"Take control or lean back?" Barriers to practicing empowerment in health promotion

During the past few decades, health promotion has increasingly focused on the empowerment of deprived communities and is shifting from a top-down approach to a participatory practice, aimed at helping people to gain control over their lives and health. Previous research shows that this shift is not without problems. In the Netherlands, an action learning program on empowerment was developed to help health promotion practitioners in this transition. Twenty-four practitioners from different fields of health promotion took part in a 6-month program. Qualitative data were collected from different sources and methods and were analyzed using a thematic analysis. The findings threw light on a core dilemma in health promotion practice and several barriers to bringing empowerment into practice, both on a personal level and in relationship to the community and the wider institutional context. The implications of this study for the empowerment ethos of health promotion and its feasibility within the current West European policy context are discussed.