Chapter 5
Community
Organizing/Building and
Health Promotion
Programming
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 Organizing/Building
Terms
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Community capacity
Empowerment
Participation and relevance
Social capital
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
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
Community Organizing Methods
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
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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
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Probable outcomes
Acceptability to the community
Probable long- and short-term effects
Costs of resources
Final Steps
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Implementing
Evaluating
Maintaining
Looping Back
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 (audience)
• Priority population – those whom the program
is intended to serve
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
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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 that Considers
the Peculiarities of the Setting
• 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
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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
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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?