Exploring the effects of government funding on community-based organizations: ‘top-down’ or ‘bottom-up’ approaches to health promotion?

2009 ◽  
Vol 16 (3) ◽  
pp. 45-52 ◽  
Author(s):  
Gemma E. Carey ◽  
Annette J. Braunack-Mayer
2019 ◽  
Vol 10 (7) ◽  
pp. 585-605
Author(s):  
Terrence Thomas ◽  
◽  
Befikadu Legesse ◽  
Cihat Gunden ◽  
◽  
...  

The failure of top-down categorical approaches for generating solutions to many local problems has led to the adoption of alternate approaches. Many scholars believe that a confluence of local and global forces have generated complex problems, which call for new approaches to problem solving. Previously, the top-down approach relied entirely on the knowledgeable elite. Communities were seen as passive study subjects and information flow was one way only- from knowledgeable elites to the less knowledgeable community agents or community-based organization acting on behalf of communities. The objectives of this study are to provide a review of governance as a means of organizing community action to address community problems in the Black Belt Region (BBR) of the Southeastern United States, and an assessment of community problems in the BBR from the perspectives of community-based organizations (CBOs). Data was collected from CBOs via a telephone survey in eleven Southeastern states and via listening sessions conducted with CBOs in 9 Southeastern states. The study provides valuable insight regarding the challenges faced by these organizations and strategies they employ in adapting to serve their communities.


Medical Care ◽  
2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Amanda L. Brewster ◽  
Traci L. Wilson ◽  
Leslie A. Curry ◽  
Suzanne R. Kunkel

Author(s):  
Sacha R.B. Verjans-Janssen ◽  
Sanne M.P.L. Gerards ◽  
Anke H. Verhees ◽  
Stef P.J. Kremers ◽  
Steven B. Vos ◽  
...  

School health promotion is advocated. Implementation studies on school health promotion are less often conducted as effectiveness studies and are mainly conducted conventionally by assessing fidelity of “one size fits all” interventions. However, interventions that allow for local adaptation are more appropriate and require a different evaluation approach. We evaluated a mutual adaptation physical activity and nutrition intervention implemented in eight primary schools located in low socioeconomic neighborhoods in the Netherlands, namely the KEIGAAF intervention. A qualitative, multiple-case study design was used to evaluate implementation and contextual factors affecting implementation. We used several qualitative data collection tools and applied inductive content analysis for coding the transcribed data. Codes were linked to the domains of the Consolidated Framework for Implementation Research. NVivo was used to support data analysis. The implementation process varied greatly across schools. This was due to the high level of bottom-up design of the intervention and differing contextual factors influencing implementation, such as differing starting situations. The mutual adaptation between top-down and bottom-up influences was a key element of the intervention. Feedback loops and the health promotion advisors played a crucial role by navigating between top-down and bottom-up. Implementing a mutual adaptation intervention is time-consuming but feasible.


1999 ◽  
Vol 26 (2) ◽  
pp. 250-265 ◽  
Author(s):  
Gary W. Harper ◽  
Lisa J. Carver

Forming collaborations between university-based researchers and community-based organizations (CBOs) serves to improve health promotion research and service. Unfortunately, members of the targeted populations are typically not included in such collaborations. This article describes the development and maintenance of a successful university-CBO collaboration that was formed to explore HIV-related risk rates and prevention strategies for suburban street youth and discusses the benefits and challenges of including out-of-the-mainstream youth as full collaborative partners in the research. Specific benefits included population-specific modifications of the research methods and instruments, recruitment of hard-to-reach youth, greater ease in tracking participants, and increased project acceptability and credibility. Among the challenges were issues related to boundaries, confidentiality, commitment, and burnout. Although such collaborations require increased time and commitment, the synergistic knowledge and experience of university researchers, community-based service providers, and out-of-the-mainstream youth can result in the development of unique and informative research and service programs.


2011 ◽  
Vol 13 (4) ◽  
pp. 544-552 ◽  
Author(s):  
Christopher M. Fisher ◽  
Michael Reece ◽  
Eric Wright ◽  
Brian Dodge ◽  
Catherine Sherwood-Laughlin ◽  
...  

2021 ◽  
pp. 175797592110513
Author(s):  
Laura E. R. Peters ◽  
Geordan Shannon ◽  
Ilan Kelman ◽  
Eija Meriläinen

Communities are powerful and necessary agents for defining and pursuing their health, but outside organizations often adopt community health promotion approaches that are patronizing and top-down. Conversely, bottom-up approaches that build on and mobilize community health assets are often critiqued for tasking the most vulnerable and marginalized communities to use their own limited resources without real opportunities for change. Taking into consideration these community health promotion shortcomings, this article asks how communities may be most effectively and appropriately supported in pursuing their health. This article reviews how community health is understood, moving from negative to positive conceptualizations; how it is determined, moving from a risk-factor orientation to social determination; and how it is promoted, moving from top-down to bottom-up approaches. Building on these understandings, we offer the concept of ‘resourcefulness’ as an approach to strengthen positive health for communities, and we discuss how it engages with three interrelated tensions in community health promotion: resources and sustainability, interdependence and autonomy, and community diversity and inclusion. We make practical suggestions for outside organizations to apply resourcefulness as a process-based, place-based, and relational approach to community health promotion, arguing that resourcefulness can forge new pathways to sustainable and self-sustaining community positive health.


2020 ◽  
Vol 14 (1) ◽  
pp. 122-141
Author(s):  
Anne Dirnstorfer ◽  
Nar Bahadur Saud

Abstract The article explores the potential of theatre art in transitional justice, particularly in the field of reconciliation and healing. Presenting the context of reconciliation in Nepal 10 years after the end of the armed conflict, the authors argue for complementary processes of top-down and community-based, bottom-up approaches by introducing the concept of ‘theatre-facilitated dialogue’ as a way to strategically integrate Playback Theatre in peacebuilding. Analyzing the project ‘EnActing Dialogue,’ the article elaborates on the learnings from theatre-facilitated dialogue work in communities where ex-combatants of the Nepali People’s Liberation Army have settled. Based on the theoretical overview of secondary resources, the authors’ participatory observations, on informal interviews and quantitative data, the study explores how artistically enacted storytelling supports bottom-up reconciliation. By staging a noncognitive dialogue through storytelling, music and theatre, Playback Theatre contributes to the deconstruction of war-related identities, an understanding of root causes, as well as personal healing and relationship building at community level.


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