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Health Promotion International, Vol. 16, No. 4, 339-353, December 2001
© Oxford University Press 2001

‘Settings’ based health promotion: a review

Sandy Whitelaw1,4, Anna Baxendale2,4, Carol Bryce3, Lindsay MacHardy3, Ian Young3 and Emma Witney3

1 Department of Primary Health Care, St Martin's College, Fusehill Campus, Carlisle CA1 2HH, 2 Greater Glasgow Health Board, Dalian House, 350 St Vincent St, Glasgow G3 8YZ and 3 Health Education Board for Scotland, Woodburn House, Canaan Lane, Edinburgh EH10 4SG, UK

Address for correspondence: Dr Sandy Whitelaw, Senior Lecturer Health Studies Department of Primary Health Care St Martin's College Fusehill Campus Carlisle CA1 2HH UK

SUMMARY

Over the past 10 years, ‘settings’ based health promotion has become a central feature of efforts to promote health that recognize the significance of context. Emerging in part from a perception of an over-reliance on individualistic methods, the approach was built on a profound belief in its value and deployed a range of novel theoretical resources, mainly from organizational sociology and psychology. This initial enthusiasm has been maintained within policy directives, in the published literature and, from our own experience, amongst health promotion practitioners. At the same time, with the maturing of the approach, has come a healthy element of critical review. Drawing upon the literature and based upon our experiences within the Health Education Board for Scotland, this paper seeks to bring together a range of perspectives, casting a critical yet constructive eye on current settings theory and practice. The paper first reviews the nature of settings based work, highlighting the varied bases and expectations that underpin it. Similarly, the many factors that influence the ability of health promoters to deliver such activities are considered. In relation to the construction and delivery of such activity, the paper suggests that there needs to be an explicit and detailed assessment of the nature of the setting, the skills of the health promoter and the associated expectations.

Key words: health promotion; practitioners; settings


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