COMMUNITYBASED HEALTH PROMOTION

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COMMUNITY-BASED HEALTH PROMOTION

• Kaia Gallagher, Ph.D.
• Douglas Easterling, Ph.D.
• Dora Lodwick, Ph.D.

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SESSON OBJECTIVES

• Define the various roles of the community in C-B
  health promotion
• Provide concrete examples of how C-B health
  promotion projects can be organized, implemented
  and evaluated
• Summarize a continuum of outcomes from C-B health
  promotion efforts

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BACKGROUND

• Project examples are derived from 7 initiatives
  funded by The Colorado Trust during the 1990s
• More detailed summaries of these initiatives are
  provided in the book PROMOTING HEALTH AT THE
  COMMUNITY LEVEL
• Purpose of this session is to synthesize the
  broader cross-site findings from these
  initiatives

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WHAT IS COMMUNITY-BASED HEALTH PROMOTION?

• The defining feature of community-based health
  promotion lies in the role given to community
  residents and their representatives in planning,
  implementing and evaluating health promotion
  initiatives.

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RANGE OF C-B INITIATIVES EXAMINED
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COMMON ELEMENTS ACROSS THE INITIATIVES

• Overall purpose was to enhance health promotion
  at the community level
• Communities were given a role to increase the
  effectiveness and relevance of the strategies
  adopted.
• An expected secondary benefit was that the
  grantees and communities would increase their
  capacity to address health-related problems.

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CONTINUUM OF ROLES FOR THE COMMUNITY

• Community-defined, community-controlled health
  interventions
• Health interventions monitored by community-based
  stakeholder groups
• Agency-based health interventions utilizing
  community advisory boards
• Agency-based health interventions seeking ways to
  become more community-responsive

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STRUCTURAL IMPLICATIONS OF COMMUNITY INVOLVEMENT

• C-B interventions are located in community
  settings.
• C-B interventions are sponsored by non-
  traditional organizations and community-based
  agencies.
• Community stakeholders assume a broader
  leadership role.

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FUNCTIONAL IMPLICATIONS OF COMMUNITY INVOLVEMENT

• Health becomes more defined beyond the absence
  of disease.
• Non-health related contextual factors assume
  greater prominence.
• Scope of interventions becomes encompasses
  community health in its broadest terms.

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HOW CAN THE SUCCESS OF THESE C-B INITIATIVES BE
JUDGED?

• Case examples describe scope of efforts and level
  of effort.
• Assessments of outcomes include consideration of
  community capacity.
• Evaluations of C-B health promotion should
  include both direct and contextual measures of
  success.

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OPTIONAL MEASURES OF COMMUNITY CAPACITY

• Knowledge and skills
• Leadership
• Collective efficacy
• Social capital

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BENEFITS OF INCREASED COMMUNITY CAPACITY

• Communities will have an increased ability to
  respond to health issues.
• C-B responses are likely to be more responsive to
  community needs and thereby more effective in
  community terms.
• Increases in social capital will have more
  generalized benefits in terms of health
  improvements.

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CHALLENGES

• Providing mechanisms for authentic community
  participation on the part of the larger
  community.
• Developing effective health promotion
  strategies that are community-based
• Sharing decision-making
• Providing appropriate technical assistance
• Clarifying expectations

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TAKE-AWAY LESSONS

• C-B health promotion efforts can take many forms,
  but offer promise in being responsive and
  effective vis-à-vis community needs.
• The value of C-B health promotion extends beyond
  the immediate outcomes of the initiatives.
• More needs to be learned about how to implement
  and evaluate C-B health promotion efforts.