Evaluation Statement

• Health promotion strategies demonstrate varying levels of effectiveness depending on their design characteristics and implementation approach.
• Assessment reveals that community engagement, evidence-based targeting and sustainable funding are most critical for achieving successful health outcomes.

Community Engagement and Cultural Relevance

• Community involvement shows excellent effectiveness in ensuring health promotion strategies meet population needs and gain widespread acceptance.
• Programs developed with target communities demonstrate superior participation rates and sustained behaviour change compared to top-down approaches.
• Aboriginal health programs incorporating Elder knowledge and cultural practices achieve significantly better outcomes than culturally inappropriate interventions.
    
• Target group participation in program design creates strong ownership and relevance that enhances message acceptance.
• For example, youth-led anti-smoking campaigns resonate more effectively with teenagers than adult-designed programs.
• Cultural competence proves essential for reaching diverse populations effectively.
• Multilingual resources and culturally appropriate imagery increase program accessibility and effectiveness across different demographic groups.

Evidence-Based Targeting and Intersectoral Collaboration

• Scientific evidence demonstrates high value in guiding strategy development and resource allocation toward proven interventions.
• Programs targeting specific risk factors with measurable objectives achieve superior results compared to broad, unfocused approaches.
• Heart health initiatives focusing on dietary modification and physical activity show clear effectiveness through reduced cardiovascular disease rates in targeted populations.
   
• Intersectoral collaboration produces substantial benefits by addressing multiple health determinants simultaneously.
• Partnerships between health services, schools, community organisations and government agencies create comprehensive support systems that reinforce health messages across different environments.
• Australia’s Slip Slop Slap campaign exemplifies this approach, combining media, education and policy interventions to achieve remarkable success in reducing skin cancer rates.

Final Evaluation

• Assessment demonstrates that highly successful health promotion strategies consistently incorporate community engagement, cultural relevance, evidence-based targeting and intersectoral collaboration.
• These characteristics create optimal conditions for sustainable health behaviour change and maximum population impact across diverse Australian communities.

\(C\)

• The Ottawa Charter action areas systematically address social justice principles by establishing equitable health opportunities and removing barriers to participation.
• Developing Personal Skills promotes equity through accessible health education programs. Health literacy initiatives enable individuals from diverse backgrounds to make informed decisions. School-based nutrition education guarantees all students receive knowledge regardless of socioeconomic status, eliminating access barriers to health information.
• Creating Supportive Environments facilitates participation by removing physical and social obstacles to healthy choices. Smoke-free public spaces safeguard everyone’s right to clean air, maintaining equitable health protection. Workplace safety regulations establish environments where all workers have equal access to safe conditions.
• Strengthening Community Action empowers communities to participate in health decision-making processes. Community health committees allow local voices to influence health services, upholding participation rights. Indigenous communities leading health programs illustrates culturally appropriate participation. 
• Reorienting Health Services addresses equity by adapting services to meet diverse population needs. Culturally responsive healthcare breaks down access barriers for multicultural communities. Mobile health services deliver access to remote areas, advancing geographical equity.
• Building Healthy Public Policy generates systematic change that supports rights-based approaches to health. Anti-discrimination legislation maintains equal access to healthcare services, tackling structural inequities that limit participation.

\(A\)

• The reorientation of health services involves shifting from purely curative approaches to preventative care models. This occurs because health services have changed focus from purely treatment centred models to those with a disease prevention focus through early intervention strategies. The National Tobacco Campaign demonstrates this reorientation effectively.
• As a result, general practitioners now provide smoking cessation counselling and prescribe nicotine replacement therapies rather than only treating smoking-related diseases. Consequently, health professionals receive training in behaviour change techniques to support patients wanting to quit smoking.
• The underlying reason is new service delivery models where doctors actively screen for smoking status during routine consultations. Thus, the major change is that patients receive lifestyle prescriptions and referrals to Quitline services before developing tobacco-related conditions.
• Therefore, the healthcare system now emphasises prevention through early identification and intervention, which means that resources focus on stopping health problems before they require expensive treatments to cure.

Judgment Statement

• Action areas of the Ottawa Charter significantly influence Australian health promotion initiatives. These frameworks provide comprehensive guidance for designing effective population health strategies across multiple health issues.

Strongest Evidence – Comprehensive Integration

• Building healthy public policy demonstrates substantial influence through legislative measures targeting population health improvements. Tobacco control policies exemplify this action area through plain packaging laws, advertising restrictions, and taxation strategies. These policies create supportive environments that make healthy choices easier for all Australians. Additionally, alcohol taxation and licensing restrictions show how policy frameworks directly shape health promotion effectiveness.
• Developing personal skills shows strong implementation across diverse health promotion programs targeting individual capacity building. The Life! program for diabetes prevention provides education sessions teaching participants about nutrition and physical activity management. This approach empowers individuals with knowledge and skills needed for sustainable behaviour change and chronic disease prevention.

Secondary Evidence – Strategic Coordination

• Creating supportive environments influences workplace health initiatives and community infrastructure development. Heart Foundation walking groups establish safe community spaces for physical activity participation. However, implementation varies across different geographical areas, with rural communities experiencing reduced access to comprehensive environmental supports compared to metropolitan areas.

Reaffirmation

• Evidence demonstrates significant influence of Ottawa Charter action areas in shaping Australian health promotion design and implementation. The framework provides essential structure for addressing population health challenges through coordinated multi-strategy approaches.

Judgment Statement

• The Ottawa Charter has significantly improved Australian health through comprehensive action across multiple areas, delivering substantial population health benefits.

Strongest Evidence – Policy and Environmental Changes

• Healthy public policy initiatives have created substantial health improvements across Australia.
• Plain packaging legislation for tobacco products demonstrates highly effective policy implementation and has contributed to declining smoking rates across all demographics.
• Creating supportive environments through comprehensive smoke-free public spaces has reduced community exposure to passive smoking.
• Building healthy public policy through mandatory helmet laws has significantly reduced head injury rates among cyclists and motorcyclists.
• Reorienting health services towards prevention has shifted healthcare focus from treatment to early intervention.
• These policy-driven changes have resulted in measurable decreases in smoking-related diseases, improved respiratory health outcome and enhanced road safety statistics nationally.

Secondary Evidence – Individual and Community Empowerment

• Developing personal skills through extensive health education campaigns has substantially enhanced health literacy among Australian communities.
• Programs like SunSmart have successfully educated diverse populations about skin cancer prevention strategies. Consequently improved sun protection behaviours have emerged and reduced melanoma incidence rates have been seen.
• Strengthening community action through locally-led health initiatives has enabled effective grassroots health promotion. In particular Aboriginal and Torres Strait Islander communities have benefited through culturally appropriate programs that respect traditional healing practices while incorporating contemporary health knowledge.

Reaffirmation

• Evidence demonstrates the Ottawa Charter has substantially improved Australian health outcomes.
• Integrated policy frameworks, environmental modifications and community-based approaches have delivered measurable benefits.
• These improvements span diverse demographic groups nationally.

• The SunSmart campaign demonstrates how strengthening community action creates sustainable health improvements across Australia. Such initiatives work by empowering local communities to develop their own skin cancer prevention strategies rather than relying solely on government directives.
• The campaign operates through community partnerships where local councils, schools and sporting clubs collaborate to implement sun protection policies. For example, surf lifesaving clubs install shade structures and enforce “no hat, no play” rules during peak UV hours. This community ownership ensures policies remain relevant to local needs and conditions.
• Furthermore, the campaign enables communities to advocate for environmental changes such as shade sails in playgrounds and UV monitoring systems. These community-driven actions result in sustained behaviour change because residents feel ownership over the initiatives. Consequently, skin cancer rates have declined in participating communities, demonstrating how strengthening community action produces long-term health improvements through local empowerment and collective responsibility.

\(B\)

\( D\)

\( B\)

\( C\)