Community Organizing Building And Health Promotion Programming
Elwanda Menhennett
Community Organizing/ Building and Health Promotion Programming. Chapter 5. Introduction. Epidemiology important to community health Two other skills for community health workers Community organizing/building Health promotion programming. Community Organizing Defined.
Assumptions of Community Organization 1. Communities of people can develop the capacity to deal with their own problems 2. People want to change and can change 3. People should participate in making, adjusting, or controlling the major changes taking place within their communities 4. Changes in community living that are self-imposed or self-developed have a meaning and permanence that imposed changes do not have
Determining the purpose & scope Generalized Model for Program Planning - 2Assessing the Needs Gathering data Analyzing the data Identifying factors linked to the health problem Identifying the program focus Validating the prioritized need
The student will be able to:
A. Describe the historical development of public health including the most important achievements of public health.
B. Identify different public health disciplines, professions and organizations, and explain how each contributes to the field of public health.
C. Demonstrate the use of basic epidemiological methods, such as the analysis of rates, and the definition of cases, population at risk, risk factors, incidence, prevalence, morbidity and mortality.
D. Define important foundational concepts in community/public health.
E. Distinguish the difference between personal and public health.
F. Distinguish how public health differs from the traditional Western medicine approach to treating disease and illness.
G. Outline the process of community organizing, building and health promotion programming.
H. Describe the interplay between health determinants, such as environmental conditions, social, behavioral and cultural factors, and biological considerations, and explain the role of each in determining local, national and global health organization and policy.
I. Explain the impact of the environment and communicable diseases on the health of populations.
J. Explain the burden of chronic diseases on morbidity and mortality and approaches to prevention, early detection and control.
K. Describe the basic organization (and payment mechanisms) of health care and public health systems and the contributions of health professionals in the U.S. healthcare system.
L. Analyze current public health issues and describe how they affect societal well-being among specific populations of age, sex, ethnicity, minority, education and socioeconomic status.
M. Identify, assess and utilize credible information resources on community health current issues, such as the internet, social media, media outlets, and libraries.
A. Assigned reading from textbook and completion of post at the end of each section of the course.
B. Practice activities to gauge understanding of content.
C. Review comprehension of key concepts.
D. Quiz knowledge of key terms.
A logic model presents a picture of how your effort or initiative is supposed to work. It explains why your strategy is a good solution to the problem at hand. Effective logic models make an explicit, often visual, statement of the activities that will bring about change and the results you expect to see for the community and its people. A logic model keeps participants in the effort moving in the same direction by providing a common language and point of reference.
Each mapping or modeling technique uses a slightly different approach, but they all rest on a foundation of logic - specifically, the logic of how change happens. By whatever name you call it, a logic model supports the work of health promotion and community development by charting the course of community transformation as it evolves.
The word "logic" has many definitions. As a branch of philosophy, scholars devote entire careers to its practice. As a structured method of reasoning, mathematicians depend on it for proofs. In the world of machines, the only language a computer understands is the logic of its programmer.
There is, however, another meaning that lies closer to heart of community change: the logic of how things work. Consider, for example, the logic to the motion of rush-hour traffic. No one plans it. No one controls it. Yet, through experience and awareness of recurrent patterns, we comprehend it, and, in many cases, can successfully avoid its problems (by carpooling, taking alternative routes, etc.).
Logic in this sense refers to "the relationship between elements and between an element and the whole." All of us have a great capacity to see patterns in complex phenomena. We see systems at work and find within them an inner logic, a set of rules or relationships that govern behavior. Working alone, we can usually discern the logic of a simple system. And by working in teams, persistently over time if necessary, there is hardly any system past or present whose logic we can't decipher.
On the flip side, we can also project logic into the future. With an understanding of context and knowledge about cause and effect, we can construct logical theories of change, hypotheses about how things will unfold either on their own or under the influence of planned interventions. Like all predictions, these hypotheses are only as good as their underlying logic. Magical assumptions, poor reasoning, and fuzzy thinking increase the chances that despite our efforts, the future will turn out differently than we expect or hope. On the other hand, some events that seem unexpected to the uninitiated will not be a surprise to long-time residents and careful observers.
Like a road map, a logic model shows the route traveled (or steps taken) to reach a certain destination. A detailed model indicates precisely how each activity will lead to desired changes. Alternatively, a broader plan sketches out the chosen routes and how far you will go. This road map aspect of a logic model reveals what causes what, and in what order. At various points on the map, you may need to stop and review your progress and make any necessary adjustments.
A logic model also expresses the thinking behind an initiative's plan. It explains why the program ought to work, why it can succeed where other attempts have failed. This is the "program theory" or "rationale" aspect of a logic model. By defining the problem or opportunity and showing how intervention activities will respond to it, a logic model makes the program planners' assumptions explicit.
The form that a logic model takes is flexible and does not have to be linear (unless your program's logic is itself linear). Flow charts, maps, or tables are the most common formats. It is also possible to use a network, concept map, or web to describe the relationships among more complex program components. Models can even be built around cultural symbols that describe transformation, such as the Native American medicine wheel, if the stakeholders feel it is appropriate.
Whatever form you choose, a logic model ought to provide direction and clarity by presenting the big picture of change along with certain important details. Let's illustrate the typical components of a logic model, using as an example a mentoring program in a community where the high-school dropout rate is very high. We'll call this program "On Track."
Putting these elements together graphically gives the following basic structure for a logic model. The arrows between the boxes indicate that review and adjustment are an ongoing process - both in enacting the initiative and developing the model.
As mentioned earlier, the generic model for Disease/Injury Control and Prevention in Examples depicts the same relationship of activities and effects in a linear and a nonlinear format. The two formats helped communicate with different groups of stakeholders and made different points.
The linear model better guided discussions of cause and effect and how far down the chain of effects a particular program was successful. The circular model more effectively depicted the interdependence of the components to produce the intended effects.
When exploring the results of an intervention, remember that there can be long delays between actions and their effects. Also, certain system changes can trigger feedback loops, which further complicate and delay our ability to see all the effects. (A definition from the System Dynamics Society, might help here: "Feedback refers to the situation of X affecting Y and Y in turn affecting X perhaps through a chain of causes and effects. One cannot study the link between X and Y and, independently, the link between Y and X and predict how the system will behave. Only the study of the whole system as a feedback system will lead to correct results.")
For these reasons, logic models indicate when to expect certain changes. Many planners like to use the following three categories of effects (illustrated in the models above), although you may choose to have more or fewer depending on your situation.
Clarify your language. In a collaborative project, it is wise to anticipate confusion over language. If you understand the basic elements of a logic model, any labels can be meaningful provided stakeholders agree to them. In the generic and TB models above, we called the effects short-, mid-, and long-term. It is also common to hear people talk about effects that are "upstream" or "proximal" (near to the activities) versus "downstream" or "distal" (distant from the activities). Because disciplines have their own jargon, stakeholders from two different fields might define the same word in different ways.
Some people are trained to call the earliest effects "outcomes" and the later ones "impacts." Other people are taught the reverse: "impacts" come first, followed by "outcomes." The idea of sequence is the same regardless of which terms you and your partners use. The main point is to clearly show connections between activities and effects over time, thus making explicit your initiative's assumptions about what kinds of change to expect and when. Try to define essential concepts at the design stage and then be consistent in your use of terms. The process of developing a logic model supports this important dialogue and will bring potential misunderstandings into the open.
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