Community-Based
vs. Community Development Practice
A more recent
framework developed for community health workers distinguishes
between community-based strategies and community development initiatives
(Labonte, 1993; Boutilier, Cleverly and Labonte, 2000).
Community-Based
Strategies link programs and services to community groups.
The health issue under consideration, usually related to the prevention
of health-related risk factors (e.g., tobacco, physical inactivity),
is identified by the sponsoring agency. Interventions are implemented
according to defined timelines, and decision making power rests
with the sponsoring organization, not community participants.
Community
Development Strategies differ from community-based strategies
in several respects. The problem or issue is defined by community
residents rather than the sponsoring organization. The process
of planning and implementing the community development initiative
is ongoing, based on continual negotiations between organizations
and community groups, with the community worker serving as a liaison.
Community development emphasizes enhanced community capacity (e.g.,
collective problem solving skills), not measurable changes in
health risk factors, as the desired outcome.
Implicit in
the definition of community development is the notion that the
needs, problems or issues around which a community is organized
must be identified by the community members themselves, not by
an outside organization or change agent.
As Minkler
and Wallerstein note:
"even
though a health education professional may borrow some principles
or methods from community organizing to help mount an AIDS organizing
effort in the community, he or she cannot be said to be doing
community organizing in the pure sense unless the community itself
has identified AIDS as the problem it wishes to address"
(1997, pp. 30-31).
Community
Capacity Building and Empowerment
Community
organization is an important health promotion strategy because
it is a recognized means of achieving one of the field's most
fundamental objectives, facilitating the process of empowerment.
Empowerment refers to the ability of individuals and communities
to assume control over their own environment (Rappaport, 1984;
Wallerstein, 1992). At the community level, empowerment often
entails some redistribution of resources or decision making power
favourable to the community group in question (Rissel, 1994).
