Strategies for Health Promotion: Healthy Dietary Habits

The province’s health decision makers have an interest in maximizing the impact of their health promotion initiatives. Knowing the research-based evidence on the effectiveness of the range of available health promotion strategies can help them attain that objective. The increasing prevalence of chronic disease in Canada in general, and in Newfoundland and Labrador in particular, underscores the importance of health promotion and the determinants of health model. Despite advances in medical and drug technologies, the prevalence of hypertension, diabetes, cardiovascular disease and certain cancers continues to increase. An estimated 80% of heart disease, diabetes and respiratory disease and up to 40% of some cancers can be prevented by eliminating the four most common risk factors: unhealthy diets, lack of physical activity, and alcohol and tobacco use. The theory and practice of health promotion have evolved considerably over the past 40 years. Previously, many health promotion efforts consisted of short-to-medium duration health communication efforts, e.g., World AIDS Day (established 1987), National Non-Smoking Week (1977), and Breast Cancer Awareness Month (1985). Many local and regional organizations in Canada still follow the “Calendar of Health Promotion Days” developed by Health Canada which is intended to promote synchronicity and consistency of messaging among and between provinces and health authorities. Health communication is a critical component of effective health promotion. However, there is now considerable skepticism that it can produce sustained effects on complex health behaviors in the absence of a broader program of change. Health promotion strategies that take the characteristics of the targeted individuals, groups and communities into account are widely believed to be more effective than health communication programs alone. The goal of this Rapid Evidence Review (RER) is to provide a brief summary of the research-based evidence on health promotion strategies that compare health communication efforts and more complex tailored programs, and to consider these strategies in the context of Newfoundland and Labrador. In order to make the scope of this RER manageable, one particular area of health promotion is studied as an exemplar, rather than attempting to synthesize the evidence across multiple areas of health promotion. We have consulted with Central Health, the original proponent of this study, and our external expert and decided to focus on health promotion initiatives that aim to increase healthy eating habits. As such, the research question is: “What health promotion strategies have been shown to be effective for improving dietary habits in settings and populations like those of Newfoundland and Labrador?