Empowerment, Participation, and Person-Centeredness as Prerequisites for Health-Promoting Settings in Everyday Practice: A Swedish Case Study.

introductionHealth promotion in everyday settings is of great importance for both individual health and organizational sustainability. A settings-based approach emphasizes how social, physical, and organizational contexts shape the conditions for health. Central principles in health promotion are participation, empowerment, and person-centeredness, which emphasize the active role of the person or group in relation to the context. Although these principles are often highlighted in policy and theory, there is limited knowledge about how they are concretely translated into everyday practice within different contexts. The purpose of the study was therefore to explore how health promotion is conducted in different everyday settings, with a particular focus on how participation, empowerment, and person-centeredness take shape in practice.

methodThe study was conducted as an exploratory qualitative collective case study supported by the Storytelling dialog method. Four different health-promoting settings in southern Sweden were studied: a preschool, a sports profile within an upper secondary school, a daily activity for persons with neuropsychiatric functionality disabilities, and municipal community development for seniors. Data collection consisted of participant observations and semi-structured interviews, and the material was written into four case stories.

findingsThe findings showed two interrelated themes: Practice-embedded prerequisites for a setting approach and an experiential and behavioral process supporting health development in settings. The first theme describes how societal support, organizational structures, staff competence, and everyday interactions create supportive conditions for health promotion. The second theme illustrates how experiences of inclusion, belonging, and motivation emerge within these conditions and foster active engagement, agency, and ongoing health development in everyday settings.

conclusionParticipation, empowerment, and person-centeredness appear to be mutually supporting and central to sustainable health promotion, regardless of setting. This study thus contributes to a deeper understanding of how these principles (participation, empowerment, and person-centeredness) can be operationalized in everyday settings through a systems and process perspective illuminated from different contexts. PATIENT OR PUBLIC CONTRIBUTION: During data collection, representatives from each organization studied were either observed and/or given the opportunity to describe in detail the everyday health promotion practices of their organization, including how participants and target groups were involved in the activities in general. Furthermore, the four case stories were written by the researchers in close dialog with and verified by representatives from the organizations before the analysis began, which helped ensure that the case descriptions accurately reflected the organizations' practices and the participants' perspectives.