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COBH4030Chp5.pptxChapter 5
Community Organizing/Building and Health Promotion Programming
Chapter Objectives (1 of 2)
After studying this chapter, you will be able to:
Explain the terms evidence, evidence-based practice, and socio-ecological perspective.
Define community organizing, community capacity, community participation, and empowered community.
Identify the assumptions that underlie the process of community organization.
Briefly explain the differences among planning and policy practice, community capacity development, and social advocacy strategies to community organization.
Explain the difference between needs-based and strengths-based community organizing models.
List the steps for a generalized model for community organizing/building.
Chapter Objectives (2 of 2)
Explain what community building means.
Explain the difference between health education and health promotion.
State and summarize the steps involved in creating a health promotion program.
Define the term needs assessment.
Briefly explain the six steps used in assessing needs.
Explain the difference between goals and objectives.
List the different types of intervention strategies.
Explain the differences among best practices, best experiences, and best processes.
Explain the purposes of pilot testing in program development.
State the difference between formative and summative evaluation.
Introduction (1 of 2)
Evidence-based Practice
Systematically finding, appraising, and using evidence as the basis for decision making
Evidence – the body of data that can be used to make decisions
Introduction (2 of 2)
Socio-ecological approach to behavior change
Interaction between and interdependence of factors within and across all levels of a health problem
Behavior has multiple levels of influence
Behavior change usually a combination of individual and environmental/policy-level interventions
Community Organizing/Building
Community health problems range from small to complex
Community organizing
Process through which communities are helped to identify common problems or goals, mobilize resources, and develop and implement strategies for reaching the goals they have collectively set
Not a science, but an art of consensus building
Community Organizing/Building Terms
Community capacity
Empowerment
Grassroots participation
Macro practice
Participation and relevance
Social capital
Need for Organizing Communities
Changes in community social structure have lead to loss of a sense of community
Advances in electronics
Communications
Increased mobility
Community organizing skills extend beyond community health
Assumptions of Community Organizing
Those who organize communities do so while making certain assumptions
Community Organizing Methods (1 of 2)
No single preferred method
Planning and policy practice, community capacity development, and social advocacy
All incorporate fundamental principles
Start where the people are
Participation
Create environments in which people and communities can become empowered as they increase problem-solving abilities
Community Organizing Methods (2 of 2)
Reproduced from Minkler, M., and N. Wallerstein (2012). “Improving Health through Community Organization and Community Building: Perspectives from Health Education and Social Work.” In M. Minkler, ed., Community Organizing and Community Building for Health and Welfare, 3rd ed. New Brunswick, NJ: Rutgers University Press, 44. Reprinted with permission.
Community organization and community building typology
Recognizing the Issue
Initial organizer
Recognizes that a problem exists and decides to do something about it
Gets things started
Can be from within or outside of the community
Grass-roots, citizen initiated, bottom-up
Top-down, outside-in
Gaining Entry into the Community
Organizers need:
Cultural sensitivity, cultural competence, cultural humility
Organizers need to know:
Who is causing problem and why; how problem has been addressed in past; who supports and opposes idea of addressing problem; who could provide more insight
Gatekeepers
Organizing the People
Executive participants
Leadership identification
Recruitment
Expanding constituencies
Task force
Coalition
Assessing the Community
Community building
Needs assessment vs. mapping community capacity
Community assets
Primary building blocks
Secondary building blocks
Potential building blocks
Determining the Priorities and Setting Goals
Criteria to consider when selecting priority issue
Problem must be winnable
Must be simple and specific
Must unite members of organizing group
Should affect many people
Should be part of larger plan
Goals written to serve as guide for problem solving
Arriving at a Solution and Selecting Intervention Strategies
Alternate solutions exist for every problem
Probable outcomes
Acceptability to the community
Probable long- and short-term effects
Costs of resources
Final Steps
Implementing
Evaluating
Maintaining
Looping Back
Health Promotion Programming
Important tool for community health professionals
Health education – part of health promotion
Health promotion – more encompassing than health education
Program planning
May or may not be associated with community organizing/building
Process by which an intervention is planned
Creating a Health Promotion Program
Involves a series of steps
Success depends on many factors
Experienced planners use models to guide work
Before process begins, important to understand and engage priority population (audience)
Priority population – those whom the program is intended to serve
Assessing Needs of the Priority Population
Determining purpose and scope of needs assessment
Gathering data
Analyzing data
Identifying risk factors linked to health problem
Identifying program focus
Validating prioritized need
Setting Appropriate Goals and Objectives
Foundation of the program
Portions of the programming process are designed to achieve the goals by meeting the objectives
Goals
Provide overall direction for the program
Are more general in nature
Do not have a specific deadline
Usually take longer to complete
Are often not measured in exact terms
Objectives (1 of 2)
More precise than goals
Steps to achieve the program goals
The more complex a program, the more objectives needed
Composed of who, what, when, and how much
Objectives (2 of 2)
Data from Deeds, S. G. (1992). The Health Education Specialist: Self-Data from Study for Professional Competence. Los Alamitos, CA: Loose Cannon Publications; Cleary, M. J., and B. L. Neiger (1998). The Certified Health Education Specialist: A Self-Study Guide for Professional Competence, 3rd ed. Allentown, PA: National Commission for Health Education Credentialing; and McKenzie, J. F., B. L. Neiger, and R. Thackeray (2017). Planning, Implementing, and Evaluating Health Promotion Programs: A Primer, 7th ed. Boston: Pearson Education, Inc.
Creating an Intervention that Considers the Peculiarities of the Setting
Intervention
Activities that will help the priority population meet the objectives and achieve the program goals
The program that the priority population will experience
May be several or a few activities
Intervention Considerations
Multiplicity
Dose
Best practices
Best experience
Best processes
Implementing the Intervention
Implementation
Putting a planned program into action
Pilot test
Trial run‒implementation to a small group
Determine problems and fix before full implementation
Phasing in
Step-by-step implementation; implementation with small groups
Evaluating the Results
Determine the value or worth of an object of interest
Evaluation should occur during first steps of program development
Formative evaluation
Summative evaluation
Impact evaluation
Outcome evaluation
Steps to Evaluation
Engage stakeholders
Describe the program
Focus on the evaluation design
Gather credible data
Justify conclusions
Ensure use and share lessons learned
Discussion Questions
How would you explain the difference between health education and health promotion?
How can community members work together to solve health problems?
