Community Participation In Health Promotion Research Articles

Navigating Voice, Vocabulary and Silence: Developing Critical Consciousness in a Photovoice Project with (Un)Paid Care Workers in Long-Term Care.

Photovoice is a widely used approach for community participation in health promotion and health promotion research. However, its popularity has a flip-side. Scholars raise concerns that photovoice drifts away from its emancipatory roots, neglecting photovoice’s aim to develop critical consciousness together with communities. Our four-year photovoice project aimed to unravel how the health of (un)paid care workers was shaped at the intersection of gender, class and race. This article springs from first, second and third-person inquiry within our research team of (un)paid care workers, academic researchers and a photographer. We observed that critical consciousness emerged from an iterative process between silence, voice and vocabulary. We learned that photovoice scholars need to be sensitive to silence in photovoice projects, as silence can be the starting point for finding voice, but also a result of silencing acts. Social movements and critical theories, such as intersectionality, provide a vocabulary for participants to voice their critical perspectives to change agents and to support collective action. We discuss our experiences using Frickers’ concept of ‘epistemic justice’, arguing that critical consciousness not only requires that communities are acknowledged as reliable knowers, but that they need access to interpretative tropes to voice their personal experiences as structural.

Digital Formats for Community Participation in Health Promotion and Prevention Activities: A Scoping Review.

Objectives: Digital technologies in public health are primarily used in medical settings and mostly on an individual and passive way of use. There are research gaps on digital media facilitating participation, empowerment, community engagement, and participatory research in community settings. This scoping review aims to map existing literature on digital formats that enable participation in the field of health promotion and prevention in community settings.Design: The databases Medline, EMBASE, and PsycINFO were used to identify studies published from 2010 up to date (date of literature search) onward that used digital formats in all or in the main sequences of the process to enable high levels of participation in health promotion and prevention activities in community settings.Results: This review identified nine out of 11 included studies relevant to the research question. We found five studies that applied qualitative participatory research, two studies on peer support and one study each on empowerment and crowdsourcing. The digital technologies used varied widely and included social media platforms, bulletin boards, online forum webpages, and customized web providers and programs. Most studies mentioned anonymity, flexibility, and convenience as benefits of digital interventions. Some papers reported limitations such as difficulties by interpreting written-only data or the possibility of selection bias due to the digital divide.Conclusion: This scoping review identified only few studies relevant to our objective, indicating an existing gap in research on this topic. Digital formats were found to be particularly suitable for purposes where anonymity and flexibility are beneficial, such as for online peer exchange and peer support programs.

Social capital, social movements and global public health: Fighting for health-enabling contexts in marginalised settings.

Research linking health and social capital is often cited in relation to global public health policies and programmes that mobilise local community participation in health promotion in marginalised settings. A long-standing criticism of this body of analysis and action is its inadequate attention to the power inequalities that drive poor health, often linked to macro-social forces beyond the reach of local community activism. Supplementing social capital research with attention to more ambitious and wide-ranging forms of health activism tackles this criticism. It puts the reproduction and transformation of health-relevant power inequalities at the heart of social capital research and community mobilisation strategies. We use the South African Treatment Action Campaign as a prototype for expanding understandings of social capital for health promotion. Existing social capital work currently focuses on facilitating community mobilisation to create co-operative bonding and bridging social capital (networks of solidarity within and between marginalised communities respectively), as well as linking social capital (networks uniting marginalised communities and more powerful champions). We call for an expanded focus that takes account of how these co-operative networks may serve as springboards for community involvement in adversarial social movements. In such cases, these networks of solidarity serve as launch pads for various forms of demand and protest where the marginalised and their allies confront power-holders in conflictual struggles over health-relevant social resources. We illustrate this expanded framework with two examples of collective action for mental health: the Movement for Global Mental Health and the UK Mental Health User and Survivor Movement. Both seek to use bonding, bridging and linking networks as the basis for movements to pressurise power-holders to increase access to appropriate psychiatric services, adequate welfare support and social respect and recognition for people living with mental distress.

Australian Football League clinics promoting health, hygiene and trachoma elimination: the Northern Territory experience.

Australia is the only developed country to suffer trachoma and it is only found in remote Indigenous communities. In 2009, trachoma prevalence was 14%, but through screening, treatment and health promotion, rates had fallen to 4% in 2012. More work needs to be done to sustain these declining rates. In 2012, 25% of screened communities still had endemic trachoma and 8% had hyperendemic trachoma. In addition, only 58% of communities had reached clean face targets in children aged 5-9 years. Australian Football League (AFL) players are highly influential role models and the community love of football provides a platform to engage and strengthen community participation in health promotion. The University of Melbourne has partnered with Melbourne Football Club since 2010 to run trachoma football hygiene clinics in the Northern Territory (NT) to raise awareness of the importance of clean faces in order to reduce the spread of trachoma. This activity supports Federal and state government trachoma screening and treatment programs. Between 2010 and 2013, 12 football clinics were held in major towns and remote communities in the NT. Almost 2000 children and adults attended football clinics run by 16 partner organisations. Awareness of the football clinics has grown and has become a media feature in the NT trachoma elimination campaign. The hygiene station featured within the football clinic could be adapted for other events hosted in remote NT community events to add value to the experience and reinforce good holistic health and hygiene messages, as well as encourage interagency collaboration.

Community Capacity Building for Health

There is a great deal of literature examining the benefits and relevance of community participation and community capacity building in health promotion and disease prevention endeavors. Academic literature embracing principles and commitment to community participation in health promotion practices often neglects the complexities involved and the flexibility required to work within this approach. This article addresses some of these challenges through a case study of two projects funded by Provincial Wellness Grants in Newfoundland and Labrador, a province in Canada with a strong tradition of community ties and support systems. In addition to addressing the unique circumstances of the community groups, this research allowed the authors to examine the situational context and power relations involved in the provision of services as well as the particular forms of subjectivity and citizenship that the institutional practices support. Recognizing this complex interdependency is an important step in creating more effective intervention practices.

Community as practice: social representations of community and their implications for health promotion

AbstractHealth promotion researchers and practitioners have increasingly turned to community‐based approaches. Although there has been much work around the diverse understandings of the term in areas such as community psychology and sociology, I am concerned with how such understandings relate directly to community health research and practice. From a discursive perspective ‘community’ is seen as a socially constructed representation that is used variously and pragmatically. However, from a wider view, community can be seen as a matter of embodied practice. This paper draws on social representations theory to examine the shifting constructions of ‘community’, the functional use of those understandings in social life, and the practices that suggest that it is important to attend to their use in particular contexts. Accordingly, the paper argues that meanings of community in the health promotion or public health context must be seen as representations used for specific purposes in particular situations. Furthermore, the broader notion of embodied practice in social life has implications for community participation in health promotion. Copyright © 2007 John Wiley & Sons, Ltd.

The development of a Health Promotion Community Participation Framework

This paper reports on research conducted through Monash University located in the state of Victoria, Australia. The outcome of the research was the development of a Health Promotion Community Participation Framework, providing guidelines for health professionals in community health centres and services to assist them with facilitating community participation in health promotion. A literature review was conducted and information collected from health professionals working in metropolitan and rural community health centres and services across the state of Victoria, Australia. The Framework does not emphasise levels of community participation as a hierarchy, but instead proposes using the levels or types of participation across a continuum. This has been done to encourage the use of appropriate transparent strategies that will enable both individual community members and different sections of communities to participate in health promotion activities. This is particularly important where government policies dictate the direction of health promotion, as this "top down" approach can lead to the community being excluded for health promotion processes. The use of a continuum promotes the concept that participation can be effective at different levels, even when the issue to be addressed has already been identified. The Framework also proposes that in order for community participation strategies to take place, there needs to be capacity building at both the organisational level and the community level.

Influence of health promotion bureaucracy on community participation: a Canadian case study.

The purpose of this paper is to illustrate, through a Canadian case study, the bureaucratic support and obstacles for community participation in health promotion. The paper begins with a brief history of the development of a participatory health promotion programme in Canada. The role of bureaucracies on participation of communities is highlighted. Secondly, the paper describes how a variety of bureaucratic factors affected grassroots community participation efforts of local projects in one province. Finally, discussion focuses on how community participation is constrained in a bureau-cratically mediated activity such as health promotion.

Sharing Power: Principles for Community Participation in Health Promotion

A literature search was conducted from which six principles were formulated, and these raise issues that health professionals and organisations should be considering when conducting health promotion activities. Some of the issues identified were that: there is strong evidence that involvement of community members in health promotion activities creates more effective outcomes; health professionals need to give up their authority and share their sources of power, knowledge and skills; health professionals need to accept the agenda set by the community and to take on roles that facilitate and mobilise community action; health professionals need to acquire the skills to facilitate effectively community participation; organisations should be committed to community participation and reflect this in the allocation of resources; community structures and values that inhibit or facilitate participation need to be identified; social trust is essential for community cooperation and mobilisation; and that community capacity should be developed and fostered.

Taking part in adolescent sexual health promotion in Peru: community participation from a social psychological perspective

This paper revisits the field of community participation in health promotion as understood from the viewpoint of social psychology. It discusses ongoing dialogues between health promotion policy discourses in relation to community involvement in development, and theoretical and practical contributions of social psychology in this respect. In particular, it introduces a social psychological framework for understanding and aiding community participation, grounded in the works of Jurgen Habermas and Paulo Freire. A community-based adolescent sexual health promotion initiative taking place in highly deprived communities in Peru serves as a case study to illustrate the approach. Findings are discussed with respect to the outcomes achieved, the light shed on the understanding of sexual health, and the impact on the adolescents partaking of the project. In the light of the results of the practical implementation of the theoretical approach outlined, the paper argues that social psychology is well positioned to contribute to community development, in particular to improving understanding and aiding of social processes of participation and change. Areas that require further research both at theoretical and at practical levels are identified and discussed. Copyright © 2000 John Wiley & Sons, Ltd.

Community representatives: Representing the “community”?

This paper takes as its starting point the apparent disjunction between the assumptions of the self-evidence of the meaning of community in major international declarations and strategies which promote community participation and the observation that meanings of “community” are a subject of extensive debate in literatures of social analysis and to some extent health. Given that the word's meaning is not agreed, those working to promote “community participation” in health are forced to adjudicate on competing meanings in order to operationalise the notion. This raises questions about how this is done and what are the implications of particular choices for what may be achieved by the participating “community”. This paper presents the findings of an empirical study which examined the manner in which ideas of “community” are operationalised by people engaged in encouraging community participation in health promotion in the context of the selection of members for health for all steering groups in healthy cities projects in the United Kingdom. It argues that the demands of the role of the “community representative” are such that particular interpretations of “community” achieve ascendance. The paper explores the consequences of the interpretation of “community” as part of the “voluntary sector” and argues that this may compromise one of the stated desired outcomes of community participation i.e. extending democracy in health decision-making.

Community Participation in Health Promotion: Evaluation of the California Wellness Guide

SUMMARY With the rapid rise in health care costs, it has become imperative that departments of health services find effective and affordable ways to prevent disease and promote health. During the past 20 years, most of the major educational interventions in the US designed to prevent disease by changing behavior have not been as successful as expected. At the same time, there is increasing evidence that community participation, a central feature of the ‘new public health’, is a powerful component of the programs that have been successful. In this paper, we describe and evaluate an intervention that heavily involves the community. The Wellness Guide is a comprehensive health promotion guide developed with community participation to improve the wellness knowledge, attitudes and behaviors of recipients. 100 000 copies of The Guide in English

Meanings of community.

Community participation in health promotion is one of the central tenets of the WHO's Health For All strategy. Throughout the United Kingdom, 'Health For All' projects have been established and efforts dedicated to the pursuit of community participation in health promotion. Despite this zeal, the deceptively simple notion of 'community' is one of the most contested in the social sciences. Taking this as its point of departure, this paper reviews the meanings of 'community' in social sciences and health literatures. Based on empirical data, it then explores meanings of 'community' for people who are involved in generating community participation in health promotion in the context of four U.K. Health For All projects. A wide variety of different meanings are found; what they share in common is that they are each constructed by people who regard themselves as 'non-members' of these 'communities' and that the views of the putative 'members' are not taken into account in their construction. This substantially differs from meanings of community constructed by their 'members', as represented by Anthony Cohen, where community members' perceptions of sharing are central to the delineation of boundaries. This paper argues that there is a fundamental difference between the construction of communities by 'members' and 'non-members'. In the former case notions are sharing are integral to the construction, in the latter case they are assumed. In the final part of the paper we examine informants daily experiences of operationalising the 'communities' which they construct and argue that commonly their assumptions of sharing prove unfounded. We conclude by arguing that recognition of the differences in the construction of communities by members and non-members is essential, not least because it demands a fundamental rethinking of the notion of community participation in health.

The Wellness Guide: towards a new model for community participation in health promotion

The Wellness Guide: towards a new model for community participation in health promotion