Collaborative Health Promotion Research Articles

Development and piloting of a Community of Practice to support learning and improvement in health promotion practice within NSW local health district.

Health Promotion Units within New South Wales (NSW) local health districts (LHDs) frequently collaborate and test innovations to address priority health issues or approaches to support the implementation of a health promotion program in a way that is consistent with the needs, resources, and contexts of their regions. Compatible with learning health system approaches, mechanisms to facilitate the exchange of evidence and expertise across districts could improve the collective impact of health promotion services across the state. This study aimed to assess the use of a health promotion Community of Practice (CoP) model as a strategy to achieve this. Type of program or service: This paper describes and shares experiences from the development and piloting process of a CoP model to develop, evaluate and exchange learnings to improve approaches to support the adoption of an effective healthy lunchbox program ('SWAP IT') across three LHDs. The functioning of the CoP was supported by key activities, funding and infrastructure over a 2-year period, including: planning workshops, implementation check-ins, and knowledge exchange meetings. A particularly novel aspect of the CoP was the harmonised evaluation of different, locally developed strategies to facilitate program adoption across the three LHDs. The alignment of the CoP with local and state priorities, as well as the operation of the CoP in a way that did not impose significant time demands, was seen as important for the sustainability of the CoP. Findings from the piloting process suggest that a formalised CoP shows promise as an effective model to enhance health promotion collaboration, information sharing and practice across LHDs, which may be suitable for broader application across the state.

Enhancing education through community engagement: Perspectives of student volunteers


 
 
 
 Background. Engagement between higher education institutions and underprivileged communities holds valuable potential for mutual benefit. In a country of vast inequalities such as South Africa (SA), community engagement also has the potential, via health promotion of local communities, to alleviate some of the burden placed on the public healthcare system, while simultaneously strengthening the personal and professional development of student participants.
 Objective. To explore the experiences, perceptions and insights of student volunteers (SVs) who assisted with a collaborative health-promotion project. Methods. This qualitative study used thematic analysis of semi-structured interviews to explore the experiences of six SVs in the Faculty of Health Sciences, Durban University of Technology, SA, who assisted in educating local vulnerable women on various aspects of female reproductive health at a wellness day for such women.
 Results. The SVs described the experience as positive and humbling, enhancing their professional and personal development. They reported that the community engagement helped them to define themselves and to grow skills they will need as future practitioners. The exposure to the challenges faced by vulnerable groups helped them to develop a sense of empathy and compassion, while igniting an eagerness to empower these groups through improved health literacy.
 Conclusion. The insights provided by this qualitative exploration strongly support the use of community engagement to develop culturally sensitive, empathetic healthcare practitioners.
 
 
 

The Effect of Education Models on Changed Misconceptions About Long-Term Medication Inducing Renal Impairment

Medication misconceptions become a factor for nonadherence. Education for Posbindu cadres is required as a community empowerment to reduce predispositions to chronic kidney disease caused by medication nonadherence. This quasi-experimental research involved one group pretest-posttest design aiming to compare four education models for Posbindu cadres in PHCs in Yogyakarta with changes in misconceptions about antihypertensives and antidiabetics in long-term use-induced renal impairment. All models employed the cadre smart module with models 3 and 4 involving health-worker collaboration. The added educational media were posters (model 1), leaflets (model 2), and posters-leaflets (model 4). Misconception changes were assessed using a validated questionnaire. Eighty-six female cadres aged 43.7±8.6 years were involved with the majority being at least high-school graduates without hypertension and diabetes mellitus risk factors. Model 3 significantly affected all knowledge domains with discussion and clarification of understanding becoming the strength of the techniques used therein. The results proved the importance of health-worker collaboration in health promotion to increase public knowledge of health and drug use, but varied education media could give no guarantee of improvements in such misconceptions. Interactive techniques through knowledge construction assisted by health-workers, especially for unfamiliar domains among society, are recommended to improve the effectiveness of similar education.

Process Evaluation of a Collaborative Social Media Health Campaign: An Analysis of Partner and User Engagement.

Collaborative health promotion campaigns are advantageous because they extend the resources and reach of any single organization. Yet, they can be challenging because they require partner commitment and compromise. On social media, however, these campaigns are especially beneficial due to the high demand for ongoing content that facilitates user engagement. This study is a content analysis of an annual collaborative campaign, Preteen Vaccine Week, conducted by the California Department of Public Health (CDPH) to promote preteen immunizations. Campaign partners are encouraged to use creative assets provided by CDPH and to follow a themed content calendar. Message characteristics and audience engagement were evaluated for 2 years of the campaign (2019-2020). Results indicate that when there was a specific health issue scheduled as the daily theme, 85% of posts reflected that health topic. However, when the theme was general awareness, only 15% of posts aligned. Furthermore, the majority of posts included supplemental audiovisual assets of which nearly half were provided by CDPH. These findings suggest partners attempted to work together. Analyses of message characteristics indicate there was little effort to encourage online user engagement; however, a majority of messages included a call-to-action. These findings indicate that health organizations continue to use social media much like they use mass media: for information dissemination and behavioral recommendations.

Identifying cross-sectoral cooperation for urban health

Abstract Empirical evidence for collaborative health promotion practices is still limited. The Cross-Sectoral Cooperation Self-Assessment Tool (CroCo SA) presented here provides a tool for cities to assess their current commitment to promote urban health and well-being across sectors. The SA tool was validated by co-operating with 9 pilot cities and seven countries in the framework of the Healthy Boost project funded by Interreg Baltic Sea Region (2019-2022). Addressing the current complexity, interdependence and emerging challenges of health promotion requires cross-sectoral cooperation and tools to assess cross-sectoral processes and make their impact visible. A digitized CroCo SA tool was developed and validated. An SA evaluation matrix was created, including 162 cells of options for reflective and guiding responses according to 6 scale x 27 items used in the SA tool. After submission of the electronic form, respondents can view anonymized results in a digital form on the Healthy Boost platform. The feedback report summarizes the results for respondents and provides, both numerical and descriptive, verbal feedback on the state of the assessed city's capacity for cross-sectoral cooperation, based on each assessment. The steps the respondents could take in their respective cities to improve cross-sectoral cooperation are outlined. Recommendations are based on the evidence found to be the prerequisites for effective cross-sectoral work for health promotion. SA can be conducted in many languages offered by the Google translation programme. Guiding feedback of CroCo SA defines areas for improvement in strategies and actions, allowing respondents also to do benchmarking and learn from other cities and countries. Self-assessment itself is a learning process. Key messages • The CroCo SA tool offers a method for gathering information about the state of cross-sectoral cooperation for urban health promotion. • By identifying strengths and weaknesses in cooperation, the city can build capacity for cross-sectoral cooperation.

Health Literacy Promotion and Its Institutional Arrangements: Rethinking collaborative health promotion in Thailand

This research explores institutional arrangements that govern health literacy promotion policies in Thailand since 2014. This study sets the main questions as what are the main institutional arrangements that governed health literacy promotion policies in Thailand since 2014 and can these arrangements be viewed as collaborative health governance? This paper argues that the military coup in 2014 transformed institutional-governing arrangements on health system management and health promotion greatly as many legal-political institutions and various social-political agencies were involved and brought together to promote health and health literacy. A so-called principle of ‘collaborative governance’ has been employed and implemented to promote health in Thailand recently, however, this study argues that the institutional constraints under authoritarian regime offer a ‘fictitious-collaborative health governance’ instead. Furthermore, deliberative processes on health literacy promotion regulated by many legal - institutional constraints had characteristics of ‘pseudo-deliberation’. This work is qualitative research, and it analyzes and explains research results by looking through theoretical concepts of institutionalism and collaborative governance. This study argues that to reach the goal of health literate community and society, Thai health agencies and authorities should re-approach health and health literacy promotion from the bottom-up perspective. Also, overcoming fictitious collaborative health promotion and pseudo-deliberation are necessary. To do that, we need a long-term project of building up a ‘critical health regime’ based on critical education and anti-authoritarianism as major principles. (*The paper was presented at The Hong Kong Polytechnic University’s College of Professional and Continuing Education (CPCE) Conference “Post-pandemic health and long-term care: A new paradigm”. September 2021)

Basic Criteria, Models, and Indicators of Intersectoral Collaboration in Health Promotion: A Scoping Review.

Background:In this study, the basic criteria, models, and indicators of intersectoral collaboration in health promotion were investigated to facilitate the implementation of collaboration.Methods:This scoping review was conducted using datasets of Embase, Web of Science, Scopus, and PubMed, and search engines of Google, Google Scholar, and ProQuest.Results:52 studies were included, and 32 codes in Micro, Meso, and Macro level, were obtained. Micro-level criteria had the highest frequency. Among the models used in the reviewed studies, social network analysis, Diagnosis of Sustainable Collaboration, Bergen, and logic models had the highest frequency. Among the indicators studied, the number of participants and the level of collaboration as well as its sustainability were the most frequent indicators.Conclusion:The findings identified the most important and widely used criteria, models, and indicators of intersectoral collaboration in health promotion which can be useful for decision-makers and planners in the domain of health promotion, in designing, implementing, and evaluating collaborative programs.

A multilevel transition perspective on embedding intersectoral action in local health policies.

SummaryIntersectoral action is advocated as a social practice that can effectively address health inequalities and related social issues. Existing knowledge provides insight into factors that may facilitate or hinder successful intersectoral action, but not much is known about how intersectoral action evolves and becomes embedded in local health policies. This is where this study aims to make its contribution, by adopting the multilevel perspective on transitions, which is increasingly used to study social innovation in sustainability transitions but has not yet been applied to public health and health promotion. Through this perspective, it was unravelled how intersectoral action between youth-care organizations and community sports clubs became embedded in local health policies of Rotterdam, a large city in the Netherlands. A single explorative case study was conducted based on content analysis of policy documents and 15 in-depth interviews with policy officers, managers and field workers operating in the fields of youth and sports in Rotterdam. The findings showed that intersectoral action between community organizations and policymakers evolves through congruent processes at different levels that changed institutional logics. Moreover, it emerged that policymakers and other actors that advocate novel social practices and act as boundary spanners can adopt multiple strategies to embed these practices in local health policy. The multi-level perspective adds value to earlier approaches to research intersectoral collaboration for health promotion as it allows to better capture the politics involved in the social innovation processes. However, further sharpening and more comprehensive application of transition concepts to study transitions in public health and health promotion is needed.

Towards family‐centered health technologies that support distributed families on sustainable healthy practices together

AbstractFamily relationships can be resources to foster individuals' healthy behaviors. However, in many families, different factors can prevent members in supporting one another around positive health outcomes. A systematic understanding of these factors is crucial for developing appropriate solutions to reduce barriers on family collaboration in health promotion. In this paper, we focus on one factor that affects family support in healthy living: geographic distance. We present a formative study composed by two research explorations which aimed to examine distributed family members' needs and challenges to engage in healthy living together. First, an interview study helped us understand families' practices in engaging in health conversations. Then, findings from focus group discussions provided necessary knowledge to explore the use of technology to support conversations around health topics by distributed families. We draw on our findings to present practical recommendations for researchers working towards supporting intergenerational families on healthy practices collectively when living apart.

Collaboration in health promotion for newly arrived migrants in Sweden.

As a group, newly arrived migrants in Sweden face inequities in health compared to the general population. Successful promotion of population health requires awareness of and focus on health from several sectors of society. In light of this, the aim was to study the views of local authority officials on collaboration in health promotion activities for newly arrived migrants. Data was collected through five focus group interviews with 23 local authority officials working with the integration of newly arrived migrants in the Establishment Program in a municipality or at the Employment Services in northern Sweden. An inductive qualitative latent content analysis was performed, and the analysis showed that the participating officials considered health promotion as desirable in the Establishment Program, but it also raised complex issues within the existing organisations. The officials described unclear roles, but also possible changes to the organisation that would improve the possibility of working to promote health. The present study adds to the relatively limited knowledge of health promotion in integration activities and offers clinical relevance for policymakers through the officials' suggestions for improvements in the Establishment Program. It also raises important questions for further research.

Opportunities for enhancing pregnancy planning and preconception health behaviours of Australian women

Problem and backgroundThe preconception period provides a significant opportunity to engage women in healthy behaviour change for improved maternal and child health outcomes. However, there is limited research exploring women’s pregnancy planning in Australia. AimThis study investigated associations between pregnancy planning, socio-demographics and preconception health behaviours in Australian women. MethodsA retrospective cross-sectional survey of pregnant women ≥18-years-of-age recruited through a Victorian public maternity service and a national private health insurer. ResultsOverall 317 women (30±4.7 years) participated (public: n=225, private: n=92). Planned pregnancies were reported by 74% of women and were independently associated with marital status (AOR=5.71 95% CI 1.92–17.00, p=0.002); having ≤2 children (AOR=3.75 95% CI 1.28–11.05, p=0.016); and having private health insurance (AOR=2.51 95% CI 1.08–5.81, p=0.03). Overall, women reported preconception: any folic-acid supplementation (59%), up-to-date cervical screening (68%), weight management attempts (75%), accessing information from health professionals (57%) and immunisation reviews (47%). Pregnancy planners were more likely to use folic-acid (AOR=17.13 95% CI 7.67–38.26, p<0.001), review immunisations (AOR=2.09 95% CI 1.07–4.10, p=0.03) and access information (AOR=3.24 95% CI 1.75–6.00, p<0.001) compared to non-planners. Women <25-years-of-age were less likely to access information (AOR=0.38 95% CI 0.16–0.89, p=0.03) and take folic-acid (AOR=0.23 95% CI 0.09–0.59, p=0.002) and were more likely to smoke 3-months preconception (AOR=6.68 95% CI 1.24–36.12, p=0.03). ConclusionsWomen with planned and unplanned pregnancies reported variable preconception health behaviour uptake and limited healthcare engagement. Opportunities exist to improve awareness and healthcare engagement for optimising preconception health and pregnancy planning benefits including collaborative health promotion. Population-based and targeted approaches reaching pregnancy planners and non-planners are required.

Needs for public health collaborations going far beyond health care systems to address majors health threat, increasing pressure from global life style and environment risks factors, collaboration in health promotion and education, advocacy

Needs for public health collaborations going far beyond health care systems to address majors health threat, increasing pressure from global life style and environment risks factors, collaboration in health promotion and education, advocacy

Interprofessional collaboration in health promotion: changing tasks as leverage for innovation

Abstract Background Increasing demand for interprofessional collaboration calls for change in organisational practice and interactions of professionals. Health promotion is a particularly interesting area for observing these changes, because it involves professionals with different disciplinary backgrounds usually also working in different sectors. In Denmark new health promotion strategies in organisations were introduced to engage professionals in new tasks and establish interprofessional ways of working. Our research aimed to explore how these strategies impact in professional practices, using a cookery project for children as a case study, which involved care assistants and school teachers. Methods A qualitative case study was conducted to investigate how care assistants from a nursing home and school teachers implemented a cookery project in a Danish school; the focus was on joint care and teaching situations among the two professions and their users. Our data consisted of documents, participatory observations, and interviews with professionals; a sociological institutional framework was applied to analyse the data. Results Institutional changes and the demand for joint care and teaching activities in the cooking project fostered new interprofessional collaboration. Three themes of new professional activities emerged: 1) ‘interplay’ related to making different generations collaborate on the tasks involved in the cookery session, 2) ‘care’ concerned with caregiving activities, and 3) ‘learning” focused on schooling on healthy food and cooking. The activities were related to traditional and new roles in professional practices of both groups. Conclusions Changes in professional practices evolved in an informal manner from new tasks and ‘lived’ experiences in the cookery project. The specific practical tasks of health promotion offer an important leverage for future interprofessional collaborations.

Living in quiet desperation: The mental health epidemic in Australia’s higher education

Objective: This study sought to investigate the relationship between personal, university, home and community influences on Australia’s university students’ mental health status. Design: Positioned within a qualitative, interpretivist paradigm, the study collected data from participants ( n = 934) by means of an online survey requesting lived or witnessed experiences concerning mental health concerns. Bronfenbrenner’s socio-ecological model informed the design of the study. Setting: Five major Australian higher educational settings. Method: Leximancer software was used for concept development. Data were analysed using thematic coding. Results: Findings provide qualitative data of university students’ experiences concerning mental health status, as measured across four domains. Themes identified include personal (stress, anxiety, life skills), university (grades/free physical activity) and home (closer to home, support networks) dimensions. There was no unprompted reference to the community domain. Results reinforce the need to ensure that current and future student mental health policies and initiatives are implemented within each of the domains addressed – to ensure a more holistic approach to students’ well-being and care. Conclusion: Findings highlight challenges concerning Australia’s university students’ mental health status. Findings present an opportunity for the university sector, community health services, and sports and fitness organisations to develop and implement future collaborative health promotion in higher education settings.

Health in All local Policies: Lessons learned on intersectoral collaboration in a community-based health promotion network in Denmark.

Health promotion increasingly involves collaboration with civil society organisations and the private sector rather than being implemented exclusively by public sector stakeholders. Health in All Policies (HiAP) is an approach that promotes health in policy-making across public sectors. This study explored intersectoral integration and collaboration for health promotion at a local community level through a qualitative single case study of a local community network in Denmark: the Husum Health Network. The paper describes and discusses strengths, weaknesses, and challenges of HiAP-inspired local efforts to build alliances and supportive environments for health within an inter-organisational community-based network. The data were generated from participant observations made at 11 meetings and events organised by the network partners and nine qualitative, semi-structured interviews with Husum Health Network partners conducted from August 2014 to February 2015. The data were analysed using a theoretical framework introduced by Axelsson and Axelsson (2006) to characterise aspects of integration and differentiation between organisations. With high levels of structural and functional differentiation between the partners, the network provided an opportunity to exercise inter-organisational integration at the local level. Integration was fostered by knowledge sharing, face-to-face interaction, and communal events. However, the loose structure of the network was a challenge to its sustainability and achievement. We argue that Health in All local Policies is a meaningful concept in the context of local community development only when referring to the polices and strategies of all stakeholder organisations involved in decision-making and agenda setting, and not just local government institutions.

2.10-P2Authority officials’ views on organisation and collaboration in health promotion for new arrivals in Sweden

Authority officials' views on organisation and collaboration in health promotion for new arrivals in Sweden

Exploring Collaborative Health Promotion Services between Public Health Centers and Public Libraries

Exploring Collaborative Health Promotion Services between Public Health Centers and Public Libraries

Measurement and evaluation practices of factors that contribute to effective health promotion collaboration functioning: A scoping review

The purpose of this scoping review was to identify promising factors that underpin effective health promotion collaborations, measurement approaches, and evaluation practices. Measurement approaches and evaluation practices employed in 14 English-language articles published between January 2001 and October 2015 were considered. Data extraction included research design, health focus of the collaboration, factors being evaluated, how factors were conceptualized and measured, and outcome measures. Studies were methodologically diverse employing either quantitative methods (n=9), mixed methods (n=4), or qualitative methods (n=1).In total, these 14 studies examined 113 factors, 88 of which were only measured once. Leadership was the most commonly studied factor but was conceptualized differently across studies. Six factors were significantly associated with outcome measures across studies; leadership (n=3), gender (n=2), trust (n=2), length of the collaboration (n=2), budget (n=2) and changes in organizational model (n=2). Since factors were often conceptualized differently, drawing conclusions about their impact on collaborative functioning remains difficult. The use of reliable and validated tools would strengthen evaluation of health promotion collaborations and would support and enhance the effectiveness of collaboration.

Building Collaborative Health Promotion Partnerships: The Jackson Heart Study.

Building Collaborative Health Promotion Partnerships: The Jackson Heart Study. Background: Building a collaborative health promotion partnership that effectively employs principles of community-based participatory research (CBPR) involves many dimensions. To ensure that changes would be long-lasting, it is imperative that partnerships be configured to include groups of diverse community representatives who can develop a vision for long-term change. This project sought to enumerate processes used by the Jackson Heart Study (JHS) Community Outreach Center (CORC) to create strong, viable partnerships that produce lasting change. Methods: JHS CORC joined with community representatives to initiate programs that evolved into comprehensive strategies for addressing health disparities and the high prevalence of cardiovascular disease (CVD). This collaboration was made possible by first promoting an understanding of the need for combined effort, the desire to interact with other community partners, and the vision to establish an effective governance structure. Results: The partnership between JHS CORC and the community has empowered and inspired community members to provide leadership to other health promotion projects. Conclusion: Academic institutions must reach out to local community groups and together address local health issues that affect the community. When a community understands the need for change to respond to negative health conditions, formalizing this type of collaboration is a step in the right direction.

Moving university campuses tobacco‐free: collective responsibility and collaboration the key to a healthier Victoria

Full article Smoking is Victoria's leading preventable cause of death and continues to kill 4,000 Victorians every year.1 In a demonstration of public health leadership, all Victorian universities have recently joined forces in the implementation of the Victorian Universities Tobacco-Free Initiative to contribute to reducing the burden from tobacco-related disease in Victoria. The reach of Victorian universities to implement public health initiatives is significant and growing, with nearly 300,000 students and more than 40,000 academic and professional staff, as is the potential for universities to influence the heath behaviours of young people in a period where life-long behaviours are formed. This is particularly important, given that Victorians of university age (aged 18–29 years) are more likely to smoke than people aged 30–49 years and 50+ years.2 The Initiative educates and engages students and staff on the benefits of reducing smoking, supports smokers to quit and creates smoke-free campuses. This approach is more than just asking students and staff to leave the campus to have a cigarette; it provides a comprehensive suite of supports to help smokers quit that is likely to have a real impact on reducing harm from tobacco. The Tobacco-Free Initiative approach is collaborative across all universities and has been designed and implemented in association with university communities. An advantage of adopting a settings-based health promotion approach is that real changes can be implemented at local level without the need for government intervention or new legislation. Health promotion approaches driven by the community are efficient, timely and allow flexibility. Like the approach used in the Initiative, they create an environment that encourages healthy choices, and supports changes in communities that will have a positive impact on individuals, and also households, families, friends and broader networks. Therefore, this approach is not about helping one individual – it is about supporting a community to be healthier. The prevalence of chronic disease is increasing in Victoria.3 Cardiovascular disease, diabetes and chronic kidney disease share many common lifestyle-related risk factors and contribute a large proportion of the disease burden.4 Lifestyle factors such as tobacco smoking, excessive alcohol use, unhealthy diet and lack of physical activity contribute to the chronic disease burden.5 The direct health costs and lost productivity from smoking add up to $2.4 billion annually in Victoria alone.1 These costs are incurred across businesses, governments and by individuals. Given the recent concern about the sustainability of the health system in Australia, the costs attributable to smoking need to be addressed immediately. Victorian universities are doing their bit to help. The Victorian Universities Tobacco-Free Initiative provides an effective framework for universities to continue to work together and demonstrate public health leadership in developing settings-based health promotion approaches to address the increasing incidence of chronic disease and lifestyle-related risk factors. The unprecedented degree of collaboration between Australian universities over this initiative also allows them to share resources and wisdom and to jointly evaluate the programs in place. This not only expedites the development and roll out of tobacco-free programs, but builds a very sound evidence-base for the most effective strategies in these settings. The framework provides guidance for other industries in Victoria to work together to support the implementation of collaborative health promotion initiatives. The gravity of the future health, social and economic burden of chronic disease requires a timely and continued investment by government, but also by the private sector. The universities of Victoria encourage other major employers to join them and take an active role in developing environments that promote health for all Victorians. References 1 Collins DJ, Lapsley HM. The Social Costs of Smoking in Victoria in 2008/09 and the Social Benefits of Public Policy Measures to Reduce Smoking Prevalence. Melbourne (AUST): Quit Victoria and the VicHealth Centre for Tobacco Control; 2011. 2 Emily Bain SD, Wakefield M. Smoking Prevalence and Consumption in Victoria: Key Findings from the 1998–2012 Population Surveys. Melbourne (AUST): Victorian Department of Health; 2013. 3 Department of Health. Victorian Population Health Survey 2010. Melbourne (AUST): State Government of Victoria; 2012. 4 Australian Institute of Health and Welfare. Chronic Diseases and Associated Risk Factors in Australia, 2001. Canberra (AUST): AIHW; 2012. 5 Begg S, Vos T, Barker B, Stevenson C, Stanley L, Lopez AD, The Burden of Disease and Injury in Australia 2003. Canberra (AUST): Australian Institute of Health and Welfare; 2007.