Prevention Programs and Community Mobilization Essay

Community mobilization engages all sectors of the population in a communitywide effort to address a health, social, or environmental issue. The process involves bringing together policymakers and opinion leaders; local, state, and federal governments; professional groups; religious groups; businesses; and individual community members. The goal of community mobilization is to empower individuals and groups to take some kind of action to facilitate change. The desired action can be generated as a part of the community process or may represent a predetermined policy or program. Part of the process includes mobilizing necessary resources, disseminating information, generating support, and fostering cooperation across public and private sectors in the community.

Community mobilization involves the following: working through coalitions, ensuring that community assessments drive policy and program support, engaging community representatives to ensure research and researchers are responsive to community needs and utilize methods that develop community capacity, engaging the media in effectively positioning a topic and presenting a forum for discussion of related issues, and evaluating outcomes to ensure community needs are met. Organizing is described in many ways, but typically it includes identifying, recruiting, and developing leadership; creating partnerships to enable action that is coordinated; working with community members to interpret why and how they should act to change their world; motivating action and challenging people to take the responsibility to act; and working through campaigns.

Community mobilization is based on empowerment theory and uses strategies to develop and sustain multilevel approaches. These approaches help the community understand the relationship between individuals, an organized group process, and social change outcomes. Models of community mobilizations may reflect community empowerment, defined as a shift toward greater equality in the social relations of power (who has resources, authority, legitimacy, or influence), or may be more specific to advancing specific policy or program objectives. These models can simply be described as bottom-up or top-down. Bottom-up represents strategies that are designed and implemented by community members; bottom-down represents approaches in which experts or self-selected community leaders establish goals and parameters for a policy or program and engage the community in achieving those.

Each approach has strengths and weaknesses. The assumption made in a bottom-up approach is that community-initiated action is essential for any prevention program to succeed. Thus, this approach involves the community in prevention efforts to more accurately reflect community needs, priorities, and cultural diversity. This approach, when involving a wide spectrum of community members and institutions in prevention, can increase the feeling of powerfulness and ownership. However, there can also be a lot of tension and competition for resources between members who ultimately can undermine the effort. The limitations, however, can be that those strategies prioritized by the community may not result in the desired outcome. For though community members are well aware of their problems, they may be less familiar with the evidence-based practices, policies, or programs available to address them (and may be unwilling to substitute evidence-based practices, policies, or programs for ones they have developed or that they have already committed to).

Top-down prevention efforts are often funded and directed to a particular concern (e.g., interpersonal violence) and are developed and controlled by an organization or institution external to the community. It is common to find that prevention programs and strategies last only as long as the funding exists and that once the funding is removed the community returns to its prior state. Thus, top-down approaches that attempt to generate community commitment and build leadership for prevention programs do not necessarily translate into community commitment or leadership. Thus, though a top-down approach may be used in promoting evidence-based strategies, they may be less sustainable because they may not reflect the communities’ true concerns, interests, and social and/or cultural structure.

Community Mobilization In Preventing Interpersonal Violence

Recognizing that violence is the result of a complex interplay of individual, relationship, social, cultural, and environmental factors, an ecological framework often represents the foundation for planning and advancing community-level violence prevention. An ecological framework when effectively applied to community mobilization efforts influences every aspect, from the process of identifying and recruiting coalition members to determining the factors to include when conducting the community assessment, determining the decision-making processes that will guide priorities and strategies, and finally, determining the identification and articulation of outcomes that are deemed priorities within the community and are specific enough to assess success.

However, community mobilization and addressing community-level factors through an ecological framework are not the same thing. The Department of Health and Human Services, Substance Abuse and Mental Health Services Administration has adopted Communities That Care (CTC) as a primary vehicle for promoting and supporting community mobilization. Described as a complete prevention planning system for healthy communities, CTC provides a framework to develop an integrated approach to positive youth development and the prevention of problem behaviors including substance abuse, academic failure, unplanned pregnancy, school dropout, and violence.

Addressing the community level of the ecological framework involves risk assessments and prioritizes strategies directed to influence broader community factors and social processes (e.g., concentrated poverty, social capital, social isolation). Violence prevention strategies have consistently been found to focus on the individual level with some efforts aimed at peer groups or families. More recent efforts within the field of violence prevention recognize the importance of influencing community factors, utilizing broad-based community-level approaches.

The skills required for effective community mobilization include developing consistent, cohesive messages; creating action plans; building coalitions and increasing partnerships; influencing and engaging stakeholders and decision makers; and developing community leadership from the bottom up. The resources listed at the end of this essay provide tools, tips, and assistance in building and supporting the skills necessary to mobilize communities to prevent interpersonal violence.

Outcomes

Effective community mobilization can infuse new energy into preventing interpersonal violence through community buy-in and support, can expand the base of community support for preventing interpersonal violence, and can help a community overcome denial of interpersonal violence. It can also promote local ownership and decision making about preventing interpersonal violence, encourage collaboration between individuals and organizations, and limit competition and redundancy of services and outreach efforts. In addition, effective community mobilization can provide a focus for prevention planning and implementation efforts and can create public presence and pressure to change laws, policies, and practices— progress that could not be made by just one individual or organization. It can also bring new community volunteers together (because of increased visibility); increase cross-sector collaboration, shared resources, and access to funding opportunities for organizations; and promote long-term, organizational commitment to the prevention of interpersonal violence.

Bibliography:

  1. Krug, E. G., Dahlberg, L. L., Mercy, J. A., Zwi, A. B., ; Lozano, R. (Eds.). (2002). World report on violence and health. Geneva: World Health Organization. Retrieved from http://www.who.int/violence_injury_prevention/violence/world_report/en/
  2. Laverack, G., ; Labonte, R. (2000). A planning framework for community empowerment goals within health promotion. Health Policy and Planning, 15(3), 255–262.
  3. Reppucci, N. D., Woolard, J. L., ; Fried, C. S. (1999). Social, community, and preventive interventions. Annual Review of Psychology, 50, 387–418.
  4. Treno, A. J., ; Holder, H. D. (1997). Community mobilization: Evaluation of an environmental approach to local action. Addiction, 92(s2), S173–S187.
  5. Centers for Disease Control and Prevention National Center for Injury Prevention and Control: https://www.cdc.gov/injury/

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