Robertson A, Minkler M
Department of Behavioral Science, University of Toronto, Faculty of Medicine, Ontario, Canada.
Health Educ Q. 1994 Fall;21(3):295-312. doi: 10.1177/109019819402100303.
In the last decade, a revolution has been occurring in the field of health promotion. Guided to a large extent by position papers disseminated by the World Health Organization (WHO) Europe Health Promotion Office, and furthered by the Ottawa Charter, the Epp Report in Canada, the Healthy Cities project, as well as by other efforts, this new health promotion movement has introduced new ideas, new language, and new concepts about what constitutes health and how health promotion efforts should be configured to achieve health. Punctuated by the terms like empowerment and community participation, this movement has generated a whole new discourse about the theory and practice of health promotion. This paper explores the multiple meanings that surround these terms, and the implications for practice, by addressing questions like: What does health mean in this new context? What is empowerment? What does participation look like? Has the tyranny of the professional been replaced by the tyranny of the community? Has anything changed about the practice of health promotion other than the language? Finally, it is argued that an acknowledgment of the multidimensionality of these concepts may facilitate their translation from rhetoric into health promotion practice.
在过去十年里，健康促进领域发生了一场变革。在很大程度上，这场变革受到世界卫生组织（WHO）欧洲健康促进办公室发布的立场文件的引导，并因《渥太华宪章》、加拿大的《埃普报告》、健康城市项目以及其他努力而得以推进。这场新的健康促进运动引入了关于健康的构成要素以及应如何配置健康促进努力以实现健康的新观念、新语言和新概念。以赋权和社区参与等术语为标志，这场运动催生了关于健康促进理论与实践的全新论述。本文通过探讨诸如以下问题来探究围绕这些术语的多重含义及其对实践的影响：在这一新背景下健康意味着什么？什么是赋权？参与是怎样的？专业人员的主导地位是否已被社区的主导地位所取代？除了语言之外，健康促进实践是否有任何变化？最后，本文认为承认这些概念的多维度性可能有助于将它们从言辞转化为健康促进实践。
