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Scientific report: Meeting, September 6th-9th UCLan, Preston, England
Programme for the event
DAY ONE
Monday September 6th
9:30-12:00: Core group meeting
13:00-13:30: Welcome and introductions
13:30-17:00: Workshop An introduction to salutogenesis
17:00-18:00 : Communication issues
DAY TWO
Tuesday September 7th
9:30-15:30: Workshop Systematic review techniques (1)
15:30-16:30: Communities of Practice: discussion
16:30-17:30: Website
DAY THREE
Wednesday September 8th
9:30 - 16:30: Working Groups and STSM group meetings
16:30-17:30: OpenSpace communication discussion
DAY FOUR
Thursday September 9th
9:30-11:00 Working Groups continued
11:00-13:00 Feedback of Working Group activity to whole group
13:00-15:30 Management Committee meeting
Attendees: see appendix one
SUMMARY OF ACTIVITIES
General overview
This was the first full meeting of the Action. It was attended by 26 individuals. 22 were MC members or other COST staff, 2 were invited experts, and 2 were interested observers/collaborators. The meeting provided the opportunity to build collaborations and contacts, and to learn about one of the key philosophical constructs underpinning the Action, namely salutogenesis, from one of the world experts in this area, Professor Bengt Lindstrom. The workshop on systematic reviews, led by Dr Beverley French, provided the initial skills and knowledge needed for the year one working activities of all the WGs.
The time set aside for WG activity resulted in clear review questions for most of the WG’s. Each WG set up its own timelines for the year, and determined who should contribute what to which review. Some also discussed future publications. An overall timetable was agreed, so that training in the selection of studies for reviews, and the skills for the quality assessment, could be built into the next Action meeting, with the intention of finishing the reviews in the first Action Meeting of year 2.
WG’s also undertook early discussion of possible bidding activity over the next year or so. Projects, networks and collaborations that were linked to the Action, though not central to the reviews for year one, were also discussed, and further developed.
Matters relating to the organisation of the Action
Following discussion about a range of issues in the meeting as a whole, the MC, Core Group and STSM meetings all considered specific processes and procedures for the Action. These included matters relating to the process and criteria for calling for and accepting STSM’s; ways of operationalizing the ESR Think Tanks; publication policies; intellectual property rights within the Action and between Action members; ethical issues relating to the studies undertaken, and more general philosophical concerns; processes for dealing with requests to join the Action from a range of sources; a short title and logo for the Action; and the way the proposed Community of Practice should be set up.
There was also extensive discussion in a range of fora on the purpose and design of the website, and on the optimum way of setting up virtual and actual communication and webworking systems for the WG’s and the MC and Core group between face to face meetings.
OUTPUTS
As this was the first formal meeting, there were no scientific outputs. However, an electronic newsletter was produced by Olga Gourni, MC member for Greece, and circulated to all the Action members (see Appendix Two).
WORKSHOP REPORTS
Workshop 1
An introduction to salutogenesis
Invited expert: Professor Bengt Lindstrom, Research Director, Head of the IUHPE (International Union for Health Promotion and Education) Working Group on Salutogenesis. Folkhälsan Research Centre, Finland
This session introduced Action members to salutogenesis, based on the following text:
A brief history of the Salutogenic Approach to Health
Salutogenesis was the first model and theory systematically exploring health in terms of development towards the health end of the health – unhealth (ease/dis-ease) continuum (Antonovsky 1979, 1987). It was later connected to health promotion (Antonovsky 1996). Now thirty years later we have convincing evidence that health promotion can be effective if run the salutogenic way (Eriksson 2007, Eriksson and Lindström 2005, 2006, 2007, 2008) and including quality of life (QoL) (Lindström 1994). Today there are several theories “under the salutogenic umbrella”. However, most of them are less consistent as of theory and evidence.
There are in fact three things that have to be in place to make health promotion effective. Health promotion (HP) according to the WHO Ottawa Charter (OC), salutogenesis (SAL) as the process and quality of life (QoL) as the outcome HP(OC) = SAL+QoL. The only necessary addition is to build in human rights (HR) as a fundament, making the value of the human being as an active participating subject a rule.
HP(OC) = SAL + QoL
HR
The evidence of salutogenic research over the human life span shows that people and systems that adopt a salutogenic way of living will be more inclined to engage in healthier behavior, withstand stress and acute and chronic disease better, live longer, and enjoy a better quality of life, perceived health and mental health. Over life there is a small but rather insignificant advantage for the male. Maybe the world as a system is constructed for the male? However, if salutogenesis is implemented we can demonstrate it does reduce inequity. Regarding young people because of developmental issues in puberty there are periods where the female have lower SOC, just as self-esteem is affected in the same direction.
In a cultural context we see the salutogenic framework works in all cultures as far as we know. Today it has been tried out in more than 50 languages on all continents of the globe. There is good scientific evidence on the effectiveness of the salutogenesis. People and systems that develop a strong SOC or a salutogenic approach to life will have populations that live longer, are more prone to choose positive health behaviour, when encountering illness acute or chronic they manage better, they endure stress better. Further, they perceive they have a better health, good quality of life and mental health. For more details see www.salutogenesis.fi
We have a fair idea of how salutogenesis could be implemented as a tool for healthy learning in early life, in families, parent – child interaction, in schools and educational settings, in workplaces and in the aging population. The problem is that salutogenesis not being implemented to the extent it should be. To develop this further, more research and systematic evaluated implementations are needed.
References:
AntonovskyA. Health, Stress and Coping. San Francisco: Jossey-Bass; 1979.
AntonovskyA. Unraveling the Mystery of Health. How people manage stress and stay well. San Francisco: Jossey-Bass; 1987.
AntonovskyA. The salutogenicmodel as a theory to guide health promotion. Health PromotInt1996;11(1):11-18.
Eriksson M. Unravellingthe Mystery of Salutogenesis. The evidence base of the salutogenicresearch as measured by Antonovsky'sSense of Coherence Scale. Doctoral thesis. FolkhälsanResearch Centre, Health Promotion Research Programme, Research Report 2007:1. Turku; 2007.
Eriksson M, Lindström B. Validity of Antonovsky'sSense of Coherence Scale -a systematic review. J Epidemiol Community Health 2005;59(6):460-466.
Eriksson M, Lindström B. Antonovsky'sSense of Coherence Scale and the relation with health -a systematic review. J EpidemiolCommunity Health 2006;60:376-381.
Eriksson M, Lindström B. Antonovsky'ssense of coherence scale and its relation with quality of life: A systematic review. Journal of Epidemiology & Community Health 2007;61(11):938-944.
Lindström B. The Essence of Existence. On the quality of life of children in the Nordic countries -Theory and practice in public health. Göteborg: Nordic School of Public Health; 1994. Lindstrom B, Eriksson M. From health education to healthy learning - implementing salutogenesis in education science. SJPH, (accepted august2010)
Workshop 2
Systematic review techniques (1)
This workshop was led by Dr Beverley French from UCLan, an invited expert in systematic review techniques using a range of qualitative and quantitative methods, with a contribution from Professor Soo Downe (Action Chair) on meta-synthesis.
Purpose
To share and disseminate skills in developing a systematic review including methodological considerations for a range of systematic review techniques.
The following areas were covered:
• Deciding on topic and formulating a good question
• Systematic search methodology
• Constructing the search strategy
• Key word definitions
• Deciding and justifying elements of the search strategy, including:
o Which databases and other sources to include (grey literature? Direct author contact?
o Which languages to include
o Quality criteria, and what level of quality to include
o Study designs that are appropriate to the question
• Specific considerations for different types of question:
o Intervention orientated
o Experience orientated
o Policy orientated
Appendix 1: Attendees
NAME Country
Kleopatra Alamantariotou,
Greece
Cecily M. Begley Ireland
Marie Berg Sweden
Nina Elisabeth Blegen, Norway
Wendy Christiaens Belgium
Declan Devane Ireland
Sharon Doherty United Kingdom
Mark Dooris United Kingdom
Soo Downe United Kingdom
Joy Duxbury United Kingdom
Angelica Ensel Germany
Lucy Frith United Kingdom
Mechthild M. Gross, Germany
Olga Gouni Greece
Bengt Lindstrom Finland
Ans Luyben Switzerland
Christine Loytved Germany
Ingela Lundgren Sweden
Egle Markuniene Lithuania
Michaela Michel-Schuldt Germany
Aranzazu Sanchez Brussels
Eva Schoening, Germany
Maria Johanna Schouten Portugal
Slobodan Sekulovic Serbia
Elisabeth Severinsson, Norway
Marlene Sinclair, United Kingdom
Katri Vehviläinen-Julkunen, Finland
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