An analysis of comprehensive health promotion programs' consistency with the systems model of health

Purpose. The purpose of this article is to report a review and analysis of the concordance between current comprehensive corporate health promotion programs as described in the published literature and the systems model of health and to explore emerging trends in the field of health promotion. Search Methods. MEDLINE, BIOSIS, and PsycINFO searches were conducted from 1985 to 1991, and the bibliographies of articles thus obtained were back searched for additional descriptions of corporate health promotion programs. Inclusive criteria included "comprehensive" corporate programs, published in peer-reviewed journals or books, and descriptions adequate enough to permit coding in the majority of analysis matrix categories. Out of 63 identified programs, 16 met the inclusion criteria; 47 were excluded. A common reason for rejection was the limitation imposed by inadequate program descriptions in the published literature. Major Findings. On average, the comprehensive corporate programs reviewed were initiated between 1984 and 1987 and set in the context of a manufacturing firm with over 10,000 employees. A minority of programs (12.5%) consistently satisfied systems model criteria. The most common category of programs were those which were inconsistent (44%), meeting some of the criteria of a systems model of health promotion, but not all. The mechanistic medical and public health models predominated strongly (63%) with the preeminent goal being individual risk factor modification. Conclusions. The limitations of the published literature do not permit strong conclusions about the number or degree to which current corporate comprehensive programs are concordant with the systems model of health. Although mechanistic models of health predominated, there is evidence that a number of comprehensive programs were inconsistent with the mechanistic model, meeting some of the criteria, but also meeting some systems model criteria. To continue the advancement of health promotion with clarity and focus, further research is needed to clarify outcomes across different "world view" models of health promotion. Health promotion specialists need to carefully scrutinize programs emanating from different "world view" models as they design, develop, implement, and evaluate corporate programs.