Health-promoting Leadership Research Articles

Designing a learning health organization for collective impact.

In May 2014, the Public Health Leadership Forum published “The High Achieving Governmental Health Department in 2020 as the Community Chief Health Strategist.”1 This groundbreaking paper started with the following statement: Local and state health departments need to adapt and evolve if governmental public health is to address emerging health demands, minimize current as well as looming pitfalls, and take advantage of new and promising opportunities. To succeed requires a view into the future. In November 2011, the San Francisco Department of Public Health (SFDPH), Population Health Division embarked on this journey to reorganize the public health division into a high-achieving governmental health department for the future. We used public health accreditation as the catalyst to reorganize, and the new organization structure launched on July 1, 2013. For the staff in the SFDPH, public health accreditation is about the humble and passionate pursuit of results, equity, and accountability for improving community health. This inspired us to call our framework for public health accreditation and improvement REACH (Results, Equity and Accountability for Community Health). Staff are focused on achieving results (impacts, goals, and outcomes); integrating equity into quality improvement efforts; designing accountability into our activities, including community-based evidence (local voice, wisdom, and knowledge) with science- and practice-based evidence; and protecting and promoting population health. REACH was developed after the SFDPH leadership embraced the idea that public health accreditation could be used as a vehicle to protect and promote the health of all San Franciscans. The San Francisco Health Commission—the governing health body—passed a resolution declaring public health accreditation a top strategic health priority for San Francisco. With this support, the SFDPH embarked on an extensive reorganization of its public health services into a new Population Health Division. The overarching goal was to design a community-centered, responsive, and agile health organization that could adapt quickly to current and emerging public health challenges and opportunities. Strategic objectives included the following: provide leadership in health protection, health promotion, disease and injury prevention, and disaster preparedness; expand our focus to community wellness, beyond disease events; promote healthy and sustainable environments; integrate health equity into quality improvement efforts; strengthen service excellence to communities, clients, and providers; ensure a culture of trust and innovation; strengthen our culture of finding, translating, and implementing science-based solutions to problems; and achieve and maintain public health accreditation. An organization design team consisting of leaders, managers, and staff was convened. Because there is limited collective knowledge and funding for developing organizational structures in local health departments, a new structure was designed using existing local experience and published resources. The design team members reviewed public health accreditation domains and standards, population health models,2,3 the Baldrige Criteria for Performance Excellence (CPE),4 key public health texts,5,6 and modern organization design books.7,8 The design team actively engaged the staff, the affected community, and other stakeholders to bring in and build connections of trust and understanding. By pulling together all those sources of input, the design team developed a strategic map and then created an organization design framework and staffing chart. With that foundation, the REACH framework evolved after reviewing and testing several quality improvement models.9–16 Finally, the SFDPH was able to leverage funding and technical assistance from the Centers for Disease Control and Prevention and the National Association of County & City Health Officials, which supported preparation for public health accreditation and funding for program collaboration and service integration.17 The purpose of this commentary is to review how the SFDPH used organization design concepts and continuous improvement frameworks to reorganize from autonomous, categorical silos of public health services to an integrated, community-centered Population Health Division. We believe that these concepts and methods can be adapted to many health organizations.

Health-promoting palliative care: a Scottish perspective.

International Journal of Palliative NursingVol. 20, No. 7 CommentaryHealth-promoting palliative care: a Scottish perspectiveRebecca M Patterson, Mark A HazelwoodRebecca M PattersonSearch for more papers by this author, Mark A HazelwoodSearch for more papers by this authorRebecca M Patterson; Mark A HazelwoodPublished Online:25 Jul 2014https://doi.org/10.12968/ijpn.2014.20.7.318AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InEmail View article References Age Scotland (2013) Mind the Gap: Age Scotland's Public Policy Review 2012-2013. Age Scotland Google ScholarChildren's Hospice Association Scotland (2013) The 100% Project film. www.chas.org.uk/100percentproject/whatis100 (accessed 5 June 2014) Google ScholarCompassionate Friends UK (2013) Say Their Name film. www.youtube.com/watch?v=GS9z3dwMhZs&feature=kp (accessed 5 June 2014) Google ScholarDepartment of Health (2008) End of Life Care Strategy: Promoting High Quality Care for Adults at The End of Life. DH, London Google ScholarDying Matters (2010) Society's wall of silence around dying and death prompts call for national debate. http://dyingmatters.org/news/society%E2%80%99s-wall-silence-around-dying-and-death-prompts-call-national-debate (accessed 5 June 2014) Google ScholarEncyclopedia of Death and Dying (2014) Continuing bonds. www.deathreference.com/Ce-Da/Continuing-Bonds.html (accessed 5 June 2014) Google ScholarGlasgow Centre for Population Health (2011) Asset Based Approaches for Health Improvement: Redressing the Balance. Glasgow Centre for Population Health, Glasgow Google ScholarKellehear A, Young B (2007) Resilient communities. In: Monroe BOlivier D, eds. Resilience in Palliative Care – Achievement in Adversity. Oxford University Press, Oxford Crossref, Google ScholarKumar S, Numpeli M (2005) Neighborhood network in palliative care. Indian J Palliat Care 11(1): 6–9 Crossref, Medline, Google ScholarLindsay J, Miller J, Currie EMC, Kelly J, Guthrie M (2013) Whole School Approach to Loss, Grief and Bereavement. www.palliativecarescotland.org.uk/content/publications/Loss-Grief-and-Bereavement-Toolkit.pdf (accessed 5 June 2014) Google ScholarNatCen Social Research (2013) British Social Attitudes 30. NatCen Social Research Google ScholarNHS Health Scotland and Joint Improvement Team (2014) Active and Healthy Aging Action Plan 2014-16. JIT Google ScholarOffice of the Public Guardian (2014) Yearly comparisons by type. www.publicguardian-scotland.gov.uk/whatwedo/historical%20stats.asp (accessed 5 June 2014) Google ScholarPatterson R, Hazelwood M (2014) Dining with Death: Conversation Menus as a means of educating people about death, dying and bereavement. BMJ Support Palliat Care 4(Suppl 1): A77 Crossref, Medline, Google ScholarSallnow L, Paul S (2014) Understanding community engagement in end-of-life care: developing conceptual clarity Critical Public Health doi: https://doi.org/10.1080/09581596.2014.909582 Medline, Google ScholarScottish Government (2008) Living and Dying Well: A National Action Plan for Palliative and End of Life Care in Scotland. Scottish Government, Edinburgh Google ScholarScottish Government (2011) Living and Dying Well: Building on Progress. Scottish Government, Edinburgh Google ScholarShort Life Working Group 7 (2010) Addressing Palliative and End of Life Care from A Public Health and Health Promotion Perspective: Facilitating Wider Discussion of Death, Dying and Bereavement Across Society. Scotttish Government, Edinburgh Google ScholarStrang F (2013) All Hands on Deck. www.jitscotland.org.uk/news-and-events-files/All%20Hands%20on%20Deck.pdf (accessed 5 June 2014) Google ScholarWorld Health Organization (1997) Jakarta Declaration on Leading Health Promotion into the 21st Century. www.who.int/healthpromotion/conferences/previous/jakarta/declaration/en/ (accessed 5 June 2014) Google Scholar FiguresReferencesRelatedDetailsCited byArea-Based Compassionate Communities: A systematic integrative review of existing initiatives worldwide30 March 2022 | Palliative Medicine, Vol. 36, No. 3New public health approaches to palliative care, a brave new horizon or an impractical ideal? An Integrative literature review with thematic synthesis6 October 2021 | Palliative Care and Social Practice, Vol. 15Resilience as a predictive factor towards a healthy adjustment to grief after the loss of a child to cancer21 March 2019 | PLOS ONE, Vol. 14, No. 3 2 July 2014Volume 20Issue 7ISSN (print): 1357-6321ISSN (online): 2052-286X Metrics History Published online 25 July 2014 Published in print 2 July 2014 Information© MA Healthcare LimitedPDF download

The Professional Occupational Therapy Doctoral Degree: Why Do It?

This article presents a rationale for the development of professional occupational therapy doctorate (OTD) programs. As more universities transition to the entry-level OTD degree, opportunities are becoming available to advance the profession and increase benefits to clients. We analyzed the current health care environment and developed the following proposed outcomes for doctoral-trained practitioners: (1) Demonstrate advanced clinical skills; (2) attain proficiency in outcomes measurement and analysis and synthesis of outcomes data; (3) routinely use standardized evidence-based practice clinical guidelines that translate research into practice; (4) develop, implement, and lead health promotion services; and (5) excel as partners in interprofessional teams.

The Impact of Health-Oriented Leadership on Follower Health: Development and Test of a New Instrument Measuring Health-Promoting Leadership

Based on previous research on leadership and follower health, three questions need to be answered or clarified. These questions refer to what health-specific leadership behavior is, whether motivational and cognitive aspects provide information beyond such behavior, and what role followers play in the leadership-health link. We introduce a new concept and measure of Health-oriented Leadership (HoL). This concept combines leaders' health-specific orientation towards followers (StaffCare; i.e., health behavior, health awareness, and value of health) and followers' health-specific attributes toward themselves (SelfCare). We present tests of construct and criterion validity from two field studies. The findings of Study 1 (N = 535) provide evidence for the construct validity of the HoL instrument. Study 2 (N = 383) examined the impact of StaffCare and SelfCare on follower health. As hypothesized, StaffCare as health-specific leadership is related to followers' state of health, irritation, health complaints, and work–family conflicts. These effects were shown independently from transformational leadership indicating incremental validity. Moreover, the relationship between StaffCare and these outcomes is mediated by followers' SelfCare. The findings contribute to a more comprehensive picture of ways in which leaders can promote follower health by (a) engaging in StaffCare and (b) fostering followers' SelfCare.

Health-promoting schools: working in partnership to address global needs, a collaboration leading to the production of practical tools for practitioners.

Modern schools do their best to motivate young people to live fulfilling, healthy and productive lives and the United Nations has put school education at the heart of the Millennium Development Goals. The context of education in schools is changing, but there is evidence from across the world that school health promotion can make a difference to health and education outcomes. The International Union for Health Promotion and Education (IUHPE) has recognized this potential in schools and, for the last five years in its work globally, has been actively engaged in strengthening efforts through successful partnerships. This commentary explores aspects of global partnerships in school health and the progress of the IUHPE's leadership and partnership work in school health promotion. It also provides some reflections on what has been achieved to date and what might lie ahead in school health promotion globally.

Using evidence in health promotion in local government: contextual realities and opportunities

New national and state preventive health investments have provided significant funding for local governments (LGs) to be involved in planning and implementing health promotion interventions. There is an expectation that this work is evidence based; however, inadequate support and systems exist for evidence-informed planning and decision making in LGs. Previous initiatives have aimed to build capacity and leadership in LG health promotion, but the training, support and infrastructure have been sporadic. Across 2009-11 we implemented a National Health and Medical Research Council of Australia (NHMRC)-funded university-LG research project to explore the feasibility, usefulness and outcomes of a knowledge translation (KT) intervention to increase the use of evidence in LGs. Within this exploratory cluster randomised controlled trial, one strategy being evaluated was workforce capacity building, during which group discussions revealed contextual challenges in delivering evidence-informed health promotion within the current funding context. Discussion was recorded. The group acknowledged the need to identify barriers and realistic practical solutions, and to communicate these more broadly. Barriers to sourcing and applying evidence to inform health promotion emerged from discussions with LG representatives. System-level contextual factors affecting decisions were also discussed, namely concerns about organisational capacity and 'culture' to plan, implement and evaluate effective initiatives in LGs. Possible solutions suggested included: systems for access to academic literature; processes that make it easier to use evidence; training in evidence-informed health promotion to build organisational culture and capacity; and research-practice partnerships and mentoring. Targeted strategies with individuals (LG staff) and organisations (leadership, systems) are needed to realise the potential of current health promotion investments. Research-practice partnerships are likely to be important. It seems obvious that it is impossible to be evidence informed without mechanisms to access and apply evidence. We invite other LGs to reflect upon their experiences in such initiatives, and to consider whether the strategies we propose may be useful. So what? The increased emphasis on health promotion and non-communicable disease prevention programs may be limited by the capacity, confidence and organisational culture to inform policies and programs with best-available evidence. We describe some of the current challenges and contextual factors as they are being experienced. There are opportunities for national and state governments, organisations representing local government (e.g. municipal associations) and research partners to provide targeted support to councils. This may assist in achieving effective health promotion at the community level.

Where are the champions of global health promotion?

For many years the World Health Organization (WHO) has provided the global direction and leadership that has helped to shape the way we view health promotion today. The future role of the WHO is now uncertain and the lack of global leadership for health promotion and identification of who will provide the future direction are issues that need to be addressed. The crucial question posed in this commentary is: Where are the individuals and organisations that will provide the global leadership and vision for health promotion in the future? We need named champions for the future leadership of health promotion practice - people and organisations who offer a leadership style that will maintain its global profile, be representative across sectors and have the ability to maintain its political efficacy. The two key health promotion approaches, top-down and bottom-up, do not always share the same goals, and they demand different styles of leadership. This is an important consideration in our goal to find champions who can work with both approaches and understand how to accommodate them as a part of the future direction of health promotion. This commentary raises key questions to stimulate discussion and action towards addressing the lack of global leadership in health promotion. It discusses some of the key players, leadership characteristics and the contradictions in style that are inherent in achieving a goal of charismatic global champions.

A Program for Thai Rubber Tappers to Improve the Cost of Occupational Health and Safety

The purposes of this research were to determine the cost of occupational health and safety and work-related health problems, accidents, injuries and illnesses in rubber tappers by implementing a program in which rubber tappers were provided training on self-care in order to reduce and prevent work-related accidents, injuries and illnesses. Data on costs for healthcare, the prevention and the treatment of work-related accidents, injuries and illnesses were collected by interview using a questionnaire. The findings revealed that there was no relationship between what was spent on healthcare and the prevention of work-related accidents, injuries and illnesses and that spent on the treatment of work-related accidents, injuries and illnesses. The proportion of the injured subjects after the program implementation was significantly less than that before the program implementation (p<0.001). The level of pain after the program implementation was significantly less than that before the program implementation (p<0.05). The treatment costs incurred after the program implementation were significantly less than those incurred before the program implementation (p<0.001). It was demonstrated that this program raised the health awareness of rubber tappers. It strongly empowered the leadership in health promotion for the community.

Evaluation of calcium excretion in Brazilian infantile and young population environmentally exposed to lead

Lead exposure is an important issue in the research of several toxic effects resulting from the biochemical interaction between this metal and the organism. Calcium is a fundamental mineral for the maintenance of the organism homeostasis where there is interaction between lead and calcium in metabolic pathways. Environmental lead exposure by verifying the usefulness and applicability of urinary calcium/creatinine ratio (UCa/Cr) in this context was evaluated. This was an extensive socio-demographic study of the nutritional profile, lead exposure biomarkers in blood and the urine and UCa/Cr ratio. The children studied were from a low socio-economic group characterized by unsatisfactory nutritional diet. Lead environmental exposure was shown by biomarkers, with UCa/Cr ratio having positive and significant correlations with both lead and delta-aminolevulinic acid in urine (ALA-U), without colinearity diagnosis. There was a strong association between calcium excretion and lead exposure as a result of linear regression construction models. In children, lead increases calcium excretion which is an additional risk to infantile health. Urinary calcium/creatinine ratio may be a useful tool in the biological monitoring of lead exposure and health promotion programs.

Student led health promotion

Student led health promotion

Occupational Therapy Led Health Promotion for Older People: Feasibility of the Lifestyle Matters Programme

The aim of this feasibility study was to see if an occupation-based health-promoting intervention for community-living older people could be delivered successfully and also to provide some information to guide a future trial of clinical effectiveness. The participants' ages ranged from 60 to 92 years. Twenty-eight participants commenced the 8-month programme and 26 completed it; they have continued to meet independently following facilitator withdrawal. The participants were interviewed qualitatively before and after the 8-month programme. Additionally, pre-programme and post-programme measurements of cognition, depression, functional dependency and quality of life were conducted with each participant before and after the intervention. The post-intervention interviews illustrated the individualised benefits experienced by the participants, with greater self-efficacy being a significant theme. A comparison of the pre-intervention and post-intervention scores on the quantitative measures showed an upward trend on all dimensions of quality of life. The measurement of cognition, depression and dependency proved useful for screening purposes and for identifying individuals at risk, but not as an outcome measure. The delivery of the programme was feasible and its benefit to participants was observed, but there is a need for further research to test the intervention rigorously and to explore applicability in a range of settings.

Adolescent Health Promotion Groups: A Primer for Milieu Therapists

SUMMARY Adolescents who are required to live away from their families of origin face many challenges that can affect mood and mental health. Milieu therapists (mental health associates) working with adolescents in a residential treatment center may be expected to provide group activities that promote mental health. It is important for new group leaders to have training prior to group sessions and ongoing supervision. The purposes of this article are (a) to describe the mental health of adolescents, (b) to delineate the basics of the therapeutic group, and (c) to offer tips for leading health promotion groups.

Health promotion competencies for Australia 2001—5: trends and their implications

This important research builds on past projects in Australia and internationally that have sought to define and clarify competencies required to work in health promotion. The paper briefly explains the process undertaken in 2005 to update the Australian health promotion competencies as a collaboration of several leading health promotion agencies. The article reports findings from research undertaken in 2001 and 2005 and compares trends in perceptions of health promotion competencies across time. This dialogue among researchers, health promotion academics and practitioners can help to further the impact of competencies research on professional practice in health promotion globally. This project placed a priority on methodology that engaged the health promotion workforce in Australia. A two-stage process was employed including expert consultation with 39 senior health promotion professionals, followed by a modified Delphi process to engage 400 practitioners. Space was allowed for comment on the competencies including suggested word changes, and respondents were also invited to add additional competencies. The research involved a modified Delphi study where participants were invited to rate each competency as "essential", "desirable" or "not relevant", and to suggest changes to wording, as well as additions to the list. Responses were received from 400 practitioners and the results were presented and compared with the 2001 survey results. Results indicate a substantial shift in perceptions about health promotion practice in Australia during the initial years of the 21(st) century.The overall significant changes in perceptions indicate that by 2005 the Australian health promotion workforce had substantially moved away from an individual behaviour-dominated perception of health promotion practice. Increasing recognition was given to competencies that reflect environmental, economic and policy influences on health, and increased recognition that these processes are legitimate and essential components of the health promotion process.

The Feasibility and Effectiveness of Translating a Matter of Balance Into a Volunteer Lay Leader Model

The purpose of this study is to examine whether A Matter of Balance, a cognitive-behavioral program previously found to be efficacious in a randomized clinical trial (RCT), could be translated into a community-based volunteer lay leader model and achieve outcomes comparable to those found in the RCT. A repeated measures, single-group design is employed. Participants experience significant increases in falls efficacy, falls management, and falls control at 6 weeks, 6 months, and 12 months, thus achieving comparable outcomes with those of participants in the RCT. This successful translation of a professionally led health promotion program into a volunteer lay leader model enables embedding the program in community-based organizations, thus making it more broadly available to older adults in diverse settings. The findings also suggest that other evidence-based programs currently requiring professional staff can be adapted for facilitation by volunteers.

Perfil y número de médicos generales que requiere el país

Medical schools curricular planning aim to obtain a physician trained to work as general practitioner and the Chilean health reform, considers ambulatory primary care as the main axis of health care. However there is still a low interest among physicians to work in primary health care, where there are problems related to a low level of clinical resolution, clinical and administrative management deficiencies and a low level of leadership in health promotion. The causes of these deficiencies stem from university training, government policies and the great attraction that exerts the technological and specialized model of secondary and tertiary health care. We analyze the ideal profüe that the general practitioner should have in our health care system and the possible solutions to primary health care problems. We also emphasize the need to coordinate the professional resource needs with university training, to reduce the existing gaps between medical training and professional practice.

Organizational leadership and its relationship to regional health authority actions to promote health

The purpose of this paper is to examine organizational leadership and its relationship to regional health authority actions to promote health. Through use of four previously developed measures of Perceived Organizational Leadership for Health Promotion, this paper focused on leadership as a distributed entity within regional health authority (RHA) jurisdictions mandated to address the health of the population in the province of Alberta, Canada. First, examination of differentials between organizational levels (i.e. board members, n = 30; middle/senior management, n = 58; and service providers, n = 56) on ratings of the four leadership measures revealed significant differences. That is, board members tended to rate leadership components significantly higher than service providers and middle/senior managers: from across all 17 RHAs; and in low health promotion capacity and high health promotion capacity RHAs. Second, regression analyses identified that the leadership measures "Practices for Organizational Learning" and "Wellness Planning" were positively associated with health authority actions on improving population heart health (heart health promotion). The presence of a "Champion for Heart Health Promotion" and the leadership measures "Workplace Milieu" and "Organization Member Development" were also positively associated with health authority actions for health promotion. A subsidiary aim revealed low to moderate positive relationships of the dimensions of Leadership, Infrastructure and Will to Act with one another, as proposed by the Alberta Model on "Organizational Capacity Building for Health Promotion." This paper, conducted on the baseline dataset (n = 144) of the "Alberta Heart Health Project's Dissemination Phase", represents a rare effort to examine leadership at a collective organizational level.

Homeless drug users' awareness and risk perception of peer "take home naloxone" use--a qualitative study.

BackgroundPeer use of take home naloxone has the potential to reduce drug related deaths. There appears to be a paucity of research amongst homeless drug users on the topic. This study explores the acceptability and potential risk of peer use of naloxone amongst homeless drug users. From the findings the most feasible model for future treatment provision is suggested.MethodsIn depth face-to-face interviews conducted in one primary care centre and two voluntary organisation centres providing services to homeless drug users in a large UK cosmopolitan city. Interviews recorded, transcribed and analysed thematically by framework techniques.ResultsHomeless people recognise signs of a heroin overdose and many are prepared to take responsibility to give naloxone, providing prior training and support is provided. Previous reports of the theoretical potential for abuse and malicious use may have been overplayed.ConclusionThere is insufficient evidence to recommend providing "over the counter" take home naloxone" to UK homeless injecting drug users. However a programme of peer use of take home naloxone amongst homeless drug users could be feasible providing prior training is provided. Peer education within a health promotion framework will optimise success as current professionally led health promotion initiatives are failing to have a positive impact amongst homeless drug users.

Providing Leadership for Health Promotion and Health Disparities: SOPHE’s Inaugural Health Education Research Disparities Summit

Providing Leadership for Health Promotion and Health Disparities: SOPHE’s Inaugural Health Education Research Disparities Summit

Introducing Health Promotion Agenda-Setting for Health Education Practitioners

Health professionals must continuously address health promotion issues using the latest strategies and research. Currently in health care, too often an underdeveloped and under supported agenda prioritizes problems, issues, and solutions. Further, an ongoing competition exists among issues due to an undocumented agenda-setting process to gain the attention of media, public, and policy makers. Agendasetting is based on the belief that the media influence what we talk about, rather than controlling what we think, and how often an issue appears in the media influences the policy agenda (Dearing &amp; Rogers, 1996). If an issue is “salient” and receives frequent or expansive coverage by media, audience members will talk more about that issue than one that is not as salient. A Health Promotion Agenda-Setting approach works to specify and prioritize problems and alternative solutions for increasing media exposure and setting agendas for “sustained” courses of action, (Kozel et al., 2003). The crucial link between agenda-setting and the process of establishing effective legislation, policy, and programs has been researched. However, many health practitioners do not understand what agenda setting is, nor how to apply agenda setting within the field of health education. Professional development in Health Promotion Agenda-Setting offers health education practitioners new knowledge, skills, methods, and opportunities to strengthen practices that influence the public health agenda and transform health promotion leadership.

Opportunities for Health Promotion Education in Child Care

Comprehensive health promotion education is not feasible through pediatric office visits alone. Opportunities may exist for enhanced health promotion in child care settings. The objectives of this study were to understand the attitudes toward, barriers to, and strategies for incorporating health promotion activities in child care settings as well as topics that are deemed most useful from the perspectives of parents, child care directors, and health consultants. We also sought to understand the health consultants' (health professionals serving as consultants to child care centers) current and desired roles in leading health promotion activities in child care settings. We conducted simultaneous surveys of all licensed child care center directors and their health consultants in Boston. A total of 240 parents in 16 randomly selected centers were also surveyed. A total of 97 (65%) directors in the 150 child care centers identified responded. A total of 71% (56 of 79) of consultants and 58% (138 of 240) of parents responded. Parents (89%), child care directors (88%), and health consultants (80%) believe that health promotion activities through child care centers would improve the health knowledge and behaviors of preschool children. A total of 45% of parents reported already receiving useful health information from child care staff and materials distributed in child care. Most topic areas that were suggested to parents were considered useful, with the greatest utility in the areas of behavior/discipline, child development, and emergency management. No significant barriers were identified by health professionals. Lack of funds (63%) and lack of someone to provide information (59%) were the top barriers identified by directors. An educational session on health topics by health care professionals was believed to be the best strategy to improve health promotion education for families. Among the health consultants, 83% of nurses or nurse practitioners said that they would be able to provide health education in child care compared with 53% of physicians. Parents, child care center directors, and health professionals believe that enhancing health promotion education in child care could improve child health. Collaboration between pediatricians and early care and education professionals has the potential to improve the breadth and effectiveness of health promotion education. Effective strategies are necessary to optimize access to health professionals by early educators, and effectively utilize the unique skills and preferences of physicians and nurses to promote health education in child care.