I totally agree with Mr. Marshall's statements. Very well stated.  At 05:25
PM 04/06/2001 +1100, you wrote:
>Re the criticism of Eberhard Wenzel's comments by DeAnne Hobbs
>.
>What disturbs me first is why someone would be so pompous as to insist that
>a person with a PhD should be referred to as Mr rather than Dr.  Especially
>when that person is calling for a professional debate.  I can find nothing
>but professional comments in his original email, whether you agree with
>them or not.  And to suggest that his comments are not to do with improving
>the health of people seems quite petulant.
>
>On a more serious note, Dr Wenzel's point is a good one. While we find
>theories of behaviour change to be useful and productive in working to
>promote the health of the community, we do need to remember that they are
>simplistic representations of complex situations.  We have learned from any
>number of expensive behaviour change projects that behaviour change is hard
>to bring off and sustain, and is most likely to occur only when other
>conditions in people's lives are favorable. At the population level,
>significant shifts in behaviour occur over extended periods of time and
>when behaviour change interventions are accompanied by a range of
>complementary health promotion initiatives, particularly community
>building, environmental change and policy and regulatory development.
>
>There is also an element of what is 'culturally' relevant in this
>discussion - in terms of the culture of the society and of the health
>professionals in that society. It is clear that the US, with its more
>individualistic perspectives on society, is more concerned with changing
>the individual and my guess is behaviour change theories are more prominent
>there. This may also explain the very different use of the term 'health
>promotion' in the US to the rest of the world and what, for many of us, is
>their inexplicable need to keep talking about health education. The
>Canadian, European and Australian approaches tend to focus more on broader
>approaches.  And this may well relate to our greater willingness to accept
>social interventions such as in the regulatory area where we have
>significant success with  random breath testing of car drivers to deter
>drink driving, mandatory bicycle helmets, mandatory seat belts etc.  The
>relationship between the individual and the society is a complex and
>variable one, and the differing perspectives and ideologies that encompass
>this area are a powerful determinant of approaches to health improvement
>and to what aspects of health promotion are likely to be acceptable and
>successful in different countries.
>
>Bernie Marshall
>School of Health Sciences
>Deakin University
>221 Burwood Hwy
>Burwood 3125, Australia
>
>Tel: (61+3) 9244 6822
>Fax: (61+3) 9244 6017
>
>http://www.hbs.deakin.edu.au/healthsci/
>
>