Academic journal article Nursing and Health Care Perspectives

Community Involvement

Academic journal article Nursing and Health Care Perspectives

Community Involvement

Article excerpt


Following the development of the Healthy People 2000 initiative by the U.S. Department of Health and Human Services, a related task force was formed in Mesa County, in western Colorado. This task force, part of the Mesa County Healthy Communities project, was funded by the Colorado Trust and represented several major health care organizations. The task force began a study of health-related issues in the community to identify health care needs, evaluate how health care is provided and delivered, and recommend actions necessary to improve the community's health. Findings were published in a booklet entitled "Mesa County: Our Picture of Health, Community Health Assessment 1995."

The study revealed 14 principal problem areas that were prioritized into five main health care issues. The task force reported the results and priorities to the various organizations. Subsequently, five teams of interested community members were formed to identify community assets and develop a plan of action to address each of the five health priorities.

One team, the Substance Abuse Prevention TrendBender Team, focused on supporting a deepening partnership between community members and service agencies to address problems associated with the abuse of alcohol, tobacco, illegal drugs, and other substances. This team of volunteers worked on various projects, including the distribution of educational pamphlets at local malls and a year-round Red Ribbon Campaign. The purpose of the campaign was to increase awareness of drug and alcohol problems and provide information about substance abuse prevention within the community. To that end, volunteers put up posters, distributed pamphlets, and spoke at area schools.

The teams had been meeting for one year when it was noted that community interest had begun to decrease and only inconsistent action plans had been established. A follow-up assessment to determine community progress revealed the need to answer several questions:

* Why did interest decrease?

* How can community interest and involvement be increased?

* What is the level of community participation in these task forces? Is it similar to that in other communities?

* What recommendations could be made to the teams to stimulate interest and greater participation?

This article contrasts the declining level of community involvement in the Mesa County project with other community health projects in the United States. The emergence of genuine grassroots efforts is explored, along with concrete strategies for enhancing community participation.

Overcoming Obstacles to Primary Health Care Consumer participation and involvement are essential components of primary health care. The achievement of health in a community often requires a call to action by persons within the community. According to the World Health Organization, health promotion must enable "people to increase control over, and improve, their health" (1). Empowering the community -- encouraging community participation in health care -- may require health care professionals to let go of control over strategies and planning. This paradigm shift can be uncomfortable for healthcare professionals, resulting in resistance to change and impeding community participation.

Other problems may interfere with community participation and action. For example, because of conflicting definitions, there may be confusion about what primary health care is. As part of the Alma-Ata Declaration of 1978, the World Health Organization defined primary health care as "essential health care made universally accessible to individuals and families in the community by means acceptable to them, through their full participation and at cost that the community and country can afford" (2).

The American Nurses Association definition, that primary health care is the care the client receives within the health care system at the first point of contact to resolve a presenting problem, may contribute to the difficulty in developing a workable plan. …

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