Principles of Community Engagement (Second Edition)

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and stakeholders are represented equally in the partnership, and all parties are mutually accountable for all aspects of the project (Russell et al , 2008) Diffusion of Innovation Everett Rogers (1995) defined diffusion as “the process by which an innovation is communicated through certain channels over time among the members of a social system” (p 5) Communication, in turn, according to Rogers, is a “process in which participants create and share information with one another in order to reach a mutual understanding” (p 5) In the case of diffusion of innovation, the communication is about an idea or new approach Understanding the diffusion process is essential to community-engaged efforts to spread innovative practices in health improvement Rogers offered an early formulation of the idea that there are different stages in the innovation process and that individuals move through these stages at different rates and with different concerns Thus, diffusion of innovation provides a platform for understanding variations in how communities (or groups or individuals within communities) respond to community engagement efforts In Rogers’ first stage, knowledge, the individual or group is exposed to an innovation but lacks information about it In the second stage, persuasion, the individual or group is interested in the innovation and actively seeks out information In decision, the third stage, the individual or group weighs the advantages and disadvantages of using the innovation and decides whether to adopt or reject it If adoption occurs, the individual or group moves to the fourth stage, implementation, and employs the innovation to some degree During this stage, the usefulness of the innovation is determined, and additional information may be sought In the fifth stage, confirmation, the individual or group decides whether to continue using the innovation and to what extent Rogers noted that the innovation process is influenced both by the individuals involved in the process and by the innovation itself Individuals include innovators, early adopters of the innovation, the early majority (who deliberate longer than early adopters and then take action), late adopters, and “laggards” who resist change and are often critical of others willing to accept the innovation 24
According to Rogers, the characteristics that affect the likelihood that an innovation will be adopted include (1) its perceived relative advantage over other strategies, (2) its compatibility with existing norms and beliefs, (3) the degree of complexity involved in adopting the innovation, (4) the “trialability” of the innovation (i e , the extent to which it can be tested on a trial basis), and (5) the observability of the results Greenhalgh et al (2004) expanded upon these characteristics of an innovation, adding (1) the potential for reinvention, (2) how flexibly the innovation can be used, (3) the perceived risk of adoption, (4) the presence of a clear potential for improved performance, (5) the knowledge required to adopt the innovation, and (6) the technical support required Awareness of the stages of diffusion, the differing responses to innovations, and the characteristics that promote adoption can help engagement leaders match strategies to the readiness of stakeholders For example, a community-engaged health promotion campaign might include raising awareness about the severity of a health problem (knowledge, the first stage in Rogers’ scheme), transforming awareness into concern for the problem (persuasion), establishing a community-wide intervention initiative (adoption), developing the necessary infrastructure so that the provision of services remains extensive and constant in reaching residents (implementation), and/ or evaluation of the project (confirmation) Community-Based Participatory Research Community-based participatory research (CBPR) is the most well-known framework for CEnR As a highly evolved collaborative approach, CBPR would be represented on the right side of the continuum shown in Figure 1 1 (page 8) In CBPR, all collaborators respect the strengths that each brings to the partnership, and the community participates fully in all aspects of the research process Although CBPR begins with an important research topic, its aim is to achieve social change to improve health outcomes and eliminate health disparities (Israel et al , 2003) Wallerstein et al (2008) conducted a two-year pilot study that looked at how the CBPR process influences or predicts outcomes Using Internet survey methods and existing published literature, the study focused on two questions: What Awareness of the stages of diffusion, the differing responses to innovations, and the characteristics that promote adoption can help engagement leaders match strategies to the readiness of stakeholders. 25
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 and 36: action at those levels This approac
Page 37: • S o c i e t y : Advocate for th
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
Page 89 and 90:
access to resources for healthy eat
Page 91 and 92:
9. THE DENTAL PRACTICE-BASED RESEAR
Page 93 and 94:
10. DIABETES EDUCATION & PREVENTION
Page 95 and 96:
11. PROJECT DULCE Background: Diabe
Page 97 and 98:
References Gilmer TP, Philis-Tsimik
Page 99 and 100:
milestones in child development, ch
Page 101 and 102:
Chapter 4 Managing Organizational S
Page 103 and 104:
engagement is not limited to coalit
Page 105 and 106:
Practice Element 1: Know the Commun
Page 107 and 108:
each capacity component for this pr
Page 109 and 110:
REFERENCES Butterfoss FD. Coalition
Page 111 and 112:
Table 4.1. Know the Community, Its
Page 113 and 114:
Table 4.3. Build and Sustain Networ
Page 115 and 116:
Challenges in Improving Community E
Page 117 and 118:
ecommended public health practices
Page 119 and 120:
community setting can be just as ri
Page 121 and 122:
These challenges do not compare, ho
Page 123 and 124:
halted its efforts to collect data
Page 125 and 126:
mechanisms for communication, the c
Page 127 and 128:
The researchers and the community b
Page 129 and 130:
Horn K, McGloin T, Dino G, Manzo K,
Page 131 and 132:
Take-Home Messages • Be explicit
Page 133 and 134:
At meetings of the CAB, decisions w
Page 135 and 136:
3. WORKING WITH NONTRADITIONAL COMM
Page 137 and 138:
B. How do you engage a state as a c
Page 139 and 140:
to those applying for funds The eva
Page 141 and 142:
4. INITIATING A PROJECT WITH A COMM
Page 143 and 144:
B. How do you set up and maintain a
Page 145 and 146:
References Blumenthal DS A communit
Page 147 and 148:
parties grew frustrated The partner
Page 149 and 150:
5. O VERCOMING COMPETING PRIORITIES
Page 151 and 152:
Reference Reifsnider E, Hargraves M
Page 153 and 154:
Take-Home Messages • “Splitting
Page 155 and 156:
Although the CTSA sites in the Bost
Page 157 and 158:
Chapter 6 The Value of Social Netwo
Page 159 and 160:
Social networks can also play an im
Page 161 and 162:
engagement effort, relationships mu
Page 163 and 164:
engagement Furthermore, social medi
Page 165 and 166:
REFERENCES Arthur T The role of soc
Page 167 and 168:
Program Evaluation and Evaluating C
Page 169 and 170:
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
Page 177 and 178:
The major goal of empowerment evalu
Page 179 and 180:
Table 7.1. Types of Evaluation Ques
Page 181 and 182:
The evaluation of community engagem
Page 183 and 184:
for understanding a community and i
Page 185 and 186:
REFERENCES Anderson RM, Funnell MM,
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Patton MQ Qualitative evaluation an
Page 189 and 190:
Chapter 8 Summary Donna Jo McCloske
Page 191 and 192:
• Know the extent to which the fo
Page 193 and 194:
Appendix A: Acronyms
Page 195 and 196:
CDC Centers for Disease Control and
Page 197:
NIH Publication No. 11-7782
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