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 tothe 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 tothe “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