Complexity: a potential paradigm for a health promotion discipline

Abstract

SUMMARYHealth promotion underpins a distancing from narrow, simplifying health approaches associated with the biomedical model. However, it has not yet succeeded in formally establishing its theoretical, epistemological and methodological foundations on a single paradigm. The complexity paradigm, which it has yet to broach head-on, might provide it with a disciplinary matrix in line with its implicit stances and basic values. This article seeks to establish complexity's relevance as a paradigm that can contribute to the development of a health promotion discipline. The relevance of complexity is justified primarily by its matching with several implicit epistemological and methodological/theoretical stances found in the cardinal concepts and principles of health promotion. The transcendence of ontological realism and determinism as well as receptiveness in respect of the reflexivity that complexity encompasses are congruent with the values of social justice, participation, empowerment and the concept of positive health that the field promotes. Moreover, from a methodological and theoretical standpoint, complexity assumes a holistic, contextual and transdisciplinary approach, toward which health promotion is tending through its emphasis on ecology and interdisciplinary action. In a quest to illustrate our position, developmental evaluation is presented as an example of practice stemming from a complexity paradigm that can be useful in the evaluation of health promotion initiatives. In short, we argue that it would be advantageous for health promotion to integrate this paradigm, which would provide it with a formal framework appropriate to its purposes and concerns.

Concept Analysis: Health-Promoting Behaviors Related to Human Papilloma Virus (HPV) Infection

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Evaluating complex community-based health promotion: Addressing the challenges

“…Tremblay and Richard (2011) see a convergence of ideas in complexity theory and health promotion as the complexity of social structures and change is being recognised. The synergies between complexity theory and health promotion include a concern for an integrated holistic approach and the need for a comprehensive, dynamic, non-linear understanding of issues such as legitimising lay knowledge and participation (Tremblay & Richard, 2011). These complexity factors mean that static, linear approaches to evaluation will miss much of the adaptive nature of the intervention and may focus on issues that are no longer relevant to many stakeholders.…”

A systematic review on empowerment for healthy nutrition in health promotion

“…This theoretical eclecticism is typical for health promotion and reflects common practice (3) . However, it poses a challenge for theory-based advancements and evaluation methods.…”