Community Health Action Model: Health Promotion by the Community
Racher, Frances E., Annis, Robert C., Research and Theory for Nursing Practice
The goal of the Community Health Action (CHA) model is to depict community health promotion processes in a manner that can be implemented by community members to achieve their collectively and collaboratively determined actions and outcomes to sustain or improve the health and well-being of their community; the community as a whole, for the benefit of all. The model is unique in its ability to merge the community development process with a compatible community assessment, planning, implementation, and evaluation framework. The CHA model supports community participation leading to community-engaged assessment and change. In this article, the CHA model is depicted, its genesis described, and its utility demonstrated.
Keywords: community health; health promotion; community development; participatory action
The Community Health Action (CHA) model has evolved through collaboration and consultation among rural community residents, rural organizations, and community-focused researchers at the Rural Development Institute of Brandon University. Literature on community development processes (Kulig, 2000; Raphael et al., 1999) and documentation of community assessment models with quality-of-life indicators (Anderson & McFarlane, 2004; Federation of Canadian Municipalities, 1999; Hancock, Labonte, & Edwards, 1999) informed the process and are readily available. The CHA model is unique, however, in its ability to merge the community development process with a compatible community assessment, planning, implementation, and evaluation framework. Using this model, the community takes ownership, gives direction, and assumes responsibility for its activities and the resulting outcomes. Through public participation, community members come together and interact as a collective unit. They express and demonstrate a sense of community before moving to action to gather information, determine goals, implement plans, and evaluate outcomes. This community development process is not linear but may be sequential and is often iterative in nature. The CHA model supports community participation leading to community-engaged assessment and change. In this article, the CHA model will be depicted, its genesis described, and its utility demonstrated. Research leading to the development of the model and its application (Annis, Racher, & Beattie, 2004; Healey & Racher, 2008; Racher, 2002; Racher & Annis, 2005; Ryan-Nicholls & Racher, 2004) are discussed elsewhere as are cultural (Racher & Annis, 2007) and ethical aspects (Racher, 2007) of community practice.
DEFINITIONS AND ASSUMPTIONS
Effective application of the CHA model is based upon understanding that the central concepts of community development and community health promotion are synonymous. Similar to definitions of community development put forth by Feather (1994) and English (2000), the term community health promotion also may be viewed as a philosophy, a process, a project, and an outcome. As a philosophy, community development, and by extrapolation community health promotion, entails the fundamental belief that people can identify and solve their problems. As a process, community health promotion supports citizens as they find the power to effect change. As a project or outcome, community health promotion involves the work of citizens to bring about change in their community.
The health of a community has to do with the way a community functions, the healthiness of the community as a whole. Community health is the ability of a community to generate and effectively use assets and resources to support the well-being and quality of life of the community as a whole in the face of challenges and barriers within the context of their environment. Community health involves reciprocal relationships between people and their environment with the goal of sustainability (Ryan-Nicholls & Racher, 2004). Community resiliency is the ability of a community to respond to adversity and, in so doing, to reach a higher level of functioning (Kulig, 2000) or extend community capacity. …