ABSTRACT
Much has been written about the rationale for health promotion, including
discussion about what specific strategies should be promoted, in what context,
for whom intervention is appropriate and how it might be undertaken most
effectively. The Ottawa Charter (WHO, 1986) has been widely adopted as the
framework for modern health promotion, and its core definition is primarily
one of enablement. The Charter emphasised the five different means of
promoting health, through healthy public policy, community participation,
personal skills development, re-oriented heath services and by means of the
creation of supportive environments. Perhaps a critical factor about Ottawa
was that it succeeded in moving thinking on from the prevalent paradigm of
individual risk factor intervention to promote health. It follows, therefore,
that a quality health promotion intervention should be measured now by
whether or not it had measurably enabled individuals or communities to take
control of their own health (Ziglio, 1997). This, however, is rarely the
parameter by which health promotion interventions are judged. In very recent
years serious consideration has been given to the issue of quality in health
promotion and a working group established to set out standards for quality
(Deccache, 1997; MacDonald, 1997; Rootman, 1997; Saan, 1997; Ovretveit,
1996). This chapter will concern itself with this issue as it applies to settings-
based initiatives, particularly in an Irish context.
