Advancing the Science of Community-Level Interventions

Department of Psychology, University of Illinois at Chicago, USA.
American Journal of Public Health (Impact Factor: 4.55). 06/2011; 101(8):1410-9. DOI: 10.2105/AJPH.2010.300113
Source: PubMed


Community interventions are complex social processes that need to move beyond single interventions and outcomes at individual levels of short-term change. A scientific paradigm is emerging that supports collaborative, multilevel, culturally situated community interventions aimed at creating sustainable community-level impact. This paradigm is rooted in a deep history of ecological and collaborative thinking across public health, psychology, anthropology, and other fields of social science. The new paradigm makes a number of primary assertions that affect conceptualization of health issues, intervention design, and intervention evaluation. To elaborate the paradigm and advance the science of community intervention, we offer suggestions for promoting a scientific agenda, developing collaborations among professionals and communities, and examining the culture of science.

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    • "Our model understands culture as a constitutive social practice based on shared ideologies, beliefs, values, norms, and meanings that act as a probabilistic causal force in shaping health outcomes (Patterson, 2014: 7). Second , CBPR emphasizes extreme contextualism but overlooks " the effects that more macro-level forces, such as state and national policies and ideologies, have on relevant aspects of community life " (Trickett et al., 2011: 1413). Our framework not only illuminates how structural forces enable or constrain people's choices, but also that individuals have the potential to effect structural and cultural changes. "
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    ABSTRACT: Although a substantial literature examines the relationship between culture and health in myriad individual contexts, a lack of comparative data across settings has resulted in disparate and imprecise conceptualizations of the concept for scholars and practitioners alike. This article examines scholars and practitioners' understandings of culture in relation to health interventions. Drawing on 169 interviews with officials from three different nongovernmental organizations working on health issues in multiple countries-Partners in Health, Oxfam America, and Sesame Workshop-we examine how these respondents' interpretations of culture converge or diverge with recent developments in the study of the concept, as well as how these understandings influence health interventions at three different stages-design, implementation, and evaluation-of a project. Based on these analyses, a tripartite definition of culture is built-as knowledge, practice, and change-and these distinct conceptualizations are linked to the success or failure of a project at each stage of an intervention. In so doing, the study provides a descriptive and analytical starting point for scholars interested in understanding the theoretical and empirical relevance of culture for health interventions, and sets forth concrete recommendations for practitioners working to achieve robust improvements in health outcomes.
    Social Science [?] Medicine 09/2015; 144:79-87. DOI:10.1016/j.socscimed.2015.09.013 · 2.89 Impact Factor
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    • "The collection of articles in this Special Section helps to address this by bringing together multiple strategies and demonstrating their strength in addressing research questions with small samples. Small sample research issues also arise in multi-level, group-based, or community-level intervention research (Trickett et al. 2011). An example of this is a study that uses a media campaign and compares the efficacy of that campaign across communities. "
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    ABSTRACT: Small sample research presents a challenge to current standards of design and analytic approaches and the underlying notions of what constitutes good prevention science. Yet, small sample research is critically important as the research questions posed in small samples often represent serious health concerns in vulnerable and underrepresented populations. This commentary considers the Special Section on small sample research and also highlights additional challenges that arise in small sample research not considered in the Special Section, including generalizability, determining what constitutes knowledge, and ensuring that research designs match community desires. It also points to opportunities afforded by small sample research, such as a focus on and increased understanding of context and the emphasis it may place on alternatives to the randomized clinical trial. The commentary urges the development and adoption of innovative strategies to conduct research with small samples.
    Prevention Science 08/2015; 16(7). DOI:10.1007/s11121-015-0585-4 · 2.63 Impact Factor
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    • "Community engagement occurred through involvement of key stakeholders. Whilst the majority reported using guidelines to inform planning of initiatives, improvements could be made by integrating high-quality evidence, regional weight gain prevention frameworks and theories across all levels of the socio-ecological model (Trickett et al., 2011; Golden and Earp, 2012; Haby et al., 2012). The majority of CBIs reported conducting and allocating a budget for evaluation. "
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    ABSTRACT: Community-based initiatives (CBIs) that build capacity and promote healthy environments hold promise for preventing obesity and non-communicable disease, however their characteristics remain poorly understood and lessons are learned in isolation. This limits understanding of likely effectiveness of CBIs; the potential for actively supporting practice; and the translation of community-based knowledge into policy. Building on an initial survey (2010), an online survey was launched (2013) with the aim to describe the reach and characteristics of Australian CBIs and identify and evaluate elements known to contribute to best practice, effectiveness and sustainability. Responses from 104 CBIs were received in 2013. Geographic location generally reflected population density in Australia. Duration of CBIs was short-term (median 3 years; range 0.2-21.0 years), delivered mostly by health departments and local governments. Median annual funding had more than doubled since the 2010 survey, but average staffing had not increased. CBIs used at least two strategy types, with a preference for individual behaviour change strategies. Targeting children was less common (31%) compared with the 2010 survey (57%). Logic models and theory were used in planning, but there was low use of research evidence and existing prevention frameworks. Nearly, all CBIs had an evaluation component (12% of budget), but dissemination was limited. This survey provides information on the scope and varied quality of the current obesity prevention investment in Australia. To boost the quality and effectiveness of CBIs, further support systems may be required to ensure that organizations adopt upstream, evidence-informed approaches; and integrate CBIs into systems, policies and environments. © The Author 2015. Published by Oxford University Press.
    Health Promotion International 04/2015; DOI:10.1093/heapro/dav024 · 1.94 Impact Factor
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