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Social clinics are grassroots health initiatives characterized by the development of mutualist practices of healthcare provision and the articulation of their action at territorial and community level. The present paper explores the development and implementation of community participation practices across three social clinics in Europe: social clinic of solidarity KIA in Greece, Village2Santé in France, and Microclinica Fatih in Italy. Drawing on findings collected through qualitative methods, our paper reflects on three overlapping themes of community participation highlighting its collective and eminently political character. Inspired by the frameworks of health promotion, comprehensive Primary Health Care and community development, we analyze three levels of community participation in the social clinics: participatory medical practices, the co-creation of health services, and the connection with broader social movements. Our paper contributes to the literature on community development by stressing the urge to reimagine the principles and practices of community participation through the creation of alternative forms of organizing and of radical empowerment. At the same time, it can inspire practitioners in experimenting with community participation initiatives from a more critical perspective, resisting the worst elements of neoliberalism. [ABSTRACT FROM AUTHOR]

Online platforms can support health and educational professionals in their daily work; however, it is challenging to keep online platforms sustainable. This paper aims to indicate the most important factors of platform sustainability from the perspective of professionals involved in online platforms. Further, it aims to understand how these factors operate. A mixed methods study was carried out among professionals from Europe, Australia, the USA and Canada. In the first phase, the importance of 54 factors from the literature was assessed with a questionnaire among 17 professionals. The relative importance of the factors and the consensus regarding this importance were calculated using median scores and interquartile deviations. In total, 19 factors were selected representing general characteristics, characteristics related to the platform, communication, visitor and context. In the second phase, insight was gained regarding the experiences with those factors through 12 individual Skype interviews. The most frequently mentioned important factors of platform sustainability were (i) having sufficient time, resources and expertise, (ii) user friendliness and (iii) creating a sense of belonging. Platforms should use a planned approach to address a combination of factors directly from platform development. Gaining long-term resources is challenging and should be considered from the start of a project by building partnerships. To promote user friendliness, platforms should be simple, have a clear set-up and provide high-quality tools. Finally, establishing a sense of belonging could be supported by branding and face-to-face networking activities. For all aspects, involving visitors and stakeholders is essential. [ABSTRACT FROM AUTHOR]

This paper reports on a study undertaken to determine what progress has been made in the uptake and impact of the CompHP Core Competencies on Health Promotion practice, education and training in Europe since their publication in 2011. The study used a purposive sample comprising health promoters who had contributed to the development of the CompHP Competencies was augmented by snowball sampling across European Health Promotion practitioners. An online survey tool was employed to elicit information on respondents' attitudes to the Competencies, levels of current and intended use, and opinions on their impact. A total of 81 responses were received from 25 European countries. Findings on factors considered likely to influence the use of the Competencies were generally positive, as were respondents' attitudes to them. However, only 53% of respondents reported that the CompHP Competencies were used in their country and 54% that they used them in their practice. The Competencies were most frequently used in Health Promotion education, where their impact was also most apparent. A lack of support and recognition of the Competencies by key organizations and stakeholders at country level emerges as a potentially critical factor influencing their uptake and use. The survey findings provide an insight into the uptake and impact of the CompHP Core Competencies to date and begin to address the gap in empirical evidence on the use and impact of Health Promotion competencies. However, further research is required to explore the factors influencing implementation of the CompHP Core Competencies at a country level. [ABSTRACT FROM AUTHOR]

The European Urban Health Indicators System Project Part 2 (EURO-URHIS 2) is a cross-national study that was implemented in Europe. It consists of four data collection tools that were specifically developed to collect health data at an urban level. This paper reviews some of the methodological constraints in adapting the EURO-URHIS 2 study in Ho Chi Minh City, Vietnam. No attempt to extend the original study beyond Europe has been reported before. Cultural, political, economic and social differences create specific obstacles as well as challenges. This paper sets out how these challenges were addressed, examining key aspects of the methodology, including study design, translation of the questionnaire and data collection. It was found that the EURO-URHIS 2 adult data collection tool methodology could not be replicated in Vietnam. A lack of basic infrastructure and population registers led to significant changes being made to the sampling and survey administration. It was recommended that the Expanded Programme on Immunization (EPI) was used as the replacement method. Despite the limitations in using the EPI method, the overall strengths and benefits were found to address methodological issues and the resource poor setting. [ABSTRACT FROM AUTHOR]

Background: To undertake an overview of health promotion research in the EEA to inform the collaborative study--SPHERE (Strengthening Public Health Research in Europe). Methods: A 'filter' (search strategy) was used to search Medline and Embase for a 10-year period from 1995 to 2005. A 32% (6000) sample of the filter output was assessed for proportion constituting health promotion. Output was analysed by country, population, gross domestic product (GDP) and health need (disability-adjusted life years, DALYs). Disease prevention (screening and immunization) and health improvement papers were separately identified. The latter were classified by methodology, level of intervention and topic area. Results: 18862 papers were identified. One-third was identified as health promotion (2206/6000, 36.7%) equivalent to 6935 (CI 6651-7230). Production varied: Nordic countries were highest producers per million population; the UK the largest net producer. There was a weak relationship between health promotion publication and population size (r²=0.38); a weak inverse relationship with relative health (DALYs per million population) (r²=0.07) and a slightly stronger relationship with GDP (r²=0.45). Twenty-eight percent (626/2206) of the papers identified were disease prevention (screening and immunization). The largest topic areas of the remainder (1580) were diet and exercise, smoking and tobacco, and cardiovascular disease reduction. Accidents and violence, alcohol and mental health each accounted for <5% of total output. Intervention studies were a minority; with less aimed at the regional/national or policy or legal and fiscal levels. Conclusion: Health promotion research production varies across Europe. Research commissioning should stress interventional and policy level research. [ABSTRACT FROM AUTHOR]

This paper discusses the work of the EUHPID Project to develop a European Health Promotion Monitoring System based on a common set of health promotion indicators. The Project has established three working groups to progress this task -- health promotion policy and practice-driven, data-driven and theory-driven. The work of the latter group is reviewed in particular. EUHPID has taken a systems theory approach in order to develop a model as a common frame of reference and a rational basis for the selection, organization and interpretation of health promotion indicators. After reviewing the strengths and weaknesses of those health promotion models currently proposed for indicator development, the paper proposes a general systems model of health development, and specific analytical, socio-ecological models related to public health and health promotion. These are described and discussed in detail. Taking the Ottawa Charter as the preferred framework for health promotion, the socio-ecological model for health promotion adopts its five action areas to form five types of systems. The structure and processes for each of these five systems are proposed to form the basis of a classification system for health promotion indicators. The paper goes on to illustrate such a system with reference to indicators in the workplace setting. The EUHPID Consortium suggest that their socio-ecological model could become a common reference point for the public health field generally, and offer an invitation to interested readers to contribute to this development. [ABSTRACT FROM AUTHOR]

Summary This paper uses data from a European health promotion evaluation study (MAREPS) to empirically test some fundamental assumptions of health promotion theory. Analysis shows that both the competence of individual actors and the opportunities provided for by health-promoting policies are significant predictors of participation in health promotion action. It also demonstrates effects of health promotion values on such action. Moreover, people's perception of their own political efficacy, e.g. their influence on community decisions that effect their health, turns out to be a significant predictor of self-rated health. In conclusion, the paper encourages further research to investigate the effectiveness of health-promoting policy strategies within a multilevel health promotion framework. As the present results indicate, effective health-promoting policies may create opportunities that enable individuals and communities to increase control over the determinants of health, and thereby improve their health. [ABSTRACT FROM AUTHOR]

Health literacy has gained momentum in the Western world, yet in Europe the concept of health literacy is only marginally integrated in research, policy and practice. The present paper presents how translation may act as an influential factor with regard to integration of the health literacy notion in Europe. This study has compared five data sources that provide translations of health literacy: The European Union's Health Strategy; the translations applied in the European Health Literacy Project; national health expert opinions and Google Translate. The comparison integrated Peter Fawcett's translation techniques as a framework for analysis. The results showed a total of 28 translations: 22 from the European Union Health Strategy; 6 from the HLS-EU project; 17 from experts; 25 from Google Translate. Some countries are consistent in translations of health literacy, other countries diverge, the reasons being that health literacy is not yet mainstreamed and the translations are primarily driven by a latent polarized discourse of the concept of literacy. The study showed that translations in general reveals enriched insights in the cohesion of health literacy as one notion and provides the European Health Literacy Glossary that can inform health professionals, academia and decision-makers to further advance health literacy across Europe. [ABSTRACT FROM AUTHOR]

Background: The worksite is a promising setting for health promotion. This review summarizes the evidence of effect of intervention studies in European countries promoting a healthy diet solely and in combination with increasing physical activity at the workplace. Methods: A systematic review of published literature was carried out. Inclusion criteria were: studies conducted in European countries; papers published from 1 January 1990 to 1 October 2010; worksite-based interventions promoting a healthy diet solely or in combination with physical activity; primary prevention; measurement of anthropometrical or behavioural change and adults (≥18 years old). Levels of evidence for intervention effectiveness on behavioural determinants, nutrition and physical activity behaviours and body composition and the quality of the included interventions were assessed. Results: Seventeen studies solely focusing on promotion of a healthy diet were identified. Eight were educational, one used worksite environmental change strategies, and eight used a combination of both (multi-component). None of the interventions were rated as ‘strong’; seven met the criteria for ‘moderate’ quality. The reviewed studies show moderately evidence for effects on diet. Thirteen studies focusing both on nutrition and physical activity (nine educational and four multi-component studies) were identified. Ten were rated as having ‘weak’ and three as having ‘moderate’ methodological quality, providing inconclusive evidence for effects. Conclusion: Limited to moderate evidence was found for positive effects of nutrition interventions implemented at the workplace. Effects of workplace health promotion interventions may be improved if stronger adherence to established quality criteria for such interventions is realized. [ABSTRACT FROM PUBLISHER]

This review provides a classification of public policies to promote healthier eating as well as a structured mapping of existing measures in Europe. Complete coverage of alternative policy types was ensured by complementing the review with a selection of major interventions from outside Europe. Under the auspices of the Seventh Framework Programme's Eatwell Project, funded by the European Commission, researchers from five countries reviewed a representative selection of policy actions based on scientific papers, policy documents, grey literature, government websites, other policy reviews, and interviews with policy-makers. This work resulted in a list of 129 policy interventions, 121 of which were in Europe. For each type of policy, a critical review of its effectiveness was conducted, based on the evidence currently available. The results of this review indicate a need exists for a more systematic and accurate evaluation of government-level interventions as well as for a stronger focus on actual behavioral change rather than changes in attitude or intentions alone. The currently available evidence is very heterogeneous across policy types and is often incomplete. [ABSTRACT FROM AUTHOR]

This paper has contributed to confirming the link between education and health in developed countries. The analysis is based on 11 European Union countries. We estimate country-specific health functions, where the dependent variable is self-reported health status and the education attainment is one of the main inputs. All eight waves (1994–2001) of the European Community Household Panel are deployed. A random effects ordered probit is estimated in order to control, to a given extent, for unobserved heterogeneity. Explanatory variables are both time invariant (education attainment and gender) and time varying (gross wages, hours of work, age and living alone). Results confirm the positive impact of secondary education on health in most cases and tertiary education in all cases, even after controlling for other inputs in the health function and taking unobserved heterogeneity into account. Secondary education has an impact on health in all countries in the sample except for The Netherlands and UK. The effect does not differ between secondary and tertiary education in France, Ireland and Greece. The correlation between education and health is interpreted in different but complementary ways by diverse approaches and we may not disentangle the precise mechanism that connects health with education from our results. Anyway, it seems clear that better coordination is needed between education and health policies to effectively improve health literacy. Other relevant results from our study are that women register poorer health than men, age contributes to worsening health status and wages contribute positively to health. [ABSTRACT FROM AUTHOR]

The article presents abstracts of working papers to be presented at the 14th Annual European Public Health Conference of the European Public Health Association in November 2006. They include "The history of Public Health: How and Why?," "Sleep and health: Gender, socioeconomic circumstances, and inequalities in sleep," and "The prevention of disease and promotion of health--The need for a new approach."