Evidence, Ethics, and Values: A Framework for Health Promotion

Carter, Stacy M; Rychetnik, Lucie; Lloyd, Beverley; Kerridge, Ian; Baur, Louise A.; Bauman, Adrian; Hooker, Claire; Zask, Avigdor

doi:10.2105/ajph.2010.195545

Cited by 114 publications

(93 citation statements)

References 65 publications

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“…These images suggest that body fat, in and of itself, is a direct cause of physical degeneration. The ethical issues of continuing to use images in social marketing campaigns that stigmatize fat people and show them as inevitably unattractive, ill and diseased have been raised by a number of critics, including those from within public health (for example, Carter et al 2011, MacLean et al 2009, Puhl et al 2012). Yet they remain a common convention of representation in anti-"obesity" campaigns.…”

Section: Discussionmentioning

confidence: 99%

“How do you Measure up?” Assumptions About “Obesity” and Health-Related Behaviors and Beliefs in two Australian “Obesity” Prevention Campaigns

Lupton

2014

Fat Studies

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This article presents an analysis of two related Australian government-sponsored "obesity" prevention campaigns, including documents produced by commercial social research companies reporting the formative research and evaluation of these campaigns. This material is critically analyzed for its underlying assumptions about weight "obesity" and the public's health-related behaviors and beliefs. These include the following: the concept of "good health" has meaning and value that is universally shared; to be "overweight" or "obese" is to be physically unfit and at risk of higher levels of disease and early death; individuals are responsible for their own health status; they lack appropriate information about health risks and providing this information leads to behavior change; and information should be provided in a way that arouses concern and a belief that individuals should make a change. These assumptions are challenged from a critical sociological perspective.

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Section: Discussionmentioning

confidence: 99%

“How do you Measure up?” Assumptions About “Obesity” and Health-Related Behaviors and Beliefs in two Australian “Obesity” Prevention Campaigns

Lupton

2014

Fat Studies

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“…Two more general observations about ethics in health promotion practice; first, doing health promotion ethics requires using and critiquing evidence. 64,65 Outcomes or consequences (especially benefits and harms) are central to ethical evaluation. However, the evidence base in health promotion, particularly regarding the effects of complex interventions, is often limited, 64,66 so decisions must be taken in the context of uncertainty.…”

Section: What Ethical Issues Arise In Activities Intended To Promote mentioning

confidence: 99%

“…Close attention to the strengths and weakness of ethical arguments and to the meaning of concepts is needed. 64 There are several codes of ethics in this field (e.g. 67 70 ).…”

Section: What Ethical Issues Arise In Activities Intended To Promote mentioning

confidence: 99%

“…16 Social marketing campaigns frequently address viewers as individuals, exhorting them to change their behaviour and suggesting that this is easy despite the overwhelming evidence to the contrary. 64,95,96 Given that these campaigns are widely thought to act on social norms, they arguably reproduce the tendency for members of the general public to unjustly allocate responsibility for health risks or diseases to individuals.…”

Section: Victim Blaming and Stigmatisationmentioning

confidence: 99%

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How to Think about Health Promotion Ethics

2012

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Health promotion ethics is moral deliberation about health promotion and its prac tice. Although academics and practitioners have been writing about ethics, and especially values, in health promotion for decades, health promotion ethics is now regaining attention within the broader literature on public health ethics. Health promotion is difficult to define, and this has implications for health promotion ethics. Health promotion can be approached in two complementary ways: as a normative ideal, and as a practice. We consider the normative ideal of health promotion to be that aspect of public health practice that is particularly concerned with the equity of social arrangements: it imagines that social arrangements can be altered to make things better for everyone, whatever their health risks, and seeks to achieve this in collaboration with citizens. This raises two main ethical questions. First: what is a good society? And then: what should health promotion contribute to a good society? The practice of health promotion varies widely. Discussion of its ethical implications has addressed four main issues: the potential for health promotion to limit or increase the freedom of individuals; health promotion as a source of collective benefit; the possibility that health promotion strategies might "blame the victim" or stigmatise those who are disabled, sick or at higher risk of disease; and the importance of distributing the benefits of health promotion fairly. Different people will make different moral evaluations on each of these issues in a way that is informed by, and informs, their vision of a good society and their understanding of the ends of health promotion. We conclude that future work in

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“…Participants considered both evidence-based and ethical values in identifying potential opportunities, scope and feasibility of PHN action in CP. Carter et al discussed the need for a framework for health promotion practice which incorporates an iterative approach to decision making that incorporates a 'both-and' process -valuing both evidence as well as also considering adequately ethics and values at the same time (30,40) . A purely evidencebased decision-making approach largely neglects the political and social context within which decisions are made.…”

Section: Public Health Nutrition Practice and Judgementmentioning

confidence: 99%

Community pharmacy as a setting for public health nutrition action: Australian nutritionists’ perspectives

Maher

Lowe

Hughes

2014

Public Health Nutr.

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Objective: To explore public health nutritionists' perceptions of nutrition and its place in community pharmacy (CP) presently and into the future; and to explore perceived opportunities, feasibility and scope of public health nutrition (PHN) interventions in CP, with a focus on maternal and infant nutrition. Design: Qualitative data were gathered through semi-structured interviews and drew on hermeneutics as the theoretical framework for analysis and interpretation. Setting: Queensland, Australia. Subjects: Public health nutritionists, identified through purposive, criterion sampling, were chosen due to (i) their role as potential stakeholders, (ii) their knowledge and emphasis on nutrition and (iii) their practice experience. Results: Opportunities for PHN action focused primarily on actions relating to early nutrient supplementation in pregnancy and breast-feeding protection and promotion. Opportunities in CP were constrained by practitioners' perception of (i) conflict between health care and commercial interests in CP, (ii) problematic practices in CP and (iii) values and motivations of practitioners and other stakeholders in the CP sector. Strategies were suggested to improve practices and enhance the setting from a PHN perspective. Participants suggested both collaborative and regulatory approaches to achieve settings-based changes, identifying the need for these to coexist for effective outcomes. Conclusions: Public health nutritionists suggest that opportunities for PHN action are constrained by perceived conflicted interests and that consumers need to be adequately protected from the influence of commercial interests. PHN action in this setting needs adequate reflection on evidence as well as ethics ensuring that practices are 'for the good' of mothers and infants.

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Evidence, Ethics, and Values: A Framework for Health Promotion

Cited by 114 publications

References 65 publications

“How do you Measure up?” Assumptions About “Obesity” and Health-Related Behaviors and Beliefs in two Australian “Obesity” Prevention Campaigns

“How do you Measure up?” Assumptions About “Obesity” and Health-Related Behaviors and Beliefs in two Australian “Obesity” Prevention Campaigns

How to Think about Health Promotion Ethics

Community pharmacy as a setting for public health nutrition action: Australian nutritionists’ perspectives

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