Understanding facilitators of and barriers to health promotion practice.
ABSTRACT The health promotion best practices literature is imbued with hope for knowledge mobilization, enhanced practice, and improved population health. Given constrained medical care systems, health promotion is key to reducing the significant burden of chronic disease. However, we have seen little evidence of change. This article investigates facilitators of, and barriers to, three stages of health promotion practice in public health organizations, interagency coalitions, and volunteer committees. The article focuses not on what works but why it does or does not, drawing on five case studies within the Canadian Heart Health Initiative. Results indicate that the presence or absence of appropriately committed and/or skilled people, funds and/or resources, and priority and/or interest are the most common factors affecting all stages of health promotion practice. The article extends the literature on internal and external factors affecting health promotion and highlights strategic influences to consider in support of effective health promotion practice.
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ABSTRACT: Setting and Objective: For decades, the World Health Organisation has promoted settings-based health promotion, but its application in leisure settings is minimal. Focusing on organised sports as an important leisure activity, the present study had three goals: exploring the health promotion profile of youth sports clubs, identifying objective club characteristics (e.g. size, type of sport), predicting the presence/absence of health promotion in youth sports clubs and identifying perceived motives and barriers to health promotion in youth sports clubs, thereby improving the basis for policy guidelines. Method: Respondents were representatives from the board of 154 youth sports clubs. Data were collected through an online survey, including the health-promoting sports club index (HPSC-I). Linear regression and analysis of variance were used to identify predictors and differences. Results: Even though the motives were strongly supported, a majority of youth sports clubs were rated as low health promoting on the HPSC-I (59%). Overall, linear regression indicated that clubs founded more recently, offering multiple types of sports and offering both recreation and competition scored higher on the health promotion indices. Health promotion not being a priority of the board and lack of expertise were identified as the most important barriers. Conclusion: Progress is needed before youth sports clubs can truly be considered health-promoting settings. Policy suggestions are made to address the barriers, for example, financial incentives to maximise efforts and establishing collaborations between sports clubs and health promotion experts.Health Education Journal 09/2014; DOI:10.1177/0017896914549486 · 0.73 Impact Factor
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ABSTRACT: Purpose – The study identifies the variation of change strategies used in a complex large scale change program in health and social services in Sweden, aimed at changing professionals' health promoting practices. The purpose is to investigate the change strategies used over time and describe the potential variation in key change agent views, using a framework inspired by De Caluwé and Vermaak's multi paradigm change typology. Design/methodology/approach – The first six years of the regional multi-sector program are examined. Results are based on content analyses of interviews with key change actors, and archival data describing program activities. Respondents belonged to either the strategic or the operational program management team, representing different sectors of health and social services in a region. Findings – Multiple strategy paradigms showed varying influence over the program's different phases, partly due to program progress, change agent influence and/or varying contextual demands. Respondents' views on strategies and program focus varied depending on their program roles. Respondents expressed insights about the varying conditions for change and on the conflicting expectations within and between program management teams. Originality/value – This study introduces the application of a new framework on a large scale, complex change program. The framework sheds light on a number of basic assumptions and change strategies that can be further compared with content and context factors, barriers, facilitators, outcomes, and in turn with other programs.Journal of Organizational Change Management 10/2013; 26(6):1020-1044. DOI:10.1108/JOCM-08-2012-0132 · 0.74 Impact Factor
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ABSTRACT: The objective of this study was to identify contextual factors influencing the degree of integration of the ecological approach in disease prevention and health promotion (DPHP) programming initiatives for older adults in two public health organizations in Québec, Canada. A case study design was used and two organizations presenting contrasting profiles in the degree of integration of the approach in their DPHP programming for older adults were selected. Face-to-face interviews with professionals and managers and archival analysis were conducted. Several factors emerged as constraining the integration of the approach in both organizations, including the lack of data showing the effectiveness of DPHP interventions for older adults and the presence of macro-contextual political factors at odds with the ideology of DPHP. Resources and partnerships with academic milieus emerged as key factors distinguishing the two organizations. These results provide increased understanding of conditions required for planning DPHP programs for older adults.Journal of Applied Gerontology 01/2012; 31(1):101-125. DOI:10.1177/0733464810382526 · 0.97 Impact Factor