BackgroundHealth promotion, with a focus on multidimensional upstream factors and an ecological, life-course approach, is establishing itself as the guiding philosophy for addressing public health. Action at the political and programmatic level on the Social Determinants of Health has proven effective for promoting and building public health at all levels but has been particularly evident at the national and international levels – due in large part to available documents and guidelines. Although research and experience establish that health promotion is most effective when settings-based, the development of health promoting policies and programs at the local level is still difficult. This study intended to investigate available knowledge on the development and implementation of health promoting policies and programs at the local level and identify factors most important for facilitating capacity building and outcome achievement.MethodsWe used a scoping review in order to review the current literature on local policy development and program implementation. Keywords were chosen based on results of a previous literature review. A total of 53 articles were divided into two categories: policy and implementation. Critical analysis was conducted for each article and a summary assembled. Data was charted with specific focus on the aims of the study, data acquisition, key theories/concepts/frameworks used, outcome measures, results, and conclusions.ResultsThe articles included in this study primarily focused on discussing factors that facilitate the development of health promoting policy and the implementation of health promotion programs. Most significant facilitators included: collaborative decision-making, agreement of objectives and goals, local planning and action, effective leadership, building and maintaining trust, availability of resources, a dynamic approach, a realistic time-frame, and trained and knowledgeable staff. Within each of these important facilitating factors, various elements supporting implementation were discussed and highlighted in this study.ConclusionOur results indicate that clear and consistent facilitators exist for supporting health promoting policy development and program implementation at the local level. These results offer a starting point for local action on the Social Determinants of Health and have the potential to contribute to the development of a framework for improving action at the local level.

By assisting these women in finding new patterns of meaningful occupations that positively affect their everyday life, the study suggests some central elements to be included in future follow-up practice for breast cancer survivors. Approaching this goal, occupational therapists should contribute to more involvement assisting cancer survivors and their partners in finding new patterns of meaningful occupations that positively affect their everyday life.

In this paper we shed light on the experiences of disabled students attending professional courses in higher education in Norway. The findings from this empirical study are based on interviews with fourteen students with diverse impairments, ranging from the visible to the invisible. They faced barriers that they resolved to address on their own, using their capabilities and working 'in silence' to meet the expectations of normal students in academia as strong and independent. In addition to their own motivation and self-determination, what facilitated their progress in their studies was that some of the staff and fellow students met them respectfully as ordinary students, while recognising their strain and providing support without calling attention to it. Leaning on the Nordic Relational Model of Disability, we call for greater awareness of the complex interactional processes between the disabled students and people in their social environment.

This article discusses ways of understanding the processes involved when disabled students negotiate accessibility in higher education. Despite legislation for universal design and political aims to increase the number of disabled students, individuals themselves have to take initiatives to obtain needed reasonable adjustments. Findings are drawn from a study of everyday lives of disabled students. Research methods employed were: time geographic diaries, in-depth interviews and focus groups. Findings include issues of disclosure and stigma management, supports provided with a twist of ambiguity, and experiences of combatting for individual accommodation. The process of negotiation is discussed in terms of traditions in higher education, the burden individual accommodation in practice place upon disabled students, and the need for changes based on universal design.