title: Quality indicators for implementation of safety promotion: towards valid and reliable global certification of local programmes.
abstract: The theoretical underpinnings of safety promotion have not yet been integrated with implementation practice to ascertain between-community programme quality. This study sets out to develop a framework for verifying of the quality of community-based safety-promotion programmes in the global context. We analysed the certification indicators deployed in the international Safe Community movement in light of systems theory. Data were collected from focus group interviews with representatives from 10 certified Swedish communities and then analysed by qualitative methods. The community representatives were found to have used the present indicators mainly for marketing the safety-promotion concept to stakeholders rather than as benchmarks for safety practice. When appraised in regard to systems theory, it was found that the indicators did not cover important aspects of health-services implementation. Attainment of outcomes at the population level was not included. Consequently, that information about programme effects in high-risk groups and in risk environments could be neglected. We conclude that programme processes and outcomes at both organisational and population levels must be assessed when the quality of safety-promotion programmes is being certified. A revised set of indicators for certification of safety-promotion programmes fulfilling these criteria is presented.
authors.affiliation: Department of Medical and Health Sciences, Linköping University, Linköping, Sweden. toomas.timpka@liu.se
authors.forename: Toomas
authors.initials: T
authors.lastname: Timpka
authors.forename: Cecilia
authors.initials: C
authors.lastname: Nordqvist
authors.forename: Karin
authors.initials: K
authors.lastname: Festin
authors.forename: Kent
authors.initials: K
authors.lastname: Lindqvist
mesh_terms: D019985:Benchmarking; D002568:Certification; D003153:Community Health Services / Q000592:standards*; D019058:Community Networks / Q000458:organization & administration; D003159:Community-Institutional Relations; D003299:Cooperative Behavior; D017144:Focus Groups; D006801:Humans; D009111:Local Government; D010043:Outcome and Process Assessment, Health Care / Q000458:organization & administration*; D011634:Public Health / Q000592:standards*; D019984:Quality Indicators, Health Care; D012449:Safety / Q000592:standards; D017751:Safety Management / Q000458:organization & administration / Q000592:standards*; D013548:Sweden