1.- Increase availability of resources |
   • Increase the interaction time between patients and professionals in order to open their work agendas to health promotion: |
- review care protocols for healthy people |
- decrease checks for people with chronic diseases, promoting patient self-control and autonomy |
- expressly prioritise health promotion activities and the reminding and recording of such activities |
- effective administrative support to free practitioners from administrative and bureaucratic tasks |
- communication, task redistribution, coordination and mutual support between physicians and nurses. |
   • Health policies defining the role of PHC in health promotion. |
   • Agreements between funding bodies and service providers specifically stating health promotion objectives, resources and indicators for evaluation. |
   • Participation of professionals in planning and quality evaluation of PHC services: |
- promote communication within the health-care system |
- establish common health promotion objectives for all professionals in the health-care organisation |
- negotiate evaluation indicators shared by all groups. |
   • Actions at an inter-institutional level: town councils, schools, health-care centres, citizens' organisations, etc. |
- designate a health promotion coordinator post at district or town level |
- integrate initiatives and resources of the different sectors involved. |
2.- Design of intervention programs |
   • Review their rationale based on scientific evidence of their effectiveness. |
   • Promote research into health promotion in PHC. |
   • Prioritise programs that are more flexible and adaptable to context. |
   • Participation of clinicians and researchers in the design and evaluation of new interventions. |
   • Use new support and reminder tools that do not interfere with the clinical practice of professionals. |
   • Take advantage of the new technologies for citizen information and education. |
3.- Program dissemination |
   • Fight against resistance to change using outcome research. |
   • Set up a network of centres particularly interested in innovation for addressing multiple risk factors in PHC. |
   • Experience-based training and action-oriented skills. |