Science

Focus:This paper presents a conceptual framework displaying how combinations of settings and populations seen in a long-term perspective may guide public health and health promotion planning and research. The notion of settings constitutes a key element of health promotion as stipulated by the Ottawa Charter from 1986. The setting approach highlights the individual, social and structural dimensions of health promotion. Likewise, the notion of populations and how they are selected forms a central pillar of public health. By joining the two perspectives, four combinations of intervention strategies appear by addressing: (1) a single population segment within a single setting, (2) multiple population segments within a single setting, (3) a single population segment within multiple settings or ( 4) multiple population segments within multiple settings. Furthermore, the addition of a time dimension inspired by the life-course perspective illustrates how trajectories of individuals and projects change settings and population segments as time goes by. The conceptual framework displays how systematic awareness of long-term, multi-setting, multi-population trajectories allow health promotion planners and researchers to systematically develop, plan and analyze their projects.

Focus: Supermarkets have been suggested as relevant settings for environmental and educational initiatives encouraging healthier shopping and eating decisions, but in the literature, limited attention has been paid to the context, perspectives, and everyday practices of supermarket staff. The aim of this study was to examine the engagement of supermarket staff in a health promotion project from a practice-oriented perspective. The study's findings point to both potentials and challenges for using supermarkets as settings for health promotion. The voluntary engagement of supermarket staff in community-based health projects cannot stand alone but should be supplemented by more long-lasting strategies and policies regulating this and other food environments. Context-sensitive and practice-oriented analyzes in local food environments could inform such strategies and policies to make sure they target unwanted elements and practices and not just individual behavior.

Focus: As a response to the complexity of reducing health inequity there has been a rise in community-based health promotion interventions adhering to the principles of complexity thinking. Such interventions often work with adaptive practice and constitute themselves in complex webs of collaborations between multiple stakeholders. However, few efforts have been made to articulate how complexity can be navigated and addressed by stakeholders in practice. This study explores how partners experience and navigate complexity in the partnership behind Tingbjerg Changing Diabetes (TCD), a community-based intervention addressing health and social development in the disadvantaged neighborhood of Tingbjerg in urban Copenhagen. The study provides important insights on the role of context and how it contributes complexity in community-based health promotion.

Focus: Research has shown that community participation in health programs is vital to ensure positive health outcomes and sustainable solutions. This is often challenged by difficulties to engage socially disadvantaged population groups. Through ethnographic fieldwork in a community initiative in a disadvantaged neighborhood in Copenhagen, Denmark, we explored which factors contributed to a conducive environment for participation. Data material consists of observation notes taken during fieldwork in a community hub from January 2020 until August 2021 and 19 semi-structured interviews with professional stakeholders and participants. We applied the analytical concept of space to elucidate how the organizational, social, and physical environments played important roles in ensuring possibilities for participation. We termed these environments Spaces of Participation. Our results highlight the importance of ensuring spaces that are flexible, informal, and responsive when engaging those who are hard to reach.

Focus: The article presents Project Sol, and how this Community-Based, Participatory, Multi-Component Intervention Increased Sales of Healthy Foods in Local Supermarkets. The intervention was based on the supersetting approach and was designed to promote healthier eating and physical activity among children and their families. The aim of this study was to examine the effects of a multi-component intervention (level 1) and a mass media intervention alone (level 2) compared to a control area (level 3) on food sales. The design was quasi-experimental. This study demonstrated significant increases in the sales of healthy foods, both in the areas with multi-component and mass media interventions alone compared to the control area.

Focus:  The article presents a follow-up study of a multi-component community-driven health promotion intervention in Denmark. The study examines the perceptions and actions of professional stakeholders 3 years after completion of a 19 months intervention period addressing healthy living, well-being and social engagement among families with young children living in three rural communities on the Danish island of Bornholm. The intervention was implemented within the framework of Project Health and Local Community, also referred to as Project SoL. Qualitative in-depth interviews were conducted with various professional stakeholders of the project.

Focus: Type 2 diabetes is an escalating public health problem closely related to socioeconomic position. There is increased risk of type 2 diabetes in disadvantaged neighbourhoods where education, occupation and income levels are low. Meanwhile, studies show positive health outcomes of participatory community interventions pointing towards the need for increased health promotion and prevention of type 2 diabetes in local communities. This study protocol describes Tingbjerg Changing Diabetes (TCD), a community-based health promotion and type 2 diabetes prevention initiative in Tingbjerg, a disadvantaged neighbourhood in Copenhagen, Denmark.

Focus: Focusing on a family cooking class program, this study addresses how community initiatives engaging parents and children together can contribute to integrating parenting support with local health promotion. The study found that visual, practical and sensory learning techniques, applied in a context-sensitive learning environment that ensured guidance, safety and a friendly social atmosphere, contributed to positive parent – child interaction and bonding. The cooking program facilitated parenting practices that support child involvement and autonomy. Thus, the program constituted an effective intervention to strengthen parent-child relationships and positive parenting.

Focus: The Integrated Diabetes Intervention initiative in Tingbjerg describes a holistic effort to strengthen the motivation of vulnerable citizens and the opportunity to participate in diabetes-related initiatives in the local area. Efforts include prevention and health promotion, early and active detection, as well as professional hand-held support for participation in complication screening and treatment for diabetes. The initiative is based on a partnership between key players in the housing area and the municipality. The partnership will ensure that support is provided by social housing employees and municipal health counselors to improve the meeting with the citizens and to strengthen the bridge building between the housing area and the health system.

Focus: Novo Nordisk has launched the Cities Changing Diabetes (CCD) initiative to try to counter the rise in diabetes, specifically focused on the growing urban populations around the world. The aim of CCD is three-fold: First, the aim of the “Mapping” phase is to conduct a qualitative and quantitative assessment of the epidemiology of diabetes and its correlated vulnerable populations. Second, the aim
of the “Sharing” phase is that learning gained from the mapping will be used to build understanding both within and between the five focus cities. Finally, the aim of the “Action” phase is to develop Action Plans in each of the focus cities in collaboration with local policymakers, authorities, private and voluntary sector stakeholders, and based on these plans to initiate interventions and policies.

Focus: This report addresses the social and structural environments of selected neighborhoods in Copenhagen as perceived by socially active representatives of socially vulnerable population groups. Emphasis is on the degree to which the social and structural environments are conducive to social engagement and healthy living. The study was carried out within the framework of Cities Changing Diabetes (CCD) and contributes to the establishment of a CCD knowledge base on barriers and opportunities for interventions addressing the escalating problem of urban diabetes within CCD partner cities, including Copenhagen.

Focus: The supersetting approach is a relevant and useful conceptual framework for developing intervention-based initiatives for sustainable impact in community health promotion. It strives to attain synergistic effects from activities that are carried out in multiple settings in a coordinated manner. The supersetting approach is based on ecological and whole-systems thinking, and stipulates important principles and values of integration, participation, empowerment, context and knowledge-based development.