Understanding Facilitators of and Barriers to Health Promotion Practice

¹ project director of the Canadian Heart Health Dissemination Project at McMaster University in Hamilton, Ontario, Canada.
² coordinator of the Environmental Studies Program and is assistant professor of the Department of Geography at the University of Ottawa in Ottawa, Ontario, Canada.
³ professor in the School of Geography and Earth Sciences, and dean of social sciences at McMaster University in Hamilton, Ontario, Canada.
⁴ university professor in the School of Geography and Earth Sciences at McMaster University in Hamilton, Ontario, Canada.

^* To whom correspondence should be addressed.

	Abstract

The health promotion best practices literature is imbued with hope for knowledge mobilization, enhanced practice, and improved population health. Given constrained medical care systems, health promotion is key to reducing the significant burden of chronic disease. However, we have seen little evidence of change. This article investigates facilitators of, and barriers to, three stages of health promotion practice in public health organizations, interagency coalitions, and volunteer committees. The article focuses not on what works but why it does or does not, drawing on five case studies within the Canadian Heart Health Initiative. Results indicate that the presence or absence of appropriately committed and/or skilled people, funds and/or resources, and priority and/or interest are the most common factors affecting all stages of health promotion practice. The article extends the literature on internal and external factors affecting health promotion and highlights strategic influences to consider in support of effective health promotion practice.

Key Words: facilitators, barriers, capacity, implementation, evaluation

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