ZusammenfassungMit der Ottawa-Charta von 1986 wurde ein Paradigmenwechsel vollzogen, der alle Public-Health-Anstrengungen auf die Stärkung kommunaler Aktivitäten und die Schaffung gesundheitsförderlicher Lebensumstände orientiert. Ein Schlüssel hierfür ist „capacity building“ (CB), verstanden als die Entwicklung und möglichst nachhaltige Implementierung von strukturellen Kapazitäten – wie koordinierte Datenerhebung, Abstimmungsprozesse über Sektorengrenzen hinweg, dauerhafte Bereitstellung grundständiger Ressourcen – in allen Bereichen der Gesundheitsförderung „vor Ort“.Vielfältige Anstrengungen und dreieinhalb Jahrzehnte später sehen wir uns noch viel zu oft Infrastrukturdefiziten, fragmentierten Public-Health-Landschaften und Hemmnissen für die intersektorale Zusammenarbeit gegenüber. Während der theoretische Konsens über das Notwendige breit erscheint, bleibt es eine Herausforderung, diese theoretischen Einsichten in die Praxis umzusetzen. In dieser Situation kann Digital Public Health (DPH) dazu beitragen, Barrieren zu überwinden und „Daten für Taten“ sichtbarer und zugänglicher zu machen. Durch DPH können Daten auf neuartige Weise integriert, strukturiert und disseminiert werden.In diesem Beitrag wird erörtert, wie die Kapazitätsentwicklung auf lokaler und kommunaler Ebene von technologischen Entwicklungen profitieren und was DPH für die Bereitstellung von Informationsservices im Bereich Public Health Capacity tun kann. Der Fokus liegt auf der webbasierten, interaktiven Repräsentation von Gesundheitsförderungsdaten, die für Informations‑, Steuerungs- und Benchmarkingzwecke genutzt werden können. Als Beispiel aus der Public-Health-Praxis wird das Tool „TEAviisari“ (National Institute for Health and Welfare, Finnland) vorgestellt.Die EU-Ratspräsidentschaft Deutschlands 2020 – u. a. mit den Themen Digitalisierung und gemeinsamer Gesundheitsdatenraum – bietet die Gelegenheit, die Kapazitätsentwicklung in der kommunalen Gesundheitsförderung auch hierzulande entscheidend voranzubringen.
The public health system in Germany, similar to education and cultural affairs, is characterised by the federal structure. It is mainly regulated and decided at the state and municipal level, and not primarily at the national level. The preventive health care act (The Act to Strengthen Health Promotion and Preventive Health Care) (2015) underlines the setting-based approach of health promotion and takes a life course perspective by recommending goals of growing up healthy, living and working healthy and healthy ageing. The act formulates broad recommendations for prevention and health promotion at the national level, that in turn take on concrete forms in mandatory framework agreements at the federal state level with uniform health objectives. On the whole, the key objective of the act is to improve preventive health care and general health promotion. Also the financing of the act by the mandatory health insurance is a special feature and at the same time a novelty. At the same time a bottom-up project has been recently launched with the aim to develop a public health strategy in Germany. The project future forum public health (ZfPH) is a platform for public health professionals, researchers and students following incorporated concepts of policy analysis as well as methods that will ensure participation, transparency and transferability of the results into policy and practice. Over the next three years, ZfPH’s steering group will moderate a participatory process, including stakeholders from public health practice and research as well as policy makers. In an evidence-based approach, they will first analyse the current state of Germany’s public health system before developing concrete policy recommendations for a coherent and efficient public health system. The presentation will give a short overview over the German public health system and the preventive health care act, its structure and the achievements as well as the bottom-up project future forum public health.
The good practice portal of the Federal Centre for Health Education / BZgA consists of a nationwide collection of projects and interventions to promote the health of socially disadvantaged groups at the community/setting level. Currently the portal includes 3067 practices, out of them 124 fulfil the good practice criteria and have been identified as such. The portal aims to disseminate (good) practice in Germany, promote its translation into action, create transparency in terms of quality criteria and make the diversity of practice more visible. A secondary aim is to promote regional networking and the exchange of experience. To this end, an exchange platform (inforo) is also offered via the operating agency, which however is still limited in use. The portal does not intend to identify the most effective practices, but to be a database of well-described interventions that were feasible to implement in Germany. Therefore, the evaluation process was designed as a mutual advisory process: Standardized description of project owners according to 12 good practice criteria- review by experts from the responsible coordinating offices of Equity in Health - peer evaluation by another coordinating body in another federal state - and finally evaluation by an expert from the nationwide working group at the BZgA. Thus, the evaluation process is also set up to promote mutual learning with the goal of in turn increasing quality of the practice nationwide, with the advantage of being close to the implementation needs and the potential disadvantage of lacking objectivity. At the moment, BZgA is assessing different possibilities to integrate evidence as criteria into its good practice portal. Therefore, this presentation will end with a discussion on possibilities to integrate the identification and selection of evidence-based/evidence-informed preventive interventions, including the use of evidence criteria and quality of evidence.
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