The concept of health promotion rests on a number of important aspirations, strategies and action areas all of which aim at enabling people to increase control over, and to improve, their health. The Ottawa Charter for Health Promotion from 1986 specifies that the practical implementation of health promotion strategies is facilitated in settings such as schools, home, work and local community. Conceptualised more broadly, a setting may be regarded as a place or social context where people actively use and shape the environment; a setting is thus both the medium and the product of human social interaction. In conjunction with the increased recognition of the importance of the social determinants and multisectoral nature of health, we reflect critically on the practical arm of health promotion and introduce a modified concept, the supersetting approach, in an effort to harmonise the setting approach with contemporary realities (and complexities) of health promotion and public health action.

The supersetting approach argues for synergistic and coordinated interventions carried out concurrently in a variety of different settings and involving a variety of different stakeholders but targeting a common goal such as increased health equity in a population. The supersetting approach optimises the effectiveness of health promotion action by working through long-term intersectoral partnerships between civil society organisations, public institutions, private companies and research institutions. These partnerships are organisationally anchored in local community structures and build on local community involvement and ownership in defining health promotion needs, and in implementing and evaluating health promotion strategies and actions. The supersetting approach generates knowledge through interdisciplinary action research using state-of-the-art qualitative and quantitative research methodologies. This knowledge is used to adjust health promotion strategies and interventions iteratively as initiatives unfold. Involved research institutions thus play an active role in supporting development processes at the expense of absolute operational (but not scientific) neutrality.      

This presentation discusses the need for revitalising the setting approach for sustainable impact in health promotion and uses ongoing initiatives within three Danish municipalities to illustrate the strengths and challenges related to contextual, political and organisational pressures of establishing local community partnerships based on the supersetting approach. It is argued that the supersetting approach provides a useful conceptual framework for modernised health promotion action and that action research as an instrument for generating knowledge and informing change processes is a proper research strategy for assessing the effectiveness and sustainability of health promotion initiatives using the supersetting approach.