In the ongoing expansion of medical systems toward prevention and health promotion, primary care is increasingly recognized as a key vehicle and agent. In order to establish a comprehensive health dialogue in the population, there is a need for innovative instruments corresponding to the information and linked media revolution that this shift is a part of. Based upon the experiences of the Department of Preventive Medicine in Malm?, Sweden, a self-mediated, interactive health testing and promotion instrument called "healthometer" has been developed and tested for feasibility. The instrument uses a special variety of a quintile-distributed visual analog scale with the thermometer as reference and allows: (a) easy summation and averaging of single or different aggregates of the test items as a "wellness" profile and score with emphasis upon the positive aspects of health, and (b) recognition against this on the whole favorable background of the weak points motivating further action. The instrument, which can be distributed on paper or electronic medium, supports participation and insight in the initial stages of a directed individual health program for the continuation of which the utilization of professional counsel is stimulated.
Community involvement implies conscientious citizen engagement, not as passive recipients but active contributors. Insufficient understanding of concepts of health outcome in a socioeconomic deprived context with unemployment'as a major feature was identified as a hindrance to intervention. This communication gives a report of a "visual starter" used as a cognitive instrument for qualitative research on concepts of joblessness and health. Health education and behavioral change efforts are often insufficient in reaching empowerment on individual or community levels. It is suggested that understanding different categories of thinking using a phenomenographic method could contribute to strategies for community involvement. The "visual starter" uses pictures to introduce the theme as well as for associative purposes in the interview.
Under designations like small areas action research and intervention, directed 'ground-up' health promotion and prevention in the population form an important part of the ongoing medical systems development. There is recent evidence of the success of community intervention against cardiovascular disease. In osteoporosis, however, there is still a lack of conclusive data on both the logics and logistics of such an approach. Since 1988, a county health policy program has been formulated and implemented in Ostergötland, Sweden, following the principles and guidelines of the WHO HFA 2000 declaration. Vadstena (n approximately 7,600) was chosen for a local and generalizable osteoporosis prevention project mediated by the primary care organization by means of health promotion and education in the community. In the present report we emphasize that community intervention is an important new advancement of the medical systems, where the basic research questions include operational and management aspects as equally vital and measurable requisites and results as other performance and outcome variables. We found that a community intervention trial against osteoporosis is both motivated and feasible and in this report wish to provide evidence on these crucial issues of logics and logistics.