Lezwijn Jeanette, Wagemakers Annemarie, Vaandrager Lenneke, Koelen Maria, van Woerkum Cees
*Corresponding author. E-mail:
Health Promot Int. 2014 Jun;29(2):328-38. doi: 10.1093/heapro/das051. Epub 2012 Sep 26.
Health promotion has a strong tradition of using planning models based on an a priori set of goals and processes defined by professionals. Those rational models only partly fit with today's view and practice of health promotion, where programmes can be considered as processes because they are guided by principles such as community participation and intersectoral collaboration. The aim of this paper is to provide a comprehensive view on approaches to planning in health promotion practice. To investigate these, Whittington's typology has been used. Whittington identifies four approaches to planning, i.e. classical, evolutionary, processual and systemic. In a retrospective multiple case study, we describe actual planning processes used in the development and implementation of a healthy ageing programme in three Dutch municipalities. These processes were described using data gathered by: interviews, participant observation and document analysis, and external auditing. Characteristics of the four planning approaches were used to interpret the data. The results show that, in practice, all forms of planning approaches were used, depending on the degree of complexity and dynamics of the context, the phase of the health promotion programme, and the time available. Our findings suggest that in the emergent practice of health promotion different approaches to planning are used. To make those planning approaches explicit and manageable for practice and science, discussion and reflection between stakeholders are essential.
健康促进长期以来一直有使用基于专业人员预先设定的目标和流程的规划模型的传统。那些理性模型仅部分符合当今健康促进的观点和实践，在当今的健康促进中，项目可被视为过程，因为它们受社区参与和部门间合作等原则的指导。本文旨在全面阐述健康促进实践中的规划方法。为了对此进行研究，采用了惠廷顿的类型学。惠廷顿确定了四种规划方法，即经典型、进化型、过程型和系统型。在一项回顾性多案例研究中，我们描述了荷兰三个城市在制定和实施一项健康老龄化项目时所采用的实际规划过程。这些过程通过以下方式收集的数据进行描述：访谈、参与观察、文件分析以及外部审计。利用这四种规划方法的特征来解读数据。结果表明，在实践中，根据背景的复杂程度和动态性、健康促进项目的阶段以及可用时间，会使用所有形式的规划方法。我们的研究结果表明，在健康促进的新兴实践中会采用不同的规划方法。为了使这些规划方法在实践和科学中清晰明了且易于管理，利益相关者之间的讨论和反思至关重要。
