"The Health Promotion Discovery Tool"

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Abstract of HP-Source.net Literature Review

As a part of the HP Source project a literature review was undertaken and the following guidelines were set for the literature search:

  • The scope of the search was limited to literature published in the English language.
  • International literature was included where appropriate.
  • The focus was on documented research including theory-based analyses of policies and programmes, documentation of evaluations and reports of case-studies.

Published literature was identified using systematic searches in the subject indexes of computerised and online databases, for example Web of Science. We also had access to a library of Health promotion literature and access to a literature search project

We have chosen to present the review as a commentary on selected research themes in the arena, rather than an account of each contribution. The overall aim was to focus on vital conditions for successful implementation of health promotion policies and to give an account for the most comprehensive evaluations that have been conducted in the field.

On the basis of the literature search, two main categories emerged:

General healthy public policy issues

Literature on healthy public policy and health promotion policy is discussed from a theory-based policy analysis perspective. This literature was used as a framework for the discussion of the various strategies in the second category.

Policy making will not be a technical process where the main issue is to find the right solution to a policy problem. There will always be a process of negotiation between parties with different agendas. Policy development consists of several phases which are a continuum rather than separate phases: initiation, adoption, implementation, evaluation and reformulation. This is seen as a continuous but not necessarily a linear process. Policy formation and implementation must thus be viewed as connected phases and the processes that lead to a policy decision, or output, will influence the implementation of the policy.

Strategies for achieving Healthy Public Policy

The strategies emerging from the literature search may be grouped in four categories:

1. Audits (Investment for health- IFH)
2. Policy tool (Health Impact Assessment-HIA)
3. Planning (Healthy Cities Initiative- HC)
4. Programmes (Canadian Heart Health Initiative- CHHI)

The strategies focused on various aspects and phases of the policy process and they each have their strengths and weaknesses. All of the strategies contributed to agenda-setting and policy-formulation. In the HC and the CHHI initiatives actors at all levels were involved, both decision-makers and lay people. These organisational arrangements seemed to contribute to increased commitment. It was only the CHHI that had explicit strategies for the implementation of the programme and the participatory approach also influenced the implementation process. The lack of explicit strategies for implementation may accordingly be viewed as a weakness in the three other strategies.

The overall impression from this literature review is that the obstacles, in terms of political and administrative structures, are difficult to overcome. However, there are promising examples that illustrate the way in which some of these obstacles might be overcome by long term work on the development of the structures necessary for building healthy public policy, for example intersectional co-operation, integrated interventions and participation from communities and decision-makers.