Health Action Zones and the problem of community

Crawshaw, Paul; Bunton, Robin; Gillen, Kate

doi:10.1046/j.1365-2524.2003.00397.x

Cited by 28 publications

(18 citation statements)

References 20 publications

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“…The problematic and nebulous nature of the term ‘community’ has been widely discussed in the literature (Jewkes & Murcott 1996, 1998, Crawshaw et al . 2003), and will not be analysed further here.…”

Section: Assessing Strategies To Achieve Cultural Sensitivity and To mentioning

confidence: 99%

Preventing stroke: a narrative review of community interventions for improving hypertension control in black adults

Connell

Wolfe

McKevitt

2007

Health &Amp; Social Care in the Community

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Incidence rates for stroke and hypertension are higher in black ethnic groups of African descent in the USA and UK than in white groups, suggesting a need for targeted intervention. We conduct a narrative review of published research evidence on community interventions to manage hypertension among black ethnic groups, and explore the concept of cultural sensitivity in these interventions. Data sources comprised computer-aided searches of published studies over the years 1981 to March 2006, on community strategies for improving hypertension control targeting black groups, and further references from these articles. Twenty-seven relevant studies were identified. Health education was associated with improvements in knowledge about hypertension, while education combined with individualised support for patients to self-manage hypertension, including goal setting and monitoring to enhance patient self-management of hypertension, and family support in managing hypertension were associated with reductions in blood pressure levels and improvements in blood pressure control. Collaboration with black communities, using local or minority ethnic staff, conducting preliminary research with target groups to investigate perceptions and canvass ideas for the intervention design were common methods assumed to achieve cultural sensitivity. Studies, however, provided insufficient robust evidence of the effectiveness of these strategies in terms of quantifiable outcomes, although this criterion is contested, with social justice arguments being offered instead. Implicit assumptions about homogeneity and shared interests within the 'community', and representation of 'community' views have implications for the effectiveness of interventions. These findings highlight areas for the future development of interventions to reduce hypertension rates in black groups, and factors that need to be robustly investigated and explicitly addressed in intervention design.

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Section: Assessing Strategies To Achieve Cultural Sensitivity and To mentioning

confidence: 99%

Preventing stroke: a narrative review of community interventions for improving hypertension control in black adults

Connell

Wolfe

McKevitt

2007

Health &Amp; Social Care in the Community

View full text Add to dashboard Cite

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“…Because communities are not homogenous, it can be challenging, however, to engage different groups in the community and especially the groups that needs the intervention the most (Crawshaw, Bunton, & Gillen, ). Moreover, residents may have different identity practices in different areas of their lives.…”

Section: Discussionmentioning

confidence: 99%

An explorative evaluation study of the mechanisms underlying a community-based fitness centre in Denmark - Why do residents participate and keep up the healthy activities?

Rasmussen

Overgaard

Bøggild

et al. 2018

Health Soc Care Community

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Health-risk behaviour like physical inactivity is more evident in deprived neighbourhoods than in nondeprived neighbourhoods, and in the former knowledge is lacking as to what causes effects in interventions on physical activity. A possible contribution to physical activity interventions is community engagement, which has been shown to be effective for changing health-risk behaviour, but more knowledge is needed on "the active ingredients" or mechanisms that make interventions work. The aim of this study was to give more insight into the possible mechanisms within an intervention on physical activity using community engagement. The study applied a theory-based evaluation approach using theory of change to uncover the underlying mechanisms of a community-based fitness centre in a deprived Danish neighbourhood. Data were gathered from documents about the intervention, semistructured interviews with three front-line workers on the intervention and ten residents participating in the centre as either volunteer instructors or members. The following mechanisms of the intervention to improve participation and health were anticipated by the front-line workers; the creation of meaningful communities through social interaction, the presence of relatable role models, residents taking responsibility and feeling co-ownership and the experience of being of value as an instructor. Interviews with members and volunteer instructors showed that the anticipated mechanisms did facilitate participation and improved health; however, with some individual variations and with the physical and mental benefits of the particular activities also functioning as mechanisms for participation and engagement. Furthermore, the study found potential unintended consequences related to engagement, such as difficulties in balancing the needs of others with own needs. Findings indicate that both the social aspect and the activities should be prioritised, as should a continued focus on the inclusion of different residents in the area. Furthermore, unintended consequences should be considered and prevented through support for volunteering residents.

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“…10 Dental disease is a very strongly socio-economically linked disease cluster. The socioeconomically disadvantaged suffer far greater burdens of disease than the more affluent members of society (this is true across many societies).…”

Section: Discussionmentioning

confidence: 99%

Travel patterns for government emergency dental care in Australia: a new approach using GIS tools

Mcguire¹,

Kruger

Tennant

2011

Australian Dental Journal

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Background: Government subsidized dental care is provided as a community safety-net to complement the private dental sector. The aim of this study was to detail the geographic catchment characteristics of three outer metropolitan government dental clinics. Methods: Three outer metropolitan dental clinics with the greatest number of geocoded triage patients were selected for the study. In total these three facilities had 5742 patients over the 12-week period with 2010 at clinic A, 1278 at clinic B and 2454 at clinic C. Cumulative proportions of patients' residential address locations at distances were calculated; there was close correlation between the three clinics. A best fit curve with a correlation coefficient of 0.998 was developed. Results: In summary, approximately 50% of patients were within 6 km of the clinic and 75% were within 10 km. Conclusions: This study has critical outcomes for the planning of future services in developing a network model for care. The data presented will assist in the development of more evidence-based approaches to planning new service network structures.

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Health Action Zones and the problem of community

Cited by 28 publications

References 20 publications

Preventing stroke: a narrative review of community interventions for improving hypertension control in black adults

Preventing stroke: a narrative review of community interventions for improving hypertension control in black adults

An explorative evaluation study of the mechanisms underlying a community-based fitness centre in Denmark - Why do residents participate and keep up the healthy activities?

Travel patterns for government emergency dental care in Australia: a new approach using GIS tools

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