Community action for health: a methodological framework for healthier local policies
R Peiró-Pérez, H Križan, L Dancero, CD De Ambroggi, C Plantz, J Jennifer Hubrich, P Sandström, L Castro, A Dreher, K BrukałoAbstract
Issue/problem
Health promotion is essential for advancing participatory governance. While other public health methodologies tend to be highly standardized, health promotion encompass a wide range of approaches undermining their ability to support the development of their central focus, the healthy public policies.
Description of the problem
We review different methodological frameworks and building on this key elements were integrated into a practical guide of community action for health, designed for professionals working in health promotion at the local level. The guide is grounded in the Ottawa Charter: intersectoral collaboration to advance a Health in All Policies approach; active community participation in decision-making processes, using a “learning by doing” approach to strengthen health-related knowledge and skills from the communities; and critical reflection on the impact of decisions to improve equity. We show the results of the implementation of the first steps of the guide, the political commitment, community engagement, the participatory analysis of situation, and strengths and barriers in the 48 pilots project that are being implemented in 15 European countries.
Results
Political support was secured in 32 pilots through participative governance structures to support their implementation. Diverse number of stakeholders are involved (from 1 to15), including local government and school decision makers. In 19 pilots community associations are part of the core-group. Thirty-one pilot initiatives reported having established a common language to enhance mutual understanding within intersectoral collaboration. In the needs assessment completed, 15 pilots used quantitative approaches and 20 qualitative analyses.
Lessons learned
There were different experiences around Europe developing health promotion intervention with different approaches. However, establishing a participative and political commitment were critical to implement the pilots