Design of an online health-promoting community: negotiating user community needs with public health goals and service capabilities.

BACKGROUND: An online health-promoting community (OHPC) has the potential to promote health and advance new means of dialogue between public health representatives and the general public. The aim of this study was to examine what aspects of an OHPC that are critical for satisfying the needs of the user community and public health goals and service capabilities. METHODS: Community-based participatory research methods were used for data collection and analysis, and participatory design principles to develop a case study OHPC for adolescents. Qualitative data from adolescents on health appraisals and perspectives on health information were collected in a Swedish health service region and classified into categories of user health information exchange needs. A composite design rationale for the OHPC was completed by linking the identified user needs, user-derived requirements, and technical and organizational systems solutions. Conflicts between end-user requirements and organizational goals and resources were identified. RESULTS: The most prominent health information needs were associated to food, exercise, and well-being. The assessment of the design rationale document and prototype in light of the regional public health goals and service capabilities showed that compromises were needed to resolve conflicts involving the management of organizational resources and responsibilities. The users wanted to discuss health issues with health experts having little time to set aside to the OHPC and it was unclear who should set the norms for the online discussions. CONCLUSIONS: OHPCs can be designed to satisfy both the needs of user communities and public health goals and service capabilities. Compromises are needed to resolve conflicts between users' needs to discuss health issues with domain experts and the management of resources and responsibilities in public health organizations.

[Abuse of women is a public health problem. All female patients over the age of 14 should be part of a routine screening program]. / Kvinnomisshandel är ett folkhälsoproblem. Alla kvinnor över 14 år som söker vård borde genomgå screening.

Abuse does not appear to be restricted to a specific sociodemographic group of women, nor to a specific period in their lives. Screening for domestic violence provides an opportunity not only to disclose family abuse but also to take action to improve the safety and health of these women. All routine health care of women should incorporate direct questions about abuse, psychological as well as physical and sexual. Staff should be trained in how to integrate routine enquiries about abuse into their daily practice.