The prevailing emphasis in health education is on understanding and changing life-style choices and individual health behaviors related to health status. Although such approaches are appropriate for some health problems, they often ignore the association between increased morbidity and mortality and social, structural, and physical factors in the environment, such as inadequate housing, poor sanitation, unemployment, exposure to toxic chemicals, occupational stress, minority status, powerlessness or alienation, and the lack of supportive interpersonal relationships. A conceptual model of the stress process incorporates the relationships among these environmental factors, powerlessness (or conversely empowerment), social support, and health status. The concept of empowerment has been examined in diverse academic disciplines and professional fields. However, there is still a lack of clarity on the conceptualization of empowerment at different levels of practice, including its measurement, relationship to health, and application to health education. The purpose of this article is to address these issues as they relate to the concept of community empowerment. It provides a definition of community empowerment that includes individual, organizational, and community levels of analysis; describes how empowerment fits within a broader conceptual model of stress and its relationship to health status; and examines a series of scales that measure perceptions of individual, organizational, community, and multiple levels of control. The article concludes with broad guidelines for and barriers to a community empowerment approach for health education practice.
Developed empowerment theory and replicated previous research on citizen participation and perceived control. Few investigators have designed studies that specifically test empowerment theory. This research further extends a theoretical model of psychological empowerment that includes intrapersonal, interactional, and behavioral components, by studying a large randomly selected urban and suburban community sample and examining race differences. Results suggest that one underlying dimension that combines different measures of perceived control may be interpreted as the intrapersonal component of psychological empowerment, because it distinguishes groups defined by their level of participation in community organizations and activities (behavioral component). The association found between the intrapersonal and behavioral components is consistent with empowerment theory. Interaction effects between race groups and participation suggest that participation may be more strongly associated with the intrapersonal component of psychological empowerment for African Americans than for white individuals. Implications for empowerment theory and intervention design are discussed.
There has been increasing interest in the development of a conceptual framework and operationalization of empowerment that explores the relationships among different levels of analysis: individual, organizational and community. In this article we discuss a multi-level conceptualization of empowerment, examine empirical suppcjrt for linking the different levels of analysis, and describe a measurement instrument developed to assess perceived control at the individual, organizational and community levels. We then present results of a series of multiple regression analyses which examine correlates of perceived control, a partial measure of empowerment, at these three levels. Participation in organizations which attempt to influence public policy, taking an active or leadership role in a voluntary organization, and belief that taking action is an effective means to influence community decisions are important predictors of perceived control at the organizational and community levels. Limitations of the study and implications for practice are discussed.Ann Arbor, MI, 48109. Gutierrez, Lorraine. (1989). Ethnic consciousness, consciousness raising and the empowerment process of Latinos. Unpublished doctoral dissertation.
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