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Carlo Fabian, Bucharest, Romania 2014
Community action for health promotion and prevention
Carlo Fabian lic. phil., Social and Health Psychologist Researcher & Project Manager
• University of Applied Sciences and Arts Northwestern Switzerland
School of Social Work, Institute for Social Planning and Urban Development
• 2007-2012: RADIX Swiss Health Foundation
Healthy communities & national prevention programs in communities
Carlo Fabian, Bucharest, Romania 2014
• Introduction
• The setting approach The Ottawa Charta of 1986
• Community-oriented work: Models, examples, experiences and quality (success) factors, tool
Overview
Carlo Fabian, Bucharest, Romania 2014
The setting approach
«A setting is a social context that is relatively permanent. Its members are
subjectively aware of it. This relationship is expressed by a formal organization
(e.g. business, school), a regional situation (e.g., municipality, district,
neighbourhood), a common life situation (e.g. retirees), common values and
preferences (e.g. religion, sexual orientation) or by a combination of these
attributes.» (translation from Rosenbrock & Hartung, 2011)
«Health is created and lived by people within the settings of their everyday
life; where they learn, work, play and love.» (Ottawa-Charta, WHO 1986, http://www.euro.who.int/de/publications/policy-documents/ottawa-charter-for-health-promotion,-1986)
Objective: to promote health supportive living environments / settings!
Carlo Fabian, Bucharest, Romania 2014
Ottawa-Charta
Health promotion pays particular attention to participation and co-
decision of the population as well as to the involvement of the public.
Carlo Fabian, Bucharest, Romania 2014
Concept of participation
6
Steps of participation (see Lüttringhaus 2000; Frehner et al. 2004)
Information
Participation
Co-Decision
Self-Government
Active Involvement
Carlo Fabian, Bucharest, Romania 2014
«The improvement of the opportunities and competences of the citizens
for their involvement, participation, and self-empowerment in all health-
related issues, as well as the strengthening of the responsibilities of the
municipality as a whole for better health are key elements of the
development of health promotion».
(translation from Ilona Kickbusch)
Health promotion
Carlo Fabian, Bucharest, Romania 2014
The setting approach
The setting approach means much more than the achievement of the target
group within the setting!
• Participation of members: concerned persons have to become participants
• Process of organizational development
• Empowerment
• Public Health Action Cycle (problem determination, strategy,
implementation, evaluation)
• Elements of situation-oriented and behaviour-oriented prevention
• Cooperation and communication
• Learning with low formal education (Rosenbrock & Hartung, 2011)
Carlo Fabian, Bucharest, Romania 2014
• Introduction
• The setting approach The Ottawa Charta of 1986
• Community-oriented work: Models, examples, experiences and quality (success) factors, tool
Overview
Carlo Fabian, Bucharest, Romania 2014
Setting-oriented health promotion and prevention projects (RADIX -> www.radix.ch - in German and French)
• «The communities act!»
(alcohol prevention)
• «Community-based tobacco prevention »
• «Watch / be attentive and act»
early identification and early intervention in the community / in the
school»
(multi-thematic: alcohol, tobacco, violence, littering, vandalism)
• «adventure island» tobacco prevention in families (-> internet-based
program)
-> www.radix.ch
Carlo Fabian, Bucharest, Romania 2014
Municipal authority
Public Space
Gastronomy / retail shops
Youth work
School / parents
Events / parties
Picture: RADIX (2009)
Counselling services
Sport and music clubs
Municipality with different players and places
Carlo Fabian, Bucharest, Romania 2014
(see Brewer & deLeon, 1983)
Process model – community-oriented projects
Carlo Fabian, Bucharest, Romania 2014
Important steps as part of the policy cycle
•Put the issue on the local agenda (agenda setting)
•Decision action plan
•Build a local commission / working group (lead, decisions, implementation)
•Situation analysis
• Implementation action plan
•Anchorage / consolidation in the municipality
3-4 years process
Process in community-oriented projects
Support by professional specialists in health promotion / prevention / project management
Carlo Fabian, Bucharest, Romania 2014
Quality factors in community-oriented projects
Structure quality
Process quality
Result quality
(Fabian & Jordi, 2009; -> www.radix.ch)
Political mandate
Organisational structure
Network
Process control
Discussion on attitudes and positions
Participation
Needs assessment
Action plan
Action guidelines
Carlo Fabian, Bucharest, Romania 2014
Hombrechtikon ZH
Structure quality: Local network (round table)
http://www.hombrechtikon.ch/documents/Der_Runde_Tisch.pdf
Carlo Fabian, Bucharest, Romania 2014
Analysis of the situation, needs assessment Approved method (in Switzerland): «bedarfserhebung.ch» = «needs assessment»
• Planning instrument and instrument for needs assessment
• Workshop with key persons of the community / municipality
• Survey of the «local problems», «resources and potentials» and «needs»
-> www.bedarfserhebung.ch (German and French)