Community Participatory Process Research Articles

A People’s process

This essay elucidates some of the lessons learnt from the community participatory process adopted by Artes, in the Post- Tsunami housing reconstruction project at Nagapatinam, Tamilnadu (2005-08). The program was a self-build process, respectful of gender. A pragmatic assessment of regional technologies, materials and skills was undertaken. The technological assessment was conducted by the community, in collaboration with structural engineers. Projects under consideration are in Sirkazhi Taluk and Akkaraipettai, Nagapatinam region in Tamilnadu, which had been adversely affected. The projects were nominated as best practices by the UNDP, India (2008) for community participatory processes. It inspired a new sense of belonging and confidence in the community. Besides indigenous construction practices, the community was provided an opportunity to learn new construction skills that they desired, which were beneficial in the longer term. The new construction skill sets ensured the community was independent to build their own dwellings incrementally in later years. The community was no more at the mercy of external contractors. The design of the dwellings also enabled future incremental growth. This research highlights some of the lessons in capacity building of communities; using construction skills to enable them to rebuild their own homes, as well as be self-reliant in future extensions and additions.

Re-visiting the Park: Reviving the “Cultural Park for Children” in Sayyeda Zeinab in the shadows of Social Sustainability

This paper aims to question the level of success of one of Egypt’s contemporary architectural milestones which is the Aga-Khan Award-winning project of the Child Park in Sayyeda Zeinab - designed by the Egyptian architect Abdel-Halim Ibrahim; from a community participation perspective. Stemming from the fact that the level of successful community participation in architecture and urban design projects affects the sustainability of the added value, this paper tackles the current process of operation of the Park and the adjacent pedestrian street, as complementary aspects of a community participatory process, and evaluates the social sustainability of the project as well. The study sheds light on the operation of the park after twenty-eight years of the initiation of the project, it explores its functional and social role in the district of Sayyeda, located at the centre of Cairo city.In order to achieve this end, the paper adopts a two-fold methodology. Based on those two main research approaches, the paper concludes with a framework and several guidelines to enhance the social sustenance of the place through rephrasing the park’s role in relation to the changing needs of the community.

A Population Health Driver Diagram to Address Neonatal Abstinence Syndrome.

This article describes the process for developing a population health driver diagram to address a priority health issue in East Tennessee: neonatal abstinence syndrome (NAS). Population health driver diagrams are used in quality improvement processes for determining and aligning actions that a community can take to achieve a specified outcome. The Tennessee Department of Health contracted with the University of Tennessee's Department of Public Health to conduct a community participatory process to contribute to a statewide health improvement plan. Colleagues in local public health practice identified NAS as the leading perinatal health issue, and community engagement was achieved by involving community health councils. Qualitative and quantitative data were collected, analyzed, and provided to these councils. A region-wide stakeholders' meeting resulted in the development of a population health driver diagram to address NAS. We describe this process and provide lessons learned that can be valuable in other settings. Population health diagrams have important implications for practice because of their use as a framework for community action, especially in the context of a community health assessment.

Promoting Policy Development through Community Participatory Approaches to Health Promotion: The Philadelphia Ujima Experience

BackgroundThe Philadelphia Ujima Coalition for a Healthier Community (Philadelphia Ujima) promotes health improvement of girls, women, and their families using a gender framework and community-based participatory research approach to addressing gender-based disparities. Institutional policies developed through community-based participatory research approaches are integral to sustaining gender-integrated health-promotion programs and necessary for reducing gender health inequities. This paper describes the results of a policy analysis of the Philadelphia Ujima coalition partner sites and highlights two case studies. MethodsThe policy analysis used a document review and key informant interview transcripts to explore 1) processes that community, faith, and academic organizations engaged in a community participatory process used to develop policies or institutional changes, 2) types of policy changes developed, and 3) initial outcomes and impact of the policy changes on the target population. ResultsFifteen policies were developed as a result of the funding from the U.S. Department of Health and Human Services Office on Women's Health. Policy changes included 1) healthy food options guidance, 2) leadership training on sexual and relationship violence, and 3) curricula and programming inclusion and expansion of a sex and gender focus in high school and medical school. ConclusionsOrganizational practice changes and policies can be activated through individual-level interventions using a community participatory approach. This approach empowers communities to play an integral role in creating health-promoting policies.

CRITERIOS DE ZONIFICACIÓN AMBIENTAL USANDO TÉCNICAS PARTICIPATIVAS Y DE INFORMACIÓN: ESTUDIO DE CASO ZONA COSTERA DEL DEPARTAMENTO DEL ATLÁNTICO

In the Integrated Coastal Zone Management frame, environmental zoning is considered a tool for land planning and management. It is based on definition and integration of biophysical, socioeconomic and governability criteria. With the aim for using this tool as part of the coastal zone environmental planning in the Atlántico province (Colombian Caribbean) the following criteria were defined: representative level, stage of ecosystem intervention, ecosystem function, current state of associated fauna, natural risks, water balance alteration, land use intensity, land use aptitude and land use conflicts. The integral analysis of criteria allowed the definition of management areas such as strategic ecosystems, recovery zones, sustainable use, sustainable production and urban-suburban areas. These areas were the base for further definition of integrated coastal zone management guidelines. The definition and integral analysis of zoning criteria were based on participatory techniques, interdisciplinary technical workshops and local community participatory process. As well, Geographic Information System supported the spatial analysis criteria over ecological landscape units. The environmental zoning is a tool for environmental planning which requires definition and integration of biophysical, socioeconomic and governability criteria for facing the conflicts and problems found in the area in order to lead management actions. It is hoped that future work will study the incorporation of models to support the selection and qualification criteria in a quantitative way; also it is expected that participatory processes will involve different sectors such as the economic, since they have less participation in these planning processes.

Empowering smallholder rice farmers in Tanzania to increase productivity for promoting food security in Eastern and Southern Africa

Despite low rice yield levels in Tanzania, the country is the leading producer in Eastern and Southern Africa. Given that this business is dominated by smallholder farmers and that the country is endowed with extensive landscapes suitable for rice production coupled with a high domestic and foreign potential market, there is an urgent need to enhance the yield as a key to promote food security from household to national and international levels. This paper seeks to demonstrate the importance of empowering smallholder farmers as a strategy for identifying and applying improved rice husbandry technologies in a holistic and integrated manner by employing a Farmer Field School (FFS) approach. The study was conducted in two sample villages, namely Kipera Njiapanda in the Morogoro region and Bwawani Visegese in the Pwani region, where culturally and ecologically rice is grown. The FFS approach was applied with the involvement of smallholders and local authorities to develop innovative ways to increase yield and promote food security. Data and information on current rice farming practices were collected using FFS participants and qualitatively analyzed at each rice production stage. Findings revealed that farmers’ socioeconomic conditions varied, thus reflecting differences in farm size, crop husbandry and associated yield as well as in non-market production along with consumption and/or market exchange. The FFS approach demonstrated that community participatory processes have the capacity to create conducive conditions for empowering smallholders to identify their rice production problems and opportunities related to access to technical and financial support in the realm of seedbed preparation and irrigation, including pest and disease control and crop marketing. The FFS approach is a robust tool for the identification of problems/challenges as well as pertinent opportunities to increase rice yield and promote food security. The paper calls for support from development partners in managing the rice production systems at all stages in the production cycle given the current potential of both the smallholder farmers and the arable land to increase rice yield, reduce poverty and promote food security at household, national and international levels.

Participatory Processes Applied to Developing Culturally Appropriate Educational Material Among the Ngäbe-Buglé Women of Panama for Domestic Violence Prevention

The Ngäbe-Buglé is the largest underserved indigenous population in Panama facing extreme health disparities compounded by structural, social, and cultural factors. Contributing factors to the poor health outcomes in this region include extreme poverty, low education, high maternal and infant mortality, alcohol use, and an increasing trend of domestic violence. The present intervention used community participatory processes to develop tailored material within the Ngäbe-Buglé community and training health promoters to deliver health education to the most rural areas. There were 78 health promoters who were trained using the training-of-trainers approach. Promoters distributed the health messages to their communities using the tailored material, the main topic discussed being domestic violence. Almost 7,000 community members received health education, demonstrating increased knowledge and intent to act on information received. Future directions include further funding, research, and education of indigenous groups in Panama on domestic violence.

A Community-Based, Environmental Chronic Disease Prevention Intervention to Improve Healthy Eating Psychosocial Factors and Behaviors in Indigenous Populations in the Canadian Arctic

Diet-related chronic diseases are highly prevalent among indigenous populations in the Canadian Arctic. A community-based, multi-institutional nutritional and lifestyle intervention-Healthy Foods North-was implemented to improve food-related psychosocial factors and behaviors among Inuit and Inuvialuit in four intervention communities (with two comparison communities) in Nunavut and the Northwest Territories, Canada, in 2008. The 12-month program was developed from theory (social cognitive theory and social ecological models), formative research, and a community participatory process. It included an environmental component to increase healthy food availability in local stores and activities consisting of community-wide and point-of-purchase interactive educational taste tests and cooking demonstrations, media (e.g., radio ads, posters, shelf labels), and events held in multiple venues, including recreation centers and schools. The intervention was evaluated using pre- and postassessments with 246 adults from intervention and 133 from comparison communities (311 women, 68 men; mean age 42.4 years; 78.3% retention rate). Outcomes included psychosocial constructs (healthy eating knowledge, self-efficacy, and behavioral intentions), frequency of healthy and unhealthy food acquisition, healthiness of commonly used food preparation methods, and body mass index (kg/m(2)). After adjustment for demographic, socioeconomic status, and body mass index variables, respondents living in intervention communities showed significant improvements in food-related self-efficacy (β = 0.15, p = .003) and intentions (β = 0.16, p = .001) compared with comparison communities. More improvements from the intervention were seen in overweight, obese, and high socioeconomic status respondents. A community-based, multilevel intervention is an effective strategy to improve psychosocial factors for healthy nutritional behavior change to reduce chronic disease in indigenous Arctic populations.

A community participatory process for peer group HIV prevention

A peer group HIV intervention programme was developed using a qualitative community-based participatory action research approach. Twenty-eight community leaders and 11 selected couples in two districts of Malawi were interviewed using individual formal interviews and focus group discussions between september 2007 and april 2008. Data was analysed using a modified constant comparison method. The study has developed HIV prevention interventions through a participatory process focusing on couple acceptability, intervention delivery methods and outcomes of participatory research. The results show that the peer education sessions should involve both men and women so that they learn together. Strategies on the spread of HIV, fidelity, HIV prevention communication, alcohol abuse, educating children on HIV prevention, sexual satisfaction, and condom use should be included in the intervention. Partnerships between researchers and communities are crucial for conducting successful community-based participatory research.

Addressing the public health burden caused by the nutrition transition through the Healthy Foods North nutrition and lifestyle intervention programme

Dietary inadequacies, low levels of physical activity, excessive energy intake and high obesity prevalence have placed Inuit and Inuvialuit populations of the Canadian Arctic at increased risk of chronic disease. An evidence-based, community participatory process was used to develop Healthy Foods North (HFN), a culturally appropriate nutrition and physical activity intervention programme that aimed to reduce risk of chronic disease and improve dietary adequacy amongst Inuit/Inuvialuit in Nunavut and the Northwest Territories. HFN was implemented over the course of 12 months in a series of seven phases between October 2008 and 2009 (Nunavut) and June 2008 and 2009 (Northwest Territories). Combining behaviour change and environmental strategies to increase both the availability of healthful food choices in local shops and opportunities for increasing physical activity, HFN promoted the consumption of traditional foods and nutrient-dense and/or low energy shop-bought foods, utilisation of preparation methods that do not add fat content, decreased consumption of high-energy shop-bought foods, and increased physical activity. Messages identified in the community workshops, such as the importance of family eating and sharing, were emphasised throughout the intervention. Intervention components were conducted by community staff and included working with shops to increase the stocking of healthy foods, point of purchase signage and promotion in shops and community settings, pedometer challenges in the workplace and use of community media (e.g. radio and cable television advertisements) to reinforce key messages. HFN represents an innovative multilevel approach to the reduction of chronic disease risk factors amongst Inuit and Inuvialuit, based on strong collaboration with local agencies, government and institutions.

Drawing on Indigenous Ways of Knowing: Reflections from a Community Evaluator

Abstract: The clash between Western and Indigenous ways of knowing has been epitomized by the “parachuting model” of the Western researcher who drops onto the reservation, collects data, and leaves, never to be heard from again. The strengths of indigenous science, for example, observation and contextual factors, are either ignored or appropriated. These past (and sometimes present) wrongs committed by academic researchers continue to be a contentious issue in Native communities, where, despite the research dollars flowing into the community to “solve” health problems, disparities between Native health status and that of the general population persist. This article shares reflections from a community-based evaluator who, along with a Lakota health educator, served as “cultural translators” in a community participatory process led by a community agency. We recognized the need to work with/in two cultures—both the academic research world and the Native community—and drew on collaborative evaluation principles and indigenous ways of knowing to conduct formative evaluation research on smoking cessation issues for pregnant Native women.

A primary health care intervention to mobilize health workers for HIV prevention in Malawi

For the last 4 years we have implemented a model to mobilize rural health workers as leaders for HIV prevention in Malawi. We use a conceptual framework that integrates the World Health Organization's (WHO) primary health care (PHC) model, the social–cognitive model of behavioural change, and contextual tailoring of the intervention. Health workers are potential rural HIV prevention leaders because they have community trust and respect. However, their leadership potential has been limited by both health system barriers such as inadequate workers, supplies, and training and personal barriers such as risky occupational and personal behaviours. In the first phase of the project, we developed collaborative relationships and conducted qualitative research to adapt a peer group intervention for rural health workers and community members. In the ongoing second phase, we trained the health workers, who then volunteered and provided the intervention to adults in the communities their health centres serve. The intervention was adapted for young people through a community participatory process. Currently the adapted intervention is being offered to young people. As a guide to replication, we discuss barriers encountered in implementing this collaborative project and how we overcame them. This project demonstrates that health workers can be effective leaders for community AIDS prevention in African countries. The primary health care model offers a feasible, cost-effective and sustainable approach to maximizing health worker-community collaboration to reduce the spread of HIV.

The internet, empowerment, and identity: an exploration of participation by refugee women in a Community Internet Project (CIP) in the United Kingdom (UK)

AbstractThis article considers the relationship between the Internet, empowerment, identity and participation; and focuses on refugee women in the United Kingdom (UK) participating in a Community Internet Project (CIP) to learn Internet skills. Semi‐structured interviews and a non‐participant observation were conducted with six refugee women and the course tutor participating in the final session of the CIP. Thematic analysis of the interviews supplemented with findings from the observation, revealed outcomes associated with technological engagement and participation. Technological engagement outcomes included intermediate outcomes of maintaining links and re‐building networks, and facilitating resettlement and integration; and empowerment and identity outcomes facilitating the maintenance and development of personal identities, and fostering psychological empowerment. Participation outcomes included the development of social identity and community narratives, and collective consciousness‐raising. These findings are used to reflect on the theory of the social psychology of participation (Campbell & Jovchelovitch, 2000), by contextualising technological engagement within participatory processes. The article concludes by discussing individual agency within participation; and calls for further research into the utility of digital technologies in community participatory processes. Copyright © 2006 John Wiley & Sons, Ltd.

Community participation in a multisectoral intervention to address health determinants in an inner-city community in central Havana.

It is increasingly acknowledged that the process of community involvement is critical to the successful implementation of community-based health interventions. Between 1995 and 1999, a multisectoral intervention called Plan Cayo Hueso was launched in the inner-city community of Cayo Hueso in Havana, Cuba, to address a variety of health determinants. To provide a better understanding of the political structures and processes involved, the Cuban context is described briefly. The interventions included improvements in housing, municipal infrastructure, and social and cultural activities. A qualitative study, consisting of interviews of key informants as well as community members, was conducted to evaluate the community participatory process. Questions from an extensive household survey pre- and postintervention that had been conducted in Cayo Hueso and a comparison community to assess the effectiveness of the intervention also informed the analysis of community participation, as did three community workshops held to choose indicators for evaluating effectiveness and to discuss findings. It was found that formal leaders led the interventions, providing the institutional driving force behind the plan. However, extensive community involvement occurred as the project took advantage of the existing community-based organizations, which played an active role in mobilizing community members and enhanced linkage systems critical to the project's success. Women played fairly traditional roles in interventions outside their households, but had equivalent roles to men in interventions within their household units. Most impressive about this project was the extent of mobilization to participate and the multidimensional ecosystem approach adopted. Indeed, Plan Cayo Hueso involved a massive mobilization of international, national, and community resources to address the needs of this community. This, as well as the involvement of community residents in the evaluation process, was seen as resulting in improved social interactions and community well-being and enhanced capacity for future action. While Cuba is unique in many respects, the lessons learned about enhancing community participation in urban health intervention projects, as well as in their evaluation, are applicable worldwide.

Land Tenure and Conflict Resolution: A Game Theoretic Approach in the Narok District in Kenya

Many conflicts in numerous parts of the developing world can be traced to disputes over land ownership, land use and land degradation. In this paper we test the hypothesis that differences in knowledge structures on land tenure and market systems between different leaders within these countries has caused marginalisation of some leaders by the others. A sustained process of marginalisation driven by this inequality has caused the disadvantaged to revolt, resulting, in many cases, in violent clashes. In this paper we develop a game theoretic model to test our hypothesis by analysing the complex interdependencies existing among the various leaders in the Narok district in Kenya. Violent clashes have been increasing in the district since the first outbreak in 1993. Preliminary results seem to confirm our suspicion that differences in knowledge structures among the various leaders in over land and agricultural markets might have been the catalysts of these conflicts. In order to reduce these discrepancies, we recommend two institutional reforms. The first involves the adoption of a hybrid land tenure system whereby land ownership is based on individual titles, while the use and sale of the land is governed by communal rules established by a community participatory process. The second recommendation involves the formation of an information network comprising all leaders, with the main objective to provide a forum for exchange of ideas and information pertaining to land use options and the opportunities offered by the market system.