Regional Health Coordination: An evaluation of the first pilot training program in Lower Austria

BACKGROUND: Starting from 2018, the University of Krems and ‘Tut gut!’ Gesundheitsvorsorge GmbH have jointly implemented the two-year academic program ‘Regional Health Coordination’, which trains students to become a Regional Health Coordinator (RHC). It is funded by the Lower Austrian Health and Social Fund. We evaluated the pilot-program and the work of the RHC in the first two years after graduation. The objectives of the evaluation were to provide 1) a basis for further development of the academic program and 2) an assessment of the achievement of the program objectives. METHODS: The evaluation ran from 2018 to 2022 and followed a mixed-methods approach. Qualitative interviews and focus groups with stakeholders, document analyses of annual RHC activity reports and repeated written community surveys in 13 municipalities were conducted. RESULTS: The evaluation showed that RHCs already bundled health promotion (HP) activities and worked on their HP network within the municipalities during the practical training period. HP was given a higher priority in some municipal administrations. The pilot program was consistently rated positively, and the curriculum was optimized. In the first two years after graduation, the RHCs developed and implemented HP measures and endeavoured to engage citizens. However, genuine involvement was rare. The results showed that future HP interventions should especially target older people, less educated and male citizens. RHCs were seldomly involved in health policy decisions, although they often worked with mayors. Personal characteristics, an existing network in the community and support from the local government were success factors for the work of the RHCs. CONCLUSIONS: RHCs play an important role in the coordination of community HP but should be stronger included in local policy decision-making. Citizens should be more involved in planning and implementing HP measures. KEY MESSAGES: • An academic training program for regional health coordination helped to improve community health promotion. • An existing network and the involvement in the local government facilitated the work of graduated regional health coordinators.