In another e-mail list-serv on Health Promotion (called just that and operated out of Karolinska Institute in Sweden by Bo Haglund & Brian Flay) there has been a recent discussion on the theoretical basis and origins of 'the settings approach' in health promotion (healthy schools, workplaces, cities/communities, environments). The discussion, ideas and references have been far-ranging and have had contributions from all parts fo the world. Although there has been discussion of case studies, stories and critical analyses of the "healthy settings" approaches, there does not appear to be much discussion [yet!] from practitioners about working in different settings whether theory comes out in practice, and if theory or models should direct community action or be shaped by it. I receive many calls and requests for information from community health organizations and practitioners across Ontario, usually seeking ideas and examples of how their work can be done effectively, what has worked in different places and what has *not*, and how they can learn about community development in health. Recently I had two calls from two public health units who wanted to look at some of the models that are being suggested for health promotion programming. They wanted to know whether there had been any critiques, analysis and evaluations or comparisons of these models of community health promotion. In particular they were asking about: * the use of the PRECEDE/PROCEED model developed by Lawrence Green & Marshall Kreuter in community-wide programs * the PATCH model (Planned Approach to Community Health) coordinated and promoted by the CDC in Atlanta in the late '80s; and * using mass media and point of purchase communications to influence peoples' attitudes, and behaviours who are in the precontemplation 'stages of change' Although I am quite familiar with the PRECEDE and PROCEED models, I have not seen analyses of these models in practice or evaluation of application of the models for community-wide health promotion programming. Can someone suggest reviews or references that might be helpful? Regarding the PATCH model, there were two Ontario projects in the early 1990s that adapted the U.S. state-wide PATCH model and reported on how applicable this approach was for regional areas with multicultural communities. As well, there was a qualitative review of the application of three PATCH model programs to three CCDPP (Community Chronic Diseasse Prevention Programs) in Maine reported in the American J Health Promotion v.7 #3 1993 that provided a useful comparison. In a commentary of that article, Green & Kreuter made an important point for all community health practitioners: "Is community organization and participation a tool of public health, or should we view the more technical, linear, public health methods as specific tools of community organization?" I suggest the latter may be more appropriate, that health promotion methods and theoretical models can be used to support community mobilization, organization and development, Are there studies, examples, and references that take this approach? Alison Stirling, health promotion consultant <[log in to unmask]> Ontario Prevention Clearinghouse <http://www.opc.on.ca> Toronto, ON, M5B 2E7 tel: 416-408-2121 fax 416-408-2122