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The purpose of this study was to identify factors that contribute to the effectiveness of community health promotion coalitions. Member survey data from 10 coalitions formed as part of North Carolina Project ASSIST were analyzed at the coalition level to identify factors related to member participation, member satisfaction, quality of the action plan, resource mobilization, and implementation. The results suggest that coalitions with good communication and skilled members had higher levels of member participation. Coalitions with skilled staff, skilled leadership, good communication, and more of a task focus had higher levels of member satisfaction. Coalitions with more staff time devoted to them and more complex structures had greater resource mobilization, and coalitions with more staff time, good communication, greater cohesion, and more complex structures had higher levels of implementation. Neither member participation nor member satisfaction correlated with the other measures of coalition effectiveness. [ABSTRACT FROM AUTHOR]

Although community capacity is a central concern of community development experts, the concept requires clarification. Because of the potential importance of community capacity to health promotion, the Division of Chronic Disease Control and Community Intervention, Centers for Disease Control and Prevention (CDC), convened a symposium in December 1995 with the hope that a consensus might emerge regarding the dimensions that are integral to community capacity. This article describes the dimensions that the symposium participants suggested as central to the construct, including participation and leadership, skills, resources, social and interorganizational networks, sense of community, understanding of community history, community power, community values, and critical reflection. The dimensions are not exhaustive but may serve as a point of departure to extend and refine the construct and to operationalize ways to assess capacity in communities. [ABSTRACT FROM AUTHOR]

Abstract Background Over the last two decades, concern has been expressed about the readiness of the public health workforce to adequately address the scientific, technological, social, political and economic challenges facing the field. A 1988 report from the Institute of Medicine (IOM) served as a catalyst for the re-examination of the public health workforce. The IOM's call to increase the relevance of public health education and training prompted a renewed effort to identify competences needed by public health personnel and the organizations that employ them. Methods A recent evaluation sought to address the role of the 10 essential public health services in job services among the Texas public health workforce. Additionally, the evaluation examined the Texas public health workforce's need for training in the 10 essential public health services. Results and conclusion Overall, the level of perceived training needs varied dramatically by job category and health department type. When comparing aggregate training needs, public health workers with greater day-to-day contact (nurses, health educators) indicated a greater need for training than their peers who did not, such as those working in administrative positions. When prioritizing and designing future training modules regarding the 10 essential public health services, trainers should consider the effects of job function, location and contact with the public.

OBJECTIVE: To use youth and parent demographic factors, youth assets (strengths), and community constructs to develop age-group-specific profiles for youth who abstain from sexual activity. METHODS: Data were collected using in-person interviews of youth (N = 1253) residing in randomly selected, inner-city neighborhood households. Data were analyzed to create classification trees. RESULTS: Results indicated that assets typically were the most important factors related to abstinence and that the profiles differed for each age group. CONCLUSIONS: When sexual abstinence is considered, the influence of youth and parent demographics, youth assets, and community factors appears to vary across adolescent developmental age periods. [ABSTRACT FROM AUTHOR]

Comprehensive smoke-free policy is a strategy to prevent cardiovascular disease (CVD) at a population-level; however, evaluating their long-term outcomes is difficult. This study used an agent-based model to estimate long-term impacts of a comprehensive smoke-free policy, as it was implemented in two communities, Arlington and Mesquite, Texas. The model predicted the percentage of myocardial infarction (MI), stroke, and diabetes in the population 10 and 20 years following policy adoption. In Arlington, the percentage of the population with these conditions each decreased by approximately 0.5% over 20 years; in Mesquite, the percentage of the population with diabetes, myocardial infarction (MI), and stroke decreased by 1.1%, 0.6%, and 0.3%, respectively, after 20 years. The results were statistically significant (p < 0.001). As an evaluation strategy, agent-based modeling can help researchers and practitioners estimate the potential long-term effects of policies and garner intervention support for implementation., (© 2022. The Author(s), under exclusive licence to Springer Nature Limited.)

Objectives: To use network analysis in order to evaluate the effectiveness of interorganizational networks in implementing policy, systems, and environmental interventions for cardiovascular disease prevention throughout the United States., Methods: Evaluators conducted an interorganizational network (ION) survey to examine information sharing and joint planning within organizational relationships in 15 community-based cardiovascular disease prevention partnership networks. Density and betweenness centrality scores at the node- and network-level were calculated for each partnership network using UCINET© network analysis software. Common data patterns were then extracted using a multiple case study format., Results: Network density scores ranged from 0.50 to 1.00 (M = 0.84, SD = 0.14) for information sharing and 0.43-1.00 (M = 0.77, SD = 0.15) for joint planning. Centralization indices ranged from 0.00 to 0.11 (M = 0.04, SD = 0.03), and 0.00-0.17 (M = 0.06, SD = 0.05), respectively. Overall, 73.33 % of communities were successful in meeting their partnership goals., Conclusions: When planning and implementing interorganizational networks, high betweenness centrality and more hierarchically structured networks were identified as the most salient partnership characteristics to programmatic success. The network findings were triangulated with previously published qualitative data to provide context. These findings provide valuable insight on how national networks can be designed and leveraged to implement systematic community health projects., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Over the past 20 years, teenage birth rates in the United States have declined substantially but continue to persist among certain populations. During this time period, a series of rigorously tested teen pregnancy prevention (TPP) programs were developed, and a number of evidence-based interventions (EBIs) emerged. In April 2017, researchers reviewed EBIs in TPP and examined each program's socioecological levels of intervention, measurements approaches, and other ecological aspects. Findings indicate that the majority of TPP EBIs are aimed at the individual and/or interpersonal level of intervention. Furthermore, the programs were evaluated using the individual as the unit of analysis, regardless of what level the EBI targets. These findings represent serious gaps, specifically a lack of system-, environmental-, and policy-level EBIs. Future TP approaches should target multiple levels of social ecology, ensure measurements appropriately capture changes within these levels, and shift to a focus on a longer term population health improvement.

Introduction: A need for innovative public health programs is evident as the field adapts to address changes in health priorities and target populations. The Innovative Teen Pregnancy Prevention Program (iTP 3 ) was created to support and enable innovation in teenage pregnancy prevention, developing programs to reach the most at risk youth., Methods: A formative evaluation was conducted to understand what innovation means in the context of program development, and examine the process of innovation. Qualitative data was collected through baseline interviews with program development teams, referred to as Innovators, prior to the start of the project period and follow-up interviews conducted at the end of a 12-month funding period. Additional open-ended written responses were collected in the middle of the funding cycle. A thematic analysis with an open-coding scheme was used to identify emergent themes., Results: Innovators considered programs innovative because of the target population of focus, program delivery mechanism, and/or program development approach. They specifically identified that a "culture" of innovation must be present if new programs are to be developed. Over time, Innovators began to shift their definition of innovation toward unique design processes and ecological approaches., Discussion: Through creating a culture of innovation and utilizing systems thinking, this project provides important insights in how to develop innovations in public health., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Introduction: In 2014, the Centers for Disease Control and Prevention funded the American Heart Association to implement policy, systems, and environment-focused strategies targeting access to healthy food and beverages, physical activity, and smoke-free environments., Method: To understand factors affecting implementation and variations in success across sites, evaluators conducted a multiple case study. Based on past literature, community sites were categorized as capacity-building or implementation-ready, for comparison. A sample of six communities were selected using a systematic selection tool. Through site visits, evaluators conducted interviews with program staff and community partners and assessed action plans., Results: Evaluators identified important implications for nationally coordinated community-based prevention programming. Differences in implementation varied by the communities' readiness, with the most notable differences in how they planned activities and defined success. Existing partner relationships (or lack thereof) played a significant role, regardless of the American Heart Association's existing presence within the communities, in the progression of initiatives and the differences observed among phases. Last, goals in capacity-building sites were tied to organizational goals while goals in implementation-ready sites were more incremental with increased community influence and buy-in., Discussion: Using national organizations as a mechanism to carry out large-scale community-based prevention work is a viable option that provides coordinated, wide-scale implementation without sacrificing a community's priorities or input. In funding future initiatives, the presence of relationships and the time needed to cultivate such relationships should be accounted for in the planning and implementation processes, as well as both local and national expectations.

The Physical Activity and Community Engagement Project utilized a comparative case study to understand how a theoretical framework called community health development (CHD) influences community capacity. Three rural communities (cases) developed interventions using a CHD framework. Researchers collected qualitative evidence measuring capacity and the CHD process for more than 3 years. Patterns identified seven capacity constructs relevant to CHD, including community history, civic participation, leadership, skills, resources, social and interorganizational networks, and critical reflection. Community health development focuses on population health improvement and strengthening community capacity. As such, it helps communities address local priorities and equips them to address future issues.

Community interventions are complex social processes that need to move beyond single interventions and outcomes at individual levels of short-term change. A scientific paradigm is emerging that supports collaborative, multilevel, culturally situated community interventions aimed at creating sustainable community-level impact. This paradigm is rooted in a deep history of ecological and collaborative thinking across public health, psychology, anthropology, and other fields of social science. The new paradigm makes a number of primary assertions that affect conceptualization of health issues, intervention design, and intervention evaluation. To elaborate the paradigm and advance the science of community intervention, we offer suggestions for promoting a scientific agenda, developing collaborations among professionals and communities, and examining the culture of science.

Despite the quickening momentum of genomic discovery, the communication, behavioral, and social sciences research needed for translating this discovery into public health applications has lagged behind. The National Human Genome Research Institute held a 2-day workshop in October 2008 convening an interdisciplinary group of scientists to recommend forward-looking priorities for translational research. This research agenda would be designed to redress the top three risk factors (tobacco use, poor diet, and physical inactivity) that contribute to the four major chronic diseases (heart disease, type 2 diabetes, lung disease, and many cancers) and account for half of all deaths worldwide. Three priority research areas were identified: (1) improving the public's genetic literacy in order to enhance consumer skills; (2) gauging whether genomic information improves risk communication and adoption of healthier behaviors more than current approaches; and (3) exploring whether genomic discovery in concert with emerging technologies can elucidate new behavioral intervention targets. Important crosscutting themes also were identified, including the need to: (1) anticipate directions of genomic discovery; (2) take an agnostic scientific perspective in framing research questions asking whether genomic discovery adds value to other health promotion efforts; and (3) consider multiple levels of influence and systems that contribute to important public health problems. The priorities and themes offer a framework for a variety of stakeholders, including those who develop priorities for research funding, interdisciplinary teams engaged in genomics research, and policymakers grappling with how to use the products born of genomics research to address public health challenges., (2010. Published by Elsevier Inc.)

The role of parental communication and instruction concerning sexual behaviour were studied in a community-based sample of 1083 youth aged 13-17 (mean age of 15 years; 51% girls, 49% White). The Youth Asset Survey was administered along with items measuring demographics and youth risk behaviours. After controlling for demographic factors, multivariate analysis revealed that youth were much less likely to have initiated sexual intercourse if their parents taught them to say no, set clear rules, talked about what is right and wrong and about delaying sexual activity. If youth were sexually active, they were more likely to use birth control if taught at home about delaying sexual activity and about birth control. Having only one sexual partner was associated with having an adult role model who supports abstinence, being taught at home about birth control, and being taught at home how to say no. If parents reported talking with youth about birth control and sexually transmitted disease (STD) prevention, youth were significantly more likely to use birth control. Our conclusion is that parents have the opportunity and ability to influence their children's sexual behaviour decisions.

Background: Over the last two decades, concern has been expressed about the readiness of the public health workforce to adequately address the scientific, technological, social, political and economic challenges facing the field. A 1988 report from the Institute of Medicine (IOM) served as a catalyst for the re-examination of the public health workforce. The IOM's call to increase the relevance of public health education and training prompted a renewed effort to identify competences needed by public health personnel and the organizations that employ them., Methods: A recent evaluation sought to address the role of the 10 essential public health services in job services among the Texas public health workforce. Additionally, the evaluation examined the Texas public health workforce's need for training in the 10 essential public health services., Results and Conclusion: Overall, the level of perceived training needs varied dramatically by job category and health department type. When comparing aggregate training needs, public health workers with greater day-to-day contact (nurses, health educators) indicated a greater need for training than their peers who did not, such as those working in administrative positions. When prioritizing and designing future training modules regarding the 10 essential public health services, trainers should consider the effects of job function, location and contact with the public.

Background and Objectives: This study explores youth and parent agreement about conversations on specific topics related to sexual risk behavior and youth-parent relationship. The study's objective was to determine if the amount of agreement was associated with youth sexual behavior., Methods: Data were collected using a computer-assisted data entry system from one parent and one youth in 1,350 randomly selected households in inner-city areas of two Midwestern cities., Results: Youth-parent positive agreement scores about these conversations were significant after controlling for youth age, race, gender, family structure, and parental income and education. Scores were associated with youth abstinence and with the use of contraception if the youth had become sexually active., Conclusions: In this study, youth-parent agreement regarding their communication was associated with positive youth behaviors, including abstinence and the use of contraception if sexually active.

Purpose: To examine the effects of 10 youth developmental assets on adolescent tobacco use., Design: Survey of a randomly selected sample using in-home interviewing methodology., Setting: Inner-city areas of two midsized Midwestern cities., Subjects: The researchers studied 1,350 teen-parent pairs., Measures: Demographic information, adolescent self-reported tobacco use, eight developmental asset Likert scales, and two one-item developmental asset measures., Results: The response rate was 51%. Logistic regression results indicate that youth who possess nine of 10 developmental assets examined are significantly less likely to report tobacco use than youth with low levels of assets. Adjusting for youth age, race, gender, parental income and education, and family structure, significant odds ratios include the following: nonparental adult role model, 2.09 (95% confidence interval [CI] = 1.45, 3.02); peer role models, 2.48 (95% CI = 1.87, 3.29); family communication, 1.73 (95% CI = 1.29, 2.31); use of time (organized groups), 1.77 (95% CI = 1.28, 2.44); use of time (religion), 2.49 (95% CI = 1.86, 3.33); good health practices (exercise/nutrition), 1.61 (95% CI = 1.21, 2.14); community involvement, 1.66 (95% CI = 1.07, 2.58); future aspirations, 2.06 (95% CI = 1.42, 2.99); and responsible choices, 2.21 (95% CI = 1.55, 3.15)., Conclusions: The findings of this study support the view that certain developmental assets may serve to protect youth from risk-taking behaviors, particularly tobacco use. Limitations include cross-sectional data and three scales with alphas below .7.

On Day 2 of the joint CDC/SOPHE conference on Creating Capacity: Establishing a Research Agenda for Health Education, the participants were asked to identify research needs or special issues in working with children and adolescents, the elderly, women, men, and underserved groups. This article presents the priority research areas across subgroups identified by the participants. The cross-group priorities are followed by research recommendations for each subgroup.

Researchers in health education have rarely convened to outline research priorities in the field. This article discusses the results of a meeting to develop a research agenda aimed at creating capacity to promote and maintain health. Salient research findings related to individual and community health are summarized and priority issues for future research are presented.

Purpose: The purpose of this study was to determine the extent of implementation of school health education curricula, to identify factors which enhanced or impeded implementation, and to examine the link between the adoption and implementation phases of the diffusion process., Design: The study used an experimental design; 22 school districts were randomly assigned to intervention and control conditions., Setting: The study was conducted in North Carolina., Subjects: All teachers in the study districts identified by their schools as "eligible to teach health" were included in the sample., Intervention: An in-depth training was conducted on the use of the middle school tobacco prevention curriculum that had been adopted., Measures: Three measures were used to assess implementation of the curricula. Independent variables of interest included organizational size and climate, teacher training, how long it took to make the adoption decision, and attitudes toward tobacco use prevention curricula. Response rates for these measures ranged from 44% to 78%., Results: Nonparametric correlations and regression modeling indicated that larger organizational size and teacher training were the strongest predictors of curricula implementation. A favorable organizational climate within school districts also improved implementation., Conclusions: While interventions to increase adoption of school health education curricula should focus on larger school districts, the majority of efforts to improve implementation should focus on smaller districts.

The practice norms of community physicians and dentists in the Lehigh Valley of Pennsylvania for counseling about smoking cessation were surveyed. In addition, 1,373 residents in the valley were interviewed by telephone about the smoking counseling behaviors of their dentists and physicians. These activities were conducted as part of the planning for an intervention by the Coalition for a Smoke-Free Valley, a coalition of 100 persons and organizations in the area. The survey response rate for 172 physicians was 77 percent, and for 103 dentists, it was 76 percent. More physicians than dentists advised patients to quit, counseled patients, provided materials, and helped the patient to set a quit date. However, there was a clear discrepancy between what physicians say they do and what smokers say they hear.

This quasi-experimental study assessed impact of factors associated with classroom implementation of health curricula by North Carolina teachers. School representatives selected and implemented one of three tobacco prevention curricula--Project SMART, Growing Healthy, or the Teenage Health Teaching Modules--in either sixth or seventh grades. Prior to implementation, experimental teachers and administrators received extensive curricula training. Implementation data were collected through teacher completed checksheets and classroom observations for two time periods--initial implementation (n = 69) and maintained implementation (n = 136). While training was associated significantly with whether teachers implemented a curriculum (p < .05), other factors also were important. Variables outside of teachers' direct control, such as supportive administrators, context in which health instruction is taught, and turbulence, affected quantity and quality of curricular implementation.

This study was conducted to test an instrument for measuring the level of institutionalization (LoIn) of health promotion programs. Institutionalization occurs when a program becomes an integral part of an organization, and the LoIn instrument is a beginning effort to measure the extent of program integration into organizations. The instrument is based on theory that holds that organizations are composed of production, maintenance, supportive, and managerial subsystems. Institutionalization occurs when a program becomes imbedded into these subsystems. A questionnaire designed to test this construct was mailed to 453 administrators in 141 organizations that operate health promotion programs. Based on 322 usable responses (71%), a confirmatory factor analysis was conducted. The results support the hypothesis of an eight-factor model: four factors concern how routinized the program was in each subsystem and four factors concern the degree of program saturation within each subsystem. Correlations of the eight factors with the number of years the programs had been in operation, and managers' perceptions of program permanency, indicated that the four routinization factors were more highly correlated with program longevity than the four niche saturation factors, and the niche saturation factors were more highly correlated with managers' perceptions of program permanence than the routinization factors. The instrument, which is available from the authors, may be used as both a research instrument and a diagnostic tool in assessing the institutionalization of health promotion programs.