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TheCompHPCoreCompetenciesFramework
for Health Promoon Handbook
February 2011
Ms. Colee Dempsey
Ms. Barbara Bael-Kirk
Professor Margaret M. Barry
Health Promoon Research Centre
Naonal University of Ireland Galway
on behalf of
the CompHP Project Partners
The CompHP Project is funded by the Execuve
Agency forHealth and Consumers (EAHC)
Project number 20081209
The CompHPCoreCompetenciesFrameworkforHealth Promoon
The CompHPCoreCompetenciesFrameworkforHealth Promoon
EAHC Project number 20081209 i
Table of Contents
Acknowledgements ii
INTRODUCTION 1
The CompHP Project 1
Context and Raonale for Developing CoreCompetenciesforHealth Promoon 1
What are Core Competencies? 2
How were theCompHPCoreCompetencies developed? 2
Who are theCompHPCoreCompetencies for? 3
How can theCompHPCoreCompetencies be used? 4
Core Concepts and Principles Underpinning theCompHPCoreCompetencies 6
CompHP CORECOMPETENCIESFORHEALTHPROMOTIONFRAMEWORK 7
Ethical Values Underpinning Health Promoon CoreCompetencies 8
Knowledge Base Underpinning Health Promoon CoreCompetencies 8
GLOSSARY 13
REFERENCES 18
APPENDIX 1 23
APPENDIX 2 26
Table of Contents entries are clickable links to the appropriate page in the text.
EAHC Project number 20081209
Acknowledgements
The wring team would like to acknowledge the support of theCompHP project partners,
collaborang partners, Internaonal Expert Advisory Group and project stakeholders who have
contributed to the development of this document and the Execuve Agency forHealth and
Consumers (EAHC) who provided the funding fortheCompHP Project.
Suggested citaon forthe document:
Dempsey, C., Bael-Kirk B., Barry M.M. and theCompHP Project Partners (2011), TheCompHP
Core CompetenciesFrameworkforHealth Promoon. IUHPE, Paris
Disclaimer
This document was developed as part of theCompHP Project – Developing Competencies and
Professional Standards forHealth Promoon Capacity Building in Europe – which received
funding from the European Union, in theframework of theHealth Programme (EAHC project
number 20081209).
The informaon and views set out in this document are those of the authors and do not
necessarily reect the views of the Execuve Agency forHealth and Consumers or any other
body of the European Union. Neither the European Union instuons and bodies nor any
person acng on their behalf may be held responsible forthe use which may be made of the
informaon contained therein.
The CompHPCoreCompetenciesFrameworkforHealth Promoon
EAHC Project number 20081209 1
INTRODUCTION
The corecompetencies presented in this Handbook were developed as part of a European project
entled ‘Developing Competencies and Professional Standards forHealth Promoon Capacity
Building in Europe’ (CompHP)
, which is funded by the Execuve Agency forHealth and Consumers.
This is the rst in a series of three Handbooks to be produced by theCompHP project and will be
followed by Handbooks on Professional Standards and a Pan-European Accreditaon Framework
for Health Promoon. TheCompHP Project will also publish reports on the processes undertaken
in developing thecore competencies, professional standards and accreditaon framework and
their tesng in academic and pracce sengs. TheCompHP Handbooks and reports will be widely
disseminated throughout the European Union (EU) member states and candidate countries and
will be available on theCompHP website
1
.
The CompHP Project
The aim of theCompHP project is to develop competency-based standards and an accreditaon
system forhealth promoon pracce, educaon and training that will have a posive impact on
workforce capacity to deliver public health improvement in Europe. TheCompHP Project brings
together 24 European partners from the professional development, policy, pracce and academic
sectors in health promoon. The work of CompHP is also supported by an Internaonal Advisory
Group of experts with experience of the development of health promoon competencies at a
global level (see Appendix 1 for a full list of CompHP partners and members of the Internaonal
Advisory Group).
The CompHP Project employs a consensus building process based on consultaon with key
stakeholders in health promoon across Europe and builds on exisng European and global
competency frameworks forhealth promoon. In parcular, it is informed by work undertaken by
the European Regional Sub Commiee on Training, Accreditaon and Professional Standards of the
Internaonal Union forHealth Promoon and Educaon (IUHPE), which developed and supported
the groundwork fortheCompHP Project, including undertaking a feasibility study (1).
Context and Raonale for Developing CoreCompetenciesforHealth Promoon
A competent workforce that has the necessary knowledge, skills and abilies in translang policy,
theory and research into eecve acon is recognised as being crical to the future growth and
development of global health promoon (2, 3, 4, 5). Idenfying and agreeing thecore
competencies for eecve health promoon pracce, educaon and training is acknowledged
as being an essenal component of developing and strengthening workforce capacity to improve
global health in the 21
st
century (6, 7, 8).
1
hp://www.iuhpe.org/?page=614&lang=en
The CompHPCoreCompetenciesFrameworkforHealth Promoon
2 EAHC Project number 20081209
Within the pan-European context, health promoon goals are clearly idened in EU strategies
but, there has been no agreement to date on Europe-wide competencies, standards or
accreditaon systems to assure quality standards in reaching those goals. The development of
the CompHP Project was driven by recognion of the need for a coherent competency based
framework that would build on related naonal and internaonal developments. Other key
drivers forthe project included: freedom of employment policies highlighng the need for agreed
standards to facilitate employment across the EU; quality assurance issues for pracce, educaon
and training idened within all health elds in Europe; and clarity on workforce capacity required
for promong health and addressing inequalies as idened in EU strategies.
It was also recognised that health promoon is an evolving eld in Europe with a diverse and
growing workforce drawn from a range of disciplines, and operang in a variety of sengs and
across a wide range of polical, economic and social contexts. Given this diversity, there is a need
for corecompetencies which delineate the specic body of skills, knowledge and experse that
represents, and is disncve to, health promoon pracce (7, 8) to unify and strengthen health
promoon workforce capacity across Europe.
What are Core Competencies?
The denion of competencies used in this Handbook is: ‘a combinaon of the essenal
knowledge, abilies, skills and values necessary forthe pracce of health promoon,’ (adapted
from Shilton et al. 2001) (9). Corecompetencies are dened as the minimum set of competencies
that constute a common baseline for all health promoon roles i.e. ; ‘they are what all health
promoon praconers are expected to be capable of doing to work eciently, eecvely and
appropriately in the eld’ (10).
How were theCompHPCoreCompetencies developed?
The key elements in the development process fortheCompHPCore Competency Frameworkfor
Health Promoon were:
• A review of the internaonal and European literature on health promoon competencies (11)
• An inial dra framework of corecompetencies based on ndings from the literature review
and consultaon with project partners
• A Delphi survey on the dra corecompetencies undertaken with health promoon experts
from across Europe to reach consensus
2
• Focus groups with health promoon experts and other key stakeholders from across Europe
2 The sample forthe two rounds of the Delphi Survey comprised six representaves from a total of 34 European countries, two from each of the
areas of pracce, policy, and academia selected on, in order of priority: naonal role in health promoon, experience in health promoon, and
experience in the competency approach.
The CompHPCoreCompetenciesFrameworkforHealth Promoon
EAHC Project number 20081209 3
• Consultaon with health promoon stakeholders across Europe using a web based consultaon
process.
The CompHP project partners and the Internaonal Expert Advisory Group advised on each stage
of the development process. TheCompHPcorecompetencies are, therefore, the result of a wide-
ranging consultaon process and draw on the internaonal and European literature, in parcular:
• The domains of corecompetencies outlined in the Galway Consensus Statement (7), together
with the modicaons to the statement suggested in a global consultaon process
• Thecorecompetenciesforhealth promoon developed in Australia (10), Canada (12), New
Zealand (13) and the UK (14)
• Corecompetencies developed in related elds such as public health (15, 16) and health
educaon (17).
Who are theCompHPCoreCompetencies for?
The CompHPcorecompetencies are primarily designed for use by health promoon praconers
whose main role and funcon is health promoon and who hold a graduate or post graduate
qualicaon in health promoon or a related discipline
3
,
4
.
A health promoon praconer is dened as a person who works to promote health and reduce
health inequies using the acons described by the Oawa Charter (18):
• building healthy public policy
• creang supporve environments
• strengthening community acon
• developing personal skills
• reorienng health services.
While job tles and academic course tles in dierent countries across Europe may not always
include the term ‘health promoon’, thecorecompetencies are designed to be relevant to all
praconers whose main role reects the denion and principles of health promoon dened
in the Oawa Charter (18). Health promoon praconers require specic educaon and training
together with ongoing professional development to maintain the parcular combinaon of
knowledge and skills required to ensure quality health promoon pracce.
3 Including, for example, public health, health educaon, social sciences including psychology, epidemiology, sociology, educaon, communicaon,
environmental health, community, urban or rural development, polical science. This is not an exclusive list as other academic qualicaons may
also be deemed as appropriate.
4 While a formal qualicaon in health promoon or related discipline is the general required minimum standard for entry into the profession, it is
recognised that there are praconers who entered the eld without a formal qualicaon. For this group, these competencies provide a frame-
work for assessing and helping achieve formal recognion for relevant past experience.
The CompHPCoreCompetenciesFrameworkforHealth Promoon
4 EAHC Project number 20081209
While thecompetencies arculated in this Handbook are aimed at entry level praconers,
acquiring a competency is not viewed as a one-me event, but rather an ongoing process. Formal
training is one means of acquiring entry level competencies, however, ongoing learning, through
experience, coaching, feedback and individual learning acvies, is required to develop advanced
competencies and maintain the knowledge and skills required by changing pracce and policy (19).
Much discussion has centred on the appropriate level for these corecompetencies and it has been
agreed that they are at ‘entry level’ i.e. the level at which a praconer enters pracce. This does
not imply that all health promoon praconers are limited to that level. Thecorecompetencies
can, for example, provide the basis for developing more advanced competenciesfor praconers
working at senior management level in health promoon or inform the development of specialised
competencies for those who work in specic sengs.
It is also recognised that those using theCompHPCoreCompetencies may wish to idenfy
dierent levels of experse for some or all of thecompetencies or to emphasise some
competencies to a greater degree than others. However, as these are core competencies, all should
be addressed if they are to be used as the basis for consistent, quality health promoon pracce
which can be recognised internaonally and be accredited though a pan-European accreditaon
system. While these competencies were developed within a Pan-European context they may also
be useful forhealth promoon competency development in other countries globally.
The competencies can also be useful to those working in other professional areas whose role
includes health promoon (e.g., community health, health educaon) or those in the other sectors
who are involved in partnerships to promote health or create healthy environments
5
.
The matrix presented in Appendix 2 illustrates how thecompetencies can be used by health
promoon praconers at dierent levels of seniority or experience and also by other
professionals whose role includes health promoon.
How can theCompHPCoreCompetencies be used?
The purpose of health promoon competencies is to provide a descripon of the essenal
knowledge, abilies, skills and values that are needed to inform eecve pracce. In this context
some countries or organisaons may use theFramework as a standalone document. However,
within the context of theCompHP Project thecorecompetencies are designed to provide a base
of knowledge and skills for pracce that will inform the development of Professional Standards
for Health Promoon and a pan-European Accreditaon Framework. An eecve competency
framework can provide a solid base for workforce development and has a wide range of potenal
useful applicaons across many areas.
5 For example, teachers, community development workers.
The CompHPCoreCompetenciesFrameworkforHealth Promoon
EAHC Project number 20081209 5
Core Competencies have a key role to play in developing health promoon by (adapted from PHAC,
2008) (16):
• Underpinning future developments in health promoon training and course development
• Connuing professional development
• Providing a basis for systems of accreditaon and development of professional standards
• Consolidaon of health promoon as a specialised eld of pracce
• Accountability to the public forthe standards of health promoon pracce.
Core Competencies may promote thehealth of the public by:
• Contribung to a more eecve workforce
• Encouraging service delivery that is evidence based, populaon-focused, ethical, equitable,
standardised and client-centred
• Forming the basis for accountable pracce and quality assurance.
Core Competencies can benet health promoon praconers by:
• Ensuring that there are clear guidelines forthe knowledge, skills and values needed to pracce
eecvely and ethically
• Informing educaon, training and qualicaon frameworks to ensure that they are relevant to
pracce and workplace needs
• Assisng in career planning and idenfying professional development and training needs
• Facilitang movement across roles, organisaons, regions and countries through the use of
shared understandings, qualicaons and, where appropriate, accreditaon systems based on
the competencies
• Promong beer communicaon and team work in muldisciplinary and mulsectoral sengs
by providing a common language and shared understanding of the key concepts and pracces
used in health promoon
• Helping to create a more unied workforce by providing a shared understanding of key
concepts and pracces
• Contribung to greater recognion and validaon of health promoon and the work done by
health promoon praconers.
The CompHPCoreCompetenciesFrameworkforHealth Promoon
6 EAHC Project number 20081209
Core Competencies can benet health promoon organisaons by:
• Idenfying sta development and training needs
• Providing a basis for job descripons, interview quesons and frameworks for evaluaon and
quality assurance
• Idenfying the appropriate numbers and mix of health promoon workers in a given seng
• Assisng employers and managers to gain a beer understanding of health promoon roles in
individual workplaces and develop appropriate job descripons.
In developing theCompHP Project it was recognised that for some countries and regions thecore
competencies may be all that is useful or appropriate for their specic pracce or policy context.
In these instances TheCompHPCoreCompetenciesforHealth Promoon Handbook may be
used as a ‘standalone’ document. However, within the context of the overall Project, thecore
competencies are designed to form the basis forthe development of Professional Standards and
a pan-European Accreditaon FrameworkforHealth Promoon as addional tools forhealth
promoon workforce capacity development across Europe.
Core Concepts and Principles Underpinning theCompHPCore Competencies
The competencies are based on thecore concepts and principles of health promoon outlined
in the Oawa Charter (18) and successive World Health Organisaon (WHO) charters and
declaraons on health promoon (5, 20-24). Health promoon is, therefore, understood to be
‘the process of enabling people to increase control over, and to improve, their health’ (18). Health
promoon is viewed as represenng a comprehensive social and polical process which not only
embraces acon directed at strengthening the skills and capabilies of individuals, but also acons
directed toward changing social, environmental and economic condions which impact on health
(25). Health is dened as ‘a state of complete physical, social and mental well-being, and not
merely the absence of disease or inrmity’ (26). Health is further conceptualised as a resource for
everyday life, emphasising social and personal resources, as well as physical capacies (18).
The CompHPCoreCompetencies are underpinned by an understanding that health promoon has
been shown to be an ethical, principled, eecve and evidence-based discipline (27, 28) and that
there are well-developed theories, strategies, evidence and values that underpin good pracce in
health promoon (29).
The term ‘health promoon acon’ is used in thecorecompetencies to describe programmes,
policies and other organised health promoon intervenons that are empowering, parcipatory,
holisc, intersectoral, equitable, sustainable and mul-strategy in nature (22) which aim to
improve health and reduce health inequies.
[...].. .The CompHPCoreCompetenciesFrameworkforHealthPromotionTHECompHPCORECOMPETENCIES FRAMEWORK FORHEALTHPROMOTION The CompHPCoreCompetencies Framework forHealthPromotion comprises domains of core competency which are illustrated in Figure 1 Ethical Values and theHealthPromotion Knowledge base are depicted as underpinning all HealthPromotion action detailed in the nine other domains... defined by the Ottawa Charter forHealthPromotion (WHO, 1986) and subsequent charters and declarations • The concepts of health equity, social justice and health as a human right as the basis forhealthpromotion action • The determinants of health and their implications forhealthpromotion action 8 EAHC Project number 20081209 TheCompHPCoreCompetenciesFrameworkforHealthPromotion • The impact... u nicat o n i h N ee d s » Figure 1: TheCompHPCoreCompetencies Framework forHealthPromotion EAHC Project number 20081209 7 TheCompHPCoreCompetencies Framework forHealthPromotion Ethical Values Underpinning HealthPromotionCoreCompetencies Ethical values and principles forhealthpromotion include a belief in equity and social justice, respect forthe autonomy and choice of both individuals... 20081209 TheCompHPCoreCompetencies Framework forHealthPromotion 10 Australian HealthPromotion Association (2009) CoreCompetenciesforHealthPromotion Practitioners AHPA Queensland, Australia Retrieved January 2011 from: http://healthpromotion.org.au/fileupload /Core% 2 0Competencies% 2 0for% 20HP%20 Practitioners.pdf 11 Dempsey, C Barry, M.M and Battel-Kirk, B (2010) Developing CompetenciesforHealth Promotion. .. shading in the matrix Entry Level Experienced Manager HealthPromotion Practitioner HealthPromotion Part of Role Broader Intersectoral Workforce Figure 2: HealthPromotion Workforce TheCompHPCoreCompetenciesFramework can also be useful to those working in other professional areas for whom healthpromotion is part of their role (e.g community health) and can inform the development of sub-sets of competencies. .. unanimity, but settle for overwhelming agreement that goes as far as possible toward meeting the interests of all stakeholders (36) EAHC Project number 20081209 13 TheCompHPCoreCompetenciesFrameworkforHealthPromotionCore Competencies: These competencies constitute the minimum sets of competencies that constitute a common baseline for all healthpromotion roles They are what all healthpromotion practitioners... those using theCompHPCoreCompetenciesFramework may wish to identify different levels of expertise for some or all of thecompetencies or to emphasise some competencies to a greater degree than others For example, thecorecompetencies could be used as the basis for developing more advanced competenciesfor practitioners working at senior management level in healthpromotion as illustrated by the deeper... alleviate their impact on public and individual healthThe Ottawa Charter (18) identifies three basic strategies forhealth promotion: • advocacy forhealth to create the essential conditions forhealth • enabling all people to achieve their full health potential • mediating between the different interests in society in the pursuit of health These strategies are supported by five priority action areas for health. .. specific area of healthpromotion practice with their associated competency statements articulating the necessary skills needed for competent practice It is the combined application of all the domains, the knowledge base and the ethical values which constitute theCompHPCoreCompetenciesFrameworkforHealthPromotion g Im Leadership p le m ta Pl n ni en an » i n to Advocate » » HealthPromotion Knowledge... http://www.nchec.org/credentialing/responsibilities/ EAHC Project number 20081209 19 TheCompHPCoreCompetenciesFrameworkforHealthPromotion 18 World Health Organisation (1986) The Ottawa Charter forHealthPromotion Geneva: World Health Organisation Retrieved January 2011 from: http://www.who.int/healthpromotion/conferences/previous/ottawa/en/index.html 19 United Nations (2010) United Nations Competenciesforthe Future United Nations, Retrieved .
Agency for Health and Consumers (EAHC)
Project number 20081209
The CompHP Core Competencies Framework for Health Promoon
The CompHP Core Competencies Framework. Developing Core Competencies for Health Promoon 1
What are Core Competencies? 2
How were the CompHP Core Competencies developed? 2
Who are the CompHP Core Competencies