to get the file - Fonds Gesundes Österreich

fgoe.org

to get the file - Fonds Gesundes Österreich

Dr. Renate KIRSCHNER

Prof. Dr. Thomas ELKELES

Dr. Wolf KIRSCHNER

With the assistance of Sven BORGMEYER

EVALUATION

OF THE ACTIVITIES OF THE

FONDS GESUNDES ÖSTERREICH

(FUND FOR A HEALTHY AUSTRIA) 1998 TO 2001

REPORT ON RESULTS

Summary, Conclusions and Recommendations


TABLE OF CONTENTS

Introduction 3

Executive Summary 5

1 Summary 9

1.1 Evaluation of the Fonds Gesundes Österreich (FGÖ):

Basis, Goals and Methods 9

1.2 Health Promotion in an Historical, Social,

Health Policy and Economic Context 11

1.3 Development of Health Promotion and Prevention in

Austria up to the Enactment of the Health Promotion Act 14

1.4 Analysis of the Three Year Program of the FGÖ -

Quality of the Structure and the Planning of Goals and Measures 18

1.4.1 Definition of Process Goals 18

1.4.2 The Structure of the FGÖ 20

1.4.3 Project Promotion and Funding by the FGÖ 20

1.4.4 Further Responsibilities of the FGÖ 22

1.5 Activities and Range of Responsibilities of the FGÖ from 1998 to 2001 23

1.5.1 Project Funding and Promotion by the FGÖ 23

1.5.2 Priority Activities and Media Campaigns 26

1.5.3 Initial, Advanced and Continuing Education and Training 27

1.5.4 International Exchange of Information and Experience 27

1.5.5 Internet Sites 27

1.5.6 Model Projects 27

1.5.7 Internal Project Database 27

1.5.8 Summary 27

1.6 Evaluative Assessment of the Activities of the FGÖ 28

1.6.1 Project Promotion and Funding 28

1.6.2 Initial, Advanced and Continuing Education and

Training and International Contacts 28

1.6.3 The Lifestyle Campaign of the FGÖ 29

1.6.4 The Internet Sites of the FGÖ 29

1.6.5 The Structure of the FGÖ 30

1.6.6 Assessment of Attainment of Process Goals and

Overall Rating of the FGÖ in the Survey 31

1.6.7 Assessments of the FGÖ in the Open-ended Interviews 33

1.6.8 International Comparisons 34

1.6.9 Summary Assessment 34

2 Conclusions 36

3 Recommendations 37

3.1 Recommendations from FB+E Based on the Evaluation 37

3.2 Recommendations from the Open-ended Interviews 40

3.3 Criticisms/Recommendations from the Quantitative Survey 41

3.4 Summary 41

4 Annexes 43

Annex 1 Questionnaire for the Quantitative Survey 47

Annex 2 Evaluations of the Quantitative Analyses 57

Annex 3 List of Interviewees for the Open-ended Interviews 76

Annex 4 Bibliography 79

Imprint 83


Introduction

This publication is a summary of the evaluation report on the activities of Fonds Gesundes

Österreich (FGÖ) in the first three years of operation. The results of the evaluation

served as a fundamental source for the FGÖ to draw on in determining the content of

its new Three Year Program 2003 to 2005 and the Work Program for 2003, which were

produced in numerous work sessions and workshops in 2002. These results form the

basis for setting the future direction of the organization.

The history of the evaluation begins with the first Three Year Program for 1999 to 2001.

The FGÖ Board set down in this document the tasks and responsibilities of the FGÖ,

which was newly established in 1998. Beside describing the strategic and substantive

direction of the FGÖ, the Board also voiced its intention in this document to have the

FGÖ’s activities and effects undergo an evaluation. In the spring of 2001 an internal

working group consisting of members of the FGÖ Board, the Advisory Committee and

the Administrative Office was set up to determine how this project could be carried out.

The group summarized its findings in a project plan and submitted it to the bodies of the

FGÖ for approval. The plan described what the FGÖ expected from the evaluation and

which activity areas were to undergo a quality evaluation (projects, structural organization,

PR).

The following points and issues were to be critically analyzed:

Are the strategies and criteria of the FGÖ suitable for bringing about the desired processes

in health promotion in Austria in an effective and sustainable manner? (process

evaluation)

Are the personnel and structural resources of the FGÖ suitable for dealing with the formulated

tasks and responsibilities? (structural evaluation)

In this plan, the FGÖ made clear that it views evaluation as an indispensable instrument

for quality assurance and as an opportunity for the organization to optimize its own activities.

The results from the planned evaluation to determine the current progress of the

FGÖ are to be used in the positive further development of the organization’s work.

In the summer of 2001, an EU-wide public tender was conducted. The Berlin-based firm

“FB+E Forschung, Beratung + Evaluation”, with project managers Dr. Renate Kirschner

and Dr. Wolfgang Kirschner, was ultimately awarded the contract by the FGÖ Board

from among the companies which had responded.

The evaluators began their work on 1 January 2002. They conducted numerous interviews

with relevant representatives of the health care and health promotion sectors in

Austria, with members of the FGÖ Board and Advisory Committee, and with FGÖ employees.

This was followed by a questionnaire-based survey, a thorough analysis and

rating of project funding and promotion as well as various other activities and of the

FGÖ’s media efforts. The results of the evaluation were presented to the FGÖ Board at its

June meeting on June 18; the finished evaluation report was officially handed over on

July 5 at the Administrative Office. There are two versions of the evaluation report, a

complete two-volume version and this summary which contains the conclusions and recommendations.

This summary is available from the FGÖ Administrative Office in German

and English.

Vienna, 2003


Executive Summary

The Fonds Gesundes Österreich (the Fund for a Healthy Austria, referred to throughout

this report as “FGÖ”) made a public call for tenders for this evaluation of its activities

and awarded the contract to the research, consulting and evaluation firm Institut Forschung,

Beratung und Evaluation (referred to in this report as “FB+E”) in January 2002.

The main focus here was to evaluate the FGÖ’s structures, processes and products. However,

in reviewing the attainment of the process goals the organization had set itself in its

three-year program, FB+E also undertook a partial evaluation of results. In light of the intervention

period that has elapsed thus far, it is neither sensible nor feasible within the

given time and budget to conduct an evaluation at this time of the overriding goals of the

Health Promotion Act, namely:

q To improve the general public’s knowledge of health promotion,

q To improve the general public’s state of health.

Nonetheless, it is time to put the requisite instruments in place for a later evaluation of

the media campaigns, e.g. in 2005.

The evaluation revolves around two central questions:

1.q How successful was the FGÖ in implementing the law with its activities?

2.q How successful was the FGÖ in initiating and stabilizing the planned process

developments in health promotion and prevention?

An array of different methods were used in this evaluation. They range from various types

of analyses and on-site visits to open-ended interviews and a written survey conducted

with individuals active in health promotion in Austria.

This expert report starts with a presentation of the development of health promotion

and prevention in a broad historical, political and economic context and then analyzes

developments in Austria up to the enactment of the Health Promotion Act in 1998.

The evaluations of the subsequent period are based on an analysis of the law itself and

on a precise analysis of the Three Year Program where the FGÖ formulated the plans

and goals to be achieved, including the process goals. The organization’s various individual

activities are then analyzed in a mostly quantitative inventory and a partial evaluation

which leads to a final evaluation of the work of the FGÖ taking a synoptic view of

all methods used and the results achieved.

The historical analysis reveals an increase in the programmatic importance of health promotion

and prevention since Ottawa (1986). In its practical development, this field faces

a number of theoretical, structural and financial problems. The Health Promotion Act can

be seen as a relatively prompt political and administrative response to these very problems.

This law substantially improved the structural and financial conditions for health

promotion and prevention in Austria and set down two overriding goals to be achieved

through action in six different areas.

The FGÖ incorporated these provisions in its Three Year Program for 1999 to 2001. All

items in the program are state-of-the-art in terms of effective and efficient goal and action

planning. The program is quite ambitious, not only in light of the limited staff resources

of the Administrative Office. In the programmatic planning, the FB+E saw no other practical

alternatives to the individual points made. At most, accentuation might have been

helpful in a few of the items. The process goals set down in the program help to ensure that

the FGÖ is quality oriented in its work and are also evaluated in terms of attainment.

5


6

In its activities, the FGÖ has implemented the planned measures quickly and consistently.

As regards implementation of the legal provisions, there are only three areas in

which the goals and plans were not (fully) achieved:

1.q Development of a standardized and networked internal database;

2.q Development of a functional Internet project database;

3.q Development of a compelling homepage (www.fgoe/org).

All detected shortcomings can be attributed essentially to the limited staff resources of

the FGÖ and the heavy workload the FGÖ staff is subject to.

The findings from the overall evaluation of the work of the FGÖ were as follows:

q Overall, results evaluation in project promotion is generally unsatisfactory in

actual practice judging from the current methods used for evaluating measures,

particularly health promotion measures, and due to the position FGÖ has

taken on evaluation, a position which was justifiable in 1998. Improvement is

needed especially in large projects. It should be noted that the evaluation standards

achieved in Austria in health promotion and prevention are certainly not

worse than in other countries.

q Project monitoring and assistance could also stand practical improvement and

should be made more client-oriented.

q Measures in advanced and continuing education and in networking are energetically

pursued and utilized by those active in the health promotion field, but

concerted efforts need to be made to maintain them.

q The vast majority of media campaigns and the Internet presence (www.gesundesleben.at)

and various media and sites are excellent in terms of quality, form

and scientific information with a few rare exceptions. With their large runs, the

print media in particular reach a large segment of the Austrian population.

The lack of reliable data on subject-based use of the Internet makes it difficult

to determine the number of Internet users who visit the FGÖ site.

q Further necessary developments in health promotion are being addressed and

promptly implemented with the model projects FGÖ began in 2002.

q The FGÖ homepage on the Internet (www.fgoe/org) contrasts starkly with the

other FGÖ Internet sites and should be improved as soon as possible.

q The non-functioning Internet project database is not really a priority in the estimation

of FB+E and requires more conceptual input.

q The internal networked project database, for its part, is a top priority project and

its execution has now been commissioned.

q With a view to the intensified media campaigns that are planned, one of the recommendations

of this expert report is that the FGÖ budget be increased.

q In the quantitative and in-depth surveys, respondents expressed great appreciation

for the work of the FGÖ, an opinion also reflected in the average overall

score of 1.9 (in a grading system where 1 is the highest and 5 is the lowest)

awarded to the FGÖ.


q The FGÖ is now viewed as a role model in health promotion, as shown, for example,

by the current discussion in Germany about taking a similiar fund approach

to health promotion.

q The FGÖ accomplished this very good to excellent work with a staff that urgently

requires enlargement.

q In the quantitative and in-depth surveys, respondents expressed a desire for

the carefully planned further development of the FGÖ and of health promotion

and prevention in Austria in line with the declarations made in Ottawa, Mexico

and Jakarta.

The FGÖ has implemented and carried out its legal mandate and the tasks and measures

set down in its Three Year Program virtually in full and completely. The few exceptions

to this relate to the Internet project database, the internal project database and the

FGÖ homepage. All three have serious shortcomings and are being worked on or revised.

The tight staff situation and constant heavy workload of the FGÖ Administrative Office

staff are solely to blame for these shortcomings.

From the standpoint of the survey respondents and the evaluation team, the FGÖ succeeded

with its activities to a great extent in meeting the majority of the process goals

it had set for itself. This view is expressed not least by the average overall rating of 1.9

(in a grading system where 1 is the highest and 5 is the lowest) awarded to the work of

the FGÖ, an unusually good rating compared to the ratings other institutions receive in

evaluation studies. The FGÖ has gained attention and professional recognition far beyond

the borders of Austria. For example, it is being held up as a model in the current health

policy discussion in Germany on the need to restructure that country’s health promotion

and prevention sector.

Total

Friendly

Prompt handling of questions,

requests, etc

Fast, easy to reach

Professionally correct

and competent

Fig. 1 Grade Awarded to the FGÖ in the Quantitative Survey (n=109)

Mean values in the scales: 1 = Agree wholeheartedly 2= Agree 3= Undecided 4= Tend to disagree

5= Completely disagree

1.4

1.7

1.7

1.9

2.5

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8

Based on the findings of the expert report, FB+E is making a total of 27 recommendations

on ways of further optimizing practices in the health promotion field and the work

of the FGÖ in the future.

These recommendations pertain to the following areas, among others:

q Improvements needed in qualitative and quantitative evaluation, particularly

for large-scale projects.

q Exclusion of small projects from central promotion/funding activities.

q The need to enlarge the staff of the Administrative Office.

q The need to establish the internal project database as quickly as possible.

q Critical comments on the cost/benefit ratio of the Internet project database.

q The need for major improvements in the epidemiological data situation in Austria,

e.g. through health surveys, especially also in order to evaluate the media

campaigns.

q Questions on the funding and efficacy of the intensified media campaigns being

planned.

q The need to step up project assistance and monitoring.

q The design of the Internet sites and measures for assessing the cost effectiveness

of Internet activities.

q The need for a clearer delineation of institutional and financial scopes of authority

and responsibilities for health promotion and prevention in Austria.

q Careful assessment of findings to determine needed action in epidemiology

and evaluation research.

q Further programmatic developments for the next three years.

On undergoing these further developments, the FGÖ is sure to become one of the showcase

projects internationally for health promotion and prevention in the years ahead.

Our evaluation sought to determine the FGÖ’s performance in executing its program

and responsibilities. Findings in an evaluation of this kind depend heavily on the willingness

of the staff to take an active part in the evaluation process. The FGÖ staff was

exceptional in this regard. They were even kind enough to take time for us outside regular

working hours to be interviewed. We sincerely thank them again at this juncture for

their cooperation.

The organization showed an openness to and keen interest in the evaluation throughout

the process. This attitude confirms the professionalism with which the FGÖ takes its responsibilities

and reflects a healthy and quite justified self-confidence regarding the work

accomplished so far.

The Authors


Summary 1

1.1 Evaluation of the Fonds Gesundes Österreich (FGÖ): Basis, Goals

and Methods

In August 2001, the FGÖ publicly invited bids for an outside evaluation of its activities

from 1998 and 2001. In January 2002 FB+E (Forschung, Beratung + Evaluation, Berlin)

was commissioned to conduct the evaluation.

As proposed and conducted by FB+E, the study focused on evaluating the organization’s

structures, processes and products. Given the limited period of FGÖ activities

and interventions so far and the time and budget restrictions in the evaluation contract,

it was neither sensible nor possible at this time to evaluate the results in achieving the

overriding goals of the Health Promotion Act, the legal basis for the work of the FGÖ.

These primary goals are as follows:

q To improve the general public’s knowledge of health, health risks and disease

and

q To improve the health of the general public.

Nevertheless, efforts must now be stepped up (see recommendations) to create the requisite

instruments for a later evaluation of results.

The evaluation revolves around two central questions:

1.q How successful was the FGÖ in implementing the law with its activities?

2.q How suitable were FGÖ activities for initiating and stabilizing the requisite process

developments in health promotion and prevention?

Before goal attainment in process development can be analyzed, appropriate process

goals must be defined within the framework of a program. The FGÖ based its activities

on a Three Year Program. This work program also sets down 26 process goals meant to

guide the activities of the FGÖ as a whole and in connection with the various performance

objectives and work priorities (project promotion/funding, advanced training,

coordination and networking, priority activities, media campaigns).

The very act of deducing and defining these process goals is a key mark of quality for

the work program deserving of special mention. The review of goal attainment for these

process goals now allows an initial evaluation to be made of the results achieved for the

process goals.

A variety of methods were utilized in this evaluation. They range from literature analyses,

desk research, Internet research, document analyses, in-depth and quantitative interviews

to on-site visits. Against the backdrop of analyses of the genesis of the Health

Promotion Act, the Three Year Program and the activities of the FGÖ, all this culminated

in an overall evaluation of FGÖ activities based on a synoptic evaluation of the findings

resulting from all methods used.

1 No bibliography is cited in connection with the findings of the expert report. The reader is kindly asked to

refer to Annex 2 for an overview of the sources cited in this report.

9


10

Qualitative and quantitative methods used in the study:

q Literature analyses/desk research

q Information acquisition on the Internet

q Creation of a database on all promoted projects (and all contracted projects >

ATS 1 million (i.e. approx. EUR 73,000)), including Internet research on all organizations

carrying out projects

q Overall analysis of a total of 26 project files (promoted and not-promoted projects)

q On-site analyses and interviews

q (56 workdays/7 trips to Austria)

q In-depth interviews (open-ended interviews n=30)

q Quantitative postal survey (questionnaire to be filled out by respondent)

q Nine-page questionnaire with 18 questions

q Random sample drawn from FGÖ address directories:

Random sample

Funding Applicants Conference Experts

Participants

Gross I n= 100 249 69

Gross II n= 96 244 67

Net n= 53 48 43

Response rate after

a written follow-up: 55% 20% 64%

Our sincere thank to all interviewees and collaboration partners for their cooperation.

Thirty open-ended interviews were conducted during the empirical survey phase. In addition

to all staff members at the FGÖ Administrative Office, 20 of these in-depth interviews

were conducted with project managers, scientists, representatives of the governmental

administration in Austria and members of the Advisory Council and Board of the

FGÖ. (Annex 6 contains a list of the interviewees). Besides the open-ended interviews,

a written survey was also conducted with persons active in health promotion in Austria.

(Annexes 4 and 5 contain the questionnaire and the basic evaluation in table form).


1.2 Health Promotion in an Historical, Social, Health Policy and

Economic Context

In its introduction, the expert report describes the development of health promotion

and prevention in an historical, social, health policy and also economic context. In the

estimation of FB+E, this is the only way to present the prevailing philosophies in health

promotion and prevention in a clear, distinct and understandable way. The major findings

of this analysis were as follows:

q Prevention and health promotion both have a long and varying tradition in

(medical) history extending back to Antiquity.

q The period after World War II must be viewed as atypical compared with earlier

periods (e.g. industrialization) in the focus on individualized curative treatment

by many health systems (especially in Austria and Germany) and in the neglect

of medicine for the general population. This was largely due to the after-effects

of the National Socialists having discredited this kind of medicine.

q The 1970’s saw an upturn in prevention in the form of secondary prevention

but the general approach of individualized curative treatment was retained. At

the same time, various European countries (e.g. Germany, Finland, Italy) conducted

model projects in primary prevention aimed mostly at cardiovascular diseases.

The objective of these projects was to demonstrate that morbidity and

mortality could be reduced with behavioral prevention measures based primarily

on risk factors of the type being carried out in the United States. This objective

was largely achieved.

q The advent of the “Health Movement” in the early 1970s (by no means the

first of its kind in history) created a platform for formulating and organizing

criticism of prevailing traditional medicine and of risk-factor oriented primary

prevention.

q The 1986 Ottawa Declaration of the WHO laid the first programmatic foundation

for a health promotion approach conceived as an alternative to risk-factor behavioral

prevention and based on worldly wisdom. This approach was subsequently

further underpinned theoretically by “salutogenesis”, a concept developed

by the Israeli-American medical sociologist Antonovsky.

q Since 1986, health promotion and prevention have attracted the increased attention

of researchers, politicians and the general public, particularly in a programmatic

sense, and have received some – quite limited – funding.

q With the demographic changes in society, increased life expectancy and the

scenarios they evoke of a further explosion of public health care costs, more

and more health economists are now recognizing and citing prevention and

health promotion as ways and means of reducing and/or stabilizing public health

costs.

q As a result of health economists’ increased recognition of the importance of

health promotion and prevention, these fields are now subject to the “efficiency

postulate” of health economics. This means that health promotion and prevention

measures must now be undertaken on the basis of evidence and that

their efficacy and efficiency must be demonstrated.

11


12

q Health promotion and prevention are recognized by most in society today across

all institutional or political party lines. However, it is important to keep in

mind that funding for prevention continues to lag far behind that given to curative

treatment. This crass imbalance also applies to the importance ascribed

social scientific prevention as opposed to medical prevention.

After making a valuative analysis of the development described here, FB+E has come

to the following conclusions:

1.q The postulated possibility of reducing costs in the health care system by means

of health promotion and prevention has a certain logical, indeed tautological,

plausibility given the range of health care costs that could be reduced by avoiding

morbidity. However, solid proof of this effect has yet to be furnished. In tackling

this issue, it is not so much the methodological problems of furnishing

proof in health economics itself that is of primary, practical interest. The key

question is where and how the enormous financial sums should be raised which

will undoubtedly be needed to put in place a policy of health promotion and prevention

aimed at substantially reducing morbidity in a verifiable manner.

2.q In FB+E’s estimation, the postulate of verifiability health economists now demand

of health promotion and prevention cannot be dismissed on the grounds

that it has been slow in gaining a foothold in other areas of medical care and is

not at all widely applied. In point of fact, only 15% to 20% of all medical procedures

currently practiced comply with solid standards of evidence-based medicine.

The evaluation required by this postulate, especially the evaluation of

the results of health promotion and prevention measures, must be tackled and

implemented. This step is essential not primarily to comply with the decisionmaking

logic of health economics but rather to obtain adequate evidence of effective

measures in health promotion and prevention and to further develop

health promotion evaluation in a careful manner on both a theoretical and practical

plane. The notions about results evaluation that health economists often express

so pedantically are largely based on classic evaluation designs for clinical

studies, especially when it comes to evaluating health promotion measures. For

many health promotion projects, this approach needs to be supplemented by

other methods, including open-ended ones. Here, too, there is a lot of research

and learning yet to be done in the field of evaluation research as to the development

and testing of adequate designs and instruments. For these reasons alone,

Austria, just like other countries, could not be expected to have efficient

widespread evaluation practices in place right now, particularly for the evaluation

of results in the field of health promotion and prevention.

3.q As indicated above, for health promotion to crystallize as a separate field, it

has to be clearly distinguishable from risk-factor-oriented measures of behavioral

prevention. The litanies one hears on the distinctions between health promotion

on the one hand and social scientific primary prevention on the other cannot

change the fact that both are social scientific methods of primary prevention

whereby:

q Health promotion reflects the connection between resource increase and health

while

q Prevention reflects the interconnection between health risks and disease/health.

The former has its scientific basis in many sub-disciplines of the social sciences – particularly

social psychology; the latter, in epidemiology. Both approaches make use of

social-psychologically based intervention processes. The lines to be drawn here, in terms

of underlying theory as well as areas of professional competence and intervention meth-


ods, are the ones between social scientific methods of primary prevention on the one

hand and medical prevention measures on the other (e.g. vaccination, preventive medication).

With the development of genetic diagnostics, social scientific primary prevention

also already faces competition today for financial resources. In this regard, we urge, without

any great hope of success, that an end be brought to the unjustified polar positioning

of behavioral prevention versus relational prevention and of resource-increasing strategies

versus risk-reducing strategies.

The figure below illustrates these distinctions.

HEALTH EDUCATION AND AWARENESS MEASURES

Health Education

Social Scientific Prevention

Increase

Resources

(Health

Promotion)

PRIMARY PREVENTION

Decrease Risk

Factors

(Prevention)

SECONDARY PREVENTION

TERTIARY PREVENTION

e.g. Vaccination, interventions

involving medicines

(e.g. blood pressure)

(Early Detection of Disease – Screening)

e.g. Examinations for early detection of cancer,

health checkups, genetic diagnosis, HIV test

Includes Rehabilitation and Nursing

Health Information

Medical Prevention

Fig. 2 Distinctions between Health Promotion, Prevention and Health Education

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1.3 Development of Health Promotion and Prevention in Austria up to

the Enactment of the Health Promotion Act

Health promotion and prevention in Austria have developed largely in line with the process

described above.

q In the 1950s and 1960s, classic medical prevention measures (vaccination,

prenatal examinations, examinations for children and adolescents) were the focal

points of prevention policy, accompanied by health education and information

efforts. Here too prevention was greatly underemphasized in comparison

with curative care.

q In terms of the importance assigned to social and public medicine and epidemiology,

Austria was also more akin to Germany than to Switzerland. In social

medicine in particular, one can see most clearly how very slowly this discipline

was developed and revived in Austria after World War II, even in comparison with

Germany.

q The data situation concerning epidemiological and health statistics had major

deficits and gaps in Austria as well, particularly also in social epidemiology, especially

regionally. These shortcomings have negatively affected the current

plans and especially the evaluation of measures in health promotion and prevention

in the work of the FGÖ, particularly the evaluation of broad-based media

campaigns. However, further progress can now be observed both in health

reporting and in the solidification of health policy content. The latter has come

about through the setting of health objectives, also in various federal provinces

in Austria.

q Nonetheless, on the whole, the activities undertaken in health promotion are not

yet being adequately coordinated with the advances made in improving health

reporting and the attempts at defining health policy goals.

q The scientific disciplines important to health promotion and prevention from a

planning and evaluation standpoint, particularly social medicine and epidemiology,

and especially also evaluation research, have been and continue to be sorely

understaffed as well as insufficiently funded in Austria. This is the unanimous

opinion of all respondents in the in-depth interviews.

q The Ottawa program has been widely disseminated in Austria through networks

established by groups of hospitals, schools, cities and businesses, e.g. the

Healthy Cities Network (Netzwerk Gesunde Städte) established in 1992.

q Various federal provinces in Austria (e.g. Vorarlberg, Styria) are setting up organizations

and clubs that promote health and prevention. Health promotion is

also emphasized more strongly in the health policy of various provinces, although

it continues to be relatively insignificant in comparison to medical prevention,

also in terms of funding. The tight financial situation in health promotion is reflected

for example, in the annual budget of at most ATS 9 million (approx. EUR

655,000) allocated to the FGÖ since its founding in 1988. According to a study

commissioned by the Austrian Health Institute (ÖBIG), outlays for prevention

in Austria in 1996 totaled EUR 806 million, with EUR 9 million (about 1.1%)

of this sum going to health promotion and to primary social scientific prevention.

q Against this political, institutional and financial backdrop, Austrian health promotion

faced a variety of problems up to the end of the 1990s both on the

theoretical and the practical plane. They were caused largely by the following

factors:


u Insufficient funding of offerings and measures

u Lack of structures and networking

u Insufficient funding to meet initial and continuing education/training needs

among health promotion practitioners

u Limits to knowledge and/or need for further research, especially in psychology,

sociology and epidemiology to allow intervention requirements and intervention

possibilities to be scientifically based and adequately evaluated.

u Lack of infrastructure for science and scientific counseling of health promotion

practitioners.

These deficits were fully confirmed in the quantitative study.

1.80 1.81 1.81 1.81

3. Measures underfinanced

7. Budgets for evaluation too small

1.84 1.84

8. Evaluation experts not involved

1.87

2. Lack of coordination + networking

Fig. 3 Assessment of the Situation of Health Promotion in Austria Prior to the Health Promotion

Act in the Survey (n=144) (Average Value: 1.95; Standard Deviation: 0.14)

Mean values in the scales: 1 = Agree wholeheartedly 2= Agree 3= Undecided 4= Tend to disagree

5= Completely disagree 2

1.89

16. Too little cont. education/evaluation

1.95 1.95

13. Lack of project promotion/funding

6. Insufficient evaluation

Average value

14. Lack of criteria for promotion/funding

15. Too little cont. ed/health promotion

2.04 2.05 2.06

2.08

4. Measures too short-term

5. Shortcomings in quality assurance

2.13

9. Insufficient documentation

12. Lack of exchange in health promotion field

10. Difficult to obtain an overview

11. Lack of exchange between scient./pract.

2 Anyone interested in a more detailed evaluation of the quantitative analysis and the diagrams should refer

to Annex 2 where they are presented in a more readable form.

2.14

2.16

1. Already a lot of measures before

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The Health Promotion Act drafted by the representatives of the Social Democratic Party

of Austria (SPÖ) and the People’s Party of Austria (ÖVP) and enacted by the coalition

government in 1998 can be viewed as a relatively quick political and administrative response

to these problems, as is indicated in the reasons given for the law.

The law itself is formulated in brief, concise language. The text of the law and the reasons

given for passing it go beyond merely expressing an understanding of health promotion

and prevention from a policy and expert viewpoint. They signal a firm intent on the part of

major figures from both parties to achieve real progress in health promotion and prevention

in Austria. The FGÖ is entrusted with implementing the law. By and large, there was no

alternative to this assignment of responsibility, a fact confirmed by the survey results.

Text of the Health Promotion Act

§

§ 1. (1) This Federal Law pertains to measures and initiatives which help to achieve

the following objectives:

1. To maintain, promote and improve the health of the population in a holistic

sense and in all phases of life;

2. To increase awareness and provide information about preventable diseases and

about emotional, psychological and social factors which influence health.

(2) This Federal Law does not pertain to measures and initiatives falling into the

scope of responsibility of the legal Social Insurance System or based on other legal

regulations.

(3) Any masculine references made in this law to persons refer equally to men and

women.

Fig 4 Text of the Health Promotion Act

5. Improving health

of gen. public

1.28 1.29

4. Improving health

behavior

1.43

1. Development of methods

1.47

Average value

1.54 1.56

6. Initiation

of process

3. Increasing the level

of knowledge

1.72

3. Generating

qual./quant. added value

Fig 5 Importance of the Overriding Goals of the Health Promotion Act. All Respondents n=144

(Average Value : 1.47; Standard Deviation: 0.17).

Mean values in the scales: 1 = Agree wholeheartedly 2= Agree 3= Undecided 4= Tend to disagree

5= Completely disagree


In citing the reasons for its passage, the law refers explicitly to the Ottawa WHO Declaration.

Yet in its two main goals:

q To improve knowledge about health, health risks and disease

q To improve the health of the general public

it defines three main intervention methods, namely, health education and information

measures, resource-increasing health promotion measures, and risk-reducing primary

prevention measures.

The law stipulates that the responsibilities of other institutions for health promotion

and prevention are to remain unaffected by these new legal regulations. What lawmakers

were primarily referring to here were the responsibilities of the social insurance funds for

medical prevention. However, one should also keep in mind the 1992 law amending

the General Social Insurance Law (ASVG) which also permits the health insurance

funds to undertake health promotion measures. It should be noted that the funds have

thus far done little to implement this aspect of the amending law.

The law provides for an annual budget of ATS 100 million (approx. EUR 7.25 million)

and also stipulates the institutional structures of the fund, including the creation of a

Board, an Advisory Committee and the FGÖ Administrative Office. Along with setting

the goals, the law defines six important fields of action:

1.q Structural development of health-promotion and prevention measures;

2.q Development and staging of programs and offerings related to health promotion

and prevention;

3.q Development and staging of programs and offerings related to health education

(lifestyle, prevention, dealing with chronic illness);

4.q Further scientific development of health promotion and prevention, epidemiology,

evaluation and quality assurance;

5.q Continuing education for practitioners;

6.q Coordination and harmonization with other institutions.

The majority of the survey respondents gave a high rating to the law and to the FGÖ being

assigned the responsibility for its implementation. Only about 5% of the respondents

gave critical ratings in this regard.

Fig. 6 Rating of the Health Promotion Act in the Survey (n=100)

1 > Very good

2 > Good

3 > Satisfactory

4 > Pass

5 > Fail

17


18

1 > Very good

2 > Good

3 > satisfactory

4 > Pass

5 > Fail

Fig. 7 Rating in the Survey of FGÖ Being Entrusted with Implementation (n=102)

On the whole, the Health Promotion Act was a compromise in that it not only allows but

in fact stipulates a wide range of methods extending from health education measures

to setting-based approaches. Depending on their method and policy preference, health

promotion practitioners in Austria may view this willingness to compromise negatively

and follow the “balancing out” of the various approaches in the work of the FGÖ with a

critical eye. Although the FGÖ clearly excludes non-preventive measures from funding

in its work principles and project funding criteria, project applications involving measures

of this kind continue to be submitted from time to time.

1.4 Analysis of the Three Year Program of the FGÖ - Quality of the

Structure and the Planning of Goals and Measures

1.4.1 Definition of Process Goals

The FGÖ has initially formulated a Three Year Program (1999-2001), which describes in

detail the basic areas of responsibility and action. In this medium-term work program,

the FGÖ set no goals regarding results in the sense of changes to be achieved in knowledge,

reported behavior or specific health parameters. What it did establish were process

goals meant to guide the FGÖ’s handling of its actual work. In terms of implementation,

these goals were initially akin to result goals.

The Austrian Audit Office was critical about the lack of concrete and measurable goals

regarding results and required them to be formulated for the future. In the view of FB+E,

a more differentiated view of evaluation methods and goals must be adopted in relation

to the intervention strategies and measures being pursued:

q The effects achieved in various practical health promotion projects have been

quite well documented thus far. Considerable improvement is needed in the

evaluation standards, particularly as regards the evaluation of results and especially

in projects involving large amounts of funding (see below).

q Successes achieved through health information measures, e.g. media campaigns

(exercise, diet), in terms of knowledge and the population’s reported behavior

require regular monitoring in the form of brief, representative surveys of the population.

This raises the question of initial empirical data prior to the campaign,

a subject to be discussed in detail in the recommendations. In the criticism of

result goals not being defined ex ante for the media campaigns, the idea is expressed

that quantitative improvements or changes to be achieved by these interventions

could be scientifically deduced and defined as regards:


u knowledge,

u reported behavior,

u or even certain health parameters themselves.

Given the lack of initial epidemiological data and the difficulty of assessing the effectiveness

of media interventions, FB+E believes this idea is infeasible as expressed

here. In our estimation, goal attainment will have to be determined in a rather iterative

process based on the procurement of the necessary epidemiological data and relatively

continuous monitoring.

q In our view, the (social) epidemiological data available in Austria must be substantially

improved, e.g. with the help of a representative health survey, in order

to evaluate the health effects FGÖ activities have on the population. In terms

of financing, this task does not fall to FGÖ alone. It should also be kept in

mind that effects on health parameters for the population can only be expected

over longer time periods and with concerted long-term actions and measures

organized on the basis of multiple centers. This, however, is no reason not to

move ahead with all due speed to make the necessary improvements in the

epidemiological data situation.

There was broad agreement in the survey with the process goals formulated by the FGÖ.

1.29 1.32 1.40 1.42 1.44 1.46 1.46 1.50 1.50 1.51 1.52 1.53 1.53 1.54 1.58 1.63 1.64 1.66 1.68 1.71 1.92

1.85

1.73 1.75 1.76 1.79

Networking of individuals active in HP

Promotes strengthening of HP as societal task

Ensures high quality of HP

Long-term improvement of all parameters

Client-oriented in work

Supports continuing education and training

Professional organization

Promotes acknowledgement of HP

Quality of management

Quality of personnel

New forms of communication

Supports new forms of communication

Improvement of epidemiological knowledge

Known institution

Involved in international developments

Scientific projects acknowledged in field

Strengthens import. of GP in init./advanced ed/training

Sustainability (mixed financing)

Database effectively used/updated

Promotes interaction/cooperation

Recognized institution

Average value

Operates project database

Motivates individuals active in HP

Scientific projects stress implementation

Promotes acknowledgement of HP as societal task

Fig. 8 Rating in the Survey of the Importance of the Process Goals Formulated by the FGÖ

(n=144) (Average Value: 1.58, Standard Deviation: 0.16).

Mean values in the scales: 1 = Agree wholeheartedly 2= Agree 3= Undecided 4= Tend to disagree

5= Completely disagree

19


20

FGÖ’s definition and deduction of action and quality goals in its Three Year Program

fully accords with state-of-the-art program planning and quality management in the business

world.

1.4.2 The Structure of the FGÖ

q The FGÖ has a simple, clear-cut structure similar to that of comparable institutions.

q The practical work done by the FGÖ Administrative Office is scientifically underpinned

and safeguarded by an Advisory Committee. The Board is the organization’s

link to politics, the governmental administration and the public. The

members of the Board and the Advisory Committee are respected individuals

from the political and scientific communities.

q These three entities have cooperated largely without conflict thus far, even during

the change in government. In the majority of cases, each entity follows the

recommendations handed down to it from the next higher entity. Since the organization

does exist and operate in the real world, problems and conflicts do inevitably

arise from time to time.

q The Administrative Office is currently staffed by eleven permanent employees

with a set of qualifications fully suitable for business management and for the

contents and methods of health promotion and prevention as well as organization,

controlling and administration. What struck FB+E was that permanent staff

with special skills in quality assurance, evaluation and IT have not been continuously

available to the organization. When it first took up its work, the FGÖ had

one staff member with proven evaluation experience available to it. From the

start of 2001 to March 2002, a health specialist with medical qualifications

assumed responsibility for quality assurance and evaluation. Since April 2002

a duly qualified staff member has once again been handling these tasks. Outsiders

are contracted to take care of IT concerns. The staff is anything but bloated,

a charge made several times in the parliamentarian debates. In fact, compared

to the associations in the German federal states or the Swiss foundation the staff

is definitely smaller than average. In terms of space, equipment and material,

the rather small offices housing the FGÖ Administrative Office are equipped in

a reasonable and usual manner.

q Scientific criteria cannot be applied in judging the suitability of the annual

funding of EUR 7.25 million. Assuming other cost centers have not reduced

their services since the allocation of these funds to the FGÖ, Austria spends an

annual EUR 2.1 per capita for these types of measures, a figure in line with

the amounts Germany and Switzerland spend. The Health Promotion Act has definitely

improved the financial situation of health promotion and primary prevention,

but of course has done little to ameliorate the considerable discrepancy

in funding between prevention and curative treatment.

1.4.3 Project Promotion and Funding by the FGÖ

q In promoting and funding projects, the FGÖ does not limit itself to priority

fields of action and subject matter. Although scientifically founded and suitable

for the structural buildup phase, this open-ended approach puts heavy knowledge

demands on the organization’s health specialists. The limitation of the priority

activities to six target groups is justified by health promotion theory and

practice and by an obvious need for epidemiological action (the elderly, the

chronically ill, the socially disadvantaged).


1.43

1.48

10. Lasting pos. changes in health behavior

10. Lasting pos. changes in health behavior

1.62 1.63 1.66 1.67 1.69

5. Indicator-based

7. Experience of applicants

6. Sufficient evidence of successful execution

11. Acceptance of project by target group

5. Indicator-based

11. Acceptance of project by target group

Average value

7. Experience of applicants

6. Sufficient evidence of successful execution

2. No promotion of projects not related to health

9. Change of processes and structures

1.76 1.77 1.80 1.98 2.01

9. Change of processes and structures

12. Acceptance of project by experts

8. Based on clear needs

Average value

Fig. 9 Assessment in Survey of the Correctness of the Criteria for Project Promotion and Funding

(n=144) (Average Value: 1.80; Standard Deviation: 0.39).

Mean values in the scales: 1 = Agree wholeheartedly 2= Agree 3= Undecided 4= Tend to disagree

5= Completely disagree

1.47

1.49

1.67

1,68

1.78

1.81

12. Acceptance of project by experts

8. Based on clear needs

2.92

1. No funding for projects with trad. health concept

4. Sustainability through mixed financing

2. No promotion of projects not related to health

Fig. 10 Assessment of the Importance of Project Promotion/Funding Criteria

All Respondents n=144 (Average Value: 1.88; Standard Deviation: 0.35)

Mean values in the scales: 1 = Agree wholeheartedly 2= Agree 3= Undecided 4= Tend to disagree

5= Completely disagree

1.88

1.93 1.95 1.96 1.99

2.08

3. No funding for projects of nat'l scope

2.79

3. No funding for projects of nat'l scope

1. No funding for projects with trad. health concept

4. Sustainability through mixed financing

21


22

q In its Three Year Program, the FGÖ has formulated a total of twelve criteria for

project promotion and funding (see below). Five of them incorporate the principles

of the health promotion strategy being pursued while the remaining seven

help to ensure that the requirements and conditions for maximum success in

project execution are in place. The basic criterion of always providing mixed financing

for projects is aimed primarily at safeguarding sustainability. This has

advantages and disadvantages. Taken as a whole, the criteria are plausible and

logical and some of them are ultimately also legally required to ensure the effective

and efficient employment of public funds. Applying them practically in

actual project evaluations can help to assure the quality of the health promotion

policies the FGÖ is seeking to implement.

The survey respondents approved of a majority of the criteria for project promotion and

funding; just three of the criteria came under some criticism.

q Projects can be assessed in an efficient, comprehensive and largely standardized

manner with the application forms created by the FGÖ. The only improvements

conceivable and also sensible and/or necessary in this area might be to require

stronger evidence regarding the theoretical basis of an intervention and a clearer

description and explanation of the proposed measures for evaluating its appropriateness.

q The FGÖ takes a rather cautious, unspecified and pragmatic approach to formulating

standards for the quality assurance and evaluation of projects and

measures. Instead of drawing up guidelines or guiding principles for evaluation,

the organization holds regular meetings on these subjects. In the view of

FB+E, there was virtually no alternative to this approach. Given the current

scientific knowledge both in evaluation research and among health promotion

practitioners, it would have been impossible to create, and where applicable also

to prescribe, theoretically sound and instrumentally tested evaluation designs

for the highly diverse measures and projects involved. In sub-areas where this

procedure might have been possible, it would have been time-consuming and

would certainly have caused delays in approving and implementing projects.

However, much more attention will indisputably have to be paid in the future to

quality assurance and evaluation in health promotion and prevention.

q Project planning and execution are to be monitored and their quality assured at

all stages by means of collateral project measures. A further goal is to promote

and initiate project activities. This procedure is state-of-the-art in scientific

and administrative project promotion and monitoring.

q Developing and maintaining a corresponding project database accessible over

the Internet is vital to scientists and health promotion practitioners alike. However,

keeping it updated and making available the types of different information

required is a highly time-consuming and costly endeavor. Moreover, a database

of this kind is ultimately only really helpful if users can be assured that

the information it contains is up to date and complete.

1.4.4. Further Responsibilities of the FGÖ

q Initial and continuing education and training are especially important in the field

of health promotion and prevention. Practical health promotion requires a wide

set of professional process-specific and process-non-specific qualifications

which generally go beyond those learned for a single occupational field. To provide

offerings that meet requirements, the organization quite logically carried out

a requirements analysis in 1998.


q A variety of events and media are used to provide a means of exchanging information

and networking actors and also measures.

q Another important responsibility is to design and implement the priority programs

and the broad-based media campaigns primarily for covering health education

and information goals.

q Through intensive cooperation with pertinent scientific disciplines, the organization

seeks to underpin health promotion practices theoretically while also

determining and addressing needs for scientific research.

q Through international contacts, the organization seeks to monitor health promotion

developments in other countries, also for the purpose of benchmarking,

and to make the work of the FGÖ known internationally.

On the whole, the quality of the Three Year Program of the FGÖ is high. It is difficult to

envisage practical alternatives to the suggested approach, apart from accentuation of certain

areas. All in all, the action program can be seen as highly ambitious, not just in light

of the tight staffing situation at the FGÖ.

1.5 Activities and Range of Responsibilities of the FGÖ from 1998 to

2001

1.5.1 Project Funding and Promotion by the FGÖ

q Over this three year period, the FGÖ received a total of 616 grant applications to

its unrestricted invitations for submissions. Of this total, 70% were related to

practical projects and just 13% to research projects. Decisions were made on

501 projects up to 31 December 2001. Of this total, 249 were approved and

252 were rejected. Practical projects also made up the majority of the approved

projects. Over the three year period, an average of 13 project applications

were received every month, their number accumulating from month to month.

q The distribution of funding among the various types of projects corresponded

to the distribution of the types of applications received. Three-fourths of the

funding went to practical projects. The average funding granted was EUR

31,400. Of the 249 projects approved:

u 167 (67%) received total funding of up to EUR 25,000

u 39 (16%) received total funding between EUR 25,000 and EUR 50,000

u 21 ( 8%) received total funding between EUR 50,000 and EUR 72,600

u 22 (9%) received total funding of > EUR 72,600.

q As regards the topics and goals of the projects, the virtually unrestricted approach

the FGÖ takes to content and subject matter has resulted, as might be

expected, in a wide variety of contents, subjects, target groups and measures.

23


24

Addiction prevention, including smoking and alcohol 16%

Health promotion at the workplace 10%

Prevention of other diseases 9%

Health promotion 8%

Nutrition, exercise, obesity 7%

Stress at work, psychological stress 5%

Pregnancy, birth, post-natal care, newborns 4%

Self-help 4%

Cancers 3%

Health report 3%

Psychological diseases 3%

HIV+AIDS 3%

The elderly 2%

Care, nursing 2%

Health promotion at schools 2%

Osteoporosis 2%

Work with migrants 2%

Continuing training and education 2%

Health education and information 2%

Cardiovascular diseases 2%

Diabetes 2%

Violence 2%

Fig. 11 Subjects and Contents of the Projects (n=249) (>1%)

The structure of project content also reflects the legal mandate for action, consisting of

a broad mix of projects from setting-based health promotion as well as measures centering

on social scientific primary prevention and health information efforts. Pupils,

school graduates, children and young people are the target groups of the practical projects

with a more than average frequency of 26%. Most of these projects focus on addiction

prevention.


Pupils and school graduates 40 13%

General population 25 8%

Personnel, staff, worker 25 8%

Young people 22 7%

Physicians, chemists (pharmacists),

occupational physicians and specialist staff 18 6%

Children 18 6%

Teachers 17 5%

Businesses 16 5%

Parents 16 5%

Patients and the chronically ill 11 3%

Family members (care givers) 10 3%

Old, elderly people 9 3%

Role models, opinion leaders, managers, peers 9 3%

Educators, trainers and leaders 7 2%

Affected individuals 6 2%

Women 6 2%

Migrants 6 2%

Healthy individuals, hospital, municipalities 5 2%

Homosexuals, bisexuals, gays, lesbians 5 2%

Fig. 12 Target Groups of Practical Projects n=315 (>1% total cited)

q The research projects showed a similarly wide range of subjects and methods.

They include secondary statistical analyses of available data as well as instrument

development and even involve carrying out clinical epidemiological studies.

The study “Municipal Health Reporting” conducted by the Health Cities

Network of Austria, for example, is a model for requirements-based research

grants in health promotion. Its intent is to bring about efficient and standardized

improvements in municipal health reporting with an eye to taking epidemiological

data more into account. This data is indispensable for planning and

evaluating health promotion and prevention measures. The study also presents

suggestions on conducting health surveys, only some of which have been carried

out thus far (e.g. Vienna, Linz, Bruck an der Mur).

q Training courses and information media/events naturally take center stage in

health promotion, but many of the approaches here are quite innovative, e.g.

theater performances.

25


26

q As regards the criterion of proportional (mixed) financing, it is already clear at

this point that FGÖ has difficulty in finding additional organizations to provide

funding for one in eight of the projects it approves for (proportional) funding.

q In terms of the evaluation of practical projects, it was found that funding was

sufficient for a somewhat solid evaluation of at most 10% of the projects. This

conclusion is based on the evaluation research and WHO principle that the

evaluation budget should amount to about 10% to 15% of total project costs.

Even the project funding ceiling of ATS 1 million (approx. EUR 73,000) is too

low, because it would mean an evaluation budget of some EUR 7,000 to

EUR 10,000. This rather randomly selected ratio for evaluation costs to project

costs is based on average figures. The actual evaluation costs are determined

by an adequate evaluation design in each case and could far exceed these reference

values.

1.5.2 Priority Activities and Media Campaigns

q In its priority activities, the FGÖ complies with its mandate to increase knowledge

about health and to change health-related behavior in the Austrian population.

Various media are used to disseminate the priority issues and to reach the

intended target groups. It is characteristic of these health information efforts

that they are not carried out isolated and separate from other types of measures

but in conjunction with them to the greatest extent possible.

q The media themselves are a good and sensible mix of various print media and

the Internet. The daily press is used along with the above to carry out priority activities

and media campaigns capable of reaching people at very different places

in their lives and with different thresholds of interest in health. These efforts

include ads and spots in interregional and regional media, the publication of the

magazine Gesundes Österreich (Healthy Austria) and two brochures on exercise

and diet.

Fig. 13 Media Coverage of FGÖ Activities (1999-2001)

1999 2000 2001 Total

Daily paper 72 171 83 326

Weekly paper 17 138 65 220

Magazines (general) 7 41 18 66

Professional health media 36 78 86 200

APA journals 7 19 10 36

Online services 27 20 388 435

Radio 225 240 10 475

TV 3 129 0 132

Professional journals (general) 22 37 64 123

Total 416 873 724 2013


q The regionally conducted lifestyle campaign is combined with concrete information

on projects taking place close to where the target group lives. This approach

allows health awareness and information actions over the media to be

nicely integrated into concrete and tangible health promotion projects and to

initiate and activate the general public and others. It is also a way of confirming

the efforts of those carrying out projects.

1.5.3 Initial, Advanced and Continuing Education and Training

q The initial, advanced and continuing education and training measures set down

in the Three Year Program were implemented from 1999 to 2001 in the form

of approx. 150 seminars involving some 1000 participants. The FGÖ also gave

the networking of health promotion actors and structures the attention intended

in the Three Year Program in its work up to 2001. The health conferences

in 1999 and 2000 alone each attracted some 500 participants.

1.5.4 International Exchange of Information and Experience

q Another important aspect of health promotion and prevention is the international

exchange of experience. In the period under review, the FGÖ cultivated 32 different

international contacts with varying degrees of intensity throughout these

three years. International exchange efforts were much more intensive in 1999

than in 2000, only to pick up again in 2001.

1.5.5 Internet Sites

q The Internet is an excellent channel for providing information on and for activating

measures in health promotion and social marketing. The FGÖ utilizes

these capabilities with the site www.gesundesleben.at. It is fully aware that

over 50% of Austrian households now have Internet access. Its own platform at

www.fgoe.org/ serves as a tool for communication between health promotion

practitioners in Austria and abroad.

1.5.6 Model Projects

q In its promotion of model projects, the FGÖ supplements its previous promotion

and tendering activities with fully funded model projects on specific topics

and for specific target groups, which are subject to consistent quality controls

and evaluation. These endeavors can also be viewed as a learning process and as

a means of gaining new experience. Previous project promotion was not always

convincing in relation to certain target groups, methods and the quality of execution

and results.

1.5.7 Internal Project Database

q The plans to create a standard networked project database at the FGÖ Administrative

Office with access for all staff and to all project information have not

yet been realized. Project information continues to be stored at a variety of

sites in various versions. However, the organization has in the meantime awarded

a contract for the planning and designing of this database.

1.5.8 Summary

In summary it can be said that the FGÖ, with its relatively tight staffing situation, has

completed the goals and measures set down in the Three Year Program on schedule

and in the stipulated quantity with very few exceptions. These exceptions pertain to the

Internet project database, which was accessible in part when we began our evaluation

27


28

but which is now no longer functional. Considering the advantages of a database of this

kind, which are definitely worth discussing, but also the problems and especially the

costs involved, FB+E does not feel that this shortcoming is of any great consequence at

the present time.

The second, much more serious shortcoming is the lack of a standard networked project

database at the FGÖ. A contract has since been awarded for the design of this database.

Incidentally, both shortcomings can be attributed to the tight staffing situation

and the heavy workload of the Administrative Office staff.

As regards the structures and measures completed in these three years and the goals

set in the Three Year Program, the FGÖ has for the most part fulfilled its task effectively

and efficiently in terms of schedule and scope. It should be kept in mind that the described

range of measures and activities does not even include time and staff input for

important core responsibilities of the FGÖ, e.g. preparations for the meetings of the Advisory

Committee and the Board.

1.6 Evaluative Assessment of the Activities of the FGÖ

1.6.1 Project Promotion and Funding

This evaluation step was based on a precise analysis of a set of selected projects. This

analysis of 26 randomly selected projects revealed the following:

q An average of four months was taken to decide on a project. The project assessment

was quite substantive given the time involved.

q The time and efforts required for formal and administrative matters are much

greater and more diverse and, in our estimation, way out of proportion in small

and tiny projects to the allocation sums and the intended goals. This has given

many organizations carrying out projects the impression that the FGÖ is more

concerned about form than substance.

q The promotion and funding criteria were applied consistently to the rejected projects.

Most of these projects were rejected not for one reason but for several

different reasons.

q The quality of about 20% of the rejected projects left much to be desired and,

in the opinion of FB+E, several of the applications were not even assessable.

q The projects carried out were generally very well documented to well documented.

However, there were definite deficits in the evaluation, especially of project

results. Firstly, the different evaluation designs reflected a widely varying understanding

of what constituted evaluation. To the extent that results evaluation

measures were described or carried out, their design was inadequate

methodologically or statistically unsound with regard to case statistics. These

deficits were expected based on the justifiable position FGÖ had taken to the

evaluation.

q Thought must be given to ways of quickly and substantially improving evaluation

practices, particularly with regard to larger projects.

1.6.2 Initial, Advanced and Continuing Education and Training and International

Contacts

The results from the survey of health promotion practitioners were utilized to evaluate advanced

and continuing education and training and the networking activities of the FGÖ.


Sixty percent of those surveyed had taken part at least once in FGÖ events while 80%

of the experts surveyed had. All in all, there continue to be great needs for advanced

and continuing education and training and for networking.

International contacts are important in health promotion and prevention for two reasons.

First, they are a way of finding out about and picking up on developments in other

countries and of using them as benchmarks to measure progress being made in Austria

and to modify various strategies where required. Second, they are a means of making the

FGÖ and its work known beyond the borders of Austria. The FGÖ has taken appropriate

steps to build up and cultivate international contacts with varying degrees of intensity

over these three years.

1.6.3 The Lifestyle Campaign of the FGÖ

q Fully meets the scientific requirements for media intervention measures aimed

at the general populace. The goals are realistic, the programs are long-term

and the campaigns are safeguarded regionally by appropriate projects and settings.

The brochures, for their part, provide brief, concise and action-guiding

information without “moralizing” and without focusing on the negative health effects,

e.g. of obesity and lack of exercise.

q The formal design and format is good to very good.

q The content conforms to the latest scientific findings.

q The target group in the population of the middle-aged to elderly is well-founded

epidemiologically and appropriately reflected in the images in the brochures.

q The brochures are supplemented and kept up to date by a nutritional hotline and

Internet information at www.gesundesleben.at as well as by the magazine

Gesundes Österreich (Healthy Austria).

q With its nutritional hotline, the FGÖ offers yet another individual service for people

especially interested in this subject.

All in all, the media campaigns have been highly successful in terms of design and implementation.

From an evaluation standpoint, it is regrettable that no representative

exercise and nutrition data on the general population is available or was collected prior

to the start of the intervention (baseline survey). This makes it difficult to analyze the

effectiveness of the interventions and underscores the urgent need for specific epidemiological

data about the health and health behavior of the Austrian population.

1.6.4 The Internet Sites of the FGÖ

The analysis of the Internet sites of the FGÖ (www.gesundesleben.at and www.fgoe.org)

revealed the following:

q Good quality in terms of form down to the level of detailed technical points on

the www.gesundesleben.at site

q Broad and diversified information on a variety of subjects

q By and large high-quality content and science in the communicated information

q There were exceptions to the above, e.g. certain pages with less successful to

poor risk information (e.g. ultrasonic examinations as annoying noise for

fetuses).

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30

1 > Very good

2 > Good

3 > Satisfactory

4 > Pass

5 > Fail

q The homepage at www.fgoe.org diverges sharply from the image of the FGÖ

elsewhere and is urgently in need of immediate revision.

q Since its launch in May 2001, www.gesundesleben.at has been visited by over

80,000 people and this number continues to rise. Visitors view an average of 29

pages each. Considering that there are a total of three million private Internet

users in Austria, at most 3% have thus far made use of this Internet site. It

should be kept in mind that there is no reliable statistical data on subjectbased

use of the Internet. This makes it very difficult, if not impossible, to interpret

this percentage figure.

q As regards the Internet project database of the FGÖ, FB+E has concluded in sum

that revamping and updating the now technically nonfunctional database is not

really an urgent priority for the FGÖ at present. This work should wait until the

FGÖ has set up its internal database and until the organization is able to determine

the interest in this kind of costly database, e.g. as a sub-database of the

internal project database. None of the searches made in comparable databases

on health promotion were convincing in terms of the quality and depth of the

information found versus the efforts and costs of procuring it.

1.6.5 The Structure of the FGÖ

q In the estimation of FB+E, the organizational structure of the FGÖ has definitely

proven to be effective. The Advisory Committee plays a major part in this,

having served not only in an expert and assessment capacity but also as a mediator

between the Board and the Administrative Office of the FGÖ in the rare

cases in which conflicts have arisen. These rare conflicts relate as a rule to the

interfaces between social scientific and medical prevention. The change in

government was a political challenge that the FGÖ also weathered very well. In

the survey among health promotion practitioners and the representatives of the

political administration, 63% of those asked rated the overall organizational

structure of the FGÖ as very good to good and 29% as satisfactory.

Fig. 14 Assessment in the Survey of the Organizational Structure of the FGÖ (n=108)

q When asked about finances, nearly half of those surveyed (46%) said the annual

budget of the FGÖ was very good or good while 36% said it was satisfactory

and 18% said it was inadequate.

q The annual funding Austria allocates to health promotion and prevention is more

or less in line with that of Switzerland and Germany as regards outlays regulated

by law. However, no reliable data and information is available on the total

funding in this area allocated by government at the federal, state and local

level and by social insurance funds and NGOs and even businesses.


q The level of financing for project funding can be viewed as adequate in terms

of the content of funding/promotion practices thus far. FB+E’s finding of satisfactory

funding thus far was confirmed in the results of the survey, where only

18% of those asked gave the annual budget a mere “pass” to “fail”.

Fig. 13 Assessment in the Survey of the Annual Budget of the FGÖ (n=119)

q However, if extensive, Austria-wide media information campaigns on health risks

(e.g. smoking) are carried out as requested, the level of funding will have to be

reconsidered in the future, in our estimation. Campaigns of this kind are always

very costly and uncertain in terms of effectiveness. Given the current

budget, any funding of these measures would have to come at the expense of

health promotion projects. This is not what health promotion activists in Austria

want. In fact, 92% expressed the opinion that health promotion and prevention

should be aligned even more closely with the Ottawa principles. The possibility

of increasing the level of funding in the future must also be revisited

against the backdrop of the model projects and not least, against the backdrop

of the substantive recommendations in this expert opinion, e.g. that the FGÖ fully

finance evaluation measures.

1.6.6 Assessment of Attainment of Process Goals and Overall Rating of the FGÖ in

the Survey

The analyses on the attainment of process goals the FGÖ set for itself in its Three Year

Program revealed, in sum, the following:

q Quite plausibly and as might be expected, the respondents rated goal attainment

as being least at the end of these three years for long-term goals to improve

health parameters, to recognize health promotion as a responsibility of society as

a whole, and to attain general recognition for health promotion.

q Respondents also saw deficits and shortcomings in the motivational and clientoriented

work of the FGÖ as well as in networking and in initial and continuing

education and training and gave these areas lower than average scores. The

same holds true for the improvement of the epidemiological data situation by the

FGÖ and the effective use of the Internet database.

q High above-average scores were awarded in the assessment of goal attainment

in the following areas, among others: qualifications of Administrative Office staff

and the management, involvement in international developments and support of

new forms of communication.

All in all, the FGÖ was given a high and good score for goal attainment.

Those surveyed felt that the work of the FGÖ had already brought about a definite improvement

in practical health promotion in Austria with only a few exceptions (e.g. exchange

between scientists and practitioners, level of evaluation budget, sustainability).

1 > Very good

2 > Good

3 > Satisfactory

4 > Pass

5 > Fail

31


32

1.76 1.83

2.01 2.02

2.12 2.14 2.16 2.19

Init./cont. ed/eval.

Init./cont. ed/HP

Project prom. criteria

Project prom. possibilities

Exchange/practitioners

Exchange scient./pract.

Web info

Documentation

Eval. personnel

Budget for eval.

Evaluation

Quality

Term/sustainability

Financing

Coordination/networking

Project/quant.

2.20 2.21 2.23 2.25 2.25 2.29

Quality of personnel

Quality of management

Professional organization

Supports continuing education and training

Operates project databasek

Sustainability (mixed financing)

Scientific projects acknowledged in field

Supports new forms of communication

Scientific projects stress implementation

Promotes acknowledgement of HP

Involved in international developments

Ensures high quality of HP

Average value

Recognized institution

New forms of communication

2.60

2.36 2.36 2.36 2.36 2.37 2.37 2.40 2.43 2.45 2.47 2.48

Promotes interaction/cooperation

Client-oriented in work

Long-term improvement of all parameters

Known institution

Networking of individuals active in HP

Promotes acknowledgement of HP as societal task

Motivates individuals active in HP

Database effectively used/updated

Promotes strengthening of HP as societal task

Strengt. imp. of GP in init./advanc. ed/train.

Improvem. of epidemiol. knowledge

Fig. 16 Rating in the Survey of Attainment of Process Goals (Grades) (n=134) (Average Value:

2.25, Standard Deviation 0.20)

Mean values in the scales: 1 = Agree wholeheartedly 2= Agree 3= Undecided 4= Tend to disagree

5= Completely disagree

Fig. 17 Assessment in the Survey of Improvements in Health Promotion in Austria Since the

Enactment of the Health Promotion Act and Since the FGÖ Started its Work (Much Improved/Improved)

(n=136)

59%

61%

62%

68%

73%

73%

74%

76%

77%

81%

82%

82%

85%

83%

86%

89%


1.8 1.83

1. Quantity and diversity of projects

1.6.7 Assessments of the FGÖ in the Open-ended Interviews

In the open-ended/in-depth interviews the following positions and evaluations of the FGÖ

and its work are expressed in a more condensed form:

Positive comments

q Effective and efficient project funding and promotion

q Structures put into place in health promotion

q High degree of professionalism

q FGÖ as a “good brand”

q Good or still adequate funding

Criticical comments

1.85 1.87 1.98 2.01 2.02 2.03 2.03 2.04

9. Documentation

13. Possibilities of project promotion/funding

15. Initial and continuing ed/training in HP

10. Possibilities for web information

q Too much bureaucracy/too many formalities

q Principle of only proportional (mixed) project financing

q Insufficient scope and quality in evaluation, particularly of results

q Promotion/funding for small and tiny projects

q Insufficient involvement in regional activities and discussions concerning health

promotion

q Overly medical orientation at times

q Insufficient staff resources

3. Funding

14. Criteria of project promotion/funding

8. Involving experts in evaluation

Average value

5. Quality and quality assurance

2.07 2.10 2.11

2. Networking

16. Initial/continuing ed &

training in evaluation

12. Exchange/practitioners

6. Evaluation

Fig. 18 Situation Since FGÖ Began its Work

All Respondents n=144 (Average Value: 2.04; Standard Deviation: 0.16)

Mean values in the scales: 1 = Agree wholeheartedly 2= Agree 3= Undecided 4= Tend to disagree

5= Completely disagree

2.2 2.25 2.25 2.32

4. Sustainability

11. Exchange/scientists and

practitioners

7. Size of evaluation budget

33


34

Recommendations

q The FGÖ must restructure its work to move from being a “money distribution

institution to being an expertise network.”

q “The strategy being pursued by the FGÖ must be made more apparent.”

q “The approach the FGÖ takes to health promotion must be expressed more clearly

and more transparently.”

q The FGÖ should orient its work more to the recommendations made in Ottawa,

Mexico and Jakarta.

1.6.8 International Comparisons

q It is impossible to compare different countries (e.g. Austria with Germany,

Switzerland) in terms of the quantity and quality of health promotion they carry

out and in terms of the substantive thrust of the health promotion projects being

carried out. This kind of overview information is simply not available. Likewise,

there is no current, reliable information in Austria right now on FGÖ projects.

q In a comparison of the legal basis for improving health promotion practices in

Austria and in Germany (the Health Promotion Act versus §20 Social Security

Code V (SGB V)) Austria emerges as having done a much better job implementing

the law with quite comparable levels of funding per insured and per

inhabitant. Germany did not fare as well primarily because implementation

conditions at regional level are not clarified sufficiently in §20 SGB V, and certain

health insurance funds have been quite hesitant about strengthening health

promotion and prevention measures. Another contributing factor was the joint

development and stipulation of guidelines for project execution and evaluation.

q All in all, the FGÖ has emerged as a role model, a fact underscored by discussions

in Germany right now about setting up a similar fund for health promotion

and prevention.

1.6.9 Summary Assessment

The overall assessment of the work of the FGÖ reveals the following:

q Results evaluation practices are unsatisfactory in project promotion/funding

given the current methods used in the evaluation of measures, particularly

health promotion measures, and due to the position FGÖ has taken to evaluation,

a position that was quite reasonable in 1998. Improvement is needed, especially

with regard to major projects. It should also be noted, however, that

the evaluation standards achieved in health promotion and prevention in Austria

are probably not worse than those in other countries.

q Project assistance and care practices must also be improved by increasing their

client orientation.

q The intensive measures in advanced and continuing education and training

and in networking are widely used by people active in the health promotion

field but must be carefully maintained.

q Most of the media campaigns and the Internet sites (www.gesundesleben.at) and

individual media and pages are, with only very few exceptions, of excellent

quality in terms of content and form and accord with the latest scientific find-


ings. The high-run print media in particular have reached large numbers of

people in Austria. The number of Internet users is difficult to determine given

the lack of reliable data on subject-related use of the Internet.

q Further necessary developments in health promotion are being recognized and

quickly implemented in the model projects started by the FGÖ in 2002.

q The homepage of the FGÖ on the Internet (www.fgoe/org) contrasts sharply

with its image elsewhere and should be improved as quickly as possible.

q The nonfunctional Internet project database is not a priority in the opinion of

FB+E and requires further conceptual work.

q A contract has now been awarded for the creation of a standard, internal networked

project database, a top priority project.

q Respondents in the quantitative and open-ended surveys greatly appreciated the

work of the FGÖ, as indicated by the total average grade of 1.9 they gave to the

FGÖ.

q The FGÖ has in the meantime become a role model in health promotion, as

shown for example by the current discussion in Germany about setting up a

similar fund.

q The very good to excellent work of the FGÖ overall is done with a staff that urgently

requires enlargement.

q Respondents in the quantitative and in-depth surveys expressed the wish for the

efficient further development of the FGÖ and health promotion and prevention

in Austria in line with the declarations made in Ottawa, Mexico and Jakarta.

Total

Friendly

Prompt handling of questions,

requests, etc

Fast, easy to reach

Professionally correct

and competent

Fig. 19 Grade Assigned to the FGÖ in the Survey (n=109) (Average Grades)

Mean values in the scales: 1 = Agree wholeheartedly 2= Agree 3= Undecided 4= Tend to disagree

5= Completely disagree

1.4

1.7

1.7

1.9

2.5

35


36

2 Conclusions

q The FGÖ has implemented and fulfilled its legal mandate and the measures set

down in the Three Year Program virtually completely and comprehensively. The

few exceptions to this pertain to the Internet project database and the internal

project database and the FGÖ homepage. There are serious shortcomings in

these areas which are currently being worked on or revised. The shortcomings are

attributable solely to the tight staff situation and the constant heavy workload

facing the staff of the FGÖ Administrative Office.

q In the opinion of the evaluation team and the survey respondents, in its work the

FGÖ has succeeded in largely reaching most of the process goals it defined for

itself. This opinion is clearly expressed in the overall average “grade” of 1.9

awarded to the work of the FGÖ. This rating is exceptionally high compared to

that awarded other institutions in evaluation studies. The FGÖ has gained attention

and recognition far beyond the borders of Austria, a fact reflected not

least in the current health policy discussion, e.g. in Germany, where the FGÖ has

been cited as a positive role model for what is seen as a necessary restructuring

of the health promotion and prevention field.


3 Recommendations

The main goal of evaluation besides assessing and evaluating programs is to deduce suggestions

and recommendations on how to further improve these programs from the results

and findings obtained. Understood and done correctly, an evaluation is primarily

a problem-oriented tool for further development rather than a monitoring check.

Recommendations should be very concrete to enable efficient and prompt implementation.

We have therefore decided to present these recommendations in detail in this

summary.

The results and findings arrived at with the different evaluation methods and the recommendations

based upon them for the future activities of the FGÖ will first be presented

separately below, primarily to indicate the mutual agreement between the recommendations

from different perspectives. They are therefore divided into individual

chapters. Chapter 8.3.1 contains recommendations from the evaluation team’s standpoint

while Chapter 8.3.2 features recommendations based on the open-ended interviews

and Chapter 8.3.3 presents recommendations drawn from the questionnaire results.

As might expected, the recommendations often overlap. This underscores the solidity of

both the findings and the recommendations.

3.1 Recommendations from FB+E Based on the Evaluation

1. Improve evaluation practices in promoted projects exceeding a certain project

sum yet to be stipulated.

The position the FGÖ took to evaluation in project promotion/funding was quite

appropriate for the initial phase of health promotion. However, it must now

strengthen and substantially improve its evaluation practices, especially with regard

to results evaluation. This task will entail a wide-ranging set of measures:

1.1 A distinction must also be made linguistically between documentation (initial

evaluation) and evaluation (more extensive and external evaluation).

1.2 Commitment to the evaluation of structures, processes, products and results

for projects exceeding a certain fixed project sum

1.3 Creation of an appropriate infrastructure (guidelines, guiding principles, consulting

competence), compare also www.quint-essenz.ch, for example

1.4 Development of scientific consulting, assessment and execution structures for

evaluation, to be oriented initially to corresponding institutions in the Germanspeaking

region given the tight staff situation

1.5 Full FGÖ financing of evaluation/participation by evaluation researchers as early

as the project planning phase

1.6 Design of an assessment procedure for the proposed evaluation designs compatible

with the current project review routines

2 Project structures (small and tiny projects) (e.g. < EUR 10,000)

FB+E sees little sense in centrally assessing and monitoring small and tiny

projects carried out at regional level. The staff and time input is way out of proportion

to the intentions. The suggestions of FB+E are as follows:

37


38

2.1 Reduce the number of these projects or delegate these responsibilities to the

federal provinces or to organizations represented there.

22 If responsibility for these projects is retained, thought must be given on how they

can be administratively processed and implemented in a way that is simpler

but also legally permissible (e.g. reviews in a random sampling procedure).

3 Staff

The small size of the staff is the main reason for the (small number of) negative

findings in the evaluation. This shortcoming must be remedied quickly and

efficiently.

3.1 An increase in the number of personnel at the FGÖ is urgently required.

3.2 The FGÖ health specialists must receive training and further instruction in

project evaluation.

3.3 Work must be geared more to clients.

4 Internal project database

A contract has already been awarded for the design of this database. Different

aspects of this design are being checked once again in a pretest and will be

optimized if required. They include:

4.1 Standardized recording of the major project contents by the applicant (enlargement

of the project applications)/creation of a short questionnaire

4.2 In case of rejection: Recording and documentation of more than one reason for

the rejection

4.3 Possibilities for cumulative statistical analysis

4.4 Resubmission functions

5 Internet project database on projects

5.1 The most sensible approach would be to wait with this Internet database until

the internal project database is up and functioning. (It could then be a sub-database

of the internal database.)

5.2 FB+E does not consider the Internet database a priority, as its benefits are disputed

and must be clarified (the continuous updating that would be necessary

would be very costly).

5.3 Interest and potential use by health promotion practitioners must be clarified beforehand

(secondary statistical analyses/if need be, separate study).

6 Epidemiological/evaluative data must be carefully improved for the later evaluation

of the priority activities and media interventions of the FGÖ.

6.1 Secondary statistical research, analyses and evaluation of data on nutrition and

exercise for the Austrian population prior to 1998 for possible use as baseline

surveys (e.g. EU survey)

6.2 Create survey methods (random samples, methods, instruments).


6.3 Monitor changes in knowledge and reported behavior with a short questionnaire

to be created in connection with representative surveys of the Austrian population.

6.4 Set priorities as regards the epidemiological knowledge required, also for planning

health promotion and prevention measures and for carrying out the corresponding

studies.

6.5 Build up a knowledge base as a theoretical foundation for health promotion

measures (documentation and evaluation of intervention measures and the theoretical

approaches underlying them from the evaluation designs).

6.6 Plan and conduct an Austrian social epidemiological health survey.

7 Further media campaigns (especially one on smoking)

7.1 Have experts conduct assessments on the unclear effectiveness and efficiency

of this measure with special emphasis on a campaign carried out in Vorarlberg

in 1998. (FB+E was told that a youth research institute evaluated this campaign

at that time).

7.2 Carry out only if projects are financed with extra funding above and beyond the

current budget.

7.3 Integrate these campaigns wherever possible in other regional activities with

complementary subjects.

8 Sustainability/maintenance of projects/project documentation

8.1 Improve documentation of what happens to funded projects after FGÖ funding

ends.

8.2 Possibly continue “compelling projects”, also in other regions where applicable.

8.3 Further improve the quality of project monitoring and documentation in general.

9 Internet sites of the FGÖ

9.1 Take immediate steps to improve the fgoe.org site, both technically and in terms

of content.

9.2 Commission a study to be done on the use of health sites on the Internet in

Austria with an emphasis on www.gesundesleben.at.

10 Launch phase two of health promotion in Austria

10.1 Center of competence in health promotion with an even stronger orientation

and guidance role

10.2 Politically safeguard the policy assessment process, also with the help of the Advisory

Committee and the Board; coordinate and merge discussions and developments

in health promotion, health reporting and health goals.

11 Clarify and possibly delineate fields of action for health promotion/social scientific

prevention/medical prevention/secondary prevention and health information

39


40

11.1 Delineate even more clearly the powers and responsibilities and the funding arrangements

between federal government, states, local government, and social

insurance funds also taking into account the ASVG regulations from 1992.

12 Retain priority activities and the topical media campaigns for the next three

years.

13 Prepare instruments for the results evaluation in 2005 (compare 61-66)

3.2 Recommendations from the Open-ended Interviews

1 Proportional (mixed) financing

1.1 Review the possibility of approaching this criterion more flexibly.

2 Reduce bureaucratic and administrative work/strengthen client orientation

2.1 Put a stop to FGÖ’s promotion of small and tiny projects.

2.2 Delegate responsibility for smaller projects to the federal provinces and the

institutions there.

2.3 Set priority issues/do not get lost in details/maintain the strategies.

3 Improve evaluation practices and documentation practices.

3.1 Draw a clear distinction between documentation and evaluation.

3.2 Compulsory guidelines

3.3 100% funding of evaluation by the FGÖ

4 Strengthen regional involvement.

4.1 Increase communications with the political federal and state administrations

and their institutions.

4.2 Cooperate in drawing up health goals (for health promotion and prevention) in

Austria and in the federal provinces.

4.3 Outsource tasks where required to involve partners.

5 Enlarge the staff.

6 Substantially increase the budget, especially if anti-smoking media campaigns

are to be carried out.

7 Drop the idea of the Internet project database.

8 Refrain from SIGIS activities at the FGÖ.

8.1 Have an assessment made to clarify an alternative institutional connection as

well as the financing and/or have the Board deal with this issue.

9 Precisely define the areas of responsibilities between the following: health promotion/prevention/prevention

and health information between the social insurance

funds and the federal, state and local governments.


10 Update the positioning of the FGÖ.

10.1 Center of competence with orientation/guidance function

10.2 Make strategy even clearer and more visible.

10.3 Place more emphasis on results evaluation and develop and use instruments appropriate

for this evaluation.

11 Precisely define what scientists in the health field should contribute to the

work of the FGÖ.

11.1 Take stock of the epidemiological data situation in Austria (national/regional)/set

priorities

(continue in a focused manner and in even greater depth the project “Health

Data in Austria” Proj.No.5/1998/1999 (Rásky, E.) and Association of Healthy

Cities in Austria (Verein Gesunde Städte Österreichs), Lüftenegger, P. (coordination):

Municipal Health Reporting, 31 March 2000

11.2 Carry out corresponding measures or commission others to carry them out

3.3 Criticisms/Recommendations from the Quantitative Survey

1 Criticized promotion criteria:

1.1 No Austria-wide projects

1.2 Proportional (mixed) financing

1.3 No promotion of projects involving only a traditional concept of health

2 Further strengthen orientation to Ottawa principles

3 Criticism of bureaucratic administrative work involved and the lack of client

orientation at FGÖ in certain instances

3.4 Summary

The recommendations confirm the findings on the work of the FGÖ, which was determined

to be very good to good overall. They also express the necessity of and the interest

in having the FGÖ further develop health promotion and prevention in Austria in a

consistent and focused manner by continuing and further developing its own program.

To achieve all this, the organization must do the following:

q Retain its basic strategic goals and measures over the next three years.

q Enlarge the FGÖ Administrative Office staff and increase financial resources.

q Remedy with all due speed the few shortcomings that were detected. A top priority

here is to improve evaluation research practices (especially in results evaluation).

With these further developments, the FGÖ will undoubtedly become one of the showcase

projects internationally in health promotion and prevention in the years ahead.

41


42

In this evaluation, FB+E sought to determine how well the FGÖ has carried out its program

and responsibilities. In an evaluation of this kind, success depends heavily on the

willingness of the institution’s staff to take an active part in the evaluation. The FGÖ staff

was outstanding in this regard, even agreeing to be interviewed outside regular working

hours. We would like to thank them once again at this juncture for their cooperation. The

organization and its staff were very open to the evaluation and displayed a keen interest

in it throughout the process. These attitudes confirm the professionalism with which

the FGÖ and its staff carries out their responsibilities and reflect the healthy and justified

self-confidence they feel about what they have accomplished thus far.


Annexes

43


Our institute was commissioned to evaluate the activities of the FGÖ. The evaluation

findings will, inter alia, be incorporated in designing and planning further annual work

programs. This questionnaire is just one example of the various instruments and methods

we use in evaluation, but it is definitely an important one. Based on a random-sample

study, we wish to assess the situation of health promotion in the Republic of Austria from

the viewpoint of those contracted to carry out projects and others active in health promotion,

experts and scientists and not least, policy makers in the health sector.

The project contractors’ addresses were drawn randomly from the FGÖ address file. The

other addresses were selected in a snowball sampling procedure.

We kindly ask you to fill out the questionnaire. It contains 18 questions. You will need an

average of 20 to 30 minutes to complete your response. Participation in this study is

naturally voluntary. By taking part, you help to improve health promotion and prevention

in Austria and have a chance to voice your opinions of the current situation. Complete

anonymity is guaranteed in our evaluation for all data you provide. In the keeping

and processing of data, our institute complies with the provisions of the German Federal

Data Protection Act (DPR-No.: 506 at Berliner Beauftragten für Datenschutz and

Informationsfreiheit (Berlin Commissioner for Data Protection and Freedom of Information)).

We also kindly ask that you not remove the code number label printed on the

questionnaire. Otherwise, we will have to write to you again in any follow-ups. We thank

you in advance for participating in this study.

Incidentally, you can also receive and return the questionnaire by e-mail. Please send

your request to: renate.kirschner@forschung-beratung-evaluation.de. If you have any

questions about the questionnaire, please feel free to contact us. If you do not send back

the questionnaire by e-mail, please return it by regular mail or by fax to our institute. To

ensure the complete transmission of the questionnaire for respondents returning it by

fax, the questionnaire has not been printed on both sides and only one staple has been

used. We hope you understand our reasoning here.

Forschung Beratung + Evaluation

Postfach 100335

D-10563 Berlin, Germany

Phone: 0049/30/450578022

Fax: 0049/30/450578922

E-mail: renate.kirschner@forschung-beratung-evaluation.de

FB + E

Forschung Beratung + Evaluation GmbH

Berlin

45


Annex 1

Questionnaire for assessing the situation of health promotion in the Republic of Austria

in conjunction with an evaluation of the activities of the Fonds Gesundes Österreich

(Fund for a Healthy Austria) based on the Austrian Health Promotion Act of 1998

(Federal Law Gazette No. 5/1998)

47


1. This question contains general statements about health promotion and prevention. Please indicate your degree of

agreement or disagreement with each using the grading scale below. If you cannot rate a given statement, simply

put an X in the “0” box.

48

1 = Agree completely 4= Tend to disagree

2= Agree 5= Disagree completely

3= Undecided 0= No response

The successful fight against infectious diseases in the 20th 1 2 3 4 5 0

century was waged primarily with medical and preventive

measures aimed at the general public.

Up to the mid-1980s prevention mainly entailed general

preventive medicine (primarily secondary prevention).

Primary prevention (except vaccinations) consisted mainly

of measures to prevent behavior related to risk factors.

It was not until the Ottawa Charter in 1986 that relational

measures also increased (e.g. approaches involving settings)

Prevention and health promotion should be oriented even more

strongly towards the Ottawa principles.

The health of the general public can be improved in the medium

and long term through health promotion and prevention.

Health promotion and prevention can reduce costs in the health

care system in the medium and long term.

The available stock of epidemiological data must be substantially

improved in order to carry out efficient, needs-based measures in

health promotion and in prevention.

Measures to promote health should be carried out more on

the basis of health reports and the health objectives arising

from those reports.

Measures for health promotion and for prevention

must be effective and economical.

The structures, products and processes of health promotion and

prevention measures should be subject to constant evaluation.

Health promotion and prevention measures

should be evaluated in terms of their results.

The current practices for evaluating measures for health

promotion and prevention are still in great need of improvement.

Initial and advanced training in project evaluation must

be strengthened.

Measures related to risk factors are easier to evaluate than

salutogenic health promotion measures (holistic approach).


2. This question contains several statements about the situation of health promotion in Austria prior to the Health

Promotion Act and prior to the existence of the new FGÖ, i.e. up to 1998. Once again, please indicate your

degree of agreement or disagreement with each statement using the grading scale below. If you cannot rate a

given statement, put an X in the “0” box.

1 = Agree fully 4= Tend to disagree

2= Agree 5= Disagree completely

3= Undecided 0= No response

A number of institutions were already engaged in the early

and mid-1990s in practical health promotion and prevention

(physicians, ÖGD, associations, networks, work groups, 1 2 3 4 5 0

health insurance funds, WHO projects, businesses,

media, etc.)(quantity and diversity of projects).

The measures and offerings were rarely coordinated or networked.

The measures and offerings were often inadequately funded.

The measures and offerings were often very limited in time.

The measures and offerings often had shortcomings in terms

of quality control.

The measures and offerings were often inadequately evaluated.

The budgets for evaluation were often too small.

Evaluation experts were often not involved in planning the projects

and measures.

The measures and offerings were often insufficiently documented.

Before the Internet became widely used, it was difficult to obtain an overview

of the measures and services on offer in this sector (web information).

There was too little exchange of information between scientists

and practitioners.

There was too little exchange of information and ideas among

practitioners in the field of health promotion.

It was not easy to find institutions prepared to promote projects and measures.

In many cases, the criteria for project promotion were unknown.

There were too few opportunities for initial and advanced training:

a) in health promotion

b) in evaluation

3. Please use the grading scale below to rate the provisions of the Health Promotion Act.

Very good Pass

Good Fail

Satisfactory Don’t know

Please explain your rating.________________________________________________________

49


4. Please use the grading scale below to rate the move authorizing the FGÖ to be the organization that implements the law.

Very good Pass

Good Fail

Satisfactory Don’t know

Please explain your rating.__________________________________________________________________________

5. Please use the grading scale below to rate the organizational structure of the FGÖ (Administrative Office, Advisory

Committee, Board).

Very good Pass

Good Fail

Satisfactory Don’t know

Please explain your rating.__________________________________________________________________________

6. Please use the grading scale below to rate the annual FGÖ budget, which is currently ATS 100 million.

Very good Pass

Good Fail

Satisfactory Don’t know

Please explain your rating.__________________________________________________________________________

7. For individual projects to be promoted, they must meet criteria formulated and published by the FGÖ. Please let

us know, first of all, if you feel

a) the various criteria are completely/more or less correct or completely/more or less wrong.

1= Completely correct 3= More or less wrong 0= No response

2= More or less correct 4= Completely wrong

a) Rating of the criteria

1. Projects advocating a traditional concept of health based strictly

on physical health shall not be promoted.

2. Projects dealing only peripherally with health shall not be promoted.

3. Nationwide, all-encompassing projects shall not be promoted.

4. Sustainability shall be achieved through proportional funding.

5. The emphasis shall be on indicators: state of health, healthy behavior,

internal and external resources or resource deficits.

6. Sufficient evidence for successful project execution

7. Applicants must have experience and expertise in

health promotion and in prevention.

8. The emphasis shall be on clear, largely consensual and

high-priority requirements and issues.

9. Changing of processes, structures or environmental parameters

10. Bringing about a lasting behavioral change conducive to health

11. Acceptance of the project by the target group

12. Acceptance and support of the program by expert

50

1 2 3 4 5 0


7b) If you rated one or more criteria in Question 7a) as completely wrong or as more or less wrong please indicate your

reason or reasons for doing so.

Criterion No. Reason or Reasons

1

2

3

4

5

6

7

8

9

10

11

12

7c) Please tell us which criteria you feel are important/rather important and unimportant/rather unimportant?

When doing so, divide the criteria into four categories: very important, rather important, rather unimportant and

not at all important.

Classification of the criteria according to importance

Please enter the criteria numbers from Question 7a) in the corresponding boxes.

Criteria: Very important Rather Important Rather unimportant Not at all important

8. Please indicate the importance you ascribe to the primary goals listed below for health promotion and prevention

from the Health Promotion Act.

1= Very important 2= Important 3= OK

4= Less important 5= Unimportant/dispensable 0= No response

To develop efficient methods of health promotion in cooperation with

the main players in the field.

To create added value in health promotion in terms of quantity

and quality.

To increase the public’s knowledge about health.

To have the public show greater health awareness in its behavior.

To improve the state of health of the general population.

To introduce, encourage and promote a process

1 2 3 4 5 0

51


9a) This question lists perspectives regarding actions and goals that the FGÖ has set for itself.*

First of all, please indicate how important you think the various perspectives are.

1= Very important

2= Important

3= OK

4= Less important

5= Unimportant/dispensable

If you are unable to indicate a rating, please write “0”.

9b) Then apply the grading scale below to each goal and behavioral area to indicate the degree to which you feel

these perspectives have been implemented thus far. When rating the degree of goal attainment, keep in mind

that some goals are achievable in the short term, some in the medium term and some only in the long term.

52

1= Very good

2= Good

3 = Satisfactory

4 = Pass

5 = Fail

If you are unable to indicate a rating, please write 0. a) b)

Importance Implementation

a) The FGÖ is a known institution in the field of

health promotion and prevention.

b) The FGÖ is a recognized institution in the field of

health promotion and prevention.

c) The FGÖ promotes the attitude that health promotion be acknowledged

as a responsibility of society as a whole.

d) The FGÖ promotes the strengthening of health promotion

as a responsibility of society as a whole.

e) The FGÖ promotes the attitude that health promotion be acknowledged in

many key areas of life (at school, at work, in cities, in municipalities).

f) The FGÖ seeks to attain sustainability by adopting defined forms

of project financing (mixed funding and continuation of projects

after the initial project period is over).

g) In its work, the FGÖ seeks to bring about

long-term improvements in definable health parameters

(e.g. food, exercise, stress).

h) The FGÖ strengthens the importance of health promotion in initial

and advanced training for pertinent occupations.

i) The FGÖ ensures a high level of quality in health promotion

and prevention.

k) The FGÖ promotes interaction and cooperation between

persons and institutions.

l) The FGÖ is involved in the development of health promotion and

prevention at international and European level.

m) The scientific projects commissioned by the FGÖ are

well-recognized in the health field.


n) The scientific projects are implementation oriented.

o) The FGÖ helps to forge stronger networks among those active

in the field of health promotion and prevention.

p) The FGÖ supports the continuing education of people active in

the field of health promotion.

q) Through its work, the FGÖ brings about improvements in

the epidemiological knowledge available for efficient, evidence-based

health promotion and prevention.

r) Through its work, the FGÖ encourages the use of new and

innovative forms of communication (Internet).

s) The FGÖ supports new and innovative forms of communication.

t) The FGÖ has a professional organizational structure.

u) The FGÖ takes a client-oriented approach to its work.

v) The FGÖ operates a database on health promotion.

w) The database is used effectively and is updated continuously.

x) The FGÖ motivates those active in health promotion and prevention.

y) The FGÖ has a qualified staff.

z) The FGÖ has a qualified management.

9c) If you gave certain items in Question 9b a rating of 4 or 5, please explain

briefly your reasons for doing so:

Field of action

Please indicate letter

Reason/Reasons _________________________________________________________

_________________________________________________________________________

Reason/Reasons _________________________________________________________

_________________________________________________________________________

Reason/Reasons _________________________________________________________

_________________________________________________________________________

Reason/Reasons _________________________________________________________

_________________________________________________________________________

53


10. From the goal and action areas named in Question 9, please indicate three areas:

a) You personally feel are most important.

b) In which you believe the most progress has been made in achieving the task.

c) In which you feel more work has to be done.

Three goal and action areas

Please indicate the letters from Question 9.

a) Most important to you personally

b) Most progress in achieving task

c) More has to be done

1. 2. 3.

11. Please tell us the areas in which you feel the situation of health promotion has changed since the Health Promotion

Act was enacted and the work of the Fonds Gesundes Österreich began. If you are unable to give a rating,

simply put an X in the “0” column.

54

1= Much improved 4= Somewhat worse than before

2= Improved 5= Definitely worse than before

3= Unchanged 0 = No response

Quantity and diversity of projects

Coordination or networking of the measures and offerings

Funding of measures and offerings

Duration of measures and offerings (sustainability)

Quality and quality control of measures and offerings

Evaluation of measures and offerings

Amount earmarked for evaluation budget

Involvement of evaluation experts in the

planning of projects and measures

Documentation of measures and offerings

Possibilities for obtaining web info on health promotion

Exchange of ideas/information between scientists and practitioners

Exchange of ideas/information among health promotion practitioners

Possibilities for project promotion/funding

Criteria for project promotion/funding

Initial and advanced training in health promotion

Initial and advanced training in evaluation

1 2 3 4 5 0


12. Are there goal areas or issues/target groups for which you see a special need for action in health promotion and

prevention that has not yet been addressed?

Goal area/Issues Target groups

Yes Please specify: _________________________________

No _________________________________ _______________________________

13. What institution or organization do you work for/are you active in? (multiple responses are possible)

Health administration (Federal) 1 Kindergarten 18

Health administration (Land) 2 Social services administration (Federal) 19

Health administration (local/city) 3 Social services administration (Land) 20

Health, accident, pension insurance 4 Social services adm. (local/city) 21

Federation/national federation 5 Social insurance 22

Medical society 6 Social counseling/social services office 23

Healthy Hospital Network 7 Environmental administration (Federal) 24

Healthy Cities Network 8 Environmental administration (Land) 25

Healthy Communities Network 9 Environmental administration (local/city) 26

Healthy Schools Network 10 Enterprise, business 27

Association, club, NPO 11 Research institution, public 28

Self-help group 12 Research institution, private 29

Medical practice, out-patient clinic 13 Chamber 30

Health counseling 14 Political party 31

Hospital 15 Other administrative body 32

University 16 Other, please specify: 33

School 17 ______________________________

14. a) Has your institution submitted one or more project applications to the FGÖ since 1998?

Yes, one application

Yes, several applications

No Please skip to Question 15

b) How many of your applications have been approved so far?

None of the applications

One application

Several applications

15. Have you or staff members from your institution participated once or several times in any of the following FGÖ

events? (multiple responses are possible)

Yes (please specify): No

Educational Network

Health Promotion Conference

Prevention Conference

Other events or offerings I don’t know

55


16. How often have you had dealings with the FGÖ over the past three years?

Very often

Often

Occasionally

Rarely

Never

17. The FGÖ is a service organization. Please use the grading scale below to rate the work of the FGÖ according to the

following criteria.

1= Very good

2= Good

3 = Satisfactory

4 = Pass

5 = Fail

0 = Unable to respond

Professionally correct and competent

Fast, easy to reach

Prompt handling of questions, requests, etc.

Friendly

Overall rating:

And now please rate the OVERALL work of the FGÖ according to the above grading scale

(decimal point ratings can be given).

18. Which of the statements below best expresses your opinion of the situation of health promotion in Austria versus the

situation of health promotion in other European countries?

Austria is among the leaders Austria is below average

Austria is in the upper middle range Cannot judge

Austria is only average

Please feel free to use the space below for further input and/or critical remarks:

_________________________________________________________________________________________________________

_________________________________________________________________________________________________________

_________________________________________________________________________________________________________

_________________________________________________________________________________________________________

56

Please skip to Q. 18


Annex 2

EVALUATIONS OF THE QUANTITATIVE ANALYSES

57


Respondent is from random sample:

All Respondents All Except Grant DB Conference DB Experts

Experts

n= 144 101 53 48 43

Experts 43 0 0 0 43

Grant database 53 53 53 0 0

Conference database 48 48 0 48 0

Total 144 101 53 48 43

Q. 1: General statements about health promotion and

prevention. Scale 1= agree completely

to 5= disagree completely

The successful fight against infectious diseases in the

20th century was waged primarily with medical and

preventive measures aimed at the general public.

Average value 1.80 1.85 1.85 1.85 1.69

Standard deviation 0.76 0.74 0.63 0.86 0.78

Up to the mid-1980s prevention mainly entailed

general preventive medicine

(primarily secondary prevention).

Average value 1.75 1.87 1.87 1.87 1.46

Standard deviation 0.76 0.80 0.79 0.81 0.60

Primary prevention (except vaccinations) consisted

mainly of measures to prevent behavior related to risk

factors.

Average value 1.79 1.85 1.88 1.82 1.64

Standard deviation 0.77 0.75 0.78 0.72 0.79

It was not until the Ottawa Charter in 1986 that

relational measures also increased

(e.g. approaches involving settings).

Average value 1.83 1.93 1.98 1.87 1.63

Standard deviation 0.77 0.75 0.79 0.70 0.77

Prevention and health promotion should be oriented

even more strongly towards the Ottawa principles.

Average value 1.43 1.47 1.47 1.47 1.37

Standard deviation 0.64 0.64 0.67 0.61 0.66

The health of the general public can be improved in

the medium and long term through health promotion

and prevention.

Average value 1.36 1.31 1.23 1.40 1.47

Standard deviation 0.55 0.51 0.47 0.54 0.63

Health promotion and prevention can reduce costs

in the health care system in the medium and long term.

Average value 1.74 1.41 1.32 1.51 2.51

Standard deviation 0.97 0.65 0.64 0.66 1.14

The available stock of epidemiological data must be

substantially improved in order to carry out efficient.

needs-based measures in health promotion and

in prevention.

Average value 1.84 1.75 1.65 1.86 2.05

Standard deviation 0.87 0.79 0.79 0.77 1.02

Measures to promote health should be carried out

more on the basis of health reports and the health

objectives arising from those reports.

Average value 1.87 1.86 1.73 2.00 1.88

Standard deviation 0.84 0.83 0.79 0.86 0.85

59


All Respondents All Except Grant DB Conference DB Experts

Experts

n= 144 101 53 48 43

Measures for health promotion and for prevention

must be effective and economical.

Average value 1.78 1.80 1.77 1.83 1.74

Standard deviation 0.87 0.92 0.87 0.99 0.76

The structures, products and processes of health

promotion and prevention measures should be subject

to constant evaluation.

Average value 1.61 1.61 1.68 1.53 1.60

Standard deviation 0.74 0.74 0.80 0.65 0.76

Health promotion and prevention measures

should be evaluated in terms of their results.

Average value 1.68 1.58 1.58 1.57 1.93

Standard deviation 0.79 0.74 0.77 0.72 0.86

The current practices for evaluating measures for health

promotion and prevention are still in great need of

improvement.

Average value 1.94 1.94 2.12 1.73 1.95

Standard deviation 0.83 0.83 0.96 0.59 0.85

Initial and advanced training in project evaluation must

be strengthened.

Average value 1.83 1.81 1.88 1.73 1.88

Standard deviation 0.83 0.85 0.91 0.78 0.79

Measures related to risk factors are easier to evaluate than

salutogenic health promotion measures (holistic approach).

Average value 1.93 2.02 2.02 2.02 1.73

Standard deviation 0.87 0.89 0.91 0.88 0.81

Q. 2: Statements about the situation of health

promotion in Austria prior to the Health Promotion Act.

Scale 1= agree completely to 5= disagree completely

A number of institutions were already engaged in the

early and mid-1990s in practical health promotion and

prevention (quantity and diversity of projects).

Average value 2.16 2.16 2.24 2.08 2.14

Standard deviation 0.88 0.85 0.99 0.66 0.96

The measures and offerings were rarely

coordinated or networked.

Average value 1.81 1.82 1.92 1.71 1.80

Standard deviation 0.78 0.73 0.79 0.66 0.90

The measures and offerings were often inadequately funded.

Average value 1.80 1.76 1.68 1.86 1.88

Standard deviation 0.86 0.84 0.81 0.87 0.91

The measures and offerings were often very limited in time.

Average value 2.05 2.04 2.00 2.08 2.08

Standard deviation 0.85 0.83 0.80 0.87 0.91

The measures and offerings often had shortcomings

in terms of quality control.

Average value 2.04 2.08 2.16 2.00 1.97

Standard deviation 0.97 0.97 1.05 0.88 0.99

The measures and offerings were often

inadequately evaluated.

Average value 1.95 2.05 2.20 1.88 1.74

Standard deviation 0.94 0.92 1.07 0.69 0.97

The budgets for evaluation were often too small.

Average value 1.81 1.90 1.77 2.06 1.60

Standard deviation 0.83 0.85 0.84 0.84 0.77

60


All Respondents All Except Grant DB Conference DB Experts

Experts

n= 144 101 53 48 43

Evaluation experts were often not involved in planning

the projects and measures.

Average value 1.81 1.86 1.75 2.00 1.72

Standard deviation 0.80 0.82 0.81 0.82 0.76

The measures and offerings were often

insufficiently documented.

Average value 2.14 2.15 1.95 2.37 2.13

Standard deviation 0.96 0.90 0.94 0.82 1.09

Before the Internet became widely used, it was difficult

to obtain an overview of the measures and services on

offer in this sector (web information).

Average value 2.08 2.05 2.06 2.05 2.14

Standard deviation 0.97 1.00 1.04 0.96 0.93

There was too little exchange of information between

scientists and practitioners.

Average value 2.06 2.03 1.88 2.23 2.12

Standard deviation 0.97 0.90 0.98 0.77 1.11

There was too little exchange of information and ideas

among practitioners in the field of health promotion.

Average value 2.13 2.02 1.96 2.10 2.35

Standard deviation 0.94 0.87 0.94 0.79 1.04

It was not easy to find institutions prepared to promote

projects and measures.

Average value 1.84 1.77 1.61 1.95 2.00

Standard deviation 0.83 0.78 0.65 0.88 0.94

In many cases, the criteria for project promotion

were unknown.

Average value 1.87 1.91 1.78 2.05 1.80

Standard deviation 0.84 0.80 0.79 0.79 0.94

There were too few opportunities for initial and

advanced training: a) in health promotion

Average value 1.89 1.97 1.69 2.28 1.71

Standard deviation 0.92 0.91 0.82 0.91 0.94

There were too few opportunities for initial and

advanced training: b) in evaluation

Average value 1.84 1.87 1.78 1.98 1.76

Standard deviation 0.88 0.90 0.94 0.86 0.82

Q. 3: Use a grading scale to rate the provisions of

the Health Promotion Act.

Average value 2.45 2.68 2.81 2.56 2.05

Standard deviation 0.77 0.76 0.83 0.67 0.62

1= Very good 5% 2% 0% 4% 12%

2= Good 34% 23% 23% 23% 60%

3= Satisfactory 26% 33% 28% 38% 12%

4= Pass 3% 3% 4% 2% 2%

5= Fail 1% 2% 4% 0% 0%

Don't know 28% 34% 36% 31% 14%

No response 3% 4% 6% 2% 0%

Total 100% 100% 100% 100% 100%

61


All Respondents All Except Grant DB Conference DB Experts

Experts

n= 144 101 53 48 43

Q. 4: Use a grading scale to rate the move authorizing

the FGÖ to be the organization that implements the law.

Average value 2.18 2.36 2.29 2.45 1.83

Standard deviation 0.88 0.85 0.93 0.77 0.85

1= Very good 17% 10% 11% 8% 33%

2= Good 30% 27% 32% 21% 37%

3= Satisfactory 20% 25% 17% 33% 9%

4= Pass 3% 3% 4% 2% 5%

5= Fail 1% 1% 2% 0% 0%

Don't know 26% 33% 32% 33% 12%

No response 3% 2% 2% 2% 5%

Total 100% 100% 100% 100% 100%

Q. 5: Use a grading scale to rate the organizational

structure of the FGÖ (Administrative Office, Advisory

Committee, Board).

Average value 2.39 2.49 2.65 2.27 2.23

Standard deviation 0.92 0.83 0.98 0.52 1.06

1= Very good 9% 3% 4% 2% 23%

2= Good 38% 39% 36% 42% 37%

3= Satisfactory 22% 22% 25% 19% 21%

4= Pass 3% 3% 6% 0% 5%

5= Fail 3% 3% 6% 0% 5%

Don't know 23% 30% 25% 35% 7%

No response 1% 1% 0% 2% 2%

Total 100% 100% 100% 100% 100%

Q. 6: Use a grading scale to rate the annual FGÖ budget,

which is currently ATS 100 million.

Average value 2.65 2.81 2.73 2.89 2.34

Standard deviation 1.20 1.21 1.05 1.37 1.13

1= Very good 15% 11% 8% 15% 26%

2= Good 23% 21% 25% 17% 28%

3= Satisfactory 30% 29% 34% 23% 33%

4= Pass 5% 6% 4% 8% 2%

5= Fail 10% 11% 8% 15% 7%

Don't know 16% 21% 21% 21% 5%

No response 1% 2% 2% 2% 0%

Total 100% 100% 100% 100% 100%

Q. 7a: For individual projects to be promoted, they must

meet criteria formulated and published by the FGÖ.

Rating of the criteria

1 = completely correct to 4 = completely wrong

Projects advocating a traditional concept of health

based strictly on physical health shall not be promoted.

Average value 1.98 2.08 2.24 1.91 1.74

Standard deviation 0.92 0.97 1.02 0.89 0.77

Percentage of answers "more or less wrong" or

"completely wrong" 26% 31% 36% 25% 14%

Projects dealing only peripherally with health shall

not be promoted.

Average value 1.67 1.75 1.82 1.67 1.49

Standard deviation 0.80 0.85 0.92 0.77 0.63

Percentage of answers "more or less wrong" or

"completely wrong" 14% 17% 21% 13% 7%

Nationwide, all-encompassing projects shall

not be promoted.

Average value 2.92 3.05 2.98 3.14 2.61

Standard deviation 0.97 0.90 1.01 0.75 1.07

Percentage of answers "more or less wrong" or

"completely wrong" 68% 72% 72% 73% 58%

62


All Respondents All Except Grant DB Conference DB Experts

Experts

n= 144 101 53 48 43

Sustainability shall be achieved through

proportional funding.

Average value 2.01 2.10 2.16 2.03 1.81

Standard deviation 0.80 0.78 0.86 0.66 0.83

Percentage of answers "more or less wrong" or

"completely wrong" 22% 22% 28% 15% 21%

The emphasis shall be on indicators: state of health,

healthy behavior, internal and external resources or

resource deficits.

Average value 1.66 1.73 1.78 1.67 1.51

Standard deviation 0.65 0.69 0.63 0.75 0.55

Percentage of answers "more or less wrong" or

"completely wrong" 6% 8% 6% 10% 2%

Sufficient evidence for successful project execution

Average value 1.62 1.68 1.59 1.77 1.49

Standard deviation 0.59 0.56 0.50 0.60 0.64

Percentage of answers "more or less wrong" or

"completely wrong" 5% 4% 0% 8% 7%

Applicants must have experience and expertise in

health promotion and in prevention.

Average value 1.63 1.71 1.60 1.82 1.45

Standard deviation 0.65 0.68 0.71 0.65 0.55

Percentage of answers "more or less wrong" or

"completely wrong" 9% 12% 11% 13% 2%

The emphasis shall be on clear, largely consensual and

high-priority requirements and issues.

Average value 1.77 1.88 1.79 1.98 1.52

Standard deviation 0.71 0.66 0.58 0.74 0.74

Percentage of answers "more or less wrong" or

"completely wrong" 15% 15% 8% 23% 14%

Changing of processes, structures or environmental

parameters

Average value 1.69 1.75 1.62 1.88 1.58

Standard deviation 0.70 0.67 0.62 0.71 0.75

Percentage of answers "more or less wrong" or

"completely wrong" 10% 9% 2% 17% 14%

Bringing about a lasting behavioral change

conducive to health

Average value 1.43 1.40 1.43 1.37 1.49

Standard deviation 0.61 0.61 0.58 0.64 0.63

Percentage of answers "more or less wrong" or

"completely wrong" 5% 4% 4% 4% 7%

Acceptance of the project by the target group

Average value 1.48 1.47 1.42 1.53 1.49

Standard deviation 0.65 0.62 0.61 0.63 0.74

Percentage of answers "more or less wrong" or

"completely wrong" 8% 6% 6% 6% 14%

Acceptance and support of the program by experts

Average value 1.76 1.76 1.67 1.85 1.77

Standard deviation 0.67 0.70 0.63 0.76 0.61

Percentage of answers "more or less wrong" or

"completely wrong" 10% 10% 8% 13% 9%

Q. 7c: Relative importance of each criterion

1 = very important to 4 = not at all important

Projects advocating a traditional concept of health based

strictly on physical health shall not be promoted.

Average value 1.99 2.04 2.20 1.82 1.88

Standard deviation 0.97 0.97 1.00 0.91 0.97

63


All Respondents All Except Grant DB Conference DB Experts

Experts

n= 144 101 53 48 43

Projects dealing only peripherally with health shall

not be promoted.

Average value 1.96 1.98 2.06 1.88 1.92

Standard deviation 1.01 1.03 1.06 0.99 0.98

Nationwide, all-encompassing projects shall

not be promoted.

Average value 2.79 2.90 2.89 2.91 2.55

Standard deviation 1.08 1.10 1.10 1.12 1.01

Sustainability shall be achieved through

proportional funding.

Average value 2.08 2.07 2.06 2.09 2.11

Standard deviation 0.93 0.92 0.98 0.85 0.96

The emphasis shall be on indicators: state of health,

healthy behavior,internal and external resources or

resource deficits.

Average value 1.67 1.77 1.63 1.91 1.48

Standard deviation 0.73 0.79 0.71 0.85 0.59

Sufficient evidence for successful project execution

Average value 1.68 1.77 1.68 1.87 1.50

Standard deviation 0.60 0.63 0.69 0.55 0.51

Applicants must have experience and expertise in

health promotion and prevention

Average value 1.81 1.92 1.83 2.05 1.57

Standard deviation 0.72 0.74 0.70 0.80 0.59

The emphasis shall be on clear, largely consensual and

high-priority requirements and issues.

Average value 1.95 2.00 2.00 2.00 1.83

Standard deviation 0.74 0.70 0.67 0.76 0.82

Changing of processes, structures or environmental

parameters

Average value 1.78 1.88 1.79 2.00 1.57

Standard deviation 0.73 0.74 0.74 0.74 0.66

Bringing about a lasting behavioral change

conducive to health

Average value 1.47 1.37 1.52 1.19 1.69

Standard deviation 0.65 0.59 0.68 0.40 0.74

Acceptance of the project by the target group

Average value 1.49 1.43 1.47 1.38 1.62

Standard deviation 0.74 0.65 0.71 0.58 0.90

Acceptance and support of the program by experts

Average value 1.93 1.84 1.75 1.96 2.12

Standard deviation 0.81 0.84 0.62 1.06 0.73

Q. 8: Importance of the primary goals for health promotion

and prevention as defined in the Health Promotion Act.

Rating: 1 = very important to 5 = unimportant/dispensable

To develop efficient methods of health promotion

together with main players in the field.

Average value 1.43 1.46 1.43 1.49 1.38

Standard deviation 0.58 0.62 0.67 0.55 0.49

To create added value in health promotion in terms of

quantity and quality.

Average value 1.72 1.71 1.68 1.74 1.76

Standard deviation 0.81 0.78 0.79 0.77 0.89

To increase the public’s knowledge about health.

Average value 1.56 1.48 1.48 1.49 1.76

Standard deviation 0.82 0.79 0.78 0.80 0.89

64


All Respondents All Except Grant DB Conference DB Experts

Experts

n= 144 101 53 48 43

To have the public show greater health awareness

in its behavior.

Average value 1.29 1.26 1.33 1.19 1.3

Standard deviation 0.61 0.62 0.68 0.54 0.61

To improve the state of health of the general population.

Average value 1.28 1.25 1.17 1.34 1.35

Standard deviation 0.54 0.54 0.43 0.64 0.53

To introduce, encourage and promote a process

Average value 1.54 1.51 1.37 1.67 1.61

Standard deviation 0.72 0.72 0.63 0.80 0.70

Q. 9a: Importance of perspectives on actions and goals

the FGÖ has set for itself.

Rating: 1 = very important to 5 = unimportant/dispensable

a) The FGÖ is a known institution in the field of

health promotion and prevention.

Average value 1.76 1.76 1.78 1.74 1.76

Standard deviation 0.88 0.84 0.83 0.86 0.98

b) The FGÖ is a recognized institution in the field of

health promotion and prevention.

Average value 1.63 1.72 1.75 1.68 1.43

Standard deviation 0.79 0.84 0.84 0.85 0.63

c) The FGÖ promotes the attitude that health promotion

be acknowledged as a responsibility of society as a whole.

Average value 1.52 1.56 1.61 1.51 1.43

Standard deviation 0.74 0.73 0.72 0.74 0.77

d) The FGÖ promotes the strengthening of health

promotion as a responsibility of society as a whole.

Average value 1.50 1.55 1.61 1.48 1.40

Standard deviation 0.73 0.70 0.72 0.66 0.80

e) The FGÖ promotes the attitude that health promotion

be acknowledged in many key areas of life (at school,

at work, in cities, in municipalities).

Average value 1.40 1.46 1.49 1.42 1.29

Standard deviation 0.58 0.62 0.64 0.59 0.46

f) The FGÖ seeks to attain sustainability by adopting

defined forms of project financing (mixed funding and

continuation of projects after the initial project

period is over).

Average value 1.68 1.69 1.61 1.79 1.66

Standard deviation 0.70 0.69 0.75 0.60 0.73

g) In its work, the FGÖ seeks to bring about long-term

improvements in definable health parameters (e.g. food,

exercise, stress).

Average value 1.46 1.44 1.51 1.36 1.51

Standard deviation 0.72 0.70 0.73 0.65 0.7

h) The FGÖ strengthens the importance of health

promotion in initial and advanced training for

pertinent occupations.

Average value 1.71 1.73 1.78 1.67 1.67

Standard deviation 0.77 0.71 0.77 0.64 0.90

i) The FGÖ ensures a high level of quality in health

promotion and prevention.

Average value 1.50 1.56 1.61 1.51 1.34

Standard deviation 0.70 0.73 0.83 0.59 0.62

65


All Respondents All Except Grant DB Conference DB Experts

Experts

n= 144 101 53 48 43

k) The FGÖ promotes interaction and cooperation

between persons and institutions.

Average value 1.64 1.69 1.61 1.79 1.51

Standard deviation 0.72 0.73 0.70 0.77 0.68

l) The FGÖ is involved in the development of health

promotion and prevention at international and

European level.

Average value 1.75 1.78 1.78 1.78 1.69

Standard deviation 0.77 0.76 0.88 0.61 0.82

m) The scientific projects commissioned by the FGÖ

are well- recognized in the health field.

Average value 1.73 1.78 1.72 1.85 1.60

Standard deviation 0.74 0.75 0.77 0.74 0.69

n) The scientific projects are implementation oriented.

Average value 1.53 1.49 1.54 1.44 1.61

Standard deviation 0.66 0.67 0.67 0.68 0.64

o) The FGÖ helps to forge stronger networks among

those working in the field of health promotion and prevention.

Average value 1.51 1.54 1.52 1.56 1.45

Standard deviation 0.60 0.60 0.65 0.55 0.60

p) The FGÖ supports the continuing education of people

working in the field of health promotion.

Average value 1.44 1.49 1.42 1.59 1.32

Standard deviation 0.60 0.62 0.64 0.59 0.53

q) Through its work, the FGÖ brings about improvements in

the epidemiological knowledge available for efficient,

evidence-based health promotion and prevention.

Average value 1.79 1.78 1.66 1.90 1.82

Standard deviation 0.82 0.78 0.73 0.82 0.91

r) Through its work, the FGÖ encourages the use of new and

innovative forms of communication (Internet).

Average value 1.92 1.93 1.92 1.95 1.88

Standard deviation 0.82 0.83 0.86 0.80 0.79

s) The FGÖ supports new and innovative forms

of communication.

Average value 1.85 1.82 1.81 1.83 1.93

Standard deviation 0.83 0.75 0.77 0.74 1.00

t) The FGÖ has a professional organizational structure.

Average value 1.42 1.50 1.50 1.50 1.24

Standard deviation 0.58 0.60 0.61 0.59 0.49

u) The FGÖ takes a client-oriented approach to its work.

Average value 1.46 1.52 1.55 1.49 1.32

Standard deviation 0.68 0.71 0.77 0.64 0.57

v) The FGÖ operates a database on health promotion.

Average value 1.54 1.59 1.65 1.51 1.44

Standard deviation 0.64 0.64 0.64 0.64 0.65

w) The database is used effectively and is updated

continuously.

Average value 1.66 1.72 1.78 1.65 1.52

Standard deviation 0.71 0.70 0.72 0.68 0.71

x) The FGÖ motivates those working in health promotion

and prevention.

Average value 1.53 1.52 1.61 1.40 1.58

Standard deviation 0.72 0.68 0.73 0.59 0.81

66


All Respondents All Except Grant DB Conference DB Experts

Experts

n= 144 101 53 48 43

y) The FGÖ has a qualified staff.

Average value 1.29 1.33 1.38 1.26 1.22

Standard deviation 0.49 0.52 0.57 0.45 0.42

z) The FGÖ has a qualified management.

Average value 1.32 1.36 1.33 1.41 1.22

Standard deviation 0.53 0.57 0.56 0.60 0.42

Q. 9b: Grading of degree of goal attainment in reaching

the action and goal perspectives the FGÖ has set for itself.

Rating based on following grade scale:

1 = very good to 5 = fail

a) The FGÖ is a known institution in the field of

health promotion and prevention.

Average value 2.37 2.59 2.54 2.64 1.90

Standard deviation 0.98 0.99 0.98 1.01 0.80

Percentage of respondents assigning a grade of 4 or 5 10% 14% 13% 15% 0%

b) The FGÖ is a recognized institution in the field of

health promotion and prevention.

Average value 2.29 2.42 2.46 2.37 2.03

Standard deviation 0.95 0.93 0.86 1.02 0.95

Percentage of respondents assigning a grade of 4 or 5 8% 9% 9% 8% 5%

c) The FGÖ promotes the attitude that health promotion

be acknowledged as a responsibility of society as a whole.

Average value 2.40 2.53 2.52 2.55 2.10

Standard deviation 0.93 0.97 0.98 0.96 0.78

Percentage of respondents assigning a grade of 4 or 5 8% 10% 13% 6% 2%

d) The FGÖ promotes the strengthening of health

promotion as a responsibility of society as a whole.

Average value 2.47 2.55 2.53 2.58 2.29

Standard deviation 0.95 0.98 1.08 0.87 0.87

Percentage of respondents assigning a grade of 4 or 5 10% 11% 13% 8% 7%

e) The FGÖ promotes the attitude that health promotion be

acknowledged in many key areas of life (at school, at work,

in cities, in municipalities).

Average value 2.21 2.40 2.41 2.38 1.83

Standard deviation 0.91 0.91 0.91 0.92 0.80

Percentage of respondents assigning a grade of 4 or 5 6% 7% 8% 6% 2%

f) The FGÖ seeks to attain sustainability by adopting defined

forms of project financing (mixed funding and continuation

of projects after the initial project period is over).

Average value 2.14 2.37 2.31 2.45 1.68

Standard deviation 0.90 0.87 0.97 0.71 0.76

Percentage of respondents assigning a grade of 4 or 5 5% 7% 11% 2% 0%

g) In its work, the FGÖ seeks to bring about long-term

improvements in definable health parameters (e.g. food.

exercise, stress).

Average value 2.36 2.46 2.47 2.45 2.13

Standard deviation 0.95 0.98 1.03 0.93 0.84

Percentage of respondents assigning a grade of 4 or 5 6% 7% 8% 6% 2%

h) The FGÖ strengthens the importance of health promotion

in initial and advanced training for pertinent occupations.

Average value 2.48 2.69 2.62 2.77 2.05

Standard deviation 0.95 0.83 0.79 0.88 1.05

Percentage of respondents assigning a grade of 4 or 5 10% 12% 9% 15% 7%

i) The FGÖ ensures a high level of quality in health promotion

and prevention.

67


All Respondents All Except Grant DB Conference DB Experts

Experts

n= 144 101 53 48 43

Average value 2.25 2.38 2.33 2.46 1.97

Standard deviation 0.99 0.98 0.99 0.98 0.96

Percentage of respondents assigning a grade of 4 or 5 8% 10% 11% 8% 5%

k) The FGÖ promotes interaction and cooperation between

persons and institutions.

Average value 2.35 2.62 2.67 2.56 1.83

Standard deviation 0.98 0.92 0.89 0.97 0.87

Percentage of respondents assigning a grade of 4 or 5 9% 11% 15% 6% 5%

l) The FGÖ is involved in the development of health

promotion and prevention at international and

European level.

Average value 2.23 2.34 2.45 2.22 2.03

Standard deviation 0.91 0.89 0.96 0.80 0.93

Percentage of respondents assigning a grade of 4 or 5 4% 5% 8% 2% 2%

m) The scientific projects commissioned by the FGÖ are

well- recognized in the health field.

Average value 2.16 2.30 2.30 2.30 1.89

Standard deviation 0.90 0.84 0.78 0.91 0.96

Percentage of respondents assigning a grade of 4 or 5 1% 1% 0% 2% 2%

n) The scientific projects are implementation oriented.

Average value 2.20 2.33 2.54 2.14 1.93

Standard deviation 0.95 1.02 0.95 1.06 0.73

Percentage of respondents assigning a grade of 4 or 5 3% 4% 4% 4% 0%

o) The FGÖ helps to forge stronger networks among those

working in the field of health promotion and prevention.

Average value 2.37 2.55 2.60 2.50 2.00

Standard deviation 0.98 0.97 0.87 1.08 0.93

Percentage of respondents assigning a grade of 4 or 5 10% 12% 9% 15% 7%

p) The FGÖ supports the continuing education of people

working in the field of health promotion.

Average value 2.02 2.17 2.17 2.17 1.70

Standard deviation 0.98 0.97 0.97 0.98 0.94

Percentage of respondents assigning a grade of 4 or 5 6% 8% 9% 6% 2%

q) Through its work, the FGÖ brings about improvements in

the epidemiological knowledge available for efficient,

evidence-based health promotion and prevention.

Average value 2.60 2.64 2.47 2.82 2.51

Standard deviation 1.05 1.01 1.03 0.98 1.12

Percentage of respondents assigning a grade of 4 or 5 12% 11% 8% 15% 14%

r) Through its work, the FGÖ encourages the use of new and

innovative forms of communication (Internet).

Average value 2.35 2.50 2.53 2.47 2.06

Standard deviation 1.05 1.02 1.08 0.95 1.06

Percentage of respondents assigning a grade of 4 or 5 8% 9% 11% 6% 7%

s) The FGÖ supports new and innovative forms

of communication.

Average value 2.19 2.35 2.37 2.33 1.89

Standard deviation 1.01 1.01 1.11 0.88 0.95

Percentage of respondents assigning a grade of 4 or 5 6% 6% 9% 2% 7%

t) The FGÖ has a professional organizational structure.

Average value 2.01 2.24 2.33 2.11 1.54

Standard deviation 1.04 1.07 1.15 0.96 0.79

Percentage of respondents assigning a grade of 4 or 5 8% 10% 13% 6% 2%

u) The FGÖ takes a client-oriented approach to its work.

Average value 2.35 2.54 2.57 2.50 1.97

Standard deviation 1.11 1.10 1.19 0.98 1.04

Percentage of respondents assigning a grade of 4 or 5 14% 17% 25% 8% 7%

68


All Respondents All Except Grant DB Conference DB Experts

Experts

n= 144 101 53 48 43

v) The FGÖ operates a database on health promotion.

Average value 2.12 2.24 2.33 2.11 1.92

Standard deviation 1.03 0.98 0.83 1.15 1.11

Percentage of respondents assigning a grade of 4 or 5 5% 4% 2% 6% 7%

w) The database is used effectively and is

updated continuously.

Average value 2.45 2.55 2.48 2.63 2.29

Standard deviation 1.14 1.04 0.92 1.17 1.27

Percentage of respondents assigning a grade of 4 or 5 9% 7% 4% 10% 14%

x) The FGÖ motivates those working in health

promotion and prevention.

Average value 2.43 2.71 2.84 2.56 1.89

Standard deviation 1.05 1.06 0.99 1.13 0.78

Percentage of respondents assigning a grade of 4 or 5 11% 15% 15% 15% 2%

y) The FGÖ has a qualified staff.

Average value 1.76 1.86 2.00 1.65 1.60

Standard deviation 0.90 0.90 0.86 0.94 0.90

Percentage of respondents assigning a grade of 4 or 5 3% 3% 4% 2% 2%

z) The FGÖ has a qualified management.

Average value 1.83 2.03 2.11 1.92 1.50

Standard deviation 0.94 1.00 1.05 0.93 0.75

Percentage of respondents assigning a grade of 4 or 5 4% 5% 8% 2% 2%

Q. 10a: Goal and action area rated most

important personally

No response 22% 24% 23% 25% 16%

Questionnaires with answers (absolute) 113 77 41 36 36

Total number of namings (absolute) 315 210 112 98 105

Variably named (percentage on questionnaires with answers)

a) The FGÖ is a known institution in the field of

health promotion and prevention 3% 0% 0% 0% 8%

b) The FGÖ is a recognized institution in the field of

health promotion and prevention 6% 6% 2% 11% 6%

c) The FGÖ promotes the attitude that health

promotion be acknowledged as a responsibility of

society as a whole. 21% 22% 22% 22% 19%

d) The FGÖ promotes the strengthening of health

promotion as a responsibility of society as a whole. 33% 32% 34% 31% 33%

e) The FGÖ promotes the attitude that health promotion

be acknowledged in many key areas of life (at school,

at work, in cities, in municipalities). 25% 23% 17% 31% 28%

f) The FGÖ seeks to attain sustainability by adopting defined

forms of project financing (mixed funding and continuation

of projects after the initial project period is over). 18% 17% 20% 14% 19%

g) In its work, the FGÖ seeks to bring about long-term

improvements in definable health parameters (e.g. food,

exercise, stress). 28% 35% 32% 39% 14%

h) The FGÖ strengthens the importance of health

promotion in initial and advanced training for pertinent

occupations. 14% 17% 17% 17% 8%

i) The FGÖ ensures a high level of quality in health promotion

and prevention 27% 25% 27% 22% 33%

69


All Respondents All Except Grant DB Conference DB Experts

Experts

n= 144 101 53 48 43

k) The FGÖ promotes interaction and cooperation between

persons and institutions. 18% 21% 17% 25% 11%

l) The FGÖ is involved in the development of health promotion

and prevention at international and European level. 1% 0% 0% 0% 3%

m) The scientific projects commissioned by the FGÖ are

well- recognized in the health field. 1% 1% 2% 0% 0%

n) The scientific projects are implementation oriented. 6% 9% 5% 14% 0%

o) The FGÖ helps to forge stronger networks among those

working in the field of health promotion and prevention. 16% 13% 15% 11% 22%

p) The FGÖ supports the continuing education of people

working in the field of health promotion. 17% 12% 22% 0% 28%

q) Through its work, the FGÖ brings about improvements in

the epidemiological knowledge available for efficient,

evidence-based health promotion and prevention. 12% 8% 7% 8% 19%

r) Through its work, the FGÖ encourages the use of new and

innovative forms of communication (Internet). 2% 1% 2% 0% 3%

s) The FGÖ supports new and innovative forms of

communication. 0% 0% 0% 0% 0%

t) The FGÖ has a professional organizational structure. 2% 3% 5% 0% 0%

u) The FGÖ takes a client-oriented approach to its work. 10% 10% 10% 11% 8%

v) The FGÖ operates a database on health promotion. 2% 1% 2% 0% 3%

w) The database is used effectively and is updated continuously. 1% 0% 0% 0% 3%

x) The FGÖ motivates those working in health promotion

and prevention. 10% 10% 10% 11% 8%

y) The FGÖ has a qualified staff. 4% 1% 2% 0% 11%

z) The FGÖ has a qualified management. 4% 4% 2% 6% 3%

Q. 10b: Most progress has been made in achieving

the stated task:

No response 28% 33% 28% 38% 19%

Questionnaires with answers (absolute) 103 68 38 30 35

Total number of namings (absolute) 289 189 106 83 100

Variably named (percentage on questionnaires with answers)

a) The FGÖ is a known institution in the field of

health promotion and prevention 12% 7% 8% 7% 20%

b) The FGÖ is a recognized institution in the field of

health promotion and prevention 16% 15% 18% 10% 17%

c) The FGÖ promotes the attitude that health promotion be

acknowledged as a responsibility of society as a whole. 18% 16% 18% 13% 23%

d) The FGÖ promotes the strengthening of health promotion

as a responsibility of society as a whole. 13% 15% 13% 17% 9%

e) The FGÖ promotes the attitude that health promotion be

acknowledged in many key areas of life (at school, at work,

in cities, in municipalities). 25% 25% 29% 20% 26%

70


All Respondents All Except Grant DB Conference DB Experts

Experts

n= 144 101 53 48 43

f) The FGÖ seeks to attain sustainability by adopting defined

forms of project financing (mixed funding and continuation

of projects after the initial project period is over). 20% 24% 26% 20% 14%

g) In its work, the FGÖ seeks to bring about long-term

improvements in definable health parameters (e.g. food,

exercise, stress). 17% 18% 16% 20% 14%

h) The FGÖ strengthens the importance of health promotion

in initial and advanced training for pertinent occupations. 12% 13% 13% 13% 9%

i) The FGÖ ensures a high level of quality in health promotion

and prevention 15% 10% 11% 10% 23%

k) The FGÖ promotes interaction and cooperation between

persons and institutions. 12% 13% 18% 7% 9%

l) The FGÖ is involved in the development of health promotion

and prevention at international and European level. 2% 3% 5% 0% 0%

m) The scientific projects commissioned by the FGÖ are well-

recognized in the health field. 4% 4% 3% 7% 3%

n) The scientific projects are implementation oriented. 8% 9% 8% 10% 6%

o) The FGÖ helps to forge stronger networks among those

working in the field of health promotion and prevention. 17% 16% 11% 23% 20%

p) The FGÖ supports the continuing education of people

working in the field of health promotion. 25% 25% 32% 17% 26%

q) Through its work, the FGÖ brings about improvements in

the epidemiological knowledge available for efficient,

evidence-based health promotion and prevention. 7% 9% 3% 17% 3%

r) Through its work, the FGÖ encourages the use of new and

innovative forms of communication (Internet). 10% 10% 8% 13% 9%

s) The FGÖ supports new and innovative forms of

communication. 4% 6% 5% 7% 0%

t) The FGÖ has a professional organizational structure. 12% 7% 5%

10% 20%

u) The FGÖ takes a client-oriented approach to its work. 4% 6% 8% 3% 0%

v) The FGÖ operates a database on health promotion. 3% 1% 0% 3% 6%

w) The database is used effectively and is updated continuously. 1% 1% 3% 0% 0%

x) The FGÖ motivates those working in health promotion

and prevention. 5% 3% 5% 0% 9%

y) The FGÖ has a qualified staff. 14% 13% 11% 17% 14%

z) The FGÖ has a qualified management. 8% 7% 3% 13% 9%

Q. 10c: More has to be done:

No response 26% 31% 28% 33% 16%

Questionnaires with answers (absolute) 106 70 38 32 36

Total number of namings (absolute) 290 189 99 90 101

Variably named (percentage on questionnaires with answers)

a) The FGÖ is a known institution in the field of

health promotion and prevention 14% 11% 11% 13% 19%

71


All Respondents All Except Grant DB Conference DB Experts

Experts

n= 144 101 53 48 43

b) The FGÖ is a recognized institution in the field of

health promotion and prevention 11% 10% 8% 13% 14%

c) The FGÖ promotes the attitude that health promotion be

acknowledged as a responsibility of society as a whole. 28% 27% 29% 25% 31%

d) The FGÖ promotes the strengthening of health promotion

as a responsibility of society as a whole. 17% 16% 11% 22% 19%

e) The FGÖ promotes the attitude that health promotion be

acknowledged in many key areas of life (at school, at work,

in cities, in municipalities). 15% 13% 8% 19% 19%

f) The FGÖ seeks to attain sustainability by adopting defined

forms of project financing (mixed funding and continuation

of projects after the initial project period is over). 8% 11% 13% 9% 0%

g) In its work, the FGÖ seeks to bring about long-term

improvements in definable health parameters (e.g. food,

exercise, stress). 19% 24% 24% 25% 8%

h) The FGÖ strengthens the importance of health promotion

in initial and advanced training for pertinent occupations. 16% 17% 16% 19% 14%

i) The FGÖ ensures a high level of quality in health promotion

and prevention 9% 4% 3% 6% 19%

k) The FGÖ promotes interaction and cooperation between

persons and institutions. 20% 24% 16% 34% 11%

l) The FGÖ is involved in the development of health promotion

and prevention at international and European level. 9% 9% 8% 9% 11%

m) The scientific projects commissioned by the FGÖ are well-

recognized in the health field. 5% 6% 5% 6% 3%

n) The scientific projects are implementation oriented. 7% 10% 8% 13% 0%

o) The FGÖ helps to forge stronger networks among those

working in the field of health promotion and prevention. 13% 13% 13% 13% 14%

p) The FGÖ supports the continuing education of people

working in the field of health promotion. 10% 10% 16% 3% 11%

q) Through its work, the FGÖ brings about improvements in

the epidemiological knowledge available for efficient,

evidence-based health promotion and prevention. 20% 10% 11% 9% 39%

r) Through its work, the FGÖ encourages the use of new and

innovative forms of communication (Internet). 3% 1% 3% 0% 6%

s) The FGÖ supports new and innovative forms of

communication. 6% 7% 3% 13% 3%

t) The FGÖ has a professional organizational structure. 2% 3% 5% 0% 0%

u) The FGÖ takes a client-oriented approach to its work. 11% 13% 13% 13% 8%

v) The FGÖ operates a database on health promotion. 5% 3% 5% 0% 8%

w) The database is used effectively and is updated

continuously. 5% 3% 3% 3% 8%

x) The FGÖ motivates those working in health

promotion and prevention. 15% 19% 24% 13% 8%

72


All Respondents All Except Grant DB Conference DB Experts

Experts

n= 144 101 53 48 43

y) The FGÖ has a qualified staff. 2% 1% 3% 0% 3%

z) The FGÖ has a qualified management. 4% 4% 5% 3% 3%

Q. 11: Changes in health promotion brought about by

Health Promotion Act/FGÖ

Scale 1= much improved to 5= definitely worse than before

Quantity and diversity of projects

Average value 1.80 1.94 2.00 1.87 1.54

Standard deviation 0.63 0.64 0.67 0.62 0.51

Coordination or networking of the measures and offerings

Average value 2.20 2.31 2.32 2.30 2.00

Standard deviation 0.67 0.58 0.57 0.60 0.78

Funding of measures and offerings

Average value 2.03 2.19 2.14 2.27 1.74

Standard deviation 0.79 0.78 0.71 0.87 0.72

Duration of measures and offerings (sustainability)

Average value 2.25 2.33 2.31 2.35 2.12

Standard deviation 0.77 0.76 0.64 0.89 0.78

Quality and quality control of measures and offerings

Average value 2.03 2.10 2.11 2.09 1.89

Standard deviation 0.64 0.59 0.61 0.58 0.72

Evaluation of measures and offerings

Average value 2.07 2.09 2.06 2.13 2.03

Standard deviation 0.70 0.70 0.79 0.61 0.72

Amount earmarked for evaluation budget

Average value 2.25 2.27 2.15 2.40 2.23

Standard deviation 0.71 0.77 0.91 0.58 0.62

Involvement of evaluation experts in the planning of

projects and measures

Average value 2.01 2.06 2.03 2.09 1.91

Standard deviation 0.67 0.64 0.60 0.69 0.70

Documentation of measures and offerings

Average value 1.98 2.01 1.77 2.25 1.92

Standard deviation 0.67 0.67 0.55 0.69 0.68

Possibilities for obtaining web info on health promotion

Average value 1.85 1.96 1.91 2.00 1.64

Standard deviation 0.65 0.63 0.56 0.70 0.64

Exchange of ideas/information between scientists

and practitioners

Average value 2.32 2.48 2.52 2.45 2.00

Standard deviation 0.76 0.76 0.74 0.79 0.66

Exchange of ideas/information among health

promotion practitioners

Average value 2.10 2.25 2.33 2.18 1.79

Standard deviation 0.69 0.66 0.74 0.58 0.64

Possibilities for project promotion/funding

Average value 1.87 2.03 2.00 2.06 1.59

Standard deviation 0.77 0.78 0.80 0.76 0.68

Criteria for project promotion/funding

Average value 2.02 2.24 2.17 2.30 1.61

Standard deviation 0.86 0.88 0.98 0.77 0.64

73


All Respondents All Except Grant DB Conference DB Experts

Experts

n= 144 101 53 48 43

Initial and advanced training in health promotion

Average value 1.83 2.01 1.91 2.12 1.49

Standard deviation 0.70 0.68 0.75 0.59 0.61

Initial and advanced training in evaluation

Average value 2.11 2.13 2.00 2.24 2.09

Standard deviation 0.74 0.77 0.82 0.71 0.71

Q. 12: Goal areas where there is a special need for action

Yes 46% 51% 55% 48% 33%

No 18% 13% 11% 15% 30%

No response 36% 36% 34% 38% 37%

Total 100% 100% 100% 100% 100%

Q. 13: The institution or organization you work for/are active

in Health administration (Federal) 4% 2% 0% 4% 9%

Health administration (Land) 13% 9% 2% 17% 23%

Health administration (local/city) 3% 2% 2% 2% 7%

Health, accident, pension insurance fund 6% 6% 0% 13% 7%

Federation/National federation 6% 8% 9% 6% 2%

Medical society 6% 8% 4% 13% 2%

Healthy Hospital Network 1% 1% 0% 2% 2%

Healthy Cities Network 4% 5% 6% 4% 2%

Healthy Communities Network 3% 3% 6% 0% 2%

Healthy Schools Network 5% 3% 2% 4% 9%

Association, club, NPO 33% 40% 51% 27% 19%

Self-help group 6% 7% 9% 4% 2%

Medical practice, out-patient clinic 10% 12% 9% 15% 5%

Health counseling 13% 13% 13% 13% 14%

Hospital 6% 8% 9% 6% 2%

University 9% 8% 13% 2% 12%

School 8% 11% 9% 13% 0%

Kindergarten 3% 4% 4% 4% 0%

Social services administration (Federal) 1% 1% 0% 2% 2%

Social services administration (Land) 1% 1% 0% 2% 0%

Social services administration (local/city) 1% 2% 4% 0% 0%

Social insurance 5% 6% 4% 8% 2%

Social counseling/social services office 1% 1% 0% 2% 0%

Environmental administration (Federal) 0% 0% 0% 0% 0%

Environmental administration (Land) 0% 0% 0% 0% 0%

Environmental administration (local/city) 7% 6% 9% 2% 9%

Enterprise, business 6% 7% 6% 8% 2%

Research institution, public 0% 0% 0% 0% 0%

Research institution, private 6% 7% 11% 2% 2%

Chamber 3% 4% 0% 8% 2%

Political party 3% 0% 0% 0% 12%

Elsewhere in public administration 2% 3% 2% 4% 0%

Other 13% 11% 9% 13% 16%

Total number of namings 189% 197% 194% 200% 170%

Q. 14a: Project applications submitted:

Yes, one application 27% 35% 47% 21% 9%

Yes, several applications 33% 27% 43% 8% 47%

No 36% 34% 6% 65% 42%

No response 4% 5% 4% 6% 2%

Total 100% 100% 100% 100% 100%

Q. 14b: Project applications approved:

New pool of respondents: Respondents who submitted

project applications 86 62 48 14 24

No applications 19% 24% 17% 50% 4%

One application 35% 44% 48% 29% 13%

Several applications 44% 29% 31% 21% 83%

No response 2% 3% 4% 0% 0%

Total 100% 100% 100% 100% 100%

74


Q. 15: Have you participated in special events staged by

the FGÖ:

All Respondents All Except Grant DB Conference DB Experts

Experts

n= 144 101 53 48 43

Yes 68% 60% 60% 60% 86%

No 23% 30% 34% 25% 7%

Don't know 3% 3% 0% 6% 5%

No response 6% 7% 6% 8% 2%

Total 100% 100% 100% 100% 100%

New pool of respondents: Participants in events 98 61 32 29 37

(n=) 32 29 37

Educational Network (Bildungsnetzwerk) 47% 43% 50% 34% 54%

Health Promotion Conference 67% 61% 66% 55% 78%

Prevention Conference 57% 46% 34% 59% 76%

Other events or offerings 46% 41% 41% 41% 54%

Total 217% 190% 191% 190% 262%

Q. 16: How often have you had dealings with the FGÖ over

the past three years:

Very often 17% 8% 13% 2% 40%

Often 25% 23% 30% 15% 30%

Occasionally 33% 40% 38% 42% 19%

Rather rarely 13% 16% 11% 21% 7%

Never 8% 11% 6% 17% 0%

No response 3% 3% 2% 4% 5%

Total 100% 100% 100% 100% 100%

Q. 17: Rating the work of the Administrative Office using a

grading scale

1= very good to 5= fail

New pool of respondents: Respondents who have had

dealings with the FGÖ at least occasionally. 109 71 43 28 38

Professionally correct and competent

Average value 1.68 1.76 1.79 1.72 1.51

Standard deviation 0.71 0.67 0.71 0.61 0.77

Easy, quick to reach

Average value 1.66 1.81 1.88 1.67 1.41

Standard deviation 0.78 0.86 0.96 0.64 0.55

Prompt handling of questions, requests, etc. 2.54 2.74 3.05 2.14 2.17

Average value 1.17 1.21 1.26 0.83 1.00

Standard deviation

Friendly

Average value 1.43 1.59 1.70 1.40 1.14

Standard deviation 0.68 0.75 0.82 0.58 0.35

Overall grade

Average value 1.91 2.09 2.17 1.96 1.59

Standard deviation 0.73 0.72 0.77 0.62 0.65

Q. 18: Situation of health promotion in Österreich as

compared with other European countries:

Austria is among the leaders 7% 8% 8% 8% 5%

Austria is in the upper middle range 40% 37% 32% 42% 49%

Austria is only average 28% 29% 34% 23% 26%

Austria is below average 7% 7% 8% 6% 7%

Cannot judge 16% 18% 19% 17% 12%

No response 2% 2% 0% 4% 2%

Total 100% 100% 100% 100% 100%

75


76

Annex 3

LIST OF INTERVIEWEES


List of Interviewees (Open-ended Interviews)

Dennis Beck,

Managing Director of the FGÖ

Dr. Hans-Peter Bischof,

Health Minister of Vorarlberg, Member of FGÖ Board -

Governor’s Conference, Bregenz

Dr. René Chahrour,

Health Specialist at FGÖ Administrative Office

Dr. Christiana Dolezal,

City Councilwoman Responsible for Health and Environmental Protection/Linz,

Member of FGÖ Board, Association of Austrian Cities and Towns, Linz

Sylvia Fellner,

FGÖ Administrative Office, Accounting, Controlling

Mag. Helmut Fornetran,

AKS (Organization for Preventive and Social Medicine), Bregenz

Dr. Wolfgang Freidl,

Professor at the University of Graz

Mag. Richard Gauss,

Federal Ministry of Finance, Member of FGÖ Board

Mag. Sylvia Groth,

Women’s Health Center Graz

Dr. Hubert Hartl,

University Lecturer, Federal Ministry for Social Security and Generations –

Office of the State Secretary for Health, Vienna

Martin Hefel,

SUPRO (Addiction Prevention Organization), Member of FGÖ Advisory

Committee since 1 January 2002, Dornbirn

Peter Jandrasits,

FGÖ Administrative Office, Business Assistant, Project Accounts

Peter Jatzko,

High-ranking Civil Servant (Oberrat) at Federal Ministry for Social Security

and Generations - Office of the State Secretary for Health, Vienna

Dr. Lindi Kalnoky,

President of Styria Vitalis (Styrian Society for Health Protection),

Member of FGÖ Board - Federal Ministry for Social Security and Generations,

Family Services Department, Graz

Mag. Rita Kichler,

Health Specialist at FGÖ Administrative Office

Elfriede Kiesewetter,

Austrian Contact Office for Workplace Health Promotion, Linz

77


78

Michael Kohlbacher,

Director of VAB (Administration Academy of the Federal Government), Graz

Christian Landsfried,

Business Manager and Deputy Managing Director of FGÖ

Mag. Andrea Lins,

Health Specialist at FGÖ Administrative Office

Fredy Mayer,

Former Member of Vorarlberg Government, President of Austrian Red Cross,

Member of FGÖ Board, 1st Deputy Chairman, FederalMinistry of Education,

Science and Culture, Bludenz

Mag. DDr. Oskar Meggeneder,

Deputy Director of Upper Austrian Health Insurance Fund, Member of

FGÖ Advisory Committee since 1 January 2002, Linz

Dr. Richard Noack,

University Professor at Institute for Social Medicine, Member of FGÖ Advisory

Committee since June 1998, Graz

Elisabeth Rass,

FGÖ Administrative Office, Secretariat, Management, PR

Mag. Karin Reis-Klingspiegl,

Styria Vitalis (Styrian Society for Health Protection), Frohnleiten

Dr. Klaus Ropin,

Health Specialist at FGÖ Administrative Office

Markus Rumelhart,

FGÖ Administrative Office, Secretariat - Project Processing

Dr. Christian Scharinger,

Consulting, Development, Coaching, Sarleinsbach

Reinhard Sonderegger,

Fonds Gesundes Vorarlberg (Fund for a Healthy Vorarlberg), Bregenz

LR Dr. Silvia Stöger,

Office of the Upper Austrian Government, Member of FGÖ Board -

Conference of Health Specialists of the Austrian Federal Provinces, Linz

Dr. Beate Wimmer-Puchinger,

University Professor, Women’s Health Ombudsperson of the City of Vienna,

Member of FGÖ Advisory Committee from June 1998 to the end of 2001, Vienna


Annex 4

BIBLIOGRAPHY

79


80

Bibliography

Abholz, H. H. u.a. (eds.): Risikofaktorenmedizin - Konzepte und Kontroverse, Berlin, New York 1982

Adelhard, K.: Qualitätssicherung medizinischer Informationsangebote im Internet, Deutsches Ärzteblatt 97,

43, 27.10.00, A - 2863

Ahrens, H.: Potentiale und Rahmenbedingungen für Prävention und Rehabilitation aus der Sicht der GKV,

Baths Conference in Bad Sassendorf of the SPD Bundestag Faction, Friday, 24 November and Saturday, 25

November 2000.

AKTIONSPROGRAMM DER GEMEINSCHAFT ZUR GESUNDHEITSFÖRDERUNG, -AUFKLÄRUNG, -ERZIE-

HUNG UND -AUSBILDUNG, ENTWURF DES ARBEITSPROGRAMMS 1999,

Altgeld, T.: Praxisnahes Qualitätsmanagement jenseits von Zertifizierungsautomatismen und Leitlinieninflation,

In BZgA, Qualitätsmanagement in Gesundheitsförderung und Prävention, BZgA Schriftenreihe Band 15, 2001

Badura, B., Stodtholz, P.: Qualitätsförderung, Qualitätsforschung und Evaluation im Gesundheitswesen. In:

Schwartz, F. W. et al.: Das Public Health Buch, Munich 1998

BAG, Bundesamt für Gesundheit, Fachbereich Evaluation: Leitfaden für die Planung von Projekt und Programmevaluation,

Bern 1997, http://www.bag.admin.ch/politik/eval/d/LeitfadenEvaluationHaupttext_d.pdf

Bellach, B.M. et. al: Leitlinien und Empfehlungen zur Sicherung von Guter Epidemiologischer Praxis (GEP),

full version, http://www.rki.de/GESUND/EPIDEM/GEP_LANG.PDF

Bengel, J. et al.: Was erhält Menschen gesund?- Antonovskys Modell der Salutogenese- Diskussionsstand und

Stellenwert, BZgA Forschung und Praxis der Gesundheitsförderung, Band 6, 2001

Berkling, J., Krasemann, E. O.: Beeinflusst Gesundheitswissen das Verhalten? Öffentliches Gesundheitswesen

52 (1990), H. 10, 580-584

Beske, F. : Prävention - Vor Illusionen wird gewarnt, Deutsches Ärzteblatt 99, 18 May 2002, C 940

Brand, H. und Hellmeier, W.: Epidemiologische Grundlagen der Prävention. In: Allhoff, P., Flatten, G., Laaser,

U. (eds.): Krankheitsverhütung und Früherkennung - Handbuch der Prävention: Springer-Verlag Berlin/Heidelberg

1993

Brennecke, R., Schelp, F.P.: Sozialmedizin, Stuttgart 1993

BzgA: Qualitätsmanagement in Gesundheitsförderung und Prävention, BZgA Schriftenreihe Band 15, 2001

Domenighetti, G.: Sind gesundheitsökonomische Analysen von praktischem Nutzen? In: Managed Care,

6/2000, 39-41

Droste, S.: Bestandsaufnahme interdisziplinärer Netzwerke im Bereich der Prävention und Gesundheitsförderung

bzgl. Kindergarten, Schule, Betrieb, Krankenhaus, Stadt, Region („Settings“) - unter besonderer Berücksichtigung

der modernen Informations- und Kommunikationstechnologien, Bonn 1999

Elkeles, T., Georg, A.: Bekämpfung arbeitsbedingter Erkrankungen. Evaluation eines Modellprogramms. Juventa,

Weinheim/Munich 2002

Eysenbach, G.: Präventivmedizin und Internet - Prävention durch Information. In: Allhoff. P.G., Leidel, J., Ollenschläger,

G., Voigt, H.P. (eds.): Präventivmedizin (5 th revision/ 6 th edition). Berlin, Heidelberg: Springer-Verlag,

1997

FGÖ Dreijahresprogramm 1998 - 2001, http://www.fgoe.org/3jahreprogramm/3jahresprogramm.htm

Fischer-Homberger, E.: Geschichte der Medizin, Springer Verlag 1977

Forschungsverbund DHP (ed.): Die Deutsche Herz-Kreislaufpräventionsstudie, Bern, Göttingen, Toronto, Seattle,

1998

Franke, A.: Zur Entmystifizierung von Gesundheit, Tübingen 1997

Gesundheitsbericht der Stadt Wien, 2000

Gesundheitsbericht Vorarlberg, 2001

Geyer, S.: Antonovskys sense of coherence - ein gut geprüftes und empirisch bestätigtes Konzept?, In: Wydler,

H., Kolip, P., Abel. T.: Salutogenese und Kohärenzgefühl. Grundlagen, Empirie und Praxis eines gesundheitswissenschaftlichen

Konzepts. Juventa, Weinheim 2000

Gotzsche, P., Olsen, O.: Is screening for breast cancer with mammography justifiable?, The Lancet

2000;355:129-34

Griffith, E. (ed.): Alkohol und Gemeinwohl, Stuttgart 1997

Grossmann R., Scala, K.: Gesundheit durch Projekte fördern, Ein Konzept zur Gesundheitsförderung durch

Organisationsentwicklung, Weinheim 1994.

Grossmann, R.: Gesundheitsförderung durch Organisationsentwicklung - Organisation der Gesundheitsförderung

in Österreich, In: Lobnig, H., Pelikan, J.M. (eds.): Gesundheitsförderung in Settings: Gemeinde, Betrieb,

Schule und Krankenhaus- Eine österreichische Forschungsbilanz, Vienna 1996

Grundböck, A. Nowak, P. Pelikan, J.M. (eds.): Neue Herausforderungen für Krankenhäuser, Qualität durch

Gesundheitsförderung - Gesundheitsförderung mit Qualität, o.O., o.J.

Grundmann, D., Blümel, S.: Konzept der Primärprävention des Suchtverhaltens im Kindesalter am Beispiel der

BZgA Kampagne Kinder stark machen, In: Bengel, J. et al: Was erhält Menschen gesund? - Antonovskys Modell

der Salutogenese- Diskussionsstand und Stellenwert, BZgA Forschung und Praxis der Gesundheitsförderung,

Band 6, 2001

Gutachten 2000/2001 des Sachverständigenrates für die Konzertierte Aktion im Gesundheitswesen - Bedarfsgerechtigkeit

und Wirtschaftlichkeit - Band I, Deutscher Bundestag, Drucksache 14/5660, 21.03.2001

Hafen, M.: Die Funktion der Prävention für die Gesellschaft, Fachzeitschrift für Prävention & Prophylaxe

1/2001

Hafen, M.: Suchtprävention - der lange Weg von der Symptom- zur Ursachenbekämpfung, Soziale Arbeit 19,

1995, 3-9

Hass, W., Petzold, H. G.: Die Bedeutung sozialer Netzwerke und sozialer Unterstützung für die Psychotherapie

– diagnostische und therapeutische Perspektiven, http://gestalttherapie.ch/IT/sozialenetzwerkelit.htm


Heinemann, L. et al. (eds.): Epidemiologie und Gesundheitsforschung - Methodeneinführung und Repetitorium;

Infratest Gesundheitsforschung Munich 1989

Helle Kieler, M.D., et al.: Routine Ultrasound Screening in Pregnancy and the Children’s Subsequent Neurologic

Development, Obstetrics and Gynecology Vol.91, 750-756, May 1998,

http://www.ama-assn.org/special/womh/library/scan/vol_4/no_13/kieler.htm

Helmert, U. et al.: Müssen Arme früher sterben? Soziale Ungleichheit und Gesundheit in Deutschland. Juventa,

Weinheim Munich 2000

Hoffmeister, H. et. al.: Bericht über die Interventionsmaßnahmen der DHP und deren Evaluation in der Teilstudie

Berlin Spandau 1984-1991, Institut für Sozialmedizin und Epidemiologie des BGA, 1992

Hoffmeister, H., Schelp, F.P., Böhning, D., Dietz, E., Kirschner, W.: Alkoholkonsum in Deutschland und seine

gesundheitlichen Aspekte, Springer, Heidelberg 1999

http://culturitalia.uibk.ac.at/obstx5/wir_neu1.html

http://de.netvalue.com/presse/index_frame.htm?fichier=cp0046.htm

http://linz.orf.at/article.php?sid=1473

http://news.zdnet.de/story/0,,t101-s2089674,00.html

http://www.acnielsen.at/at/news/press/2001_09_25_155448/FULLTEXT.PDF

http://www.arcs.ac.at/news/PRESS/2000/common.senseSN.pdf

http://www.biomedcentral.com/news/20011220/04

http://www.biostatistik.uibk.ac.at/PH-Linz.ppt

http://www.bmu.de/download/dateien/hintergrundpap_oekobilanz.pdf

http://www.bverfg.de/entscheidungen/frames/1%20BvR%201580/91

http://www.fgoe.org/foerderung/kurzinformation.htm,

http://www.fgoe.org/p_konferenz/191099/bewusst_leben.htm

http://www.fgoe.org/tagungen/der2.htm

http://www.fgoe.org/wasist.htm

http://www.gesundesleben.at/

http://www.gesundheit.steiermark.at/vorsorge/gf_1.htm - 78k

http://www.gesundheitsfoerderung.ch/de/fs.asp?nav=sti

http://www.healthproject.ch/index.php?lang=fr&partner=162

http://www.ibe.co.at/web/start.htm

http://www.kfunigraz.ac.at/ippwww/psychotherapie.doc

http://www.lbi.at/geschaeftsbericht.asp?ID=64&Y=1997

http://www.lbi.at/geschaeftsbericht.asp?ID=64&Y=1998

http://www.merkur.at/cms/news/2216.htm

http://www.oeph.at/

http://www.optipage.de/leib/zusammen.html

http://www.parlinkom.gv.at/pd/pm/BR/I-BR/texte/056/I.BR/05643.rtf

http://www.parlinkom.gv.at/pd/pm/XX/NRSP/NRSP_109/109_078.html

http://www.parlinkom.gv.at/pd/pm/XXI/J/his/001/J00167_.html

http://www.popilu.at/Seitenblicke/News/News.asp?NewsID=676

http://www.quint-essenz.ch

http://www.stmk.gv.at/verwaltung/fagw/Gb9603.htm#Heading42

http://www.supro.at/

http://www.thieme.de/dmw/inhalt/dmw1999/dmw9946/beitrag/gbt09.htm

http://www.uni-graz.at/weiterbildung/publichealth.html

http://www.univie.ac.at/hph/oraoenet/www/info_datenbank.html

Keupp, H.: Psychosoziales Handeln in der Postmoderne,

http://www.ipp-muenchen.de/texte/psychosoziales_handeln_in_der_postmoderne.pdf

Kirschner, W., Radoschewski, M.; Kirschner, R.: § 20 SGB V - Gesundheitsförderung, Krankheitsverhütung. Untersuchung

zur Umsetzung durch die Krankenkassen. Asgard-Verlag Sankt Augustin 1995

Kirschner, W.: Evaluationsmethoden, Seminarscript, Freie Universität Berlin 1998

Kirschner, W.: Inhaltliche und methodische Probleme der HIV-Surveillance, Berlin 1992

Kirschner, W.: Small Effects in Epidemiology - Radon im Innenraum, Werkstattbericht, Radiz - Dokumentations-

und Informationszentrum, Schlema,1999

Köhler, B.M.: Bevölkerungsbezogene Präventionspolitik. Ernährung- Realisierungschancen und Probleme, In:

Rosenbrock, R. et al.: Präventionspolitik, Berlin 1994, 305-325

Kolip, P.: Gesundheitsförderungsprojekte für Jugendliche - Anforderungen aus wissenschaftlicher Sicht, Managed

Care 2, 2001, 17-19

Kühn, H., Rosenbrock, R.: In: Rosenbrock, R. et al. (eds.): Präventionspolitik, 1994

Kunze, M. et al.: Vorsorgebericht Niederösterreich, Oktober 1998

Labisch, A.: Hygiene ist Moral - Moral ist Hygiene, Soziale Disziplinierung durch Ärzte und Medizin, In: Sachße,

C., Tennstedt, F. (eds.): Soziale Sicherheit und soziale Disziplinierung, Frankfurt/Main, 1986

Lauterbach, K.W.: Zwei Dogmen der Gesundheitspolitik - Unbeherrschbare Kostensteigerungen durch Innovation

und demographischen Wandel? Gutachten für den Gesprächskreis Arbeit und Soziales der Friedrich-Ebert-

Stiftung, Bonn, July 2001

Leggewie, H.: Theorie und Forschung zur Gesundheitsförderung, Berlin, o. J.

Locher, B.: Notwendigkeit und Möglichkeit suchtpräventiver Maßnahmen im Interventionsfeld des jugendlichen

Vereinssports, Dissertation, Heidelberg 2000

Lühmann, D., Kohlmann, T., Raspe, H.: Die Evaluation von Rückenschulprogrammen als medizinische Technologie;

veröffentlicht auf der Website des Deutschen Instituts für medizinische Dokumentation und Information

(DIMDI), Cologne 1997

81


82

Maynard, A.: The relevance of health economics to health promotion, In: Badura, B., Kickbusch, I.: Health Promotion

Research, WHO Regional Publications, European Series, No. 37, 29-53

McKeown, T.: Die Bedeutung der Medizin, Frankfurt 1982

Meggeneder, O.: Prävention und Rehabilitation“, In: Berger, F., Meggeneder, O. (eds.): Stand der medizinischen

Prävention und Rehabilitation in Österreich, Linz 1997, Schriftenreihe Gesundheitswissenschaften

Band 5

Meier, E.: Prävention - Allheilmittel oder Placebo? Strukturelle und individuelle Ansätze am Beispiel von

Herz-Kreislaufkrankheiten, Verlag Hans Jacobs, Lage 2001

Mielck, A., Bloomfield, K. (eds.): Sozial-Epidemiologie. Eine Einführung in die Grundlagen, Ergebnisse und

Umsetzungsmöglichkeiten. Juventa, Weinheim/Munich 2001

Mielck, A.: Soziale Ungleichheit und Gesundheit. Empirische Ergebnisse, Erklärungsansätze, Interventionsmöglichkeiten.

Verlag Hans Huber, Bern 2000

Noack, R.H.: Gesundheitsförderung, http://www.gesundheit.steiermark.at/vorsorge/gf_1.htm,Graz, 1998

Noack, R.H.: Public Health, Salutogenese und Gesundheitsförderung, In: Lobnig, H., Pelikan, J.M. (eds.):

Gesundheitsförderung in Settings: Gemeinde, Betrieb, Schule und Krankenhaus - Eine österreichische Forschungsbilanz,

Vienna 1996

ÖBIG: Öffentliche Ausgaben für Prävention und Gesundheitsförderung in Österreich, Bericht, Vienna, October

2000

Oeser, H.: Krebs: Schicksal oder Verschulden? Thieme Verlag Stuttgart, 1979

Österle, A.: Möglichkeiten der Wirtschaftlichkeitsanalyse von Maßnahmen der Prävention und Gesundheitsförderung,

In: Berger, F., Meggeneder, O. (eds.): Stand der medizinischen Prävention und Rehabilitation in

Österreich, Linz 1997, Schriftenreihe Gesundheitswissenschaften Band 5, 27-33

ÖVP-FPÖ Regierungsprogramm, http://staedtebund.wien.at/service/regierungsprogramm.pdf

Pelikan, J.M. et al.: Forschung über Gesundheitsförderung in Österreich, In: Lobnig, H., Pelikan, J.M. (eds.):

Gesundheitsförderung in Settings: Gemeinde, Betrieb, Schule und Krankenhaus - Eine österreichische Forschungsbilanz,

Vienna 1996

Pelikan, J.M., Demmer, H, Hurrelmann, K. (eds.): Gesundheitsförderung durch Organisationsentwicklung. Konzepte,

Strategien und Projekte für Betriebe, Krankenhäuser und Schulen. Weinheim 1993

Perkins, E.R., Simnett, I., Wright, L.: Evidence Based Health Promotion, John Wiley & Sons Ltd.,1999

Prümel-Philippsen, U.: Die Neufassung des §20 SGB V im Rahmen des GKV-Gesundheitsreformgesetzes 2000:

Stand und Perspektiven, HAG-Standpunkte 3/2001

Rásky, E.: Die Datenlage zur Gesundheit in Österreich, manuscript no indication of place or year

Röhrle, B.: Vorbeugen ist besser als heilen, In: Röhrle, B., Sommer, G. (eds.): Prävention und Gesundheitsförderung,

dgvt Verlag, Tübingen, 1999

Rose, G.: Strategy of prevention: Lessons from cardiovascular disease. Br. Med. J. 282 (1981): 1847-1851

Rosenbrock, R.: AIDS kann schneller besiegt werden, Hamburg 1987

Scharinger, C., Svoboda, B.: Gesundheitsförderung, In: Berger, F., Meggeneder, O. (eds.): Stand der medizinischen

Prävention und Rehabilitation in Österreich, Linz 1997, Schriftenreihe Gesundheitswissenschaften

Band 5, 47-49

Schauer, G., Pirolt, E.: Projekt Spagat - Erfahrungen, Ergebnisse und Reflexionen eines Gesundheitsförderungsprojektes,

ppm Nr. 18/2001

Schmacke, N.: Qualitätssicherung in der Gesundheitsförderung: Zumutung, Unmöglichkeit oder Notwendigkeit?

In: Kaupen-Haas, H., Rothmaler, C.: Doppelcharakter der Prävention, Frankfurt/Main, 1995

Seidler, E.: Probleme der Tradition. In: Blohmke, M. et al.: Handbuch der Sozialmedizin Bd. I, Stuttgart 1975

Spectra Nr. 29, November 2001

Supro: Jahresbericht zu Kinder Stark Machen mit Sport, 1999 - 27.7.2000

Trautner, C. und Berger, M.: Medizinische Grundlagen der Gesundheitswissenschaften. In: Hurrelmann, K.,

Laaser, U. (eds.): Gesundheitswissenschaften - Handbuch für Lehre, Forschung und Praxis. Beltz-Verlag

1993 (Neuausgabe Juventa, Weinheim/Munich 1998)

Trojan, A.: Qualitätsentwicklung in der Gesundheitsförderung, In: BZgA, Qualitätsmanagement in Gesundheitsförderung

und Prävention, BZgA Schriftenreihe Band 15, 2001

Trojan, A.: Zukunftsmodelle der Prävention: Prädiktive Medizin versus Gesundheitsförderung. In: Kaupen-Haas,

H., Rothmaler, C.: Doppelcharakter der Prävention, Frankfurt/Main, 1995

Von Troschke, J., Stützner, W.: Soziale Umwelt und Genussmittelkonsum. Gesomed, Freiburg 1984

Von Troschke, J.: Gesundheits- und Krankheitsverhalten. In: Hurrelmann, K., Laaser, U. (eds.): Gesundheitswissenschaften

- Handbuch für Lehre, Forschung und Praxis. Beltz-Verlag 1993, 155-175 (Neuauflage. Juventa,

Weinheim/Munich 1998, 371-394)

Vorsorgebericht Niederösterreich, 1998

Waller, H.: Gesundheitswissenschaft. Eine Einführung in Grundlagen und Praxis. 2 nd edition, Kohlhammer,

Stuttgart 1996)

Wasem, J.: Methoden zur vergleichenden ökonomischen Evaluation von Therapien und zur rationalen Ressourcenallokation

über Bereiche des Gesundheitswesens hinweg - Einführung, Vorteile, Risiken, Greifswald, o. J.

Weiß, O., et al.: Sport und Gesundheit, Die Auswirkungen des Sports auf die Gesundheit - eine sozioökonomische

Analyse, Bundesministerium für soziale Sicherheit und Generationen (eds.), Vienna 2000

Werner, C., Haubner, S.: Der Arzt im Netz - Auf der Suche nach medizinischem Beistand gehen immer mehr

Menschen online, http://www.abendblatt.net/contents/ha/news/computer/html/280700/co1.htm

WHO European Working Group on Health Promotion Evaluation, Health Promotion Evaluation: Recommendations

to Policy-Makers, Report, EUR/ICP/IVST/ 050103, 1998, http://www.who.dk/document/e60706.pdf

WHO-Tagung Evaluation von Kosteneffektivität in der Gesundheitsversorgung, Celle, 9.-12.12.1996, Bericht

der WHO, Regionalbüro für Europa, Copenhagen, EUR/ICP NHP 021VD 96,POLC020103

Wolf, N.: Krankheitsursachen Gene - Neue Genetik und Public Health - Veröffentlichungsreihe der Arbeits-


gruppe Public Health, Nr. P02-202, Wissenschaftszentrum Berlin für Sozialforschung, Berlin 2002

Worm, N.: http://www.nicolai-worm.de/

Zanoni, U.: Grundlagen für die Umsetzung von Promotionsmassnahmen im Bereich Bewegung, Ernährung, Entspannung,

Schlussbericht, Juni 2001, http://www.hepa.ch/deutsch/pdf-hepa/Grundlagen%20Promotion.pdf

Ziglio, E., Krech, R: Brückenschlag zwischen Politik und Forschung in der Gesundheitsförderung, In: Lobnig,

H., Pelikan, J.M. (eds.): Gesundheitsförderung in Settings: Gemeinde, Betrieb, Schule und Krankenhaus- Eine

österreichische Forschungsbilanz, Vienna 1996, 23- 24

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Authors:

Dr. Renate Kirschner

Prof. Dr. Thomas Elkeles

Dr. Wolf Kirschner

With assistance from Sven Borgmeyer

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Translation:

Mark Wilch, M.A.

Printed by: Druckerei Ferdinand Berger & Söhne, Horn

83

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