Labonte R
Health Educ Q. 1994 Summer;21(2):253-68. doi: 10.1177/109019819402100209.
Recent reformulations of health promotion focus on empowerment as both a means and an end in health promotion practice. Both concepts, however, are rarely examined for their assumptions about social change processes or the potential of community groups, professionals, and institutions to create healthier living situations. This article attends to some of these assumptions, expressing ideas generated during 6 years of professional training workshops with over 2,500 community health practitioners in Canada, New Zealand, and Australia. The article first argues that health promotion is not a social movement but a professional and bureaucratic response to the new knowledge challenges of social movements. As such, it has both empowering and disempowering aspects. The article analyzes empowerment as a dialectical relation in which power is simultaneously given and taken, and illustrates this in the context of health promotion programs. A model of an empowering professional (institutional) health promotion practice is presented, in which linkages among personal services, small group supports, community organizing, coalition advocacy, and political action are made explicit. Practice examples are provided to illustrate each level of the empowering relation, and the article concludes with a brief discussion of the model's educational and organizational utility.
近期健康促进的重新规划将赋权视为健康促进实践的手段和目的。然而，这两个概念很少因其关于社会变革过程的假设，或社区团体、专业人员及机构创造更健康生活环境的潜力而受到审视。本文关注其中一些假设，阐述了在加拿大、新西兰和澳大利亚与2500多名社区卫生从业者开展的为期6年的专业培训工作坊中产生的观点。文章首先指出，健康促进并非一场社会运动，而是对社会运动新知识挑战的专业和官僚式回应。因此，它既有赋权的一面，也有去权的一面。文章将赋权分析为一种辩证关系，在这种关系中，权力既被给予又被获取，并在健康促进项目的背景下对此进行了说明。本文提出了一个赋权型专业（机构）健康促进实践模型，其中明确了个人服务、小组支持、社区组织、联盟倡导和政治行动之间的联系。文中提供了实践示例来说明赋权关系的每个层面，文章最后简要讨论了该模型的教育和组织效用。
