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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.

The present paper investigates possible gender and age differences on emotional states (state depression and state anxiety) and sense of coherence (SOC) as well as the association between SOC and emotional states. The cross‐sectional sectional sample consists of 1209 adolescents 13–18 years from public elementary and secondary schools in Mid‐Norway. The results showed that girls reported higher scores on state anxiety and state depression, whereas boys consistently scored higher on SOC in all age groups. SOC was inversely associated with both state depression and state anxiety. An interaction effect of gender by SOC was found on both state depression and state anxiety, where the association was stronger for girls than for boys. Conclusions: The associations found give support for the implications of salutogenic factors in relation to emotional health in adolescents.

These data suggest that emotional distress, cognitive function and overall health are important priority areas in rehabilitation programmes to improve work ability.

Neighborhood social capital has repeatedly been linked to favorable health-outcomes and life satisfaction. However, it has been questioned whether it's impact on health has been over-rated. We aim to investigate relationships between neighborhood social capital and self-rated health (SRH) and life satisfaction (LS) respectively, both directly and indirectly mediated via Sense of Coherence and self-esteem. Based on a cross-sectional population-survey (N=865) in a medium size Norwegian municipality, we specified a structural equation model (SEM) including the above-listed variables, while controlling for gender, age, education, income, and employment status. The applied model explains more variance in LS (46%) than in SRH (23%). Social capital has a stronger impact on life satisfaction than on health. The indirect pathway via SOC had the highest impact on life satisfaction, but no significant relationship to SRH. Self-rated health was more tightly linked to personal background variables. Enhancing social capital in the neighborhood might be a beneficial strategy to promote life satisfaction, as well as strengthening sense of coherence even in healthy communities.

In conclusion our findings underline the need for extended collaboration between the employees, employer, and rehabilitation staff, and should encourage occupational therapists to direct even more of their expertise towards the situation at the workplace.

BackgroundHealth and conditions for health are unevenly distributed across neighbourhoods. Within a salutogenic perspective, neighbourhood-resources can be internalised, and become generalised resistance resources. This paper aims to examine whether the neighbourhood could be a supportive arena for health-promotion, and for whom.Design and MethodsA cross-sectional study, based on register data from the population-survey in Malvik, Norway, (N=865) was conducted. Using multiple regression analysis, total sample and sub-group analyses (men/women, low/high earners, employed/unemployed) of 5 independent neighbourhood-measures (overall satisfaction, neighbourhood Social Capital, satisfaction with availability and quality of neighbourhood-resources, and neighbourhood participation) on Sense of Coherence (SOC) and health respectively were obtained.ResultsOverall satisfaction (β=0.153) and neighbourhood social capital (β=0.134) emerged as the most consistent partial correlates of SOC across groups. In turn, SOC was the strongest coefficient for health-outcomes (β=0.238). Neighbourhood participation had more consistent correlations with health than SOC across groups. Group-differences became visible in proportions of explained variance in SOC (varying from 7 to 23.7%) and health (varying from 6.7 to 20.6%), and in the relative importance of neighbourhood-variables. Satisfaction with quality of neighbourhood-resources was significantly related to SOC in non-workers (β=0.451) and low-earners (β=0.261), and health-outcomes in women (β=0.143).ConclusionsHealth might be promoted in the neighbourhood mainly through strengthening SOC, and deprived groups, especially non-workers, may benefit most from health-promotion in the neighbourhood. Findings suggest that high satisfaction with quality can contribute to better health-outcomes for groups with weaker average SOC. The proposed theoretical framework is only partly supported.Significance for public healthThe creation of health-promoting settings has been outlined as one of the main strategies ahead by the Ottawa-charter. Findings from this study suggest that health can be promoted through the neighbourhood, both through strengthening Sense of coherence (SOC), and providing resources for health-promotion. It is suggested that the neighbourhood might be of benefit for promoting health in groups which might be otherwise hard to reach, such as people outside the work-force. Moreover, investigating the relationships between various perceptions of neighbourhood-resources and SOC/health across groups allows for developing strategies for positive change, including improving quality of neighbourhood-resources, and facilitating neighbourhood participation.

BackgroundProviding individuals with psychosocial resources such as sense of coherence (SOC) seems a beneficial strategy for health promotion in the neighborhood. In order to become a supporting theory for health promotion, Salutogenesis should renew its focus on resources for health, and explore how the development of a strong SOC can be facilitated.MethodsRelevant issues were explored using a Grounded Theory- approach. Three focus-group-sessions and three in-depth interviews were conducted with strategically sampled participants. The transcripts of the focus groups were initially analyzed line-by-line to ensure that insights emerged from the data. We then applied focused and systemic analyses to achieve axial coding, and to include insights into how social interactions during focus groups may reveal social processes in real-life-neighborhoods. The data from the in-depth interviews were used to validate and fill emerging categories, as well as to ensure data-saturation.ResultsFindings indicate the importance of repeated experiences with resources and every-day-challenges to develop a strong SOC. Active engagement with resources is a favorable condition for significant experiences, which enhance the internalization of resources. Core experiences are characterized by a re-organization of resources. Participation in intellectual meaning-making through equal power dialogue seems to broaden perspectives and promote the strengthening of SOC. A strong SOC can also be described as a deeper understanding of how and why resources work, which allows for a more flexible use of resources, including replacing missing resources.ConclusionA new understanding of SOC as an intuitive understanding of how, why and under which circumstances resources work, as well as a new focus on everyday life and repeated experiences might facilitate new approaches to a purposeful strengthening of SOC through the planning and implementation of public measures.