The APHA criteria for development of health promotion programs applied to four Healthy Community projects in British Columbia

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Abstract
The British Columbia Healthy Communities projects are intersectoral health promotion programs emphasizing local policy development to put the vision of the World Health Organization's and Canadian federal initiatives of Achieving Health for All into practical community action and organization. They attempt to convert the Ottawa Charter for Health Promotion into practical community action projects, including operationalizing the concepts of participation, empowerment and ownership. The American Public Health Association's (APHA) criteria for the development of health promotion and education programs (American Journal of Public Health, 77 , 89–92, 1987) offer five standards by which to guide program design and implementation. As a test of the compatibility of these two models, we present case analyses of four Healthy Community projects in relation to the APHA criteria. At this early stage of the projects we can only speculate as to the results likely to be attained by these municipalities. We conclude that the APHA criteria would disqualify most of the Healthy Community projects as worthy health promotion programs, mainly on the APHA criteria requiring projects to have a modifiable risk-factor target of known epidemiological importance to health outcomes, having interventions that will clearly and effectively reduce a targeted risk factor and having built-in evaluation. We weigh the relative merits of the Canadian community projects around the APHA criteria, concluding that different criteria might apply to different types of health promotion policies and programming.

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