** Low Priority **
I know I'm coming in late on this, but for what it's worth, we did a fairly interesting project "Lakeshore Community Audit" which was led and implemented by a steering committee of community representatives. It was community led, but there are power differentials within communities too! My biased opinion is that we did some positive work that ersulted in community action, but there were some pretty vicious poiulitcal struggles along the way. SOmetimes we use motherhood words like community and grassroots without being clear who we're talking about.
>>> [log in to unmask] 8/3/2005 6:54 PM >>>
Ken,
Thanks so much for your help.
ANA
Ana Natale-Pereira, MD, MPH
Assistant Professor of Medicine
Division of Academic Medicine, Geriatrics, and Community Programs
Medical Director
Focus Community Health Center
449 Broad Street
Newark, New Jersey 07102
973-972-0980
973-972-0984 Fax
[log in to unmask]
>>> [log in to unmask] 8/2/2005 10:23:55 PM >>>
hi ana,
what you are doing is exactly right... and very rare in the us..
most folks continue to think that the problem for poor folks is only
lack of access to clinical care..very few seem to have figured out, like
you have that, that care is already too late and that what folks lack is
access to an environment that supports/promotes health.. saying, as you
do, that folks are underserved for health promotion and health
education, is exactly right..
your model sounds great.
places you might look too..
are you in touch with the social medicine program at montefiore in the
bronx? you might also connect with sandor galea at the ny academy of
medince urban medicine project..
you might find information from canada on their efforts at health
promotion of real interest.. the international society for urban health
is meeting there in october in toronto..
finally there is a great deal of activity around health promotion in
the uk that might be of interest... take a look at the usuk dialogue for
achieving health equity in the post de-industrial regions
www.ucis.pitt.edu/gap/health_ineq for more information..
let me know if you would like to join the email list for the
dialogue..
ken
-----Original Message-----
From: Social Determinants of Health on behalf of Ana Natale-Pereira
Sent: Tue 8/2/2005 7:47 PM
To: [log in to unmask]
Subject: Re: [SDOH] community-based?
Ken,
I am very much interested in the same concept, and perhaps would be
able to respond to your important question. As a practicing primary
care physician in an academic setting, in an urban area, I have
observed
first hand the need for true community health (not just care for those
who are insured or even if underinsured). My patient population lacks
good access to health promotion and health education. As such, I have
now been commissioned to develop a true community partnership for
better
health in the Newark, NJ area.
In our proposed model, we will be seeking to strenghten our
relationships (built through CBPR) with community based organizations
and churches by creating a community based primary care service model
first targeting health promotion and disease prevention. The
University
Hospital of New Jersey Medical School, is a safety net hospital and
will
servie as the back up for health care services. The idea is for a
true
partnership between the CBO's (providing space and social services)
and
the primary care division (providing health education, a provider, a
navigator and access). In our model we will accomodate medical
students
and nursing students to serve as health ambassadors and at the same
time
enrich their experience by being part of the community.
I hope you, and any one else in the listserv with much more experience
than me, can provide links to resources, comments, criticism, and
feedback.
I greatly appreciate it.
Ana Natale-Pereira, MD, MPH
Assistant Professor of Medicine
Division of Academic Medicine, Geriatrics, and Community Programs
Medical Director
Focus Community Health Center
449 Broad Street
Newark, New Jersey 07102
973-972-0980
973-972-0984 Fax
[log in to unmask]
>>> [log in to unmask] 8/2/2005 3:03:17 PM >>>
Hi all,
one of the interesting things about cbpr is its existence without a
corresponding "community based practice", at least in the US. this, i
think, may have some connection to the conversation below.
specifically,
i have been struck by the work being done to involve communities in
the
research interests of researchers pursuing federal funds- while
little,
if any effort, is expended to ensure that communities are really
engaged
with the provision of services. while i am aware that some health
centers in the US mandate a community controlled board, many dont.
beyond this, i have seen almost no literature on how to develop
services
with real community participation.. except, of course, if the service
is part of a cbpr project...
seems to me we might have it backward- we need real community-based
practice. once we have that, we can have real cbpr. not the other
way
round..
ken
-----Original Message-----
From: Social Determinants of Health [mailto:[log in to unmask]]On Behalf Of
Wellner, Cathryn
Sent: Tuesday, August 02, 2005 1:01 PM
To: [log in to unmask]
Subject: Re: [SDOH] community-based?
A thoughtful analysis, Linda. I worked as a community development
consultant in northern BC for many years. The most successful projects
with which I was associated were definitely grassroots. They were
generated by the communities, in response to needs the communities had
identified. The participatory research component measured things of
interest to the communities. The results were useful because they
answered (or attempted to answer) the community's own questions. The
results also belonged to them, through a process shaped by them.
By contrast, most of the research was generated by a universities with
questions that would provide results of interest to the scholarly
community - but which would rarely trickle back down to the
communities.
The subjects of the research, the targets of the projects, were rural
people. They got tired, very tired. They didn't much like being bugs
on
pins, to be examined and then ignored. They got tired of cooperating
with researchers and projects that required enormous investments of
their time - and for which there was no or, when they were lucky,
little
monetary compensation. They got tired of being examined and then
seeing
no benefit from the examination.
And that situation goes on. Increasingly, funding for community
programs is contingent on an evidence base that is more the province
of
universities than already-stretched NGOs. With a full and equal
partnership, rather than a distant and elite relationship,
universities
would be well placed to assist communities rather than just study
them.
I remember a gathering in rural BC of academics who were studying
rural
and small-town issues. As coordinator of a regional community economic
development organization, I was invited to attend the conference. I
was
the only community person there. I was the only rural person there. A
lot of what I was hearing was inaccurate and irrelevant to the
realities
of rural life. It felt a bit as if I'd fallen into the rabbit hole of
Alice in Wonderland.
Cathryn
Cathryn Wellner
Food and Health Project Manager
Interior Health
2180 Ethel Avenue
Kelowna, BC V1Y 3A1
(250) 862-4335; fax (250) 712-9923
-----Original Message-----
From: Social Determinants of Health [mailto:[log in to unmask]]On Behalf Of
Linda Green
Sent: Tuesday, August 02, 2005 9:27 AM
To: [log in to unmask]
Subject: [SDOH] community-based?
>Announcing the publication of Methods in Community-Based
Participatory
>Research
>for Health Edited by Barbara A. Israel DrPH, Eugenia Eng DrPH, Amy J.
>Schulz
>PhD, Edith A. Parker DrPH
>
>Written by distinguished experts
Let's just flag the phrase 'distinguished experts' for a moment
in light of the claims being made about equal partnerships below.
With the respect due those who have developed CBPR and are
promoting it so that community based organizations can get into
line with the requirements of new evidentiary regimes (including
program and outcomes evaluation), I noticed that the principles
and practices that inform community based participatory research
are essentially those of community psychology. Given that, I wonder
about the strength of the argument that CBPR is truly community
based? I find it very difficult given my exposure to the practices
of knowledge production in the field of psychology to see the field
as capable of leading anything truly grassroots. When I inquired of
those online recently about the history of usage of the term citizen
engagement, someone (forgive me for forgetting for the moment
who that was) responded with a comparison with the participatory
approach that is credited to Paolo Freire. However, I want to point
out that from my point of view, it is a significant political leap
from
CBPR to the work of Freire. This was an extremely generous
comparison I think.
For those who weren't aware of the origins of CBPR in community
psychology, take a look at the book Community Psychology: Linking
Individuals and communities. Dalton, J.H. (2001). Stamford, Conn.
Wadsworth Publishing.
>in the field, this book shows how researchers,
>practitioners, and community partners can work together to establish
and
>maintain equitable partnerships
why are we so sure these are equitable partnerships? I think
that assertion may need some reality testing. My experience is
you don't have to dig very deep to hear how this isn't quite a fit
on the community side of these partnerships. I suspect we need to
have a closer look at how the role and power of universities and
academics in knowledge production are being reasserted and
redefined by the machinery of evidence based policy making.
>using a community-based participatory research
>(CBPR) approach to increase knowledge and improve health and
well-being
>of the
>communities involved. What distinguishes CBPR from other approaches
to
>research
>is the active engagement of all partners in the process. This book
>provides a
>comprehensive and thorough presentation of CBPR study designs,
specific
>data
>collection and analysis methods, and innovative partnership
structures
>and
>process methods. This book informs students, practitioners,
researchers,
>and
>community members about methods and applications needed to conduct
CBPR
>in the
>widest range of research areas?including social determinants of
health,
>health
>disparities, health promotion, community interventions, disease
>management,
>health services, and environmental health.
just a few observations. Linda
>
____________________________
Linda Green, OISE/UT
Counselling for Community Settings
[log in to unmask]
-------------------
Problems/Questions? Send it to Listserv owner: [log in to unmask]
To unsubscribe, send the following message in the text section -- NOT
the subject header -- to [log in to unmask]
SIGNOFF SDOH
DO NOT SEND IT BY HITTING THE REPLY BUTTON. THIS SENDS THE MESSAGE TO
THE ENTIRE LISTSERV AND STILL DOES NOT REMOVE YOU.
To subscribe to the SDOH list, send the following message to
[log in to unmask] in the text section, NOT in the subject header.
SUBSCRIBE SDOH yourfirstname yourlastname
To post a message to all 1000+ subscribers, send it to [log in to unmask]
Include in the Subject, its content, and location and date, if
relevant.
For a list of SDOH members, send a request to [log in to unmask]
To receive messages only once a day, send the following message to
[log in to unmask]
SET SDOH DIGEST
To view the SDOH archives, go to:
https://listserv.yorku.ca/archives/sdoh.html
-------------------
Problems/Questions? Send it to Listserv owner: [log in to unmask]
To unsubscribe, send the following message in the text section -- NOT
the subject header -- to [log in to unmask]
SIGNOFF SDOH
DO NOT SEND IT BY HITTING THE REPLY BUTTON. THIS SENDS THE MESSAGE TO
THE ENTIRE LISTSERV AND STILL DOES NOT REMOVE YOU.
To subscribe to the SDOH list, send the following message to
[log in to unmask] in the text section, NOT in the subject header.
SUBSCRIBE SDOH yourfirstname yourlastname
To post a message to all 1000+ subscribers, send it to [log in to unmask]
Include in the Subject, its content, and location and date, if
relevant.
For a list of SDOH members, send a request to [log in to unmask]
To receive messages only once a day, send the following message to
[log in to unmask]
SET SDOH DIGEST
To view the SDOH archives, go to:
https://listserv.yorku.ca/archives/sdoh.html
-------------------
Problems/Questions? Send it to Listserv owner: [log in to unmask]
To unsubscribe, send the following message in the text section -- NOT
the subject header -- to [log in to unmask]
SIGNOFF SDOH
DO NOT SEND IT BY HITTING THE REPLY BUTTON. THIS SENDS THE MESSAGE TO
THE ENTIRE LISTSERV AND STILL DOES NOT REMOVE YOU.
To subscribe to the SDOH list, send the following message to
[log in to unmask] in the text section, NOT in the subject header.
SUBSCRIBE SDOH yourfirstname yourlastname
To post a message to all 1000+ subscribers, send it to [log in to unmask]
Include in the Subject, its content, and location and date, if
relevant.
For a list of SDOH members, send a request to [log in to unmask]
To receive messages only once a day, send the following message to
[log in to unmask]
SET SDOH DIGEST
To view the SDOH archives, go to:
https://listserv.yorku.ca/archives/sdoh.html
-------------------
Problems/Questions? Send it to Listserv owner: [log in to unmask]
To unsubscribe, send the following message in the text section -- NOT
the subject header -- to [log in to unmask]
SIGNOFF SDOH
DO NOT SEND IT BY HITTING THE REPLY BUTTON. THIS SENDS THE MESSAGE TO
THE ENTIRE LISTSERV AND STILL DOES NOT REMOVE YOU.
To subscribe to the SDOH list, send the following message to
[log in to unmask] in the text section, NOT in the subject header.
SUBSCRIBE SDOH yourfirstname yourlastname
To post a message to all 1000+ subscribers, send it to [log in to unmask]
Include in the Subject, its content, and location and date, if
relevant.
For a list of SDOH members, send a request to [log in to unmask]
To receive messages only once a day, send the following message to
[log in to unmask]
SET SDOH DIGEST
To view the SDOH archives, go to:
https://listserv.yorku.ca/archives/sdoh.html
-------------------
Problems/Questions? Send it to Listserv owner: [log in to unmask]
To unsubscribe, send the following message in the text section -- NOT
the subject header -- to [log in to unmask]
SIGNOFF SDOH
DO NOT SEND IT BY HITTING THE REPLY BUTTON. THIS SENDS THE MESSAGE TO
THE ENTIRE LISTSERV AND STILL DOES NOT REMOVE YOU.
To subscribe to the SDOH list, send the following message to
[log in to unmask] in the text section, NOT in the subject header.
SUBSCRIBE SDOH yourfirstname yourlastname
To post a message to all 1000+ subscribers, send it to [log in to unmask]
Include in the Subject, its content, and location and date, if
relevant.
For a list of SDOH members, send a request to [log in to unmask]
To receive messages only once a day, send the following message to
[log in to unmask]
SET SDOH DIGEST
To view the SDOH archives, go to:
https://listserv.yorku.ca/archives/sdoh.html
-------------------
Problems/Questions? Send it to Listserv owner: [log in to unmask]
To unsubscribe, send the following message in the text section -- NOT the subject header -- to [log in to unmask]
SIGNOFF SDOH
DO NOT SEND IT BY HITTING THE REPLY BUTTON. THIS SENDS THE MESSAGE TO THE ENTIRE LISTSERV AND STILL DOES NOT REMOVE YOU.
To subscribe to the SDOH list, send the following message to [log in to unmask] in the text section, NOT in the subject header.
SUBSCRIBE SDOH yourfirstname yourlastname
To post a message to all 1000+ subscribers, send it to [log in to unmask]
Include in the Subject, its content, and location and date, if relevant.
For a list of SDOH members, send a request to [log in to unmask]
To receive messages only once a day, send the following message to [log in to unmask]
SET SDOH DIGEST
To view the SDOH archives, go to: https://listserv.yorku.ca/archives/sdoh.html
-------------------
Problems/Questions? Send it to Listserv owner: [log in to unmask]
To unsubscribe, send the following message in the text section -- NOT the subject header -- to [log in to unmask]
SIGNOFF SDOH
DO NOT SEND IT BY HITTING THE REPLY BUTTON. THIS SENDS THE MESSAGE TO THE ENTIRE LISTSERV AND STILL DOES NOT REMOVE YOU.
To subscribe to the SDOH list, send the following message to [log in to unmask] in the text section, NOT in the subject header.
SUBSCRIBE SDOH yourfirstname yourlastname
To post a message to all 1000+ subscribers, send it to [log in to unmask]
Include in the Subject, its content, and location and date, if relevant.
For a list of SDOH members, send a request to [log in to unmask]
To receive messages only once a day, send the following message to [log in to unmask]
SET SDOH DIGEST
To view the SDOH archives, go to: https://listserv.yorku.ca/archives/sdoh.html
|
