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
• Community capacity- community characteristics affecting
its ability to identify, mobilize and address problems
• Empowerment- social action process for people to gain
mastery over their lives and the lives of their communities
• Participation and relevance- community organizing should
start with the people and engage community member as
equals
• Social capital- process and conditions among people and
organizations that lead to their accomplishing a goal of
mutual social benefit
Assumptions of Community Organizing
• Communities of people can develop the capacity to deal with their own
problems
• People want to change and can change
• People should participate in making, adjusting or controlling the major
changes taking place within their communities
• Changes in community living that are self-imposed or self-developed have a
meaning and permanence that imposed changes do not have
• A “holistic approach”can successfully address problems with which a
“fragmented approach” cannot cope
• Democracy requires cooperative participation and action in the affairs of the
community and people must learn the skills that make this possible
• Frequently, communities of people need help in organizing to deal with their
needs just as many individuals require help in coping with their individual
problems
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
• 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
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
• 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
• 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?
