Cross Cultural Health
Care Conference
Community Collaborations and
Interventions: Models of
Community Engagement
October 8, 2011
Angela Sy, DrPH
Assistant Professor
Office of Public Health Studies
UH John A. Burns School of Medicine
Background and Rationale
Community members have an extensive set of
skills, strengths, and resources which can be
harnessed to address the social determinants of
health and to promote good health
Complex health and social problems ill-suited to
“outside experts”
Background and Rationale
Enhance the effectiveness of public health
interventions
Tailored to the concerns and cultures
 Include participants in all aspects of intervention
design, implementation & evaluation
 Holistic focus on broader social & structural
determinants of health

Background and Rationale

“It is a powerful vehicle for bringing about
environmental and behavioral changes that
will improve the health of the community and
its members” (CDC, 1997)
Definition of
Community Engagement
CDC, 1997: “The process of working
collaboratively with and through groups of
people affiliated by geographic proximity,
special interest, or similar situations
to address issues affecting the well-being
of those people.”
Definition of “Community”
A group of people:
Linked by social ties
Sharing common perspectives or interests
Who may or may not share a geographic
location
Definition of “Community”
Common designations:
Culture or ethnic heritage
Where we live
Similar age
Speak the same language
Religion
Concepts of
Community Engagement
Culture: Kieffer, 2007
Community organizing: Minkler, 1990
Community participation: Butterfoss, 2006;
Wandersman et al , 1987
Capacity building: Eng et al., 1994
Community empowerment: Maton, 2008
Coalition building: Cohen, 2002
Benefits of Community Engagement
Agenda
Implementation design, delivery and change:
–
–
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Relevance
Feasibility
Sustainability
Community involvement and goodwill:
–
–
–
Competence
Capital
Capacity
Benefits of Community Engagement
Co-learning:
–
–
–
–
–
Academic
Community organizations
Research participants
Community members
General public
Models and Frameworks
Social Ecological Model: Stokols, 1996
CDC, 2007
Models and Frameworks
Social Ecological Model: Stokols, 1996
Constructing Social, 2009
Models and Frameworks
Association of Alaska School Boards
Models and Frameworks
International Association of Public Participation
Models and Frameworks
International Association of Public Participation
Models and Frameworks
ABLe Change Framework – Engaging Community Toward Systems Changes
Foster-Fishman & Watson, 2011
Community-Based
Participatory Research
Brings together researchers and communities



Share power
Address community identified needs
Foster co-learning
Cultural humility


Vis a vis cultural competence
Professionals cannot master another’s culture
What it is and isn’t

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An approach involving empowerment, social justice
values—health disparities
Applied to influence equitable change in community health,
norms, systems, programs, policies
Models and Frameworks
CBPR Trajectory
Co-Option
ON
Parkes, 2001
Compliance
FOR
Consultation
FOR/WITH
Cooperation
WITH
Co-Learning
WITH/BY
(CPPR)
Collective
Action
BY
Community sets
research agenda and
mobilizes with or
without outside
facilitation
Models and Frameworks
Ripple Model for Growing Effective CPP Researchers
community
Cultural
safety
training
Strengthening
communities
on
community’s
terms
Burke, 2011
Models and Frameworks
Routes of Transformation
Cultural safety training
Burke, 2011
Models and Frameworks
CBPR Conceptual Model
Minkler et al., 2008
Principles of Community Engagement
(CDC,2011)
Be clear about the purposes or goals of the
engagement effort, and the populations and/or
communities you want to engage.
Become knowledgeable about the community in
terms of its economic conditions, political structures,
norms and values, demographic trends, history, and
experience with engagement efforts. Learn about the
community’s perceptions of those initiating the
engagement activities.
Principles of Community Engagement
(CDC,2011)
Go into the community, establish relationships, build
trust, work with the formal and informal leadership,
and seek commitment from community organizations
and leaders to create processes for mobilizing the
community.
Remember and accept that community selfdetermination is the responsibility and right of all
people who comprise a community. No external
entity should assume it can bestow on a community
the power to act in its own self-interest.
Partnering with the community is necessary to create
change and improve health.
Principles of Community Engagement
(CDC,2011)
All aspects of community engagement must
recognize and respect community diversity.
Awareness of the various cultures of a community
and other factors of diversity must be paramount in
designing and implementing community engagement
approaches.
Community engagement can only be sustained by
identifying and mobilizing community assets, and by
developing capacities and resources for community
health decisions and action.
Principles of Community Engagement
(CDC,2011)
An engaging organization or individual change agent
must be prepared to release control of actions or
interventions to the community, and be flexible
enough to meet the changing needs of the
community.
Community collaboration requires long-term
commitment by the engaging organization and its
partners.
Questions?
Examples of Community Engagement and
Culture
in the Clinic:
Drs. Susana Helm, Dale Fryxell, Bradley
Chun, Darryl Salvador