MEDIA REVIEWS

Practising Health Promotion, Dilemmas

and Challenges by Jennie Naidoo & Jane

Wills. Bailliere Tindall, London, 1998, 280

pages, £17á95, ISBN 07020 2122 9.

Translating health promotion theory into

practice in a manner which strives to

address the core principles proposed by

the World Health Organization (WHO),

and which responds to the current

emphasis on measuring effectiveness,

poses complex dilemmas and challenges

for professional and lay practitioners. This

excellent book provides a stimulating

examination of such complexities in a

manner which offers guidance, and which

leaves the reader feeling able to undertake

a critical review of health promotion prac-

tice. The text is presented in three parts.

Part 1 explores the knowledge that under-

pins the discipline of health promotion.

Chapter 1 examines health promotion

theory and highlights some of the prob-

lems associated with its application to

practice. Chapters 2 and 3 focus on the

contribution of research to generating new

knowledge and evidence from which

effectiveness can be judged. The case is

made for research to be based upon

methods sympathetic to the aims and

values of health promotion, and for a range

of evaluation criteria to be utilized in order

to recognize the contribution of process

issues in addition to outcome.

Part 2 critically examines the

dilemmas associated with incorporating

the core principles embodied within the

WHO Health For All (1977) initiative and

Ottawa Charter (1986) into health promo-

tion practice. Chapters 4, 5 and 6 discuss

an array of issues relating to equity,

targeting and marketing health. Particular

reference is made to the role of health

promotion in the light of existing health

inequalities. Chapter 7 considers the

primary health care setting for health

promotion and the challenges associated

with moving from a traditional focus on

ill-health to a broader positive health-

orientated perspective. The ®nal chapter

in this section focuses on the principle of

collaborative working and presents two

theoretical frameworks which can help to

identify themes for successful practice.

The third and ®nal section includes ®ve

chapters resulting from an interesting

collaboration with professionals in the

®eld and draws on the preceding content

to examine initiatives relating to the ®ve

key areas identi®ed within the 1992

National Strategy for Health (DoH,

London, 19921 ). Issues relating to prob-

lems of de®nition, evidence of effective-

ness and application of core principles

are discussed. The inclusion of case

studies not only provides excellent exam-

ples of innovation within the ®eld of

health promotion, but also grounds the

theory within the context of the realities

of practice.

The writing style is accessible and each

chapter commences with an overview and

ends with an annotated reading list

informing the reader what the suggested

texts have to offer. The reference material

is up to date and wide ranging. A partic-

ularly strong feature of this book is the way

in which it engages the reader through

activities, discussion points and an inno-

vative approach which skilfully encour-

ages readers to re¯ect upon their own

health promotion practice. Written as a

stimulating analysis of the theory,

research and principles which inform the

discipline of health promotion, this

thought-provoking text equips one with

the knowledge and skills to indulge in

critical appraisal of their health promotion

work and provides guidance and examples

to support the advancement of practice.

The inclusion of issues pertinent to

inequalities in health, targeting, collabor-

ative working and the primary health care

setting make this book particularly rele-

vant in the light of current UK government

proposals. Overall Practising Health

Promotion, Dilemmas and Challenges is a

key text which can be enthusiastically

recommended to all involved in health

promotion, including student and quali-

®ed nurses in all service settings.

Gillian Barrett

MSc PGDHP DipN CEd(FE) RCNT RGN

Senior Lecturer in Nursing

and Health Promotion

University of the West of England

Bristol

England

World Health Organization (1977) Health

For All by the Year 2000. WHO, Geneva.

World Health Organization (1986) Ottawa

Charter for Health Promotion. WHO,

Geneva. Department of Health (1992)

National Strategy for Health, DoH, London.

Evaluating Health Promotion by David

Scott and Ros Weston, Wolfe Publishing,

London,2 1998, 184 pages, £18á00, ISBN

0748 73313 2.

The overall purpose of this book is to

stimulate debate about the process of

evaluating the effectiveness of health

promotion. It should therefore be of great

relevance and value to a nursing audience

as nursing interventions lie in the domain

of the promotion of health and achieving

health gain. As a profession we certainly

have much to learn from an analysis of

the complexities of evaluations of effect-

iveness of such interventions. The aims of

the book are ambitious. They encompass

providing an overview of the various

frameworks which have been developed

for evaluating health promotion initiat-

ives and interventions; judging their ef®-

cacy, validity, reliability and usefulness;

locating the various models within social

political and epistemological frameworks;

discussing of successful and unsuccessful

evaluations of health promotion initiat-

ives and interventions and enriching

these interventions and initiatives.

Within the ®rst section there are some

particularly useful chapters notably those

by Keith Tones and Ros Weston. The rest

of the book is disappointing. Although

many of the contributors have presented

useful material the content came across as

disjointed and chapters do not ¯ow

comfortably. I suspect that the explanation

for this lies in the fact that the text evolved

from the work of an EU research project

and subsequent seminars. The lack of

cohesive structure means that some of

the debate is dif®cult to follow and even

more dif®cult to apply in practice. Two

things come over clearly. Firstly, the need

for diversity in research and evaluation

design and the importance of qualitative

data in understanding the relationship

between process and outcomes. Secondly,

the similarity between nursing and health

Journal of Advanced Nursing, 2000, 31(2), 491±496

Ó 2000 Blackwell Science Ltd 491