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Intervention Components a. Community development, community competence. b. Policy, education, countermarketing, immunization. c. Treatment, pharmaceutical, counseling.
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For well over two decades, the public health community has undertaken a broad range of initiatives to identify and eliminate various health-related disparities among populations. The Centers for Disease Control and Prevention's (CDC) Office on Smoking and Health (OSH), for example, has committed resources to help states eliminate population dispari...
Citations
... This finding suggests that local communities can ready themselves for flavor policy passage by implementing related tobacco control policies and conducting targeted community-engagement campaigns. Caldwell and colleagues (21) described the Community Capacity Building Curriculum developed by the Center for Black Health & Equity, as theory-based, practical, and strategic guidance for community coalitions and advocacy groups to build community mobilization and menthol and flavor policy adoption in Black communities and other communities of color. This curriculum centers on health equity and social justice through multiethnic, multigenerational coalitions of partners. ...
... Knowing the community requires an indepth understanding of community members and stakeholders, barriers and assets, population demographics, and community context. The Community Development Model for Public Health Applications is a comprehensive model that integrates the factors essential to knowing a community as the primary unit of analysis and can be used as a framework to guide community-engaged research efforts [5]. Additionally, Community-Based Participatory Research (CBPR) principles and methods also serve as a foundation for collaborative approaches to research that enhance and support community engagement research activities across a variety of topics and disciplines. ...
There is a widespread recognition that health disparities impact Hispanics collectively; however, much less is known about the disease risk and outcomes with respect to the heterogeneity of Hispanic subgroups. Community-engaged approaches and strategies to research are essential for reaching these at-risk populations and building trust among community and research partners who serve and care for Hispanics. These methods are not only useful for engaging diverse populations but also useful in elucidating and differentiating nuances within and among Hispanic subgroup characteristics and their perspectives regarding participation in biomedical research. There is a growing body of evidence supporting the use of participatory research methods in studying, developing, and implementing culturally sensitive cancer prevention interventions and strategies among diverse racial/ethnic minority populations. Much of the previous work in this area has addressed program adaptation or cultural tailoring of existing cancer educational programs and materials. However, the adoption of community engaged research approaches in translational or transdisciplinary research are less understood and may have the potential to improve inclusion and representation of Hispanics in biomedical research studies and to shed light on how to create conditions for health and health equity. This chapter describes novel applications of community-based approaches to biobanking and biospecimen research areas to highlight (1) three critical steps for engaging Hispanic communities in cancer research, (2) best practices and scientifically based strategies and considerations for enhancing community engagement in research, and (3) lessons learned.
... Such an approach is modeled by community-based participatory research. 140 Similarly, it is important to closely examine macrolevel factors that impact health outcomes, such as the socioeconomic, cultural, and dimensions of the community/ environmental context. This approach further illuminates the impact of social determinants of health on African American women and expands opportunities and strategies for primary prevention. ...
Background: The sexual and reproductive health of African American women has been compromised due to multiple experiences of racism, including discriminatory healthcare practices from slavery through the post-Civil Rights era. However, studies rarely consider how the historical underpinnings of racism negatively influence the present-day health outcomes of African American women. Although some improvements to ensure equitable healthcare have been made, these historical influences provide an unexplored context for illuminating present-day epidemiology of sexual and reproductive health disparities among African American women.
Methods: To account for the unique healthcare experiences influenced by racism, including healthcare provision, we searched online databases for peer-reviewed sources and books published in English only. We explored the link between historical and current experiences of racism and sexual and reproductive health outcomes.
Results: The legacy of medical experimentation and inadequate healthcare coupled with social determinants has exacerbated African American women's complex relationship with healthcare systems. The social determinants of health associated with institutionalized and interpersonal racism, including poverty, unemployment, and residential segregation, may make African American women more vulnerable to disparate sexual and reproductive health outcomes.
Conclusions: The development of innovative models and strategies to improve the health of African American women may be informed by an understanding of the historical and enduring legacy of racism in the United States. Addressing sexual and reproductive health through a historical lens and ensuring the implementation of culturally appropriate programs, research, and treatment efforts will likely move public health toward achieving health equity. Furthermore, it is necessary to develop interventions that address the intersection of the social determinants of health that contribute to sexual and reproductive health inequities.
... "Putting the two terms together -community development -means that a community itself engages in a process aimed at improving the social, economic and environmental situation of the community." (Cavaye, 2006:1) From an intervention perspective, community development is concerned with utilising existing infrastructures, resources and social capital within a community to improve health or take action on issues of concern within a community (Benatar, 2003;Robinson, 2005). A community development intervention may include enhancing or developing community capacity and existing infrastructure(s), and investing in seeking support from specialised consultants to provide technical assistance and upskill community members (Robinson, 2005). ...
... (Cavaye, 2006:1) From an intervention perspective, community development is concerned with utilising existing infrastructures, resources and social capital within a community to improve health or take action on issues of concern within a community (Benatar, 2003;Robinson, 2005). A community development intervention may include enhancing or developing community capacity and existing infrastructure(s), and investing in seeking support from specialised consultants to provide technical assistance and upskill community members (Robinson, 2005). However, the capacity and readiness of a community engage with and utilise these resources is dependent on their social capital. ...
The goal of achieving social change is a pursuit that traverses sectors, disciplines and levels of society. However, measuring social change, defining the concept and evaluating the impact of efforts to achieve social change is an area where there is much debate, and little empirical knowledge about the effectiveness of social change efforts. This thesis explored and developed proxy indicators for measuring progression towards social change in complex interventions, through a mixed methods concurrent triangulation research design. A narrative literature review in the first phase of the research identified how social change is defined, and what variables could inform the development of proxy indicators. The review findings indicated that intervention design and implementation characteristics are related to intervention effectiveness. From these findings, proxy indicators were developed and tested in a meta-analysis of community-based interventions addressing modifiable cardiac risk factor reduction by acting on the social determinants of health (SDOH). The meta-analysis demonstrated that the indicators could moderate the impact of community-based interventions addressing modifiable cardiac risk factor reduction. A case study of
a public health systems intervention, Help Me Grow, then investigated the content validity of the indicators, and the practicality of using them for monitoring and evaluation during intervention implementation. The Help Me Grow case demonstrated that the indicators were both practical and applicable for monitoring the implementation of the intervention, and could be incorporated into a continuous quality improvement system. This thesis has demonstrated that indicators associated with intervention design and implementation are appropriate proxy impact indicators of complex community-based public health interventions, particularly for interventions with long periods of implementation aiming to achieve generational change. Further research is required to test the reliability and other forms of validity of the indicators in sectors and settings outside public health,
and identify what measures could be used to gather data on these indicators.
... LAAMPP occupies a unique space as a leadership development model that recognizes and celebrates cross-cultural participants and supports their development as tobacco policy leaders. It is essential for people working in priority population communities to understand the history and context of communities (Robinson, 2005;Báezconde-Garbanati et al., 2007;Arndt et al., 2013;David et al., 2013;Mukherjea, Wackowski, Lee, & Delnevo, 2014;Burgess et al., 2014;Palmer et al., 2013). The development of LAAMPP III Fellows' networks suggest that they can use their newly-developed capacity to make decision makers and mainstream tobacco control practitioners more aware of the needs of their communities, applying that community wisdom both within their own and other's communities, as well as in broader mainstream efforts. ...
... Other frameworks also emphasized community-based participatory research 31 and community competency. 32 The Georgetown-Lombardi Office of Minority Health and Health Disparities Research (OMH) and the Capital Breast Cancer Center (CBCC), our two community-based offices (CBOs) located within a 1-mile radius of each other, were opened in the southeast regions of Washington, DC. The OMH (opened in 2012) is composed of Georgetown-Lombardi faculty and staff who seek to engage the community in clinical research. ...
Research suggests that community involvement is integral to solving public health problems, including involvement in clinical trials-a gold standard. Significant racial/ethnic disparities exist in the accrual of participants for clinical trials. Location and cultural aspects of clinical trials influence recruitment and accrual to clinical trials. It is increasingly necessary to be aware of defining characteristics, such as location and culture of the populations from which research participants are enrolled. Little research has examined the effect of location and cultural competency in adapting clinical trial research for minority and underserved communities on accrual for clinical trials. Utilizing embedded community academic sites, the authors applied cultural competency frameworks to adapt clinical trial research in order to increase minority participation in nontherapeutic cancer clinical trials. This strategy resulted in successful accrual of participants to new clinical research trials, specifically targeting participation from minority and underserved communities in metropolitan Washington, DC. From 2012 to 2014, a total of 559 participants enrolled across six nontherapeutic clinical trials, representing a 62% increase in the enrollment of blacks in clinical research. Embedding cancer prevention programs and research in the community was shown to be yet another important strategy in the arsenal of approaches that can potentially enhance clinical research enrollment and capacity. The analyses showed that the capacity to acquire cultural knowledge about patients-their physical locales, cultural values, and environments in which they live-is essential to recruiting culturally and ethnically diverse population samples.
... Place of residence may play a role in the persistence and/or widening of health disparities (Robinson 2005;Bernard et al. 2007;Diez Roux and Mair 2010). To this end, an important component in health research is to identify the risk factors that vary across affluent and deprived neighborhoods. ...
BACKGROUND
In the United States (US), the area-based measure of neighborhood socioeconomic characteristics used in health research varies considerably from one study to another. However, it is unclear whether different area-based measures capture the same or different dimension of neighborhood context.
OBJECTIVE
The purpose of this study is to examine the relationships between single measures (i.e., area-based median household income and median family income) and composite measures (i.e., area-based measures derived from a combination of multiple variables) of neighborhood socioeconomic characteristics.
METHODS
Area-based socioeconomic data at the census tract level were obtained from the 2005– 09 American Community Survey (ACS) for St. Louis, Missouri; Chicago, Illinois; San Diego, California; and Los Angeles, California. Single measures of neighborhood socioeconomic characteristics were simply taken from the ACS data, and composite measures were derived from the computational methods described in previous studies. Separate correlation statistics were then conducted for four US cities.
RESULTS
Despite the differences in how selected area-based measures of neighborhood socioeconomic characteristics were derived from the ACS data, they were highly correlated (either negatively or positively) with one another. In other words, selected area-based measures capture the same dimension of neighborhood context.
CONCLUSIONS
A neighborhood affluence-deprivation continuum in US cities may be captured by an area-based median household (or family) income. Nevertheless, to ensure the generalizability and transportability of results from four US cities, further comparisons of area-based measures (not limited to those considered in this study) are needed in different US cities.
... Context is often treated as a nuisance, addressed mainly if it compromises implementation fidelity or program outcomes (Poland, Frohlich, & Cargo, 2008) or if it impacts upon health status. In fact, many authors consider that a majority of public health interventions still target individual determinants instead of structural ones and few aim the reduction of health inequities (Cohen & Schuchter, 2012;O'Campo, 2012;Ridde et al., 2007;Robinson, 2005). ...
... Facilitated by the presence of community organizers in Quebec's health and social services who have long practiced local development and community development (Rothman, Erlich, & Tropman, 2001;Robinson & Green, 2011), this strategy could be unique to Quebec. Indeed, no other example of such a strategy formally integrated into a national public health program and aimed at improving population health by interventions at various levels, from the local to the national, has been identified (Robinson, 2005). Since its inception in 2003, SDC has been inscribed into numerous regional and local public health action plans. ...
In order to improve population health, public health authorities in the province of Quebec (Canada) have integrated in 2003 a crosscutting health promotion strategy in their public health plans: " Support for the development of communities ". Although it has been in the plans for several years, its implementation had not yet been documented. Using an ethnographic case study, the project aimed at answering the following question: How does the implementation of a community development initiative, as defined in the official documents of public health authorities in Quebec, actually occur? After 32 months of participant observation and 14 semi-structured interviews with key informants, it was possible to describe how it happened in an inner-city neighborhood of Quebec City, chosen as an exemplary case to study. The results revealed that such an initiative is significantly conditioned by a neighborhood's culture and that the context in which the process occurs needs to be centrally taken into account. Authors advocate for a culturally sensitive strategy that focuses on the contexts where the action takes place and considers the culture of place as a central element when wanting to improve population health and health equity.
... Two key theoretical models may enhance the potential for culturally specific, population-level interventions to reduce tobacco-associated health disparities. The community competence model considers history, culture, context, and geography as foundational intervention constructs (Robinson, 2005). For African Americans, this includes slavery, racism/discrimination, and health care inadequacy. ...
... The framework for the culturally specific DVD, Pathways to Freedom: Leading the Way to a Smoke Free Community©, was guided by the Robinson (2005) and Resnicow et al. (1999) models for targeted interventions. The PTF DVD combines knowledge regarding the history of smoking among African Americans, smoking cessation, and relapse prevention, with an ethnocultural context. ...
... Finally, there were several positive trends in behavior change, all favoring the PTF DVD condition-although the differences were not statistically significant. Overall, the current findings also supported the community competence model, which purports that interventions that are responsive to the underlying complexity of a target population and/or community have the potential for greater success in achieving behavior change (Robinson, 2005). ...
Introduction:
Previous research suggests that African American smokers may have improved outcomes if interventions are culturally specific. However, few interventions sufficiently address the unique needs of this population in a format with large reach potential. The purpose of this study was to test the efficacy of a newly developed digital video disc (DVD)-based cessation intervention targeting African Americans.
Methods:
In a 2-arm randomized trial, smokers (N = 140) were randomly assigned to view either the new Pathways to Freedom (PTF) DVD or a standard control DVD. Participants were assessed at baseline, immediately postviewing the DVD, and at a 1-month follow-up. The primary outcomes were feasibility and process variables, including intervention evaluations, readiness to quit, and risk perceptions, and smoking-related behavior changes were examined as secondary outcomes.
Results:
Findings demonstrated the hypothesized positive effects of the PTF DVD compared with the control DVD on content evaluations, risk perceptions, and readiness to quit at follow-up.
Conclusions:
We found initial evidence for the efficacy of the PTF DVD as a stand-alone intervention. Future research will test the efficacy of the DVD for smoking cessation in a larger randomized trial. The ultimate goal of this research is to validate a new intervention for an underserved community of smokers that can be used in multiple settings, such as community health clinics, primary care, quitlines, cessation clinics, and seminars/workshops.
... • cultural influences, lifestyles, eating, immigration, acculturation, food habits, physical activity, and body size from the perspectives of multiple disciplines (Anderson, 2011;Axelson, 1986;Berry, 1997;Brown and Konner, 1987;Butterfoss, 2006;Cockerham, 2005;De Garine and Koppert, 1991;De Garine and Pollock, 1995;Harrison, 2005;Jelliffe, 1967;Mintz, 1996;Mintz and DuBois, 2002;Murcott, 2002;Nelson et al., 2010;Popenoe, 2005;Sallis et al., 2006;Scheffer, 2011;Tharp, 2001); • ecological and life course models for analyzing influences on obesity-related risks or outcomes (Booth et al., 2001;Castro et al., 2009;Daniel et al., 2011;Glass and McAtee, 2006;Kumanyika et al., 2002;Swinburn et al., 1999;Wetter et al., 2001); • frameworks for understanding and addressing health inequalities related to race/ ethnicity or socioeconomic status (Adler and Newman, 2002;Adler and Stewart, 2009;Dressler, 2005;Gutmann, 2003;Krieger, 2005;Kumanyika and Morssink, 2006;LaVeist, 2005;Thomas, 1998;Thomas et al., 2011); • frameworks for addressing cultural influences in obesity and in behavior change and health promotion more broadly (Airhihenbuwa, 1995;Caperchione et al., 2009;Castro et al., 2010;Corneille et al., 2005;Dressler, 2005;James, 2004;Kreuter et al., 2003;Kumanyika and Morssink, 1997;Kumanyika et al., 2007;Kumanyika et al., 2003Kumanyika et al., , 2007Mavoa and McCabe, 2008;Page, 2005;Resnicow et al., 1999;Robinson, 2005;Singer, 1990;Thomas, 2002;Vrazel et al., 2008); • empirical studies and reviews about cultural and contextual influences on eating, physical activity, and body size (Airhihenbuwa et al., , 1996Brewis et al., 1998;Casagrande et al., 2009;Craig et al., 1996;D'Alonzo and Fischetti, 2008;Diaz et al., 2007;Gray et al., 2005;James and Underwood, 1997;Nicolaou et al., 2008;Nicolaou et al., 2009;Nicolaou et al., 2012;Parham and Scarinci, 2007;Renzaho, 2004;Renzaho, 2009Renzaho, , 2011Renzaho et al., 2008Renzaho et al., , 2009aRenzaho et al., ,b, 2011Rucker and Cash, 1992;Taylor et al., 1994Taylor et al., , 1998Taylor et al., , 1999Taylor et al., , 2001Taylor et al., , 2006Taylor et al., , 2007aTeufel-Shone, 2006;Vallianatos and Raine, 2008;Van Duyn et al., 2007;Whitt-Glover and Kumanyika, 2009;Wilson et al., 2010). ...
... A "community energy balance" framework for identifying cultural and contextual influences predisposing to high risk of obesity in ethnic minority populations. blend historical and current experiences and exposures (Robinson, 2005). Minority communities then are contrasted, and contrast themselves, with the "general" population on these variables. ...
