Measurement of Community Empowerment in Three Community Programs in Rapla (Estonia)

Community empowerment approaches have been proven to be powerful tools for solving local health problems. However, the methods for measuring empowerment in the community remain unclear and open to dispute. This study aims to describe how a context-specific community empowerment measurement tool was developed and changes made to three health promotion programs in Rapla, Estonia. An empowerment expansion model was compiled and applied to three existing programs: Safe Community, Drug/HIV Prevention and Elderly Quality of Life. The consensus workshop method was used to create the measurement tool and collect data on the Organizational Domains of Community Empowerment (ODCE). The study demonstrated considerable increases in the ODCE among the community workgroup, which was initiated by community members and the municipality’s decision-makers. The increase was within the workgroup, which had strong political and financial support on a national level but was not the community’s priority. The program was initiated and implemented by the local community members, and continuous development still occurred, though at a reduced pace. The use of the empowerment expansion model has proven to be an applicable, relevant, simple and inexpensive tool for the evaluation of community empowerment.

[1]  Michael Quinn Patton,et al.  Book Review: Empowerment Evaluation Principles in Practice , 2005 .

[2]  Peter A. Toma,et al.  The case of Hungary , 1971 .

[3]  Douglas S. Noonan,et al.  Empowerment Zones, Neighborhood Change and Owner Occupied Housing , 2009, SSRN Electronic Journal.

[4]  J. Rappaport,et al.  In praise of paradox: A social policy of empowerment over prevention , 1981, American journal of community psychology.

[5]  Ignacio de los Ríos Carmenado,et al.  Empowering communities through evaluation: some lessons from rural Spain. , 2007 .

[6]  S. Elliott,et al.  The practice of community development approaches in heart health promotion. , 2000, Health education research.

[7]  M. Minkler,et al.  Contributions of Community Involvement to Organizational-Level Empowerment: The Federal Healthy Start Experience , 2001, Health education & behavior : the official publication of the Society for Public Health Education.

[8]  Public Health: Power, empowerment and professional practice , 2006 .

[9]  M. Zimmerman Empowerment theory: Psychological, organizational, and community levels of analysis. , 2000 .

[10]  Michael Scriven Empowerment Evaluation Examined , 1997 .

[11]  Empowerment Evaluation for Violence Prevention Public Health Programs , 2009, Health promotion practice.

[12]  P. Butraporn,et al.  An empowerment program to enhance women's ability to prevent and control malaria in the community, Chiang Mai Province, Thailand. , 2007, The Southeast Asian journal of tropical medicine and public health.

[13]  V. Mohan,et al.  Community empowerment--a successful model for prevention of non-communicable diseases in India--the Chennai Urban Population Study (CUPS-17). , 2006, The Journal of the Association of Physicians of India.

[14]  D. Fetterman,et al.  Empowerment evaluation: a collaborative approach to evaluating and transforming a medical school curriculum. , 2010, Academic medicine : journal of the Association of American Medical Colleges.

[15]  N. Wallerstein,et al.  Measuring community empowerment: a fresh look at organizational domains. , 2001, Health promotion international.

[16]  Bret R. Shaw,et al.  Empowering Processes and Outcomes of Participation in Online Support Groups for Patients With Breast Cancer, Arthritis, or Fibromyalgia , 2008, Qualitative health research.

[17]  Beverley Lloyd,et al.  Indicators to help with capacity building in health promotion , 2000 .

[18]  C. Rissel Empowerment: the holy grail of health promotion? , 1994 .

[19]  C. Mahoney,et al.  A Framework for Evaluating Comprehensive Community Initiatives , 2003, Health promotion practice.

[20]  A. Plough,et al.  Implementing the Boston Healthy Start Initiative: A Case Study of Community Empowerment and Public Health , 1994, Health education quarterly.

[21]  G. Laverack Public Health: Power, Empowerment and Professional Practice , 2005 .

[22]  P. Makara Policy implications of differential health status in East and West Europe. The case of Hungary. , 1994, Social science & medicine.

[23]  R. Labonté,et al.  Health Promotion and Empowerment: Reflections on Professional Practice , 1994, Health education quarterly.

[24]  Ronald Labonté,et al.  Capacity building in health promotion, Part 2: Whose use? And with what measurement? , 2001 .

[25]  M. Rich,et al.  Rethinking Empowerment: Evidence from Local Empowerment Zone Programs , 2010 .

[26]  J. Lennie,et al.  Empowerment Evaluation: A Practical Method for Evaluating a National School Breakfast Program , 2005 .

[27]  R. Labonté,et al.  Empowerment Forum: A Dialogue between Guest Editorial Board Members , 1994, Health education quarterly.

[28]  Ann Robertson,et al.  New Health Promotion Movement: A Critical Examination , 1994, Health education quarterly.

[29]  David M. Fetterman,et al.  Empowerment Evaluation: An Introduction to Theory and Practice , 1996 .

[30]  K. Harris,et al.  Evaluating community initiatives for health and development. , 2001, WHO regional publications. European series.

[31]  C. Swift,et al.  Empowerment: An emerging mental health technology , 1987, Journal of Primary Prevention.

[32]  M. Minkler Community Organizing among the Elderly Poor in the United States: A Case Study , 1992, International journal of health services : planning, administration, evaluation.

[33]  G. Laverack,et al.  Addressing the contradiction between discourse and practice in health promotion , 1999 .

[34]  David W. Lounsbury,et al.  Building Collaborative Capacity in Community Coalitions: A Review and Integrative Framework , 2001, American journal of community psychology.

[35]  Y. Motohashi,et al.  A decrease in suicide rates in Japanese rural towns after community-based intervention by the health promotion approach. , 2007, Suicide & life-threatening behavior.

[36]  Glenn Laverack,et al.  Evaluating community capacity. , 2002, Health & social care in the community.

[37]  P. C. Wright,et al.  Strategic performance empowerment model , 1998 .

[38]  R. Wageman How Leaders Foster Self-Managing Team Effectiveness: Design Choices Versus Hands-on Coaching , 2001 .

[39]  R. Labonté,et al.  A planning framework for community empowerment goals within health promotion. , 2000, Health policy and planning.

[40]  Beth R. Crisp,et al.  Four approaches to capacity building in health: consequences for measurement and accountability , 2000 .