Policy, competence and participation: empirical evidence for a multilevel health promotion model

This paper uses data from a European health promotion evaluation study (MAR EPS) to empirically test some fundamental assumptions of health promotion t heory. Analysis shows that both the competence of individual actors and the opportunities provided for by health-promoting policies are significant pr edictors of participation in health promotion action. It also demonstrates effects of health promotion values on such action. Moreover, people's perce ption of their own political efficacy, e.g. their influence on community de cisions that effect their health, hems out to be a significant predictor of self-rated health. In conclusion, the paper encourages further research to investigate the effectiveness of health-promoting policy strategies within a multilevel health promotion framework. As the present results indicate, effective health-promoting policies may create opportunities that enable in dividuals and communities to increase control over the determinants of heal th, and thereby improve their health.