Action across the continuum

A range of actions are needed to create effective health promotion services, strategies and programs. These action areas span the continuum of work we do in health and community services, from working with individuals to help them build knowledge and skills, through to building public health policy that embeds health promoting practices at a systems level.Health and community workers operate in a variety of ways within the one system. Some people work with individuals, some work with individuals and with the broader community, others work on policy and planning. All of these workers aim to improve health outcomes by addressing social, environmental and economic conditions, or by helping people be active self-managers of their own health and life. This is a continuum of work.

Health and community services staff are encouraged to acknowledge the role they play in this continuum, to look for chances to link services and ensure a comprehensive approach to promoting health and wellbeing across communities. This includes addressing inequities in health and developing collaborative whole-of-government and whole-of-community approaches.

The Victorian Department of Human Services developed a model to describe health promotion interventions and capacity building strategies (see the table below). This was based on the action areas of the Ottawa Charter for Health Promotion. This model shows a continuum from the individual to the whole population across which we can implement health promotion strategies.

The following table shows each component on the continuum and an example of a health promotion strategy.



Screening and individual risk assessment

Clinical testing to detect early signs of cardiovascular disease

Health education and skill development

Community-based healthy cooking demonstrations

Social marketing and health information

Population-wide campaigns to promote healthy eating and physical activity

Community action for social and environmental change

Parent advocacy for increased promotion and availability of healthy options in school canteens

Settings and supportive environments

Local government planning for increased physical activity opportunities in the community

To be effective, this approach needs the support of a strong and well-resourced system that invests in capacity building through developing organisations and the workforce.

A note on social marketing

Social marketing aims to change or maintain people's behaviour for their benefit and the benefit of society as a whole. To do social marketing properly we need to understand our target audience and see things from their perspective. It may be useful to ask: 'Do the benefits of doing what we want them to do outweigh the costs or barriers to doing it?'.

Social marketing is less likely to be effective if we ignore other factors that restrict people's ability to change their lifestyle. For example, a campaign to encourage more physical activity will have limited success if the environment where people live does not support them to be active. Or a campaign to promote healthy eating will be undermined by the advertising of high fat and high sugar foods.

Social marketing has been used effectively in Australia to encourage people to eat vegetables and fruit and to stop smoking. More research is needed to understand how sustainable changes made after a social marketing intervention are.

Social marketing is most effective when it is part of multiple and related strategies - such as linking with community activities, or changing community attitudes towards smoking legislation. It needs to be well targeted and involve the community in developing culturally sensitive messages. In the longer term, it seems campaigns building community coalitions or influencing policy outcomes are more effective.

For further information and to apply these principles in your work, view this checklist