Community-Driven Solutions to Public Health Problems

GB LeaPSpotlight on Research at COPH – Both social marketing and community-based participatory research demonstrate the importance of understanding the perspective of people impacted by a given issue. However, each stops short of fully engaging people in the entire process of researching, developing, implementing, and evaluating solutions to those problems. Leveraging points of convergence between those two proven approaches has led a proposed integrated approach to developing sustainable interventions. The integrated approach is currently being tested in a project with farm women to address farm injuries. The Central States Center for Agricultural Safety and Health provided funding for the pilot project.

The points of convergence between those two approaches results in five constructs:

1.     Explicit inclusion of all participants’ knowledge. People living with a given situation have a practical understanding gained from their personal experience with that situation. Researchers have an empirical understanding gained from their own and others research. By accepting community members as equal partners and incorporating their life experience into efforts to address issues, we tap into an underutilized resource.

2.     Co-creation through reciprocal transfer of knowledge. As people with varying perspectives of an issue engage in constructive dialogue, a natural outcome is shared understanding that forms the basis for decision making. This reciprocal transfer of knowledge enriches the community by increasing understanding of the origins and consequences of public health issues. The work of the researchers is enhanced through exposure to new ways of thinking about the issues and the opening of new avenues for exploration.

3.     Long-term commitment to the process. Respectful, trusting relationships underlie the first two constructs. Without those foundational relationships, true inclusion and knowledge transfer cannot occur. The process of building relationships and developing sustainable solutions requires a commitment from individuals and organizations to work through the cyclical and iterative process of consensus building and decision making.

4.     Sustainability through shared ownership of the process and outcomes. Because all participants involved in developing the solutions have a voice in decision making throughout the process, both as individuals and as organization or community representatives, they can hold a sense of ownership in the outcomes. By owning the results, community members become invested in developing solutions that are relevant to them. The sense of ownership developed by community members and researchers contributes to a commitment to keep the solutions going even to the point of adapting the work if circumstances change.

5.     Continuous improvement. Reciprocal transfer of knowledge and long-term commitment lead to opportunities for insights both personally and professionally. The natural outcome of these insights is continuous evaluation of the process of decision making and the results of those decisions. Thus continuous improvement becomes both a function of the group interactions as well as conscious attention to the process of decision making and the development and implementation of solutions. Monitoring and evaluation also enhance abilities to adapt both the process of identifying and implementing solutions and the solutions themselves to changing environments.

This article was written by Lea Pounds, PhD(c), MBA, an instructor in the UNMC COPH Department of Health Promotion, Social and Behavioral Health.


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