Principles of Community Engagement - ATSDR - Centers for ...

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and stakeholders are represented equally in the partnership, and all partiesare mutually accountable for all aspects of the project (Russell et al, 2008)Diffusion of InnovationEverett Rogers (1995) defined diffusion as “the process by which an innovationis communicated through certain channels over time among the members of asocial system” (p 5) Communication, in turn, according to Rogers, is a “processin which participants create and share information with one another in orderto reach a mutual understanding” (p 5) In the case of diffusion of innovation,the communication is about an idea or new approach Understanding the diffusionprocess is essential to community-engaged efforts to spread innovativepractices in health improvementRogers offered an early formulation of the idea that there are different stagesin the innovation process and that individuals move through these stages atdifferent rates and with different concerns Thus, diffusion of innovation providesa platform for understanding variations in how communities (or groupsor individuals within communities) respond to community engagement effortsIn Rogers’ first stage, knowledge, the individual or group is exposed to aninnovation but lacks information about it In the second stage, persuasion,the individual or group is interested in the innovation and actively seeks outinformation In decision, the third stage, the individual or group weighs theadvantages and disadvantages of using the innovation and decides whether toadopt or reject it If adoption occurs, the individual or group moves to the fourthstage, implementation, and employs the innovation to some degree During thisstage, the usefulness of the innovation is determined, and additional informationmay be sought In the fifth stage, confirmation, the individual or group decideswhether to continue using the innovation and to what extentRogers noted that the innovation process is influenced both by the individualsinvolved in the process and by the innovation itself Individuals include innovators,early adopters of the innovation, the early majority (who deliberate longerthan early adopters and then take action), late adopters, and “laggards” whoresist change and are often critical of others willing to accept the innovation24
According to Rogers, the characteristics that affect the likelihood that an innovationwill be adopted include (1) its perceived relative advantage over otherstrategies, (2) its compatibility with existing norms and beliefs, (3) the degreeof complexity involved in adopting the innovation, (4) the “trialability” of theinnovation (ie, 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 thesecharacteristics 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 knowledgerequired to adopt the innovation, and (6) the technical support requiredAwareness of the stages of diffusion, the differing responses toinnovations, and the characteristics that promote adoption can helpengagement leaders match strategies to the readiness of stakeholdersFor example, a community-engaged health promotion campaignmight include raising awareness about the severity of a health problem(knowledge, the first stage in Rogers’ scheme), transformingawareness into concern for the problem (persuasion), establishinga community-wide intervention initiative (adoption), developing thenecessary infrastructure so that the provision of services remainsextensive and constant in reaching residents (implementation), and/or evaluation of the project (confirmation)Awareness of the stages ofdiffusion, the differing responses toinnovations, and the characteristicsthat promote adoption can helpengagement leaders matchstrategies to the readiness ofstakeholders.Community-Based Participatory ResearchCommunity-based participatory research (CBPR) is the most well-knownframework for CEnR As a highly evolved collaborative approach, CBPRwould be represented on the right side of the continuum shown in Figure 11(page 8) In CBPR, all collaborators respect the strengths that each brings tothe partnership, and the community participates fully in all aspects of theresearch process Although CBPR begins with an important research topic,its aim is to achieve social change to improve health outcomes and eliminatehealth disparities (Israel et al, 2003)Wallerstein et al (2008) conducted a two-year pilot study that looked at how theCBPR process influences or predicts outcomes Using Internet survey methodsand existing published literature, the study focused on two questions: What25
Page 1: PRINCIPLES OFCOMMUNITY ENGAGEMENTSE
Page 6 and 7: PUBLICATION DEVELOPMENTThis publica
Page 8 and 9: Foreword
Page 10 and 11: detailed practical information abou
Page 12 and 13: EXECUTIVE SUMMARYInvolving the comm
Page 15 and 16: REFERENCESAhmed SM, Palermo AG Comm
Page 19: clinics, agencies, after-school pro
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 34 and 35: 2006; Wing, 2002) There is also unc
Page 40 and 41: ContextsSocioeconomic, Cultural,Geo
Page 44 and 45: REFERENCESAirhihenbuwa CO Health an
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: Yale Center for Clinical Investigat
Page 58 and 59: successful Each principle covers a
Page 60 and 61: cultural environment and its intera
Page 62 and 63: is of the community when it is cont
Page 64 and 65: the “trigger” for the engagemen
Page 66 and 67: Successful Examples in the Field
Page 68 and 69: 3 Project SuGAR4 The Community Heal
Page 70 and 71: 1. COMMUNITY ACTION FOR CHILD HEALT
Page 72 and 73: including the collection of biospec
Page 74 and 75: Applications of Principles of Commu
Page 77 and 78: Websiteshttp://academicdepartmentsm
Page 79 and 80: of the community context, developme
Page 81 and 82: 5. HEALING OF THE CANOEBackground:
Page 83 and 84: 6. FORMANDO NUESTRO FUTURO/SHAPING
Page 85 and 86: 7. IMPROVING AMERICAN INDIAN CANCER
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and the mistreatment of some Americ
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Applications of Principles of Commu
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The success of the initialprogram h
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12. DETERMINANTS OF BRUSHING YOUNG
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Managing Organizational Supportfor
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al., 2009), and (3) the constituenc
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Practice Element 1: Know the Commun
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each capacity component for this pr
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REFERENCESButterfoss FD. Coalitions
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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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Chapter 5Challenges in Improving Co
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1. ENGAGING AND MAINTAINING COMMUNI
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• Collaboratively developing an M
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• Employ a variety of participati
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ChallengeThe John Avery Boys and Gi
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2. OVERCOMING DIFFERENCES BETWEEN A
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the West Virginia PRC, the North Ca
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Action StepsThe university partners
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C. How do you engage a community wh
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As seats came open on the CAB, memb
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ought a communication from the cont
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and research leadership Partners al
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ReferencesDino G, Horn K, Abdulkadr
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Action StepsMorehouse continued to
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ReferencesBlumenthal DS A community
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parties grew frustrated The partner
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5. OVERCOMING COMPETING PRIORITIES
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ReferenceReifsnider E, Hargraves M,
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Take-Home Messages• “Splitting
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Although the CTSA sites in the Bost
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Chapter 6The Value of Social Networ
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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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REFERENCESArthur T The role of soci
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Program Evaluation and EvaluatingCo
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approaches to evaluation that are p
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Several institutions have identifie
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PlanningThe relevant questions duri
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was evaluated (Anderson et al, 2009
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• Participants meet to communicat
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Table 7.1. Types of Evaluation Ques
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conducted with a loose set of quest
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for understanding a community and i
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REFERENCESAnderson RM, Funnell MM,
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Patton MQ Qualitative evaluation an
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Chapter 8SummaryDonna Jo McCloskey,
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• Know the extent to which the fo
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Appendix A:Acronyms
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CDCCenters for Disease Control and
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NIH Publication No. 11-7782
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