Community Level Interventions

Community: Functional spatial units Units of patterned social interaction Symbolic units of collective identity A social unity that is people coming together to act politically to make changes

Ecological System Perspective Particularly useful in the study of autonomous geographical communities Focusing as it does on population characteristics such as size, density, and heterogeneity, physical environment, the social organization or structure of the community, and the technological forces affecting it.

Social Systems Perspective Focuses primarily on the formal organizations that operate within a given community, exploring the interactions of community subsystems Subsystems- economic, political…

Different ways of looking at health in a community: Compositional Differences in the kinds of people who live in these places- poor people is reason. Poor people dye younger therefore, mortality is higher in area with lots of poor people Contextual variation in health between people living in different places because of differences between the places. Physical or social context- people who are poor live in area with more pollution and crime, therefore they die younger and have higher mortality rates.

What is community level intervention? Community-level interventions aim to change the attitudes, norms, and behaviors of communities. The approaches recognize that local values, norms, and behavior patterns have a significant effect on shaping an individual's attitudes and behaviors (Thompson and Kinne, 1990).

Model for Community Level Interventions

Community Organization and Community Building Empowerment is implicit Aims to improve sustainability Participation, control, and critical awareness Community capacity

Community Based Participatory Research (CBPR) “Community-based participatory research for health is a collaborative approach to research that equitably involves all partners in the research process and recognizes the unique strengths that each brings to the research.” W.K. Kellogg Foundation, Community Health Scholars Program, 2001

Addressing Health through Health Promotion: Ethical Considerations Include “Authentic” community members Talk to and work with people who experience the health problems Include multiple stakeholders All community have people with differences in their influence and experiences Agencies, organizations, leaders and others impact health of the community

Why is it important? Many health interventions do not achieve their goals.“ Community ownership for sustaining past funding period Participation can lead to important tailoring of intervention, which can improve effectiveness Community partners identify assets that can be fostered and barriers that may not otherwise be identified and addressed

Successful interventions: Comprehensive, flexible, responsive, and sustainable. They address many aspects of an issue rather than a single one; they can, and do, change according to the needs of the participants and the community; and They last for as long as it takes to accomplish their purpose. They are developed and implemented in the context of the social and cultural features of a community.

Successful interventions: Are collaborative and truly involve community members They also aim and building community capacity to address issues so when leave they can be sustained. People who implement community based interventions need to recognize the positions of power they represent in relation to the community or target population.

Successful interventions: Acknowledge the interaction between the different levels from an ecological approach. They deal with families as parts of neighborhoods and communities. Such interventions respond to community needs, staff themselves with people from the same groups as those who live in the community, and try to build leadership and other capacities in local people.

Example of Community Level Intervention Goal: Increase the capacity of the REACH communities to increase diabetes awareness and improve the quality of the neighborhood environment. Objectives: Identify, document and disseminate information about community social and physical resources that support healthy lifestyles. Increase connections between community members and health information and education resources that support diabetes awareness and healthy lifestyles. Increase community access to healthy foods and recreation opportunities. http://www.sph.umich.edu/reach/about/interventions/community.html ** Center for Disease Control and Prevention REACH Project in Detroit, Michigan

Some Accomplishments of REACH Project: Conducted a Community Asset Survey Established working relationships with city and community organizations to plan and develop community resources. Recruited and trained neighborhood resident Community Health Advocates Conducted presentations regarding diabetes, healthy lifestyles and REACH at health fairs, organization and community meetings throughout Eastside and Southwest Detroit Hosted two "Healthy Soul Food" community education activities.