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Health Promot Int. 2014 Dec;29(4):705-19. doi: 10.1093/heapro/dat029. Epub 2013 May 8.

Health promotion in Australian multi-disciplinary primary health care services: case studies from South Australia and the Northern Territory.

Author information

1
Southgate Institute for Health, Society, and Equity and SA Community Health Research Unit, Flinders University, GPO Box 2100, Adelaide, SA 5001, Australia fran.baum@flinders.edu.au.
2
Southgate Institute for Health, Society, and Equity and SA Community Health Research Unit, Flinders University, GPO Box 2100, Adelaide, SA 5001, Australia.
3
Sexual Health Information Networking & Education SA (SHine SA), 64C Woodville Road, PO Box 76, Woodville, SA 5011, Australia.
4
Central Australian Aboriginal Congress, PO Box 1604, Alice Springs NT 0871, Australia.
5
Southgate Institute for Health, Society, and Equity and SA Community Health Research Unit, Flinders University, GPO Box 2100, Adelaide, SA 5001, Australia Institute of Population Health, University of Ottawa,1 Stewart Street, Ottawa, ON, Canada K1N 6N5.
6
School of Public Health, University of the Western Cape, Private Bag X17, Bellville, Cape Town 7535, South Africa.

Abstract

This paper reports on the health promotion and disease prevention conducted at Australian multi-disciplinary primary health care (PHC) services and considers the ways in which the organizational environment affects the extent and type of health promotion and disease prevention activity. The study involves five PHC services in Adelaide and one in Alice Springs. Four are managed by a state health department and two by boards of governance. The study is based on an audit of activities and on 68 interviews conducted with staff. All the sites undertake health promotion and recognize its importance but all report that this activity is under constant pressure resulting from the need to provide services to people who have health problems. We also found an increased focus on chronic disease management and prevention which prioritized individuals and behavioural change strategies rather than addressing social determinants affecting whole communities. There was little health promotion work that reflected a salutogenic approach to the creation of health. Most activity falls under three types: parenting and child development, chronic disease prevention and mental health. Only the non-government organizations reported advocacy on broader policy issues. Health reform and consequent reorganizations were seen to reduce the ability of some services to undertake health promotion. The paper concludes that PHC in Australia plays an important role in disease prevention, but that there is considerable scope to increase the amount of community-based health promotion which focuses on a salutogenic view of health and which engages in community partnerships.

KEYWORDS:

aboriginal health; community health; health promotion; primary health care

PMID:
23656732
DOI:
10.1093/heapro/dat029
[Indexed for MEDLINE]
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