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Community Approaches to Health Promotion

Community Approaches to Health Promotion. OVERVIEW Public health researchers and practitioners have increased interest in community-based approaches Community as a setting, target, resource, agent ( McLeroy et al., 2003)

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Community Approaches to Health Promotion

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  1. Community Approaches to Health Promotion • OVERVIEW • Public health researchers and practitioners have increased interest in community-based approaches • Community as a setting, target, resource, agent (McLeroy et al., 2003) • Viewing community as a catalyst for change and from an ecological perspective

  2. Community Capacity: Theory and Application DCK Chapter 10 Wendel, Burdine, McLeroy, Alaniz, Norton, Felix

  3. Community First • Discussing community allows us to better understand community capacity • Paradox of American society • Individualist, do-it-yourself ideals go against the idea of collectivism and mutual trust of community • Gemeinschaft and gesellschaft • Historically communities were bound by geography, but that notion has become less relevant • Breakdown of community?

  4. Community Capacity • “Community capacity is regarded as a set of dynamic community traits, resources, and associational patterns that can be brought to bear for community building and community health improvement.” (Wendel et al., p. 285) • How effectively can a community mobilize to address systemic issues?

  5. Contrasting Theoretical Perspectives • Dichotomous terms – but really represent continua • No theory or capacity is represented by absolute terms • Value-free vs. value-based • Level of Analysis – individual vs. social org • Approach • Harmonious/consensus vs. conflict/risk driven • Boundaries – locational vs. relational • Community - homogeneous vs.heterogeneous • Stability of Social Systems – fixed vs. dynamic • Insider (emic) vs. Outsider (etic) Point of View • Issue Focus – specific vs. generalized

  6. Dimensions of Community Capacity • Skills, Knowledge, and Resources • Nature of Social Relations • Structures and Mechanisms for Community Dialogue • Leadership • Civic Participation • Value System • Learning Culture

  7. Real Life: Building Capacity • The Brazos Valley, Texas • Utilized community health development model, guided by Partnership Approach • Formation of Brazos Valley Health Partnership • http://www.cchd.us/ • http://www.cchd.us/pages/reports.html

  8. Back to the Dimensions of Community Capacity: Brazos Valley • Skills, Knowledge, and Resources • Nature of Social Relations • Structures and Mechanisms for Community Dialogue • Leadership • Civic Participation • Value System • Learning Culture

  9. Building Community Capacity:Common Themes • Capacity-building is a parallel outcome of health improvement initiatives • Need for trained facilitators • Participatory nature varies with culture and economic settings • Need to establish the role and impact of social determinants of health • Capacity building includes aspects of skill and knowledge, as well as relational aspects

  10. The Future • Systems perspective is valuable for understanding factors affecting communities’ ability to build capacity • The research agenda: • Narrow the gap between theory and practice • Apply systems perspective to the study of community capacity, focusing on how the components are connected, and viewing capacity as a property • Synthesize measures to enhance our understanding of the dynamics of community capacity • Community Capacity Building - Canada

  11. Four Main Capacities Built • Network development and collaboration • Share skills and resources • Individual leadership capacity • Collective identity and culture • Everyone can contribute • Access to resources • Human, financial, learning opportunities

  12. Natural Helper Models to Enhance a Community’s Health and Competence DCK Chapter 11 Eng, Rhodes, Parker

  13. Who Are Natural Helpers? • Individuals to whom others naturally turn to for advice, emotional support, or tangible aid • Natural helps are effective because they possess an intimate understanding of their communities • Different than lay health advisors or peer educators?

  14. Roots • Natural helper research began with a group of South African researchers • Sidney Kark and Guy Steuart • Continued in the United States, North Carolina

  15. Natural Helper Interventions in Public Health Practice • Community support system • Power to reduce vulnerability to disease and illness • Neighborhood attachment • Informal helping networks • Community competence

  16. Natural Helper Intervention Model • “…natural helpers are linked to individuals, groups, and the wider society that no health professional could begin to reach by him or herself” (p. 317) • Professionals can form partnerships with natural helpers to achieve three levels of outcomes: • Improved health practices • Improved coordination of agency services • Improved community competence

  17. The Future • Challenge for natural helper interventions • enable community support systems and their natural helping networks to understand and respond to unplanned determinants of stability and changes • Generic model for natural helper interventions is unlikely to exist • Future research…

  18. Community-Based Prevention Marketing: A New Framework for Health Promotion Interventions DCK Chapter 12 Bryant, McCormack Brown, McDermott, Debate, Alfonso, Baldwin, Monaghan, Phillips

  19. Community-Based Prevention Marketing (CBPM) • CBPM Theory blends social marketing techniques and community organizing principles • Conceptualized after years of observing social marketing in communities and not with communities • Nine-step process (Table 12.1, p. 334)

  20. Social Marketing • Committed to optimizing the benefits of a behavior while minimizing the costs associated with that behavior • Utilization of the 4 Ps (marketing mix) • Product • Price • Place • Promotion

  21. Nine Stages of CBPM • Mobilize the community • Develop community profile • Select target behaviors, audiences, and interventions • Build community capacity • Formative research • Strategy development for designing or tailoring the intervention • Program development • Program implementation • Tracking and evaluation

  22. Applying CBPM • Applied successfully in 4 settings • Table 12.2, p. 338 • Sarasota, FL – Believe in All Your Possibilities BiAYP • Immokalee, FL - Partnership for Citrus Worker Health • Lexington, KY – Kentucky Tweens Fitness & Nutrition Project • Central South Carolina – Step Up, Step Out!

  23. VERB Summer Scorecard • VERB Summer Scorecard • http://health.usf.edu/publicaffairs/newsreleases/newsrelease08162006.html

  24. Community Approaches • Important points • Awareness as public health researchers and practitioners • Socio-cultural context of the communities we work in • Models are not one size fits all

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