Transcript Community Health: Yesterday, Today, and Tomorrow

Community
Organizing/
Building and
Health
Promotion
Programming
Chapter 5
Introduction
• Epidemiology important to community health
• Two other skills for community health workers
– Community organizing/building
– Health promotion programming
Community Organizing Defined
“A process through which communities are
helped to identify common problems or
goals, mobilize resources, and in other ways
develop and implement strategies for
reaching their goals they have collectively
set” (Minkler & Wallerstein, 2005)
Related Definitions - 1
• Community capacity– Community characteristics
affecting its ability to identify, mobilize, & address
problems (Goodman et al., 1999)
• Empowered community– “One in which
individuals and organizations apply their skills and
resources in collective efforts to meet their respective
needs” (Israel et al., 1994)
Related Definitions - 2
• Participation & relevance– “Community
organizing that starts where the people are and
engages community members as equals” (Minkler &
Wallerstein, 2005)
• Social capital– “relationships and structures within
a community that promote cooperation for mutual
benefit” (Minkler & Wallerstein, 2005)
Need for Organizing Communities
• Advances have moved us to the need to
organize
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Electronics (e.g., digital TV)
Communications (e.g., multi-function cell phones)
Household upgrades (e.g., energy efficiency)
Increased mobility (e.g., frequency of moving)
Lack of interaction with neighbors
Size of communities
Assumptions of Community Organization
1. Communities of people can develop the
capacity to deal with their own problems
2. People want to change and can change
3. People should participate in making,
adjusting, or controlling the major changes
taking place within their communities
4. Changes in community living that are selfimposed or self-developed have a meaning and
permanence that imposed changes do not have
Assumptions of Community Organization - 2
5. A “holistic approach” can deal successfully with
problems with which a “fragmented approach”
cannot cope
6. Democracy requires cooperative participation
and action in the affairs of the community, &
people must learn the skills that make this
possible
7. Frequently, communities of people need help in
organizing to deal with their needs, just as many
individuals require help with individual problems
Community Organizing Methods
• Locality development– based on the concept of
broad self-help participation from the local community
• Social planning– is heavily task oriented, stressing
rational-empirical problem solving & involves various
levels of participation from many people & outside
planners
• Social action– a technique that involves the
redistribution of power & resources to disadvantaged
segments of the population
Generic Approach to Community Organizing - 1
• Recognizing the issue
– From the inside– grass-roots, citizen initiated,
bottom up
– From the outside– top down
• Gaining entry into the community
– Gatekeepers
– Being culturally sensitive & working toward
culturally competent
Generic Approach to Community Organizing - 2
• Organizing the people
– Executive participants
– Networking & expanding the constituencies
– Creating an association, task force or coalition
• Assessing the community
– Needs based vs. assets based; mapping
– Community building: “an orientation to community
that is strength-based rather than need-based &
stresses the identification, nurturing, & celebration
of community assets” (Minkler, 2005)
Generic Approach to Community Organizing - 3
• Determining the priorities & setting goals
– Build ownership
– 5 criteria for selecting problem: winnable, simple
& specific, must unite, affect many & build
community, & part of larger plan (Miller)
• Arriving at a solution & selecting
intervention strategies
– Create an intervention
– Avoid turfism
Generic Approach to Community Organizing - 4
The Final Four Implementing
Steps
Looping back
Evaluating
Maintaining
Other Models Used for Community
Organizing/Building
• Healthy
Cities/Healthy
Communities
• Mobilizing for Action
through Planning &
Partnerships
(MAPP)
• Planned Approach to
Community Health
(PATCH)
© Centers for Disease Control and Prevention
Health Promotion Programming - 1
• Health education– “any combination of planned
learning experiences based on sound theories that
provide individuals, groups, and communities the
opportunity to acquire information and the skills to
make quality health decisions” (Joint Committee, 1991)
• Health promotion– “any planned combination of
educational, political, environmental, regulatory, or
organizational mechanisms that support actions and
conditions of living conducive to health of individuals,
groups, and communities” (Joint Committee, 1999)
Health Promotion Programming - 2
• Many different planning models
– PRECEDE/PROCEED: best known
– Multilevel Approach to Community Health
(MATCH)
– Intervention Mapping: newest model
– CDCynergy: best for health communication
– Social Marketing Assessment & Response Tool
(SMART)
– Generalized Model for Program Planning
Generalized Model for Program Planning - 1
• Preliminary steps
– Who makes up the priority population?
– Understand & engage the priority population
– Planning committee
• Assessing the Needs of the Priority Population
Generalized Model for Program Planning - 2
Assessing the Needs
Determining the purpose & scope
Gathering data
Analyzing the data
Identifying factors linked to the health problem
Identifying the program focus
Validating the prioritized need
Generalized Model for Program Planning - 3
After the needs assessment should have answers to:
• Who is the priority population?
• What are the needs of the priority population?
• Which subgroups within the priority population have the
greatest need?
• Where are the subgroups located geographically?
• What is currently being done to resolve identified needs?
• How well have the identified needs been addressed in the
past?
Generalized Model for Program Planning - 4
• Setting Appropriate Goals & Objectives
– Goals: future event
– Objectives: steps to reach goals; several levels
(process/administrative, learning, action/behavioral,
environmental, program)
• Creating an Intervention
– Activities to reach goals & objectives
– Amount is important; multiple exposures
– Consider ecological perspective; multiple levels
Generalized Model for Program Planning - 5
• Implementing the Intervention
– Pilot test
– Phasing in
– Full implementation
• Evaluating the Results
– The process of determining the value or worth of the
object of interest
– Standards of acceptability: stated in the objectives
– Formative & summative
Generalized Model for Program Planning - 6
Evaluating the results - 1
Planning the evaluation
Evaluating the Results - 2
Planning the
evaluation
Collecting the data
Evaluating the Results - 3
Planning the evaluation
Collecting the data
Analyzing the data
Evaluating the Results - 4
Planning the evaluation
Collecting the data
Analyzing the data
Reporting results
Evaluating the Results - 5
Planning the evaluation
Collecting the data
Analyzing the data
Reporting results
Applying the results
Community Organizing/Building and
Health Promotion Programming
Chapter 5 - The End