The design of health promotion strategies for seafarers.

Health promoting interventions among seafarers have, to date, been limited in scope and their effectiveness is questionable. There is good knowledge base from a wide range of onshore settings that indicates how best to structure health promotion initiatives in ways that are accepted by those affected by them and where their effectiveness has been fully evaluated. Here we identify the main lessons to be learnt from experience in other sectors and note the special features of the settings in which seafarers live and work as the basis for strategic development. The history of health promoting initiatives in seafarers is also summarised. The aim of this review is to foster debate about the best means to formulate seafarer health promotion initiatives and to introduce them in such ways that their effectiveness can be evaluated. The review has its origins as a scoping document for a strategic review of seafarer health promotion supported by the Seafarers' Trust.