**1. Introduction**

In as early as 1986, the WHO's Ottawa Charter stressed the central importance of participation and civic involvement in the implementation of health promotion programs, policies, and activities. The normative demand for democratic involvement and the strengthening of civic communities, neighborhoods, and groups, but also of the individual citizen in terms of the development of personal competences and skills, pervades the entire text of the Ottawa Charter but is particularly emphasized in individual passages:

"Strengthen community action.

Health promotion works through concrete and effective community action in setting priorities, making decisions, planning strategies and implementing them to achieve better health. At the heart of this process is the empowerment of communities, their ownership and control of their own endeavors and destinies. Community development draws on existing human and material resources in the community to enhance self-help and social support, and to develop flexible systems for strengthening public participation and direction of health matters. This requires full and continuous access to information, learning opportunities for health, as well as funding support" [1].

Of course, this applies not only to the activation and participation of the envisaged target groups [2] in the population, but also to the leading actors in health policy programs and activities. Participation, sharing, civic involvement, cooperation, community action – whatever terminology is used or argued within this context – it tends to move away from the "top-down" approach and toward a more "bottom-up" approach. The advantages of bottom-up approaches are based on opportunities to participate and strong efforts to empower local communities. They have been demonstrated in a number of well-researched examples [3].
