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BACKGROUND: The first step of handling health promotion (HP) in Diagnosis Related Groups (DRGs) is a systematic documentation and registration of the activities in the medical records. So far the possibility and tradition for systematic registration of clinical HP activities in the medical records and in patient administrative systems have been sparse. Therefore, the activities are mostly invisible in the registers of hospital services as well as in budgets and balances.A simple model has been described to structure the registration of the HP procedures performed by the clinical staff. The model consists of two parts; first part includes motivational counselling (7 codes) and the second part comprehends intervention, rehabilitation and after treatment (8 codes).The objective was to evaluate in an international study the usefulness, applicability and sufficiency of a simple model for the systematic registration of clinical HP procedures in day life. METHODS: The multi centre project was carried out in 19 departments/hospitals in 6 countries in a clinical setup. The study consisted of three parts in accordance with the objectives.A: Individual test. 20 consecutive medical records from each participating department/hospital were coded by the (coding) specialists at local department/hospital, exclusively (n = 5,529 of 5,700 possible tests in total).B: Common test. 14 standardized medical records were coded by all the specialists from 17 departments/hospitals, who returned 3,046 of 3,570 tests.C: Specialist evaluation. The specialists from the 19 departments/hospitals evaluated if the codes were useful, applicable and sufficient for the registration in their own department/hospital (239 of 285). RESULTS: A: In 97 to 100% of the local patient pathways the specialists were able to evaluate if there was documentation of HP activities in the medical record to be coded.B: Inter rater reliability on the use of the codes were 93% (57 to 100%) and 71% (31 to 100%), respectively.C: The majority of the study participants found the codes to be useful (71%), applicable (92%) and sufficient (92%). CONCLUSION: Systematic registration of HP activities is relevant in clinical day life and the suggested codes proved to be applicable for international use. HP is an essential part of the clinical pathway or the value chain. This model promises to improve the documentation and thereby facilitate analysis of records for evidence based medicine as well as cost and policy analyses.

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The concept of health promotion for children and adolescents in hospitals is relatively new, and an international working group within the WHO-network of Health Promoting Hospitals, is currently seeking to establish specific guidelines. An exploratory study based on a literature review was performed in order to identify (i) what are the health promotion needs of children and adolescents when they access the hospital either as patients, as visitors, or as members of their community; and (ii) if there are any recommended strategies to empower children and strengthen their life-skills and participation capacity in the hospital, as recommended by the Ottawa Charter for Health Promotion. The results of this literature review are mainly descriptive of current practices and recommendations regarding organizational issues, health-care providers' practice behavior, health-care providers' skills and training, children's education, education of parents and social environment.

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"This collection of case studies is meant to enable countries to share their experiences in the planning and implementation of actions to improve children’s health and environment with other member states. Specifically, this project aims to draw attention to actions and implementation experiences carried out at the local and national level as well as highlight the practical elements that made such an action possible and successful. The final aim in collecting the case studies is to provide member states with a collection of relevant examples of actions (with an assessment of the underlying mechanisms and the results achieved) that were prompted by environmental health issues affecting children, to elicit an exchange of experience, inspiration and adaptation to different contexts throughout Europe. Where possible, useful tools and resources that aided the implementation of the given action are documented within the case study. "

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Эта серия исследований имеет своей целью дать различным странам возможность поделиться с другими участниками опытом в планировании и реализации мер по улучшению детского здоровья и окружающей среды. В частности, этот проект нацелен на привлечение внимания к опыту разработки и реализации конкретных мер на местном и национальном уровне, и выделяет практические элементы, благодаря которым эти меры были успешно применены. Конечная цель сбора исследований заключается в предоставлении участникам программы собрания значимых образцов конкретных действий (включая оценку внутренних механизмов и достигнутых результатов) по предотвращению негативного влияния окружающей среды на здоровье детей, поощрении обмена опытом, внедрения и адаптации мер в различных национальных контекстах Европы. В некоторых случаях в исследованиях приведены примеры полезных инструментов и средств, которые помогли реализации программных мер.

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