Community participation in health initiatives for marginalized populations.
ABSTRACT Community-based participatory methods have emerged as a response to conventional approaches that have historically failed to make notable improvement in health status or reduce chronic disease among marginalized populations. The social-ecological model provides a framework to develop and implement strategies directed to affecting multiple levels (societal, community, organizational, and individual) of influence on health status. A systems approach can facilitate the identification of the complex interrelationships of factors at all levels that contribute to health disparities by making use of the unique knowledge, expertise, and resources of community partners. Community engagement in the planning, implementation, and evaluation of health initiatives builds community capacity to create sustainable changes at all levels to achieve and maintain optimal health for those who bear the greatest burden of disease.
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ABSTRACT: Background: In an effort to form and sustain community-academic partnerships (CAPs) to enhance clinical and translational research, an assessment of needs for selecting and implementing evidence-based programs (EBPs) was conducted among a group of community-based organizations (CBOs) throughout Puerto Rico.Methods: The survey was based on an instrument developed by the Cancer Prevention and Control Research Network. It assessed specific service information, program selection/implementation processes, knowledge and perception of EBPs, funding venues, evaluation processes, and capacity and training needs. Recruitment consisted of contacting 100 nonprofit organizations in Puerto Rico that work or address specific health areas, namely, cancer, neurological disorders, HIV, and cardiovascular health.Results: The survey revealed wide variability in understanding what constitutes an EBP. Training needs for building a productive translational research process also were identified. Prominent among these were securing funding for ongoing operations, utilizing data for decision making, developing collaborations, managing information, conducting community needs assessments, and program evaluation.Conclusions: These findings point to important implications for promoting community-campus partnerships for advancing clinical and translational research.Progress in Community Health Partnerships Research Education and Action 01/2014; 8(1):53-60. DOI:10.1353/cpr.2014.0009
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ABSTRACT: Once the Ottoman Empire collapsed, a new Turkish state was established after a struggle for national freedom. The founder of the Turkish Republic, Mustafa Kemal Atatürk,1 aimed to develop a western-like democratic state for the people of the remaining Empire, even though he could have become the next sultan. All stages necessary for the emergence of a new state had already been fulfilled before the collapse of the Ottoman Empire, and the establishment of the Turkish Republic was the final element within the transformation process of the Ottoman state.2 Atatürk, as the successor of the Young Turks who gained political power through the constitutional movement in 1908, abolished the monarchy and established a secular republic, a western-like democracy.3 Yet, the new state, the Republic of Turkey, encountered some profound problems with respect to its desire to develop a new social and political structure in order to establish a full-fledged democracy. It was not an easy task for the leaders of the Republic, especially considering the fact that the idea of democracy was a completely new concept for people who had been under the rule of an empire, an absolute power and authority, for centuries. This end demanded a whole transition: not only a change in political and economic structures but also a cultural transformation that was highly dependent upon the education of the masses. Within this context, the Republic conceived of education as an essential instrument in order to re-shape the social order, to inform citizens about democracy, and to disseminate the new ideology. This study examines the essential perspective of Kemalism4 on concepts, such as nation, culture, and education, while elucidating the ideas of some influential figures in Atatürk’s thoughts on such notions. In particular, two prominent thinkers, Ziya Gökalp and John Dewey, had a significant impact on the official ideology and education system of the Turkish Republic. Gökalp’s Turkism and Dewey’s ideas on the education system of Turkey are the focal points throughout this study. While Gökalp was a main source of the Kemalist nation-state, Dewey’s thoughts about Turkish education provided practical examples of educational reform in order for Kemalism to develop a desired society. However, official authorities did not consider Dewey’s concerns on some important issues, such as centralization and uniformity. Rather, the leaders during the early republican period adopted Dewey’s suggestions in a different way from his actual intentions. Some important educational reforms and organizations indicate that the Turkish state during the early period found the theoretical aspect of Turkish education in Gökalp’s Turkism and some practical solutions in Dewey’s ideas on education. In short, I argue that Kemalism modified Dewey’s suggestions within the official understanding of nation-state based on Gökalp’s Turkism. In this sense, I also argue that Gökalp framed ideas while Dewey provided ways and means, although the two thinkers held different conceptions of the individual and viewed the role of emotions in educating members of a society from different perspectives. Religious toleration was an essential characteristic of the Ottoman state.5 In a broader sense, toleration was one of the distinguishing features of the Ottoman community and a governing principle embraced by the Ottoman rulers. Despite the fact that the Ottoman state was an empire and that Islam was the foundation of the state, Ottoman rulers never tried to impose a single culture based on one religion or language. Ottomans developed a unique social order called the millet system to maintain the social unity of the different communities of the Empire based upon the ideas of autonomy and equality. This system can be traced back to the conquest of Constantinople. Mehmet II granted the patriarch and Greek Church full religious and civil authority over its own Orthodox millet despite being dependent on the support of the Ottoman sultan.6 This autonomy, in time, was extended in the same way to the other millets, such as Armenians and Jews. All millets of the Empire were subject to the same political constraints but could form autonomous institutions, such as...Progress in Community Health Partnerships Research Education and Action 01/2014; 8(1):9. DOI:10.1353/cpr.2014.0013
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ABSTRACT: CONTEXT: Policymakers and practitioners continue to pursue initiatives designed to engage individuals in their health and health care despite discordant views and mixed evidence regarding the ability to cultivate greater individual engagement that improves Americans' health and well-being and helps manage health care costs. There is limited and mixed evidence regarding the value of different interventions. METHODS: Based on our involvement in evaluating various community-based consumer engagement initiatives and a targeted literature review of models of behavior change, we identified the need for a framework to classify the universe of consumer engagement initiatives toward advancing policymakers' and practitioners' knowledge of their value and fit in various contexts. We developed a framework that expanded our conceptualization of consumer engagement, building on elements of two common models, the individually focused transtheoretical model of behavior and the broader, multilevel social ecological model. Finally, we applied this framework to one community's existing consumer engagement program. FINDINGS: Consumer engagement in health and health care refers to the performance of specific behaviors ("engaged behaviors") and/or an individual's capacity and motivation to perform these behaviors ("activation"). These two dimensions are related but distinct and thus should be differentiated. The framework creates four classification schemas, by (1) targeted behavior types (self-management, health care encounter, shopping, and health behaviors) and by (2) individual, (3) group, and (4) community dimensions. Our example illustrates that the framework can systematically classify a variety of consumer engagement programs, and that this exercise and resulting characterization can provide a structured way to consider the program and how its components fit program goals both individually and collectively. CONCLUSIONS: Applying the framework could help advance the field by making policymakers and practitioners aware of the wide range of approaches, providing a structured way to organize and characterize interventions retrospectively, and helping them consider how they can meet the program's goals both individually and collectively.Milbank Quarterly 03/2013; 91(1):37-77. DOI:10.1111/milq.12002 · 5.06 Impact Factor