Public health practice in Communities WITH THIRUVENGADAM MUNIRAI CHAPTER OUTLINE a public health agency, such as the commissioner of health THEORIES OF COMMUNITY CHANGE 318 or agency staff. However, the principles of community plan A. Social Cognitive Theory 321 ning and evaluation pertain to B. Community Organization 321 in improving the community(stakeholders, policy cipatory Resea including an employee of a foundation, schoo C. Diffusion of Innovations Theory 322 office, or political party and any interested citizen. Social Marketing in Public Health 322 there are many ideas on how to improve the health of a com- D. Communication Theory 323 munity, many good ideas fail. Reasons include lack of com- Delphi Technique 323 munity or organizational support, lack of coordination, 2. Role of Media Communication 323 turf battles, inefficient and duplicative efforts, and failure E. Environmental Influences on Behavior 323 to use evidence-based interventions. Careful planning before II. STEPS IN DEVELOPING A HEALTH PROMOTION a project begins can make a significant impact on the success PROGRAM 325 of the pre A. Define Strategy and Assemble Team 325 This chapter discusses the steps involved in planning and B. Identify Primary Health Issues 325 evaluating a program, highlighting two special applications PRECEDE/PROCEED Model of community planning:(1) tobacco prevention, as ar 2. Planned Approach to Community Health 326 example of multiple successful community interventions 3. Mobilizing for Action through Planning and Partnerships 32 (Box 26-1), and(2) health disparities, one of the greatest C. Develop Objectives to Measure Progress 3 ublic health problems. a community is only as strong as its Healthy People 2020 327 weakest link. Therefore, public health practitioners shoul D. Select Effective Interventions 328 aim not just to raise health overall, but to raise most the Community Preventive Services 328 health of the vulnerable populations. Box 26-2 lists some 2. Cultural Congruence of Interventions 329 examples how health disparities have been successfully ddressed mplement Innovations 329 Many models and acronyms describe the steps of co munity planning(Box 26-3). They all have their strengths III. FUTURE CHALLENGES 330 and weaknesses. We follow mainly the steps outlined in the A. Integrating CLinical Care and Prevention 330 Centers for Disease Control and Prevention(CDC) model B. Integrating Community-Based Prevention with Other Community Health Assessment and Group Evaluation Community Services 330 (CHANGE). Other models are described in the section that C. E-Health 331 addresses their main emphasis. Any other model of com- IV. SUMMARY 331 munity planning likely works equally well as long as planners REVIEW QUESTIONS, ANSWERS, AND EXPLANATIONS follow the following basic principles Assemble community stakeholders and, in collaboration with them, define the agend nd pri Perform a needs assessment a Design measurable objectives and interventions Chapters 24 and 25 discuss the organization and health of the public health system overall. This chapter discusses the Build evaluation into the entire process theory and practice of improving community health. Theo Table 26-1 provides an overview of the process and pos ries are important because a theory-based program is more ible resources for each step. likely to be effective(see Chapter 15). The technical term for attempts to improve community health is community/ program planning . THEORIES OF COMMUNITY CHANGE Community planning is defined nized proces to design, implement, and evaluate a When behavioral factors are a threat to health, improving based project to address the needs of a health requires behavior change, Unhealthy behaviors(e.g Community planning is often the prov personnel in sedentariness) need to be replaced by healthy ones(e.g 318