Community-Based Health Interventions covers the skills necessary to change health in a community setting through the reduction of disease, disease conditions, and risks to health, as well as create a supportive environment for the maintenance of the behavior changes. The first section provides background information about why interventions in communities are important, the history of several major community interventions, ethical issues in the design and implementation of interventions and the different types of interventions. The second section covers planning and activities needed to complete an intervention, along with the theoretical basis of interventions. The third section shows how to assess the needs and strengths of a particular community, gain community support, define the goals of an intervention and get started. This section also contains information on obtaining material and financial support and on strategies for continuing the intervention beyond its initial phase. The final section examines current work and problems encountered as well as projecting future trends. Each chapter includes practice exercises or activities useful to students learning to develop interventions at the population or community level, such as public health, social work and nursing.
Table des matières
Tables, Figure, and Exhibit ix
Preface xi
Acknowledgments xiii
The Authors xv
PART ONE introducing community-based interventions 1
1 IMPROVING HEALTH IN COMMUNITY SETTINGS 3
Defining Community 4
Ecological Theory and Levels of Prevention 5
2 A BRIEF HISTORY OF COMMUNITY-BASED HEALTH INTERVENTIONS 11
Diana Silver
Community-Based Health Interventions: An Instrument for Change 12
Early Community-Based Health Interventions 15
Assessing the Evidence from Early Community-Based Health Interventions 18
The Evolution of Community-Based Health Interventions 19
3 ETHICAL ISSUES IN COMMUNITY INTERVENTIONS 25
The Integration of Ethics into Public Health Practice 26
Institutional Review Boards 28
Vulnerable Populations 29
Permission and Consent 30
Protection for Research Participants 33
Ensuring Research Quality 34
Maintaining the Integrity of Research 35
4 LEVELS AND TYPES OF COMMUNITY-Based INTERVENTIONS 39
An Ecological Focus on Types of Prevention 40
Selecting a Goal for the Intervention 42
Examples of Interventions at Different Levels of Prevention 45
PART TWO developing the intervention 51
5 A FRAMEWORK FOR DESIGNING COMMUNITY-Based INTERVENTIONs 53
Theoretical Guidance for Health Interventions 54
Examples of Theories Used at the Four Ecological Levels 56
6 COLLECTING AND MANAGING DATA 65
Data: A Crucial Component of Research 66
Collecting Quantitative Data 67
Collecting Qualitative Data 73
After Data Collection 75
PART THREE working through the intervention 81
7 ASSESSING COMMUNITY NEEDS 83
Basic Components of a Community Assessment 84
Strengthening Your Findings 87
8 PLANNING A COMMUNITY-BASED INTERVENTION 95
Intervention Content and Format 96
A Logic Model as an Organizing Strategy 101
A Fictional Community Assessment: Adolescent Tobacco Use 104
9 IMPLEMENTING A COMMUNITY-BASED INTERVENTION 115
Implementation at the Four Ecological Levels 116
Interventions at the Community or Policy Level 123
10 EVALUATING A COMMUNITY-BASED INTERVENTION 127
Reasons for Evaluation 128
Preparing for an Evaluation 130
Designing the Evaluation 130
Flexibility: An Essential Skill in Evaluation 135
PART FOUR learning from the past and adapting to the future 137
11 FUNDING AND SUSTAINABILITY 139
Financing Community-Based Health Interventions 140
Components of the Proposal for Funding 143
Components of the Budget 150
Continuing and Sustaining an Intervention 155
12 IMPLEMENTATION PITFALLS 157
Things Happen 158
13 THE FUTURE OF COMMUNITY-BASED HEALTH INTERVENTIONS 165
Adapting Methods of Intervention to Twenty-First-Century Communities 166
A Challenge and an Opportunity for Public Health Practitioners 169
A Limitation of the New Technologies 173
14 COMMUNITY-BASED HEALTH INTERVENTIONS IN PRACTICE 177
Arthritis 178
Asthma 179
Adult Vaccinations 181
Alcohol Use 182
Cardiovascular Disease 183
Childhood Vaccinations 184
Injuries from Motor Vehicle Accidents 185
Sexual Assault and Relationship Violence 186
Smoking 187
Glossary 191
References 203
Index 211
A propos de l’auteur
Sally Guttmacher, Ph D, is professor of Public Health in the Department of Nutrition, Food Studies and Public Health at New York University. Patricia J. Kelly, Ph D, MPH, APRN, is professor at the University of Missouri, School of Nursing. Yumary Ruiz-Janecko, Ph D, is a clinical assistant professor of Public Health at New York University.
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