Variability in the implementation of health-promoting community activities in Spain

Abstract

Background. To describe the variability in the application of community activities (CA) promoting health, in support received, in training, and in evaluation of the participation of professionals, administration and social partners in these. Methods. Survey to key informants identified in each region with the help of the Spanish Society of Family and Community Medicine. The questionnaire included a definition of a health promotion community activity. The study was conducted in 2008. Results. There was variability in community activities by region. The most involved professionals are nurses and social workers. Most of the regions (15 of 17) offer training in these issues to their professionals, especially in health education. It is less frequent to offer training to family medicine residents (10 of 17 regions) and to the different nursing specialties (6 of 17). The main institutional support comes from primary health care management, regional health services, municipalities, and public health services, and non-institutional support from scientific societies, civic associations and NGOs. On the evaluation of the involvement of different organizations and institutions in these activities, the only entities receiving pass grades were NGOs (3 out of 5) and primary health care (2.5 out of 5). Conclusions. There is a high variability in the ways of supporting and promoting community activities in each region and consequently in their dissemination and implementation by primary health care teams. Nurses and social workers are key players in this process.