Kimberly D. Bess

Public Health Literacy Defined

Public health literacy is an emerging concept necessary to understand and address the broad array of factors, such as climate change, globalization, and poverty, that influence the publics health. Whereas health literacy has traditionally been operationalized as an individual-level construct, public health literacy takes into account the complex social, ecologic, and systemic forces affecting health and well-being. However, public health literacy has not yet been fully articulated. This paper addresses this gap by outlining a broad, new definition of public health literacy. This definition was developed through an inductive analytic process conducted in 2007 by a multidisciplinary research team, and two expert-panel sessions were convened to assess the consensual validity of the emergent definition. Based on this process, public health literacy is defined as the degree to which individuals and groups can obtain, process, understand, evaluate, and act on information needed to make public health decisions that benefit the community. Three dimensions of public health literacy--conceptual foundations, critical skills, and civic orientation--and related competencies are also proposed. Public health literacy is distinct from individual-level health literacy, and together, the two types of literacy form a more comprehensive model of health literacy. A five-part agenda is offered for future research and action aimed at increasing levels of public health literacy.

Psychological Sense of Community: Theory, Research, and Application

The idea that we belong to communities and that these communities provide benefits and responsibilities is one that has gained a growing appreciation in the last decade. As a reaction to the urbanization faced by many people, globalization, cross-national forms of media and their impact on cultures, physical and social isolation from family and friends, and a growing fear of change and the unknown, images of community, belonging and support have become paramount. However, what is actually meant by community, how a community functions, and what are the benefits and costs of community membership has not necessarily been well explored.

Participatory organizational change in community-based health and human services: From tokenism to political engagement

Community psychologists have long worked with community-based human service organizations to build participatory processes. These efforts largely aim at building participatory practices within the current individual-wellness paradigm of human services. To address collective wellness, human service organizations need to challenge their current paradigm, attend to the social justice needs of community, and engage community participation in a new way, and in doing so become more openly political. We use qualitative interviews, focus groups, organizational documents, and participant observation to present a comparative case study of two organizations involved in such a process through an action research project aimed at transforming the organizations’ managerial and practice paradigm from one based on first-order, ameliorative change to one that promotes second-order, transformative change via strength-based approaches, primary prevention, empowerment and participation, and focuses on changing community conditions. Four participatory tensions or dialectics are discussed: passive versus active participation, partners versus clients, surplus powerlessness versus collective efficacy, and reflection/learning versus action/doing.

Levels of Community Engagement in Youth Violence Prevention: The Role of Power in Sustaining Successful University-Community Partnerships

Previous research indicates that communities can be engaged at various levels in research to reduce youth violence. In this paper, we argue that the method of power sharing among partners is a central factor distinguishing different levels of engagement. Using cases from the Nashville Urban Partnership Academic Center of Excellence, we identify community initiation and community collaboration as distinct approaches to community engaged violence prevention research. The power relationships among partners are analyzed to highlight differences in the types of engagement and to discuss implications for establishing and sustaining community partnerships. Also, the implications of levels of engagement for promoting the use of evidence-based practices are discussed.

Testing a Measure of Organizational Learning Capacity and Readiness for Transformational Change in Human Services

Transformative organizational change requires organizational learning capacity, which we define in terms of (1) internal and (2) external organizational systems alignment, and promoting a culture of learning, including (3) an emphasis on exploration and information, (4) open communication, (5) staff empowerment, and (6) support for professional development. We shortened and adapted Watkins and Marsicks Dimensions of Learning Organizations Questionnaire into a new 16-item Organizational Learning Capacity Scale (OLCS) geared more toward nonprofit organizations. The OLCS and its subscales measuring each of the above 6 dimensions are unusually reliable for their brevity. ANOVAs for the OLCS and subscales clearly and consistently confirmed extensive participant observations and other qualitative data from four nonprofit human service organizations and one local human service funding organization.

Food Systems Change and the Environment: Local and Global Connections

Making changes to the way food is produced, distributed, and processed is one strategy for addressing global climate change. In this case study, we examine the “forming” stage of an emergent and locally-based coalition that is both participatory and focused on promoting food security by creating food systems change. Social network analysis is used to compare network density, centrality, and centralization among coalition partners before the formation of the coalition and at its one-year anniversary. Findings reveal that the coalition facilitated information seeking, assistance seeking, and collaborative efforts related to food security among a group of organizational stakeholders that were relatively disconnected pre-coalition. Results also illuminate tensions related to increased centralization of the network, coalition efficiency, and the goals of democratic decision-making. This study highlights the utility of social network analysis as a tool for evaluating the aims and trajectory of locally-based coalitions focused on global concerns.

Ecological Contexts in the Development of Coalitions for Youth Violence Prevention An Organizational Network Analysis

Community coalitions are a recognized strategy for addressing pressing public health problems. Despite the promise of coalitions as an effective prevention strategy, results linking coalition efforts to positive community outcomes are mixed. To date, research has primarily focused on determining organizational attributes related to successful internal coalition functioning. The authors’ research complements and adds to this literature by offering a network conceptualization of coalition formation in which coalition participation is studied within the broader context of local organizational networks both within and beyond a coalition. The authors examine participation in the first year of a youth violence prevention coalition exploring both differences between participating and nonparticipating organizations and levels of participation. Each network variable, reflecting prior collaboration and being viewed by other organizations as a local leader, approximately doubled the explained variance in coalition participation beyond the predictive power of all available organizational attributes combined. Results suggest that initial coalition participation emerged out of a preexisting network of interorganizational relations and provide an alternative perspective on coalition formation that goes beyond conceptual orientations that treat coalitions as bounded organizational entities that exist apart from the communities in which they are embedded.

A Heuristic Framework for Understanding the Role of Participatory Decision Making in Community-Based Non-Profits

This paper explores the role of member participation in decision-making (PDM) from an organizational learning (OL) perspective. Community-based organizations (CBOs) serve as mediators between the individual and the local community, often providing the means for community member participation and benefiting organizationally from members’ input. Community psychologists have recognized these benefits; however, the field has paid less attention to the role participation plays in increasing CBOs’ capacity to meet community needs. We present a framework for exploring how CBO contextual factors influence the use of participatory decision-making structures and practices, and how these affect OL. We then use the framework to examine PDM in qualitative case study analysis of four CBOs: a youth development organization, a faith-based social action coalition, a low-income neighborhood organization, and a large human service agency. We found that organizational form, energy, and culture each had a differential impact on participation in decision making within CBOs. We highlight how OL is constrained in CBOs and document how civic aims and voluntary membership enhanced participation and learning.

Reframing Coalitions as Systems Interventions: A Network Study Exploring the Contribution of a Youth Violence Prevention Coalition to Broader System Capacity

AbstractThis longitudinal research conceptualizes community coalitions as events in local intervention systems (Hawe et al. in Am J Commun Psychol 43(3–4):267–276, 2009). It explores the potential contribution coalitions make, through the collaborative activities of their members, to the broader intervention systems in which they are embedded. Using social network analysis, it examines patterns of structural change in a network of 99 organizations focused on youth violence prevention (YVP) over a 5-year period in which 30 of the 99 organizations were involved in a local YVP Coalition. Both longitudinal modeling and cross sectional analyses are used to examine change in system capacity—strong interorganizational networks—related to patterns of network density, centralization, and hierarchy. Somewhat surprisingly, the study found that capacity in the broader YVP Intervention System actually diminished during the 5-year period of the coalition’s operation, though part of the system—the sub-network that made up the YVP Coalition—was marginally strengthened. In this case, therefore, the evidence suggests that power and relational resources in the broader YVP Intervention System were redistributed. The article explores how the definition of capacity related to density and hierarchy may be contextually dependent. Implications for the role of coalitions in building system capacity are discussed.

People and places shaping food procurement among recipients of Supplemental Nutrition Assistance Program (SNAP)

ABSTRACT A key gap in existing food environment research is a more complex understanding of the interplay between physical and social contexts, including the influence of social networks on food habits. This mixed methods research examined the nature of social connections at food procurement places among a sample of 30 people receiving Supplemental Nutrition Assistance Program (SNAP) benefits in an urban setting. Results highlight the significance of social connections as motivators to use food places, the value of access to information and other resources at food places, and the role of weak ties with actors within food places to facilitate utilization and interaction. Social connections at the varied places individuals procure food may be leveraged to disseminate information and resources to further healthy food access. HIGHLIGHTSPeople are generally social in their food procurement habits.Purely social connections at food procurement places create a positive atmosphere.People value access to information and other resources transmitted through people within food procurement places.Findings highlight the importance of weak ties for nutritional public health interventions.