Greetings from a click4HP list-owner,

I just found that the following message from David Seedhouse, replying
to Blake Poland, had not been successful in getting posted to this list.
In the spirit of keeping this lively discussion flowing, I am copying it
here.

For any who may have missed the very interesting exchanges over the past
week on health promotion - you can access the Click4HP Archives in two
ways:

 1. The URL to see the CLICK4HP Public Folders
 http://community.opc.on.ca/Exchange/ Please note that there is no www
and that there is a directory called /Exchange in the name. These are
visible to anyone on the net with the right browser or newsreader. These
folders can be seen through a JAVA enabled browser, that is Navigator
2.2  or better or Internet Explorer 3.0 or better. Click on Public
Folders, then Click4HP

 2. These same folders are visible to newsreader software. The news
server is called community.opc.on.ca; this type of software has the
ability to get newsgroups and to subscribe to them. The folders appear
under the hierarchy community-news. Another quick way to access them
through the  newsreaders built into the recent versions of Navigator and
Explorer is to type the following URLs into the location area of the
browser. news://community.opc.on.ca/community-news.click4hp

* * * * * * * * * * * * * * * * * * * * * * *
Alison Stirling, Click4HP co-facilitator, editor OHPE Bulletin
E-Mail: [log in to unmask]  Internet: http://www.web.net/~stirling/
* * * * * * * * * * * * * * * * * * * * * * * * * *

Posting once more on the assumption that the first didn't arrive.


> Dear David,
>
> Thank-you for continuing the dialogue. This has been most interesting.
I
> think on fundamental points (principally the need for critical
reflexivity)
> we agree wholeheartedly. While we may at times draw different
conclusions,
> the field is immesurably enriched by being provoked to wrestle with
the
> issues you raise.

Blake:

It is good to agree!

>
> Of considerable interest to me in this discussion is the extent to
which
> the alleged lack of consensus regarding the core aims and purpose of
health
> promotion is seen as problematic or not, and whether it is interpreted
as
> vagueness, false consensus, polivocality, or (more likely) some
combination
> thereof. I suspect that there is a fine line between vagueness and
> plurality (the latter often being used inappropriately as evidence of
the
> former).
>

That isn't the way I see it.  I find that most of the 'voices' are
equally vague about the purpose of health promotion.

> I guess this brings me to my next point: is it (formal) theory that is
> going to "save" (legitimize, strengthen, rejuvinate) health promotion,
or
> (as Rhonda so ably points out), are the criticisms of health
promotion's
> ostensible weaknesses (vis a vis theory, evidence-based practice etc)
a
> cover for some people's discomfort with the ideological stance (or
social
> justice agenda) of more radical approaches to health promotion (such
that
> addressing those criticisms will not necessarily legitimize hp, but
rather
> succeed in persuading them to find different bases for critiquing or
> ignoring the hp agenda)?  I'm not arguing against thoughtful
reflection on,
> and articulation of, the theoretical traditions from which health
promotion
> draws its inspiration, or the evidence used to determine the efficacy
of
> its interventions. Rather, my concern is that we see calls (not
necessarily
> yours, but those of others) for health promotion to "get with it" vis
a vis
> the tenets of traditional science for what they often are: ideological
> challenges (challenges that don't always have to be met on the
'opponent's'
> turf - ie in their terms).

This is clearly not what I'm saying.

In my
> observation, calls for "evidence-based practice" are, furthermore,
applied
> selectively and with, at times, some hostility, directed at arenas of
> practice where those making the challenge are unconvinced of the
merits of
> the practices they call into question (e.g. there is little evidence
that
> neo-conservative social policy is "effective" even on it's own terms,
and
> growing evidence that it's impacts in terms of weakened social capital
may
> have profound economic as well as social consequences).
>

I agree - my version of health promotion would/does also suffer from
not always being easily measurable - but I think it is all the
more valuable for that.

> I believe that critical reflexivity about theory and practice in hp
means
> not only _conceptual_ clarity about our own goals and objectives, but
also
> a politically astute assessment of the (ideological, economic and
social)
> climate in which hp operates, and what exigencies this places on the
> practice of hp which has a more overt social justice agenda
(acknowledging
> that disease prevention that takes a more biomedical or behaviourist
> perspective does not face the same exigencies or challenges - and why
(a
> theory that explains this); and also that we need to guard against
> excessive "healthism" in which social goals are assessed exclusively
in
> terms of their impacts on "health", however defined, thereby
simultaneously
> devaluing other social goals or forms of human suffering or alienation
for
> which more or less direct "health" impacts cannot be demonstrated).
>

I think we need to be honest.  I do not believe that conceptual
fuzziness for political reasons makes any long-term sense.  I think
we need to make it clear that health promotion is not only disease
prevention but _is_ to do with work towards 'other social goals'
and on social conditions that are debilitating for reasons other
than that they may cause disease.

Please re-read Part Three of my Health Promotion book - and get past
my criticisms of 'woolly thinking'.  What matters is how we progress
theoretically and practically - I'd much prefer a debate on positive
ways forward for health promotion, of which my Fondations Theory is
one option.

Let's carry on with this.

Thank you Blake

Best wishes



David