Action-Oriented Community Diagnosis: A Health Education Tool

Abstract

Health education research and practice have found individuals' health decisions and behaviors to be related to their perceptions of need. It has also been found that physical, social, and political conditions generated by one's community can exert important influences on individuals' ability to act on the basis of need. It appears that conducting a needs assessment is a necessary component of program planning, but the information is not sufficient for designing sustainable interventions. An Action-Oriented Community Diagnosis procedure has been developed over several years to: 1) identify normative and comparative needs determined by service agencies as well as expressed and perceived needs experienced by clients; 2) assess community conditions contributing to collective competence as well as the barriers and gaps contributing to disease and illness; and 3) increase collective competence of communities and agencies to collaborate in defining problems and needs. One of the many health education projects that have conducted such a diagnosis has been selected to illustrate the features of the procedure, the rationale behind the methods and sequence of steps, how the methods can be operationalized, and the outcomes.

Get full access to this article

View all access options for this article.

References

Green

L. W.

Kreuter

M. W.

Deeds

S. G.

, and Partridge

K. B.

, Health Education Planning: A Diagnostic Approach, Mayfield Publishing Company, Palo Alto, California, 1980.

Schiller

Steckler

Dawson

, and Patton

, Participatory Planning in Community Health Education, Third Party Publishing, Oakland, California, 1987.

Marti-Costa

and Serrano-Garcia

, Needs Assessment and Community Development: An Ideological Perspective, Prevention in Human Services, 2: 4, pp. 75–88, Summer 1983.

Thomas

Israel

, and Steuart

, Cooperative Problem Solving: The Neighborhood Self-Help Project in Advancing Health through Education: A Case Study Approach, Cleary

Kichen

, and Ensor

(eds.), Mayfield Publishing, Palo Alto, California, pp. 225–239, 1985.

Steuart

, Social and Behavioral Change Strategies, in Aging and Public Health, Phillips

H. T.

and Gaylord

S. A.

(eds.), Springer Publisher, New York, pp. 217–247, 1985.

Dignan

and Carr

, Program Planning for Health Education and Health Promotion, Lean & Febiger, Philadelphia, 1987.

Suchman

E. A.

, Preventive Health Behavior: A Model for Research on Community Health Campaigns, Journal of Health and Social Behavior, 8, pp. 197–209, 1967.

Kahneman

and Tversky

, Prospect Theory: An Analysis of Decisions under Risk, Econometrica, 47, pp. 263–291, 1974.

Azjen

and Fishbein

, Attitude-Behavior Relations: A Theoretical Analysis and Review of Empirical Literature, American Psychology Bulletin, 84: 5, pp. 888–918, 1977.

10.

Porter

R. A.

, Ecological Strategies of Prevention in Rural Community Development, Journal of Primary Prevention, 3: 4, pp. 235–243, Summer 1983.

11.

Germaine

, Social Work Practice: People and Environments: An Ecological Perspective, Columbia University Press, New York, 1979.

12.

McLeroy

Bibeau

Steckler

, and Glanz

, An Ecological Perspective on Health Promotion Programs, Health Education Quarterly, 15: 4, pp. 351–377, Winter 1988.

13.

Heller

, The Return to Community, American Journal of Community Psychology, 17: 1, pp. 1–15, 1989.

14.

Wellman

and Leighton

, Networks, Neighborhoods and Communities: Approaches to the Study of the Community Question, Urban Affairs Quarterly, 14: 3, pp. 363–390, March 1979.

15.

Biddle

and Biddle

, Community Development Process: The Rediscovery of Initiative, Holt, Rhinehart & Winston, New York, 1965.

16.

Warren

R. B.

and Warren

D. I.

, The Neighborhood Organizer's Handbook, University of Notre Dame Press, Notre Dame, Indiana, 1977.

17.

Tweeten

and Brinkman

, Micropolitan Development, Iowa State University Press, Ames, 1976.

18.

Brown

E. R.

and Margo

G. E.

, Health Education: Can the Reformers Be Reformed?, International Journal of Health Services, 8: 1, pp. 3–26, 1978.

19.

Hatch

and Eng

, Community Participation and Control: Or Control of Community Participation, in Reforming Medicine: Lessons of the Last Quarter Century, Sidel

and Sidel

Sidel

and Sidel

(eds.), Pantheon Books, New York, pp. 223–244, 1984.

20.

Eng

Hatch

, and Callan

, Institutionalizing Social Support through the Church and into the Community, Health Education Quarterly, 12: 1, Spring 1985.

21.

Levin

and Idler

E. L.

, The Hidden Health Care System: Mediating Structures and Medicine, Ballinger Publishing, Boston, 1981.

22.

Berger

and Neuhouse

, To Empower People: The Role of Mediating Structures in Public Policy, American Enterprise Institute for Public Policy Research, Washington, D.C., 1977.

23.

Cottrell

, The Competent Community, in Further Explorations in Social Psychiatry, Basic Books, New York, pp. 195–209, 1976.

24.

Hatch

and Eng

, Health Worker Roles in Community Oriented Primary Care, in Community Oriented Primary Care, Connor

and Mullan

(eds.), National Academy of Medicine Press, Washington, D.C., pp. 138–158, 1983.

25.

Hatch

and Lovelace

, Involving the Southern Rural Church and Students of the Health Professions in Health Education, Public Health Reports, 95, January-February 1980.

26.

Isely

Davies

Gaston

, and Sylvestre

, A Village Takes a Hand in Its Future: Ekali I (Cameroon), in Primary Health Care: The African Experience, Carlaw

and Ward

(eds.), Third Party Publishing, Oakland, California, pp. 11–35, 1988.

27.

Brieger

Ramakrishna

Adeniyi

, and Kale

, Health Education Interventions to Control Onchocerciasis in the Context of Primary Health Care, in Primary Health Care: The African Experience, Carlaw

and Ward

(eds.), Third Party Publishing, Oakland, California, pp. 341–371, 1988.