In this blog post, Renske van Lonkhuijzen (renske.vanlonkhuijzen@wur.nl), PhD candidate at Wageningen University, addresses empowerment. She explains why empowerment is not a buzzword but rather an ability that has great importance in public health and requires a shift in roles of health professionals.

The word ‘empowerment’ is often treated as an empty buzzword because of being overused. Though, I’m sure most would agree on the importance of this ability. Because empowerment is, as defined by Portela and Santarelli, ‘the ability of individuals or groups to improve capacities, to critically analyse situations and to take actions to improve those situations’ Using my research as an example, I will explain why empowerment is not a buzzword, but rather a crucial aspect in public health policy.

In my research I aim to improve dietary intake among pregnant women. Though my research is not the first initiative in the world to do this, what ís unique is the use of empowerment to achieve this aim. In my research I will further develop, implement and evaluate a strategy that empowers pregnant women to have a healthier dietary intake – a strategy that has been developed in collaboration with professionals and pregnant women. In this blog, I will 1) explain the concept of empowerment using three main aspects: conducting a dialogue, a positive viewpoint and its holistic approach, 2) apply these aspects to my research, and 3) make my concluding remarks.

Conducting a dialogue

A key aspect of empowerment is conducting a dialogue in which parties, for example professionals and clients, are on the same level in terms of power. Ultimately, clients determine what meaningful goals are for them, to make sure the focus is on something the client is open to work on and where room for change is available. This is crucial, as literature shows that individuals are most likely to change their behaviour to make healthier choices when they are motivated and educated to do so, in addition to environments and policies that supports these decisions. Therefore, for example, an empowering dialogue means for my research that if a professional argues the client benefits most from eating more fish, but the client would like to focus on eating less red meat – the clients’ desires are leading. Of course, the professional can create awareness, in dialogue, about the importance of eating more fish, but that is always with the approval of the client (by e.g. asking: ‘May I tell you something about that?’).

Positive viewpoint

The modern concept of empowerment is not only associated with the emancipation of disadvantaged individuals, but also increasingly as a strategy to strengthen the capabilities and the self-reliance of individuals. Therefore, empowerment is about increasing opportunities to achieve life goals and reinforcing what is already going well. Empowerment allows for a shift in thinking to a more positive viewpoint and a focus on: what is going well and where do you want to take another step? This positive shift in thinking provides motivation and can be applied to most aspects of public health. In particular to the theme of nutrition, a more positive point of view will provide motivation to the pregnant women. Research shows that nutrition often has a negative connotation of “diet” and “nothing is allowed”. This causes approaches where the main message is ‘you are not eating properly’ to not be effective.

Holistic approach

Although unthinkable for many, health is not the most important life goal for everyone. Especially for groups of lower socioeconomic status, other life goals such as income, stress and social relationships can be more important. Working from an empowerment perspective allows for a holistic approach. This is important in such cases, to be aware of experienced barriers, integrate specific needs and to not solely insist on health. Failing to recognize these barriers can be disempowering, as Boumans states: “People become empowered when they learn to distinguish between the current situation and their future possibilities, but always with the recognition of existing vulnerabilities and impossibilities”. Especially among pregnant women, aspects like sleep, stress and physical complaints are very influential on someone’s dietary intake and can cause barriers. In my research therefore, besides solely nutrition, also other topics are discussed such as someone’s nutritional environment and experienced barriers. Failing to recognize these barriers can be disempowering. Empowering and supporting pregnant women to take small steps in their dietary intake – steps they are motivated for and can succeed in – will open possibilities for taking next steps.

In conclusion

Empowerment in public health will result in collaborative, reciprocal and trusting relationships between professionals and clients, driven by a shared goal and mutual respect. My research is one of the examples of how empowerment is not an empty buzzword, but an ability that can contribute to the field of public health. Though, literature shows that creating an open dialogue as a health professional is not self-evident and requires health professionals to become empowered as well. This approach requires health professionals to reconsider their role – shifting from a more traditional role (e.g. focusing solely on providing advice) to a more innovative role (e.g. with increased focus on changing people’s environments). In this role, as mentioned by Koelen and Lindstrom, professionals can ‘support people by enabling reflection on barriers and opportunities for change and strengthening one’s capacity to make those changes’. In an empowering relationship, the client is involved in not only defining the problem, but also in actively finding a solution to this problem. Empowerment is therefore gained by people themselves, and not something that can be imposed on someone.