title: [Preventive health care and health promotion: Which models for supporting the evolution of clinical practice in primary health care?].
abstract: OBJECTIVE
  Published operating models about preventive health care and health promotion in primary care were sought with the aim of (1) compiling a functional inventory; and (2) to formulate working hypotheses for the improvement of clinical practice towards more efficiency and more equity.
  
  
  METHODS
  Narrative literature review, using keywords related to the various prevention classes, health promotion, primary care, practice models and health care delivery. The diversity of models led to a multi-criteria analysis.
  
  
  RESULTS
  Twelve models were selected. Their characteristics were unevenly distributed. The models, whose authors announce that they apply to prevention, mainly describe approaches that focus on individuals within physician-patient relationship, and take into account practice organization. Some socio-ecological and systems models illustrate health promotion: educational practice, group- or population-based targets, community environment and social determinants of health. There is little room for patients in elaborating the models, as they have little role in health care systems. The definitions of prevention, health promotion and patient education greatly differ from one model to another.
  
  
  CONCLUSIONS
  Little is known about practical implementation of the models; assessment data are scarce. Some elements valued by health promotion could be integrated to health care: empowerment of citizens, addressing community environment; increased involvement in local health professionals' networks; integration of individual and collective approaches within the same health care facilities to address simultaneously individual customization, efficiency and equity objectives. These developments may call for adaptation in vocational training and continuous professional development: communication skills, awareness to public health concepts, and early and longitudinal exposure to community-based learning experiences for students.
authors.affiliation: CHU du Sart-Tilman B23, université de Liège, département de médecine générale, 4000 Liège, Belgique. Electronic address: marc.vanmeerbeek@ulg.ac.be.
authors.forename: Marc
authors.initials: M
authors.lastname: Vanmeerbeek
authors.affiliation: CHU du Sart-Tilman B23, université de Liège, département de médecine générale, 4000 Liège, Belgique.
authors.forename: Julien
authors.initials: J
authors.lastname: Mathonet
authors.affiliation: CHU du Sart-Tilman B23, université de Liège, appui en promotion et en éducation pour la santé, école de santé publique, 4000 Liège, Belgique.
authors.forename: Marie-Christine
authors.initials: MC
authors.lastname: Miermans
authors.affiliation: CHU du Sart-Tilman B23, université de Liège, département de médecine générale, 4000 Liège, Belgique.
authors.forename: Anne-Laure
authors.initials: AL
authors.lastname: Lenoir
authors.affiliation: CHU du Sart-Tilman B23, université de Liège, appui en promotion et en éducation pour la santé, école de santé publique, 4000 Liège, Belgique.
authors.forename: Chantal
authors.initials: C
authors.lastname: Vandoorne
mesh_terms: D006293:Health Promotion; D006801:Humans; D008962:Models, Theoretical; D011320:Primary Health Care / Q000592:standards / Q000639:trends