90110 pp tx_ch05


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90110 pp tx_ch05

  1. 1. Community Organizing/Building and Health Promotion Programming Chapter 5
  2. 2. Introduction <ul><li>Social ecological approach to behavior change </li></ul><ul><ul><li>Interaction between and interdependence of factors within and across all levels of a health problem </li></ul></ul><ul><ul><li>Behavior has multiple levels of influence </li></ul></ul><ul><ul><li>Behavior change usually a combination of individual and environmental/policy-level interventions </li></ul></ul>
  3. 3. Community Organizing/Building <ul><li>Community health problems range from small to complex </li></ul><ul><li>Community organizing </li></ul><ul><ul><li>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 </li></ul></ul><ul><ul><li>Not a science, but an art of consensus building </li></ul></ul>
  4. 4. <ul><li>Community capacity </li></ul><ul><li>Empowerment </li></ul><ul><li>Participation and relevance </li></ul><ul><li>Social capital </li></ul>Community Organizing/Building Terms
  5. 7. Need for Organizing Communities <ul><li>Changes in community social structure has lead to loss in sense of community </li></ul><ul><ul><li>Advances in electronics </li></ul></ul><ul><ul><li>Communications </li></ul></ul><ul><ul><li>Increased mobility </li></ul></ul><ul><li>Community organizing skills extend beyond community health </li></ul>
  6. 8. Assumptions of Community Organizing <ul><li>Those who organize communities do so while making certain assumptions </li></ul>
  7. 9. <ul><li>No single preferred method </li></ul><ul><li>All incorporate fundamental principles </li></ul><ul><ul><li>Start where the people are </li></ul></ul><ul><ul><li>Participation </li></ul></ul><ul><ul><li>Create environments in which people and communities can become empowered as they increase problem-solving abilities </li></ul></ul>Community Organizing Methods
  8. 10. Community Organizing Methods <ul><li>Locality development </li></ul><ul><ul><ul><li>Broad self participation; process oriented; stresses consensus and cooperation; builds group identity and sense of community </li></ul></ul></ul><ul><li>Social planning </li></ul><ul><ul><ul><li>Heavily task oriented; involves people and outside planners </li></ul></ul></ul><ul><li>Social action </li></ul><ul><ul><ul><li>Task and process oriented; disadvantaged segments of the population </li></ul></ul></ul>
  9. 11. Process of Community Organizing/Building
  10. 12. Recognizing the Issue <ul><li>Initial organizer </li></ul><ul><ul><li>recognizes that a problem exists and decides to do something about it </li></ul></ul><ul><ul><li>Gets things started </li></ul></ul><ul><ul><li>Can be from within or outside of the community </li></ul></ul><ul><ul><ul><li>Grass-roots, citizen initiated, bottom-up </li></ul></ul></ul><ul><ul><ul><li>Top-down, outside-in </li></ul></ul></ul>
  11. 13. Gaining Entry into the Community <ul><li>Organizers need: </li></ul><ul><ul><li>Cultural sensitivity, cultural competence, cultural humility </li></ul></ul><ul><li>Organizers need to know: </li></ul><ul><ul><li>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 </li></ul></ul><ul><li>Gatekeepers </li></ul>
  12. 14. Organizing the People <ul><li>Executive participants </li></ul><ul><li>Leadership identification </li></ul><ul><li>Recruitment </li></ul><ul><ul><li>Expanding constituencies </li></ul></ul><ul><li>Task Force </li></ul><ul><li>Coalition </li></ul>
  13. 15. Assessing the Community <ul><li>Community building </li></ul><ul><li>Needs assessment vs. mapping community capacity </li></ul><ul><li>Community assets </li></ul><ul><ul><li>Primary building blocks </li></ul></ul><ul><ul><li>Secondary building blocks </li></ul></ul><ul><ul><li>Potential building blocks </li></ul></ul>
  14. 16. Determining the Priorities and Setting Goals <ul><li>Criteria to consider when selecting priority issue </li></ul><ul><ul><li>Problem must be winnable </li></ul></ul><ul><ul><li>Must be simple and specific </li></ul></ul><ul><ul><li>Must unite members of organizing group </li></ul></ul><ul><ul><li>Should affect many people </li></ul></ul><ul><ul><li>Should be part of larger plan </li></ul></ul><ul><li>Goals written to serve as guide for problem solving </li></ul>
  15. 17. Arriving at a Solution and Selecting Intervention Strategies <ul><li>Alternate solutions exist for every problem </li></ul><ul><ul><li>Probable outcomes </li></ul></ul><ul><ul><li>Acceptability to the community </li></ul></ul><ul><ul><li>Probable long- and short-term effects </li></ul></ul><ul><ul><li>Costs of resources </li></ul></ul>
  16. 18. Final Steps <ul><li>Implementing </li></ul><ul><li>Evaluating </li></ul><ul><li>Maintaining </li></ul><ul><li>Looping Back </li></ul>
  17. 19. Process of Community Organizing/Building
  18. 20. Health Promotion Programming <ul><li>Important tool for community health professionals </li></ul><ul><li>Health education – part of health promotion </li></ul><ul><li>Health promotion – more encompassing than health education </li></ul><ul><li>Program planning </li></ul><ul><ul><li>May or may not be associated with community organizing/building </li></ul></ul><ul><ul><li>Process by which an intervention is planned </li></ul></ul>
  19. 22. Creating a Health Promotion Program <ul><li>Involves a series of steps </li></ul><ul><li>Success depends on many factors </li></ul><ul><li>Experienced planners use models to guide work </li></ul><ul><li>Before process begins, important to understand and engage priority population </li></ul>
  20. 23. Generalized Model for Program Planning
  21. 24. Assessing Needs of the Priority Population <ul><li>Determining purpose and scope of needs assessment </li></ul><ul><li>Gathering data </li></ul><ul><li>Analyzing data </li></ul><ul><li>Identifying factors linked to health problem </li></ul><ul><li>Identifying program focus </li></ul><ul><li>Validating prioritized need </li></ul>
  22. 25. Setting Appropriate Goals and Objectives <ul><li>Foundation of the program </li></ul><ul><li>Portions of the programming process are designed to achieve the goals by meeting the objectives </li></ul>
  23. 26. Goals <ul><li>More encompassing than objectives </li></ul><ul><li>Written to cover all aspects of the program </li></ul><ul><li>Provide overall program direction </li></ul><ul><li>Are more general in nature </li></ul><ul><li>Usually take longer to complete </li></ul><ul><li>Do not have a deadline </li></ul><ul><li>Are usually not observed, but inferred </li></ul><ul><li>Often not measured in exact terms </li></ul>
  24. 27. Objectives <ul><li>More precise than goals </li></ul><ul><li>Steps to achieve the program goals </li></ul><ul><li>The more complex a program, the more objectives needed </li></ul><ul><li>Composed of who, what, when, and how much </li></ul>
  25. 29. Creating an Intervention <ul><li>Intervention </li></ul><ul><ul><li>Activities that will help the priority population meet the objectives and achieve the program goals </li></ul></ul><ul><ul><li>The program that the priority population will experience </li></ul></ul><ul><ul><li>May be several or a few activities </li></ul></ul>
  26. 30. Intervention Considerations <ul><li>Multiplicity </li></ul><ul><li>Dose </li></ul><ul><li>Best practices </li></ul><ul><li>Best experience </li></ul><ul><li>Best processes </li></ul>
  27. 31. Implementing the Intervention <ul><li>Implementation </li></ul><ul><ul><li>Putting a planned program into action </li></ul></ul><ul><li>Pilot test </li></ul><ul><ul><li>Trial run-implementation to a small group </li></ul></ul><ul><ul><li>Determine problems and fix before full implementation </li></ul></ul><ul><li>Phasing in </li></ul><ul><ul><li>Step-by-step implementation; implementation with small groups </li></ul></ul>
  28. 32. Evaluating the Results <ul><li>Determine the value or worth of an object of interest </li></ul><ul><li>Evaluation should occur during first steps of program development </li></ul><ul><li>Formative evaluation </li></ul><ul><li>Summative evaluation </li></ul><ul><li>Impact evaluation </li></ul><ul><li>Outcome evaluation </li></ul>
  29. 33. Steps to Evaluation <ul><li>Planning the evaluation </li></ul><ul><li>Collecting the data </li></ul><ul><li>Analyzing the data </li></ul><ul><li>Reporting the results </li></ul><ul><li>Applying the results </li></ul>
  30. 34. Discussion Questions <ul><li>How would you explain the difference between health education and health promotion? </li></ul><ul><li>How can community members work together to solve health problems? </li></ul>