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Reconsidering community-based health promotion: Promise, performance, and potential

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  • Merzel, C.
  • D'Afflitti, J.

Abstract

Contemporary public health emphasizes a community-based approach to health promotion and disease prevention. The evidence from the past 20 years indicates, however, that many community-based programs have had only modest impact, with the notable exception of a number of HIV prevention programs. To better understand the reasons for these outcomes, we conducted a systematic literature review of 32 community-based prevention programs. Reasons for poor performance include methodological challenges to study design and evaluation, concurrent secular trends, smaller-than-expected effect sizes, limitations of the interventions, and limitations of theories used. The effectiveness of HIV programs appears to be related in part to extensive formative research and an emphasis on changing social norms.

Suggested Citation

  • Merzel, C. & D'Afflitti, J., 2003. "Reconsidering community-based health promotion: Promise, performance, and potential," American Journal of Public Health, American Public Health Association, vol. 93(4), pages 557-574.
  • Handle: RePEc:aph:ajpbhl:2003:93:4:557-574_3
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    Cited by:

    1. Selma Metintas & Cemalettin Kalyoncu & İnci Arıkan, 2009. "Two Distinct Training Methods for a Doctrine of Life with Healthy Heart in a Low Socioeconomic Society Model," IJERPH, MDPI, vol. 6(11), pages 1-15, November.
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    3. Chung-Chih Lin & Pang-Hsiang Yu & Jin-Kwan Lin, 2022. "Prompts for the Future to Live Healthier: A Study of Cognition and Motivation for Healthy Behaviors," IJERPH, MDPI, vol. 19(11), pages 1-10, May.
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    10. McNeish Taormina, Roxann & Massey, Tom & Walker-Egea, Connie & Sowell, Cathy & Rigg, Khary K. & Simmons, Christopher & Tran, Quynh, 2023. "Building capacity to create community change (BC4): A model to support successful program planning and implementation," Evaluation and Program Planning, Elsevier, vol. 97(C).
    11. Kristie L. Ebi, 2011. "Resilience to the Health Risks of Extreme Weather Events in a Changing Climate in the United States," IJERPH, MDPI, vol. 8(12), pages 1-14, December.
    12. Andrew Osehi Enaifoghe & Cotties Toyin Adetiba, 2019. "Understanding Dynamic Engagement of Community in Local Governance, Enhancing Grassroots Development in South Africa," Journal of Social and Development Sciences, AMH International, vol. 10(1), pages 22-32.
    13. Vermeulen, Lisa & Schäfer, Willemijn & Pavlic, Danica Rotar & Groenewegen, Peter, 2018. "Community orientation of general practitioners in 34 countries," Health Policy, Elsevier, vol. 122(10), pages 1070-1077.
    14. Ahern, Jennifer & Galea, Sandro & Hubbard, Alan & Karpati, Adam, 2008. "Population vulnerabilities and capacities related to health: A test of a model," Social Science & Medicine, Elsevier, vol. 66(3), pages 691-703, February.
    15. Yiwei Qian & Yi Ming Zheng & Sarah-Eve Dill & Scott Rozelle, 2020. "Correlates of participation in community-based interventions: Evidence from a parenting program in rural China," PLOS ONE, Public Library of Science, vol. 15(9), pages 1-19, September.
    16. Hoon Chuah, Fiona Leh & Srivastava, Aastha & Singh, Shweta Rajkumar & Haldane, Victoria & Huat Koh, Gerald Choon & Seng, Chia Kee & McCoy, David & Legido-Quigley, Helena, 2018. "Community participation in general health initiatives in high and upper-middle income countries: A systematic review exploring the nature of participation, use of theories, contextual drivers and powe," Social Science & Medicine, Elsevier, vol. 213(C), pages 106-122.
    17. Smylie, Janet & Kirst, Maritt & McShane, Kelly & Firestone, Michelle & Wolfe, Sara & O'Campo, Patricia, 2016. "Understanding the role of Indigenous community participation in Indigenous prenatal and infant-toddler health promotion programs in Canada: A realist review," Social Science & Medicine, Elsevier, vol. 150(C), pages 128-143.
    18. Phyllis Dako-Gyeke & Adolphina Addoley Addo-Lartey & Deda Ogum Alangea & Yandisa Sikweyiya & Esnat Dorothy Chirwa & Dorcas Coker-Appiah & Rachel Jewkes & Richard Mawuena Kofi Adanu, 2019. "'Small small quarrels bring about happiness or love in the relationships’: Exploring community perceptions and gendered norms contributing to male perpetrated intimate partner violence in the Central ," PLOS ONE, Public Library of Science, vol. 14(11), pages 1-22, November.
    19. Maria Felice Arezzo & Cristina Giudici, 2017. "The Effect of Social Capital on Health Among European Older Adults: An Instrumental Variable Approach," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 134(1), pages 153-166, October.
    20. Huan-Cheng Chang & Ting-Huan Chang & Hsiao-Yen Kang & Yu-Wei Chen & Sheng-Pyng Chen & Mei-Chin Wang & Jersey Liang, 2022. "Retention in Community Health Screening among Taiwanese Adults: A 9-Year Prospective Cohort Study," IJERPH, MDPI, vol. 19(11), pages 1-13, June.
    21. Katz, Jason & Wandersman, Abraham & Goodman, Robert M. & Griffin, Sarah & Wilson, Dawn K. & Schillaci, Michael, 2013. "Updating the FORECAST formative evaluation approach and some implications for ameliorating theory failure, implementation failure, and evaluation failure," Evaluation and Program Planning, Elsevier, vol. 39(C), pages 42-50.
    22. Stephen Linder & Dritana Marko & Ye Tian & Tami Wisniewski, 2018. "A Population-Based Approach to Mapping Vulnerability to Diabetes," IJERPH, MDPI, vol. 15(10), pages 1-13, October.
    23. Andrej Belak & Zuzana Dankulincova Veselska & Andrea Madarasova Geckova & Jitse P. van Dijk & Sijmen A. Reijneveld, 2017. "How Well Do Health-Mediation Programs Address the Determinants of the Poor Health Status of Roma? A Longitudinal Case Study," IJERPH, MDPI, vol. 14(12), pages 1-18, December.
    24. Maria Felice Arezzo & Cristina Giudici, 2017. "Social Capital and Self Perceived Health Among European Older Adults," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 130(2), pages 665-685, January.
    25. Mertens, Frédéric & Saint-Charles, Johanne & Mergler, Donna, 2012. "Social communication network analysis of the role of participatory research in the adoption of new fish consumption behaviors," Social Science & Medicine, Elsevier, vol. 75(4), pages 643-650.

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