Principles of Community Engagement (Second Edition)

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The first level of the model (at the extreme right) includes individual biol- ogy and other personal characteristics, such as age, education, income, and health history The second level, relationship, includes a person’s closest social circle, such as friends, partners, and family members, all of whom influence a person’s behavior and contribute to his or her experiences The third level, community, explores the settings in which people have social relationships, such as schools, workplaces, and neighborhoods, and seeks to identify the characteristics of these settings that affect health Finally, the fourth level looks at the broad societal factors that favor or impair health Examples here include cultural and social norms and the health, economic, educational, and social policies that help to create, maintain, or lessen socioeconomic inequalities between groups (CDC, 2007; Krug et al , 2002) The CDC model enables community-engaged partnerships to identify a comprehensive list of factors that contribute to poor health and develop a broad approach to health problems that involves actions at many levels to produce and reinforce change For example, an effort to reduce childhood obesity might include the following activities at the four levels of interest: • Individual: Conduct education programs to help people make wise choices to improve nutritional intake, increase their physical activity, and control their weight • Interpersonal relationships: Create walking clubs and work with community groups to introduce healthy menus and cooking methods Promote community gardening groups • Community: Work with local grocery stores and convenience stores to help them increase the amount of fresh fruits and vegetables they carry Establish farmers’ markets that accept food stamps so that low-income residents can shop there Work with the city or county to identify walking trails, parks, and indoor sites where people can go to walk, and publicize these sites If the area needs additional venues for exercise, build community demand and lobby for new areas to be built or designated Work with local employers to develop healthier food choices on site and to create other workplace health programs 22
• S o c i e t y : Advocate for the passage of regulations to (1) eliminate soft drinks and high-calorie snacks from all schools, (2) ban the use of trans–fatty acids in restaurant food, or (3) mandate that a percentage of the budget for road maintenance and construction be spent on creating walking paths and bike lanes Long-term attention to all levels of the social ecological model creates the changes and synergy needed to support sustainable improvements in health The Active Community Engagement Continuum The Active Community Engagement (ACE) continuum provides a framework for analyzing community engagement and the role the community plays in influencing lasting behavior change ACE was developed by the Access, Quality and Use in Reproductive Health (ACQUIRE) project team, which is supported by the U S Agency for International Development and managed by EngenderHealth in partnership with the Adventist Development and Relief Agency International, CARE, IntraHealth International, Inc , Meridian Group International, Inc , and the Society for Women and AIDS in Africa (Russell et al , 2008) The ACE continuum is based on a review of documents, best practices, and lessons learned during the ACQUIRE project; in a paper by Russell et al (2008) the continuum is described as follows: The continuum consists of three levels of engagement across five characteristics of engagement The levels of engagement, which move from consultative to cooperative to collaborative, reflect the realities of program partnerships and programs These three levels of community engagement can be adapted, with specific activities based on these categories of action The five characteristics of engagement are community involvement in assessment; access to information; inclusion in decision making; local capacity to advocate to institutions and governing structures; and accountability of institutions to the public (p 6) The experience of the ACQUIRE team shows that community engagement is not a one-time event but rather an evolutionary process At each successive level of engagement, community members move closer to being change agents themselves rather than targets for change, and collaboration increases, as does community empowerment At the final (collaborative) level, communities 23
Page 1 and 2: PRINCIPLES OF COMMUNITY ENGAGEMENT
Page 3 and 4: TABLE OF CONTENTS CTSA Community En
Page 5 and 6: Editorial and Research Staff Mina S
Page 7 and 8: For further information on the CTSA
Page 9 and 10: FOREWORD As Surgeon General, I am p
Page 11 and 12: Executive Summary
Page 13 and 14: of Veterans Affairs, and other fede
Page 15 and 16: REFERENCES Ahmed SM, Palermo AG Com
Page 17 and 18: Chapter 1 Community Engagement: Def
Page 19 and 20: clinics, agencies, after-school pro
Page 21 and 22: The eligibility criteria that scien
Page 23 and 24: 2 Design and delivery—Improvement
Page 25 and 26: There is no question that culture a
Page 27 and 28: oot causes of problems while at the
Page 29 and 30: • Know the community, its constit
Page 31 and 32: • Coalitions require that each pa
Page 33 and 34: studies demonstrate that IRBs gener
Page 35: action at those levels This approac
Page 39 and 40: According to Rogers, the characteri
Page 41 and 42: is the added value of CBPR to the r
Page 43 and 44: • It is important to understand c
Page 45 and 46: Butterfoss FD, Kegler MC (2002) Tow
Page 47 and 48: Flicker S, Travers R, Guta A, McDon
Page 49 and 50: Jones MR, Horner RD, Edwards LJ, Ho
Page 51 and 52: Minkler M Community organizing and
Page 53 and 54: Shore N Community-based participato
Page 55 and 56: Yale Center for Clinical Investigat
Page 57 and 58: Chapter 2 Principles of Community E
Page 59 and 60: • Ask community members to specif
Page 61 and 62: trust for a true partnership Such m
Page 63 and 64: that affect health and health dispa
Page 65 and 66: difference in the health of the pop
Page 67 and 68: Chapter 3 Successful Examples in th
Page 69 and 70: 59 TABLE 3.1. MATRIX OF CASE EXAMPL
Page 71 and 72: a mission statement written in the
Page 73 and 74: 2. HEALTH-E-AME Background: The Med
Page 75 and 76: 3. PROJECT SUGAR Background: Gullah
Page 77 and 78: Websites http://academicdepartments
Page 79 and 80: of the community context, developme
Page 81 and 82: 5. HEALING OF THE CANOE Background:
Page 83 and 84: 6. FORMANDO NUESTRO FUTURO/SHAPING
Page 85 and 86: 7. IMPROVING AMERICAN INDIAN CANCER
Page 87 and 88:
and the mistreatment of some Americ
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access to resources for healthy eat
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9. THE DENTAL PRACTICE-BASED RESEAR
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10. DIABETES EDUCATION & PREVENTION
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11. PROJECT DULCE Background: Diabe
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References Gilmer TP, Philis-Tsimik
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milestones in child development, ch
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Chapter 4 Managing Organizational S
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engagement is not limited to coalit
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Practice Element 1: Know the Commun
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each capacity component for this pr
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REFERENCES Butterfoss FD. Coalition
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Table 4.1. Know the Community, Its
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Table 4.3. Build and Sustain Networ
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Challenges in Improving Community E
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ecommended public health practices
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community setting can be just as ri
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These challenges do not compare, ho
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halted its efforts to collect data
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mechanisms for communication, the c
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The researchers and the community b
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Horn K, McGloin T, Dino G, Manzo K,
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Take-Home Messages • Be explicit
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At meetings of the CAB, decisions w
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3. WORKING WITH NONTRADITIONAL COMM
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B. How do you engage a state as a c
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to those applying for funds The eva
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4. INITIATING A PROJECT WITH A COMM
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B. How do you set up and maintain a
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References Blumenthal DS A communit
Page 147 and 148:
parties grew frustrated The partner
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5. O VERCOMING COMPETING PRIORITIES
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Reference Reifsnider E, Hargraves M
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Take-Home Messages • “Splitting
Page 155 and 156:
Although the CTSA sites in the Bost
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Chapter 6 The Value of Social Netwo
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Social networks can also play an im
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engagement effort, relationships mu
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engagement Furthermore, social medi
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REFERENCES Arthur T The role of soc
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Program Evaluation and Evaluating C
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approaches to evaluation that are p
Page 171 and 172:
Several institutions have identifie
Page 173 and 174:
Planning Defining and identifying s
Page 175 and 176:
Once the positive outcome of a prog
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The major goal of empowerment evalu
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Table 7.1. Types of Evaluation Ques
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The evaluation of community engagem
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for understanding a community and i
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REFERENCES Anderson RM, Funnell MM,
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Patton MQ Qualitative evaluation an
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Chapter 8 Summary Donna Jo McCloske
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• Know the extent to which the fo
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Appendix A: Acronyms
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CDC Centers for Disease Control and
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NIH Publication No. 11-7782
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