Health promotion partnerships in Israel: motives, enhancing and inhibiting factors, and modes of structure.
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Multisectoral cooperation is an important strategy in working for health promotion. Fifty-two health professionals completed a questionnaire measuring factors motivating, enhancing and inhibiting partnerships. The respondents also reported the type or structure of the partnerships. The results indicated that partnerships were formed primarily in order to promote the project; however, previous positive experience with partnerships was also very important as a motivating force for joining partnerships. The three most important facilitating factors were related to project management: effective leadership, aims of the project, and sharing a vision and goals. The two most frequent items mentioned as very important barriers to partnerships were related to dysfunction of the steering committee. Two types or structures of partnerships were identified. The first was fragmental, where partnerships existed only at specific stages of the project; most respondents reported working within this structure. The second type was continuous, where partnerships existed through all the project's stages. Using multiple regression analysis we found that health staff (mainly nurses) worked more frequently in fragmental partnership structures than did health promotion and welfare workers. In addition, the more experienced the respondents, the less they worked in fragmental partnership structures. These results highlight the importance of acquiring skills for working in partnerships and indicate a need for guidelines to be agreed by the partners at the beginning of the working process. (+info)
A case study of sodium reduction in breakfast cereals and the impact of the Pick the Tick food information program in Australia.
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In 1997, one of Australia's largest food companies undertook a program of salt reduction in 12 breakfast cereals. The National Heart Foundation's Pick the Tick program criterion (<400 mg sodium per 100 g) was used as a target value where possible. Twelve products were reformulated, with reductions ranging from 85 to 479 mg sodium per 100 g and an average reduction of 40% (12-88%). As a result, 235 tonnes of salt were removed annually from the Australian food supply and five more products were able to carry the tick logo. The impact of the Pick the Tick program in changing the food supply extends beyond those products that are part of the food approval program. (+info)
Moving further upstream: from toxics reduction to the precautionary principle.
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Early policies to reduce the amount of toxic waste in the environment focused on cleaning up downstream sources of pollution, such as toxic disposal sites. Public attention in the 1980s encouraged both industry and government to develop an alternative to this command-and-control approach. This article describes the emergence of that alternative-pollution prevention-and its application in Massachusetts through the 1989 Toxics Use Reduction Act. Pollution prevention focuses on the sources of pollution, both metaphorically and physically, more upstream than its predecessors. The success of the Toxics Use Reduction Act in Massachusetts helped create an opportunity where an alternative pollution prevention paradigm could develop. That paradigm, the precautionary principle, is popular among environment activists because it focuses further upstream than pollution prevention by calling attention to the role the social construction of risk plays in decisions regarding the use of hazardous substances. The authors examine the evolution of the precautionary principle through an investigation of three major pathways in its development and expansion. The article concludes with a discussion of the increased potential for protecting public health and the environment afforded by this new perspective. (+info)
Preparing for a bioterrorist attack: legal and administrative strategies.
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This article proposes and discusses legal and administrative preparations for a bioterrorist attack. To perform the duties expected of public health agencies during a disease outbreak caused by bioterrorism, an agency must have a sufficient number of employees and providers at work and a good communications system between staff in the central offices of the public health agency and those in outlying or neighboring agencies and hospitals. The article proposes strategies for achieving these objectives as well as for removing legal barriers that discourage agencies, institutions, and persons from working together for the overall good of the community. Issues related to disease surveillance and special considerations regarding public health restrictive orders are discussed. (+info)
The politics of emergency health powers and the isolation of public health.
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The Model State Emergency Health Powers Act became a contentious document in more than 30 states in 2001 and 2002. Controversy has focused on recommendations by the authors of the Model Act that seemed to accord higher priority to collective action in emergencies than to protecting privacy and property. This situation has several causes that derive from the characteristics of public health emergencies during the past half century and the relative isolation of public health officials from both their colleagues in government and many members of the public. (+info)
Implications of the World Trade Center attack for the public health and health care infrastructures.
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The September 11, 2001, attack on the World Trade Center had profound effects on the well-being of New York City. The authors describe and assess the strengths and weaknesses of the city's response to the public health, environmental/ occupational health, and mental health dimensions of the attack in the first 6 months after the event. They also examine the impact on the city's health care and social service system. The authors suggest lessons that can inform the development of a post-September 11th agenda for strengthening urban health infrastructures. (+info)
Aligning quality for populations and patients: do we know which way to go?
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Both the medical care and public health systems have invested considerable resources to define, measure, and improve quality and health outcomes. A movement toward accountability has generated performance indicators from the medical arena and "leading health indicators" from the public health arena. The focus on specific conditions by the medical care system has been at odds with public health's emphasis on improving population health and has perpetuated a bifurcated system. Aligning the goals of medical care with those of public health will require reformulation of performance measurement and accountability into a common language that is valued by both systems. Such a creation would amount to a whole that is stronger than the sum of the component parts. (+info)
Broadening participation in community problem solving: a multidisciplinary model to support collaborative practice and research.
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Over the last 40 years, thousands of communities-in the United States and internationally-have been working to broaden the involvement of people and organizations in addressing community-level problems related to health and other areas. Yet, in spite of this experience, many communities are having substantial difficulty achieving their collaborative objective, and many funders of community partnerships and participation initiatives are looking for ways to get more out of their investment. One of the reasons we are in this predicament is that the practitioners and researchers who are interested in community collaboration come from a variety of contexts, initiatives, and academic disciplines, and few of them have integrated their work with experiences or literatures beyond their own domain. In this article, we seek to overcome some of this fragmentation of effort by presenting a multidisciplinary model that lays out the pathways by which broadly participatory processes lead to more effective community problem solving and to improvements in community health. The model, which builds on a broad array of practical experience as well as conceptual and empirical work in multiple fields, is an outgrowth of a joint-learning work group that was organized to support nine communities in the Turning Point initiative. Following a detailed explication of the model, the article focuses on the implications of the model for research, practice, and policy. It describes how the model can help researchers answer the fundamental effectiveness and "how-to" questions related to community collaboration. In addition, the article explores differences between the model and current practice, suggesting strategies that can help the participants in, and funders of, community collaborations strengthen their efforts. (+info)