Dennis: Thanks for the book promo. The working title is: "Negotiating Health
Behavior Change: Individual and Organizational Approaches".

The book underscores the need to focus simultaneously on change at both
individual (ie. patient/client and practitioner) and organizational (eg. primary care,
community health organizations)levels. Within this focus, the need for larger
structural change (eg. public policy) is also considered.

Harvey
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My concern was that the original person in question has said that she was
"preparing a presentation on health promotion" and then went on to limit her
request to a) nutrition, b) smoking, and c) activity.  It seemed to me that this was a
limited view of health promotion.  If she had said that she was preparing a
"presentation on lifestyle change" then her request would have been more
understandable and I would not have taken issue with her definition of "health
promotion".

Having stated all of this it is clear that Harvey Skinner and Michel O'Neill, no
slouches in the health promotion department, are well aware of the dangers of
limiting the definition of health promotion to lifestyle changes that ignore the
contextual factors that influence our individual behaviours.

Indeed, I would assume that Harvey Skinner's upcoming book titled something like
Lifestyle Behaviours and Change -- to be published by Sage Publications -- will
recognize the reciprocal determinism of all of our behaviours.

Hopefully, nobody is disturbed anymore.

Best wishes,


Dennis Raphael


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      Harvey A. Skinner   PhD
          Professor and Chair
               Department of Behavioural Science
          Acting Chair
               Department of Preventive Medicine and Biostatistics
          Acting Chair
               Graduate Department of Community Health
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          Faculty of Medicine, McMurrich Building
          University of Toronto
          Toronto,  Ontario,  Canada   M5S 1A8

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