Abstract

Rural communities across the United States experience increased risk and prevalence of chronic diseases associated with both individual and community-based factors. Thus, there is a need for rural capacity development for chronic disease prevention. Traditional health promotion and intervention approaches often focus on diet-related health disparities from a positivist, evidence-based paradigm. To counter positivist bias within health promotion research, a hybridized approach is proposed using a critical-constructivist paradigm incorporating dialectical thinking, appreciative inquiry, and dialectical inquiry to address cultural and structural barriers, as well as community-based social norms, through evaluation of community-based health promotion interventions. Three dialectical models were identified through interviews with community coalition members: social ties, infrastructure, and worldviews, examining underlying assumptions and counter assumptions. By revealing the dialectic assumptions and counter assumptions within project implementation, practitioners can engage in constructive dialogue with communities to determine more effective and culturally responsive pathways for project development.

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