Abstract
Background: There have been repeated calls for research on the factors that promote the spread of successful local health promotion initiatives from one community to another. We examined the factors that affected the uptake of an initiative designed in one community to improve the health of women living below the poverty line through increased access to community recreation.
Methods: Workshops were held in three other communities and uptake efforts were tracked for one year through follow-up site visits and telephone interviews with workshop participants.
Results: Making the issue a priority, actively involving the women in planning, pooling resources, sharing responsibility through partnerships, and addressing the structural dimensions of poverty were factors that enabled uptake. Factors that inhibited uptake included an emphasis on revenue generation, professionally led planning, inadequate attention to structural barriers, the undervaluing of certain resources, and an over-reliance on one idea champion.
Conclusion: A shift in how municipal recreation departments view their role as partners in community health promotion is required if programs are to promote health and be accessible to under-served populations.
Résumé
Contexte: On encourage beaucoup la recherche sur les facteurs qui favorisent la propagation, d’une localité à l’autre, des initiatives de promotion de la santé. Nous avons donc examiné les facteurs de propagation d’une initiative locale conçue pour améliorer la santé des femmes vivant sous le seuil de pauvreté en les amenant à participer à des programmes de loisirs municipaux.
Méthode: Nous avons organisé des ateliers dans trois autres localités et suivi les efforts de propagation de l’initiative sur une période d’un an par l’entremise de visites aux centres de loisirs communautaires et d’entrevues par téléphone avec les participantes aux ateliers.
Résultats: Parmi les facteurs qui ont favorisé la propagation de l’initiative, on compte la participation des femmes à la planification, la mise en commun des ressources, le partage des responsabilités par le biais de partenariats et l’étude des aspects structurels de la pauvreté. Par contre, l’obligation de rentabilité, l’embauche de professionnels pour effectuer la planification, le peu d’importance accordée aux barrières structurelles, la sous-évaluation de certaines ressources et la confiance excessive en un maître d’oeuvre sont des facteurs qui ont nui à la propagation de l’initiative.
Interprétation: Les services de loisirs municipaux doivent revoir leur rôle dans la promotion de la santé communautaire s’ils veulent que leurs programmes favorisent la santé et soient accessibles aux populations mal desservies.
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