A planning framework for community empowerment goals within health promotion
A planning framework for community empowerment goals within health promotion
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DOI：
10.1093/heapol/15.3.255
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发表时间：
2000-09-01
影响因子：
3.2
通讯作者：
Labonte, R
中科院分区：
文献类型：
--
作者：
Laverack, G;Labonte, R
健康促进往往包括"自下而上"和"自上而下"方案拟订之间的紧张关系。前者更多地与社区赋权的概念联系在一起，从特定群体或个人关注的问题开始，并将其总体权力或能力的某种改善视为重要的健康成果。后者更多地与疾病预防工作联系在一起，首先设法让特定群体或个人参与主要由卫生机构界定的问题和活动，并将特定行为的改善视为重要的健康成果。增强社区能力被视为更有工具性的手段，以达到改变健康行为的目的。这两种方法之间的矛盾并非无法解决，但这要求负责规划较传统的自上而下方案的人改变方向。本文提出了一个框架，旨在帮助规划者，实施者和评估者系统地考虑自上而下的健康促进规划中的社区赋权目标。该框架通过提出一个平行的"赋权"轨道，"解开"了更传统的、自上而下的方案周期每个阶段的健康促进紧张局势。该框架还提出了一种新的技术，评估和战略规划的9个确定的“域”，代表组织的影响，社区赋权的过程。未来的论文分析了这种评估和规划方法的设计，并讨论了在斐济农村社区实地测试的结果。
Health promotion often comprises a tension between 'bottom-up' and 'top-down' programming. The former, more associated with concepts of community empowerment, begins on issues of concern to particular groups or individuals, and regards some improvement in their overall power or capacity as the important health outcome. The latter, more associated with disease prevention efforts, begins by seeking to involve particular groups or individuals in issues and activities largely defined by health agencies, and regards improvement in particular behaviours as the important health outcome. Community empowerment is viewed more instrumentally as a means to the end of health behaviour change. The tension between these two approaches is not unresolvable, but this requires a different orientation on the part of those responsible for planning more conventional, top-down programmes. This article presents a framework intended to assist planners, implementers and evaluators to systematically consider community empowerment goals within top-down health promotion programming. The framework 'unpacks' the tensions in health promotion at each stage of the more conventional, top-down programme cycle, by presenting a parallel 'empowerment' track. The framework also presents a new technology for the assessment and strategic planning of nine identified 'domains' that represent the organizational influences on the process of community empowerment. Future papers analyze the design of this assessment and planning methodology, and discuss the findings of its field-testing in rural communities in Fiji.