and long-lasting partnerships involving a diverse range of actors in public institutions, private enterprises, non-governmental organisations and civil society.SummaryThe supersetting approach is a relevant and useful conceptual framework for developing intervention-based initiatives for sustainable impact in community health promotion. It strives to attain synergistic effects from activities that are carried out in multiple settings in a coordinated manner. The supersetting approach is based on ecological and whole-systems thinking, and stipulates important principles and values of integration, participation, empowerment, context and knowledge-based development.
Highlights
Primary Health Care (PHC) has remained a priority on the global health agenda since the Alma Ata meeting [1]
The Adelaide Statement on Health in All Policies proposes a new form of governance where there is “joined-up leadership within governments, across sectors and between levels of government“ in efforts to improve health outcomes and advance human development, sustainability and equity [15]. In recognition of this notion, the supersetting approach argues for optimised effectiveness of health promotion action by integrating efforts in intersectoral partnerships involving a diversity of relevant sectors such as health, environment, education, politics and finance
As a supplement to the setting approach, the supersetting approach insists on bringing very different community stakeholders together for jointly developing, planning, organizing and implementing integrated health promoting actions across settings and across the wide spectrum of political, economic, social, professional and environmental interests; and as a supplement to the ecological whole-systems approaches, the supersetting approach insist on empowering community stakeholders through structured participatory development and implementation processes respecting the challenges of every-day life circumstances and fostering local ownership, motivation, responsibility and competences to act for a common cause
Summary
This paper introduces a new concept, the supersetting approach, in an effort to further develop the concept of the setting approach. “Health and Local Community” represents an example of a supersetting initiative with a variety of interesting features: It is broadly integrated into the local community and its human and material resources; it involves ordinary citizens, mainly children and their parents; it is developed and implemented with broad local ownership and engagement; it includes wellbeing and life quality in its health perspective; it combines pedagogic, social and structural interventions; it includes multiple actions targeting the same overall goal; it operates through several sectors and settings; and it is research and knowledge-based. We believe that the supersetting approach and its associated values and principles contribute new inspiration for future health promotion initiatives and recommend researchers and development partners to carefully consider, from the very early stages of conceptualization, how to secure integration of interventions, broad participation of stakeholders, empowerment of citizens and communities, understanding and responding to context, and generation and use of researchbased knowledge to revisit interventions. All authors read and approved the final version of the manuscript
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