This study assessed changes in community members’ ratings of the dimensions of individual community related empowerment (ICRE) before and two years after the implementation of an empowerment expansion framework in three community health promotion initiatives within the Estonian context. We employed a self-administered questionnaire, the adapted mobilisation scale–individual. As the first step, we investigated the multidimensional nature of the ICRE construct and explored the validity and reliability (internal consistency) of the ICRE scale. Two datasets were used. The first dataset comprised a cross-sectional random sample of 1,000 inhabitants of Rapla County selected in 2003 from the National Population Register, which was used to confirm the composition of the dimensions of the scale and to examine the reliability of the dimensions. The second dataset comprised two waves of data: 120 participants from three health promotion programs in 2003 (pre-test) and 115 participants in 2005 (post-test), and the dataset was used to compare participants’ pre-test and post-test ratings of their levels of empowerment. The content validity ratio, determined using Lawshe’s formula, was high (0.98). Five dimensions of ICRE, self-efficacy, intention, participation, motivation and critical awareness, emerged from the factor analysis. The internal consistency (α) of the total empowerment scale was 0.86 (subscales self-efficacy α = 0.88, intention α = 0.83, participation α = 0.81 and motivation α = 0.69; critical awareness comprised only one item). The levels of ICRE dimensions measured after the application of the empowerment expansion framework were significantly more favourable for the dimensions self-efficacy, participation, intention and motivation to participate. We conclude that for Rapla community workgroups and networks, their ICRE was rendered more favourable after the implementation of the empowerment expansion framework.
The importance of community empowerment has been strongly emphasized in health promotion publications in Western societies. Only a few studies exist to highlight the empowerment processes in countries in transition in Eastern Europe. A multi-stage study was designed to develop a context-specific survey instrument appropriate for evaluating the changes in the community empowerment process within the context of health promotion programs in Rapla, Estonia. The current study comprises the first stage, which aims to identify and systematize empowering domains and activities perceived by community members during the empowerment evaluation process. Semi-structured interviews were undertaken with sixteen participants from three health promotion programs. Purposive sampling was used, and data were analyzed using constant comparison. The findings suggest that there are four key organizational domains that characterize the community empowerment process in Rapla: activation of the community, competence development of the community, program management development, and creation of a supportive environment
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