Eng E, Parker E
Department of Health Behavior and Health Education, School of Public Health, University of North Carolina, Chapel Hill 27599.
Health Educ Q. 1994 Summer;21(2):199-220. doi: 10.1177/109019819402100206.
If political dynamics are included in the definition of community, health promotion programs have a greater potential to recognize that assisting people to empower their communities is as important as assisting them to improve their health. This paper reports on the evaluation methods employed for a health promotion program in a rural poor county of the Mississippi Delta that chose to define community in this way. The evaluation took an action research approach so that the methods would not contradict or interfere with the program's empowerment agenda. The methods required a close and collaborative working relationship among evaluators and local service providers, community leaders, and program staff who defined and operationalized eight dimensions of community competence, determined the units of analysis, and developed the data collection protocol. Emphasis was placed on using the data to engage the program and three communities in a dialogue on how to confront a system with the difficult issues they faced. The findings revealed that after 1 year of implementation, community competence moved from social interactions internal to communities to those more externally focused on mediating with outside institutions and officials. At the same time, measures of self-other awareness and conflict containment showed a decrease or virtual nonexistence.
如果将政治动态纳入社区的定义，那么健康促进项目就更有可能认识到，帮助人们增强其社区的能力与帮助他们改善健康同样重要。本文报告了在密西西比三角洲一个农村贫困县开展的一个健康促进项目所采用的评估方法，该项目选择以这种方式定义社区。评估采用了行动研究方法，以便这些方法不会与该项目的赋权议程相矛盾或产生干扰。这些方法要求评估人员与当地服务提供者、社区领袖以及项目工作人员建立密切的合作关系，他们共同定义并实施了社区能力的八个维度，确定了分析单位，并制定了数据收集方案。重点是利用这些数据促使该项目和三个社区就如何应对它们所面临的难题与系统进行对话。研究结果显示，实施一年后，社区能力从社区内部的社会互动转向了更多地侧重于与外部机构和官员进行调解的外部互动。与此同时，自我与他人意识及冲突控制的指标显示有所下降或几乎不存在。
