National public health target awareness of staff at two organisational levels in health care.

ABSTRACT

OBJECTIVE: To investigate national public health target awareness at two organisational levels in health care comprising public officials and district nurses (DNs). To determine if the targets were incorporated in county council public health policy documents and if DNs worked in accordance with them. METHOD: Telephone interviews were performed with 21 county council officials and personal interviews were conducted with 54 DNs representing Sweden's 21 health care regions. RESULTS: Sixteen officials reported that their county council had documented public health programs, and in 13, some of the national targets were incorporated. Primary care was given major responsibility for public health. Two programs mentioned DNs' work. The officials said prevention should focus on all age groups and they emphasised the importance of health promotion. The DNs did not mention the national targets for public health and rarely mentioned targets at the county council level. Their work with prevention included self-care advice, changes in lifestyle, and preventing and relieving consequences of chronic disease. The DNs considered themselves as key persons in this work. CONCLUSIONS: The results reflect difficulties in implementing national targets and the existence of communication problems between political authorities, public officials, and "doers". Preventive work is nevertheless done in relevant areas.