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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?