Background There are gaps in the research regarding the implementation and evidence of overall strategies for municipal health promotion addressing communities. The aim of this scoping review is to gain initial findings concerning theoretical models, approaches and evidence on strategies of municipal health promotion, which include self-care, mutual aid and healthy environments. The findings can enrich the development of health promotion services. Methods A systematic scoping literature analysis was conducted in the databases PubMed, Web of Science, SAGE-Journals, Wiley-Online, ScienceDirect, LIVIVO and WiSo database as well as in a German project database. Evaluation studies and research reports on strategies in municipal health promotion were included and analysed qualitatively. Results According to our predefined inclusion and exclusion criteria, 15 hits were included. Capacity building, planning and the establishment of structures for health promotion were identified as theory-based models and approaches. None of the publications included showed clear evidence of the effects of municipal health promotion measures in terms of classically medically defined evidence. Conclusions The use of evidence-based theoretical models and approaches is no guarantee for the success of strategies for municipal health promotion. Challenges with regard to evidence are the execution of study designs corresponding to higher evidence classes and the isolation of effects of health promotion measures in complex environments. Trial registration This scoping review was not registered beforehand.

Zusammenfassung Hintergrund Die Diskrepanz zwischen rein theoretisch erarbeiteten Maßnahmen der Gesundheitsförderung, unabhängig von lebensweltlichen, gesundheitsrelevanten Erlebnissen und Erfahrungen ohne Einbezug der Adressat*innen stellt weiterhin ein Problem bezüglich der Wirksamkeit innerhalb verschiedener vulnerabler Gruppen dar. Der Beitrag beschreibt die theoretische Herleitung des Ansatzes der Gesundheitsförderungskultur anhand der Kinder- und Jugendarbeit. Der Ansatz stellt eine Weiterentwicklung des Verständnisses des Setting-Ansatzes dar, indem es einen theoretischen und analytischen Überbau für den Setting-Ansatz schafft und versucht diesen theoretisch stärker zu fundieren. Das hier vorgestellte Konzept ermöglicht eine ganzheitliche Sichtweise auf Gesundheitsförderung, die über das bisherige Verständnis von Verhaltens- und Verhältnisprävention hinausgeht. Methoden Das theoretische Konzept wurde mittels einer Verknüpfung des Lebensweltbegriffs und des Habituskonzepts. Ergebnisse Um soziale und gesundheitliche Ungleichheiten angemessen zu adressieren, sind lebensweltspezifische Ansätze und Methoden erforderlich, auf deren Basis mithilfe eines Bottom-up-Ansatzes gesundheitsförderliche Verhältnisse partizipativ geschaffen werden. Das Zusammenwirken von Partizipation, Selbstwirksamkeit, Empowerment und Exploration steht im Fokus der Gesundheitsförderungskultur. Die partizipative Einbindung der Adressat*innen bereits bei der Bedarfsermittlung sowie der Maßnahmenentwicklung soll Selbstwirksamkeitserfahrungen fördern, um zum Empowerment aller Adressat*innen zu führen. Schlussfolgerung Langfristig sollen Adressat*innen durch die direkte Auseinandersetzung mit ihrer Lebenswelt befähigt werden, (gesundheits-)kulturschaffende Akteur*innen in ihrer Lebenswelt zu sein, sodass sie ihre Umwelt gesundheitsförderlich beeinflussen und ihr eigenes Gesundheitsverhalten reflektieren können.

(1) In the field of health promotion, municipalities offer opportunities to reduce SES-based health inequalities by addressing vulnerable communities. This research project aims to identify facilitating and inhibiting factors for the creation of healthy living environments. (2) After preliminary literature and qualitative research work, an online-based Delphi survey was conducted (December 2020–March 2021). This included the rating and commentating of 22 theses at two times, whereby the results of the first round of rating were visible to the participants the second time. (3) Twelve experts from seven European countries participated in the Delphi survey across both rounds (1st round: n = 37; 12 countries). The consensus was particularly clear with regard to providing resources, which, in turn, are especially necessary for involving target groups in health promotion. (4) The results illustrate the relevance of further cross-national exchange. Certain aspects however, such as the HiAP approach or strategies to reach disadvantaged groups, are still challenging in practice. In order to develop concrete recommendations, the theses need to be further operationalised. The Delphi method offers a suitable possibility to map international expertise in this field and with a focus on health equity.

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Background Municipal health promotion provides the opportunity to promote health equity and to design health-promoting living environments by developing individual strategies. The Place Standard tool is a participatory instrument to identify needs by asking citizens to evaluate their living environment. It is increasingly being implemented and recommended on an international level. The aim of the study was to identify the potential of the Place Standard tool for the development of strategies in a municipal context as well as to identify facilitators and barriers when designing these. Methods Within a qualitative study design, nine guided interviews were conducted with international experts who have applied the tool at a municipal level in Europe. The interviews were recorded, subsequently transcribed and analysed using MAXQDA software. The analysis was based on a qualitative content analysis according to Mayring, using a deductively developed category system. Results A total of 355 statements were analysed. Some refer to the fact that a comprehensive needs analysis is enabled by the Place Standard tool, empowerment can be promoted and that the development of strategies can only be carried out with follow-up work. Furthermore, some facilitating factors, e.g. participation and intersectoral cooperation, were described. Mentioned inhibiting factors are e.g. lack of support from political decision-makers and the Covid 19 pandemic. Conclusions The results of the research indicate that the Place Standard tool can be used to identify priorities for action regarding the needs of the population at a municipal level. They show that a successful strategy development for municipal health promotion strongly relies on the application of the tool in an overall process. Key messages The Place Standard tool can be used to analyse needs at a municipal level. In order to develop sustainable strategies for municipal health promotion, it should be applied in an integrated process.