title: Barriers to population-focused health promotion: the experience of public health nurses in the province of Manitoba.
abstract: There is growing evidence that population health is influenced by broad socio-environmental factors that require population-focused health promotion strategies. The author reports on a study of the perspectives of public health nurses (PHNs) on the nature of their health promotion practice in the Canadian province of Manitoba, highlighting their perceptions about barriers to population-focused health promotion. A descriptive, exploratory research design was used to conduct standardized open-ended interviews with 24 PHNs in 3 geographically and demographically diverse health authorities. There were remarkable similarities in PHNs' perceptions about their practice. Three categories of barrier to population-focused health promotion were identified: barriers at the level of individual PHNs; organizational barriers (culture, policies, processes); and extra-organizational barriers at the level of the community or province. The results point to a gap between the theory that population-focused health promotion is at the heart of PHN practice and the experience of PHNs at the 3 sites. A concerted effort to address the barriers is needed so that PHNs in Manitoba can play a leadership role in creating a health-care system that truly invests in population health.
authors.affiliation: Faculty of Nursing, Helen Glass Centre, University of Manitoba, Winnipeg, Canada.
authors.forename: Benita
authors.initials: B
authors.lastname: Cohen
mesh_terms: D001291:Attitude of Health Personnel; D002983:Clinical Competence; D018672:Community Health Planning / Q000458:organization & administration*; D005069:Evaluation Studies as Topic; D006291:Health Policy; D006293:Health Promotion / Q000458:organization & administration*; D006297:Health Services Accessibility / Q000458:organization & administration*; D006301:Health Services Needs and Demand; D006801:Humans; D007857:Leadership; D008350:Manitoba; D009313:National Health Programs / Q000458:organization & administration; D024802:Nurse's Role / Q000523:psychology; D015404:Nursing Methodology Research; D009740:Nursing Staff / Q000193:education / Q000458:organization & administration / Q000523:psychology*; D015279:Organizational Culture; D009936:Organizational Innovation; D009937:Organizational Objectives; D011637:Public Health Nursing / Q000193:education / Q000458:organization & administration*; D020377:Self Efficacy; D012931:Social Environment; D011795:Surveys and Questionnaires