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IIHP Second Annual Meeting, October 12-15, 1997 in Mauritius

The meeting built on the discussions and spirit of the Inaugural Meeting last year. The event was supported by American University and by various private organizations on the island. This time a number of African institutions were represented and health promotion issues in Africa were highlighted to make this a truly global event.

• Quick facts
• Meeting purpose
• Schedule of events

Proceedings:

• Summary
• Introduction
• Mission of the IIHP
• Concept of health promotion
• Health fitness data
• Curriculum development
• Communication and technology
• Communication hour highlights
• Open Forum
• Summary of Outcomes
• Country Profiles

Quick Facts:

Where: Mauritius, a beautiful island in the Indian Ocean off the east coast of Africa.

When: October 12-15, 1997

Who: IIHP network partners and affiliates

Why should you attend? You will have the opportunity to:

• build partnerships with leaders from government, education, and the private sector in the health promotion field;
• learn from a program tailored to your needs: training and curriculum development, research and database development, strategic planning, and standardization (additional topics possible if strong interest);
• continue a cooperative relationship started with the agreement signing and last year's Inaugural Meeting in Washington DC;
• present a paper on your specialty area in relation to health promotion
• participate in outcome-oriented and practical working sessions in small groups in an informal and innovative atmosphere expanding on the traditional conference approach; and
• enhance your professional and personal development through information, resources, latest trends, networking.

Organizers: IIHP Headquarters at American University in Washington DC (Wolf Kirsten) .

Support: American University will support the event as well as various private organizations on the island. Please check the discounted rates with Air Mauritius and the Les Pavillons Hotel and Berjaya Hotel.

Meeting Purpose:

Besides the unique opportunity to meet and build partnerships with leaders in health promotion from throughout the world in an informal and personal setting, participants had the chance to enhance their professional development in their field of interest:

• educators - curriculum development
• researchers - health fitness data issues
• government officials - policy development
• corporate representatives - training program development / quality standards

Preliminary Schedule of Events

Sunday - October 12 - 18:00 Welcome Ceremony

Monday - October 13

7:00-8:00 Morning Activity

9:00 Briefing of last year's IIHP activities

Description of the IIHP network

10:00 Open forum - plenary discussion about past year

11:00-12:00 Organizational issues of the IIHP

Fine-tuning of mission, objectives, and structure

13:30 Communication hour: Africa

14:30 Core topic I: Health fitness data

* common data points

* protocols - standardization

* development of database

16:30-17:00 Action plan for data exchange project

Tuesday - October 14

7:00-8:00 Morning Activity

9:00 Mauritius Hour: Health promotion in Mauritius

10:00-12:00 Core topic II: Curriculum development

* curriculum for university programs, seminars, training programs

* identification of providers and consumers

* certification - quality standards

13:30 Communication hour: Asia

14:30 Core topic III: World Forum on Physical Activity and Sport

* summary of concept and First World Forum report

* relationship to IIHP - involvement of IIHP partners

16:00-17:00 Communication hour: The Americas

19:00 Evening activity / Dinner

Wednesday - October 15

7:00-8:00 Morning Activity

9:00 Core topic IV: Funding of the IIHP

* sources of support: international, regional, national, local

* action plan for 1997-98

* Third Annual IIHP Meeting

11:00-12:00 Briefing of World Health Organization International Conference

in Jakarta July 1997

13:30 Communication hour: Europe

14:30 Core topic V: Communication and technology

* effectiveness of communication channels

* electronic network of IIHP - World Bank project

* international health promotion newsletter

16:30-17:00 Closing ceremony

Note: This schedule is not final and subject to changes. We encourage your input with regard to content areas and especially format. The IIHP partners as a whole should agree upon the meeting agenda. In addition, delegates will take the lead of and facilitate specific sessions. If you are interested in leading a session in your expertise please let us know (see"session leaders" in the attachement).

Proceedings

• Summary
• Introduction
• Mission of the IIHP
• Concept of health promotion
• Health fitness data
• Curriculum development
• Communication and technology
• Communication hour highlights
• Open Forum
• Summary of Outcomes
• Country Profiles

Summary

The International Institute for Health Promotion (IIHP) at American University, inaugurated in June of 1996 in Washington DC, held its second annual meeting in Mauritius from October 12-15. The IIHP is a global network and public forum for professionals from different backgrounds to discuss health issues and advance the field of health promotion worldwide.

The Second Annual Meeting attracted 26 distinguished health promotion professionals from 15 countries out of five continents. The IIHP brought its annual meeting to this island off the East coast of Africa to provide this region of the world the opportunity to meet with international leaders in health promotion.

Facilitated and interactive discussions focused on the following core topics: curriculum development, health fitness global database, concept of health promotion, and communication and technology. In addition, numerous participants presented about successful programs back in their home country during the communication hours designated for each continent. The Junior Minister of Education of Mauritius, the Hon. Dhaneshwar Beeharry, introduced the latest health promotion initiative in the Mauritian schools.

The forum confirmed the IIHP mission, a result of last year's Inaugural Meeting, and pointed the IIHP into the future by agreeing on several programmatic initiatives: formation of a committee on health fitness testing protocols, international newsletter (start: 1998), health promotion training seminar in early 1998, and future annual IIHP meetings.

Introduction

The participants deliberated over three days at the Berjaya Hotel in Le Morne, Mauritius. The discussions had informal character and w IIHP will accomplish this through the facilitation and development of collaborative strategies, research and education initiatives, and communication networks."

Comments regarding this proposed change and any additional input is welcome in order to finalize the drafted version.

I Mission of the IIHP

Facilitator: Bob Karch - American University, USA

The IIHP mission statement was validated as drafted last year with a proposed minor change:

"In response to the universal aim to improve the quality of life, the International Institute for Health Promotion (IIHP) provides a cooperative forum for organizations promoting a healthy way of living (instead of health-related organizations). The IIHP seeks effective solutions to challenges for the advancement and application of health promotion concepts."

II Concept of health promotion:

Facilitator: Bob Karch - American University, USA

A number of models were presented and discussed during the opening session:

· Health Continuum by John Travis (1975)

· American University's Optimal Wellness Model (1983)

· Health Promotion model by Downie, Fyfe & Tannahill (1990)

· Wellness Wheel by the South African Association for Biokinetics

All participants are familiar with the term "health promotion" which is regarded as the most universal and inclusive term. The difference between the concept of health promotion, curative medicine and prevention was pointed out. All three fulfill important functions, but too little attention and resources are being devoted to health promotion. Health promotion has a positive connotation as the root of the word states: pro - motion = for - action. There was consensus that the field of health promotion not only includes traditional health professions but a wide array of disciplines. In order to advance the field and improve the quality of life, it is absolutely essential to address this multitude of disciplines, such as psychology, politics, public administration, physical education, business, law, etc. This diversity is reflected in the make-up of the IIHP and regarded as a strength.

Some discussion surrounded the issue of self-responsibility which is at the heart of the optimal wellness model. The significance of self-responsibility in health promotion was recognized but several participants pointed out that supportive environments are just as essential. Education was mentioned as one of the most important means to make people aware of the necessity of healthy lifestyles. In conclusion, in spite of the vast cultural differences worldwide, optimal wellness should be striven for by every culture / nation.

III Health fitness data

Facilitator: Dieter Lagerstrøm - IPN, Germany

The need for a global database with health fitness data has been pointed out by many international institutions over the last few years and was reinforced at the IIHP meeting in Mauritius. Many countries are currently gathering data on the health and fitness status of their population and have an interest in comparing this data with other countries. However, most often, protocols are different and varying parameters are measured making it virtually impossible to compare the data. Just as gross domestic product (GDP) figures are compared between countries, health profiles of different nations need to be compared, especially in this time of increasing globalization. This kind of information would be of great interest to governments, business, researchers, health care organizations, etc. Global health fitness standards could be developed as a result of this coordinated data collection.

The goal is to design basic assessments with universal scope. It should be possible to administer these tests in every participating country with the available resources. With China and India participating in this project already half of the world's population would be covered. For example, China uses four groups of parameters:

- anthropometric: height, weight, skin folds, circumferences

- functional: pulse rate, blood pressure, vital capacity, aerobic capacity

- physical ability: sprint, 800/1000 meter run, shuttle run, chin-up, sit-up, vertical jump, push-ups

- health questionnaire

The testing is sponsored by the government. Ten massive surveys have been completed since 1975 and more than 300 monitoring centers now exist throughout China.

The discussion focused around the issue of valid testing methods and instruments. The body mass index (BMI) is a widely used tool in India but was questioned by several participants. In conclusion, it was agreed upon that the measures do not have to be that accurate but should give a good indication of the fitness level of the individual. It is not necessary to apply the same standards as exercise physiologists do with high performance athletes. However, the need to validate these basic parameters through more scientific testing measures was mentioned.

The following parameters were suggested:

1. body composition: weight/height, waist-hip-ratio, body mass index (BMI)

2. strength: sit-ups (10 sec crunch)

3. flexibility: sit-and-reach

4. coordination: one-foot standing

5. cardiovascular endurance: Rockport test?

A self-assessment component was proposed as an addition: to ask individuals to rate their own health.

A committee was formed with the task of finalizing and fine-tuning the testing parameters and initiating the process of the standardization of fitness data worldwide:

· Lead: Dieter Lagerstrøm - IPN, Germany

· Cao Wenyuan - National Research Institute of Sport Science, China

· G.L. Khanna - Sports Authority of India

· Marius Coetsee - University of Zululand, South Africa

Other institutions with testing experience are welcome to join this committee.

IV Curriculum development

Facilitator: Michael O'Donnell - American Journal of Health Promotion, USA

With the changing global disease pattern and the emergence of lifestyle diseases the need for quality training in health promotion has become very pronounced throughout the world. A strong desire for the development of curriculum in health promotion has been expressed by numerous educational institutions. Traditional public health, medical, physical education, or even business study programs have recently adopted a health promotion class or module and often plan to offer an entire degree program in health promotion. An increased demand for these programs has spurred the rapid growth of health-related programs but too often such programs inadequately prepare students to succeed in the field.

Therefore, a need for quality control and international coordination on some basic courses and topical areas was expressed.

Two participants introduced a related curriculum within their institution:

· Bohuslav Hodan - degree in Health Promotion, Department of Recreology, School of Physical Culture, Palacky University, Olomouc, Czech Republic

· Gert Strydom - degree in Biokinetics, Potchefstroom University, Potchefstroom, South Africa

A number of other attendees provided information on training programs in their countries. In most countries, either the public health (Estonia, Germany, Finland, Zimbabwe) or physical education field (South Africa, Czech Republic, Mauritius) are broadening their scope and venturing into the health promotion arena. For example, in Zimbabwe the village health workers are responsible for health education and health promotion, and these are trained by nurses at medical clinics. Health promotion in Africa is very much integrated in the primary health care approach. In South Africa, the Association of Biokinetics focuses on the improvement of quality of life through movement. The discipline of biokinetics is recognized by the South African Medical and Dental Council, and as a result close cooperation exists across disciplines. A number of institutions pointed out the significance of practical experience as part of the curriculum. The South African biokinetics program requires a one-year internship. Palacky University also encourages the practical aspect by facilitating work opportunities and emphasizing "learning by doing".

Creating internship opportunities across borders was identified as a priority regarding cooperation between IIHP partners. Formal linkages between institutions should be put in place before interns can be exchanged and communication mechanisms need to be installed. Multinational corporations could play a major role in providing these opportunities as corporate wellness programs are increasing in number and quality around the world. The Socrates exchange program, as part of Erasmus (European Union program), was named as a possibility to fund internship opportunities.

A recent IIHP survey on training seminars in health promotion revealed that the following topics were of special interest:

· policy development

· strategic planning

· program evaluation

· health promotion for special populations

American University in Washington DC was the most popular location - one week the most often requested duration for the seminar. In addition, many survey participants pointed out the significance of regional tailoring. Specific topics find great interest and need in certain countries/regions (e.g. a workplace health promotion seminar is planned for Brazilian human resource managers and medical directors).

Additional discussions are necessary to identify curriculum components which may have universal appeal and to analyze how the IIHP could play a facilitative role in offering training programs with a specific focus.

V Communication and technology

The significance of regular and effective communication between IIHP partners and any affiliated organizations was reinforced at the meeting in Mauritius. The role of existing and new technologies in achieving effective communication was pointed out. After demonstrating an array of new technologies at the Inaugural Meeting last year, this year's discussion focused on problems and challenges the participants have to deal with regard to technology and how the communication flow can be improved globally.

A communication and technology survey was handed out to record knowledge level, equipment, interests, goals, barriers, and preferred form of communication. Some of the findings were:

· Barriers - roadblocks - challenges:

- slow data transmission

- line breakdowns

- phone system overburdened

- infrastructure not sufficient

- outdated equipment

- financial constraints

- lack of technical knowledge

- lack of skills

· Outlook:

- fast growth of technology

- plans for new communication infrastructure (e.g., fiber optic network) in numerous countries

- e-mail most desired application to purchase --> steady increase in users among IIHP network

- internet access desired to use as information resource and research tool

- fax currently preferred form of communication

- many different types of training and support are being used (one-on-one, manuals, workshops, on-line)

- design of World Wide Web pages necessary and links between IIHP network partners (in particular to American University)

- interest in IIHP news group or listserv

· Newsletter:

A strong interest was expressed in an expansion and more formal version of the current IIHP Newsflash which is currently disseminated monthly. The need for an international newsletter was underlined. Caution was advised with regard to information overload and that news items should have informational value. The possibility of publishing such a newsletter through the American Journal of Health Promotion (AJHP) in cooperation with the IIHP was discussed with Michael O'Donnell, Editor-in-Chief of the AJHP. Michael also talked about the developments in the U.S. publishing industry and the advantages of electronic distribution to cut costs and increase global reach. Dieter Lagerstrøm, as member of the European Network Fitness Committee (ENFC), introduced the ENFC newsletter which could be used as a model. The goal is to launch a global health promotion newsletter by early 1998. American University and the AJHP will work together in the remaining months of 1997 to make this a reality.

In conclusion of the session, a consensus was reached that technology has made many professional duties easier and that there is a strong interest in expanding technological capabilities. As expected, the survey documented varying levels of knowledge, accessibility to hard- and software, and technology adoption. Above all, the participants pointed out the significance of communicating regularly and sharing information between institutions to carry out the mission of the IIHP.

VI Communication hour highlights

The communication hours provided the participants a chance to introduce to the forum the current health issues in their countries and present the work and latest projects of their institution. The sessions were arranged by region in order to facilitate a discussion on regional health issues and common programmatic ideas. The following is a listing of the presenters and topics. For additional information the presenters can be contacted directly. The IIHP web site will also feature some of these presentations.

AFRICA

Facilitator: Marius Coetsee, University of Zululand, South Africa

· South Africa - Gert Strydom, Potchefstroom University

· Zimbabwe - Julita Chideme Maradzika, Department of Community Medicine, University of Zimbabwe

· Zimbabwe - Tabeth Ashani, Cancer Association of Zimbabwe

· Zimbabwe - Tendai Mundanda, Epilepsy Support Foundation

· Tunisia - Lassoued Belhassen, Tunisian Federation of Sport for All

· Mauritius - The Hon. Dhaneshwar Beeharry, Junior Minister of Education of Mauritius.

- Facilitator: Jorge Mota, University of Porto

· Germany - Dieter Lagerstrøm, Institut für Prävention und Nachsorge

· Finland - Antero Heloma, Finnish Institute of Occupational Health

· Romania - George Dumitru, Ovidius University, Constanta

· Israel - Itzik Weinstein, Wingate Institute for Physical Education and Sport

ASIA - Facilitator: Wolf Kirsten, American University

· China - Cao Wenyuan, National Research Institute of Sport Science

· India - G.L. Khanna, Sports Authority of India

AMERICAS - Facilitator: Wolf Kirsten, American University

· Brazil - Enadio Moraes, Hygieia Health, Salvador

· USA - Michael O'Donnell, American Journal of Health Promotion

VII Open Forum

The following issues were discussed outside of the core topic sessions:

· World Forum on Physical Activity and Sport

The World Forum on Physical Activity and Sport is an independent, complementary and consultative organization which seeks to contribute to increased health and quality of life through participation in sport and physical activity. The World Forum will develop programs and engage in collaborative action and events with existing institutions that will foster both regional and worldwide development of sport and physical activity.

The structure is composed of a global, world center located in Montreal and several regional centers located in designated regions around the world that will be flexible enough to allow for traditional continental division or regional and cultural interests. The first World Forum was held in Quebec City in May 1995 and attracted approximately 300 participants from 101 countries. A World Forum will be held every four years and regional fora will be organized as part of the process as required to produce a World Forum's agenda that reflects the reality and responds to need on sport and physical activity. The establishment of a permanent secretariat is planned for 1997 and the second World Forum for 1999.

Close ties with the World Forum organization have been established since IIHP partners Carlos Vera Guardia (Venezuela), Lassoued Belhassen (Tunisia), and Bob Karch (USA) are members of the Program Committee of the 1999 Forum. Continuing collaboration is envisioned between the IIHP and the World Forum as both organizations have common goals and can complement each other in the area of physical activity and sport.

· Relationship to World Health Organization (WHO)

The WHO has been coordinating international health activities for 50 years and plays a major role in developing countries. A number of participants have been involved in WHO-led or sponsored projects and the WHO Collaborating Center at Tokyo Medical College in Japan is an IIHP partner. Wolf Kirsten attended the 4th International Conference on Health Promotion in Jakarta in July and made first official contact with WHO Headquarters and the Pan American Health Organization (PAHO). It was agreed upon that all three organizations will explore possibilities to cooperate and form an unofficial alliance. In particular, the proximity of PAHO headquarters and IIHP headquarters in Washington DC will facilitate a collaborative relationship.

The forum consented that the IIHP should complement the weaknesses of the WHO by playing on its strengths: informality, lack of bureaucracy, flexibility, and multi-disciplinary forum of distinguished professionals. For example, the IIHP can play (and already has played) a crucial role in educating individuals about the link between physical activity and health and in promoting the benefits of physical activity because of the expertise and high standing of numerous IIHP institutions in the field. The "Active Living" project of the WHO would be a natural link. Informal contact has already been made with the project coordinator.

In addition, the IIHP should add to the existing body of research in health promotion and education and strive towards systematic growth across the world.

· Funding

Up to now, American University has been the main funding source and supporter of the IIHP (including the 2nd Annual Meeting in Mauritius). Some conferences, seminars and other training programs have been partially funded by private companies on an individual basis. In addition, the World Bank has been approached with regard to funding a communication infrastructure for the IIHP, and a number of other multi-national corporations and foundations have been informed about the initiatives of the IIHP.

However, the forum recognized the need to produce a concerted global effort in attracting funding for the IIHP. IIHP partner institutions have to support each other with useful contacts, documents, support letters, and press clippings/media coverage about the IIHP. All affiliated organizations are encouraged to gather and/or generate information and materials which underline the need for the IIHP and document successful initiatives. American University's National Center for Health Fitness (NCHF) has produced a color brochure, a video film, an award-winning World Wide Web page, and collected many support letters from throughout the world. The NCHF is in the position to facilitate fundraising efforts but needs constructive assistance from all interested organizations. The discussion about funding opportunities must continue on a regular basis through the existing and planned communication channels.

· Third Annual Meeting

The entire forum supported the idea of the IIHP holding a third annual meeting. A survey is being distributed (attached to this report) among the IIHP network inquiring about preferences regarding location and time of the Third Annual Meeting. A likely location is American University in Washington DC (like the Inaugural Meeting). Enadio Moraes of Hygieia Health expressed interest to host the IIHP meeting in Salvador, Brazil in 1999. The city of Salvador will be celebrating its ?th anniversary that year. Other countries also interested in hosting the meeting in the future are Norway and China. It was discussed that the meeting could be coordinated with other major conferences (e.g., AJHP). In addition, a more practical approach ("doing instead of listening") was desired.

VIII Summary of Outcomes

• Expansion of network into African and Indian Ocean region + other new participants
• Confirmation of IIHP mission
• Formation of committee on health fitness testing
• Plan for international newsletter (start: March 1998)
• Plan for health promotion training seminar in fall 1998
• Planning of future annual IIHP meetings

Satish Jagarnath, present at the Inaugural Meeting in Washington DC, coordinated the meeting in Mauritius and officially opened the event on Monday October 13. Last year's proceedings and additional input from active IIHP partners throughout the year were used as a foundation for the discussions. A number of new faces could be seen at the second meeting contributing to a very diverse make-up of the group. The following countries were represented: Brazil, China, Czech Republic, Estonia, Finland, Germany, India, Israel, Mauritius, Portugal, Romania, South Africa, Tunisia, USA, and Zimbabwe.

This year's meeting focused on several core topics which were identified beforehand as major areas of interest:

· curriculum development

· health fitness global database

· concept of health promotion

· communication and technology

The scope of operations of the IIHP in the coming year will be dictated by these topics.