scholarly journals Complexity, evaluation and the effectiveness of community-based interventions to reduce health inequalities

2009 ◽  
Vol 20 (3) ◽  
pp. 221-226 ◽  
Author(s):  
Anna Matheson ◽  
Kevin Dew ◽  
Jackie Cumming
Keyword(s):  
Health Inequalities ◽  
Community Based Interventions ◽  
Community Based

scholarly journals Complexity, Evaluation and the Effectiveness of Community-based Interventions to Reduce Health Inequalities

2020 ◽  
Author(s):  
Anna Matheson ◽  
Kevin Dew ◽  
Jacqueline Cumming
Keyword(s):  
New Zealand ◽  
Health Inequalities ◽  
Comparative Case Study ◽  
Successful Implementation ◽  
Intervention Effectiveness ◽  
Community Based Interventions ◽  
Community Based ◽  
Theoretical Understanding ◽  
System Perspective

Reducing health inequalities has been part of the New Zealand government's agenda since the early 1990s. As a result, interventions have been implemented nationally with the explicit goal of reducing health inequalities. This paper describes findings from a comparative case study of two community-based interventions - carried out in different New Zealand communities. Complexity theory was used as an analytic tool to examine the case data, and provided a systematic way in which to explore 'local' issues by taking a 'whole system' perspective. The findings showed that two important influences on the successful implementation of the interventions were the existence and capacity of local organisations and their relationships with government agencies. The analysis provided a dynamic picture of shared influences on the interventions in different communities and in doing so offered insight into intervention effectiveness. It is argued in this article that, for examining intervention effectiveness, it is essential to have a theoretical understanding of the behaviour of the complex system in which they are implemented. This theoretical understanding has implications for the appropriate design of interventions to reduce health inequalities, and in turn should lead to more meaningful ways to evaluate them.

scholarly journals Complexity, Evaluation and the Effectiveness of Community-based Interventions to Reduce Health Inequalities

2020 ◽  
Author(s):  
Anna Matheson ◽  
Kevin Dew ◽  
Jacqueline Cumming
Keyword(s):  
New Zealand ◽  
Health Inequalities ◽  
Comparative Case Study ◽  
Successful Implementation ◽  
Intervention Effectiveness ◽  
Community Based Interventions ◽  
Community Based ◽  
Theoretical Understanding ◽  
System Perspective

Reducing health inequalities has been part of the New Zealand government's agenda since the early 1990s. As a result, interventions have been implemented nationally with the explicit goal of reducing health inequalities. This paper describes findings from a comparative case study of two community-based interventions - carried out in different New Zealand communities. Complexity theory was used as an analytic tool to examine the case data, and provided a systematic way in which to explore 'local' issues by taking a 'whole system' perspective. The findings showed that two important influences on the successful implementation of the interventions were the existence and capacity of local organisations and their relationships with government agencies. The analysis provided a dynamic picture of shared influences on the interventions in different communities and in doing so offered insight into intervention effectiveness. It is argued in this article that, for examining intervention effectiveness, it is essential to have a theoretical understanding of the behaviour of the complex system in which they are implemented. This theoretical understanding has implications for the appropriate design of interventions to reduce health inequalities, and in turn should lead to more meaningful ways to evaluate them.

scholarly journals Do multiple community-based interventions on health promotion tackle health inequalities?

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Stefan Nickel ◽  
Olaf von dem Knesebeck
Keyword(s):  
Health Promotion ◽  
Health Inequalities ◽  
Economic Status ◽  
Research Question ◽  
Smoking Behavior ◽  
Component Community ◽  
Community Based Interventions ◽  
Community Based ◽  
Wide Range ◽  
The Impact

Abstract Background Previous systematic reviews of the impact of multi-component community-based health promotion interventions on reducing health inequalities by socio-economic status (SES) were restricted to physical activity and smoking behavior, and revealed limited and rather disillusioning evidence. Therefore, we conducted a comprehensive review worldwide to close this gap, including a wide range of health outcomes. Methods The Pubmed and PsycINFO databases were screened for relevant articles published between January 1999 and August 2019, revealing 87 potentially eligible publications out of 2876 hits. In addition, three studies out of a prior review on the effectiveness of community-based interventions were reanalyzed under the new research question. After a systematic review process, 23 papers met the inclusion criteria and were included in the synthesis. Results More than half (56.5%) of the studies reported improvements of socially disadvantaged communities overall (i.e. reduced inequalities at the area level) in at least one health behavior and/or health status outcome. Amongst the remaining studies we found some beneficial effects in the most deprived sub-groups of residents (8.2%) and studies with no differences between intervention and control areas (34.8%). There was no evidence that any program under review resulted in an increase in health disparity. Conclusions Our results confirm that community-based interventions may be reducing absolute health inequalities of deprived and disadvantaged populations, but their potential so far is not fully realized. For the future, greater attention should be paid to inequalities between sub-groups within communities when analyzing changes in health inequality over time.

Community-Based Interventions to Reduce Child Maltreatment

2021 ◽  
pp. 104973152098696
Author(s):  
Camilla Kin-Ming Lo ◽  
Yuet Wing Cho
Keyword(s):  
Child Maltreatment ◽  
Hybrid Approach ◽  
Inclusion Criteria ◽  
Community Members ◽  
Protective Services ◽  
Community Based Interventions ◽  
Community Based ◽  
Community Institutions ◽  
Core Components ◽  
Further Development

Purpose: This review seeks to summarize selected literature on existing findings on the impacts of community-based interventions on the actual reduction of child maltreatment and to identify the core components of the interventions. Methods: This study systematically searched electronic databases, including PsycInfo, Medline, and Web of Science. The findings of the selected studies were summarized using narrative synthesis. Results: A total of four studies met the inclusion criteria of this study. The studies showed declines in child maltreatment incidences reported by child protective services and hospitals during the study periods. Four major components and approaches were identified among the selected interventions, including (1) the involvement of community members, (2) partnerships with community institutions, (3) multidisciplinary collaboration, and (4) responsiveness to the needs of the communities involved. Conclusions: The results of this review support the need for further development of community-based interventions using a hybrid approach.

scholarly journals Homeless on Main Street: Using Photovoice to Highlight Older Adults Among the Hidden Homeless

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 728-728
Author(s):  
H Shellae Versey
Keyword(s):  
Older Adults ◽  
Rural Areas ◽  
Meaning Making ◽  
Small Towns ◽  
Photo Elicitation ◽  
Service Agency ◽  
Structured Interviews ◽  
Community Based Interventions ◽  
Community Based ◽  
Formerly Homeless

Abstract Homelessness is a reality for a growing number of Americans living in small towns and rural areas. However, unlike in cities, housing instability may be less visible. Using a photo-elicitation method (i.e., Photovoice), this study explores the meaning of place and obscured visibility to currently and formerly homeless older adults living in a small town in central Connecticut. Participants (N = 27) were recruited from a local service agency, given cameras and asked to photograph areas around town that were meaningful to them. Photographs were developed and followed by in-person, semi-structured interviews with participants in which photos and experiences during the project were discussed. Primary themes included belonging, generativity, social isolation, and place-making as meaning-making. The study culminated in a community photography exhibition in which photographs from the project were displayed in public spaces around town. Implications for community-based interventions to reach homeless groups in rural areas are discussed. Part of a symposium sponsored by the Qualitative Research Interest Group.

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