The authors' aim was to explore clients' and health care providers' perceptions of health and its determinants in preparation for the development of a screening tool to assess client health determinants at a community health center through template and editing analyses of interviews with 6 health care providers and 7 clients. Participants defined health as a multidimensional state, with common themes including the ability to cope and to function according to expectations. They identified multiple interrelated factors that affect health. The findings support existing health determinant frameworks but provide greater detail about specific determinants within broad categories presented in these frameworks. The results create a foundation for the development of a screening tool to assess client health determinants.
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References
1.
Alberta Health. (1995). Summary: Evidence-based decision making—A guide to using indicators in health planning. Edmonton, Canada: Alberta Health.
2.
Bolaria, B. (1994). Sociology, medicine, health and illness: An overview. In B. Bolaria & H. Dickinson (Eds.), Health, illness and health care in Canada (pp. 1-18). Toronto, Canada: Harcourt Brace.
3.
Calgary Regional Health Authority. (1996). Primary health care report: A work in progress. Calgary, Canada: Regional Health Authority.
4.
Clarke, J. N. (1996). Health, illness and medicine in Canada. Toronto, Canada: Oxford University Press.
5.
Conte, R. A., Andrews, J. A., & Acton, R. A. (2000). The evaluation of the Alexandra Community Health Centre. Edmonton, Canada: Alberta Health and Wellness.
6.
Engel, G. L. (1977). The need for a new medical model: A challenge for biomedicine. Science, 196, 129-136.
7.
Evans, R. G., & Stoddart, G. (1994). Producing health, consuming health care. In R. G. Evans, M. Barer, & T. Marmor (Eds.), Why are some people healthy and others not: The determinants of health of populations (pp. 27-64). New York: Aldine de Gruyter.
8.
Johnston, C. W. (1996). Community health centers: Evaluation issues and approaches. Canadian Journal of Program Evaluation, 11, 149-157.
9.
Kickbusch, I. (1992). Enhancing health potential. In A. Kaplun (Ed.), Health promotion and chronic illness (pp. 8-10). Cologne, Germany: WHO Regional Publications.
10.
Krieger, N., Moss, N. E., & Williams, D. R. (1997). Measuring social class in US public health research: Concepts, methodologies and guidelines. Annual Review of Public Health, 18, 341-378.
11.
Kuzel, A. J. (1999). Sampling in qualitative inquiry. In B. F. Crabtree & W. Miller (Eds.), Doing qualitative research (2nd ed., pp. 33-45). Thousand Oaks, CA: Sage.
12.
Lalonde, M. (1974). A new perspective on the health of Canadians. Ottawa: Department of National Health and Welfare.
13.
Lepnurm, R. (1995). Consumer-sponsored health centers and health reforms in Canada. Journal of Ambulatory Care Management, 18, 39-46.
14.
Marmot, M., & Wilkinson, R. G. (2001). Income and health: Psychosocial and material pathways—A reply to Lynch et al. British Medical Journal, 322, 1233-1236.
15.
Miles, M., & Huberman, A. (1994). Qualitative data analysis: An expanded sourcebook. Thousand Oaks, CA: Sage.
16.
Miller, W., & Crabtree, B. F. (1999a). Clinical research: A multimethod typology and qualitative roadmap. In B. F. Crabtree & W. Miller (Eds.), Doing qualitative research (2nd ed., pp. 3-30). Thousand Oaks, CA: Sage.
17.
Miller, W., & Crabtree, B. F. (1999b). The dance of interpretation. In B. F. Crabtree & W. Miller (Eds.), Doing qualitative research (2nd ed., pp. 127-143). Thousand Oaks, CA: Sage.
18.
Morse, J. M. (1995). Qualitative research methods for health professionals (2nd ed.). Thousand Oaks, CA: Sage.
19.
Patton, M. Q. (1990). Qualitative evaluation and research methods. Newbury Park, CA: Sage.
20.
Raeburn, J., Rootman, I., & O'Neill, M. (1994). The concept of health: Health promotion in Canada. Toronto, Canada: W. B. Saunders.
21.
Sadler, J. Z., & Hulgus, Y. F. (1990). Knowing, valuing, acting: Clues to revising the biopsychosocial model. Comprehensive Psychiatry, 31, 185-195.
22.
Sadler, J. Z., & Hulgus, Y. F. (1992). Clinical problem solving and the biopsychosocial model. American Journal of Psychiatry, 149, 1315-1323.
23.
Stewart, M., Brown, J., Weston, W., McWhinney, I., McWilliam, C., & Freeman, T. (1995). Patient-centered medicine: Transforming the clinical method. Thousand Oaks, CA: Sage.
24.
World Health Organization. (1998). Health promotion glossary. Geneva: WHO.
25.
Zimmermann, C., & Tansella, M. (1996). Psychosocial factors and physical illness in primary care: Promoting the biopsychosocial model in medical practice. Journal of Psychosomatic Research, 40, 351-358.
