553546 editorial2014
SJP0010.1177/1403494814553546Health Promotion In The Normal SettingS. Torp et al.
Scandinavian Journal of Public Health, 2014; 42(Suppl 15): 3–6
Editorial
Promoting health in everyday settings: Opportunities and challenges
Steffen Torp1, Sami Kokko2 & Karin C. Ringsberg3,4 1Department
of Health Promotion, Buskerud and Vestfold University College, Tønsberg, Norway 2Department of Health Sciences, University of Jyväskylä, Jyväskylä, Finland 3Nordic School of Public Health NHV, Gothenburg, Sweden 4Department of Health and Caring Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
The 7th Nordic Health Promotion Research Conference (“Promoting health in everyday settings: Opportunities and challenges”) was held in Vestfold, Norway, on 17–19 June 2013, and it was hosted by Buskerud and Vestfold University College (www.hbv. no). The aim of the conference was to focus on ongoing Nordic health promotion research, as well as international research. The conference had a specific focus on settings and the settings approach to health promotion. In order to respond to the conference’s aim and content, and to reach an international audience, all the keynote speakers and some selected researchers were asked to write scientific articles based on their conference presentations. Thus, this supplement of the Scandinavian Journal of Public Health (SJP) represents the main themes addressed at the conference. The supplement provides articles discussing important challenges for health promotion in general, and for the settings approach to health promotion in particular, covering health promotion research in a wide variety of settings. The keynote speakers’ articles give an overview of research related to a particular topic or setting, and discuss extensively the opportunities and challenges for future health promotion. Moreover, empirical articles provide an evidence base for future discussions, and challenge previous knowledge and thinking of a given issue. All articles published in this supplement underwent a double-blind review process, in line with SJP’s high academic standards. The settings approach to health promotion There are promotion:
three
main
approaches
in
health
•• The issue approach (such as nutrition and physical activity); •• The population approach (such as children and the elderly); and •• The settings approach (such as schools and workplaces). The settings approach is well known, widely utilized and top-rated, and has been developing for almost 30 years [1–3]. Still, the approach lacks a common understanding and conceptualization in theory and research [4] (see the current supplement’s articles by Mittelmark and by Dooris, Wills and Newton), and its evidence base can be questioned.The World Health Organization (WHO) [5] defines settings as “the place or social context in which people engage in daily activities in which environmental, organizational and personal factors interact to affect health and well-being.” In practice, the settings approach has been implemented in a variety of ways. In some cases, the settings have been seen as surroundings through which a particular and desired target group could be reached, but not as the target of actions per se. Targeting the setting itself would be closer to what is regarded as settings-based work [6], i.e. work in which the contextual factors affecting health and health behaviors would be acknowledged. This, in turn, would imply that peoples’ health-related decisions could be supported through policies and changes in these contextual factors. One important, often overlooked, aspect of settings-based health promotion is the link between health promotion and the core business of the setting in question, like teaching and learning in schools, or productivity in companies. That is, the core business of a setting is most often an important determinant of health; therefore, it should be targeted.
Correspondence: Steffen Torp, Department of Health Promotion, Buskerud and Vestfold University College, PO Box 2230, N-3103 Tønsberg, Norway. Email: [email protected] © 2014 the Nordic Societies of Public Health DOI: 10.1177/1403494814553546
Downloaded from sjp.sagepub.com at GEORGIAN COURT UNIV on April 17, 2015
4 S. Torp et al. At the same time, the health of the individuals in a given setting may influence the core business of the settings’ activities. For health promotion to be successful, it is necessary that important stakeholders of the setting in question are committed to the health promotion activities. Therefore, it is of utmost importance that health promotion research provide evidence of the benefits that health promotion may have to the core business of settings, such as learning in schools and universities, productivity in workplaces and enhancement of well-being in local communities. An often-argued critique for the settings approach is that different setting initiatives work in their own silos, i.e. only within their own particular setting [7]. Indeed, in community-wide programs, multiple settings are involved; therefore, coordination and cooperation within and across settings is needed [8]. Historical, critical and future perspectives to the settings approach The five first articles in the supplement focus on how health promoters may face the challenges of health promotion in the future, by being critical, retrospective and holistic. With reference to a scoping review on healthy universities; supplement authors Mark Dooris, Jane Wills and Joanne Newton hold that the settings approach to health promotion lacks a clear and coherent theoretical framework. Furthermore, they discuss the nature of a setting, how health is created in a setting, why the settings approach is useful and how health promotion can be embedded in a setting. Supplement author Maurice Mittelmark follows up this discussion, by focusing on how health promotion activities may have unintended and even untoward effects on the setting; therefore, he calls for more robust socio-ecological approaches to health promotion that are concerned with both intended and unintended effects. ‘Policy is important’ is a statement often heard from health promoters, but seldom studied and reflected upon in depth, utilizing the potential of an ecological approach. In her supplement article, Marit Helgesen focused on how important it is to understand the governance structures, and particularly the role of local governments, in health promotion in the Nordic countries. She claims that health promotion is at the forefront of Finnish and Swedish public health policies, while in Denmark and Norway, their policy focuses mainly on disease prevention and hospital admissions. Nanna Mik-Meyer addresses the so-called obesity epidemic, by focusing on the increasing tendency of medicalization of people’s life spheres. She holds that a combination of biomedical perspectives and
dominant societal values of self-responsibility and self-control may lead to health promotion with a problematic moral endeavor. In his conference lecture ‘The role of activism in health promotion’, Glenn Laverack showed us how health activism has helped people whom have limited economic or social protection from social injustice and inequality, to address their concerns; and he debates the future role of activism in health promotion and in public health. Laverack does not provide an article in this supplement, but his ideas are already presented in the article ‘Health activism’, published in Health Promotion International [9]. Relevant settings The following eight articles in this supplement link theory and practice in different settings that are highly relevant for health promotion, and vice versa. Together with the ‘Healthy Ageing Group’ of the Nordic Health Promotion Research Network, Marianne Mahler and her co-authors describe the home as a setting for promoting health among older people; and that with increasing age, the home environment becomes a crucial determinant for independence. The authors argue that only by taking into consideration the meaning of home and the resources of the individual older person, can the home function as a true health-promoting setting. Also, Leeni Berntsson and Karin C. Ringsberg underline in their article that the home and family may be an important setting for health promotion, and describe how parents’ activities together with their children can promote children’s health. Schools are settings that are highly relevant for health promotion and many of the presentations in the conference focused on this setting. Unfortunately, this supplement does not include articles focusing on schools for children; but relevant information has been provided by, for instance, the International Union for Health Promotion Education (IUHPE) [10], Samdal and Rowling [11], and Viig [12]. In addition to schools for children, WHO underlines that universities are important settings for promoting health among young adults [13]. As mentioned above, Dooris, Wills and Newton focus, in this supplement’s first article, on the conceptual frameworks of different health-promoting university projects: They had found that they differed a lot. With reference to a large European study on alcohol consumption among university students, Christiane Stock and colleagues discuss how social norms interventions, targeted at correcting misperceptions about peer alcohol use, may be a useful health promotion tool in the context of a health-promoting university.
Downloaded from sjp.sagepub.com at GEORGIAN COURT UNIV on April 17, 2015
Health Promotion in the Normal Setting 5 Non-governmental organizations (NGOs) are important stakeholders for health promotion and will probably play an increased role in future Nordic public health. In the Nordic countries, sports clubs form the largest organized leisure-time setting for youth and they have been underutilized in the field of health promotion. Author Sami Kokko discusses the role of the sports clubs as settings for health promotion, and argues that there is a need for widening the settings approach to non-traditional and non-institutional settings, to meet current societal health challenges. The workplace is an important health-promotion setting, since many adults spend much of their life at work and since their well-being is closely related to enterprise and national productivity; thereby being the basis for robust welfare states. In addition, almost all settings for health promotion include workers as one of several important stakeholders for healthpromoting activities. In their supplement article, Margaretha Strandmark and Gull-Britt Rahm are concerned with promoting mental health and describe an intervention model for how one can train the staff to cope with workplace bullying. Based on the results of their scoping review of workplace health promotion intervention research in the Nordic countries, Steffen Torp and Hege Forbech Vinje concluded that workplace health promotion research is not on the right track, because published health promotion research resembles traditional preventive medicine. They call for more intervention research on how to promote positive measures of health, by use of resource-oriented participatory settings approaches. Public health and community-based health promotion have recently been much in focus in the Nordic countries, as is described by Helgesen in her article. Closely linked to Helgesen’s political focus, supplement article author Jane South describes the UK experiences with community-based programs and focuses particularly on how to promote citizen participation. She claims that community-based interventions have to be reframed, if the challenges of both citizen participation and evidence practice are to be met. The last article of this supplement, by Charlie Eriksson and colleagues, touches upon South’s conclusion because they describe how they established trustful partnerships between academics, practitioners and policy makers in three different communitybased projects in Sweden. They conclude that high-quality and effective health promotion intervention research depends on trustful partnerships, and that developing such partnerships takes time and depends on the willingness of all stakeholders to learn from each other.
At the end of this supplement, we present the winner of the best poster prize at the conference. Migrant health among the elderly is an increasing challenge to health services and public health in the Nordic countries. Beate Lie Sverre et al. focused on how migrant older female Pakistanis promote their own health and found that they promote health by building social relationships. The authors claim that establishing voluntary organizations run by and for immigrants may be worthwhile to meet immigrants’ needs for healthrelated support. Conclusions Health promotion is genuinely interdisciplinary and includes a wide range of approaches to health promotion. To categorize health promotion into either issue-, population- or settings-based approaches is difficult, as most projects include aspects of all three approaches. Nevertheless, we find that these analytical dimensions are useful, when reflecting on the opportunities and challenges in health promotion. We also believe that more health promotion in line with the settings approach is needed. That is, health promotion taking into account that contextual factors are important health determinants; that health should be dealt with preferably alongside the core business of the settings, not separately nor independently; and that the contextual factors of the settings interact with other settings [7,8]. We hope that this supplement, containing a mix of ‘traditional’ empirical research and theoretical and discursive articles, will provide readers thought-provoking knowledge, and will inspire further theoretical discussions and empirical research in the field of settings-based health promotion. Acknowledgements We would like to express our gratitude to all the authors, the sponsors (Research Council of Norway, PriceWaterhouseCoopers and the Vestfold County Council), and to Buskerud and Vestfold University College, whom have made the conference and this supplement possible. Special thanks go to Hans Abraham Hauge and the local organizing committee; and also to the scientific committee from the Nordic Health Promotion Research Network (NHPRN), for preparing and running a ‘seamless’ conference of high scientific quality. All seven of the NHPRN research conferences held until now were a result of inspiring cooperation among researchers forming NHPRN (www.nhprn.wordpress.com/). Also, a thank you is extended to the Nordic School of Public Health (www.nhv.se), which has hosted this network
Downloaded from sjp.sagepub.com at GEORGIAN COURT UNIV on April 17, 2015
6 S. Torp et al. for the last 8 years. We look forward to further discussions on health promotion at the next Nordic Health Promotion Research Conference, to be held in Jyväskylä, Finland in June 2016. References 1. World Health Organization (WHO). Ottawa Charter for Health Promotion. An International Conference on Health Promotion, November 17–21. Copenhagen: WHO Regional Office for Europe, 1986. 2. Richard L, Gauvin L and Raine K. Ecological models revisited: Their uses and evolution in health promotion over two decades. Ann Rev Publ Health 2011;32:307–26. 3. Golden SD and Earp JAL. Social ecological approaches to individuals and their contexts: 20 years of health education and behavioral health promotion interventions. Health Educ Behav 2012;39:364–72. 4. Kokko S, Green LW and Kannas L. A review of settingsbased health promotion with applications to sports clubs. Health Promot Int 2014;29(3):494–509. 5. Nutbeam D. Health promotion glossary. Health Promot Int 1998;13:349–64. 6. Whitelaw S, Baxendale A, Bryce C, et al. ‘Settings’ based health promotion: A review. Health Promot Int 2001;16: 339–53. 7. Dooris M. Expert voices for change: Bridging the silos towards healthy and sustainable settings for the 21st century. Health Place 2013;20:39–50. 8. Poland B, Krupa G and McCall D. Settings for health promotion: An analytic framework to guide intervention design and implementation. Health Promot Pract 2009;10: 505–16. 9. Laverack G. Health activism, http://heapro.oxfordjournals.org/content/27/4/429.extract. Health Promot Int 2012; 27:429–34. 10. International Union for Health Promotion and Education (IUHPE). Achieving health promoting schools: Guidelines for promoting health in schools, www.iuhpe.org/images/PUBLICATIONS/THEMATIC/HPS/HPSGuidelines_ENG.pdf. Saint-Denis Cedex, France: IUHPE, 2008. 11. Samdal O and Rowling LT. The implementation of healthpromoting schools. Exploring the theories of what, why and how. New York: Routledge, 2013. 12. Viig NG, Fosse E, Samdal O, et al. Leading and supporting the implementation of the Norwegian Network of Health Promoting Schools. Scand J Educ Res 2012;56: 671–84. 13. Tsouros AD, Dowding G and Dooris M. Strategic framework for the Health Promoting Universities project. In: Tsouros AD, Dowding G, Thompson J, et al. (eds) Health Promoting Universities. Copenhagen: World Health Organization, 1998, pp. 111–26.
Steffen Torp Professor of Health Promotion Buskerud and Vestfold University College, Norway
Sami Kokko Senior Researcher in Health Promotion University of Jyväskylä, Finland
Karin C. Ringsberg Professor of Public Health. Nordic School of Public Health, and senior researcher at Sahlgrenska Academy, University of Gothenburg, Sweden
Downloaded from sjp.sagepub.com at GEORGIAN COURT UNIV on April 17, 2015
SJP0010.1177/1403494814553546Health Promotion In The Normal SettingS. Torp et al.
Scandinavian Journal of Public Health, 2014; 42(Suppl 15): 3–6
Editorial
Promoting health in everyday settings: Opportunities and challenges
Steffen Torp1, Sami Kokko2 & Karin C. Ringsberg3,4 1Department
of Health Promotion, Buskerud and Vestfold University College, Tønsberg, Norway 2Department of Health Sciences, University of Jyväskylä, Jyväskylä, Finland 3Nordic School of Public Health NHV, Gothenburg, Sweden 4Department of Health and Caring Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
The 7th Nordic Health Promotion Research Conference (“Promoting health in everyday settings: Opportunities and challenges”) was held in Vestfold, Norway, on 17–19 June 2013, and it was hosted by Buskerud and Vestfold University College (www.hbv. no). The aim of the conference was to focus on ongoing Nordic health promotion research, as well as international research. The conference had a specific focus on settings and the settings approach to health promotion. In order to respond to the conference’s aim and content, and to reach an international audience, all the keynote speakers and some selected researchers were asked to write scientific articles based on their conference presentations. Thus, this supplement of the Scandinavian Journal of Public Health (SJP) represents the main themes addressed at the conference. The supplement provides articles discussing important challenges for health promotion in general, and for the settings approach to health promotion in particular, covering health promotion research in a wide variety of settings. The keynote speakers’ articles give an overview of research related to a particular topic or setting, and discuss extensively the opportunities and challenges for future health promotion. Moreover, empirical articles provide an evidence base for future discussions, and challenge previous knowledge and thinking of a given issue. All articles published in this supplement underwent a double-blind review process, in line with SJP’s high academic standards. The settings approach to health promotion There are promotion:
three
main
approaches
in
health
•• The issue approach (such as nutrition and physical activity); •• The population approach (such as children and the elderly); and •• The settings approach (such as schools and workplaces). The settings approach is well known, widely utilized and top-rated, and has been developing for almost 30 years [1–3]. Still, the approach lacks a common understanding and conceptualization in theory and research [4] (see the current supplement’s articles by Mittelmark and by Dooris, Wills and Newton), and its evidence base can be questioned.The World Health Organization (WHO) [5] defines settings as “the place or social context in which people engage in daily activities in which environmental, organizational and personal factors interact to affect health and well-being.” In practice, the settings approach has been implemented in a variety of ways. In some cases, the settings have been seen as surroundings through which a particular and desired target group could be reached, but not as the target of actions per se. Targeting the setting itself would be closer to what is regarded as settings-based work [6], i.e. work in which the contextual factors affecting health and health behaviors would be acknowledged. This, in turn, would imply that peoples’ health-related decisions could be supported through policies and changes in these contextual factors. One important, often overlooked, aspect of settings-based health promotion is the link between health promotion and the core business of the setting in question, like teaching and learning in schools, or productivity in companies. That is, the core business of a setting is most often an important determinant of health; therefore, it should be targeted.
Correspondence: Steffen Torp, Department of Health Promotion, Buskerud and Vestfold University College, PO Box 2230, N-3103 Tønsberg, Norway. Email: [email protected] © 2014 the Nordic Societies of Public Health DOI: 10.1177/1403494814553546
Downloaded from sjp.sagepub.com at GEORGIAN COURT UNIV on April 17, 2015
4 S. Torp et al. At the same time, the health of the individuals in a given setting may influence the core business of the settings’ activities. For health promotion to be successful, it is necessary that important stakeholders of the setting in question are committed to the health promotion activities. Therefore, it is of utmost importance that health promotion research provide evidence of the benefits that health promotion may have to the core business of settings, such as learning in schools and universities, productivity in workplaces and enhancement of well-being in local communities. An often-argued critique for the settings approach is that different setting initiatives work in their own silos, i.e. only within their own particular setting [7]. Indeed, in community-wide programs, multiple settings are involved; therefore, coordination and cooperation within and across settings is needed [8]. Historical, critical and future perspectives to the settings approach The five first articles in the supplement focus on how health promoters may face the challenges of health promotion in the future, by being critical, retrospective and holistic. With reference to a scoping review on healthy universities; supplement authors Mark Dooris, Jane Wills and Joanne Newton hold that the settings approach to health promotion lacks a clear and coherent theoretical framework. Furthermore, they discuss the nature of a setting, how health is created in a setting, why the settings approach is useful and how health promotion can be embedded in a setting. Supplement author Maurice Mittelmark follows up this discussion, by focusing on how health promotion activities may have unintended and even untoward effects on the setting; therefore, he calls for more robust socio-ecological approaches to health promotion that are concerned with both intended and unintended effects. ‘Policy is important’ is a statement often heard from health promoters, but seldom studied and reflected upon in depth, utilizing the potential of an ecological approach. In her supplement article, Marit Helgesen focused on how important it is to understand the governance structures, and particularly the role of local governments, in health promotion in the Nordic countries. She claims that health promotion is at the forefront of Finnish and Swedish public health policies, while in Denmark and Norway, their policy focuses mainly on disease prevention and hospital admissions. Nanna Mik-Meyer addresses the so-called obesity epidemic, by focusing on the increasing tendency of medicalization of people’s life spheres. She holds that a combination of biomedical perspectives and
dominant societal values of self-responsibility and self-control may lead to health promotion with a problematic moral endeavor. In his conference lecture ‘The role of activism in health promotion’, Glenn Laverack showed us how health activism has helped people whom have limited economic or social protection from social injustice and inequality, to address their concerns; and he debates the future role of activism in health promotion and in public health. Laverack does not provide an article in this supplement, but his ideas are already presented in the article ‘Health activism’, published in Health Promotion International [9]. Relevant settings The following eight articles in this supplement link theory and practice in different settings that are highly relevant for health promotion, and vice versa. Together with the ‘Healthy Ageing Group’ of the Nordic Health Promotion Research Network, Marianne Mahler and her co-authors describe the home as a setting for promoting health among older people; and that with increasing age, the home environment becomes a crucial determinant for independence. The authors argue that only by taking into consideration the meaning of home and the resources of the individual older person, can the home function as a true health-promoting setting. Also, Leeni Berntsson and Karin C. Ringsberg underline in their article that the home and family may be an important setting for health promotion, and describe how parents’ activities together with their children can promote children’s health. Schools are settings that are highly relevant for health promotion and many of the presentations in the conference focused on this setting. Unfortunately, this supplement does not include articles focusing on schools for children; but relevant information has been provided by, for instance, the International Union for Health Promotion Education (IUHPE) [10], Samdal and Rowling [11], and Viig [12]. In addition to schools for children, WHO underlines that universities are important settings for promoting health among young adults [13]. As mentioned above, Dooris, Wills and Newton focus, in this supplement’s first article, on the conceptual frameworks of different health-promoting university projects: They had found that they differed a lot. With reference to a large European study on alcohol consumption among university students, Christiane Stock and colleagues discuss how social norms interventions, targeted at correcting misperceptions about peer alcohol use, may be a useful health promotion tool in the context of a health-promoting university.
Downloaded from sjp.sagepub.com at GEORGIAN COURT UNIV on April 17, 2015
Health Promotion in the Normal Setting 5 Non-governmental organizations (NGOs) are important stakeholders for health promotion and will probably play an increased role in future Nordic public health. In the Nordic countries, sports clubs form the largest organized leisure-time setting for youth and they have been underutilized in the field of health promotion. Author Sami Kokko discusses the role of the sports clubs as settings for health promotion, and argues that there is a need for widening the settings approach to non-traditional and non-institutional settings, to meet current societal health challenges. The workplace is an important health-promotion setting, since many adults spend much of their life at work and since their well-being is closely related to enterprise and national productivity; thereby being the basis for robust welfare states. In addition, almost all settings for health promotion include workers as one of several important stakeholders for healthpromoting activities. In their supplement article, Margaretha Strandmark and Gull-Britt Rahm are concerned with promoting mental health and describe an intervention model for how one can train the staff to cope with workplace bullying. Based on the results of their scoping review of workplace health promotion intervention research in the Nordic countries, Steffen Torp and Hege Forbech Vinje concluded that workplace health promotion research is not on the right track, because published health promotion research resembles traditional preventive medicine. They call for more intervention research on how to promote positive measures of health, by use of resource-oriented participatory settings approaches. Public health and community-based health promotion have recently been much in focus in the Nordic countries, as is described by Helgesen in her article. Closely linked to Helgesen’s political focus, supplement article author Jane South describes the UK experiences with community-based programs and focuses particularly on how to promote citizen participation. She claims that community-based interventions have to be reframed, if the challenges of both citizen participation and evidence practice are to be met. The last article of this supplement, by Charlie Eriksson and colleagues, touches upon South’s conclusion because they describe how they established trustful partnerships between academics, practitioners and policy makers in three different communitybased projects in Sweden. They conclude that high-quality and effective health promotion intervention research depends on trustful partnerships, and that developing such partnerships takes time and depends on the willingness of all stakeholders to learn from each other.
At the end of this supplement, we present the winner of the best poster prize at the conference. Migrant health among the elderly is an increasing challenge to health services and public health in the Nordic countries. Beate Lie Sverre et al. focused on how migrant older female Pakistanis promote their own health and found that they promote health by building social relationships. The authors claim that establishing voluntary organizations run by and for immigrants may be worthwhile to meet immigrants’ needs for healthrelated support. Conclusions Health promotion is genuinely interdisciplinary and includes a wide range of approaches to health promotion. To categorize health promotion into either issue-, population- or settings-based approaches is difficult, as most projects include aspects of all three approaches. Nevertheless, we find that these analytical dimensions are useful, when reflecting on the opportunities and challenges in health promotion. We also believe that more health promotion in line with the settings approach is needed. That is, health promotion taking into account that contextual factors are important health determinants; that health should be dealt with preferably alongside the core business of the settings, not separately nor independently; and that the contextual factors of the settings interact with other settings [7,8]. We hope that this supplement, containing a mix of ‘traditional’ empirical research and theoretical and discursive articles, will provide readers thought-provoking knowledge, and will inspire further theoretical discussions and empirical research in the field of settings-based health promotion. Acknowledgements We would like to express our gratitude to all the authors, the sponsors (Research Council of Norway, PriceWaterhouseCoopers and the Vestfold County Council), and to Buskerud and Vestfold University College, whom have made the conference and this supplement possible. Special thanks go to Hans Abraham Hauge and the local organizing committee; and also to the scientific committee from the Nordic Health Promotion Research Network (NHPRN), for preparing and running a ‘seamless’ conference of high scientific quality. All seven of the NHPRN research conferences held until now were a result of inspiring cooperation among researchers forming NHPRN (www.nhprn.wordpress.com/). Also, a thank you is extended to the Nordic School of Public Health (www.nhv.se), which has hosted this network
Downloaded from sjp.sagepub.com at GEORGIAN COURT UNIV on April 17, 2015
6 S. Torp et al. for the last 8 years. We look forward to further discussions on health promotion at the next Nordic Health Promotion Research Conference, to be held in Jyväskylä, Finland in June 2016. References 1. World Health Organization (WHO). Ottawa Charter for Health Promotion. An International Conference on Health Promotion, November 17–21. Copenhagen: WHO Regional Office for Europe, 1986. 2. Richard L, Gauvin L and Raine K. Ecological models revisited: Their uses and evolution in health promotion over two decades. Ann Rev Publ Health 2011;32:307–26. 3. Golden SD and Earp JAL. Social ecological approaches to individuals and their contexts: 20 years of health education and behavioral health promotion interventions. Health Educ Behav 2012;39:364–72. 4. Kokko S, Green LW and Kannas L. A review of settingsbased health promotion with applications to sports clubs. Health Promot Int 2014;29(3):494–509. 5. Nutbeam D. Health promotion glossary. Health Promot Int 1998;13:349–64. 6. Whitelaw S, Baxendale A, Bryce C, et al. ‘Settings’ based health promotion: A review. Health Promot Int 2001;16: 339–53. 7. Dooris M. Expert voices for change: Bridging the silos towards healthy and sustainable settings for the 21st century. Health Place 2013;20:39–50. 8. Poland B, Krupa G and McCall D. Settings for health promotion: An analytic framework to guide intervention design and implementation. Health Promot Pract 2009;10: 505–16. 9. Laverack G. Health activism, http://heapro.oxfordjournals.org/content/27/4/429.extract. Health Promot Int 2012; 27:429–34. 10. International Union for Health Promotion and Education (IUHPE). Achieving health promoting schools: Guidelines for promoting health in schools, www.iuhpe.org/images/PUBLICATIONS/THEMATIC/HPS/HPSGuidelines_ENG.pdf. Saint-Denis Cedex, France: IUHPE, 2008. 11. Samdal O and Rowling LT. The implementation of healthpromoting schools. Exploring the theories of what, why and how. New York: Routledge, 2013. 12. Viig NG, Fosse E, Samdal O, et al. Leading and supporting the implementation of the Norwegian Network of Health Promoting Schools. Scand J Educ Res 2012;56: 671–84. 13. Tsouros AD, Dowding G and Dooris M. Strategic framework for the Health Promoting Universities project. In: Tsouros AD, Dowding G, Thompson J, et al. (eds) Health Promoting Universities. Copenhagen: World Health Organization, 1998, pp. 111–26.
Steffen Torp Professor of Health Promotion Buskerud and Vestfold University College, Norway
Sami Kokko Senior Researcher in Health Promotion University of Jyväskylä, Finland
Karin C. Ringsberg Professor of Public Health. Nordic School of Public Health, and senior researcher at Sahlgrenska Academy, University of Gothenburg, Sweden
Downloaded from sjp.sagepub.com at GEORGIAN COURT UNIV on April 17, 2015
