This study aimed to identify and reach consensus among primary health care participants [registered nurses (RNs) who receive clients, directors of nursing, senior physicians, health promotion officers, and local councillors] on the types of service provider that RNs who receive clients represent in the implementation of health promotion practices in primary health care in Eastern Finland.

There is an increasing focus on public health thinking in many countries as the population ages. To meet the growing needs of the health promotion practices of populations, advance practice has been recognized as effective in the primary health care setting. The advance practice nurses share many common features, such as being RNs with additional education, possessing competencies to work independently, treating clients in both acute and primary care settings, and applying a variety of health promotion practices into nursing.

The two-stage modified Delphi method was applied. In round one, semi-structured interviews were conducted among primary health care participants (n=42) in 11 health centres in Eastern Finland. In round two, a questionnaire survey was conducted in the same health centres. The questionnaire was answered by 64% of those surveyed (n=56). For data analysis, content analysis and descriptive statistics were used.

This study resulted in four types of service provider that RNs who receive clients represented in the implementation of health promotion practices in the primary health care setting in Eastern Finland. First, the client-oriented health promoter demonstrated four dimensions, which reached consensus levels ranging between 82.1 and 89.3%. Second, the developer of health promotion practices comprised four dimensions, which reached consensus levels between 71.4 and 85.7%. Third, the member of multi-professional teams of health promotion practices representing three dimensions, with consensus levels between 69.6 and 82.1%. Fourth, the type who showed interest towards health policy reached a consensus level of 55.4% in this study.

To evaluate the impact on nutrition- and health-related practice of two methods of delivery of a nutrition and health intervention in Irish full-day-care pre-schools: training of pre-school managers only or training of managers and their staff.

A simple randomised study with pre-schools divided into two training groups: ‘manager trained’ and ‘manager and staff trained’. Direct observational data – food and fluid provision, physical activity, outdoor time, staff practices and availability of nutrition and health resources – were recorded during one full day spent in each pre-school both pre- and post-intervention, using a specifically developed and validated Pre-school Health Promotion Activity Scored Evaluation Form. Post-intervention, self-assessment data were also collected using the same evaluation tool.

Pre-schools, Midlands of Ireland.

A convenience sample of forty-two pre-schools registered with the Irish Health Service Executive.

From pre- to post-intervention, significant improvement (P < 0·05) in nutrition- and health-related practice was observed within both intervention delivery groups in all areas evaluated: environment, food service, meals and snacks. No additional effect attributable to staff training was observed. Scores assigned by direct independent observation were lower than pre-school self-assessment scores.

The implementation of a training intervention in pre-schools significantly improved practice with no significant benefit of additional staff training. Direct independent observation is required to quantify practice accurately.