TABLE 3.
Data extraction of original publications identified in the scoping review chronologically ordered by category and language published (Professional characteristics of health promotion: a scoping review of German and international literature, Switzerland, 2021).
| Authors (nature of literature) | Title | Year | Method | Aim | Outcome | Country |
|---|---|---|---|---|---|---|
| Category: Profession | ||||||
| Zocher, U. (grey literature) | About the challenge to study and teach health promotion–results of participatory evaluation | 2013 | Mixed methods evaluation study | Evaluating student’s perspective on the profession of HP a including strength and challenges of the study course | The holistic approach of HP for some students is hard to capture. Problematic are the diverse professional backgrounds of lecturers. Main conclusions for professionalization in HP are: 1) Expert knowledge/professional understanding (theory on HP), 2) Didactic for HP (reflective processes), 3) Leadership culture in sense of HP | Germany (g) b |
| Pawlis, S., Boettcher, A., Metzner, F., Plaumann, M. and Walter, U. (journal article) | Relevance and implementation of prevention in Germany–a national survey of decision makers in health insurance association, state and communities | 2015 | Quantitative online survey | Identifying the relevance and implementation of HP and prevention at decision makers’ level at health insurance companies, the state and communities | Intervention of health insurances are mainly pathogenetic oriented, whereas interventions of the state are also focusing on social inequities. Policy makers are more positive towards capacity building in HP and prevention than health insurance companies. Main barriers are financial issues and personal resources as well as unclear roles. | Germany (g) |
| Walter, S. (master thesis) | HP on the way to a profession–an interview study | 2015 | Qualitative study using interviews | Exploring the field of action and the need of HP practitioners asking experts in the field | HP is currently performed by a variety of professions. Most organizations employ at least one person with a professional background in health sciences, whereas related disciplines (sports, nutrition) don’t see a gain for the field of action. There are also persons working in HP who don’t have any specific or related training. There was agreement on the need of professionals in HP, but the diversity of study programs in Germany related to health are seen as a barrier, lacking transparent competencies. Unclear definitions of roles in HP are barriers for developing a professional identity. The study revealed clear chances of professionalization of HP, but some major challenges which seem to be solvable. | Germany (g) |
| Golden, S. D. and Earp, J. A. (journal article) | Social ecological approaches to individuals and their contexts: twenty years of Health Education and Behavior health promotion interventions | 2012 | Literature review | Identifying socio-ecological approaches in HP interventions published in the journal “health education and behavior” between 1989 and 2008 | Out of 157 articles, 2/3 focused on the individual and not specially on institutions, communities or politics. Interventions in settings like schools or the community or with topics such as nutrition and physical activity were more often integrating socio-ecological approaches compared to other topics. Competencies in HP have to be strengthened in order to address socio-ecological determinants of health in interventions. | United States (e) c |
| Harris, N. and Maria, S. (journal article) | Defining sustainable practice in community-based health promotion: A Delphi study of practitioner perspectives | 2013 | Quantitative Delphi study | Identifying definitions and features of sustainable practice in community-based HP practice | Definitions of sustainable practice highlight the importance of collaboration, health determinants, aspirations, processes and outcomes. Four specific features were identified: 1) effective relationships and partnerships, 2) evidence-based decision making and practice, 3) emphasis on building community capacity, 4) supportive contexts | Australia (e) |
| Tretheway, R., Taylor, J., O’Hara, L. and Percival, N. (journal article) | A missing ethical competency? A review of critical reflection in health promotion | 2015 | Narrative literature review | Exploring the current use of critical reflection in HP | Very limited literature exists on critical reflection in HP, whereas its potential to support critical practice is widely acknowledged. Critical reflection is seen as a core competency for HP practitioners to reflect the ethical issues of HP practice. | Australia (e) |
| McFarlane, K., Judd, J., Devine, S. and Watt, K. (journal article) | Reorientation of health services: enablers and barriers faced by organisations when increasing health promotion capacity | 2016 | Systematic literature review | Identifying enablers and barriers of primary health care organizations integrating HP approaches and capacity building of HP | 25 articles were identified which summarize enablers for primary health care organizations: Management support, skilled staff, committed staffing and financial resources, leadership and external partners to collaborate; barriers were the opposite of the enablers including competing priorities to HP within a health care organization which is quite often the case. | Australia (e) |
| Legrand, K., Minary, L. and Briançon, S. (journal article) | Exploration of the experiences, practices and needs of health promotion professionals when evaluating their interventions and programs | 2018 | Quantitative written survey | Describing practices of HP practitioners regarding evaluation of their interventions and identifying the need of an evaluation and monitoring tool | More than half of 246 respondents in total had difficulties with conducting process evaluation. On the one hand selecting the proper evaluation tool was difficult and on the other hand a lack of time and finances. Authors identify a need for an online tool for evaluation of HP interventions. Evaluation is a major competence in HP practice. | France (e) |
| Category: Ethics | ||||||
| Carter, S. M., Klinner, C., Kerridge, I., Rychetnik, L. and Li, V. (journal article) | The ethical commitment of health promotion practitioners: an empirical study from New South Wales, Australia | 2012 | Qualitative study using interviews | Describing the good in HP by conducting interviews and observations to complete the theory of HP ethics | Ethics in HP has substantive and procedural dimensions: substantive: meliorism, holism, setting approach, focus on primary prevention and communities. Procedural: interventions built on respectful relationships, flexible collaboration with communities, and are capabilities oriented and sustainable. | Australia (e) |
| Bull, T., Riggs, E. and Nchogu, S. N. (journal article) | Does health promotion need a code of ethics? Results from an IUHPE mixed methods survey | 2012 | Online survey including closed and open-ended questions | Identifying the global need of a code of ethics in HP | Low response rate (11.8%, N = 236). 83% confirmed the need of a code of ethics to clarify roles and definitions of HP. Main ethical issues are: equity, social justice and respect. The CompHP was seen as a possible basis for developing a code of ethics. | International IUHPE (e) |
| Vallgarda, S. (journal article) | Ethics, equality and evidence in health promotion - Danish guidelines for municipalities | 2014 | Documental analysis | Analyzing the content of Danish national guidelines for HP regarding equity, evidence and ethical aspects | Results show a low integration of equity, evidence and ethics in the national guidelines for HP, even though it was declared as an aim of the Danish national board of health. To meet this aims in practice of HP, more effort of public health authorities is necessary. | Denmark (e) |
| Spencer, G. (journal article) | “Troubling” moments in health promotion: Unpacking the ethics of empowerment | 2015 | Ethnographical mixed methods study | Critical analyses of the outcomes of empowerment in HP interventions, exemplified with adolescence health | Young adults’ health priorities are set differently, e.g. smoking and drinking promotes their quality of life and self-determination. The different priorities raise some ethical dilemmas for HP practice regarding using empowerment. This reinforces the importance of ethical reflection of HP, especially the dimension of empowerment. | Australia (e) |
| Axford, A. and Carter, D. (journal article) | Building workforce capacity for ethical reflection in health promotion: a practitioner’s experience | 2015 | Case study | Analyzing the effect of a program for capacity building in HP on the influence of ethical reflection in practice | The implemented program on capacity building, which consisted of different components based on organizational change management, was evaluated by participants to have a positive impact on ethical reflection in daily practice. The ethical framework was seen as a very practical tool. Challenges for capacity building in this rural area were different professional backgrounds of HP practitioners. | Australia (e) |
| Reilly, T., Crawford, G., Lobo, R., Leavy, J. and Jancey, J. (journal article) | Ethics and health promotion practice: exploring attitudes and practices in Western Australian health organizations | 2016 | Qualitative study using interviews | Analyzing attitudes, practices, enablers and barriers of applied ethics in HP practice | Out of ten interviews, most practitioners include ethical principals in their practice. Enablers were: support with ethical applications, tools and training in ethical practice, organizational support. Barriers were: limited time resources, little knowledge, ethical application not noticed as one’s task. HP practice is still lacking evidence-based practice and including ethical principles, which must be amended in the future. | Australia (e) |
| Category: Education/training | ||||||
| Sachs, I. and University of Applied Sciences Neubrandenburg (grey literature) | Study courses and job perspectives of graduates in nursing and health sciences | 2014 | Quantitative online survey | Identifying: Conditions of study program, progress, competencies, follow up, job search, job description, job satisfaction | Participation of five study programs: BA health science results: 66% prior professional education (BA), 56% satisfied, 15% dissatisfied with study program, 2/3 direct access to job, 1/3 master program, high satisfaction with job situation, broad field of actions (few in HP and prevention) | Germany (g) |
| Hartmann, T., Baumgarten, K., Dadacynski, K. and Stolze, N. (journal article) | Public health and health promotion in Germany. State of development of bachelor’s and master’s courses | 2015 | Online search in data bases for health-related study programs in Germany | Overview of accredited study courses in public health and HP in Germany | 43 courses identified, 13 bachelor’s and 30 master’s at universities and universities of applied sciences, eight bachelor’s, five master’s in HP, great effort is necessary to synchronize the curriculum content | Germany (g) |
| Lang, G. and Gajar, P. (journal article) | Continuing education and training in health promotion. A survey about intentions and conditions among participants of a countrywide seminar program in Austria | 2018 | Quantitative online survey | Identifying factors influencing the intention to participate in continuing education and training in HP | Influencing factors identified: Self-efficacy, attitudes toward seminars, social expectations of significant others, seminar attendance in the past, interplay of personal behavior and institutional conditions | Austria (g) |
| Tremblay, M. C., Richard, L., Brousselle, A. and Beaudet, N. (journal article) | How can both the intervention and its evaluation fulfill health promotion principles? An example from a professional development program | 2013 | Case study | Describing core principles of HP, the professional development program and its evaluation (HP Laboratory) | The HP Laboratory is a program to foster HP competencies in public health professionals. Participants with different professional backgrounds working in health departments developed a common understanding of HP core principles. Evaluation of the program on HP principles was challenging. | Canada (e) |
| Tremblay, M. C., Richard, L., Brousselle, A. and Beaudet, N. (journal article) | Learning reflexivity from a health promotion professional development program in Canada | 2014 | Qualitative study using interviews | Describing outcomes of reflexivity of the professional development program in HP. Implications of reflexivity for HP practice | Formal and critical reflection are important methods in HP practice and helped the participants to understand their professional roles. Especially critical reflection was hard to encourage, but is important for a critical societal perspective on social justice and equity concerns in HP. | Canada (e) |
| Wilkins, A., Lobo, R. C., Griffin, D. M. and Woods, H. A. (journal article) | Evaluation of health promotion training for Western Australian Aboriginal maternal and child health sector | 2015 | Quantitative evaluation study (online survey or telephone interview) | Evaluation of a HP training for health professionals - impact of using information given in the training - barriers of implementing the trainings’ resources in practice | Low response rate (N = 17); diverse professional backgrounds of participants; Job descriptions often with HP, but no training in HP; Chances of the training: planning tools for HP; networking in HP; Barriers: lacking finances, low organizational support | Australia (e) |
| Wiggins, N. and Pérez, A. (journal article) | Using popular education with health promotion students in the United States | 2017 | Case study using mixed methods | Evaluation of a course in popular education method within a master’s in public health. This method is supposed to train skills for a systemic analysis of power and privilege to address health and social inequities. | The method was very useful for students to learn focusing attention and creating community, cooperative learning to support accountability to one another and dramatic techniques. Barriers for using this method are students who are not used to liberal pedagogy and controversy environment of the university. | United States (e) |
| Torres, S., Richard, L., Guichard, A., Chicchio, F., Litvak, E. and Beaudet, N. (journal article) | Professional development programs in health promotion: Tools and processes to favor new practices | 2017 | Case study using mixed methods | Evaluation of a professional development program which focuses on improving HP interventions including health promoting principles | The results showed positive findings implementing several principles of HP (equity, holism, an ecological approach, intersectorality and sustainability). Participants had problems integrating empowerment and participation in their interventions developed. | Canada (e) |
| Komro, K. A., Lang, D. L., Reisinger Walker, E. and Harper, P. D. (editorial) | Integrating structural determinants into MPH training of health promotion professionals | 2018 | Review of curricula of master’s in public health | Identifying structural and social determinants in curricula of master’s in public health in the United States | 16% of 275 master’s in public health contain structural determinants of health in the curriculum: Study courses in social science focus more on social and structural determinants of health; interprofessional collaboration is necessary to efficiently address these determinants of health | United States (e) |
| Category: Competencies | ||||||
| Baumgarten, K., Blättner, B., Dadaczynski, K. and Hartmann, T. (journal article) | The German professional qualification framework for bachelor’s and master’s degrees in health sciences/public health and health promotion | 2015 | Framework development based on content analysis | Developing a qualification framework for health sciences/public health and HP bachelor’s and master’s programs to enable comparability | Involving nine universities a shared framework was developed for bachelor’s programs based on the Public Health Action Cycle and Dublin descriptors. No consensus was found for the heterogenic master’s programs. | Germany (g) |
| Karg, S., Blättner, B., Krüger, K. and Micheew, N. (journal article) | Competences for working in health promotion. Perceptions of stakeholders | 2020 | Interview study | Identifying stakeholders’ needs of competencies in HP and possibilities for students preparing for employment during study course | There was agreement on professional competencies: project management, networking and teamwork, conceptual work, research, public communication, as well as social competencies. Stakeholders appreciate the holistic approach of HP practitioners. | Germany (g) |
| Speller, V., Parish, R., Davison and Zilnyk, A. (journal article) | Developing consensus on the CompHP professional standards for health promotion in Europe | 2012 | Mixed methods study | Description of the process of framework development (CompHP) including testing for acceptance at pan European level | There was a great acceptance and agreement upon the framework CompHP. This goes along with some concerns: 1) high level for practitioners, 2) developed for master’s programs, 3) relationship between Public Health and HP | United Kingdom (e) |
| Madsen, W. and Bell, T. (journal article) | Using health promotion competencies for curriculum development in higher education | 2020 | Case study | Analyzing chances and challenges of one institution by developing undergraduate and postgraduate courses building on national competencies of HP. | Main chances of implementing national competencies in curricula of HP education are transparency and comparability. Challenging were organizational structures, characteristics of the study cohorts and capacity of lecturers as well as national and international expectations. One main risk is the lacking flexibility of the curriculum. This was fully obvious when CompHP was developed internationally in the meantime. The institution could restructure the curriculum again on CompHP. | Australia (e) |
| Battel-Kirk, B., Van der Zanden, G., Schipperen, M. Contu, P., Gallardo, C., and Barry, M. M. (journal article) | Developing a competency-based pan-european accreditation framework for health promotion | 2012 | Mixed methods study including focus groups, online survey and web-based consultation | Find consensus on CompHP pan-European accreditation framework for HP practice, education and training | 405 participants out of 29 countries were involved in the study. Mainly positive agreement on an accreditation framework to assure quality and competence in HP. Barriers for implementation were mentioned regarding lacking resources for implementation of the accreditation framework. Furthermore, the unclear interrelationship between Public Health and HP are barriers for implementation in some countries. | Europe (e) |
| Hicks, K. (grey literature) | Health promotion competencies baseline implementation survey report | 2013 | Quantitative written survey | Collecting information on the current knowledge and implementation of New Zealands’ HP competencies amongst the HP workforce | 105 responses revealed that 88% had at least some knowledge on the national HP competencies. The competencies are used for personal development plans, performance reviews, planning programs. They realized an increase of clarity of their professional role and understanding of HP. Challenges for implementing the competencies were other organizational priorities. | New Zealand (e) |
| Battel-Kirk, B. and Barry, M.M. (journal article) | Has the development of health promotion competencies made a difference? A scoping review of the literature | 2019 | Scoping review | Explore current impact of HP competencies on practice, education and training in Europe | 39 sources were identified, mainly focusing on competency frameworks and their development, some report on the use of the frameworks and only two evaluated the frameworks. There is a lack of studies on the implementation of HP competencies. | Ireland and Malta (e) |
| Battel-Kirk, B. and Barry, M. M. (journal article) | Implementation of health promotion competencies in Ireland and Italy—A case study | 2019 | Case study including desk reviews and semi-structured interviews | Exploring the promoting and challenging factors for implementation of CompHP at a national level comparing two countries, Ireland and Italy | The progress of CompHP implementation reflected the HP infrastructure and capacity in the countries. Major limitations were a lack of awareness of the CompHP also by main stakeholders and employees. The CompHP has to be promoted over the next years to build capacity of HP. | Ireland and Malta (e) |
| Battel-Kirk, B. and Barry, M.M. (journal article) | Evaluating progress in the uptake and impact of health promotion competencies in Europe | 2020 | Online survey conducted with consortium included in the development of CompHP | Identify attitudes regarding the CompHP, level of current and intended use and opinions on their impact | Only 81 responses were received from 25 countries: attitudes were generally positive, while only 53% confirmed the use of the CompHP in their country. The competencies were mainly used in education of HP. Main barriers for implementation of the CompHP was the lacking recognition of key organizations and stakeholder at a national level. | Ireland and Malta (e) |
| Category: Quality | ||||||
| Wright, M. T., Noweski, M. and Robertz-Grossmann, B. (journal article) | Quality development in primary prevention and health promotion. A survey of the member organizations of the Federal Association for Prevention and Health Promotion in Germany | 2012 | Quantitative online survey | Identify implementation of quality development strategies and standards used in HP and prevention in Germany | The results are very limited. Responses confirmed a great variety of quality standards used in HP and prevention. Therefore, the questionnaire could not be answered properly. The authors concluded that a qualitative research approach is necessary to capture the variety of quality standards used in HP and prevention. | Germany (g) |
| Bär, G., Noweski, M., Ihm, M. and Voss, A. (journal article) | Prevention of overweight in children: Standard setting documents | 2016 | Literature review | Assessing quality standards of overweight prevention in children found in databases and google | German literature on quality standards and overweight prevention in children is rare. Standard setting documents of key stakeholders of HP and prevention in Germany are comparable with each other but do not refer to each other. Moreover, it is not clear which document guides the quality standards for overweight prevention in children in Germany. | Germany (g) |
| Grossmann, B. and Noweski, M. (journal article) | Quality in primary prevention. Results of a survey of members of the Federal Association for Prevention and Health Promotion | 2016 | Qualitative study using expert interviews | Exploring the current status of quality standards used in HP and prevention | 42 experts were interviewed: Using quality standards in practice correlates with financial resources and qualified staff in the institutions. Good practice examples would be a helpful tool as well as a nationwide monitoring system. First, more funding is required for assuring quality standards in practice. | Germany (g) |
| Reisig, V., Kuhn, J., Loos, S., Nennstiel-Ratzel, U., Wildner, M. and Caselmann, W. H. (journal article) | Primary prevention and health promotion in Bavaria: Taking stock | 2016 | Mixed methods approach including an online survey and expert interviews | Assessing the status quo of prevention and HP in Bavaria, aiming at a quality-oriented development of the field | HP and prevention practice mainly address health literacy and mental health issues by providing health information relating to behavior change interventions. Rather low is the engagement with gender specific topics or socially disadvantaged groups including working with a setting approach in communities. About half of the participants include scientific results in their project development and 43% conduct evaluations. | Germany (g) |
| Noweski, M., Bär, G., Voss, A., Ihm, M. and Fricke, L. (journal article) | Common quality standards in primary prevention. The expert survey PräKiT | 2018 | Qualitative study using expert interviews | Identifying the need of common quality standards for HP and prevention | A common quality standard is meaningful to the interviewed experts. A complex and challenging process to identify this common standard is expected to meet specific needs of different topics within HP and prevention. Even within these expert interviews no theoretical saturation could be revealed because expectation varied meaningfully. | Germany (g) |
a
HP: health promotion
b
(g): German.
c
(e): English.