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Hospitals' health promotion services in their communities: Findings from a literature review

Olden, Peter C.; Hoffman, Keith E.

doi: 10.1097/HMR.0b013e3181fb0f2b

Background: Hospitals have long had an important role in the health of communities and the nation. Health promotion (HP) has gained attention in American health and will become more important with the 2010 health reform legislation. Many U.S. hospitals provide HP services in their communities, and hospital leaders are accountable for HP.

Purposes: This article uses a systematic review of research literature to answer three questions about U.S. hospitals' HP services in their communities: (a) What are the characteristics of hospitals that offer HP services? (b) What are the reasons that hospitals offer HP services? And (c) what are the implementation processes hospitals use to offer HP services?

Methodology/Approach: Authors used search criteria and found 255 articles published between 1985 and 2009. Inclusion/exclusion criteria were applied to screen and select articles, and 25 articles were kept and reviewed. Authors independently completed a standard data extraction form for each article, combined and reconciled their data, and created a database of findings.

Findings: Hospital size was positively associated with HP, as were participation in systems, alliances, and networks. Communities' median income, existing HP, population younger than 65 years, population above poverty, and employment levels were positively related to hospitals' HP. Relationships with hospital ownership, managed care, and competition were less clear. External norms, HP diffusion, and mimetic behavior were reasons for hospitals' HP; community benefit laws were less important. To implement HP, hospitals applied management methods, shared resources, collaborated with community organizations, and used a variety of HP methods.

Practice Implications: Collaboration and linkages with other organizations enable hospitals to expand HP. Hospitals should apply management methods (not just HP methods) to effectively offer HP services. Support for small hospitals' HP is needed.

Peter C. Olden, PhD, MHA, is Professor of Health Administration, University of Scranton, PA. E-mail:

Keith E. Hoffman, MHA, BS, is Operations Analyst, Westchester Medical Center, Valhalla, NY.

This work was supported by a grant from the University of Scranton. It was presented on November 10, 2009, at the American Public Health Association Annual Meeting in Philadelphia, PA.

© 2011 Lippincott Williams & Wilkins, Inc.