Empowering health promotion as a vehicle for achieving health equity: The health promotion change management process at the Multnomah County Health Department

Beginning in 1999, a series of employee groups began to shift public health practice at the Multnomah County Health Department (MCHD) in Portland, Oregon, towards the vision of health promotion articulated in the World Health Organization's Ottawa Charter. In 2007, a cross-departmental team created a conceptual framework grounded in the principle that health promotion is a means for achieving health equity. Based on a formative evaluation, a plan for implementation of the Framework was developed. The first step was the creation of a Health Promotion Community of Practice (CofP) to lead the process. During Year One, CofP members focused on enhancing their own health promotion competence through reading and discussion. In Fall 2009, the CofP moved into the implementation phase, developing and administering a baseline survey, revising and disseminating a new version of the Health Promotion Framework, and conducting empowering health promotion trainings for all MCHD staff. To date, results of the Change Process have included: 1) development of a cadre of staff who are well-versed in progressive health promotion theory and practice; 2) enhanced ability to use popular education for health promotion; and 3) creation of several pilot projects based on the principles of empowering health promotion. In this presentation, we will describe the process of forming and maintaining the CofP, explain how popular education methods have been used to guide the Change Process, and highlight the lessons learned to-date that may apply to other agencies interested in promoting social justice and health equity via empowering health promotion.