HEALTH PROMOTION IN SASKATCHEWAN: INITIATIVES, SUPPORTS, AND BARRIERS

Over the years, health promotion has evolved from an approach focused on medical and behavioural factors to one that addresses broader determinants of health. Research to date has largely focused on medical and behavioural prevention activities of singular health disciplines. A descriptive, cross-sectional study design was used to explore perceived current and desired health promotion initiatives, supports, and barriers of Saskatchewan general practitioners/family physicians, nurses, pharmacists, and dietitians. The study was based on Labonte's framework for health promotion (medical, behavioural, and socio-environmental practice paradigms). An 80 item researcher-developed questionnaire was mailed to 400 randomly sampled health practitioners (100/professional group under study). Parametric (one-way ANOVAs, Pearson's product moment), non-parametric (chi-square), and multivariate (factorial validity) statistics were conducted. Response rates of nurses (53%), pharmacists (63%) and dietitians (69%) were impressive; the physician response rate was smaller than hoped (41%) limiting generalintions of physician's results. Reliability and correlation measures determined the 6-point Prevention Activities Scale (PAS) and subscales were highly reliable (r -values ranged from 0.72 to 0.81), linearly related (correlation values statistically significant at p ≤0.05), and highly associated (i.e., respondents did not distinguish between current and desired prevention activities). Factor analysis did not fully support the use of Labonte's three practice paradigms, yet produced a new PAS scale consisting of three discrete, highly reliable constructs (individual prevention, education, and advocacy initiatives). The reliability assessment of the factor analytically-based PAS suggested the subscales were more reliable than the original (r-values ranged from 0.77 to 092). The respondents' were largely middle-aged females (between 30 to 50 years of age) working in large urban settings with 0 to 10 years work experience. One-way ANOVAs determined most professions worked primarily within the medical and behavioural paradigms, with infrequent involvement in the socio-environmental paradigm. Approximately 50% of the respondents' most prominent bathers were limitations in time, remuneration, and funds. The respondents' personal belief in health promotion, perceived job responsibilities, multidisciplinary work environments, and the endorsement of colleagues, managers, health authorities, and professional association(s) were considered health promotion enabling factors