Community Health Assessment

• What is health promotion?

  A process of enabling people to improve their health.
• What does health promotion support?

  Governments, communities, and individuals addressing health challenges
• What does health promotion involve?

  Building health public health policies, creating supportive environments, and strengthening community action and personal skill.
• What are the target factors of health promotion?

  They have a direct and/or indirect influence on health
• Social Ecological Model?

  Individual

  Level 1: Intrapersonal

  Level 2: Interpersonal

  Level 3: Organizational

  Level 4: Community

  Level 5: Society
• Primary Prevention?


  Avoid disease occurrence
• Secondary Prevention?


  Detect disease early and avoid progression
• Tertiary prevention?


  Reduce further complications and prevent death
• Ottawa Charter for Health Promotion


  Established in 1986, with the purpose of generating action to achieve Health for All by the year 2000 and beyond.
• The fundamental conditions and resources for health of the Ottawa Charter for Health Promotion are?

  • Peace
  • Shelter
  • Education
  • Food
  • Income
  • A stable eco-system
  • Sustainable resources
  • Social justice
  • equity
• Types of health promotion interventions include:

  Communication

  Education

  Policy, Systems, and Environment
• Communication

  Raising awareness about healthy behaviors for the general public
• Education


  Empowering behavior change and actions through increased knowledge.
• Policy, Systems, and Environment

  Making systematic changes - through improved laws, rules, and regulations (policy), functional organizational components (systems), and economic, social, and physical environment - to encourage, make available, and enable healthy choices.
• Community Engagement in Health Promotion:

  • Encompasses strategies and processes to enhance community involvement in addressing health priorities.
  • Helps understand the interests, characteristics, values, and needs of your target population.
  • Ensures an intervention is acceptable and feasible before launching.
  • Critical step in program development and implementation.
• What is a community?

  A group of individuals sharing:

  • Specified geographical boundaries

  • Social or economic characteristics

  • Interests, values, or traditions

  • Experiences
• Utilitarian Models of Engagement?


  Involve communities as a means to an end (e.g., improve intervention effectiveness) may not involve communities throughout the entire process partnerships are not often sustained.
• Community Empowerment Model:


  Empowerment models asks questions such as: “Is the community better equipped to address internal issues that arise in the absence of the coalition, program, institution, etc.?”Lack of attention to empowerment can increase community distrust and potentially perpetuate inequity
• What are stakeholders?

  people or organizations with vested interest in a program/intervention

  
  

  representing their needs and interests throughout the process is

  fundamental to good program development, implementation and

  evaluation
• What are the three major groups of key stakeholders?

  Those involved in program operations

  Those who are intended users of the evaluation findings

  Those served or affected by the program
• What are the roles of stakeholders in an intervention?

  1. Stakeholder input ensures a clear and consensual understanding of the program's activities and outcomes.

  2. The perspectives and values that stakeholders bring to the project are explicitly acknowledged and honored in making judgements about evidence gathered.

  3. Stakeholder input in ensures that the key questions of most importance will be included.

  4. Stakeholders may also have insights or preferences on the most effective and appropriate ways to collect data from target respondents.
• What happens when you prioritize stakeholders?

  Can increase the credibility of efforts

  Are responsible for day-to-day implementation of the activities that are part of the program

  Will advocate for or authorize changes to the program

  Will fund or authorize the continuation or expansion of the program
• What is the importance of stakeholders?

  • Stakeholders can help (or hinder) an intervention before it is conducted, while it is being conducted, and after the results are collected and ready for use.
  • Stakeholders are much more likely to support the intervention if they are involved in the evaluation process.
  • Without stakeholder support, your intervention may be ignored, criticized, resisted, or even sabotaged.
• What should evaluators ask stakeholders?

  1. Who do you represent and why are you interested in this program?
  2. What is important about this program to you?
  3. What would you like this program to accomplish?
  4. How much progress would you expect this program to have made at this time?
  5. What resources (i.e., time, funds, evaluation expertise, access to respondents, and access to policymakers) might you contribute to this effort?
• Who are potential stakeholders in public health programs?

  Program managers and staff, state or local health departments, program critics, private citizens, religious organizations, and community organizations.
• What is a partnership?

  Composed of organizations that share a common focus and combine resources to implement joint activities.
• What can partnerships avoid, ensure, and enhance?

  They can avoid duplication of effort, ensure synergy resources, and enhance overall leadership.
• What is a coalition?

  A group of individuals and/or organizations with a common interest who agree to work together toward a common goal.
• Coalitions may be loose associations in which members work for short time to achieve a specific goal, and then disband.
• Coalitions may also become organizations in themselves, with governing bodies, particular community responsibilities, funding, and permanence.
• Goals of coalition:

  Change individual behavior

  Increase community capacity to address an issue

  Influence or develop public policy, usually around a specific issue
• When should you develop a coalition?


  When dramatic or disturbing events occur in a community

  When new information becomes available

  When circumstances or the rules change

  When new funding becomes available

  When there's an outside threat to the community

  When a group wishes to create broad, significant community change
• Who should be a part of a coalition?

  Stakeholders

  Community Opinion Leaders

  Policy Makers
• How do you start a community coalition?

  • Put together a core group
  • Identify most important potential coalition members
  • Recruit members to the coalition
  • Plan and hold a first meeting
  • Follow up on the first meeting
  • Next steps
• Barriers to building a coalition:

  Turf issues

  Bad history

  Domination by one or more stakeholders

  Poor links to the community

  Minimal organizational capacity

  Limited funding

  Failure to provide and create leadership within the coalition

  The perceived - or actual - costs of working together outweigh the benefits for many coalition members
• General guidelines for getting a coalition off the ground:

  Communicate

  Be as inclusive and particpatory as possible

  Network

  Set concrete and reachable goals

  Be creative and meetings

  Be realistic, and keep your promises

  Acknowledge diversity among your members, including their ideas and beliefs
• Designed primarily to understand community coalitions, community engagement have a common focus on long term relationships?

  Community Coalition Action Theory
• Addresses the full range of processes from initiation of new collaborative activities to institutionalization of mature relationships.

  Community Coalition Action Theory
• What theory supports community engagement?

  Community Coalition Action Theory
• What model abandons individual agendas or a single common agenda?

  Collective Impact Approach