18. Planning a Community Health Program

Question 1

Planning in Partnership With the Community

Answer 1

• Review diagnoses
• Categorize according to population most affected
• Validate diagnoses with community members
• Acknowledge rights of community leaders and members to confidentiality and to choose not to participate

Question 2

Considerations Implied by Partnership

Answer 2

• Community’s particular social structure
• Normative behaviours and value system
• Potential conflict between values of community health worker and community
• Need to validate diagnosis with community
• Commit to empowerment, participation, inclusion, and self-determination

Question 3

The community health worker (CHW) forms a partnership in the community. In addition to the partnership, the CHW must consider the influences of the community’s issues. Which of these does not apply?
- Entertainment issues
- Economic issues
- Social issues
- Environmental issues
- Political issues

Answer 3

A. Entertainment issues

In addition to forming a partnership with the community, the community health worker must consider the influences of social, economic, environmental, and political issues.

Question 4

Prioritizing Community Diagnoses

Answer 4

• Magnitude of concern expressed by members of the community
• Extent of existing resources to deal with the concern (e.g., knowledge, time, money, equipment, supplies, facilities, personnel)
• Potential for success in solving the problem with existing resources
• Need for special education or training
• Extent of additional resources and policies needed for equitable, cost-effective, and efficient response

Question 5

Transtheoretical Model of Change

Answer 5

Stages of change
Precontemplation
Contemplation
Preparation
Action
Maintenance
Termination

Question 6

Lewin’s Stages of Planned Change

Answer 6

Unfreezing
Identify a need for change

Moving Process
Presence of change agent
Identify of problems
Consider alternatives
Adapt plan to circumstances

Refreezing
Implementation and Stabilization

Question 7

Reinkemeyer’s Stages of change

Answer 7

• Development of a felt need and desire for the change
• Development of a change relationship between the agent and the client system
• Clarification or diagnosis of the client system’s problem, need, or objective
• Examination of alternative routes and tentative goals and intentions of actions
• Transformation of intentions into actual change
• Stabilization
• Termination of the relationship between the change agent and the client system

Question 8

According to Kurt Lewin, the change actually occurs in which of the following stages?
Freezing
Refreezing
Educating
Moving
Unfreezing

Answer 8

D. Moving

In the moving stage, the change actually occurs. The problem is clarified, and the program for solving the problem is planned in detail and begun.

Question 9

Program Logic Model

Answer 9

A diagrammatic representation of a program
Program—an organized set of activities intended to meet specific goals and objectives (outcomes)

What you are trying to accomplish
What you want to do
Actions (Components)
Services or procedures
Change, improvements, or benefits
Evidence, proof, or information showing progress and attainment of outcomes

Question 10

When the focus of an intervention is a group, people in the group fall into five categories

Answer 10

Innovators
Early adopters
Early majority adopters
Late majority adopters
Laggards

Question 11

Program Activities

Answer 11

Have a program goal then change it into bite size pieces
Map out the actions necessary to deliver the program and thereby reach the goal(s)

Question 12

Program Objectives

Answer 12

Derived from a goal
Are S.M.A.R.T.
May be process or outcome oriented

Question 13

Constraints Constraints

Answer 13

can limit task achievement
Difference between needs and resources
Lack of staff, budget, space, equipment
Resistance to change
Must revise plans to take constraints into account

Question 14

Is the following statement True or False?
This is an example of appropriate program objectives:
The community will:
Demonstrate engaged participation
Understand the Canadian community-as-partner model
Explain the purposes of community assessment
Write a summary statement about the population

Answer 14

False

These are not appropriate program objectives because none of these objectives are S.M.A.R.T. (specific, measurable, attainable, relevant, timebound).

Question 15

Promoting Community Ownership

Answer 15

Community ownership moves beyond partnership and collaboration.
Meaningful participation in all the previous stages then responsibility during implementation is necessary

Question 16

primordial prevention, primary prevention, secondary prevention, tertiary prevention

Answer 16

primordial prevention – address far upstream factors that prevent stressors from forming (health promotion programs)

primary prevention – improve the health and wellbeing of community making it less vulnerable stressors (health promotion programs)

secondary prevention– begin after a disease/condition present. Emphasis on screening, detection, early diagnosis, treatment of possible stressors that adversely affect com health. (flexible lines of defense against stressors, temporary measures to help during times of stress)

tertiary prevention– focus on restoration and rehabilitation and acts to return community to optimal functioning