COMMUNITY HEALTH SETTING

Levels of Intervention used in the Community Health Setting

Levels of Intervention used in the Community Health Setting

Introduction

The term community-based may also have a very different meaning, that of the community serving as the target of change [1]. The community as target refers to the goal of creating healthy community environments through broad systemic changes in public policy and community-wide institutions and services. As setting, the community is primarily defined geographically and is the location in which interventions are implemented. Such interventions may be citywide, using mass media or other approaches, or may take place within community institutions, such as neighborhoods, schools, churches, work sites, voluntary agencies, or other organizations. Various levels of intervention may be employed, including educational or other strategies that involve individuals, families, social networks, organizations, and public policy. These community-based interventions may also engage community input through advisory committees or community coalitions that assist in tailoring interventions to specific target groups or to adapt programs to community characteristics. However, the focus of these community-based projects is primarily on changing individuals' behaviors as a method for reducing the population's risk of disease. As a result, the target of change may be populations, but population change is defined as the aggregate of individual changes.

Public health interventions are population-based if they consider all levels of practice. This concept is represented by the inner three rings of the model. The inner rings of the model are labeled community focused, systems-focused, and individual/family-focused. A population-based approach considers intervening at all possible levels of practice. Interventions may be directed at the entire population within a community, the systems that affect the health of those populations, and/or the individuals and families within those populations known to be at risk.

Community-level practice

Changes community norms, community attitudes, community awareness, community practices, and community behaviors. They are directed toward entire populations within the community or occasionally toward target groups within those populations. Community-focused practice is measured in terms of what proportion of the population actually changes[2].

Community-level interventions are multi-component interventions that generally combine individual and environmental change strategies across multiple settings to prevent dysfunction and promote well-being among population groups in a defined local community. For example, a community-level intervention for tobacco control might combine a school curriculum for youth to prevent initiation of smoking and a media campaign aimed at reducing parental smoking in the presence of youth (individual change strategies) with policy change efforts advocating a municipal smoking ban for restaurants and increased enforcement of ordinances prohibiting youth access to tobacco.

Community Level Intervention combines community organization and social marketing - a strategy that takes a systems approach. Its foundation is an assumption that individuals make up large and small social networks or systems. Within these social networks or systems, individuals acquire information, form attitudes, and develop beliefs. Also, within these networks, individuals acquire skills and practice behaviors.

The goal of community-level practice is to increase the knowledge and attitude of the entire community about the importance of immunization and the consequences of ...