Preparación comunitaria y contextos de intervención: el caso de los trabajadores sociales de atención primaria en Andalucía (España) / Community readiness and intervention contexts: The case of primary health care social workers in Andalusia (Spain)

La preparación comunitaria hace referencia a la predisposición del contexto comunitario al cambio que conlleva una intervención social. En el presente estudio se ha evaluado la preparación comunitaria en diferentes contextos de salud. Para ello, se aplicó una escala de 18 ítems a 81 trabajadores sociales de centros de atención primaria en Andalucía. Esta escala evalúa cuatro dimensiones del concepto de preparación comunitaria: el ajuste comunitario, la participación comunitaria, la implicación de los trabajadores sociales y la implicación de otros profesionales del contexto comunitario. Mediante el análisis de conglomerados se encontraron 3 perfiles fundamentales de contextos de intervención en función de las dimensiones evaluadas: un contexto de corte comunitario, un contexto técnicoasistencial y un contexto de perfil bajo o biomédico. A partir del Modelo de Preparación Comunitaria propuesto inicialmente por Oetting et al. (1995) profundizamos en la dimensión comunitaria del concepto (AU)

Community readiness refers to the disposition to change contingent to social intervention in a community context. In this research, we have evaluated the community readiness of different health contexts. We apply an 18-item scale to 81 social workers of the primary health system in Andalusia (Spain). This scale assesses four dimensions of the community readiness concept: community adjustment, community participation, and implication of social workers and other professionals of the community context. Using Cluster Analysis, 3 key profiles of contexts of intervention were found: a community profile, a welfare profile and a biomedical profile. The results show that from the Community Readiness Model initially proposed by Oetting et al. (1995), it is possible to deepen the community dimension of that concept and use the community context in the definition of the core elements of this model (AU)

Women front and center: the opportunities of involving women in participatory health research worldwide.

Participatory research involving communities, especially women, is increasingly recognized as a valuable and scientifically sound approach to improve the relevance of a study, the accuracy of data collection and interpretation, the adherence to study procedures, and the likelihood of adopting any resulting intervention. This approach has interdisciplinary roots dating back more than half a century. Although widely used in community-based conservation and development projects worldwide, international public health research has yet to fully embrace this inclusive approach, which requires the sharing of power with research participants and a more involved relationship building process with communities. In return, the gap between publication and public action can be narrowed because ownership of the research process by an empowered community can lay the foundation for an accelerated implementation of interventions tailored to community needs and based on research results. This article draws on the professional experiences of the authors as well as published examples of international participatory health research with women. Factors critical for the success of participatory research are discussed, including attention to initial planning, early community involvement, conceptual clarity, defined community benefits, and joint interpretation of results, as well as translation to action. It includes common challenges and strategies to overcome them, such as conflict resolution and data ownership.

Early INCAP longitudinal nutrition studies at the community level.

This paper reviews the findings of early field studies of INCAP comparing the effects of vitamin B12 and animal and vegetable protein on the growth of poorly nourished schoolchildren. It also describes a 5-year community-based intervention study showing that a protein-rich supplement given to preschool children improves growth and cognition and decreases morbidity and mortality. Medical care in one village had no detectable benefits. A classical seven-year community-based detailed observational study of the infection status and growth in children from birth is also summarized.

The rise of the community-based participatory research initiative at the National Institute for Environmental Health Sciences: an historical analysis using the policy streams model.

BACKGROUND: Community-based participatory research (CBPR) is an approach to research that seeks equitable and collaborative involvement of community members and researchers in all aspects of the research process. It has moved slowly into the areas of health and public health research. In 1995, the National Institute for Environmental Health Sciences (NIEHS) launched the first research initiative at NIH specifying the use of the CBPR approach. OBJECTIVES: The purpose of this paper is to provide the historical record and to identify factors and events that led to the development of the policy creating the CBPR initiative at NIEHS. METHODS: The study used Kingdon's policy streams model as an analysis framework. The policy streams model explains that policies are developed when three "streams" (problem, policy and political) come together at a point called the policy window. Information collected from key informant interviews and document analyses were coded to the components of the policy streams model. RESULTS: The study documented factors and events in each of the three streams of the model. All these occurred about the same time to bring together the three streams, causing the opening of a policy window. This analysis demonstrates an importance of problem awareness and changes in leadership positions or ideology/mood to bring a policy option to the attention of policymakers, and the importance of a policy entrepreneur to advocate for a particular policy when the opportunity arises. CONCLUSIONS: Policy entrepreneurs should be alert for opportunities to take advantage of the open policy windows when they emerge, thereby achieving success in moving policy ideas forward.