Health Promotion Capacity Building Research Articles

Perspectives of primary school teachers on the capacity of schools to support post-pandemic health needs emerging among school-age children.

This study aimed to explore the impact of the COVID-19 pandemic on capacity building for health promotion in primary schools from the perspectives of primary school teachers. A cross-sectional observational study was conducted via an anonymous online survey between February and May 2022. Three-quarters (n2460) of all schools in the Republic of Ireland were invited to participate. Demographics such as gender, teaching experience, school type and delivering equality of opportunity in schools (DEIS) designation were collected. Perceived capacity for health promotion was measured on a 10-point Likert scale. Facilitators and barriers related to health promotion and aspects of child health prioritised for health promotion in the 2years after restrictions eased were explored via closed- and open-ended questions. Of the 595 responses, 493 were eligible for analysis. Participants were based in schools in every county in the Republic of Ireland, with most (85.4%, n421) being female. Almost a third (30.5%, n150) were 11-20 years post-qualification, and a quarter (25.2%, n124) had over 30 years' teaching experience. Mean capacity for school-based health promotion pre-pandemic was moderate, at 6.6±2.2 on a 10-point scale. Mean capacity in spring 2022 decreased significantly (p< 0.001) to 4.1±2.4, indicating poor capacity. Capacity ratings did not significantly differ by school type (p= 0.31), socioeconomic designation (p= 0.27) or years post-qualification (p= 0.08). Capacity decrements were most frequently (49.7%, n245) attributed to organisational factors, while individual and community-level factors were cited by 27.6% (n136) and 21.5% (n106) of respondents, respectively. Healthy eating significantly (p< 0.001) decreased as a priority for health promotion between pre-pandemic times (76.3%, n376) and spring 2022 (23.1%, n114). Mental health significantly (p< 0.01) increased as a priority, being listed by 38.1% (n188) as a priority pre-pandemic and doubling to 72.6% (n358) in spring 2022. Fostering a holistic approach to health promotion in schools remains a challenge. Further efforts are needed to support schools to implement sustainable and balanced systems of health promotion.

Health Promotion Actions and School Violence-A Cluster Analysis from Finnish Comprehensive Schools.

(1) Schools have a significant role in violence prevention activities. This study aimed to first identify profiles of Finnish comprehensive schools based on school violence. The second aim was to examine the associations between profiles concerning health promotion actions, reactive or punitive actions, and school characteristics. (2) The study used the large-scale, nationally representative Benchmarking System of Health Promotion Capacity-Building (BSHPCB) data (n = 2057 schools) completed by the school’s principal together with a student welfare team. The data was analyzed by cluster analysis and Chi-squared and Kruskal–Wallis tests. For post hoc testing, Fisher’s exact test with odds ratios and Mann–Whitney U-test were used. (3) The cluster analysis yielded five profiles of school violence: “No violence”, “Adolescent violence” (violence both among pupils and from pupils towards staff, but not inappropriate behavior from school staff towards pupils), “Not known” (principals either did not respond to these questions or they did not know whether there had been any school violence incidents), “Peer violence” (school violence occurred among pupils but not from pupils towards staff, nor inappropriate behavior from school staff towards pupils), and “All violence” (all types of school violence and inappropriate behavior from school staff towards pupils). These clusters differed according to type of school and municipality. Additionally, both management and monitoring as health promotion actions were related to higher incidence of school violence whereas other actions, such as commitment, resources, common practices, and participation were not related to school violence. (4) The findings of this study indicate that schools have different profiles in terms of school violence and providing evidence and guidance for school violence prevention work.

Competências de promoção da saúde: em foco os usuários do projeto Praia sem Barreiras

Abstract Carrying out university extension actions on beaches represents an innovative opportunity to promote the health of people with disabilities or reduced mobility. This article aims to analyze the understanding of users of the Beach Without Barriers (PSB, Praia sem Barreiras) Project about the Health Promotion practices developed by undergraduate students in the health area. Qualitative, descriptive and exploratory study, based on interviews with ten PSB users in Recife, Pernambuco, Brazil. A thematic analysis of content was carried out anchored on Developing Competencies and Professional Standards for Health Promotion Capacity Building in Europe. Six empirical categories emerged: Dedication of students working in the PSB, Technical qualification of students in the PSB, Emotion during contact with the sea, Mental health improvement, User guidance to students as future professionals and Opinions about the PSB. The qualification of students as agents of change in the local reality, effective communication and strategic partnerships were demonstrated. Actions that transcend bodily limitations and assess the participants’ health needs should be valued in undergraduate school.

Intersectoral partnerships and competencies for mental health promotion: a Delphi-based qualitative study in Finland.

The importance of intersectoral collaboration and partnership working in mental health promotion, together with the requisite competencies for effective collaboration, is widely acknowledged. This Delphi-based qualitative study examined how intersectoral collaboration and partnership work are constructed and adopted in mental health promotion practice. Descriptive data from a Delphi panel of mental health promotion practitioners working in the health sector (n = 32) were used as a data source. Thematic analysis was used to analyze the data. Applying the theory of collaborative advantage, eight themes of collaboration advantage and the related competencies were identified: management structure, leadership, communication and language, common aims, working processes, resources, trust, and commitment and determination. The themes capture the competencies required to influence and work with others to improve the mental health and wellbeing of individuals and communities. The identified theme areas can be used to inform education and training and capacity building for professional practice in mental health promotion. Future research is needed to explore other possible collaborative advantage themes in mental health promotion practice and the competencies required to facilitate effective partnerships across sectors. Further investigations are also needed on the identified theme areas in order to develop and guide capacity building and training in mental health promotion.

Competences in health promotion in the environmental education practices of community health agents.

To recognize the domains of competencies in promoting health in the environmental education practices performed by community health agents. A mixed study, which adopted the Developing Competencies and Professional Standards for Health Promotion Capacity Building in Europe (CompHP) as a theoretical framework, conducted in Crato, Ceará, with 16 community health agents, based on semi-structured interviews and data organization through the ALCESTE software. The following domains of competencies in health promotion were evidenced: partnership, possibility of changes, and diagnosis. We recognize evidence signaling other domains, although with less statistical significance, such as: communication, planning and implementation, with a view to developing environmental education activities. There is a mobilization of a limited number of health promotion competences in the environmental education practices developed by community health agents, which requires the wholeness of these elements to implement health promotion practices and, thus, positive transformations on the environment and health.

Developing and validating a self-assessment tool for health promotion competencies with training participants in Austria.

A key objective of health promotion capacity building and professional development programmes is to enhance competencies in the workforce or training participants. The goal of this study was to investigate and validate the psychometric properties of a recently developed self-assessment tool, based on 'The CompHP core competencies framework for health promotion', to establish whether it is suitable for evaluating training. The tool was employed in 2018 to evaluate two different programmes, with 584 participants submitting their assessment and evaluation of 77 different health promotion training courses in a paper and pencil questionnaire. Longitudinal data were available for 148 participants in the programme for workplace health promotion because they completed an online questionnaire beforehand. The reliability and validity of the assessment tool were tested in several confirmatory factor analyses and structural equation models. Structurally, there was a significant increase in health promotion competencies when comparing measurements before and after training. Furthermore, participants were shown to have different levels of competencies due to their prior knowledge, the format of the course or the professional development programme attended but not based on gender, age or sector. The results justify the creation of an overall scale to assess core health promotion competencies that are suitable for evaluating training courses. However, various methodological issues need to be considered in future applications including decisions about the design of the study (e.g. pre-post test, control groups), type of measurements (e.g. general and specific instrument, background information) and depth of analysis (e.g. confirmatory model and invariance testing).

Development of the Healthy Work Collaborative: Findings From an Action Research Study to Inform a Policy, Systems, and Environmental Change Capacity-Building Initiative Addressing Precarious Employment

Precarious employment (PE) is a complex problem that affects an increasing number of workers across all economic sectors who experience low wages, hazardous conditions, and few benefits, and results in adverse health outcomes. PE is characterized by nontraditional work arrangements, precluding workplace-based interventions. Policy, systems, and environmental initiatives that engage cross-sectoral stakeholders may be an applicable health promotion approach to address PE. The University of of Illinois at Chicago Center for Healthy Work's Healthy Communities through Healthy Work (HCHW) is an outreach project of the Centers for Disease Control and Prevention/National Institute for Occupational Safety and Health-funded Center of Excellence for Total Worker Health that conducted a multiphased qualitative action research (AR) study. AR designs may be a novel approach to develop initiatives to address problems like PE. This article reports on HCHW's first AR phase to answer four research questions: (1) What are participants' perceptions of PE? (2) What are participants' perceptions of their roles in addressing PE? (3) What initiatives are under way that address PE? and (4) How can the findings be used to facilitate opportunities for healthy work? Key informant interviews with health (public health and health care; N = 23) and labor sector organizations (worker centers, worker advocacy organizations, and unions; N = 21) were conducted. Data were thematically analyzed alongside a chart-based content analysis, and shared in 11 key stakeholder meetings. Findings revealed an opportunity for the labor sector to improve health sector readiness to address PE in the context of health, and were used to develop the Healthy Work Collaborative, a cross-sectoral health promotion capacity building policy, systems, and environmenta change initiative to address PE.

Strengthening health promotion practice

Abstract Health services in most developed countries were developed to meet the needs of a demand-led health care, and focus mostly on treatment, cure and care. This system is challenged by the growing burden of non-communicable diseases, increased multi-morbidity, newly emerging communicable diseases, and increasing anti-microbial resistance. At the same time, widening health inequalities pose an additional threat to health systems that do not give enough attention to the factors that produce health. To address these challenges, it is necessary to reorient health services towards more preventive, people-centred and community-based approaches, with a more prominent role for health promotion, integrated within the wider health system. This shift of focus requires the strengthening of health workforce capacities to effectively implement health promotion. Whereas a competent health workforce has always been considered a key condition for the delivery of effective health services, the nature of the necessary 'competencies' is being redefined in the light of the current changes of the health system. Within the diversifying primary care and public health workforce, new skills and tasks must be added to existing professional roles, new professional profiles emerge, and collaborations between professions become more important. This presentation will consider the place of health promotion workforce development within the broader context of public health and health promotion capacity building systems targeting a diversifying primary care and public health workforce. Drawing on recent reviews it will provide an overview of existing capacity development systems in primary and secondary prevention and health promotion, and consider possibilities for integration and implementation of capacity systems within and across disciplinary boundaries.

Network analysis of the concept of health promotion capacity-building

ABSTRACT Health promotion capacity-building (HPCB) emerged in the public health literature in the 1990s. The objective of this study was to examine the origins and show the developments of the concept in the twenty years following the seminal work. Citation network consisting of 230 texts was constructed in two phases. Texts identified in Phase A were articles with all of the words health, promotion, capacity, and building in their title (n = 79). In Phase B all texts that were cited by more than one phase A text (n = 151) were added to the population. Three quantitative methods - main-path analysis, k-core decomposition, and community detection - were used to identify the strongest path, the core of the network and distinct cliques within the network, respectively. The intellectual source was traced to the diffusion of innovations theory. All dimensions of HPCB could be traced back to the seminal work on the adoption of innovations in organizations. The single strongest path of more recent applications focused on global level HPCB. However, the majority of the more recent texts highlighted in the analyses were associated with community capacity-building. Other recent developments detected were organizational development, workforce development, health promoting schools, and a German Kapazitätsentwicklung application. These results suggest that HPCB has on the one hand given birth to a global-level core competencies approach, while on the other hand it has mostly focused on community capacity-building. As a consequence, other scenarios have received considerably less attention.

ACTION for Men: Study Protocol of a Community Capacity Building Intervention to Develop and Implement Gender-Sensitive Physical Activity Programs for Men 50 Plus.

Introduction: Capacity building for health promotion is a relevant precondition for sustainable, health-related changes in community settings. So far, there are few evidence-based recommendations about how to implement and evaluate community capacity building approaches. ACTION for men (A4M) is a project designed to build and evaluate capacities for health promotion in three rural communities in Bavaria, Germany, via a participatory approach including multiple community stakeholders. The project specifically aims at improving physical activity (PA) in men over 50 years of age (50 plus).Methods and Analysis: As a strategy to build the communities' capacities, we set up stakeholder groups in so far two communities. Those stakeholder groups will be facilitated over a period of 1–3 years. In regular meetings, the group members will be motivated to actively participate in planning and implementing PA programs for men 50 plus. The facilitation will systematically address key domains of community capacity (e.g., critical awareness, problem assessment, resource mobilization). The evaluation of the capacity building processes will be carried out using a mixed-methods design. Evaluation instruments consist of structured documentations and face-to-face interviews with stakeholder group participants (and drop-outs) as well as a pre-post-test using a standardized questionnaire in order to detect activity-related changes in men 50 plus from the involved communities. In community three, we will conduct the same procedure with a delay of 6 months.Discussion: Building community capacity for health promotion programs is the primary aim in A4M, and thus differs from previous research in which capacity is mostly a means to an end or an “incidental” result of a health promotion program. Therefore, A4M is expected to deliver important findings about how to implement and evaluate capacity building processes for health promotion, as well as how to address physical activity in community settings.

The Meta Salud Diabetes Implementation Study: Qualitative Methods to Assess Integration of a Health Promotion Intervention Into Primary Care to Reduce CVD Risk Among an Underserved Population With Diabetes in Sonora, Mexico.

Background: Within health promotion research, there is a need to assess strategies for integration and scale up in primary care settings. Hybrid interventions that combine clinical effectiveness trials with implementation studies can elicit important contextual information on facilitators and barriers to integration within a health care system. This article describes lessons learned in developing and implementing a qualitative study of a cluster-randomized controlled trial (RCT) to reduce cardiovascular disease (CVD) among people with diabetes in Sonora, Mexico, 2015–2019.Methods:The research team worked cooperatively with health center personnel from 12 Centers that implemented the intervention. The study used observations, stakeholder meetings, case studies, staff interviews and decision maker interviews to explore issues such as staff capacity, authority, workflow, space, and conflicting priorities, as well as patients' response to the program within the clinical context and their immediate social environments. Applying a multi-layered contextual framework, two members of the research team coded an initial sample of the data to establish inclusion criteria for each contextual factor. The full team finalized definitions and identified sub nodes for the final codebook.Results: Characteristics of management, staffing, and the local environment were identified as essential to integration and eventual adoption and scale up across the health system. Issues included absence of standardized training and capacity building in chronic disease and health promotion, inadequate medical supplies, a need for program monitoring and feedback, and lack of interdisciplinary support for center staff. Lack of institutional support stemming from a curative vs. preventive approach to care was a barrier for health promotion efforts. Evolving analysis, interpretation, and discussion resulted in modifications of flexible aspects of the intervention to realities of the health center environment.Conclusion: This study illustrates that a robust and comprehensive qualitative study of contextual factors across a social ecological spectrum is critical to elucidating factors that will promote future adoption and scale up of health promotion programs in primary care. Application of conceptual frameworks and health behavior theory facilitates identification of facilitators and barriers across contexts.Trial registration: www.ClinicalTrials.gov, identifier: NCT02804698 Registered on June 17, 2016.

Assessing health promotion practice in Finland with a benchmarking tool

Abstract The Finnish Benchmarking System for Health Promotion Capacity Building (BSHPCB) is a nationwide system developed to assess structures, capacities and actions taken to develop health promotion practices at local level. BSHPCB data is collected biannually from all Finnish municipalities in the following sectors of administration: primary healthcare, basic education, upper secondary education, vocational education, physical activity and sport, municipal management and culture. The data collection form and reporting format are based on the theoretical health promotion capacity-building framework, which has seven dimensions that the organization should consider: (1) commitment of the organization to the promotion of population health; (2) management of health promotion; (3) population health monitoring, needs assessment, and evaluation; (4) resources for health promotion; (5) common working practices; (6) public participation/partnership in the planning and evaluation of activities and services; and (7) other core health-promotion functions. Data has been collected since 2010 and results are published on-line (www.teaviisari.fi) within two months of data collection. The online benchmarking tool serves multiple purposes: first, it provides national actors evidence base for assessing law enforcement and drafting new legislation and developing national strategies and action plans; second it gives regional actors good understanding of municipalities’ work and capacities in their region in order to support them and, third municipalities get feedback of their work, are able to benchmark their situation to similar municipalities and develop their health promotion practices. The development and use of BSHPCB has been encouraging. The coverage of the data serves a sound base for further development of the tool. The next steps involve strengthening the quality of the data and auditing practices.

Matrix of essential competencies in health promotion: a proposal for the Brazilian context.

The article presents a Matrix of Essential Competencies in Health Promotion, directed to the context of Brazilian health professionals (CompEPS). It is a methodological study, carried out from September 2017 to March 2018. The validation of the matrix was guided by the Delphi methodology, by electronic means, and the use of the Google Forms tool. Thirty-nine professors of Higher Education Institutions, with representation from all regions of the country, composed the panel of experts. The initial material that triggered the preparation of the Matrix was the European document originating from the Developing Competencies and Professional Standards for Health Promotion Capacity Building in Europe (CompHP) project, being analyzed in two rounds. The items were agreed when they reached the minimum of 80% agreement among the panelists. After obtaining a consensus regarding its content and textual clarity, the CompEPS Matrix was outlined in 45 core competencies grouped in nine domains, incorporating principles and foundations of Brazilian health policies and aligned with the documents guiding the health formative processes, conferring singularity and directed to the daily life of the actions carried out in collective health by professionals in Brazil. It is considered that the CompEPS Matrix will contribute to the qualification of the training in health and the certification of the competencies for the actions effectively promoters of health, carried out by the professionals in their diverse scenarios of performance.

Capacity building in sexual health promotion: a longitudinal evaluation of a training-the-trainer programme in Ireland

This paper reports on the findings of a pre-post and follow-up evaluation of a sexual health promotion programme in Ireland. Substantial progress in skills, knowledge, confidence and comfort were reported by participants which were to a large extent maintained over time. Evidence emerged of the successful translation of learning into practice in a number of areas, including engaging proactively with service users about sexual health and developing educational programmes and materials. The paper highlights contextual factors that support and inhibit sustainable changes to practice that need to be addressed in order to maximise the impact of capacity building education.

Competências em promoção da saúde: o domínio parceria na residência multiprofissional em saúde

Objetivo: Conhecer como o domínio parceria manifesta-se nas ações de promoção da saúde realizadas na Residência Multiprofissional em Saúde da Família. Métodos: Pesquisa qualitativa, de caráter exploratório, baseada no manual Competências Principais em Promoção da Saúde do projeto “Desenvolvendo competências e padrões profissionais para a construção de capacidades e do fortalecimento institucional em promoção da saúde na Europa (CompHP)”. Ocorreu de janeiro a março de 2016, e teve como cenário um programa de residência multiprofissional em saúde do estado do Ceará, Brasil, com foco em seu componente comunitário. Participaram do estudo 16 residentes e obtiveram-se os dados através de entrevista semiestruturada, com base nas seguintes perguntas condutoras: Quais as competências necessárias para desenvolver ações de promoção da saúde? Como a parceria manifesta-se nas ações de promoção da saúde desenvolvidas na residência multiprofissional em saúde? Os dados foram organizados e avaliados por meio da análise de conteúdo. Resultados: Os discursos elucidam fortes parcerias na residência para construção de redes de trabalho que contribuem com a efetivação dos princípios da promoção da saúde. A intersetorialidade representa o desejo de concretude enquanto manifestação efetiva de parcerias entre setores e serviços afins para alcance de objetivos conjuntos. As ações que promovem a integração ensino-serviço-comunidade possibilitam a constituição de espaços dialógicos entre universidades/instituições formadoras, instituições de saúde e comunidade. Nesse contexto, os preceptores da residência multiprofissional são fundamentais na constituição de parcerias e no fortalecimento das ações. Conclusão: A residência multiprofissional mostra-se como espaço favorável ao desenvolvimento da parceria enquanto competência para a realização de ações promotoras de saúde.

Regional Health Coordinators: Community Capacity Building for Health Promotion and Prevention

Regional Health Coordinators: Community Capacity Building for Health Promotion and Prevention

Training of adolescent multipliers from the perspective of health promotion core competencies.

Recognize the domains of health promotion core competencies in the training process of adolescents carried out by nursing students. Qualitative and descriptive study, which used the theoretical methodological contribution Developing Competencies and Professional Standards for Health Promotion Capacity Building in Europe (CompHP), carried out with 14 nursing students. There were four domains: Enable Change; Mediate through Partnership; Communication; and Leadership. These domains came from the interest and commitment of adolescents in intersectoral partnership, the use of communication techniques, and the role of facilitator to catalyze learning and empowerment. There were some domains of core competency in the training of adolescents, suggesting that nursing students act as health promoters. Challenges for Nursing are the implementation of a theoretical contribution of CompHP in undergraduate and ongoing training to carry out health promotion action.

Health in All Policies: From rhetoric to implementation and evaluation - the Finnish experience.

The principles of the Health in All Policies (HiAP) approach are not new. Their international roots can be traced back to 1978 and the Alma-Ata Declaration and the 1986 Ottawa Charter. In Finland, the roots of HiAP go back to 1972 when the Economic Council of Finland, chaired by the Prime Minister, launched the 'Report of the working group exploring the goals of health'. The paper discusses the history, rationale, and implementation of the principles underlying the umbrella concept of HiAP. A rationale for implementing a new concept - HiAP in 2006 during the Finnish European Union presidency - is given. The focus here will be on implementation of HiAP. International material supporting the implementation is introduced and practical examples from Finland presented. The Benchmarking System for Health Promotion Capacity Building is introduced, since it has been used as a primary source of information for monitoring and evaluating HiAP in Finland at the local level. The experience from Finland clearly indicates that HiAP as an approach and as a way of working requires long-term commitment and vision. For working across sectors it is crucial to have data on health and health determinants and analyses of the links between health outcomes, health determinants, and policies across sectors and levels of governance. Intersectoral structures, processes, and tools for the identification of problems and solutions, decisions, and implementation across sectors are prerequisites of HiAP. Legislative backing has proven to be useful, especially in providing continuation and sustainability.

Measuring health promotion capacity building in schools – Finnish comprehensive schools as an example

Measuring health promotion capacity building in schools – Finnish comprehensive schools as an example

The origins and developments of health promotion capacity-building

The origins and developments of health promotion capacity-building