Literature

Review: Health Promotion Barriers

Literature Review: Health Promotion Barriers

Roxana Lievanos
Health 499: Senior Capstone Project
California Sate University, Channel Islands
Fall 2020

1
Literature Review: Health Promotion Barriers

Health promotion focuses on improving the health of individuals. As stated by the

World Health Organization, “ health promotion is the process of empowering people to

increase control over their health and its determinants through health literacy efforts and

multisectoral action to increase healthy behaviors” (World Health Organization). As

health promotion encourages healthy behaviors and reduces the risk of disease, there are

still many barriers to health promotion. For this literature review I will be analyzing

articles to determine the barriers in health promotion. It is essential to determine what

barriers there are in health promotion in order to address the needs of communities and

reduce health disparities.

In the article Understanding facilitators of and Barriers to Health promotion

Practice, a case study was conducted based off of research from previous projects. These

projects had previously used participatory, longitudinal mixed methods, and parallel

qualitative research designs. All data from the previous projects was collected and

examined using a qualitative software NUD*IST. Through the information gathered the

health promotion barriers that were determined, as stated by the article, were “ internal

organizational factors relating to the presence or absence of appropriately skilled and

committed people (staff and volunteers), funds and/or material resources, priority and/or

interest, and senior leadership” (Robinson et al., 2006). The barriers acknowledged in

this article were similar to the ones found in the research by Maria de Jesus. Through her

research she also determined insufficient research as a barrier. In addition, her article

Institutional barriers and strategies to health promotion: perspectives and experiences of

cape Verdean Women Health promoters, states that restrictive institutional policies and

lack of culturally and linguistically appropriate health resources “ (Jesus, 2008). The

2
Literature Review: Health Promotion Barriers

barriers in both articles are all internal factors that influence the ability to effectively

provide health promotion to individuals and communities.

The data collected in the study by De Jesus was collected through in depth semi

structured interviews. The semi structure interview method was also used in the article,

Barriers, facilitators and attitudes influencing health promotion activities in general

practice: an explorative pilot study. With the use of this method researchers were able to

interview general practitioners and practice Nurses. Through coding by ATLS.ti. 6x

researches discovered barriers described through these professionals on health promotion.

The barriers they reported were “ patients not motivated to change their unhealthy

lifestyles”, “lack of time in their consultations”, “problems regarding the content of

health promotion”, and “reimbursement of the programs” (Geense el al., 2013).

Reimbursement and lack of time were barriers also found in the article Attitudes,

barriers, and facilitator for health promotion in the elderly in primary care, as well as

the use of semi structure interviews. Furthermore, the article states that participants

expressed that without the assistance of government and health insurances, they were not

willing to provided health promotion services (Badertscher et al., 2012).

The last article I reviewed described barriers that individuals personally

experience and prevents them from engaging in health promotion. The article, What

Makes It So Hard? Barriers to health Promotion Experienced by People with Multi

Sclerosis and Polio, describes that an individuals environment is often a barrier and the

attitudes of health professionals, with fatigue being the highest rated barrier (Becker &

Stuifbergen, 2004). The barriers were identified through collection of data through cross

3
Literature Review: Health Promotion Barriers

and longitudinal studies. This data was then entered into SPSS 10.0 for statistical analysis

(Becker & Stuifbergen, 2004).

Common barriers that were recognized among the articles were lack of time and

inadequate reimbursement or funding. Additionally, appropriate cultural and language

resources, policies, unqualified personnel, motivation and fatigue are barriers also seen to

affect health promotion. Efforts to overcome such barriers can help improve the quality

of life of individuals. We can overcome these barriers by forming supportive internal

structures (Jesus, 2008). Internal structures can improve by recruiting qualified

professionals and developing time saving tools (Badertshcher et al., 2012). Reducing the

gap between public health requirements and the reimbursement system will also assist

with reimbursement (Badertshcher et al., 2012). In closing, it is certain that barriers in

health promotion remain. However, continuous efforts must be made to overcome these

barriers. In doing so, we will help individuals improve their quality of life.

4
Literature Review: Health Promotion Barriers

References

Badertscher, N., Rossi, P., Rieder, A., Herter-Clavel, C., Rosemann, T., & Zoller, M.
(2012). Attitudes, barriers and facilitators for health promotion in the elderly in
primary care. Swiss Medical Weekly. https://doi.org/10.4414/smw.2012.13606

Becker, H., & Stuifbergen, A. (2004). What Makes It So Hard? Barriers to Health
Promotion Experienced by People With Multiple Sclerosis and Polio. Family &
Community Health, 27(1), 75–85. https://doi.org/10.1097/00003727-200401000-
00008

Geense, W. W., Glind, I. M. V. D., Visscher, T. L., & Achterberg, T. V. (2013). Barriers,
facilitators and attitudes influencing health promotion activities in general practice:
an explorative pilot study. BMC Family Practice, 14(1).
https://doi.org/10.1186/1471-2296-14-20

Jesus, M. D. (2008). Institutional Barriers and Strategies to Health Promotion:

Perspectives and Experiences of Cape Verdean Women Health Promoters. Journal
of Immigrant and Minority Health, 12(3), 398–407. https://doi.org/10.1007/s10903-
008-9127-5

Robinson, K. L., Driedger, M. S., Elliott, S. J., & Eyles, J. (2006). Understanding
Facilitators of and Barriers to Health Promotion Practice. Health Promotion
Practice, 7(4), 467–476. https://doi.org/10.1177/1524839905278955

World Health Organization. Eastern Mediterranean Region. World Health Organization.

http://www.emro.who.int/about-who/public-health-functions/health-promotion-
disease-prevention.html.