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La Ventana: Conceptualizing "Community Health"                            by Kingsley C. Iheanacho 

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La Ventana: Conceptualizing "Community Health"                            by Kingsley C. Iheanacho 

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What are ways a community can be defined?

• A community encompasses population groups and the locus (e.g., place, venue, or other unit) of programs, interventions, and other actions.

•A group of people with diverse characteristics who are linked by social ties, share common perspectives and engage in joint action in geographical locations or settings

•Venues or areas that are physically-, geographically-, culturally-, and administratively- or geopolitically defined

•Venues or areas that are identified with key activities, such as residence, work, education, and recreation

List key skills and methods needed for community health promotion

•Skills

•Engage partners

•Assess needs and assets

•Set priorities, goals, and objectives

•Plan intervention

•Implement and monitor the delivery of intervention

•Evaluate intervention

•Methods:

1. Culture sharing

2. Participatory mapping and photovoice

3. Data gallery (i.e., Data Walk)

4. Community-facilitated logic model (i.e., tearless logic model)

5. Community health dashboard

6. Evaluation tree

List specific 'targets' of 'community' that can be harnessed, changed or enhanced for health promotion. Consider also what conceptual/theoretical frameworks may be helpful for guiding identification of environmental changes for individual and community health promotion.

•Targets of Community

1. Communication to raise awareness about healthy behaviors and preventive actions

2. Education to empower change and actions through increased knowledge and skills via activities such as training, support groups, and counseling

3. Policy, systems, and environmental (PES) change, including legislation and regulation, organizational change, and economic, social, and physical environmental improvements

4. Strengthening community action to create, advocate, and support healthy PES change and promote personal skills

•Conceptual and theoretical frameworks for identification of environmental changes

1. Plan-Do-Study-Act Inquiry Cycle

2. Human-Centered Design

3. Health Promotion Interweaving Into Context

4. Behavior and Environmental Change Methods (behavior change techniques taxonomy and taxonomy of behavior change methods, )

5. Goal setting (Goal setting theory, Latham and Locke, 2019)

6. Guided practice (SCT, Bandura 1986)

7. Organizational diagnosis and feedback and technical assistance (Organizational development theory-Cummings & Worley, 2015)

8. Media advocacy (Models of community organization and advocacy- Dorfman & Krasnow, 2014)

9. Facilitation (SCT)

10. Structural redesign (Organizational development theory -Cummings & Worley, 2015)

11. PRECEDE-PROCEED model (Fielding et al., 2022), IM (Bartholomew-Eldredge et al., 2016), and

12. Mobilizing for action through planning and partnerships (MAPP; National Association of City and County Health Officials [NACCHO], n.d.)

What are some challenges with community-level health promotion research and practice? What are some opportunities and potential benefits of community health promotion? What are ways we can enhance community health promotion?

Challenges:

•No consensus on the definition of community which impacts the ambiguity and overly general use of the term “community health”.

•Methodological challenges to study design and evaluation, concurrent secular trends, smaller-than-expected effect sizes, limitations of the interventions, and limitations of theories used.

•The need for better integration of “practice-based” evidence which is critical to enable public health scientists to understand the community and generate evidence that will be relevant to practice.

•For many public health outcomes, particularly decreases in chronic diseases, the full benefits of community-level efforts to reduce chronic disease risk factors, such as obesity and tobacco use, may not be evident for many years, further challenging program evaluation. The outcomes often are influenced by factors that might be addressed differently in different communities.

Benefits/ opportunities:

•It is a constantly evolving field, with great opportunity for emerging researchers and practitioners to build from and further shape our planning frameworks, intervention methods, evaluation designs, and strategies for addressing larger issues of social justice and health equity.

• Improved and shared understanding of the meaning of community health should help further the broader attainment of healthier communities characterized by better health and quality of life for members of the community, however defined.

•The field of “community health” reflects the needs of the community and exemplifies the best of public health research and methods to achieve the shared goal of improving health

What are ways we can enhance community health promotion?

•Engage communities, governmental, academic, and other stakeholders in developing a shared agenda for applied research on community health in the United States.

•Implement and use results of community health assessments (e.g., measuring and characterizing risk factors within, and the health status of, the community) as a core element in improving a community's health.

•Identify short- and long-term measures for defining the “healthy community” as an endpoint for the effects of interventions or actions that reflect the community's interest.

•Improve methods of surveillance for community health, including the development of a case definition for a “healthy community”.

•Enhance scientific design principles for generating and documenting both practice- and research-based evidence from programs and interventions that improve community health (using, as indicated, community trials, retrospective cohort studies, cross-sectional surveys and studies, time-series analyses, and ecological studies), and enhancing methods for using “control” communities for evaluation, as well as meeting challenges associated with control communities.

•Maintain engagement with communities from the start through post-completion of a program or intervention (i.e., community health’s commitment transcends implementation and assessment of an intervention by building evidence through sustained engagement with the community).

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2. List key skills and methods needed for community health promotion 

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2. List key skills and methods needed for community health promotion 

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3. List specific 'targets' of 'community' that can be harnessed, changed or enhanced for health promotion. Consider also what conceptual/theoretical frameworks may be helpful for guiding identification of environmental changes for individual and community health promotion.

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3. List specific 'targets' of 'community' that can be harnessed, changed or enhanced for health promotion. Consider also what conceptual/theoretical frameworks may be helpful for guiding identification of environmental changes for individual and community health promotion.

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4. What are some challenges with community-level health promotion research and practice? What are some opportunities and potential benefits of community health promotion? What are ways we can enhance community health promotion?

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4. What are some challenges with community-level health promotion research and practice? What are some opportunities and potential benefits of community health promotion? What are ways we can enhance community health promotion?

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Ways to Enhance/Strengthen Community Health Promotion Research and/or Practice

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Ways to Enhance/Strengthen Community Health Promotion Research and/or Practice

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1. What are ways community can be defined? 

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1. What are ways community can be defined? 