community organizing/ building and health promotion programming chapter 5

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– 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 self-imposed 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


• 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)


• 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


EvaluatingLooping back

Maintaining

ImplementingThe Final Four Steps

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


Assessing the Needs Determining the purpose & scope

Gathering dataGathering data

Analyzing the dataAnalyzing the data

Identifying factors linked to the health problemIdentifying factors linked to the health problem

Identifying the program focusIdentifying the program focus

Validating the prioritized needValidating the prioritized need


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?


• 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


• 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


Evaluating the results - 1

Planning the evaluation

Evaluating the Results - 2


Collecting the data



Collecting the data

Analyzing the data



Collecting the data

Analyzing the data

Reporting results



Collecting the data

Analyzing the data

Reporting results

Applying the results

Community Organizing/Building and Health Promotion Programming

Chapter 5 - The End

community organizing/ building and health promotion programming chapter 5

Documents

empowered community

community members

community gatekeepers

community organizing

communities of people

competent slide

communities advances

individual problems