Abstract
Genuine community participation does not denote taking part in an action planned by health care professionals in a medical or top-down approach. Further, community participation and health education on breast cancer prevention are not similar to other activities incorporated in primary health care services in Iran. To propose a model that provides a methodological tool to increase women's participation in the decision making process towards breast cancer prevention. To address this, an evaluation framework was developed that includes a typology of community participation approaches (models) in health, as well as five levels of participation in health programs proposed by Rifkin (1985 and 1991). This model explains the community participation approaches in breast cancer prevention in Iran. In a 'medical approach', participation occurs in the form of women's adherence to mammography recommendations. As a 'health services approach', women get the benefits of a health project or participate in the available program activities related to breast cancer prevention. The model provides the five levels of participation in health programs along with the 'health services approach' and explains how to implement those levels for women's participation in available breast cancer prevention programs at the local level. It is hoped that a focus on the 'medical approach' (top-down) and the 'health services approach' (top-down) will bring sustainable changes in breast cancer prevention and will consequently produce the 'community development approach' (bottom-up). This could be achieved using a comprehensive approach to breast cancer prevention by combining the individual and community strategies in designing an intervention program for breast cancer prevention.
Highlights
The emphasis on community participation in health from 1978 in the Alma-Ata conference as the heart of primary health care has increased the need for planners in health programs and in funding agencies to understand the way in which community participation develops (Rifkin, 1986)
An evaluation framework was developed that includes a typology of community participation approaches in health, as well as five levels of participation in health programs proposed by Rifkin (1985&1991)
The objective of this paper is to describe a model the medical approach to solve the health problems and for community participation approach to breast cancer health planning approach
Summary
The emphasis on community participation in health from 1978 in the Alma-Ata conference as the heart of primary health care has increased the need for planners in health programs and in funding agencies to understand the way in which community participation develops (Rifkin, 1986). Women’s participation levels in breast cancer prevention programs starts from a level of passive participation where women participate to get benefits to the higher level that underlines their participation in planning programs This approach enables women to identify the problems regarding breast cancer issue and deal with the health care professionals to develop participatory planning and decision making to meet the breast cancer prevention needs of women’s community. A comprehensive approach can be reached by combining the individual and community strategies results in improvement of community participation in breast cancer prevention, and could reduce delay to diagnosis, improve treatment, and enhance health promotion strategies in breast cancer issue As a consequence, it can be a dynamic, genuine, and feasible way to provide the mean/end goal in community participation in health. The use of the mean /end goal and active participation of individuals in community participation in health are critical
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