European Health Promotion Indicator Development (EUHPID Project) John Kenneth Davies & Caroline Hall on behalf of the EUHPID Consortium This project is funded by the European Commission (DG SANCO)

EUHPID Project Aims To establish a European Health Promotion Monitoring System, including a set of common health promotion indicators To recommend suitable methodology and systems to collect the above data on health promotion indicators and activate the monitoring system To recommend dissemination strategies to policy makers and practitioners at Community level and within Member States

EUHPID Consortium Universities –Athens –Bergen –Brighton –Brussels –Galway –Graz –Jyvaskyla –Maastricht –Magdeburg –Marseille –Perugia –Southern Denmark Nordic School of Public Health - Goteborg National School of Public Health - Lisbon Regional School of Public Health -Valencia Flemish Centre for Health Promotion - Brussels International Union for Health Promotion & Education – Paris Also colleagues from –University of Vienna –University of Zurich –Health Promotion Switzerland

EUHPID Working Groups Data-driven- –Links with HP Source, EUROSTAT, etc. Policy-driven- –Links with Health Promoting Schools, Workplace Health Promotion & Health Promoting Hospitals Theory-driven –EUHPID Health Development Model

Focus on key perspectives of HP field (model specifications) health development = interaction between individual/population (health/health capacities) and environment (health opportunities) distinguish health development & intentional interventions health of individuals/populations at centre health defined by three interacting dimensions distinguish health and health capacity

EUHPID Model Specifications distinction between pathogenic & salutogenic health development –negative health (disease) vs. positive health (wellbeing) –Risk factors vs. resources Ottawa Charter action areas define –Health promotion actions (interventions) –Health promoting areas (targets of interventions)

Detailed sub-levels of classification system structure vs. processes functional systems vs. environment –not generalizable distinction –context-specific, to be defined by user - health promotion user window –possible to propose key settings and sectors for HP

1) HEALTH DEVELOPMENT MODEL HEALTH DISEAS E POSITIVE HEALTH WELLBEING PATHOGENESISSALUTOGENESIS RISK FACTORSRESOURCES SOCIO-ECOLOGICAL ENVIRONMENT INDIVIDUAL(S ) mental physical social HEALTH CAPACITIES HEALTH HEALTH OPPORTUNITIES ANALYTICAL PERSPECTIVES ON HEALTH DEVELOPMENT

3) EUHPID HEALTH PROMOTION MODEL HEALTH PROMOTION ACTIONS - socio-ecological context development - policy development - organisational/network development - community development - competency building/health education - empowering - participatory - holistic - intersectoral - equitable - sustainable - multistrategy HEALTH PROMOTION PRINCIPLES HEALTH PROMOTION INTERVENTION (HP Process indicators) HEALTH DEVELOPMENT (HP Outcome indicators) - advocate - enable - mediate HEALTH PROMOTION APPROACHES HEALTH DISEASE POSITIVE HEALTH WELLBEING PATHOGENESISSALUTOGENESIS RISK FACTORSRESOURCES SOCIO-ECOLOGICAL ENVIRONMENT INDIVIDUAL(S) mental physical social HEALTH CAPACITIES HEALTH HEALTH OPPORTUNITIES - socio-ecological context - policy - organisation/network - community ANALYTICAL PERSPECTIVES ON HEALTH DEVELOPMENT

Health Promotion Policy & Practice Policy formulation Infra-structure development Implementation Campaigns & programmes Evaluation Funding

Settings Based Health Promotion User Windows Hospitals Work places Schools

Endpoints of health diseasepositive health/wellbeing Sub-dimensions social social isolation amongst staff Information is available on patient organisations and those related to his/her condition. mental % of staff smoking Suicide attempts (staff and patients) Patient and staff need for health promotion intervention are assessed. physical % of patients educated about risk factor modification and disease treatment options in the management of their condition. % of work related injuries % of patients educated about specific actions in the self- management of their condition. % of discharge letters sent to GP within 2 weeks. Classifying Indicators of health (level: individual(s))

Endpoints of health capacities riskfactorsresources Sub-dimensions social Social withdrawal Opportunities and resources for leisure allocated to staff and patients mental Resignation rates staff awareness of content and location of health promotion policies. physical Morbidity rates Immobility rates % of patients assessed for disease specific risk factors according to guidelines % of patients assessed for generic risk factors Classifying indicators of health capacities (level: individual(s))

Endpoints of health opportunities riskfactorsresources Sub-dimensions socio-ecological context Number of snack machines for staff and patients. Non-smoking environments Environmental determinants of physical activity policy Hire and fire culture. Access to healthy food Existence/adherence to an equal opportunity policy. organisation/ network Multi-level hierarchy of staff. % budget dedicated to staff health promotion activities Resources allocated to the processes of implementation, evaluation and regular review of health promotion policy. community Regularity of strike action by work force. social support amongst colleagues Classifying Indicators of health opportunities (level: environment)

Current Status Final report submitted April 2004 Outcomes Influence overall European Health Monitoring and Information System Enhance ECHI framework: settings, policy and practice indicators Concept of EUHPID Health Promotion User Window

Recommendations: Use of the EUHPID Health Promotion model: construction, selection and classification of European HP indicators Develop indicators: integrated settings approach; policy and practice Testing concept of user windows Links to key players/ dissemination Complex task and further work required- Phase 2 …

euhpid / International Health Development Research Centre, Faculty of Health, University of Brighton, Mayfield House, Falmer, Brighton BN1 9PH, UK