HEALTH PROMOTION PRACTICE AND PUBLIC-HEALTH - CHALLENGE FOR THE 1990S

The issue of practice skills arose in the course of a process evaluati on of the Heart Smart North Shore (HSNS) project in British Columbia. We created a Think Tank of and community practitioners to make recomme ndations for improvement of our skills. These recommendations differed according to different values for health and opinions on how to creat e health in the community. Because the site reviewers of the HSNS proj ect were clear this was a disease prevention project and not a communi ty development initiative, HSNS's orientation to skill development aft er the Think Tank moved toward the Precede/Proceed model, the Transthe oretical model and social marketing approaches. The Health Unit has no w been restructured into multidisciplinary service teams which must fo cus on population health, evidence-based practice and the social deter minants of health, and thus need to consider health promotion from a c ommunity development perspective and empowerment model. We suggest tha t learning and the development of staff and community volunteers shoul d be seen as a continous and reflective process that takes place at th e individual, community and organizational level.