A Compelling Health Promoting Primary Care Clinic Using a Settings-Based Approach: A Demonstration Project
Bibliographic record
Abstract
The Ottawa Charter for Health Promotion, issued by the World Health Organization in 1986, called for several strategies to promote the public's health. One of the strategies was to create health-promoting health services. Over 35 years have passed since the Ottawa Charter was released, since then, efforts to improve health care have been implemented such as the Patient-Centered Medical Home, the Triple Aim, and the Affordable Care Act, yet little has been done to reorient the cultural and physical environment of health care services to one focused on health promotion. In this perspective, the author offers a compelling description of how one primary care clinic, serving an ethnically and economically diverse population, utilized a settings-based approach to design and implement several health-promoting policies, systems, and environmental strategies. This reorientation of a primary care clinic to one that is health-promoting leveraged the clinical specialty of lifestyle medicine as a cornerstone of the settings-based approach.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.009 | 0.006 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.013 | 0.004 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.003 | 0.007 |
| Research integrity | 0.004 | 0.007 |
| Insufficient payload (model declined to judge) | 0.007 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".