Community Level Models;Participatory Research and

Challenges

Alexandra VargaH571

Public Health

• Public health is “the science and art of preventing disease, prolonging life and promoting health through the organized efforts and informed choices of society, organizations, public and private, communities and individuals.”

Winslow, C.E. (1920). The untilled fields of public health. Science, 51(1306), 23-33.

Social Ecological Model

Agency for Healthcare Research and Quality. (2013). What Is the Clinical-Community Relationships Measurement Framework?: Clinical-Community Relationships Measures (CCRM) Atlas. . Retrieved from http://www.ahrq.gov/professionals/prevention-chronic-care/resources/clinical-community-relationships-measures-atlas/ccrm-atlas3.html3

Community level interventions must address these issues to address health disparities

Disparities in health status due to:•Exposures•Health care access•Social experience/support

Community Level Models

• Strategies for a variety of settings• Community: “a group of people with diverse

characteristics who are linked by social ties, share common perspectives, and engage in joint action in geographical locations or settings.”

aMacQueen, K.M. et al. (2001). What is community? An evidenced- based definition for participatory public health. American

Journal of Public Health, 91 (12), 1929-1939.

Strategies for Community Level Intervention

• Community organization and other participatory models

• Diffusion of innovations theory

• Communications theory

Community Organization

• Seeks to expand participants sense of self interest outward

• Communities are helped to identify, assess, and solve a problem- mobilization

• More likely to succeed with community’s priorities (as opposed to external agenda)

3 General Types of Community Organizing

Type Focus GoalCommunity development

process of community building

develop group identity

Social planning

task goals and issues of resources allocation

problem solving

*Social action process and task oriented; grassroots based; conflict oriented

increase community capacity and solve problems; concrete change to social injustice (policy change)

6 Common Elements of Community Organization

Element DefinitionEmpowerment Social action process though which people gain

confidence and skills to improve quality of life

Community Capacity Characteristics of a community that allow it to identify and address problems

Participation in organizing process

Engagement of community members

Relevance Participants identify issues that are important to them

Issue Selection Problems are dissected into solvable pieces

Critical Consciousness Awareness of social, political and economic factors contributing to social problems

Media Advocacy

• Definition: “the strategic use of mass media and community advocacy to advance environmental change or a public policy initiative”

• Purpose: Advocate for the goals of safe, healthy and prosperous communities; identify barriers to strategic policy implementation; and share current research through

Centers for Disease Control and Prevention. Media Advocacy. Designing and Implementing an Effective Tobacco Counter Marketing Campaign. Retrieved from http://www.cdc.gov/tobacco/stateandcommunity/counter_marketing/manual/pdfs/chapter9.pdf

Community-Based Participatory Research

• Recognizes community as an unit of identity.• Builds on strengths and resources within the community.• Facilitates collaborative, equitable involvement of all partners in all

phases of the research.• Integrates knowledge and intervention for mutual benefit of all

partners.• Promotes a co-learning and empowering process that attends to

social inequalities• Addresses health from both positive and ecological perspectives.• Disseminates findings and knowledge gained to all partners.• Involves a long-term commitment by all partners

O’Fallon, L.R., Tyson, F.L., Dearry, A. (2000). Successful models of community-based participatory research. National Institute of Environmental Health Sciences.

Discussion…

• A few examples of CBPR…

• What are some challenges, issues, or gaps?• What are some facilitating factors or ways to

promote CBPR?