Health promotion and prevention involve interventions in complex social systems. Due to the rapid pace of change in the field and the variety of contexts in which interventions are made, standardised procedures tend to be the exception and the level of complexity hinders clear, generally applicable statements concerning the "optimal" or "best" approach.
Values, knowledge and context
Health Promotion Switzerland, together with national and international partners, has defined a framework for best practices in health promotion and prevention, which serves as a reference for intervention planning and decision-making in health promotion and prevention. Its three dimensions (values, knowledge, context) are intended to promote ethically responsible, scientifically sound and context-sensitive decisions and actions.
Correspondingly, best practice in health promotion and prevention means "systematically take into account the values and principles of health promotion and public health, are supported by current scientific knowledge as well as knowledge from experts and derived from practice, observe the relevant context factors and achieve the intended positive effects whilst avoiding negative ones." (Health Promotion Switzerland, 2010, p. 7).
It is impossible to provide a generally valid, context-independent list of "best practice" interventions in the sense of practically applicable "recipes" for most areas of health promotion and prevention. Interventions must be deliberated with the target groups in each new environment and adjusted to changed contextual conditions.
The implementation of the best practice framework requires systematic, recurrent reflection or critical questioning by professionals when making decisions or when planning, implementing and evaluating activities relating to health promotion and prevention (see figure). This is carried out through the three best practice dimensions and the associated criteria and indicators, similar to a radar beam which criss-crosses the skies for airplane safety. This demand for periodic, systematic reflection corresponds to the development cycles that are typical throughout the course of a project, according to quint-essenz.
The quality criteria of quint-essenz essentially take into account and operationalise the key aspects of the best practice criteria. Systematically applying the quality criteria of quint-essenz to the planning, execution, evaluation and reflection of intervention projects therefore also covers the key aspects of the best practice criteria.
- Health Promotion Switzerland (Ed.) (2010). Best Practice. A normative framework for optimal health promotion and disease prevention. Berne: Health Promotion Switzerland [Link/Download]
- Systematic reflections are time-consuming and daily project activities do not allow for them.
- It is very difficult to discuss questions concerning values with those involved as they are not usually a priority.
- It is easier to apply a project that has already been successful once to different contexts as-is than it is to adjust it each time.
- Well-founded reflection on the values and principles of public health and health promotion takes basic concerns such as equal opportunity and respect for autonomy and turns them into more than just catchphrases, incorporating them into the planning, decision-making and evaluation of interventions.
- A context-sensitive process takes account of the peculiarities of individual settings and target groups and prevents the heedless imposition of inappropriate programmes.
- By taking into account current scientific knowledge and broader practical and expert experience, you provide a solid professional basis for your health promotion and prevention project.
- Pay adequate attention to the three dimensions of values, knowledge and context, regardless of whether you are responsible for strategy development, project planning or the evaluation questions.
- From time to time, make sure your project complies with the quint-essenz quality criteria.
- In addition to this, use the best practice criteria to systematically evaluate your work.
- Are the key players familiar with the values and principles of health promotion and were they discussed as a group?
- Have you thought about how the setting in which you are intervening differs from similar ones and what effect this has on the transferability of strategies and measures?