1. Chapter 5 Community Organizing/Building and Health Promotion Programming

2. 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

3. 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

4. Community Organizing/Building Terms
Community capacity
Empowerment
Participation and relevance
Social capital

5. 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

6. Assumptions of Community Organizing
Those who organize communities do so while making certain assumptions

7. Community Organizing Methods
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

8. Community Organizing Methods

9. 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

10. 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

11. Organizing the People Executive participants Leadership identification
Recruitment
Expanding constituencies
Task Force
Coalition

12. Assessing the Community
Community building
Needs assessment vs. mapping community capacity
Community assets
Primary building blocks
Secondary building blocks
Potential building blocks

13. 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

14. 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

15. Final Steps
Implementing
Evaluating
Maintaining
Looping Back

16. 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

17. 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

18. 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

19. Setting Appropriate Goals and Objectives
Foundation of the program
Portions of the programming process are designed to achieve the goals by meeting the objectives

20. 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

21. 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

23. Creating an Intervention that Considers the Peculiarities of the Setting
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

24. Intervention Considerations
Multiplicity
Dose
Best practices
Best experience
Best processes

25. 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

26. 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

27. Steps to Evaluation Planning the evaluation Collecting the data
Analyzing the data
Reporting the results
Applying the results

28. Discussion Questions
How would you explain the difference between health education and health promotion?
How can community members work together to solve health problems?