Health promotion and prevention in early times of the COVID-19 pandemic: insights from a Delphi study in Switzerland.

Background: COVID-19 pandemic and confinement measures had a major impact on the health and well-being of the population. Health promotion and prevention (HP&P) professionals had to rethink their practices to respond to the challenges raised by the pandemic context. This study aimed to build a professional consensus on the HP&P priorities (apart from the COVID-19 fight) in the early times of the pandemic in Switzerland and to identify the most relevant interventions to respond to these issues.

Methods: HP&P experts from the three main linguistic regions of Switzerland reached a consensus through a two-round Delphi methodology with online questionnaires in June-July and October-November, 2020. Out of 282 experts contacted, 121 (43%) contributed in the first round and 99 (35%) in the second.

Results: A strong consensus emerged about the importance of tackling mental health problems, non-communicable diseases and their main risk factors, as well as multiple social determinants of health. Although they believed that HP&P priorities changed in this context, experts reported that professional practices had only partially adapted to this new context due to multiple constraints (political, strategic, financial). The experts noted the need to adapt the means of communication to reach the different target groups. They underlined the potential of communication via digital technologies, but also drew attention to the risk of widening social inequalities due to the unequal access to these resources.

Conclusions: This study generated new insights and confirmed pre-established knowledge regarding the orientations the field of HP&P should follow. While stressing the need to consolidate the traditional missions of the field (i.e. the fight against non-communicable diseases and the actions on social determinants of health), experts surveyed in this study also revaluated health priorities and rethought the way of developing HP&P actions in this specific context of the early pandemic of COVID-19.