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Pan-Canadian Discipline-Specific Competencies for Health Promoters: A Progress Report

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I Introduction

There is growing concern that current and emerging challenges faced by public health will require systemic enhancements to its workforce. One approach to strengthening the public health labour force not only within Ontario but across Canada is through the implementation of well defined competencies for health professionals working in public health. The competency-based approach has been a common message manifested from a series of stakeholder workshops on public health education held in 2004 as well as in a review of international best practices for public health workforce development (1,2). As such, the development of "Core Competencies for Public Health in Canada: Release 1.0" has been a significant catalyst for public health disciplines such as public health nurses, inspectors, physicians, dieticians, dentists and epidemiologists to define their own set of discipline-specific competencies.

This article outlines the recent development of competencies for health promoters as well as the opportunity for those working in health promotion to provide input into these proposed competencies.        

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II Development of Health Promoter Competencies

The emergence of health promotion as a distinct speciality has created further need to better define the scope of its practice. Recently, Health Promotion Ontario (HPO), a professional association representing health promoters within Ontario, in collaboration with Public Health Agency of Canada (PHAC), has been working to develop a set of competencies for health promoters. (Note: competencies can be defined as a set of skills, knowledge and abilities necessary for the practise of health promotion.) This collaboration has lead to the development of two foundational documents:

  1. A literature review of health promotion competencies, entitled "Development of a Discipline-Specific Competency Set for Health Promoters - Findings from a Review of the Literature" (Moloughney, 2006).
  2. An environmental scan of health promotion organizations in Canada, entitled "Health Promoters in Canada, an Overview of Roles, Networks and Trends" (Hyndman, 2006).

These documents have laid the foundation for a discussion paper entitled "Towards the Development of Competencies for Health Promoters in Canada" (Hyndman, 2007), including a draft set of discipline-specific competencies for health promoters (see below).

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III Why Health Promoter Competencies?

Some key reasons for health promoters to identify discipline-specific competencies are:

  • To inform and structure the content of health promotion training programs.
  • To assist in the development of competency-based job descriptions.
  • To inform the development of training needs assessment tools.
  • To inform curriculum development of continuing education.
  • To increase understanding of the range of knowledge and skills required by health promoters to effectively plan, deliver and evaluate health promotion initiatives.

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IV  Who Can Use the Competencies?

The research described above has been funded by PHAC, primarily to support health promotion practitioners in public health. The competencies were written for health promoters working within public health settings in Canada and/or for those with the term ‘health promotion' in their job title. This includes organizations such as public health units, community health centres and regional health authorities.

However, the competencies are not meant to exclude individuals practising health promotion in other settings; they are offered as a resource that can help inform the work of any individual, group or organization engaged in health promotion practice. The proposed competencies are not meant to be a definitive list to be distributed for explicit adoption by key stakeholder groups in Canada; rather they are meant to be the initial step in a multi-stage consultation process to achieve consensus on the scope of competencies for health promoters (3).

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V Consultation Process     

The proposed competencies serve as a starting point for an extended consultation process with health promotion stakeholders in Canada. This, in turn, will help guide the modification of the competencies to ensure that they reflect a truly Pan-Canadian perspective. To date, the competencies developed by HPO have been presented and consulted on in the following ways:

  • the Health Promotion Ontario 2007 conference;
  • the International Union of Health Promoters and Educators (IUHPE) 2007 conference;
  • an online feedback survey distributed via email to HPO members and participants of the IUHPE workshop;
  • the Canadian Public Health Association 2008 conference; and
  • an update on progress at the Health Promotion Ontario 2008 conference.

In general, the feedback received this far has been positive and constructive. Future plans for ongoing consultation to refine the draft competencies include:

  • collating and analyzing feedback results;
  • exploring the feasibility of a national public health promotion network with representation from across Canada; and
  • validating the draft competencies using a Pan-Canadian perspective.

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VI  Proposed Pan-Canadian Competencies for Health Promoters (for Discussion Purposes Only)

A summary of the proposed competencies follows. These have been excerpted from the HPO-commissioned report, "Towards the Development of Competencies for Health Promoters in Canada". For those wishing to understand the process and intent behind the proposed competencies, it is recommended to read this paper in its entirety.

All health promoters should be able to:

1.    Demonstrate knowledge necessary for conducting health promotion that includes:

1.1.    Applying a determinants of health framework to the analysis of health issues.
1.2.    Applying theory to health promotion planning and implementation.
1.3.    Applying health promotion principles in the context of the roles and responsibilities of public health organizations.
1.4.    Describing the range of interventions available to address public health issues.

2.    Conduct a community needs/situational assessment for a specific issue that includes:

2.1.    Identifying behavioural, social, environmental and organizational factors that promote or compromise health.
2.2.    Identifying relevant and appropriate data and information sources.
2.3.    Identifying community assets and resources.
2.4.    Partner with communities to validate collected quantitative and qualitative data
2.5.    Integrating information from available sources to identify priorities for action.

3.    Plan appropriate health promotion programs that includes:

3.1.    Identifying, retrieving and critically appraising the relevant literature.
3.2.    Conducting an environmental scan of best practices.
3.3.    Developing a component plan to implement programs including goals, objectives and implementation steps.
3.4.    Developing a program budget.
3.5.    Monitoring and evaluating implementation of interventions.

4.    Contribute to policy development that includes:

4.1.    Describing the health, economic, administrative, legal, social and political implications of policy options.
4.2.    Providing strategic policy advice on health promotion issues.
4.3.    Writing clear and concise policy statements for complex issues.

5.    Facilitate community mobilization and build community capacity around shared health priorities that includes:

5.1.    Engaging in a dialogue with communities based on trust and mutual respect.
5.2.    Identifying and strengthening local community capacities to take action on health issues.
5.3.    Advocating for and with individuals and communities that will improve their health and well-being.

6.    Engage in partnership and collaboration that includes:

6.1.    Establishing and maintaining linkages with community leaders and other key health promotion stakeholders (e.g., schools, businesses, churches, community associations, labour unions, etc.).
6.2.    Utilizing leadership, team building, negotiation and conflict resolution skills to build community partnerships.
6.3.    Building coalitions and stimulating intersectoral collaboration on health issues.

7.    Communicate effectively with community members and other professionals that includes:

7.1.    Providing health status, demographic, statistical, programmatic and scientific information tailored to professional and lay audiences.
7.2.    Applying social marketing and other communication principles to the development, implementation and evaluation of health communication campaigns.
7.3.    Using the media, advanced technologies and community networks to receive and communicate information.
7.4.    Interacting with, and adapting policies and programming that respond to the diversity in population characteristics.

8.    Organize, implement and manage health promotion interventions that includes:

8.1.    Training and coordinating program volunteers.
8.2.    Describing scope of work in the context of organization's mission and functions.
8.3.    Contribute to team and organizational learning.

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VII Opportunities to Comment on the Proposed Health Promotion Competencies

Pending funding, it is anticipated that a broad national consultation will begin in the fall of 2008. In the meantime, stakeholders, agencies and individual health promoters have an opportunity to "test-drive" the proposed competencies.

When reviewing the proposed competencies, some possible questions for health promoters to consider are:

  1. Do these competencies describe the scope and breadth of the majority of health promotion work I am engaged in?
  2. Are these competencies generic enough to apply to a variety of settings, especially in a pan-Canadian context?
  3. Are these competencies specific enough to distinguish the work of health promoters from other disciplines?
  4. Will this delineation of competencies help others to understand the work of health promoters?
  5. Will these competencies help employers create or revise job descriptions for health promoters?
  6. Will these competencies be useful to those involved in planning and delivering training, education and professional development for health promoters?

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VIII Conclusion

HPO believes the proposed competencies will assist health promoters in reaching consensus on the shared knowledge and skills that constitute effective health promotion practice. Ultimately, the purpose is to improve the health of the public through improved public health programming. HPO welcomes feedback from any individual or organization that shares its commitment to defining and raising awareness on health promoter competencies.

Feedback and questions on the proposed competencies can be addressed to Marco Ghassemi, Peel Public Health - Chronic Disease and Injury Prevention, at marco.ghassemi@peelregion.ca or Kevin Churchill, Health Promotion Ontario, at kevin.churchill@county-lambton.on.ca.

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IX References

1.    Moloughney B (2006). Development of a Discipline-Specific Competency Set for Health Promoters - Findings from a Review of the Literature.
2.    Hyndman B (2006). Health Promoters in Canada, an Overview of Roles, Networks and Trends.
3.    Hyndman B (2007). Towards the Development of Competencies for Health Promoters in Canada.