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Application to communities with multiple variables that may impact the problem at hand. Cost and resource limitations present significant problems for developing interventions that meet outcome changes. - TC

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We can adopt comprehensive approaches to program interventions. Introducing primary interest groups in the planning process to weigh opportunities for improvement is key. Additionally, finding ways to mirror policy level interventions over time and how those can impact individual and organizational level change. - TC

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One of the interventions that interested me were the smoke-free policy changes adopted to reduce tobacco use. The adoption among communities as discussed in Bunnell show the efficacy of these policies and support more widespread adoption. - TC

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Tobacco cessation and obesity interventions - TC

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Include the community and incorporate multiple levels

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Include the community and incorporate multiple levels

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I believe that it is imperative that to incorporate the community throughout the process-planning, development, testing, and implementation of the community health intervention and to recognize that there a multiple factors and inequitable systems at play that have created health disparities. In the systematic review article, I liked the approach of the socio-ecological paradigm of health that highlighted the collaboration between user-addressed intervention (targeting changes at the individual, interpersonal, community levels) and the structured intervention (build up community capacity). This also needs to be considered moving forward. -Chishinga

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Low dosages of the intervention, short duration of the implementation phase (unable to carry out all program activities), self-reported measures (may not be validated)
-Chishinga

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In Bunnell et al. (2012), the nutrition promotion interventions were of interest to me. I liked that 85% of the communities were supporting local food production and promoting school and home gardens. I liked the intervention by De Heer et al. (2015) from the systematic review that included a comprehensive outreach program on heart healthy behavior, cooking and dancing classes, walking groups, etc., and a capacity building component.-Chishinga

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Healthy eating behaviors, fruit and vegetable intake, breastfeeding, stress management, BMI, waist circumference, CVD risk factors, intensity of physical activity -Chishinga

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We talked about equity (thanks to the super impressive picture Taylor presented) last week. Different population has different needs and have various starting point. Accurate and effective needs assessment can guide us better utilize limited resources on the populations who need help the most.
- Yiqun

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Possible effects may have been masked by contextual
or ‘spill-over’ effects, both in the intervention and
the control areas. Also people living in deprived environments have restricted scope for action.
- Yiqun

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From the Nicek and von dem Knesebeck article, I was struck by the fact that all the interventions included showed some kind of significant results. I wonder if this is an indication of publication bias? Personally I'm even more interested in the interventions that failed to show significant results. So that future practitioners can avoid unnecessary efforts. -Yiqun

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Dietary behavior (e.g. fat and meat consumption)

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Dietary behavior (e.g. fat and meat consumption)

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-Yiqun

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Be fully representative of the population

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Be fully representative of the population

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I think planning long-term, sustainable solutions in a community can only occur if all potential stakeholders and sociodemographic groups are able to participate in some capacity.
-JJ

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reducing sodium through purchasing actions and restaurant standards - it's imperative to tackle this issue of excess sodium intake at the policy level to limit the temptation available to the public
-JJ

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Promotion of healthy foods and drinks
-JJ

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Sarrafzadegan et al (2012): the quasi-experimental study about the education of healthy cooking and healthy lifestyle training for high-risk groups.
-Ghia

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To enhance community health intervention research and practice it will be important to invest in collaborating with community residents and stakeholders from beginning to end (e.g., program planning, implementation, and evaluation) to make sure everyone who needs to be at table is present; this helps to strengthen community capacity and empowerment to increase sustainability of the efforts being implemented.
-Ghia

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a. Some challenges in their review was that the studies in extracted has too many varieties in population characteristics (e.g., culture, ethic, socioeconomic backgrounds) which can impact measurable effects.
b. Additional challenges in community health research and practice includes high drop-out rates which negatively impact the program effect.
-Ghia

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Walkability to improve the physical environment
-Ghia

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Most community capacities (e.g., participation and community structures) grew in the studies cited, but the authors note that this process required a significant “up front” time investment before health outcomes data could demonstrate change. -(Sharon)

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Define "Community Health" for all Community Partners

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Define "Community Health" for all Community Partners

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Define and explain to communities and their partners that
"community health" is characterized by better health and quality of life for members of the community (Goodman, 2014). Quality of life improvement is the ultimate goal. (Sharon)

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Increasing Physical Activity and Walkability

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Increasing Physical Activity and Walkability

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Done in 97% or 39 of the total communities in support of obesity prevention (Bunnel, 2012)

Six ‘walkability’ initiatives to enhance the physical environment. (Nickel, 2020).

(Sharon)

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(Sharon)

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Possible reasons are 1) methodological limitations, 2) concurrent context(ual) effects, and 3) limitations of the interventions used. (Sharon)

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One key explanation is that people in populations with low socio-economic status, high unemployment rates and a large percentage of migrants have restricted options and scope for action. This can hinder the effectiveness of such interventions
-JJ

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It is important to maintain an open channel with the target population, to understand their situation and co-create solutions by involving them during all the steps of the community health intervention, including planning, implementation and evaluation.
-Lorena

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These programs had limited changes in primary health outcomes. One explanation is that the dosage of activities was low, and the interventions often reached small groups.
-Lorena

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It was very interesting to learn about the different levels of strategies that were implemented to improve nutrition outcomes. For example, almost all communities focused on enhancing access to healthy food and used media strategies to promote healthy food and beverage choices. More than half of the programs worked with SNAP beneficiaries, and promoted breastfeeding through baby-friendly hospitals and workplaces.
-Lorena

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Obesity and tobacco use reduction
-Lorena

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4.) How can we enhance comm. health intervention research and practice?

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4.) How can we enhance comm. health intervention research and practice?

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3.) Challenges with Community Health Interventions

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3.) Challenges with Community Health Interventions

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Nickel and von dem Knesebeck (2020) found limited effects for their review. a.) What were reasons for those limited effects? b.) What are additional challenges with community health research and practice based on the readings?

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1.) Community Health Promotion Topic Areas

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1.) Community Health Promotion Topic Areas

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Based on the readings, what are examples of outcomes that were targeted by community health promotion interventions?

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2.) Approaches: Community Health Interventions and PES Changes

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2.) Approaches: Community Health Interventions and PES Changes

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Based on Bunnel et al (2012) and Nickel and von dem Knesebeck (2020) readings, list examples of community health interventions and policy, environmental and systems change applications. What interventions/changes interested you?

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Explore the following questions. Use "sticky notes + function" to 'think, share & discuss'.  Appoint a presenter to share back key points with larger group.

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Explore the following questions. Use "sticky notes + function" to 'think, share & discuss'.  Appoint a presenter to share back key points with larger group.

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1)Health Topics & Community Outcomes: Based on the Communities Putting Prevention to Work initiative (Bunnel et al, 2012) and Nickel & von dem Knesebeck (2020) review, what have been topic areas of past community health interventions (obesity? substance use?). What have been some of the main outcomes studied?

2)Approaches: Describe examples of policy, systems & environmental approaches applied.  Any innovative approaches to highlight?

3)Positive yet limited effects: According to Nickel & von dem Knesebeck (2020) review: “Despite the high number of studies that found positive effects, the impact of the interventions seemed to be rather limited. This holds especially true for large-scale community programs.”
What were the reasons given for limited effects? Other reasons?

4.) How can we enhance community health intervention practice & research?