Resources for community developmen
Barriers to community development
Laverack identifies nine domains in empowerment strategies5
empowerment strategies that a health promotion practitioner might undertake to increase citizen power.
Participation, community-based organisations, local leadership, resource mobilisation, assessment of problems within the community
spend time with community members and demonstrate that they can help supply some of the needs or wants of the community.
What is required for a health promoter to work effectively within communities?
They need to spend time with community members and demonstrate that they can help supply some of the needs or wants of the community
first step is for them to become known and trusted by the community.
health promoters must become known and trusted by the community
Arnstein’s Ladder of Citizen Participation.
The different levels of citizen participation
If ethics is concerned with the values underlying deci-sions and action, what values and whose values are rel-evant?
Ethics based values consider why those specific actions are the right actions not only for individuals but as a whole. Individual values may see that specific policies are better for themselves than others eg: no smoking policies, safe injection clinics, sex education.
Health ethics has a broad focus, taking in ethical issues faced by health professionals, health policy-makers and health researchers, as well as by patients, families, and communities in a range of contexts related to health, including clinical care, health services and systems, public health, epidemiology, information technology and the use of animals in research.
Health ethics encompasses all parties involved with the health intervention. Policy maker, health professionals, medical system, governments, individuals and population groups
Take into consideration the principles of ethics based health promotion as a professional
Data quality assessment template
Data quality assessment template detailed in Table 3 outlines each of the 7 elements and the specific questions you should be asking yourself in relation to the data you are analysing to see if it meets the data quality criteria.
Coherence
Does it use common methodologies? Is it consistent with its data collection? does it use standard concepts, classifications and target populations?
Coherence means it consistently uses the same methods in data collection.
6 An AIHW framework for assessing data sources for population health monitoring 6. Accuracy
Is it accurate. Does it correctly describe the condition? Major sources of errors detailed in Box 2. show how certain factors impact overall validity of the information.
Interpretability
Does it portray the measured concepts/data in a manner that is easily interpreted. Measurements of accuracy, metadata?
Accessibility
Does it allow users to easily access all required information. Cost to access?
imeliness reflects the length of time between the availability of the data source and the event or phenomenon it describes.
Time between collecting the data and presenting the information. ( is the data recent? )
Relevance
Does it meet specific needs in relation to measurements, populations.
Institutional environment
Assess data origin and quality (who/what governed the collection). Influences validity and reliability
Figure 2
Fig 2. details the process in which the 7 elements are used during the assessment process
elements
7 elements of of data quality. All are considered in the assessment process however some are more important than others
The third step assesses the quality of the data to determine if it is 'fit-for-purpose’.
Does the gathered data meet the specific research requirements ie; what was their methodology for data gathering, does it cover a broad amount of variables. is it limited to only specific population groups, age groups ect.
The monitoring areas identified for different data sources potentially vary, depending on the condition or disease under investigation and the focus of the monitoring work. The information areas included in Table 2 have been selected for monitoring arthritis and other musculoskeletal conditions (AIHW 2014b).
Monitoring areas for data sources vary depending on what type of disease/condition is under investigation. This may mean specific data sets will be left out and additional ones may be included.
he first step of the assessment process collects information about the data source, using categories as described in the template at Table 1. This includes:
Table 1. provides useful information on the specific information needed to be gathered from data to see whether or not it will be viable against the topic in question
Their actions canencourage governments to take action andcan develop popular constituencies to sup-port action initiated by the government
bottom up pressure.
health equity will reflect a com-plex mix of sufficient evidence, good under-standing of what changes populationhealth, a political elite committed tochanges and active civil society pressurefor that change
It is important for all parties concerned in health equity understand the multiple facets involved with this change and how one cannot work without the others.
nutcracker effect: top down and bottom up action for health equity
Nutcracker effect: where politicians and policy makers implement policy to effect change within societies on the SDoH (Top down) and the individuals come together to implement those policies at a community level (Bottom up) This is pertinent as the nutcracker effect will only cause change when both work simultaneously as if only one is to implement change then the nutcracker will not work.
advertising and constraints of healthfood availability are likely to have stronginfluences on the choices people are ableto make
Living in areas with access to healthy food choices, as well as affordable strongly dictates the choices individuals and societies make.
supportiveenvironments
Having a strong community makes it easier for individuals to implement change.
Modern medicineoffers individuals considerable possibilities
Modern medicine takes an individual approach instead of a population. making it easy to treat individual conditions multiple ways but hard (expensive) to implement for whole populations.
The gradientin health suggests that we need populationwide universalist strategies as well as thosetargeted at the most disadvantaged
Target the entire population, but utilise strategies to further target those at the lower end of the social gradient
Unless policies are well planned to combat health determinants, they may be more beneficial for people of higher socioeconomic status. This is due to the SDoH, eg; social conditions, born, grown, live, work, age.
unless designed with a very strongequity lens, health promotion can act toincrease the difference between groupsrather than reduce them even if theyimprove population health as a whole
in certain circumstances if health promotion is looked at with an equality lens and not equity then policy change may further increase the gap between the most and least healthy within certain population and health groups.
bringing change atthat level involved a complex interplay ofpolicy and strategy, creating supportiveenvironments, encouraging communityaction and reorienting health services
For policies to provide substantial change it is up to societies to implement these changes at an individual level which will then provide a greater impact at a group and community level
Knowing whatis to be done requires coming to grips withthe range of choices that lie inside and out-side the health sector.
Knowing that there are a multitude of viable options to remediate health inequities that lie outside of the health sector. It is therefore up to policy makers to ensure that sectors outside of health understand they can play an important role and must work with the health sector in implementing strategies.
health promotion and public health initia-tives often fall into a zone of complexity thatleads to uncertainty about what works andconsequently to a lack of agreement amongpolicy makers and practitioners.
Inability to take decisive action on SDoH policies is why equity gaps within certain population groups is not changing.
evidence and knowledgetogether with understanding and a com-mitment to equity
Evidence on the inequalities that in turn form inequities within countries allows for specific changes to be made to certain groups and societies.
This paper focuses on factors that arelikely to encourage and initiate practicalaction on the social determinants of healthinequities
Practical action both individually and as a society is fundamental in creating change within the SDoH.
Joined the Hypothes.is group