90110 pp tx_ch05

Community Organizing/Building and

Health Promotion Programming

Chapter 5

Introduction

• Social 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 capacity

• Empowerment

• Participation and relevance

• Social capital

Community Organizing/Building Terms

Need for Organizing Communities

• Changes in community social structure has lead to loss in 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

• No single preferred method

• 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

Community Organizing Methods

• Locality development• Broad self participation; process oriented; stresses

consensus and cooperation; builds group identity and sense of community

• Social planning• Heavily task oriented; involves people and

outside planners

• Social action• Task and process oriented; disadvantaged

segments of the population

Process of Community Organizing/Building

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

Process of Community Organizing/Building

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

Generalized Model for Program Planning

Assessing Needs of the Priority Population

• Determining purpose and scope of needs assessment

• Gathering data

• Analyzing data

• Identifying 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

• More encompassing than objectives

• Written to cover all aspects of the program

• Provide overall program direction

• Are more general in nature

• Usually take longer to complete

• Do not have a deadline

• Are usually not observed, but inferred

• Often not measured in exact terms

Objectives

• 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

Creating an Intervention

• 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

• Planning the evaluation

• Collecting the data

• Analyzing the data

• Reporting the results

• Applying the results

Discussion Questions

• How would you explain the difference between health education and health promotion?

• How can community members work together to solve health problems?