K E Y W O R D S:intravaginal digital palpation; levator hiatal parameter; pelvic floor muscle contraction; polar coordinate system; stress urinary incontinence
ABSTRACT
Community problem solving is believed to help coalitions achieve community changes and subsequent population‐level reductions in targeted community health problems. This study empirically examined a community problem solving model used by CADCA, a national coalition training organization, to determine if the model explains how coalitions become effective community change agents and the extent to which it fits for different types of coalitions. The sample consisted of 551 substance abuse coalitions, and SEM was used to test the research questions. Results suggest the overall conceptual model fits the data and provides an adequate representation of the community problem solving process for coalitions. Additionally multi‐group modeling indicates the model fits for a variety of coalitions. CADCA's model appears to have wide utility and applicability and appears to have honed in on critical elements of community problem solving that may increase the likelihood of coalition success at reducing substance abuse within their community.
Excessive alcohol use causes approximately 80,000 deaths in the United States each year. The Guide to Community Preventive Services recommends reducing the density of alcohol outlets — the number of physical locations in which alcoholic beverages are available for purchase either per area or per population — through the use of regulatory authority as an effective strategy for reducing excessive alcohol consumption and related harms.We briefly review the research on density of alcohol outlets and public health and describe the powers localities have to influence alcohol outlet density. We summarize Regulating Alcohol Outlet Density: An Action Guide, which describes steps that local communities can take to reduce outlet density and the key competencies and resources of state and local health departments. These include expertise in public health surveillance and evaluation methods, identification and tracking of outcome measures, geographic information systems (GIS) mapping, community planning and development of multisector efforts, and education of community leaders and policy makers. We illustrate the potential for partnerships between public health agencies and local communities by presenting a contemporary case study from Omaha, Nebraska.Public health agencies have a vital and necessary role to play in efforts to reduce alcohol outlet density. They are often unaware of the potential of this strategy and have strong potential partners in the thousands of community coalitions nationwide that are focused on reducing alcohol-related problems.
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