Health Promotion Partnerships Research Articles

Community-Based Organizations as Trusted Messengers in Health.

Trust is a key component in delivering quality and respectful care within health care systems. However, a growing lack of confidence in health care, particularly among specific subgroups of the population in the United States, could further widen health disparities. In this essay, we explore one approach to building trust and reaching diverse communities to promote health: engaging community-based organizations (CBOs) as trusted community messengers. We present case studies of partnerships in health promotion, community education, and outreach that showcase how CBOs' programs build and leverage trust in health care systems through their workforce, services, and engagement with the community.

Public Libraries and Health Promotion Partnerships: Needs and Opportunities

Objective – Across North America, public libraries have increasingly served their communities by working with partners to connect patrons to essential healthcare services, including preventative. However, little is known about the extent of these partnerships, or the need for them, as seen from the perspective of public library workers. In this study, we set out to address the following research question: What needs and opportunities are associated with health promotion partnerships involving public libraries? Methods – Using snowball sampling techniques, in September 2021, 123 library workers from across the state of South Carolina in the United States (US) completed an online survey about their health partnerships and health-related continuing education needs; an additional 19 completed a portion of the survey. Results – Key findings included that library capacity is limited, but the desire to support health via partnerships is strong. There is a need for health partnerships to increase library capacity to support health. Public libraries already offer a range of health-related services. Finally, disparities exist across regions and between urban and rural communities. Conclusion – As an exploratory study based on a self-selecting sample of public library workers in a particular state of the US, this study has some limitations. Nonetheless, this article highlights implications for a variety of stakeholder groups, including library workers and administrators, funders, and policy makers, and researchers. For researchers, the primary implication is the need to better understand, both from the public library worker’s perspective and from the (actual or potential) health partner’s perspective, needs and opportunities associated with this form of partnership work.

Achieving partnership synergy: resource inputs, shared mission and interdependencies in Danish health promotion partnerships

Intersectoral partnerships have the potential to co-produce 'synergistic' solutions to complex public health problems, exceeding what any single organization acting alone might achieve. Synergy requires shared decision-making and equitable co-construction by partners. However, many partnerships struggle to realize such synergistic potential. Building on the Bergen Model of Collaborative Functioning, this study offers insights for optimizing partnership synergy by examining interactions between 'inputs' to the partnership-shared mission, and partner resources. Specifically, we introduce the concept of 'dependency structure' to draw attention to how these input interactions shape the balance of power and hence the potential for shared decision-making and co-construction. Findings are based on qualitative data from 10 intersectoral, health promotion partnerships in Denmark, including 27 interviews, 10 focus groups, partnership documents and meeting observations. We identified eight distinct types of 'input resources', which were important in shaping the potential balance of power between partners in more or less productive ways. However, the dependency structure that materialized-and its synergistic potential-was contingent on how these inputs interacted with the partnership mission. Our findings suggest a well-developed shared mission serves three functions-(i) foregrounding a common purpose, (ii) aligning individual partner's self-interests and (iii) enabling action. The extent to which partnerships developed a shared mission serving all three functions influenced realization of a balanced dependency structure in which collaborators recognized their interdependencies, in turn promoting shared decision-making. To ensure the greatest potential for synergy, early and ongoing discursive processes to co-develop the partnership mission were particularly important.

The CREATION Health Assessment Tool for Patients (CHAT-P): Development & Psychometric Testing.

The CREATION Model is a whole-person wellness model facilitating patient-provider partnerships for health promotion. CREATION is an acronym that represents eight whole-person health principles: Choice, Rest, Environment-Interpersonal Relationships, Activity, Trust, Outlook, and Nutrition, all focusing on the relationship between individual choice and physical, psychological, social, and spiritual health. This study develops and tests the psychometric properties of the CREATION Health Assessment Tool for Patients (CHAT-P). A 125-item-bank using a 5-point Likert scale with 1 to 5 rating was generated through focus-groups of clinicians, patients, and healthcare leaders. An expert panel assessed content adequacy, reducing items to 82. Patient survey data (n = 599) from 15 inpatient medical units were randomly divided into two datasets. Exploratory Factor Analysis applied to Dataset 1 resulted in a 7-factor (Choice/Rest/Environment-Interpersonal Relationships/Activity/Trust/Outlook/Nutrition) and 28-item tool with factor loading 0.47-0.86. The model structure was confirmed by Structural Equation Modeling on Dataset 2 with goodness-of-fit test results: X2/df = 2.41 < 5.0, RMSEA = 0.05 < 0.08, GFI = 0.91 and AGFI = 0.90. Cronbach's Alpha = 0.83 showed satisfactory reliability. The final CHAT-P totals ranged from 28-140 (higher scores indicating better health/well-being). When assessing the effectiveness of educational/behavioral interventions, this tool can measure the improvement of a patient's overall mind-body-spirit well-being or measure well-being for individual CREATION principle(s). It fills that gap and facilitates healthcare providers' ability to assess and plan interventions to support holistic well-being.

Health promotion partnership to promote physical activity in Swedish children with ASD and ADHD.

Children with autism spectrum disorder (ASD) or attention-deficit/hyperactivity disorder (ADHD) have a higher risk of inactivity, and efforts to promote physical activity among this population have been limited. Physical activity on prescription (PAP) may be a suitable tool for motivating participation in physical activity among children with these diagnoses. However, PAP calls for synergy and partnership between health care and other sectors of the community. The aim of this study was to describe a health promotion partnership for physical activity targeting children with ASD or ADHD. Data were obtained through individual interviews with professionals at CAP (n = 11) and three focus-group interviews with coaches from local sports clubs. We used the Bergen Model of Collaborative Functioning as the theoretical framework and used qualitative content analysis as the method of analysis to study partnerships between professionals from the Child and Adolescent Psychiatry outpatient clinic (CAP) and coaches from local sport clubs. The findings demonstrate that the partnerships included both positive and negative processes. Although the two partners shared values regarding the project, such as working for a good cause for the children and seeing the potential in the collaboration, there were doubts about sharing common resources and uncertainties about the sustainability of the PAP project. Challenges remain and further research is needed into developing, monitoring and evaluating health promotion partnerships when promoting physical activity for all.

Implementation of “health promoting educational institute” strategies in the state of Himachal Pradesh, India: challenges, opportunities and the way forward

Health promotion is the process of enabling people to increase control over, and to improve their health. Schools and other educational institutes can play a vital role in inculcating health promoting behaviour at early stage of life for sustainable health and well-being. A health promoting school is one that constantly strengthens its capacity as a healthy setting for living, learning and working through multi stakeholder engagements. Health Department has a key role in developing strategies and building partnerships for health promotion at school level. Keeping in view these facts, the department of health and education developed the protocol and implementation plan for certification of educational institute as “health promoting educational institute” in the state of Himachal Pradesh in northern India. The World Health Organization (WHO) protocol for health promoting schools (HPS) has been adopted with some state specific modifications which came into force from 6th November 2020 through a notification by the state government. However, the process of certification got delayed due to the COVID pandemic and closure of the schools. The institutional ethics committee (IEC) activities and capacity building measures were strengthened and Government Senior Secondary School Mahunag in district Mandi with strength of 120 students from 6-12th class was certified as the first health promoting educational institute in the state on 18th December 2021. The purpose of this study is to discuss the process for certification of health promoting educational institute in the state of Himachal Pradesh so that the strategy can be replicated in similar settings.

Assessing youth empowerment and co‐design to advance Pasifika health: a qualitative research study in New Zealand

ObjectivesThe Pasifika Prediabetes Youth Empowerment Programme (PPYEP) was a community‐based research project that aimed to investigate empowerment and co‐design modules to build the capacity of Pasifika youth to develop community interventions for preventing prediabetes. MethodsThis paper reports findings from a formative evaluation process of the programme using thematic analysis. It emphasises the adoption, perceptions and application of empowerment and co‐design based on the youth and community providers’ experiences. ResultsWe found that the programme fostered a safe space, increased youth's knowledge about health and healthy lifestyles, developed their leadership and social change capacities, and provided a tool to develop and refine culturally centred prediabetes‐prevention programmes. These themes emerged non‐linearly and synergistically throughout the programme. ConclusionsOur research emphasises that empowerment and co‐design are complementary in building youth capacity in community‐based partnerships in health promotion. Implications for public healthEmpowerment and co‐design are effective tools to develop and implement culturally tailored health promotion programmes for Pasifika peoples. Future research is needed to explore the programme within different Pasifika contexts, health issues and Indigenous groups.

Conflict and synergy in health promotion partnerships: a Danish case study.

Intersectoral partnerships constitute a central approach in health promotion. By combining different perspectives, knowledge and resources from different sectors, partnerships are important for addressing complex health problems. When successful, intersectoral partnerships create synergy, which is suggested to be a proximal outcome that links partnership functioning to health effects. Nonetheless, partnerships are also difficult and time-consuming and may result in conflicts, hostility and power struggles. Such antagonist outputs are expected to produce negative results. However, conflicts may also be a source of valuable learning. This article explores the relationship between conflict and synergy in health promotion partnerships. The empirical material is derived from an evaluation of a 4-year Danish government partnership program. Data consist of survey data collected from 35 partnerships and in-depth qualitative case studies of 10 partnerships. The analysis was inspired by realist evaluation. The qualitative data were coded, and cases written up. Cross-case analysis was conducted and triangulated with survey data. Surprisingly, disagreements and conflicts of interests between partners were common and associated with synergy creation. Moreover, the partnerships' experiences of synergy were often linked to their attribution of differences rather than to common goals or value congruences. The study identifies that a potential for synergy lays in the productive confrontation between partners different perspectives. Moreover, a key mechanism enabling productive conflicts was inclusive dialog, in which the partners' differences were valued, and all voices were included. The study thus builds on the existing synergy literature and adds nuance to the understanding of conflicts in health promotion partnerships.

Patient and Family Engagement

British Columbia Mental Health and Substance Use Services (BCMHSUS) provides mental health services, education, and health promotion initiatives to people with mental health and substance use issues across the province of BC. As a Project Coordinator in the Patient and Community Engagement portfolio, I performed a variety of work to support patient and family engagement under the newly created Patient Engagement Framework. Engaging patients and families as active participants and co-designers of their own care is an important component of patient-centred care that improves healthcare quality, health outcomes, and overall experiences of care at a system level. To work towards this goal, I developed a trauma-informed policy and procedure for BCMHSUS on patient and family engagement to serve as a guideline for giving patients and families a voice in the design and delivery of their mental health care. I also drafted two patient engagement playbooks called Managing Conflict and Respecting Emotions and Engaging Mandated and Incarcerated Patients, which focus on barriers and solutions to engaging patients in vulnerable circumstances. Moreover, I worked with provincial stakeholders to write the annual report for the BC Partners, which is a collaborative mental health promotion partnership between BCMHSUS and 7 provincial organizations with different mental health and substance use specialties (e.g. BC Schizophrenia Society, The Mood Disorders Association of BC, Canadian Institute for Substance Use Research, etc.). I also performed a literature review of the evidence supporting family engagement in patient- and family-centred care, and I made infographics and other visual designs to translate research and knowledge in visually appealing ways. Overall, my practicum helped me contribute towards advancing public mental health by valuing patients' knowledge, skills, and lived experience in the health system and working on a variety of initiatives to promote mental health in the province.

Planetary health indicators for the local level: opportunities and challenges in applying the happy planet index in Victoria, Australia.

The United Nations Sustainable Development Goals, New Urban Agenda and Paris Agreement on Climate Change are blueprints for health promotion action that mandate human health is linked inextricably to the health of the environment. In the Anthropocene, new indicators are required to promote community engagement with, and measurement of, healthy and sustainable wellbeing for people and planet. This study explored the need for a metric such as the Happy Planet Index that explicitly links human health to health of the environment for a local level scale in Australia. The project arose from an international coalition of health promoters advocating for 'planetary health' approaches. Qualitative description methods guided the study design involving key informant interviews (n = 17) and four focus groups (n = 27 participants) with health and/or sustainability academics, practitioners and policy-makers. Document analysis of health and environment indices and policy mandates augmented the analysis. Qualitative content analysis techniques were used to analyse the findings. There was strong interest for a local level composite indicator, such as a rescaled Happy Planet Index (life expectancy × life satisfaction × equity adjustment/ecological footprint) for use at a local level. The value of a composite index was: its ability to promote community engagement with planetary health thinking; an advocacy tool for joint health and sustainability policy; to justify programs on health and environmental co-benefits; and to provide a mechanism for correlative comparisons between local governments and national comparisons. However, disciplinary silos currently limit partnerships for health promotion and planetary health and a local composite index could help bridge these divides.

Answering the Call: Educating Future Nurses on LGBTQ HealthCare

ABSTRACT The purpose of this population-focused educational strategy was to improve knowledge and attitudes of senior-level baccalaureate nursing students regarding LGBTQ health. Surveys were conducted to assess achievement in learning objectives: (a) understanding the prevalence and impact of health disparities among individuals who identify as LGBTQ, (b) understanding the ways to provide effective support for individuals who identify as LGBTQ, (c) identification of ways to engage with individuals who identify as LGBTQ in an active partnership for health promotion. The majority of students responded to survey questions acknowledging that communication skills and style changed as a result of the innovation, new or advanced knowledge was obtained and a better awareness upon which to base decisions/actions in the practice setting was gained. All health-care professionals are encouraged to practice open-mindedness and should welcome opportunities to be educated on best practice related to care of LGBTQ individuals.

Promoting population health with public-private partnerships: Where\u2019s the evidence?

BackgroundAlthough public-private partnerships have become common in the health sector, the evidence supporting their effectiveness is limited, and when the products or services provided by the private partner are harmful to health inherent conflicts of interest may be difficult to overcome. The objective of this study is to appraise the evidence describing process or effectiveness of public-private partnerships (PPPs) that aim to promote population health, and analyse how characteristics such as independence or competing interests influence the results of their evaluation.MethodsWe carried out a systematic search of Medline and Web of Science to identify scientific reports evaluating the process or effectiveness of PPPs that aim to promote population health. Two reviewers applied inclusion criteria, extracted and evaluated study quality. We classified PPPs according to the health problem tackled, the independence of the evaluation, and the potential for competition between business interests of the private partner and health promotion activity undertaken. We classified the conclusions of the evaluation as positive (supportive/tentatively supportive) or negative (semi-critical/critical).ResultsWe identified 36 studies evaluating 25 PPPs. Evaluations that were favourable to the use of PPPs in health promotion were more frequently classed as “not independent” and of poor quality. On the other hand, negative evaluations were more common when the PPP involved a private partner with a high potential for competition between the health promotion activity undertaken and their financial interests. PPPs that sought to prevent non-communicable diseases were more frequently negatively evaluated compared to PPPs tackling infectious disease or other types of health problem. Almost all of the evaluations evaluated process, with only 2 papers reporting quantitative health related outcomes.ConclusionsThere is still a lack of sound evidence supporting the effectiveness of public-private partnerships in health promotion, and the evidence base is skewed by non-independent evaluations. Public health actors should abstain from engaging in agreements with industries whose business interests have a high potential for competition with the health promotion activity undertaken.

The Bristol Oral Health Promotion Partnership

The Bristol Oral Health Promotion Partnership

Quality of collaboration within health promotion partnerships: Impact on sense of community, empowerment, and perceived projects' outcomes.

Community coalitions or intersectoral partnerships have long been advocated for the promotion of population health. In the present study, we assessed the quality of the functioning of health promotion partnerships created within a large community health promotion program implemented by the Emilia-Romagna region located in the north-east of Italy (2014-2016). In particular, we aimed to test the effectiveness of partnership working in strengthening participants' empowerment, sense of community and ultimately, the outcomes of a well-functioning partnership, conceptualized as including perceived effectiveness of health promotion interventions developed by the partnership, trust in their implementation and personal commitment in health promotion in the future. Participants were 238 stakeholders (e.g., health professionals, representatives of local administrations, teachers, representative of community and volunteer organizations, and citizens) formally included in six partnerships lead by six major local health services. Using Bayesian structural equation modeling, we found that a higher perceived quality of collaboration within the partnership enhances the outcomes of a well-functioning partnership, by strengthening their sense of a health-promoting community and empowerment. Sense of community responsibility did not predict future commitment in health promotion. The study findings suggest that community members' ownership and feeling of responsibility, as well as empowerment constitute positive partnership processes.

Synergism in Perioperative Services.

This article presents an analysis of the concept of synergism in perioperative services. Perioperative services can account for a hospital's highest expenditures and net income or loss, and leaders must understand how to maximize outcomes by creating value above expectations. Using Walker and Avant's methodology, I examined the use of synergism in the literature across multiple databases. The concept has been used in business, information technology, psychology, engineering, and theology. In health care, it is used to explain the effects of combined medications, teamwork, biological systems, patient care, cleaning effectiveness, and health promotion partnerships. I identified two attributes: an emergent property and increased positivity. Optimized outcomes, increased patient and employee satisfaction, and high net revenue are evidence of perioperative synergism. Synergism in this context is dependent on team cohesion, communication, workplace adaptability, and the tactical allocation of resources to ensure unimpeded flow of the patient through the system.

Factors That Impact the Success of Interorganizational Health Promotion Collaborations: A Scoping Review.

To explore published empirical literature in order to identify factors that facilitate or inhibit collaborative approaches for health promotion using a scoping review methodology. A comprehensive search of MEDLINE, CINAHL, ScienceDirect, PsycINFO, and Academic Search Complete for articles published between January 2001 and October 2015 was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. To be included studies had to: be an original research article, published in English, involve at least 2 organizations in a health promotion partnership, and identify factors contributing to or constraining the success of an established (or prior) partnership. Studies were excluded if they focused on primary care collaboration or organizations jointly lobbying for a cause. Data extraction was completed by 2 members of the author team using a summary chart to extract information relevant to the factors that facilitated or constrained collaboration success. NVivo 10 was used to code article content into the thematic categories identified in the data extraction. Twenty-five studies across 8 countries were identified. Several key factors contributed to collaborative effectiveness, including a shared vision, leadership, member characteristics, organizational commitment, available resources, clear roles/responsibilities, trust/clear communication, and engagement of the target population. In general, the findings were consistent with previous reviews; however, additional novel themes did emerge.

Analysis of the Partnership for Health Promotion at School in Bulgaria

According to the concept of health promotion, health is a shared responsibility of individuals, the community, the state, and non-governmental organizations. Partnership offers great potential for addressing problems and achieving goals, but it is also associated with certain difficulties. Establishing a successful partnership requires common purpose, shared responsibilities, complementary competencies, collaboration, and mutual respect. The aim of this paper is to analyze whether partnership as a main principle of health promotion has been put into practice in the observed school community. A comprehensive medico-social survey on school health promotion was conducted from September 2012 to May 2013 over a representative sample of schools in the Pleven region of Bulgaria. Data were collected through a self-administered questionnaire among 1,280 members of the school community, interviews with school principals, and a review of the documents. Questions are directed toward the elements of the coordinated school health model. Data analysis of the presented part of the study, which examined the partnership for health promotion at school, was consistent with the methodology of the partnerships analysis tool using a specially designed checklist for evaluation. Over 90% of the investigated subjects and organizations realize the necessity of partnership. They have a clear goal to improve the well-being of the school community and a shared understanding that the benefits from partnership outweigh the exertions and costs. On the other hand, not all potential partners are included in the process of planning priorities for action. Almost half do not always have a clear idea about their responsibilities for fulfilling the goals. Both the positive and weak points of the partnership were able to be considered. The necessity for partnerships in promoting school health is recognized but difficult to transform into real action due to limited competencies and collaborations.

Predictors and mediators of sustainable collaboration and implementation in comprehensive school health promotion

PurposeThe Diagnosis of Sustainable Collaboration (DISC) model (Leurs et al., 2008) specifies five factors (i.e. project management, change management, context, external factors, and stakeholders’ support) which predict whether collaboration becomes strong and stable. The purpose of this paper is to study the dynamics of these factors in a study of multiple partnerships in comprehensive school health promotion (CSHP).Design/methodology/approachA Dutch two-year DISC-based intervention to support coordinators of five CSHP partnerships in the systematic development of intersectoral collaboration was studied in a pretest-posttest design. To uncover the determinants of sustainable collaboration and implementation of CSHP and to find possible mediators, the authors carried out multi-level path analyses of data on the DISC factors obtained from 90 respondents (response of approached respondents: 57 percent) at pretest and 69 respondents (52 percent) at posttest. Mediation mechanisms were assessed using joint significance tests.FindingsThe five DISC factors were important predictors of implementation of CSHP (explained variance: 26 percent) and sustainable collaboration (explained variance: 21 percent). For both outcomes, stakeholders’ support proved to be the most important factor. Regarding sustainable collaboration, mediation analysis showed that stakeholders’ support fully mediated the effects of change management, project management, external factors and context. This indicates that the extent of stakeholders’ support (e.g. appreciation of goals and high levels of commitment) determines whether collaboration becomes sustainable. The authors also found that the extent of stakeholders’ support in turn depends upon a well-functioning project management structure, the employment of change management principles (e.g. creation of a common vision and employment of appropriate change strategies), a favorable organizational context (e.g. positive experience with previous collaboration) and external context (e.g. positive attitudes of financing bodies and supporting health and educational policies). For the actual implementation of CSHP, partial mediation by the support factor was found. There was a direct positive effect of change management indicating that organizational knowledge is also necessary to implement CSHP, and a direct negative effect of project management, probably pointing to the negative effects of too much negotiation in the collaboration.Research limitations/implicationsA design lacking a control group, a small sample and a relatively early assessment after implementation support stopped limit the generalizability of the results.Practical implicationsStrategies targeting the DISC factors can enhance stakeholders’ support and thereby promote sustainable intersectoral collaboration and the implementation of CSHP.Originality/valueThe DISC model provides a fruitful conceptual framework for the study of predictors and processes in public health partnerships. The importance of stakeholders’ support and other factors in the model are demonstrated.

Political Challenges in Complex Place-Based Health Promotion Partnerships: Lessons From an Exploratory Case Study in a Disadvantaged Area of Queensland, Australia.

Settings-based health promotion involving multiple strategies and partners is complex, especially in disadvantaged areas. Partnership development and organizational integration are examined in the literature; however, there is more to learn from the examination of practice stakeholders' experience of intersectoral partnership processes. This case study examines stakeholder experiences of challenges in new partnership work in the context of a culturally diverse and socioeconomically disadvantaged region in Queensland, Australia. Health promotion staff and community representatives participated in interviews and focus groups, and the thematic analysis included observations and documentary analyses. Our findings highlight the retrogressive influence of broader system dynamics, including policy reform and funding changes, upon partnership working. Partnership enablers are disrupted by external political influences and the internal politics (individual and organizational) of health promotion practice. We point to the need for organization level commitment to a consistent agreed vision specifically accounting for place, as a cornerstone of intersectoral health promotion partnership resilience. If organizations from diverse sectors can embed a vision for health that accounts for place, complex health promotion initiatives may be less vulnerable to broader system reforms, and health in all policy approaches more readily sustained.

Examining the integration of sport and health promotion: partnership or paradox?

ABSTRACTCross-sector partnerships between public health agencies and non-profit sport organisations may offer an effective approach to health promotion given their mutual interest in facilitating opportunities for individual and community well-being. The study draws on conceptual framing from the public non-profit partnership literature to understand the potential role of sport organisations in health promotion partnerships and the factors associated with engaging these cross-sector partners. The research involves a case study of a local, cross-sector partnership for health promotion aimed at increasing physical activity through strategic marketing campaigns. Data were gathered through semi-structured interviews with representatives from partner organisations in the sport sector and members of the partnership executive committee, as well as active-member participant observation. The results suggest that despite congruent organisational priorities and policy imperatives that link sport and health-based organisations, there was evidence of misalignment in the partners’ capacity to collaborate. There was also notable incongruence in the discourses related to sport and health and the norms and values underpinning the partnership of public health and non-profit community sport. The implications of the research suggest that despite higher-order policy agendas emphasising partnerships as a means to advance health outcomes, there are significant constraints in local capacity for collaboration to meet these policy goals.