Mapping health promotion practices across key sectors and its intersectoral approach at the local level: Study protocol.

AIMS: This study outlines a protocol aimed at identifying and mapping health promotion practices in need of development from the perspectives of key sectors responsible for it at the local level and from an intersectoral perspective across four Spanish regions. DESIGN: A complementary multi-method study combining survey methods and qualitative interviews will be adopted. METHODS: Purposive snowball sampling will be employed to select potentially rich informants from city councils, primary care centres, primary and secondary schools, and public health and civil society organizations in 12 municipalities sensitive to local health. Data on the degree of execution of health promotion activities, the level of intersectorality in their implementation, and their origins will be collected using PromoACTIVA questionnaires, an intersectoral typology model and an interview protocol. A parallel mixed analysis encompassing descriptive statistics and a 'framework analysis' will be performed. DISCUSSION: This study is expected to yield thorough and reliable insights into health promotion practices and omissions at the local level by focusing on key stakeholders, both individually and collaboratively. This information can enhance health promotion planning and improve its effectiveness, efficiency and contextual relevance. The development and testing of a methodology for the integration and interpretation of these data will ensure sustainable capacity building. IMPACT: Managers and practitioners interested in health promotion planning in the researched settings can benefit from a comprehensive map of the current state of their practices and insights into the starting points of collaboration. In addition, planners from other local settings will gain access to tools and methodologies to replicate and expand these maps to their own contexts. STAKEHOLDER ENGAGEMENT: Engaging key stakeholders with experience working in or with primary care centres, public health organizations, primary and secondary schools, civil society organizations, and city councils was vital to ensure the study's relevance and feasibility.

Theory-based capacity building intervention for intersectoral action for health at local governments: An exploratory pilot study.

AIM: To design, implement and evaluate a nurse-led capacity building intervention (PromoGOB) for intersectoral action for health at local governments. DESIGN: The programme was based on theories of the policy process and organizational change and facilitated by a nurse developing a health broker role. A complex intervention perspective was adopted in carrying out the study. The intervention was evaluated using a mixed method embedded design. METHODS: Quantitative component relied on a specific questionnaire. This tool, designed and piloted ad hoc, measured the capacity in terms of knowledge, awareness, resources, skills, and commitment, both at sectoral and government levels. For the qualitative component, semi-structured interviews were conducted. These explored the perceived capacity and feasibility and acceptability issues. The programme was initiated at the end of October 2019, and it lasted a total of 5 weeks. Nineteen individuals representing various sectors at a local government in northern Spain participated in the study. The data analysis was concluded by the end of March 2020. FINDINGS: PromoGOB positively influenced participants' capacity for addressing health promotion. Awareness component, intersectoral work and the nurse as health broker were essential in the programme. The necessity of political participation was identified as an issue to be prioritized in future studies. CONCLUSION: This study highlights the relevance of capacity building at local governments and the role that nurses can play in it. Further work should be undertaken to continue developing Health in All Policies approach at local level. IMPACT: This study offers a starting point for nurses to get involved in the policy process of health promotion, performing a specific role as health brokers, building capacity at local governments for addressing social determinants of health, and delving into theories and concepts of the Health in All Policies field.

Development of a taxonomy of activities in health prevention and promotion for primary care.

AIM: To develop a taxonomy of activities in health prevention and promotion for primary care. BACKGROUND: Despite health promotion being considered a keystone for population health and health care sustainability, its implementation remains insufficient. Customized evaluation tools are needed to address prevention and promotion omissions in primary care. METHOD: A taxonomy was designed using documentary analysis. Documents describing frontline primary care professionals' health prevention and promotion activities or omissions were identified and analysed using framework analysis. RESULTS: The 'Taxonomy of Activities in Health Prevention and Promotion for Primary Care' (TaxoPromo) includes 43 activities grouped into eight categories: planification, situational analysis, capacity building, development of awareness/public opinion, advocacy, development of networks, development of partnerships and intervention strategies. CONCLUSION: By contrasting the usual practices with the activities collected in the TaxoPromo, opportunities for improvement can be unveiled. IMPLICATIONS FOR NURSING MANAGEMENT: The TaxoPromo can be used at organisational and system levels to identify actions to integrate health prevention and promotion activities into a systematic, data-driven process; design implementation plans and tailor-made strategies for capacity building; enable benchmarking; and address omissions. The TaxoPromo can serve as a catalyst tool for the clarification and expansion of the nursing role in health prevention and promotion.

Building capacity for health promotion by addressing nurses' role confusion: Study protocol of a pilot clustered randomised controlled trial.

AIM: To describe the protocol for the pilot phase of a complex intervention, designed to address primary care nurses' role confusion in health promotion. DESIGN: A pilot clustered randomized controlled trial, with control and intervention groups. METHODS: The study will be conducted in a primary care setting. Participants will be nurses from the primary care health service working in a primary care team (PCT, 15 control group; 15 intervention group). Nurses in the experimental group will receive the ROLE-AP programme over a 3-week period. The control group will continue with the normal routine. The pilot will help determine the intervention's feasibility, acceptability, fidelity and quality of the programme components. Data collected preintervention, postintervention and 3 months after intervention will provide estimates of the intervention's preliminary effects on the main variable, nurses' degree of agreement concerning their expected role in health promotion. The study received funding from the local government in December 2019. DISCUSSION: Role confusion is promoting primary care nurses' omissions in their health-promoting practice, which is far from the ideal portrayed by the Ottawa Charter. Interventions are needed that reveal the most appropriate mechanisms for addressing role confusion, which requires reaching an intraprofessional agreement about the expectations for role activities. Healthcare organisations could benefit from the incorporation of a programme of these characteristics into standard practice. IMPACT: This study will produce a novel and comprehensive complex intervention that is expected to build nurses' capacity in primary healthcare organizations for health promotion, which is key to increasing the quality, efficiency and sustainability of the National Health System. The programme evaluation and feasibility study will reveal how to better use existing resources in a full-scale clinical trial. TRIAL REGISTRATION: ClinicalTrials.gov (ID: NCT04726696).

Nurses' role in health promotion and prevention: A critical interpretive synthesis.

BACKGROUND: Role confusion is hampering the development of nurses' capacity for health promotion and prevention. Addressing this requires discussion to reach agreement among nurses, managers, co-workers, professional associations, academics and organisations about the nursing activities in this field. Forming a sound basis for this discussion is essential. AIMS AND OBJECTIVES: To provide a description of the state of nursing health promotion and prevention practice expressed in terms of activities classifiable under the Ottawa Charter and to reveal the misalignments between this portrayal and the ideal one proposed by the Ottawa Charter. METHODS: A critical interpretive synthesis was conducted between December 2018 and May 2019. The PubMed, CINAHL, Scopus, PsychINFO, Web of Science and Dialnet databases were searched. Sixty-two papers were identified. The relevant data were extracted using a pro-forma, and the reviewers performed an integrative synthesis. The ENTREQ reporting guidelines were used for this review. RESULTS: Thirty synthetic constructs were developed into the following synthesising arguments: (a) addressing individuals' lifestyles versus developing their personal skills; (b) focusing on environmental hazards versus creating supportive environments; (c) action on families versus strengthening communities; (d) promoting community partnerships versus strengthening community action; and (e) influencing policies versus building healthy public policy. CONCLUSIONS: There are notable misalignments between nurses' current practice in health promotion and prevention and the Ottawa Charter's actions and strategies. This may be explained by the nurses' lack of understanding of health promotion and prevention and political will, research methodological flaws, the predominance of a biomedical perspective within organisations and the lack of organisational prioritisation for health promotion and prevention.

"Missed nursing care" in health promotion: Raising awareness.

AIM(S): This commentary aims to raise awareness of the possible causes of "missed nursing care" in health promotion and to propose possible solutions. BACKGROUND: Although health promotion is an essential function of nursing practice, "missed nursing care" has been scarcely studied in this area. It is crucial to know both its causes and possible strategies to prevent it. EVALUATION: We used evidence to identify possible causes of "missed nursing care" in health promotion, and we classified them into categories. We suggested the concept of capacity building to address its underlying causes. KEY ISSUE(S): Four main factors are involved in "missed nursing care" in health promotion, that is intrapersonal, interpersonal, organisational and cultural. Capacity building, including the development of knowledge, skills, commitment, structures, systems and leadership, could reduce missed care. CONCLUSION(S): "Missed nursing care" in health promotion is complex and is multifactorial in its origins. Capacity building could be a way to address its causes. IMPLICATIONS FOR NURSING MANAGEMENT: Nursing care in health promotion is paramount and a long-term investment that can contribute to the sustainability of the health system. Organisations and managers could view capacity building processes as a tool to prevent "missed nursing care" in health promotion.

Volunteerism as adolescent health promotion asset: a scoping review.

The Aim of this scoping review was to explore the available literature on volunteerism in adolescence and the benefits that this activity may report in their healthy development, from a salutogenic perspective. Searches were conducted in Pubmed, Cinahl, PsycINFO and Cochrane Library home databases; 15 articles were selected. Almost all of the studies were conducted in the United States between 1990 and 2000, primarily developed by psychologists and sociologists. The impact of volunteering was reflected in aspects that can be classified based on Lerner's dimensions of the PYD model. Volunteer activities promote an Improved academic, social, cognitive, and vocational competence in adolescents. An increase in conflict resolution capacity, leadership and personal agency, as well as improved pro-social attitudes and relationships with adults and peers, all of which contributed to their self-identification with the community. Moreover, increased positive development of adolescents reduces the rates of risky behaviors. Volunteerism may represent an opportunity for health promotion in adolescence. The concept of volunteering as an asset for health promotion during adolescence evokes the need to adopt and favor this view with regard to key areas of study associated with this stage such as education and health. Teams that work in community health, especially those in primary care, should recognize and value existing volunteer groups as an asset to promote the healthy development of adolescents. Friendlier health services should be encouraged that include comprehensive services from within educational institutions to community actions.