Sept 10 Building Capacity of Communities Flashcards
Social Planning
Task oriented, problem solving, usually outside expert but does not have to be
Social Action
Task and process oriented. Enhancing solving problems from within, and attempt concrete changes in power dynamics (i.e. training locals/community members)
Power (5 things)
- Marginalized communities are vulnerable to exploitation 2. world view is not neutral, value driven (Public health views are NOT neutral, have specific view) 3. those receiving intervention have diff values, norms, rewards. 4. Views of more powerful is seen in outcome (oppressive - bulldozer approach). 5. power dynamics between all (community leader, funding agency, evaluator)
Historical definitions of Empowerment
- What is powerlessness? Subjectively
- What is powerlessness? Objectively
Opposite of powerlessness (lack of control over destiny)
- learned helplessness and external locus of control (medicaid choice, taxes, taking the bus)
- people may lack economic and political power, living in resource deprivation and internalize this as feeling of powerlessness (social service system)
Broad Definition of Empowerment
people gain control of their lives - participating with others to change their social and political realities. Communities having equity and capacity to solve its problems through increased participation of its members in activities and increased control over determinants of health
Empowerment Framework
Agency - groups ability to make purposeful choices (able to envision and choose options)
Opportunity Structure - institutional context within which “actors” live and work (rules of game influences choices and interactions)
Empowerment Education
Education is not neutral - people bring issues and teacher brings agendas. Involves people in group efforts to identify problems, critically analyze cultural and SES roots of problems. Develop strategies to effect positive changes (every classroom is different)
Examples of Empowerment Education
Coping skills, communication, decision making, peer training, media and social policy analysis was taught. What emerged was community pride.
Critical Characteristics of Empowerment Process
Individual empowerment, bridging social ties (people you meet and classmates that helped you during school), synergy (the interaction or cooperation of two or more organizations is greater in sum than in separate effects)
Capacity Focused
Community development works and sustains only when local community people are committed to investing in themselves and their resources. Identifying assets - individual, org, and structural is important
(inventory) Individual capacity
skills, talents, and abilities, incomes, labeled people, individual businesses, home-based enterprises
(inventory) organizational capacity
citizen orgs, assns of businesses, financial institutions, cultural orgs, communication orgs, religious orgs
Examples of private or non-profit orgs
police, hospitals, social services, schools, libraries, parks, physical resources
Outcome Questions for measuring Perceived Capacity
I have control over decisions that affect my life…my community has influence over decisions that affect my life….I can influence decisions that affect my community…by working together, people in my community can influence decisions that affect the community
Map of Community Capacity
label primary, secondary and potential building blocks, use of GIS, small group tasks and come together as a larger group, sit down with community members and leaders (to assess which orgs effective at asset development and discuss how build bridges to resources outside community)
Community Health Governance Model
Collaborative process important to address problems and identify assets, participatory collaborative process, strengthen capacity to solve problems that affect health and wellbeing-capacity of multiple stakeholders
Leadership and management is needed to…3 things
- promote active and broad participation 2. ensure broad based influence-promote diverse resource base 3. facilitate productive group dynamics - foster meaningful discourse (mediator), combine skills and resources
Guiding perspective of CBPR (definition)
Community-based participatory research for health is a collaborative approach to research that equitably involves all partners in the research process and recognizes the unique strengths that each brings to the research
CBPR approach (4 things)
- involves partners in the research process, 2. research of important to the community, 3. aim of combining knowledge and action for social change to improve community health and eliminate health disparities 4. includes capacity building
Participation (4 things)
- true participation involves having an equal say, ownership, and active roles in the project 2. levels of participation vary by level of ownership 3. participation and control are never static 4. principles for each project recognize specific local context
CBPR - who is representing the community? (4 things)
- varies by community and heterogeneous within community 2. leaders not always representative 3. understanding community culture helps to approach and work with representatives 4. stakeholders - power relations within community, isms may still apply, resource allocation needs to be understood
CBPR - how do ‘isms place a role? (4 things)
- power and privelege influence relationships- lack of involvement of commitment by community may result 2. may subvert project process or hinder collaboration to exert control 3. professional roles may create boundaries 4. lack of trust - extendning olive branch may be seen as meddling opr trying to take control or ownership
Rhetoric Vs. Reality of community participation (5 things)
- an emphasis on CAPACITY as opposed to DEFICIENCY approach 2. informality that can give professionals impression of being inefficient or unorganized 3. community stories - communication strat to reach back into common hx and indiv exp for knowledge about truth/direction for future 4. incorp of celebration, tragedy, and fallibility into life of community 5. all encompass a sense of connectedness - social space/environment
Tokenism (2 things)
- citizens somewhat involved but not heard and advice/input not incorporated 2. professionals decide what to focus on in terms of health issue, get community to take ownership of professionally defined health agenda and convince community to take responsibility for and carry out activities w/o them being in decision process
Participation (4 things)
- citizens heard and their needs and concerns are responded to 2. they may negotiate and engage in trade offs of research/promotion activities 3. community is a part of agenda setting, defining problems, and developing solutions 4. professionals see themselves as co-learners
Cultural Humility (Participation)
commitment to self-evaluation and self-critique to redress power imbalances and develop and maintain mutual respectful and dynamic parternships with communities
The process of Partnership Development and Maintenance (5 things)
- truly value participatory research 2. networks* 3. listen 4. acknowledge power dynamics in community 5. relationships established (“Authentic” community members)
DARE
Who DETERMINES the goals of the project?
Who ACTS to achieve them?
Who RECEIVES the benefits of the actions?
Who EVALUATES the actions?
Lessons Learned (4 things)
- Goals refined and improved relevance will improve outcomes, 2. intervention is more interesting and relevent to the population, 3. community is more willing to sustain in tailored to their needs, 4. potential for future grands with community commitment.
Lessons Learned - Obstacles (3 things)
- takes mroe time to build relationships 2. do not forget to engage “authentic” community members 3. conflict with other agendas
Ethics of CBPR (3 things)
- Current ethics regulations are too narrow (based on biomedical research, using “subjects”) 2. what os subjective/objective is often not questioned in traditional research, yet judgment and subjectivity a part of process from the beginning 3. b/c no ONE way of doing CBPR, poses challenge to create ethical guidelines
Ethical Issues (3 things)
- Authenticity of partnerships (covered by ladder) 2. Conflicting Loyalties - trust established and immediate concerns of people get #1 attention, other health concerns may be having saliency 3. Funding source dilemmas - disease focus priorities may not be same as community needs, seeking non-gov’t sources may need to asking something not comfortable with
Ethical Issues - Unanticipated consequences (4 things)
- others hurt or stereotyped by health education 2. empowering - training leaders may cause leaders to be indoctrinated in your way of thinking to point that no longer legitimate or trusted by community 3. also leadesr may use skills to manipulate others or leave others out 3. Act locally, think globally –larger implications of activities
(Ethics) - 1. Favorable risk-benefit ratio 2. Respect for participants
minimize risks and increase potential benefits. most reasearch in social and behavior does generally does not benefit the participant 2. CBPR can lead to confidentiality and privacy issues especially in a rural area
