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promotion training, development and practice in health promotion in Australia and other countries.Debate and discussion has led to a qualified acceptance of the usefulness of competencies as a powerful and precise language for describing the field and for determining training and development needs. However, this acceptance is contingent upon competencies being used for positive intents rather than as a tool for bureaucratic control.This study has demonstrated that health promotion is now sufficiently established that it is possible to achieve broad consensus about 'core' competencies, as well as 'specific' competencies. In the face of continuing health sector reform and change, these competencies need to be articulated and communicated. Health promoters need to be able to define their practice and training needs in terms of competencies. In doing so they will ensure the survival of health promotion in a complex and changing health system.While the competencies identified in this study have provided a framework for identifying competency standards for health promotion as an occupation or profession, this is beyond the scope of this research. This is a potential area of future debate, research and development.Competencies are evolutionary, and the health promotion field is dynamic. It is recommended that similar investigations are repeated at least five yearly.

Health professionals must continuously address health promotion issues using the latest strategies and research. Currently in health care, too often an underdeveloped and under supported agenda prioritizes problems, issues, and solutions. Further, an ongoing competition exists among issues due to an undocumented agenda-setting process to gain the attention of media, public, and policy makers. Agendasetting is based on the belief that the media influence what we talk about, rather than controlling what we think, and how often an issue appears in the media influences the policy agenda (Dearing & Rogers, 1996). If an issue is “salient” and receives frequent or expansive coverage by media, audience members will talk more about that issue than one that is not as salient. A Health Promotion Agenda-Setting approach works to specify and prioritize problems and alternative solutions for increasing media exposure and setting agendas for “sustained” courses of action, (Kozel et al., 2003). The crucial link between agenda-setting and the process of establishing effective legislation, policy, and programs has been researched. However, many health practitioners do not understand what agenda setting is, nor how to apply agenda setting within the field of health education. Professional development in Health Promotion Agenda-Setting offers health education practitioners new knowledge, skills, methods, and opportunities to strengthen practices that influence the public health agenda and transform health promotion leadership.

Policy makers take action largely on issues that attain the pinnacle of the policy agenda (Pertschuck, 2001). As a result, how decision makers choose which issues are important has been the subject of much research. Agenda-setting conceptualizes the process of how issues move from relative unimportance to the forefront of policymakers’ thoughts (Dearing & Rogers, 1996). An area within agenda-setting research, Health Promotion Agenda-Setting, provides Health Promotion practitioners with an innovative framework and strategy to set agendas for sustained courses of action (Kozel, Kane, Rogers, & Hammes, 1995). In this interdisciplinary and bi-national exploratory study, funded by the Center for Border Health Research of the Paso del Norte Health Foundation, we examine agenda-setting processes in the Paso del Norte Region and evaluates how the public health agenda is determined within the U.S.-Mexico border population. Integrating both quantitative and qualitative data collection methods, the current research is focused on identifying deficiencies in the public health infrastructure in the U.S.-Mexico border area, and identifying channels that exist for working toward the bi-national goals presented in Healthy Border 2010 (U.S.-Mexico Border Health Commission, 2003). Research directions, design, and methodologies for exploring health promotion agenda-setting in applied settings, such as Healthy Border 2010, provide health practitioners and policy makers the potential to improve public health leadership by influencing the public health and policy agendas.

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