How is success measured and defined in upstream health promotion?

Abstract

Upstream health promotion refers to interventions and policies that target environmental, social, and structural conditions that affect a population's health before the onset of illness. Included in this definition are interventions that target social and structural determinants such as income, housing, early childhood environment, transportation, local infrastructure, access to care, and other systemic influences. Upstream approaches in public health promotion have become quickly adopted and prioritized within British Columbia (B.C). This shift has occurred to acknowledge the role of prevention, equity, and early intervention in addressing structural and social determinants of health. While upstream initiatives have become embedded in provincial health strategies, a major gap still remains in how upstream success is defined and measured between actors.  The purpose of this research was to examine how success is defined and measured in upstream health promotion from the perspective of different actors involved in health research and care. By examining how different actors conceptualize success and the indicators they use to assess it, this research focuses on better understanding how upstream health goals can be translated into evaluation practices. This research contributes to existing literature on health promotion by identifying similarities and differences in how success is defined and measured in upstream research. Understanding these variations and similarities within the definitions and evaluations will offer guidelines for future designs of upstream interventions to help better coordinate public health efforts and interpretability. The purpose guides the research question, “how is success measured and defined within upstream health promotion?”.