Silberberg Mina, Dupre Matthew E, Moody James, Patel Meera, Vemulapalli Anika, Easterling Douglas
Department of Family Medicine and Community Health, Duke University School of Medicine, Durham, NC 27710, USA.
Department of Population Health Sciences, Duke University School of Medicine, Durham, NC 27710, USA.
Healthcare (Basel). 2024 Dec 9;12(23):2486. doi: 10.3390/healthcare12232486.
: Place-based initiatives (PBIs) invest in a geographic area and often build community power to improve well-being. However, there can be differences in results for different groups within a community. : In six communities, we measured differences in "power to" by race/ethnicity at two points for the first phase of the PBI Healthy Places North Carolina (HPNC) using five indicators: (1) representation in network of actors collaborating to improve health, (2) leadership attributes, (3) perceived change in attributes due to HPNC, (4) network centrality, and (5) perceived change in network ties due to HPNC. : Latine populations were underrepresented. In four (majority White) communities, there were indications of White advantage. In one, White centrality was greater than non-White. In another, White actors consistently rated themselves higher for leadership attributes. In two, a gap in leadership attributes favoring White actors appeared at Wave 2. In two counties with African American majorities, non-White attributes ranked higher than White. : Each indicator provided unique insight. Results provide new evidence of measurement validity and reliability. Results indicate that when PBIs designed to address the needs of low-resource communities do not proactively concern themselves with racial/ethnic equity and power (as HPNC would do in the years after this study), they may result in greater White benefit from PBI or failure to close existing gaps. Findings aligned with the "political reality" model of the correspondence between the size of African American population and their perceived self-efficacy. Changes over time and inter-county differences confirm need for early measurement of power differences and changes.
基于地点的倡议(PBIs)对一个地理区域进行投资,并常常增强社区力量以改善福祉。然而,社区内不同群体的结果可能存在差异。在六个社区中,我们在北卡罗来纳州健康场所(HPNC)这一基于地点的倡议的第一阶段的两个时间点,使用五个指标衡量了不同种族/族裔群体在“权力去做”方面的差异:(1)参与协作改善健康的行动者网络中的代表性;(2)领导属性;(3)因HPNC导致的属性感知变化;(4)网络中心性;(5)因HPNC导致的网络联系感知变化。拉丁裔人口代表性不足。在四个(白人占多数)社区中,有白人优势的迹象。在一个社区,白人的中心性高于非白人。在另一个社区,白人行动者在领导属性方面一直给自己的评分更高。在两个社区,在第二波时出现了有利于白人行动者的领导属性差距。在两个非裔美国人占多数的县,非白人属性的排名高于白人。每个指标都提供了独特的见解。结果为测量的有效性和可靠性提供了新证据。结果表明,当旨在满足资源匮乏社区需求的基于地点的倡议没有积极关注种族/族裔公平和权力问题时(就像本研究之后几年HPNC所做的那样),它们可能会使白人从基于地点的倡议中获得更大利益,或者无法弥合现有的差距。研究结果与非裔美国人人口规模与其感知自我效能之间对应关系的“政治现实”模型相符。随时间的变化和各县之间的差异证实了早期测量权力差异和变化情况的必要性。