Green Care: A Conceptual Framework - Frisk i naturen
Green Care: A Conceptual Framework - Frisk i naturen
Green Care: A Conceptual Framework - Frisk i naturen
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elative model of health may be feasible in connection with green care<br />
because it starts from the premise that health is a multidimensional and<br />
dynamic process and not merely an absence of a disease.<br />
When green care is viewed as health promotion, it enables a wide range<br />
of outcomes to be considered on different levels, both on that of the<br />
individual and of society. Effective health promotion leads to changes in the<br />
determinants of health which can be related both to individuals and to the<br />
structure of the society (see: International Union for Health Promotion and<br />
Education, 1999). In addition to direct changes in health status, outcomes<br />
arising from green care can be seen as changes in health behaviour or in<br />
community participation or environmental and political changes.<br />
Health outcome measures include reduced mortality, morbidity, and<br />
disability (ill-health). Social outcomes are related to an individual, and<br />
measured by quality of life, functional independence, and equity (wellbeing).<br />
Health and social outcomes can be achieved by affecting their determinants<br />
such as personal behaviour, environmental conditions and health care<br />
services. Changes in personal behaviour which represent healthy lifestyles<br />
could be measured, for example, by the degree of physical exercise<br />
undertaken or by changes in nutrition.<br />
Environmental conditions may include the quality of the air, the noise level<br />
and the amount of social opportunities present at a green care project. The<br />
effectiveness of health care service may be measured by the provision of<br />
preventive services (for example, a park or a farm can, in this context, be<br />
considered a green care service). These three determinants of health can<br />
be affected by modifying personal, social, and structural factors through<br />
health promotion interventions. An effective health promotion strategy<br />
may affect all three of these at the same time; health and social outcomes,<br />
the determinants of health, and modifiable factors which change the<br />
determinants of health. The effectiveness of green care, when regarded as<br />
health promotion, could be therefore assessed by measuring changes in<br />
different levels i.e. in knowledge, in policy, or in organisational practices.<br />
Changes in lifestyle or in environmental conditions, and in the use of health<br />
services are also relevant indicators in addition to changes in health status.<br />
The health promotion perspective is not a complete framework for green<br />
care, neither does it give unambiguous answers regarding how to measure<br />
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