Document Type : Original Article


1 Department of Public Health, School of Public Health, Maragheh University of Medical Sciences, Maragheh, Iran

2 Dehaghan Health Center, Isfahan University of Medical Sciences, Isfahan, Iran

3 Vice Chancellor for Resources and Management Development, Isfahan University of Medical Sciences, Isfahan, Iran,


CONTEXT: The World Health Organization (WHO) has emphasized the need for reorientation of
hospitals toward health promotion (HP).
AIMS: This study explores health‑care professionals’ perception of barriers and strategies to
implementing HP in educational hospitals of Isfahan Province in Iran.
SETTINGS AND DESIGN: The study settings included four selective educational hospitals and the
Treatment Administration affiliation to the Isfahan University of Medical Sciences.
SUBJECTS AND METHODS: A qualitative content analysis approach was employed in this study,
with semi‑structured in‑depth interviews. Eighteen participants from hospital and accreditation
managers, nurses, community medicine specialist, and directors of health‑care quality improvement
and accreditation participated in the study by purposeful sampling method. The data were analyzed
using content analysis method.
RESULTS: The barriers can be categorized into the following areas: (1) barriers associated with
patient and community, (2) barriers associated with health‑care professionals, (3) barriers associated
with the organization, and (4) external environment barriers. The results were summarized into four
categories as strategies, including: (1) marketing the plan, (2) identifying key people and training, (3)
phasing activities and development of feasible goals, and (4) development of strategic goals of health
promoting hospitals and supportive policies.
CONCLUSIONS: The interactions of individual, organizational, and external environmental factors
were identified as barriers to implementation of HP in hospitals. To hospital reorientation toward HP,
prioritizing the barriers, and using the proposed strategies may be helpful.


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