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Health Promot Int. 2015 Sep;30(3):625-36. doi: 10.1093/heapro/dat089. Epub 2014 Jan 20.

Strengthening health promotion in hospitals with capacity building: a Taiwanese case study.

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Center for General Education, National Chung Cheng University, 168 University Road, Minhsiung Township, Chiayi County 62102, Taiwan
Department of Social Welfare, National Chung Cheng University, Chiayi County, Taiwan.
Division of Plastic Surgery, Department of Surgery, Buddhist Taichung Tzu Chi General Hospital, Taichung, Taiwan.
Ludwig Boltzmann Institute Health Promotion Research, Vienna, Austria.
Department of Medical Humanities, Tzu Chi University, Hualien, Taiwan.
Center for Environment and Population Health, Griffith University, Brisbane, Australia.


Organizational capacity building for health promotion (HP) is beneficial to the effective implementation of HP in organizational settings. The World Health Organization (WHO) Health Promoting Hospitals' (HPHs) initiative encourages hospitals to promote the health of their stakeholders by developing organizational capacity. This study analyzes an application case of one hospital of the HPH initiative in Taiwan, characterizes actions aiming at building organizational support to strengthen health gains and identifies facilitators of and barriers to the implementation of the HP in this hospital. Case study methodology was used with a triangulation of various sources; thematic analysis was used to analyze qualitative information. This study found a positive impact of the HPH initiative on the case hospital, such as more support from leadership, a fine-tuned HP mission and strategy, cultivated pro-HP habits of physical activities, a supportive intramural structure, an HP-inclusive system, improved management practices and enhanced staff participation. Transformational and transactional enablers are of equal importance in implementing HPH. However, it was also found that the case hospital encountered more transactional barriers than transformational ones. This hospital was hindered by insufficient support from external environments, leadership with limited autonomy and authority, a preference for ideals over professionalism, insufficient participation by physicians, a lack of manpower and time, a merit system with limited stimulating effect, ineffective management practices in weak central project management, a lack of integration, insufficient communication and an inability to inculcate the staff on the importance of HP, and inadequate staff participation. Several implications for other hospitals are suggested.


Health Promoting Hospitals; capacity building; organizational change; qualitative methods

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