Purpose: The purpose of this study was to define and clarify the concept of health promotion 'competence' in public health nurses (PHNs). Methods: A hybrid model was used to develop the concept of competence. The model included a field study carried out in Seoul, Korea. The participants in this study were 20 PHNs who were working in the health promotion area. Results: The concept of health promotion competence was found to be a complex phenomenon having a meaning in two dimensions: personal-relationship and environmental-relationship. Four attributes and eight indicators were defined. Conclusion: Health promotion competence was defined as the ability to have understanding and flexibility in practicing (personal-relationship dimension) and to have capacity for uniqueness and leadership in planning (environmental-relationship dimension). Therefore, PHNs who work in the health promotion area should be equipped with attributes and indicators of health promotion competence to enhance their competence in health promotion.
Objectives: This paper reviews the integrated health promotion program in health center to analyse the problems and to provide the future directions aiming to health promotion block grants. Methods: The guidebook for the integrated health promotion program published by the Minister of Health and Welfare were reviewed in this study. And also the empirical results and theoretical considerations were used in making future directions. Results and Conclusion: This paper suggested four improvement directions as follows; first, the legal review committee is needed to approve when the central government change the way of health promotion program in health center. Second, the required programs should be replaced by an integrated outcom evaluation indicators. Third, the central government should strengthen the capacity of local government. And finally, visiting training should be conducted each health center.
Objectives: The community network is a foundation laid by the local community which has been formed historically and geographically to develop itself. This paper as a Korean way of healthy network survey for the community capacity building is an exploratory research to grasp the character of Korean society and then to organize an resident-governing partnership for that. Methods: Research objectives are CBOs(Community-Based Organizations) in S-district of Seoul. This region is a new town, however the solidarity and volunteerism of this resident is lively. The survey tool is Cho's CBOs Evaluation Questionnaire which was originated to measure the community capacity. The period of survey is from the January 2009 to the March 2009 and the study organizations which were collected by snowball sampling were 80. Results: The result shows two main networks: one is the civil society and craft union cluster, the other is welfare organization cluster. Groups of high centrality were organizations whose members are mainly women and craft organizations which were organized before 1990's. The group of high betweenness was the Association of Women's Organizations(0.188). Bi-components were six and they could be divided by organization's aim. In terms of the determinants of the participation to the health center enterprise, only the number of link(B=-0.60, p<0.04) was statistically significant. It means that when organization variables are controlled a tendency appears: the more the voluntary associations network, the less participation in the health enterprise. Conclusion: CBHOs(Community-Based Health Organizations) enhances residents' spontaneity and cohesion to increase the capability of the local community. If the surveyed healthy network, together the community health project, are used for various community development projects, the existing CBOs including CBHOs will be reorganized and furthered newly. For this it will be needed to construct an effective partnership of healthy network by restructuring the existing networks of voluntary associations.
Community-Based Participatory Research(CBPR) has gained attention as a public health approach to develop community health interventions to address health disparities in recognition of the community relevance of specific health issues associated with social determinants of health. It emphasizes community involvement in equal partnership with researchers and public health professionals to address community-identified needs. The characteristics and principles of CBPR discussed in this paper highlight participatory nature, capacity development, partnership building, and process-orientation of CBPR. A 6-step process model for community empowerment is then introduced as a CBPR operationalization strategy. Mixed methods research approaches are valuable in CBPR as well as process evaluation. For the application of CBPR in Korean contexts, the Diffusion of Innovation theory is suggested as a theoretical framework for implementation. Building public health partnerships between public and private sectors to create partnership synergy is a necessary condition for successful CBPR for health promotion in Korea. Accompanying critical factors for the CBPR application include: common understanding of CBPR and its values, establishment of the definition of 'community,' 'community-based' and 'participation' in community health, development of accommodating research infrastructure for CBPR, recognition of the importance of program evaluation (particularly process evaluation), and training CBPR specialists.
Objectives: This paper discusses the current contexts of the collaboration between public health centers(PHCs) and community partners for health promotion. Then it suggests directions for the development and enhancement of the collaboration. Methods: The discussion in this paper is based on key literature on community health promotion, including literature reviews and case reports. Results: PHCs are mostly engaged in networking and cooperation rather than collaboration with the community. A typical pattern of cooperation is where PHCs provide healthy-setting types of programs to the community in single-partnered relationships. Current cooperation rarely involves co-planning by a multi-partnered partnership, and is greatly influenced by the interest of PHC directors and PHC performance evaluation indicators. Systems change is recommended to foster collaboration for community health promotion. Such change involves: shared understanding of health promotion and collaboration, inclusion of collaboration mechanism in public health governance, leadership development, capacity enhancement of all partners. role definition of PHCs for community collaboration, and development of collaborative system, at the least. Conclusions: At this point where collaboration should be more than rhetoric, multi-faceted, intersectoral, and concurrent approaches are required to create discourses, to develop cases, and to share experience for actual realization of collaboration for community health promotion.
Purpose: The objective of this study were to examine the determinants of self-rated health, specially focused on the effect of functional capacity of community dwelling sedentary older adults on self-rated health. Method: The data has been collected from 654 community-dwelling sedentary older adults (mean age: 75 years) during the period from April to June in 2007. The data were collected by the in-person interview and direct measurement of functional capacity. The data were analyzed using chi-square test and multiple regression analysis with the SPSS 9.1 program. Result: The elderly rated their health as very good (3%), good (28%), fair (38%), poor (29%0, and very poor (2%). The higher average daily walk minutes ($\beta$=0.12, p<.01), number of chair stand ($\beta$=0.10, p<.05), scores of self-efficacy ($\beta$=0.16, p<.001) and the lower number of disease ($\beta$=-0.44, p<.001) show better self-rated health. Conclusion: Self-rated health is the most commonly used indicators in social epidemiology and geriatric research because it has been known as the good predictor of mortality and reflects health related disability. The finding suggested that daily walking habits, lower body strength, physical self-efficacy should be considered to improve the senior's self-perception of health. The community-based intervention associate increase these factors should be considered.
At the opening of a new millennium and a new century, health promotion and education services in Korea are in the early developmental stage. The National Health Promotion Act legislated in 1995 was a milestone for initiating a national and local health promotion program in Korea. And since then local governments and health centers have been developing and providing health promotion program for the community populations. The short history of health promotion and education in Korea has meant that local governments and health centers have a limited experience and organizational capacity for health promotion and education planing and practice. This study was attempted to measure health education need of rural community and to analyze the factors for health education need assessment. Surveyors interviewed 1250 subjects randomly selected. Subjects were 2.17% of men and women in Changnyung county and older then 20 years old. Data were collected from April 17, 2000 through April 27, 2000. The questionnaire consisted of general characteristics, health educational experiences, health educational method, health educational content and health educational needs for rural community residents. The questions on the health educational needs of content consist of 36 questions in 8 fields. The statistical methods used for the analysis were $X^2$-test, t-test, F-ratio and ANOVA using SPSS program. In conclusion, despite more needs to the respondents who are in the low education level and socioeconomic state, in the old age, in the low health knowledge, they required less health education. To enjoy a more healthy life after more community residents actively understand and are interested in health education and health promotion, we certainly require a designed and systemic health education. The resources of health department in Korea are limited and the investment involved in health promotion and health education is severely reduced. Particularly this situation is more severe in the rural community. To select and perform an effective health education methods that the nature and reality of the rural community are considered, well use the resources to invest in health promotion affairs as effectively as possible and then they will take the responsibility of healthy community.
The National Health Promotion Law passed in 1995 was a milestone for initiating a national health promotion program in Korea, and government officers and health professionals are working on how to approach health promotion issues. The purpose of this study was to analyse methods and use of constructivist paradigm in health promotion and education. The health promotion area needs community empowerment, building community partnerships, and community capacity. To meet these health promotion requirements health promotion workforce should be trained through professional preparation programs that contains communication skills, group process skills, and management of programs in advanced countries such as the United States and Australia. Skills and responsibilities of those who are in charge of providing health promotion services have not yet been clearly defined in Korea because the area of health promotion is a multi-academic field, and needs a different approach, constructivist approach. Constructivist paradigm requires relativism, reasoning skills, collaborating, and motivation. These components are needed for community empowerment. Constructivism also has been applied to the field of education. Problem-based education, outcome-based education, performance-based education came from the constructivism. These educational methods are student-centered method. As the modernizing society becomes more complicated, traditional or conventional teacher-centered education cannot meet the needs of students. Students need to learn skills necessary to make healthy decisions with individual value system. So these interactive, self-learning methods can serve much more to the learner. Constructivist educational methods can be applied to educational programs in computers, too. To expand and differentiate the area of health education and health promotion from other health related fields, it is crucial to devote efforts in application and development of constructivist methods.
Community Health Planning has been used in public health centers for over 10 years, but little is known about its effect and how it is utilized by public health centers. This paper examines the effect of Community Health Planning on public health centers'organizational performance through the use of the Structural Equation Modeling(SEM) technique. We conducted e-mail surveys of chiefs, people in charge of planning and other staff members in all the public health centers in the country. The instrument measured self-evaluated levels of Community Health Planning, implementation and the effect on the public health centers. The model of the SEM technique has five latent constructs: requirements of planning, plan formulation, implementation, organizational capacity and performance. The SEM technique validated the instrument used in the study and exhibited a relatively good fit. Results of this study were as follows. First, the requirements of planning have positive effects on plan formulation. Second, plan formulation has positive effects on organizational capacity but plan implementation doesn't. Third, there was no statistically significant path between plan formulation, implementation and performance. Fourth, organizational capacity has positive effects on performance. Consequently, this study revealed that Community Health Planning has a positive influence on organizational performance through organizational capacity.
'Health in All Policies' is a new strategy for governance for health in 21st century. The evolution of health promotion has affected the creation of the strategy through the efforts to tackle health inequalities by addressing social determinants of health. More concern about health inequalities, involving wider policy areas, and higher level of institutionalization distinguish the strategy from the old intersectoral collaboration such as intersectoral action for health and healthy public policy. Making intersectoral collaboration the mainstream of policy making is important to address integrated policy agendas such as 'Health in All Policies' and 'Sustainable Development Goals.' Political leadership and interpersonal skills are also required to strengthen the capacity of public health sector for implementing 'Health in All Policies' in local, national, and international circumstances.
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