Prilleltensky Isaac
Peabody College of Vanderbilt University, Nashville, TN 37202, USA.
Scand J Public Health Suppl. 2005 Oct;66:53-60. doi: 10.1080/14034950510033381.
The promotion of personal, relational, and collective well-being has evolved markedly in the last three decades. However positive and needed, recent developments in health promotion require further conceptual clarification and synergistic applications. To assist with conceptual clarification, this article proposes to distinguish among sites, signs, sources, and strategies of well-being. With respect to applications, progress is discussed along four domains: temporal, ecological, participation, and capabilities. The temporal domain refers to the timing of interventions and entails a continuum from reactive to proactive strategies. The ecological domain pertains to the site of interventions, ranging from person-centered to community-centered. The participation domain refers to voice and choice of citizens and consumers in delivery of services and access to resources. At one end of this continuum there is empowerment, while at the opposite end we see disempowerment and detachment. Finally, the capabilities domain refers to the concentration on either strengths or deficits. This article argues that a singular focus on strength, prevention, empowerment, or community conditions is insufficient. It presents a framework for the conceptual integration of these four approaches, while illustrating the benefits of their synergy and the risks of their fragmentation. It is high time for a paradigm shift in health and human services, and this article argues that only a new approach that focuses on strengths, prevention, empowerment, and community conditions can make considerable progress towards the achievement of well-being for all.
在过去三十年中，促进个人、人际关系和集体福祉方面有了显著发展。然而，尽管健康促进方面的最新进展积极且必要，但仍需要进一步的概念澄清和协同应用。为了帮助进行概念澄清，本文提议区分福祉的场所、标志、来源和策略。在应用方面，沿着四个领域讨论进展情况：时间、生态、参与和能力。时间领域指干预的时机，涵盖从反应性策略到前瞻性策略的连续统一体。生态领域涉及干预的场所，从以个人为中心到以社区为中心。参与领域指公民和消费者在服务提供和资源获取方面的发言权和选择权。在这个连续统一体的一端是赋权，而在另一端则是无权和脱离。最后，能力领域指关注优势或缺陷。本文认为，单一关注优势、预防、赋权或社区状况是不够的。它提出了一个将这四种方法进行概念整合的框架，同时说明了它们协同的好处以及分散的风险。健康和人类服务领域早就应该进行范式转变了，本文认为只有一种关注优势、预防、赋权和社区状况的新方法才能在实现全民福祉方面取得重大进展。
