Hello, I’m Vincent Francisco, Associate Professor in the Department of Public Health Education at the University of North Carolina at Greensboro. In working with initiatives that span from very small and targeted program development to state and national-level initiatives for broader systems improvement, there are several challenges and opportunities that present themselves.
- Ever changing nature of community context – including social and physical contexts
- Vague community data sets to inform problem definition and potential solutions
- Huge variables influencing the emergence and sustainability of problems
- Small variables that we include in solutions, when compared to the large forces that cause the problems
- Lots of competing theories and approaches to explain pieces of the overall picture, but little to explain everything enough to guide population-level solutions
- Very little funding for solution development, or evaluation/applied research
- Same list as above
Lesson Learned: Potential solutions and evaluation activities must draw heavily on an open-systems framework, given the open context of communities. Related evaluation activities include process variables, intermediate systems change (e.g., new and/or modified programs, policies and practices), and outcomes of these systems changes at the population level.
Lessons Learned: A variety of strategies for behavior change and broader community systems improvement are needed in varying amounts at varying times. Some artistry is required. The outcome has to matter. Many people need to be involved in implementation. Many solutions are needed, which requires significant planning and capacity building. A few people need to be tasked with coordination and follow-through. This takes real vision and significant leadership to implement. Selecting the right people is important, but so is building the capacity of them and others to make a difference. This is the only way to make large enough changes for behavior change to occur, and to the longevity of those changes, to make a difference in the outcomes we seek at the community-level. The same is true for targeted programs, as well as broad community coalitions and partnerships.
The result is a focus on approaches that include building the capacity of others to do this work.
Rad Resource: This capacity-building focus was part of the spirit behind the development of the Community Tool Box , a web-based resource for building the capacity of people to develop community-level solutions. To the training materials, we added several online resources that help people to organize their data to allow for ongoing feedback and improvement.
Rad Resource: We developed the CTB Work Stations to allow programs and community initiatives to track implementation of the solutions they develop and how implementation relates to changes in selected population-level outcomes. These outcomes could be community health and development issues, behavior or changes in risk and protective factors.
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