Professional development programs in health promotion: tools and processes to favor new practices

Developing innovative interventions that are in sync with a health promotion paradigm often represents a challenge for professionals working in local public health organizations. Thus, it is critical to have both professional development programs that favor new practices and tools to examine these practices. In this case study, we analyze the health promotion approach used in a pilot intervention addressing children's vulnerability that was developed and carried out by participants enrolled in a public health professional development program. More specifically, we use a modified version of Guichard and Ridde's (Une grille d'analyse des actions pour lutter contre les inégalités sociales de santé. In Potvin, L., Moquet, M.-J. and Jones, C. M. (eds), Réduire les Inégalités Sociales en Santé. INPES, Saint-Denis Cedex, pp. 297-312, 2010) analytical grid to assess deductively the program participants' use of health promotion practices in the analysis and planning, implementation, evaluation, sustainability and empowerment phases of the pilot intervention. We also seek evidence of practices involving (empowerment, participation, equity, holism, an ecological approach, intersectorality and sustainability) in the intervention. The results are mixed: our findings reveal evidence of the application of several dimensions of health promotion (equity, holism, an ecological approach, intersectorality and sustainability), but also a lack of integration of two key dimensions; that is, empowerment and participation, during various phases of the pilot intervention. These results show that the professional development program is associated with the adoption of a pilot intervention integrating multiple but not all dimensions of health promotion. We make recommendations to facilitate a more complete integration. This research also shows that the Guichard and Ridde grid proves to be a thorough instrument to document the practices of participants.

Measuring the progress of capacity building in the Alberta Policy Coalition for Cancer Prevention

The Alberta Policy Coalition for Cancer Prevention (APCCP) represents practitioners, policy makers, researchers, and community organizations working together to coordinate efforts and advocate for policy change to reduce chronic diseases. The aim of this research was to capture changes in the APCCP's capacity to advance its goals over the course of its operation. We adapted the Public Health Agency of Canada's validated Community Capacity-Building Tool to capture policy work. All members of the APCCP were invited to complete the tool in 2010 and 2011. Responses were analyzed using descriptive statistics and t tests. Qualitative comments were analyzed using thematic content analysis. A group process for reaching consensus provided context to the survey responses and contributed to a participatory analysis. Significant improvement was observed in eight out of nine capacity domains. Lessons learned highlight the importance of balancing volume and diversity of intersectoral representation to ensure effective participation, as well as aligning professional and economic resources. Defining involvement and roles within a coalition can be a challenging activity contingent on the interests of each sector represented. The participatory analysis enabled the group to reflect on progress made and future directions for policy advocacy.

A pilot study of Aboriginal health promotion from an ecological perspective

BACKGROUND

For health promotion to be effective in Aboriginal and Torres Strait Islander Communities, interventions (and their evaluation) need to work within a complex social environment and respect Indigenous knowledge, culture and social systems. At present, there is a lack of culturally appropriate evaluation methods available to practitioners that are capable of capturing this complexity. As an initial response to this problem, we used two non-invasive methods to evaluate a community-directed health promotion program, which aimed to improve nutrition and physical activity for members of the Aboriginal community of the Goulburn-Murray region of northern Victoria, Australia. The study addressed two main questions. First, for members of an Aboriginal sporting club, what changes were made to the nutrition environment in which they meet and how is this related to national guidelines for minimising the risk of chronic disease? Second, to what degree was the overall health promotion program aligned with an ecological model of health promotion that addresses physical, social and policy environments as well as individual knowledge and behaviour?

METHODS

Rather than monitoring individual outcomes, evaluation methods reported on here assessed change in the nutrition environment (sports club food supply) as a facilitator of dietary change and the 'ecological' nature of the overall program (that is, its complexity with respect to numbers of targets, settings and strategies).

RESULTS

There were favourable changes towards the provision of a food supply consistent with Australian guidelines at the sports club. The ecological analysis indicated that the design and implementation of the program were consistent with an ecological model of health promotion.

CONCLUSIONS

The evaluation was useful for assessing the impact of the program on the nutrition environment and for understanding the ecological nature of program activities.

Ecological models revisited: their uses and evolution in health promotion over two decades

Since the 1980s, ecological models of health promotion have generated a great deal of enthusiasm among researchers and interventionists. These models emerged from conceptual developments in other fields, and only selected elements of the ecological approach have been integrated into them. In this article, we describe the tenets of the ecological approach and highlight those aspects that have been integrated into ecological models used in health promotion. We also analyze how ecological models have been applied to the study of two important public health issues, namely physical activity promotion and the increased consumption of fruits and vegetables, by conducting an archival study of published research. Finally, we make a statement regarding the usefulness of ecological models for research and practice and propose recommendations for future research, program planning, and evaluation.