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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.
Sally Guttmacher, PhD, is professor of Public Health in the Department of Nutrition, Food Studies and Public Health at New York University. Patricia J. Kelly, PhD, MPH, APRN, is professor at the University of Missouri, School of Nursing. Yumary Ruiz-Janecko, PhD, is a clinical assistant professor of Public Health at New York University.
Tables, Figure, and Exhibit ixPreface xiAcknowledgments xiiiThe Authors xvPART ONE introducing community-based interventions 11 IMPROVING HEALTH IN COMMUNITY SETTINGS 3Defining Community 4Ecological Theory and Levels of Prevention 52 A BRIEF HISTORY OF COMMUNITY-BASED HEALTH INTERVENTIONS 11Diana Silver Community-Based Health Interventions: An Instrument for Change 12Early Community-Based Health Interventions 15Assessing the Evidence from Early Community-Based Health Interventions 18The Evolution of Community-Based Health Interventions 193 ETHICAL ISSUES IN COMMUNITY INTERVENTIONS 25The Integration of Ethics into Public Health Practice 26Institutional Review Boards 28Vulnerable Populations 29Permission and Consent 30Protection for Research Participants 33Ensuring Research Quality 34Maintaining the Integrity of Research 354 LEVELS AND TYPES OF COMMUNITY-Based INTERVENTIONS 39An Ecological Focus on Types of Prevention 40Selecting a Goal for the Intervention 42Examples of Interventions at Different Levels of Prevention 45PART TWO developing the intervention 515 A FRAMEWORK FOR DESIGNING COMMUNITY-Based INTERVENTIONs 53Theoretical Guidance for Health Interventions 54Examples of Theories Used at the Four Ecological Levels 566 COLLECTING AND MANAGING DATA 65Data: A Crucial Component of Research 66Collecting Quantitative Data 67Collecting Qualitative Data 73After Data Collection 75PART THREE working through the intervention 817 ASSESSING COMMUNITY NEEDS 83Basic Components of a Community Assessment 84Strengthening Your Findings 878 PLANNING A COMMUNITY-BASED INTERVENTION 95Intervention Content and Format 96A Logic Model as an Organizing Strategy 101A Fictional Community Assessment: Adolescent Tobacco Use 1049 IMPLEMENTING A COMMUNITY-BASED INTERVENTION 115Implementation at the Four Ecological Levels 116Interventions at the Community or Policy Level 12310 EVALUATING A COMMUNITY-BASED INTERVENTION 127Reasons for Evaluation 128Preparing for an Evaluation 130Designing the Evaluation 130Flexibility: An Essential Skill in Evaluation 135PART FOUR learning from the past and adapting to the future 13711 FUNDING AND SUSTAINABILITY 139Financing Community-Based Health Interventions 140Components of the Proposal for Funding 143Components of the Budget 150Continuing and Sustaining an Intervention 15512 IMPLEMENTATION PITFALLS 157Things Happen 15813 THE FUTURE OF COMMUNITY-BASED HEALTH INTERVENTIONS 165Adapting Methods of Intervention to Twenty-First–Century Communities 166A Challenge and an Opportunity for Public Health Practitioners 169A Limitation of the New Technologies 17314 COMMUNITY-BASED HEALTH INTERVENTIONS IN PRACTICE 177Arthritis 178Asthma 179Adult Vaccinations 181Alcohol Use 182Cardiovascular Disease 183Childhood Vaccinations 184Injuries from Motor Vehicle Accidents 185Sexual Assault and Relationship Violence 186Smoking 187Glossary 191References 203Index 211