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articulated the need for development of an integrated health care system with increased emphasis on primary health care, and incorporation of principles and practices of health promotion. Our article elucidates the requisite dimensions of a health promotion philosophy and approach in primary health care settings. We provide a strategy and framework to support practical and attainable action. Our aim is to provide clarity and an operational definition to health promotion so that it can be practically addressed. Context and rationaleIn recent decades, health promotion has developed in isolation and functioned separately from primary Jurisdictions around the world have articulated a need for development of an integrated health care system with increased emphasis on primary health care and incorporation of the principles and practices of health promotion. To date, the medical model has been the default model of care. Yet, treatment alone is unlikely to have marked effects on health inequities or health status. This article presents and discusses two foundational dimensions (values, structures) of a health promotion philosophy and approach in primary health care settings. We propose a strategy and framework to support practical and attainable action. Our article (the first of a series of two) is based on a literature review, validation by key experts and a national survey of Canadian primary health care settings. We argue that fundamental philosophical values provide a foundation for health promotion in primary health care. These values should be reflected in the structures that create a supportive environment for health promotion. Our remaining three domains (strategies, processes, outcomes) are presented in a second following article. Based on values and structures, we conclude that subsequent strategies (interventions), processes (client-and community-centred care), and desired health promotion outcomes (intended or unintended) may be achieved.

Introduction We developed screening criteria to identify population health interventions with an equity focus for inclusion on the Public Health Agency of Canada’s Canadian Best Practices Portal. We applied them to the area of “healthy weights,” specifically, obesity prevention. Methods We conducted a review of the literature and obtained input from expert external reviewers on changes to midstream environments. Interventions had to identify outcomes for groups with an underlying social disadvantage. We included papers with a focus on equity and vulnerable populations, intervention and/or evaluation studies, social determinants of health and healthy weights or obesity prevention. We then appraised the shortlisted studies for quality of evidence to determine eligibility for inclusion as promising practices on the Canadian Best Practices Portal. Results Few of the references reviewed passed the equity screening criteria (26 out of 2823 published papers reviewed, or 0.9%). Six (of the 26) interventions qualified as promising practices. Conclusion The ability of the equity screening criteria to distinguish midstream-level interventions for obesity prevention suggests that the criteria have potential to be applied to other public health topics. What is most important about our work is that the Portal, which is no longer being updated but is still accessible, was broadened to include interventions with a focus on equity.

Objective: This study investigated the relative effectiveness of a nutrition education brochure based on a theoretical model versus a more traditional information-based brochure in getting subjects to accurately assess daily calcium intake, make a plan to increase intake if needed, and to implement the plan. Design: A randomized trial involving 216 women between the ages of 19 ± 49 y. Subjects were randomly assigned to a group which received educational materials containing an interactive brochure designed using the Motivation Generating model (Calcium Calculator 2 ), or to a group which received a calcium information brochure (An Appetite for Good Health). Within a two week period the women were contacted by telephone to assess use of materials, calcium intake assessment information, and plans for dietary change. Setting: Subjects were recruited at ®ve ®tness centres in the Vancouver area. The research was conducted by the Institute of Health Promotion Research at the University of British Columbia. Results: Results indicated signi®cantly greater numbers of subjects conducting self-assessment and increased group accuracy for calcium intake assessment in subjects using the interactive brochure. Conclusion: Use of a theoretical model designed to create behaviour change such as the Motivation Generating Model can increase speci®c behaviours which may lead to improvements in dietary consumption. Sponsorship: This study was funded by the BC Dairy Foundation and the Dairy Bureau of Canada. Descriptors: theoretical model, behaviour change, nutrition education tool, behaviour-enhancing factors.