Alf Trojan

By Alf Trojan, Christopher Kofahl and Stefan Nickel

Collaboration between laypersons and professionals is closely linked to the concept of patient centeredness. Patient centeredness means meeting the needs of individual patients as well as reacting to patients’ demands on the collective level. The support of self-help groups and their integration into healthcare institutions represent a major policy approach to fulfilling this requirement. Here, we first deal with the concept of patient centeredness in general, and the understanding of concept and use in Germany. We also provide a short definition of self-help friendliness (SHF) and discuss the success achieved in implementing it in Germany so far. We then clarify the closely related concepts of patient centeredness, patient participation and patient involvement SHF is seen as a strategy for increasing both patient centeredness and patient participation in healthcare services. We subsequently describe the involvement of self-help groups and patient associations in a series of empirical studies and practice-oriented projects carried out between 2004 and 2013. The last section contains a general discussion of the SHF approach as a means of systematically increasing sustainable patient centeredness and patient participation in healthcare services. Finally, we address the chances for future development in Germany and the transferability of SHF to other countries.

Part of the book: Patient Centered Medicine

By Alf Trojan

The contribution will present a highly visible health promotion programme in a deprived urban neighbourhood, initiated in 2004 by the health authority of the Hamburgian district Eimsbüttel. Its focus was on capacity building in cooperation with local actors/parties and residents. During 2005 and 2017, the programme, called ‘Lenzgesund’, was researched by a team of the Institute of Medical Sociology. The research aimed at giving feedback to the actors about how well they achieved their goals. For this purpose, we had to develop and test new approaches to evaluation. KEQ (Kapazitätsentwicklung im Quartier/capacity building in residential quarters/neighbourhoods) is the acronym of a newly developed questionnaire for measuring community capacities being considered as relevant for health. KEQ can be seen as an intermediate outcome parameter for health promotion programmes and activities on the community level. Another innovative approach to evaluation was an audit of the programme through experts from outside Hamburg in order to have a more neutral external view. The first paragraphs will present the practical programme and its development in phases from 2004 to 2012. In the second part, we will give a short account of the two main approaches to long-term evaluation of the programme.

Part of the book: Health Promotion

By Alf Trojan, Christian Lorentz and Stefan Nickel

One of the key principles of the Ottawa Charta is participation. Community health interventions should involve the community, i.e., residents and local actors. In Hamburg, we tried to put this principle into practice during a project initiated by the municipal health service in a disadvantaged quarter with about 3000 inhabitants. The contribution starts with an account of the meaning of participation in health promotion (1) and gives an overview of participation methods in general (2). The next part contains a short account of our project (3). Five examples are presented in part four: a survey with key actors and two approaches to listening to residents’ perceptions of capacity building in the neighborhood. Another survey of residents was meant to explore the use of health promotion offers and the preparedness to get involved. The last example is the round table of local actors as a sort of steering committee for health promotion interventions (4). Key findings of the examples are: Surveys do result in valuable information for the local actors. The expressed willingness to participate is larger than the actual participation. Opportunities to participate (in surveys and at the round table) are welcome by local actors. In the last section we discuss the advantages, problems and some illusions concerning participation in health promotion (5).

Part of the book: Health Promotion