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The literature regarding the prevention of diabetes provides few standards for community-based initiatives. The present article offers four principles for engaging communities in comprehensive community approaches to diabetes prevention including (1) facilitating meaningful and central roles for communities, (2) giving primary attention to participatory processes rather than to best practices, (3) emphasizing cultural relevance in designing interventions particularly in racial and ethnic communities, and (4) incorporating social ecology approaches that are holistic and that address larger environmental influences rather than individual behavioral change alone. In order that community public health practitioners may operationalize the principles, models are provided for each. [ABSTRACT FROM AUTHOR]

A case study was conducted of the formation of a diabetes initiative in a largely African American urban community. The study focused on how confluent the original project model was with actual formation, what benefits were produced, what areas of needed improvement surfaced, and how different stakeholder groups characterized one another's involvement. The project produced several benefits but also experienced needed improvements in its formation, which suffered from a lack of communication, cooperation, and coordination; unclear goals and personnel roles; and early delays. Lessons include treating project formation as an important developmental stage and reducing bureaucratic management approaches not suited for community partnerships. [ABSTRACT FROM AUTHOR]

OBJECTIVE: This article reports on a qualitative study that contrasts implementation patterns across community-based public health initiatives, resulting in a construct for building the capacity of such initiatives in racial and ethnic communities. By specifying which capacities provide optimum leverage, community initiatives may increase precision in developing intervention strategies that are pivotal in producing desired outcomes. METHOD: Cross-case comparisons were made on the basis of intensive interviews with key initiative leaders. RESULTS: Several capacities distinguish highly successful initiatives from those that had greater difficulty in realizing their goals. Leadership was the most important distinguishing capacity. Organizing capacity, or the propensity to provide structure, operational procedures, oversight, and activity formation, was also critical in leveraging community action and desired outcomes. CONCLUSION: The study concludes that developing high levels of community capacity where it can produce the most strategic advantage is a promising pathway for mitigating antagonistic social factors. [ABSTRACT FROM AUTHOR]