J K Davies/Firenze/ May 2003 Developing European Health Promoting Hospital Indicators: the EUHPID Project John Kenneth Davies University of Brighton on behalf of EUHPID Consortium

J K Davies/Firenze/ May 2003 EC Health Monitoring Programme information & knowledge base for Public Health improving health information & knowledge responding rapidly to health threats addressing health determinants across all policies/activities

J K Davies/Firenze/ May 2003 European Community Health Indicator (ECHI) System  Demographic & socio- economic factors  population  socio-economic factors  Health status  mortality  morbidity  generic health status  composite health measures  Determinants of health  personal & biological factors  health behaviours  living & working conditions  Health care systems  prevention & protection  resources  utilisation  expenditure  quality

J K Davies/Firenze/ May 2003 Issues in EUHPID Indicator Development Use/Users Definition Framework Process: social construction

J K Davies/Firenze/ May 2003 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

J K Davies/Firenze/ May 2003 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

J K Davies/Firenze/ May 2003 EUHPID Outline HP indicators - definition,expectations, use/users HP quality framework for indicator selection- why, types, quality criteria theoretical/expert vs social construction of indicators outlook - from general framework to specific measures

J K Davies/Firenze/ May 2003 Health Promotion “the process of enabling people to exert control over, and to improve, their health” (WHO 1986) Tackling determinants at levels of individual health behaviours and social, economic and environmental conditions Health promotion matrix –setting/health issue/population group

J K Davies/Firenze/ May 2003 Technical Steps in EUHPID Development Define purpose of indicator system identify complex system define framework define components select indicators select measures collection dissemination

J K Davies/Firenze/ May 2003 Use/Users of HP Indicators  USE  agenda setting, advocacy  policy development  planning  monitoring & evaluation  USER  public health community, general public  policy makers inside & outside public health  health promotion experts, field partners  health promotion experts, field partners, researchers

J K Davies/Firenze/ May 2003 EUHPID Working Groups Theory-driven data-driven policy-driven

J K Davies/Firenze/ May 2003 Need for Framework Describes system to be reflected by indicators rationale for selection of indicators describes relationship between indicators basis for interpretation of indicators basis for defining,communicating and advocating unique, generic health promotion perspective

J K Davies/Firenze/ May 2003 Socio-Ecological Model of Health Development environmental structure cultural socio-economical physical/ecological system structure cultural socio-economical physical/ecological environmental process cultural socio-economical physical/ecological Health Development Pathogenesis Salutogenesis system process cultural socio-economical physical/ecological Systems quality environment policies organization community person Systems scale micro - macro

J K Davies/Firenze/ May 2003 Socio-Ecological Model of Health Promotion Health Promotion action areas Create supportive environments Build healthy public policy Reorient health services Strengthen community action Develop personal skills combined into Health Promotion strategies Systems quality environment policies organization community person Systems scale environmental structure health opportunities system structure health capacities environmental process health opportunities Health Development Pathogenesis Salutogenesis system process health actions Health Promotion Principles (participation, empowerment, equity) Assessment Planning Implementation Evaluation micro - macro

J K Davies/Firenze/ May 2003 Hospital Setting physical environment –how can it be protected built environment –how can design protect & promote health social environment –how to promote social & psychological wellbeing of users and staff health promoting environment –how it can play direct role in promoting health

J K Davies/Firenze/ May 2003 HPH Indicator Use monitoring of HP projects evaluation of HP projects culture change/reorientation to health gain –disease reduction to health development –continuous process of organisational & cultural development –supportive organisational context

J K Davies/Firenze/ May 2003 HPH Development Indicators individual behaviour setting/s development (management policy) patients focus (assessment, information, intervention) staff focus (promoting healthy workplace) community focus (partnerships)

J K Davies/Firenze/ May 2003 Workshop Task With reference to your understanding & experience of HPH, what are the key sets of relevant health promotion indicators that you can identify within the EUHPID socio- ecological model of health promotion?

J K Davies/Firenze/ May 2003 EUHPID