Family and Community Health Issues, Near and Far
We are honored to be asked to return to serve as issue editors for this issue of Family and Community Health, volume 34.4, which deals with "Issues Related to Family and Community Health." The broad theme of this issue will provide you with ample opportunities to learn the latest in health promotion and maintenance from scholars both near and far. Our own issue editorial team reflects this theme as well by including both editors and reviewers from across the globe. Although difficult to find a common theme among the articles arrayed in this issue, we note a resounding call for intervention development that is community oriented, participatory, culturally relevant, and easily shared with others. These calls reflect our own work in community-based participatory action research (CBPAR), which we conceive of as a 5-phase iterative process.1-3 CBPAR begins with partnership formation among individuals, families, and communities, followed by an assessment (information gathering) phase from which plans for actions or activities are developed. Next, an implementation phase occurs through program or project activity, followed by an evaluation phase reflecting and celebrating accomplishments, and finally a dissemination phase, which allows for sharing and initiation of next steps to begin the process again (Figure 1). Each of the articles in this issue incorporate 1 or more of the CBPAR phases.
All of the articles include a partnership formation phase in their development. It is interesting to note that these partnerships occur at different levels. For example, while Cherrington et al, Marko et al, and Unal et al, all focus on the family as the level of interest, Adedze et al and Lua et al focus on program participants and patients, respectively. Chika et al and Patterson et al focus at the programmatic level on behalf of the participants embedded within an organization. The Makhoul et al article provides a wonderfully rich narrative description of the lives of daughters of internally displaced families resulting from civil war. The authors provide some compelling policy implications regarding the effects of displacement.
Many of the articles also provide us with needed information and data that were collected during the assessment phase. Both qualitative and quantitative data were collected and a variety of methodologies were used during data gathering. For example, in the Lua and Bakar article the robust 36-item short form health survey instrument was used to collect data on health-related quality of life among family caregivers. This instrument with great crosscultural validity and reliability is an excellent choice for researchers who may be interested in conducting crosscultural comparative studies across other global populations to the Malaysian population studied here, with relative ease. In contrast, the Unal et al article describes a newly created instrument the authors developed to collect information for a study on nonmedical healing methods that parents use in treating their children with mental health disorders. The authors provide insights into this often-neglected area of mental health research-children.
Several articles illustrate the importance of considering both the insights of the program staff and the characteristics of organizations hosting or sponsoring the program during the implementation stage. The Chika et al article points out the often difficult roles that program staff may face when communicating potentially uncomfortable information, in this case concerns to parents about their child's weight and eating patterns. The authors provide a continuum of level of comfort for communication purposes that is applicable to many programmatic settings. The Patterson et al article expands our thinking about program implementation to consideration of organizational factors such as location, attendance, diversity, and enthusiasm, all of which may influence significantly the successfulness of program implementation. The successes learned in working with veteran's organizations should be of value to all.
Two of the articles illustrate the evaluation phase by highlighting the need for asking program participants directly about their opinions on programs in which they are current participants. The Adedze et al article looks at an often difficult-to-reach client population, namely those receiving services of the Women, Infants, and Children program. The article assesses knowledge, attitudes, and beliefs about nutrition, physical activity, and health risks related to childhood overweight, with findings indicating risk differences according to ethnic group identity. The Cherrington et al article evaluates the facilitators and barriers to diabetes self-management among Latino immigrants with diabetes, another difficult-to-reach population. The authors remind us of the importance of sex differences that may impact upon program success, as well as how these differences play themselves out as barriers and facilitators to individual self-management of a chronic disease.
The article by Marko and Watt brings us full circle to the critical role that a dissemination phase plays in any health-promotion intervention, particularly, how program participants can become spokespersons for the program or project. The article describes a social marketing campaign, which was jointly developed and implemented by youth leaders and adult facilitators. The importance of structuring a dissemination strategy such as a marketing campaign requires both a conceptual framework to guide development and implementation of the campaign and a mechanism for feedback to all those who have participated in and been impacted by the campaign.
In summary, we are confident that the articles in this issue will be of great importance and interest to the readers of the Journal. It is our hope that by using the 5 phases of the CBPAR approach we described earlier (ie, partnership formation, assessment, implementation, evaluation, and dissemination), readers may gain additional insights into how best to gain new knowledge, skills, and strategies for structuring their own health promotion programs and projects in the future.
-Karen E. Peters, DrPH
Issue Editor
Assistant Professor, School of Public Health
National Center for Rural Health Professions
Illinois Area Health Education Centers Network
Program, University of Illinois at Chicago.
-Sergio Cristancho, PhD
Issue Editor
Research Assistant Professor, National Center
for Rural Health Professions, University of
Illinois at Chicago; College of Medicine
Rockford, Illinois; and National
School of Public Health, Universidad de Antioquia
Medellin, Colombia.
-D. Marcela Garces, MD, MSPH
Issue Editor
Coordinator, National Center for Rural Health
Professions, University of Illinois at Chicago
College of Medicine, Rockford, Illinois; and
School of Medicine, Universidad de Antioquia
Medellin, Colombia.
REFERENCES