Community-Based Health Interventions

Tables, Figure, and Exhibit ix

Preface xi

Acknowledgments xiii

The Authors xv

PART ONE introducing community-based interventions 1

1 IMPROVING HEALTH IN COMMUNITY SETTINGS 3

Defining Community 4

Ecological Theory and Levels of Prevention 5

2 A BRIEF HISTORY OF COMMUNITY-BASED HEALTH INTERVENTIONS 11
Diana Silver

Community-Based Health Interventions: An Instrument for Change 12

Early Community-Based Health Interventions 15

Assessing the Evidence from Early Community-Based Health Interventions 18

The Evolution of Community-Based Health Interventions 19

3 ETHICAL ISSUES IN COMMUNITY INTERVENTIONS 25

The Integration of Ethics into Public Health Practice 26

Institutional Review Boards 28

Vulnerable Populations 29

Permission and Consent 30

Protection for Research Participants 33

Ensuring Research Quality 34

Maintaining the Integrity of Research 35

4 LEVELS AND TYPES OF COMMUNITY-Based INTERVENTIONS 39

An Ecological Focus on Types of Prevention 40

Selecting a Goal for the Intervention 42

Examples of Interventions at Different Levels of Prevention 45

PART TWO developing the intervention 51

5 A FRAMEWORK FOR DESIGNING COMMUNITY-Based INTERVENTIONs 53

Theoretical Guidance for Health Interventions 54

Examples of Theories Used at the Four Ecological Levels 56

6 COLLECTING AND MANAGING DATA 65

Data: A Crucial Component of Research 66

Collecting Quantitative Data 67

Collecting Qualitative Data 73

After Data Collection 75

PART THREE working through the intervention 81

7 ASSESSING COMMUNITY NEEDS 83

Basic Components of a Community Assessment 84

Strengthening Your Findings 87

8 PLANNING A COMMUNITY-BASED INTERVENTION 95

Intervention Content and Format 96

A Logic Model as an Organizing Strategy 101

A Fictional Community Assessment: Adolescent Tobacco Use 104

9 IMPLEMENTING A COMMUNITY-BASED INTERVENTION 115

Implementation at the Four Ecological Levels 116

Interventions at the Community or Policy Level 123

10 EVALUATING A COMMUNITY-BASED INTERVENTION 127

Reasons for Evaluation 128

Preparing for an Evaluation 130

Designing the Evaluation 130

Flexibility: An Essential Skill in Evaluation 135

PART FOUR learning from the past and adapting to the future 137

11 FUNDING AND SUSTAINABILITY 139

Financing Community-Based Health Interventions 140

Components of the Proposal for Funding 143

Components of the Budget 150

Continuing and Sustaining an Intervention 155

12 IMPLEMENTATION PITFALLS 157

Things Happen 158

13 THE FUTURE OF COMMUNITY-BASED HEALTH INTERVENTIONS 165

Adapting Methods of Intervention to Twenty-First–Century Communities 166

A Challenge and an Opportunity for Public Health Practitioners 169

A Limitation of the New Technologies 173

14 COMMUNITY-BASED HEALTH INTERVENTIONS IN PRACTICE 177

Arthritis 178

Asthma 179

Adult Vaccinations 181

Alcohol Use 182

Cardiovascular Disease 183

Childhood Vaccinations 184

Injuries from Motor Vehicle Accidents 185

Sexual Assault and Relationship Violence 186

Smoking 187

Glossary 191

References 203

Index 211