Child development concepts - meaning

Clinical Reference Groups Nursing CRG
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Hi all,

A customer request has been received looking to clarify the meaning of two child development procedure concepts. The requester would like to understand the meaning of each and the difference between the two concepts. This includes understanding the difference between promotion and enhancement.

ICNP definitions:

  • Promoting: “Assisting: Helping to begin or advance something for somebody.”
  • Enhancing: “Promoting: Heightening, intensifying, or improving something already of good quality.”
  • Promoting is a parent of enhancing in ICNP.

Input from the Nursing CRG members on their understanding of these concepts would be appreciated.

Thank you.

Cathy

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Notes from the December 2025 Nursing CRG:

  • Gravity Project uses promotion in the intervention framework
  • Input will be sought regarding terming used in the Nursing Intervention Classification
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Discussed in the January meeting

  • The difference between the two terms isn’t clear to several in the group.
  • The definitions from ICNP help to explain the differences but definitions are not necessarily present in the interface.
  • The two terms (enhancement and promotion) are an issue from a translation perspective.
  • This issue has been discussed in the past in Sweden and potentially at the international level. Erica to seek further information on this from a Swedish perspective. Cathy will check the international group tracker.
  • Friso will look further too on the meaning of these concepts and add comments here.
  • A query on whether this was an issue more broadly in relation to the use of both enhancement and promotion used for similar concepts will be looked at.

Post meeting the International Translation User Group tracker was checked but I was unable to find a ticket on the topic.

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I was able to speak with our terminologist and here is her response:

In a large national terminology investigation, where the Public Health Agency of Sweden (FOHM), the Swedish Agency for Health Technology Assessment (SBU), as well as representatives from both healthcare and social services participated, we discussed issues closely related to what you refer to as Promote. In a separate national pharmaceutical investigation led by the Swedish Association of Local Authorities and Regions (SKR), we addressed questions similar to what you refer to as Enhance. One of the challenges identified in that work was that “treatment” is often not clearly defined, leading many to equate it solely with pharmacological treatment, which is in fact only a subordinate concept.

Starting from your definitions:

  • Promoting: “Assisting: Helping to begin or advance something for somebody.”

  • Enhancing: “Promoting: Heightening, intensifying, or improving something already of good quality.”

  • Promoting is a parent of enhancing in ICNP.

A potential issue with the definition of Enhancing is the phrase “already of good quality.” usage of Enhancing, in Sweden, does not necessarily imply that the starting point is good. In Sweden, for example, health services (hälsovård) are not limited to individuals without problems. The definition without this ending would be more accurate.

In Swedish terminology work, we described the distinction as follows:

  • Treatment to improve (strengthen, increase, elevate) a patient’s outcome or capacity (ENHANCE)

  • Measures to “promote,” meaning health-promoting actions aimed at preventing, curing, or alleviating conditions—that is, health-oriented interventions (PROMOTE)

When we were doing the terminology analysis of terms related to prevention, this was a part of the discussion and the definitions. Prevention is more or less what you call promote. FOHM in Sweden also use promote (främja) for exactly the same kind of actions as the health care sector, but the difference is that primary prevention could be directed to groups or the sopciety as well, but secondary and tertiary prevention are for the individual person. For FOHM it is only groups or the society as a whole. So in Sweden, Prevention would be a better term compared to promote.

Enhancing would be down to the individual treatment of something you want to prevent from escalating (going from bad to worse), developing at all (there is a predisposition for something), or prevent it from recurring. So enhance would be the individual actions taken, while promote/prevent would be the procedure.

  • Enhance refers to individual therapeutic or supportive actions.

  • Promote/Prevent refers more broadly to preventive or health-oriented procedures.

I think you got the right order that Promote is the parent concept (where the definition should be re-written) but the term could need a definition where prevention or similar terms with the same meaning (promote is a tricky word to translate in many languages and not explicitly a medical term) are used, which emphasizes the three different kinds of prevention I outlined above.

I hope this is helpful!

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Response from Cheryl Wagner during then Nursing CRG meeting

Hello,

I have included Christina Spisla on this as she was asking Karen and I previously for this information. I apologize that it was so long for us to respond - we had - and still have - quite a few commitments that tend to backlog some of our work!

But thanks for checking Friso, and hopefully I will see you at the meeting in case more information is needed.

The NIC has a section in its Appendices, Appendix B, where some definitions of terms that might be used in NIC activities are provided, largely I suppose, because Dr. Dochterman and Dr. Bulechek addressed many of these questions decades ago when the NIC was created.

The definition for Enhancement is

Making greater, augmenting, increasing

The definition for Promotion is

Advancing

Interestingly, both also include directions to see the other one in their definitions.

AI responds that the difference between the two is that enhancement is more internally related to quality and internal improvements, while promotion is an external advancement. Enhancement is internal refinement, promotion is external elevation.

In relation to child development, it seems that the intention - at least from the NIC application of the terms - is to advance the child through stages of development, so in this case Promotion seems to be more of a correct selection.

Nonetheless, increasing their development ability could also be enhancing it without necessarily promoting or advancing it - but the user of the term would have to be clear what they intend.

I will try to be at the meeting today to field questions on this, in case it helps.

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Thank you all for the input on this one. I have fed back to the requester on the differences in meaning.