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 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

Generic Approach to Community Organizing - 2 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)

Generic Approach to Community Organizing - 3 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

Generic Approach to Community Organizing - 4 EvaluatingLooping back Maintaining Implementing The 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

Generalized Model for Program Planning - 2 Assessing the Needs Determining the purpose & scope Gathering data Analyzing the data Identifying factors linked to the health problem Identifying the program focus Validating the prioritized need

Generalized Model for Program Planning - 3 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?

Generalized Model for Program Planning - 4 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

Generalized Model for Program Planning - 5 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

Generalized Model for Program Planning - 6 Evaluating the results - 1 Planning the evaluation

Evaluating the Results - 2 Planning the evaluation Collecting the data

Evaluating the Results - 3 Planning the evaluation Collecting the data Analyzing the data

Evaluating the Results - 4 Planning the evaluation Collecting the data Analyzing the data Reporting results

Evaluating the Results - 5 Planning the evaluation Collecting the data Analyzing the data Reporting results Applying the results

Community Organizing/Building and Health Promotion Programming Chapter 5 - The End