Table 1 - uploaded by Sandy Whitelaw
Content may be subject to copyright.
Source publication
Over the past 10 years, 'settings' based health promotion has become a central feature of efforts to promote health that recognize the significance of context. Emerging in part from a perception of an over-reliance on individualistic methods, the approach was built on a profound belief in its value and deployed a range of novel theoretical resource...
Contexts in source publication
Context 1
... example, Leeder provides a strong endorsement of the need for 'policy driven' health promotion practice in various settings (Leeder, 1997), and Ziglio, under the notion of achieving an 'investment for health', sees this form of action as 'identifying relevant policy attributes; consider- ing factors that may enhance or inhibit policy change; assessing change options …; and planning the political process of achieving the necessary legislative, regulatory, financial, organizational or educational changes' [(Ziglio, 2000), p. 27]. These five themes are summarized in Table 1. ...
Context 2
... have sympathy with this cautious statement and would not support a dash towards overly or unnecessarily simplifying the nature of settings work. However, in a similar vein to that proposed by Pavis (Pavis, 1998) in relation to community development, we believe that a greater degree of precision can be achieved, and this is addressed in this paper by the development of maps of both the range of possible settings activities and their associated features (Table 1), and the relation- ship between the features of the settings and the potential of the health promoter (Table 2). This promotes clarity in relation to the starting points of settings activity, offers a view to the link- ages and progression between distinct elements and the potential role for health promoters in the varied settings in which they will find themselves. ...
Citations
... Gesundheitsförderung in Settings bedeutet, dass Gesundheit am besten dort gefördert wird, wo sich Menschen viel aufhalten -Ar-beitsplatz, Schule, Krankenhäuser usw. [24]. Die Neuorientierung des Gesundheitssystems betrifft die Ausrichtung des Gesundheitswesens in Richtung Gesundheitsförderung über die Bereitstellung klinischer und kurativer Dienste hinaus. ...
Zusammenfassung
Hintergrund
Hausärzt:innen sind für viele Menschen die erste Ansprechpersonen bei Fragen rund um ihre Gesundheit. Im Rahmen von Patientengesprächen gibt es viele Möglichkeiten die Gesundheit zu fördern und die Gesundheitskompetenz zu steigern. In Österreich ist wenig darüber bekannt, welche Methoden und Informationen Hausärzt:innen dafür einsetzen. Es wurde deshalb der Frage nachgegangen, was Hausärzt:innen brauchen, um verstärkt Maßnahmen zur Gesundheitsförderung sowie zur Steigerung der Gesundheitskompetenz ihrer Patient:innen umsetzen zu können.
Methoden
Zur Beantwortung der Frage wurde ein Methodenmix angewendet: Neben drei Interviews mit Expert:innen (Ärztekammer und Gesellschaft für Allgemeinmedizin) wurden eine Online-Befragung (n = 268) und qualitative Interviews (n = 10) mit Hausärzt:innen in Österreich durchgeführt.
Ergebnisse
Die befragten Hausärzt:innen messen der Gesundheitsförderung und Gesundheitskompetenz einen hohen Stellenwert bei und setzen bereits vieles um. Die größten Hürden für sie sind v. a. fehlende Zeit und fehlender Überblick über verfügbare Angebote und Materialien.
Diskussion und Schlussfolgerung
Hausärzt:innen benötigen mehr Zeit für die Gesundheitsförderung und Gesundheitskompetenz ihrer Patient:innen. Diese Zeit muss als Arbeitszeit honoriert werden, um eine breite Umsetzung zu ermöglichen. Zudem ist wichtig, die Hausarztpraxis verstärkt als gesundheitsförderliches und gesundheitskompetentes Setting zu etablieren und gleichzeitig die Gesundheit der Ärzt:innen und ihrer Mitarbeiter:innen zu fördern.
... Settings often have some sort of structure, culture, policies, and institutional values that can influence health behaviour [16]. Some of the common settings for health promotion include the workplace, schools, neighbourhoods or communities, and primary health care and hospitals [17,18]. It is important that a health promotion settings approach is inclusive of people with an intellectual disability in these community settings [14,15]. ...
... It is important that a health promotion settings approach is inclusive of people with an intellectual disability in these community settings [14,15]. Whitelaw et al. [18] discussed the different elements of a settings-based approach and showed that there were different ways in which a settings-based model has been used. The most conservative approach uses the settings as a means to access populations for the delivery of individualbased programs. ...
... A systemsbased approach has many common elements with settings approaches, whereby the focus is on the changes to policies, routines, relationships, power structures, and values [52]. Addressing settings-based change has been recommended as a way to move away from the more limited approach of individual behavioural risk factors and to address higher levels of social organisation [18,19]. Key to this is understanding that settings are complex environments, and flexible approaches are required to address the culture and structure of a setting/system [53,54]. ...
Research has shown that people with an intellectual disability have higher rates of certain preventable health conditions and a higher rate of avoidable mortality relative to the general population. With respect to health behaviours, they also have lower levels of physical activity and poorer nutrition. Despite the increased health needs, this population cohort is less likely to have the opportunity to participate in health promotion programs. The interventions that have been delivered are programmatic and individual in focus and have lacked a broader ecological and settings focus, which makes them very difficult to scale. Health promotion programs designed for the general population, such as lifestyle campaigns, rarely reach people with an intellectual disability. This increases the importance of ensuring that the settings in which they live and engage with are as health promoting as possible. Interventions have been particularly absent in the workplace for people with an intellectual disability. This paper highlights gaps in a settings-and-systems-based approach to promoting the health and wellbeing of people with an intellectual disability, particularly with respect to workplace health promotion. The paper concludes with recommendations for a systems approach that integrates approaches across multiple settings to better promote the health of this population cohort.
... The conceptual approach of WHP reflects the current state of research on the relevance of behavioral aspects and the respective mesosociological living environment -in this case, the workplace -as factors that influence health (11,12). Thus, it can be derived from the Luxembourg Declaration (7) that WHP is much more than the "access route" to a target group (13,14). Beyond, from a healthcare perspective, WHP pursues both risk reduction in the sense of prevention and competence development in the sense of health promotion (15). ...
Background
The workplace is a recognized setting for promoting health among adults, and physical activity (PA) interventions are an integral part of workplace health promotion (WHP).
Objectives
The present review of reviews aims to provide an overview of the main objectives and related outcomes addressed in WHP-related PA interventions, as well as the setting-specific aspects considered in the research field.
Methods
A scoping review of reviews was conducted. Reviews were included if they were peer-reviewed, written in English, and focused on PA interventions conducted in the context of WHP. A literature search was conducted in PubMed, SPORTDiscus, and Web of Science. Reviews were included if they had been published after the year 2000. Information on the following dimensions was extracted: author, region, number of primary studies included, target group(s), PA interventions included, main objective(s), related outcomes, and setting-specific aspects.
Results
A total of 17 reviews were included. Six reviews aimed at solely identifying the effectiveness of promoting daily PA and reducing sedentary behavior. Eleven reviews showed a combined approach considering physical activity behavior and/or health and job-related outcomes. Outcomes in the primary studies were heterogeneous. None of the reviews had an explicit definition of WHP and setting-specific information was very general and sparse. The reported setting-specific information was referred to the general importance of the workplace setting, the specific importance as an access route to target groups, and implementation aspects. Regarding the additional characteristics of the reviews, the selection of primary studies was restricted to a specific region in 2 of the 17 reviews in advance. Three reviews restricted the target group (sedentary workers, women, desk-based workers), while eleven reviews included working adults in general and, three reviews gave no information about the target group. Eleven intervention approaches of the reviews were behaviorally oriented, two focused solely on environmental interventions, and four reviews can be attributed to a combined approach considering behavioral and environmental interventions.
Conclusion
For sustainable future developments, the present results indicate a strong need for conceptual consolidation of WHP in the research field of PA interventions. Therefore, both WHP and health-related PA interventions need to take a comprehensive approach comprising behavioral and environmental interventions.
... A settings-based approach to HP acknowledges that change is not solely focused on individuals and their health problems, but is generated in organizations and communities to ensure the development of environments that support population-wide changes in health-related behavior (Whitelaw et al., 2001). The application of the settings-based approach has already shown promise in other settings, such as schools (Langford et al., 2014), cities (De Leeuw, 2009) and universities (Dooris et al., 2014). ...
... The present case study has shown that HCP is organized in sports clubs by a rather independent HCP team, supported by club executive, comprised of one to six persons, whose purpose is to deliver healthrelated activities, mostly dedicated to new members across the local community. Results reflect those observed by a previous quantitative evaluation of the project, showing improvement on HP promotion in sports clubs, but highlighting barriers on structural changes at the coaching and among all levels of the sports club (Lane et al., 2021) and prompt consideration of the position of the HCP between the fourth stage of the application of the settings-based approach to sports clubs (Whitelaw et al., 2001), called sportclub based HP (principally focusing on delivering different programs) and the last stage, called HPSC (having a health in all policy, decision-making process and health embedded in sports clubs activities ). In other words, health is not fully embedded in sports club's decisionmaking process and policy, even if HCP has support from the executive, and HP programs and activities are delivered. ...
... Results also question the application of the settings-based approach to sports clubs (Whitelaw et al., 2001), where HCP seems to be considered by sports participants as promoting sport 'around' and not in the sports clubs, while the settings-based approach recommends to embed HP in the core business of clubs, which is sport provision (Kokko, 2014). Nevertheless, the most implemented activities are walking clubs or PA for recreation rather than competition, especially targeting vulnerable or sedentary groups, thereby enlarging sports clubs reach and contribution of the sport sector to PA (Eime et al., 2013;Kokko et al., 2019). ...
The sports clubs’ role in promoting health has been acknowledged by policy makers and researchers, but there is little evidence on how sports clubs implement health-related interventions. The present article investigates the Gaelic Athletic Association Healthy Club Project (HCP) implementation process (mechanisms, barriers, leverages) over a 10-year timeframe. A case study design helped to produce and compare a data synthesis for five clubs involved since 2013. A qualitative iterative data collection, including document analysis was conducted through 20 focus groups with Healthy Club Officers, coaches, participants and members. The Consolidated Framework for Implementation Research was used in the deductive analysis process, conducted by the first author. Results have shown the success of the HCP in placing health promotion on the agenda of sports clubs leading to informal policy for health promotion, even if activities and recognition are directed toward and coming from the community. This study also underlines the virtuous cycle of the settings-based approach in enhancing membership and volunteer recognition through health promotion actions, and the importance of social good and corporate social activities for sports clubs. Nevertheless, the HCP still relies on limited human resources, is not recognized by competitive oriented adult playing members. and acknowledged as a resource by some coaches, limiting its rootedness in the core business of sports clubs. Future research should empower the HCP community to focus on organizational changes and develop outcomes for individuals, for the club as a whole as well as for the local community.
... Kokko and Baybutt (4) provide an overview of more recent academic publications on the theoretical basis and practical principles of setting-based health promotion. Consequently, the setting approach emphasizes the individual, social and structural dimensions of health promotion (5,6). ...
This paper presents a conceptual framework displaying how combinations of settings and populations seen in a long-term perspective may guide public health and health promotion planning and research. The notion of settings constitutes a key element of health promotion as stipulated by the Ottawa Charter from 1986. The setting approach highlights the individual, social and structural dimensions of health promotion. Likewise, the notion of populations and how they are selected forms a center pillar of public health. By joining the two perspectives, four combinations of intervention strategies appear by addressing: (1) a single population segment within a single setting, (2) multiple population segments within a single setting, (3) a single population segment within multiple settings or (4) multiple population segments within multiple settings. Furthermore, the addition of a time dimension inspired by the life-course perspective illustrates how trajectories of individuals and projects change settings and population segments as time goes by. The conceptual framework displays how systematic awareness of long-term, multi-setting, multi-population trajectories allow health promotion planners and researchers to systematically develop, plan and analyze their projects.
... Globally, a settings-based, whole-systems approach to improving health has been widely advocated for. [7][8][9][10] In UK HEIs, this has gained momentum with the 'University Mental Health Charter', which outlines how institutions can take a 'whole-university' approach to mental health and encourages peer support to be represented in their strategies. 11 Peer support is 'support provided by and for people with similar conditions, problems or experiences'. ...
... Eight studies used the term 'peer mentoring' [4, 11-13, 20, 23-24, 28], whereas two others used similar terms such as 'specialised peer mentoring' [27] or 'peer dyad mentoring' [2]. One study used 'peer helper' [7], but this was a one-to-one pairing of a more experienced student with a less experienced student. ...
... Three studies measured well-being with the Shortened Warwick-Edinburgh Scale of Wellbeing 57,58 (n = 1) [3], Positive and Negative Affect Schedule 59,60 (PANAS; n = 1) [7] and Satisfaction with Life Scale 61,62 (SWLS; n = 1) [7]. ...
Background
Higher education institutions (HEIs) are seeking effective ways to address the rising demand for student mental health services. Peer support is widely considered a viable option to increase service capacity; however, there are no agreed definitions of peer support, making it difficult to establish its impact on student mental health and well-being.
Aims
This systematic review aims to better understand and evaluate peer support in HEIs.
Method
Five databases, OpenGrey and Grey Matters were searched in May 2021. Included studies were quantitative, longitudinal (with and without a control) or cross-sectional with a control. The vote-counting method was used for synthesis. The risk of bias was assessed with the National Institutes of Health Quality Assessment Tool.
Results
Three types of peer support were represented in 28 papers: peer-led support groups, peer mentoring and peer learning. Peer learning and peer mentoring had more positive, significant results reported for the outcomes of anxiety and stress. Peer-led support groups were the only type targeting students with mental health difficulties.
Conclusions
The heterogeneity of measures and outcomes prevents firm conclusions on the effectiveness of peer support for mental health and well-being. Most studies were rated ‘poor’ or ‘fair’ in their risk of bias. There is not a solid evidence base for the effectiveness of peer support. Nonetheless, HEIs can use the terminology developed in this review for shared discussions that guide more robust research and evaluation of peer support as an intervention.
... It is underpinned by understanding the social determinants of health and the ecological model of health promotion. 3,4 It offers opportunities to target, adapt, and optimise the contextual structure present in the 'setting' to influence the health behaviours of the community members. 5 Examples of settings include schools, workplaces, hospitals and community organisations. ...
Issued Addressed
Workplaces have considerable potential for enhancing personal resources and providing a supportive working environment for staff health, including oral health and well‐being. To date, assessments of workplace oral health promotion (WOHP) activities have observed benefits ranging from self‐reported oral health to clinical parameters. However, previous WOHP actions were not based on a theoretical framework and did not consider the working environment as part of the planning and evaluation process.
Methods
This article used evidence‐based health promotion theoretical frameworks, and associated facilitators and barriers, in constructing an integrated and theoretically robust approach to planning and evaluating oral health promotion activities in the workplace.
Results
The PRECEDE‐PROCEED Model for planning and evaluation, the reach effectiveness adoption implementation maintenance, and the Salutogenic Model of Health were chosen to complement each other in the planning and evaluation process, based on their different features and the applicability of those features to the workplace setting. Because of the limited literature in this area, the current article also used evidence from oral health promotion in other settings (including schools and the community) and general health promotion in the workplace to construct a theoretical framework for planning and evaluating WOHP activities.
Conclusions
The theoretical framework developed could assist in planning or improving existing workplace health promotion programs that focus on or incorporate oral health elements.
So What?
Future research on applying and adapting the proposed framework is required.
... Despite being a major actor in the community, the societal role which sports club can play by promoting health has been underexploited (Schulenkorf et al. 2016). Aligned with the role of schools or cities, sports clubs can also be considered as health romoting settings, defined as 'the place or social context where people engage in daily activities in which environmental, organizational and personal factors interact to affect health and well-being' (Whitelaw et al. 2001 HealthPromoting Sports Clubs (HPSC) approach focuses on moving beyond a behaviour-focused approach (i.e. increasing physical activity (PA) or preventing doping) to a socioecological approach, by working on multilevel determinants of health (Glanz and Bishop 2010) and multiple health behaviours. ...
... Previous studies have illustrated both the benefits and challenges when incorporating policy sciences framework in public health research (Shroff et al. 2012, Clarke et al. 2018, as well as the fuzzy definition of health policy . The health promoting sports clubs-national audit tool (HPSC-NAT) (Johnson et al. 2022) has been created by merging both settings based (Whitelaw et al. 2001) and health in all policies (De Leeuw and Peters 2014) approaches of HP, and analysing how national policies support HP in sports clubs. ...
The societal role which sports clubs can play in promoting health has been underexploited, and sports clubs have called for support from policymakers. Based on the Health Promoting Sports Clubs National Audit Tool, the present study has as objective to investigate how national public policies support health promotion in sports clubs, by questioning indicators of quality (references to other document, policy framing and evaluation), the content (target groups, health topics, type of policy instruments) and the mechanisms used by Irish decision-makers for coordination, evaluation, dissemination and implementation of these policies. The tool was completed in two steps comprising a systematic search of policy plans, programmes or regulations and 12 interviews with key informants. A content analysis of 17 policy documents, identified 49 policy actions targeting HP in sport clubs, coming from different sectors, but only policies from the health sector considered a settings-based approach, supporting a unique sports federation programme. Policies focus on a single health behaviour, where the most targeted were physical activity participation, gender inequity and the disability gap in access to sport clubs. The policy structure lacks coordination, monitoring, media campaigns and events, and therefore not adopting the HPSC concept, but only a health education approach. Future studies should support the acknowledgement of HP as an umbrella concept, in order to support the understanding and development of organisation and system change since policies are drivers for sport federations, local sport actors and sports clubs.
... It is through this interaction that an intervention becomes adopted [8], changes individual behaviours and builds the capacity to achieve an intervention's 'function' in terms of long-lasting health improvements [7,[9][10][11]. Conceiving implementation as an intervention-context interaction implies that the implementation setting serves as an active intervention element, rather than as an inactive site offering access to a population and/or a space to carry out an intervention as it is [7,12]. ...
Background:
From a complex systems perspective, implementation should be understood as the introduction of an intervention in a context with which it needs to interact in order to achieve its function in terms of improved health. The presence of intervention-context interactions could mean that during implementation particular patterns of crucial interaction points might arise. We examined the presence of - and regularities in - such 'bottlenecks for implementation', as this could create opportunities to predict and intervene in potential implementation problems.
Methods:
We conducted a cross-sectional observational study against the background of municipal intersectoral policymaking in the Netherlands. We asked implementers of health promotion interventions to identify bottlenecks by rating the presence and importance of conditions for implementation in a range of intervention systems. We used descriptive statistics to characterize these systems (by their behaviour change method, health theme and implementation setting) and the conditions that acted as bottlenecks. After stratifying bottlenecks by intervention system and the system's characteristics, we tested our hypotheses by comparing the number and nature of the bottlenecks that emerged.
Results:
More than half of the possible conditions were identified as a bottleneck for implementation. Bottlenecks occurred in all categories of conditions, e.g., relating to the implementer, the intervention, and political and administrative support, and often connected with intersectoral policymaking, e.g., relating to the co-implementer and the co-implementer's organization. Both our hypotheses were supported: (1) Each intervention system came across a unique set of - a limited number of - conditions hampering implementation; (2) Most bottlenecks were associated with the characteristics of the system in which they occurred, but bottlenecks also appeared in the absence of such an association, or remained absent in the presence thereof.
Conclusions:
We conclude that intervention-context interactions in integrated health policymaking may lead to both regularities and variations in bottlenecks for implementation. Regularities may partly be predicted by the function of an intervention system, and may serve as the basis for building the capacity needed for the structural changes that can bring about long-lasting health improvements. Variations may point at the need for flexibility in further tailoring the implementation approach to the - mostly unpredictable - problems at individual sites.
... Many universities are considering proactive interventions as part of a whole university approach. The whole university approach, advocated for globally [10][11][12][13], is multifaceted, recognising that every aspect of university life can affect all community members' mental health and wellbeing [14,15]. The approach is gaining momentum in the UK with the 'University Mental Health Charter,' which outlines peer support as a proactive intervention that can improve wellbeing [14,16] as part of an integrated system of student mental health care [17,18]. ...
In university settings, peer support brings people together based on their student identity. Peer support has been advocated as an innovative intervention to aid student mental health and wellbeing as part of a whole university approach, especially post-pandemic when student support is critical. While the literature describes three types of university peer support for student mental health and wellbeing, peer-led support groups, peer mentoring, and peer learning, the sector lacks agreed definitions for these interventions. Formal reporting on peer support initiatives is rare, suggesting further types of peer support practice may exist. This qualitative study, comprising semi-structured interviews with 16 university staff members at 14 different institutions, aimed to generate comprehensive definitions of the types of peer support used in the sector through template analysis. The study also sought to understand the current practice, experiences, and challenges around implementing peer support interventions for undergraduate and postgraduate students’ mental health and wellbeing from the perspective of the staff who support and coordinate these programmes. Five types of peer support were identified and defined. In addition, the challenges of engagement, resource and capacity, and evaluation were highlighted. Finally, lessons learnt provided potential ways to address the challenges outlined and provided sector guidance for further developing peer support as part of a whole university approach to student mental health and wellbeing.
