8 Health promotion, health education and social communication on health : specificities, interfaces, intersections V.L.G. Pereira Lima et al. conceptual imprecision in some Brazilian and t international publications, with reflection oñ practices and management of actions, have inspired the authors to present this paper, whose objectives are: (1) analysis of the Health Promotion, Health Education and Health Social Communication concepts, (2) definition of their specificities and (3) identification of their interfaces and intersections.individual abilities, or the integration of both social communication and professional training programmes, or any other actions that aim at personal/social developmentit will always be considered educational action. Social communicationHistorically, three forces have been recognised in the communication process: emission, message and reception. The idea of these separate forces in a sequencial order was related to a mechanical view -unidirectional and irreversible of the process, according to which the quality of communication depended on the emission. In another historical moment, the content or message, and even the emission plus message, were considered important factors for the assessment of the communication quality (Shannon & Weaver, in Martins'+). Later on, the information conveyance is considered reversible, and when the conveyance was not successful, the reason lied in the loss of information due to a noise or some sort of interference. Nowadays, noise is understood as an integrating element of communication.
en français à la page 264. Resumen en español en la página 278.Abstract: The evolution of health promotion within the Brazilian health system is examined, including an assessment of the intersectoral and development policies that have influenced the process. Particular attention is paid to the legal characteristics of the Unified Health System. Human resources formation and research initiatives in health promotion are outlined, with a summary of the obstacles that need to be overcome in order to ensure the effective implementation of health promotion in the future. Up to the end of the 20th Century health promotion was not used as a term in the Brazilian public heath context. Health promoting activities were concentrated in the area of health education, although targeting the social determinants of health and the principle of intersectoral action were part of the rhetoric. The situation has changed during the last decade, with the publication of a national policy of health promotion, issued by the Ministry of Health and jointly implemented with the States and Municipals Health Secretaries. More recently there has been a re-emergence of the discourse on the social determinants of health and the formation of intersectoral public policies as the basis of a comprehensive health promotion. Health promotion infrastructure, particularly around human resources and financing, requires strengthening in order to ensure capacity and sustainability in health promotion practice. (Promotion & Education, 2007, XIV (4): pp 209-213).
É discutida a eficácia do Programa Escola de Pais, da 1ª Vara da Infância e Juventude do Rio de Janeiro. Os objetivos são: construção da evidência de eficácia da promoção da saúde; discussão sobre o conceito de eficácia; identificação de estratégias para sustentabilidade de resultados, e discussão de modelos de avaliação. A análise baseia-se no acompanhamento de 48 pais ou responsáveis por crianças e adolescentes. Os resultados são fortemente favoráveis para "integração familiar" e "busca dos direitos sociais", e favoráveis para "reintegração de crianças" antes institucionalizadas.
This article focuses on health promotion (HP) outcomes, illustrated through evaluation of case studies and identification of strategies which have contributed to their success and sustainability. Evaluation research and practice in three distinct sceneries are discussed: (i) institutional and governmental agencies; (ii) communities in the “Manguinhos Complex” and Nova Iguaçu Municipality, and (iii) building of potentially healthy municipality networks.The effectiveness of a social program in a health promotion perspective was based in the “School for Parents” program, undertaken by the First Court of Childhood and Youth of Rio de Janeiro, between 2001 and 2004. The analysis was grounded in the monitoring of 48 parents in charge of children under 18, who were victims of abuse, violence or negligence, and social exclusion, most of all. The study's objectives were: illustrating the evidence of effectiveness of health promotion, discussing the concept of HP effectiveness under macro unfavorable conditions, and identifying strategies that foster sustainability of results. Institutional resources included a multi-professional staff, multidisciplinary approaches, participatory workshops, family case management, partnership with public and private institutions, and volunteer and civil society sponsorship of the families. Evaluation was based on social impact indicators, and psychosocial and contextual determinants. Evaluation methods included program monitoring and quantitative-qualitative methods, through a longitudinal evaluation of 3 years, including one year post program. The evaluation showed highly favorable results concerning “family integration,” “quality of family relations” and “human rights mobilization.” Unsatisfactory results such as “lack of access to formal employment” are likely related to structural factors and the need for new public policies in areas such as education, professional training, housing, and access to formal employment.The training process of social actors in environmental management and housing, supported by the Public Health Technology Development Project of the Oswaldo Cruz Foundation, was employed as a tool of environmental education and healthy housing. The purpose of this study was to construct an integrated and participatory model of environment management. The methodology included training, research and evaluation of participants, from 21 to 50 years of age, who participated in building Thematic Learning Books and Community Guides about water quality monitoring. Participants'evaluations emphasized the training process, encouraging them to become multiplier agents of environmental education in their communities and to continue learning how to bring together sectors for problems solving.The Potentially Healthy Districts' Network (RMPS) aimed at increasing knowledge and building capacity to develop actions which originate from each of the local units, based on their characteristics and practices. Developed by the Preventive and Social Department of Campinas State University with PAHO/W...
Brazil, a Latin American country of continental proportions and contrasts, demographic inequalities, and social inequities, concomitantly faces the challenge of preventing and controlling infectious diseases, injuries, and non-communicable diseases. The loss of strength of the biomedical paradigm, the change in epidemiological profile, and the sociopolitical and cultural challenges of recent decades have fostered the emergence of new formulations about public health thinking and practice. Among them, are the paradigms of Brazilian Collective Health and Health Promotion. The former provides philosophical support for Brazil's Unified Health System (SUS). The aim of this article is to discuss the development of public health within the country's history, and to analyze and compare the theoretical assumptions of Health Promotion and Collective Health. We conclude that health promotion, based on the principles and values disseminated by the international Charters and concerned with social actors and social determinants of the health-disease process, has significant potential to promote the improvement of living and health conditions of the population. This frame of reference guided the formulation of the National Policy of Health Promotion within the Unified Health System, which was institutionalized by a ministerial decree. The importance and application of evaluating the effectiveness of health promotion processes and methodologies in Brazil have been guided by various frames of reference, which we clarify in this article through describing historical processes. (Promotion & Education, 2007, Supplement (1): pp 7-12)
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