Transcript Models and Frameworks - Cross Cultural Health Care Conference
Cross Cultural Health Care Conference Community Collaborations and Interventions: Models of Community Engagement
October 8, 2011 Angela Sy, DrPH Assistant Professor Office of Public Health Studies UH John A. Burns School of Medicine
Background and Rationale Community members have an extensive set of skills, strengths, and resources which can be harnessed to address the social determinants of health and to promote good health Complex health and social problems ill-suited to “outside experts”
Background and Rationale
Enhance the effectiveness of public health interventions
Tailored to the concerns and cultures
Include participants in all aspects of intervention design, implementation & evaluation
Holistic focus on broader social & structural determinants of health
Background and Rationale
“It is a powerful vehicle for bringing about environmental and behavioral changes that will improve the health of the community and its members” (CDC, 1997)
Definition of Community Engagement
CDC, 1997: “ The process of working collaboratively with and through groups of people affiliated by geographic proximity, special interest, or similar situations to address issues affecting the well-being of those people.
”
Definition of “ Community ” A group of people: Linked by social ties Sharing common perspectives or interests Who may or may not share a geographic location
Definition of “ Community ” Common designations: Culture or ethnic heritage Where we live Similar age Speak the same language Religion
Concepts of Community Engagement Culture: Kieffer, 2007 Community organizing: Minkler, 1990 Community participation: Butterfoss, 2006; Wandersman et al , 1987 Capacity building: Eng et al., 1994 Community empowerment: Maton, 2008 Coalition building: Cohen, 2002
Benefits of Community Engagement Agenda Implementation design, delivery and change:
–
Relevance
– –
Feasibility Sustainability Community involvement and goodwill:
–
Competence
– –
Capital Capacity
Benefits of Community Engagement Co-learning:
– – – – –
Academic Community organizations Research participants Community members General public
Models and Frameworks Social Ecological Model: Stokols, 1996
CDC, 2007
Models and Frameworks Social Ecological Model: Stokols, 1996
Constructing Social, 2009
Models and Frameworks
Association of Alaska School Boards
Models and Frameworks
International Association of Public Participation
Models and Frameworks
International Association of Public Participation
Models and Frameworks ABLe Change Framework – Engaging Community Toward Systems Changes
Foster-Fishman & Watson, 2011
Community-Based Participatory Research
Brings together researchers and communities
Share power Address community identified needs Foster co-learning Cultural humility
Vis a vis cultural competence Professionals cannot master another’s culture What it is and isn’t
An approach involving empowerment, social justice values—health disparities Applied to influence equitable change in community health, norms, systems, programs, policies
Models and Frameworks CBPR Trajectory
Co-Option Compliance Consultation Cooperation Co-Learning Collective Action ON Parkes, 2001 FOR FOR/WITH WITH WITH/BY (CPPR) BY Community sets research agenda and mobilizes
with or without
outside facilitation
Models and Frameworks Ripple Model for Growing Effective CPP Researchers community Cultural safety training Strengthening communities on community’s terms
Burke, 2011
Models and Frameworks
Routes of Transformation Cultural safety training
Burke, 2011
Models and Frameworks CBPR Conceptual Model
Minkler et al., 2008
Principles of Community Engagement (CDC,2011)
Be clear about the purposes or goals of the engagement effort, and the populations and/or communities you want to engage.
Become knowledgeable about the community in terms of its economic conditions, political structures, norms and values, demographic trends, history, and experience with engagement efforts. Learn about the community’s perceptions of those initiating the engagement activities.
Principles of Community Engagement (CDC,2011)
Go into the community, establish relationships, build trust, work with the formal and informal leadership, and seek commitment from community organizations and leaders to create processes for mobilizing the community.
Remember and accept that community self determination is the responsibility and right of all people who comprise a community. No external entity should assume it can bestow on a community the power to act in its own self-interest.
Partnering with the community is necessary to create change and improve health.
Principles of Community Engagement (CDC,2011)
All aspects of community engagement must recognize and respect community diversity. Awareness of the various cultures of a community and other factors of diversity must be paramount in designing and implementing community engagement approaches. Community engagement can only be sustained by identifying and mobilizing community assets, and by developing capacities and resources for community health decisions and action.
Principles of Community Engagement (CDC,2011)
An engaging organization or individual change agent must be prepared to release control of actions or interventions to the community, and be flexible enough to meet the changing needs of the community.
Community collaboration requires long-term commitment by the engaging organization and its partners.