Measuring community competence in the Mississippi Delta: the interface between program evaluation and empowerment.
If political dynamics are included in the definition of community, health promotion programs have a greater potential to recognize that assisting people to empower their communities is as important as assisting them to improve their health. This paper reports on the evaluation methods employed for a health promotion program in a rural poor county of the Mississippi Delta that chose to define community in this way. The evaluation took an action research approach so that the methods would not contradict or interfere with the program's empowerment agenda. The methods required a close and collaborative working relationship among evaluators and local service providers, community leaders, and program staff who defined and operationalized eight dimensions of community competence, determined the units of analysis, and developed the data collection protocol. Emphasis was placed on using the data to engage the program and three communities in a dialogue on how to confront a system with the difficult issues they faced. The findings revealed that after 1 year of implementation, community competence moved from social interactions internal to communities to those more externally focused on mediating with outside institutions and officials. At the same time, measures of self-other awareness and conflict containment showed a decrease or virtual nonexistence.
Department of Health Behavior and Health Education, School of Public Health, University of North Carolina, Chapel Hill 27599.
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D000293:Adolescent; D000328:Adult; D001741:Black or African American; D000368:Aged; D002648:Child; D002675:Child, Preschool; D003256:Community Participation / Q000639:trends; D005260:Female; D006266:Health Education / Q000379:methods*; D006293:Health Promotion / Q000379:methods*; D006297:Health Services Accessibility / Q000639:trends; D006301:Health Services Needs and Demand / Q000639:trends; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007389:Internal-External Control; D008019:Life Style; D008297:Male; D008489:Medical Indigency / Q000639:trends*; D008875:Middle Aged; D008922:Mississippi; D010348:Patient Care Team / Q000639:trends; D011209:Power, Psychological; D011247:Pregnancy; D012017:Referral and Consultation / Q000639:trends; D012423:Rural Health / Q000639:trends*; D012931:Social Environment