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Community Member and Stakeholder Perspectives on a Healthy Environment Initiative in North Carolina.

Carter-Edwards L, Lowe-Wilson A, Mouw MS, Jeon JY, Baber CR, Vu MB, Bethell M - Prev Chronic Dis (2015)

Bottom Line: Evaluations of the PE sessions and key informant interviews indicated that access (convenience, cost, safety, and awareness of products and services) and community fit (community-defined quality, safety, values, and norms) were important constructs across the strategies.Both community fit and access are essential constructs for promoting health equity.Findings demonstrate the feasibility of and need for formative research that engages community members and local stakeholders to shape context-specific, culturally relevant health promotion strategies.

View Article: PubMed Central - PubMed

Affiliation: Public Health Leadership Program, Gillings School of Global Public Health, 4111 McGavran-Greenberg Hall, University of North Carolina at Chapel Hill, CB no. 7469, Chapel Hill, NC 27599-7469. Email: lori_carter-edwards@unc.edu. Dr Carter-Edwards is also affiliated with the Department of Health Behavior and the UNC Center for Health Promotion and Disease Prevention at the University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.

ABSTRACT

Introduction: The North Carolina Community Transformation Grant Project (NC-CTG) aimed to implement policy, system, and environmental strategies to promote healthy eating, active living, tobacco-free living, and clinical and community preventive services to advance health equity and reduce health disparities for the state's most vulnerable communities. This article presents findings from the Health Equity Collaborative Evaluation and Implementation Project, which assessed community and stakeholder perceptions of health equity for 3 NC-CTG strategies: farmers markets, shared use, and smoke-free multiunit housing.

Methods: In a triangulated qualitative evaluation, 6 photo elicitation (PE) sessions among 45 community members in 1 urban and 3 rural counties and key informant interviews among 22 stakeholders were conducted. Nine participants from the PE sessions and key informant interviews in the urban county subsequently participated in a stakeholder power analysis and mapping session (SPA) to discuss and identify people and organizations in their community perceived to be influential in addressing health equity-related issues.

Results: Evaluations of the PE sessions and key informant interviews indicated that access (convenience, cost, safety, and awareness of products and services) and community fit (community-defined quality, safety, values, and norms) were important constructs across the strategies. The SPA identified specific community- and faith-based organizations, health care organizations, and local government agencies as key stakeholders for future efforts.

Conclusions: Both community fit and access are essential constructs for promoting health equity. Findings demonstrate the feasibility of and need for formative research that engages community members and local stakeholders to shape context-specific, culturally relevant health promotion strategies.

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Related in: MedlinePlus

Conceptual model of health equity through contextual perceptions of community members and other stakeholders.
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Related In: Results  -  Collection


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Figure 1: Conceptual model of health equity through contextual perceptions of community members and other stakeholders.

Mentions: Multiple factors influenced PE participants’ perspectives on the 3 NC-CTG strategies (Table 2). Both rural and urban participants individually discussed safety, cost, quality, convenience, values, perceived norms, and awareness. When viewed collectively, 2 broader community-level themes emerged: access and community fit. Access referred to how easy or difficult it was for groups or communities to be connected to or use resources related to a NC-CTG strategy. Community fit was the collective acceptability or desirability of a strategy for community members. If an implemented strategy was deemed inconvenient for many respondents, it was viewed as an access issue. Likewise, community fit was shaped by commonly shared, individual-level factors such as values, perceived norms, knowledge, and safety. Unequal levels of access or community fit influenced the perceived health equity impact of a strategy (Figure).


Community Member and Stakeholder Perspectives on a Healthy Environment Initiative in North Carolina.

Carter-Edwards L, Lowe-Wilson A, Mouw MS, Jeon JY, Baber CR, Vu MB, Bethell M - Prev Chronic Dis (2015)

Conceptual model of health equity through contextual perceptions of community members and other stakeholders.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4552138&req=5

Figure 1: Conceptual model of health equity through contextual perceptions of community members and other stakeholders.
Mentions: Multiple factors influenced PE participants’ perspectives on the 3 NC-CTG strategies (Table 2). Both rural and urban participants individually discussed safety, cost, quality, convenience, values, perceived norms, and awareness. When viewed collectively, 2 broader community-level themes emerged: access and community fit. Access referred to how easy or difficult it was for groups or communities to be connected to or use resources related to a NC-CTG strategy. Community fit was the collective acceptability or desirability of a strategy for community members. If an implemented strategy was deemed inconvenient for many respondents, it was viewed as an access issue. Likewise, community fit was shaped by commonly shared, individual-level factors such as values, perceived norms, knowledge, and safety. Unequal levels of access or community fit influenced the perceived health equity impact of a strategy (Figure).

Bottom Line: Evaluations of the PE sessions and key informant interviews indicated that access (convenience, cost, safety, and awareness of products and services) and community fit (community-defined quality, safety, values, and norms) were important constructs across the strategies.Both community fit and access are essential constructs for promoting health equity.Findings demonstrate the feasibility of and need for formative research that engages community members and local stakeholders to shape context-specific, culturally relevant health promotion strategies.

View Article: PubMed Central - PubMed

Affiliation: Public Health Leadership Program, Gillings School of Global Public Health, 4111 McGavran-Greenberg Hall, University of North Carolina at Chapel Hill, CB no. 7469, Chapel Hill, NC 27599-7469. Email: lori_carter-edwards@unc.edu. Dr Carter-Edwards is also affiliated with the Department of Health Behavior and the UNC Center for Health Promotion and Disease Prevention at the University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.

ABSTRACT

Introduction: The North Carolina Community Transformation Grant Project (NC-CTG) aimed to implement policy, system, and environmental strategies to promote healthy eating, active living, tobacco-free living, and clinical and community preventive services to advance health equity and reduce health disparities for the state's most vulnerable communities. This article presents findings from the Health Equity Collaborative Evaluation and Implementation Project, which assessed community and stakeholder perceptions of health equity for 3 NC-CTG strategies: farmers markets, shared use, and smoke-free multiunit housing.

Methods: In a triangulated qualitative evaluation, 6 photo elicitation (PE) sessions among 45 community members in 1 urban and 3 rural counties and key informant interviews among 22 stakeholders were conducted. Nine participants from the PE sessions and key informant interviews in the urban county subsequently participated in a stakeholder power analysis and mapping session (SPA) to discuss and identify people and organizations in their community perceived to be influential in addressing health equity-related issues.

Results: Evaluations of the PE sessions and key informant interviews indicated that access (convenience, cost, safety, and awareness of products and services) and community fit (community-defined quality, safety, values, and norms) were important constructs across the strategies. The SPA identified specific community- and faith-based organizations, health care organizations, and local government agencies as key stakeholders for future efforts.

Conclusions: Both community fit and access are essential constructs for promoting health equity. Findings demonstrate the feasibility of and need for formative research that engages community members and local stakeholders to shape context-specific, culturally relevant health promotion strategies.

Show MeSH
Related in: MedlinePlus