Hintergrund: Gesundheitssoziologische Theorien gehen davon aus, dass individuelles Gesundheitshandeln in kollektive Lebensstile eingebettet ist. Für die Primärprävention wird damit das Wissen um die Zusammenhänge von Lebensstilen, deren sozio-strukturelle Bedingungen und individuellem Gesundheitshandeln essentiell. Der Beitrag stellt erste Teilergebnisse zu gesundheitsrelevanten Lebensstilen und deren sozio-strukturellen Bedingungen im ländlichen Milieu nord-ostdeutscher Landgemeinden vor. Methodik: Datengrundlage der Querschnittuntersuchung ist die 3. Erhebungswelle der ‘Landgesundheitsstudie' der Hochschule Neubrandenburg – gesundheitssoziologische Surveys der Jahre 1973 (n=3.510), 1994 (n=2.285) und 2004/08 (n=1.246). Bislang wird geprüft, welche Konzepte und Methoden der Lebensstilforschung mit Hinblick auf die Spezifika des Datensatzes und der Fragestellung zielführend sind. Ergebnisse/Diskussion: Aktuelle Ergebnisse dimensionsreduzierender Verfahren zu allgemeinen sowie gesundheitsrelevanten Orientierungen/Einstellungen (z.B. Relevanz bestimmter Kriterien „beim oder am Essen„ oder bei der Lebensmittelauswahl) und Verhaltensweisen (z.B. Handlungsstrategien bei gesundheitlichen Beschwerden) lassen erste kollektive Muster der Lebensführung erkennen. Es soll einerseits der Theorieanschluss dieser Konstrukte und Befunde, andererseits deren Potenzial für die weiteren Analysenschritte diskutiert werden. Ausblick: Aktuell wurden Daten aus der 2. und 3. Erhebungswelle zu einem Paneldatensatz zusammengeführt. Hiermit eröffnet sich die Möglichkeit insbesondere die folgenden kausalen Effekte abschätzen zu können: In welchem Ausmaß bedingt die soziale Lage den Lebensstil bzw. der Lebensstil die soziale Lage? In welchem Ausmaß führt eine schlechte Gesundheit zu einem gesundheitsbewussten Lebensstil bzw. wirkt sich der Lebensstil auf die Gesundheit aus?
Background: Secular trends in health-related behavior, the frequency of illness, and life satisfaction in rural areas are inadequately documented.Such information is essential for the planning of health-care policy.Methods: In 1973 and 1994, surveys were performed on the health and lifestyle of all adult inhabitants of 14 selected rural communities in the northern part of the former East Germany.The inhabitants were surveyed again in 2008, and the findings of the surveys were compared.Results: Both the number of respondents and the response rate of the officially registered population in the 14 rural communities declined over the years, from 3603 (83%) in 1973 to 2155 (68%) in 1994 and 1246 (37%) in 2008.In 1973, 3.2% of the women and 2.7% of the men responding to the survey reported that they had diabetes mellitus.For arterial hypertension, the corresponding fig ures in 1973 were 21.7% and 11.4%; for chronic heart diseases, 16.7% and 12.8%.In 2008, most of the prevalence figures for these conditions were higher: for diabetes, 12.4% and 12.8%; for arterial hypertension, 34.7% and 33.9%; for chronic heart diseases, 12.3% and 15.0%.Men became less likely to report being in good or very good health (decline from 51.1% to 45.0%), while women became more likely to report being in good health (rise from 36.7% to 49.3%).Women generally had a more healthful lifestyle than men.Conclusion: Over the long term, there have been both improvements, particularly in lifestyle, and turns for the worse, e.g., in life satisfaction.While the latter might be due to the increasing marginalization of rural eastern Germany, we interpret the observed improvements as benefits of modernization.
Abstract Aim In community-based prevention, adopting an evidence-based strategy is known to predict prevention success. Evidence-based prevention includes a theoretical framework, empirical assessment, effective programs, and monitoring of community efforts and outcomes. This study aims to examine the extent to which community capacity explains variation in evidence-based prevention, a known predictor of community-based prevention success. Subject and methods The present study is a secondary data analysis based on a survey of 182 key informants in 38 communities. To determine the validity of the measurement, structural validity, internal consistency, and inter-rater agreement were assessed. Associations between adoption of evidence-based prevention and ten domains of community capacity (participation, knowledge & skills, resources, leadership, community power, collaboration consisting of prevention collaboration and sectoral-collaboration, sense of community, critical awareness & problem solving, and community structure) were investigated at the community level using logistic regression models. Results Most findings of the validation analysis indicate that the community capacity domains could be reliably measured using key informant reports. Results of logistic regression models indicate that adopting evidence-based prevention is related to increased sense of community (OR 6.62; 95 % CI 2.39-18.39), prevention collaboration (OR 26.05; 95 % CI 5.98-13.39), sectoral-collaboration (OR 10.49; 95 % CI 4.04-27.25), community power (19.29; 1.74-28.12), and community structure (OR 4.79; 95 % CI 1.85-12.43). Availability of leadership was predictive of higher chances of adopting evidence-based prevention (OR 5.21; 95 % CI 1.93-14.02). Conclusion Our findings suggest that communities with higher community capacity have increased chances of adopting an evidence-based prevention strategy. Trial registration This study was registered with German Clinical Trial Register: DRKS00022819 on Aug 18, 2021.
Hintergrund Die kommunale Prävention von Substanzgebrauch bei Heranwachsenden erfordert ausreichende Kapazitäten (Community Capacity). Der Beitrag untersucht die Zusammenhänge zwischen Community Capacity und Substanzgebrauch.
Zusammenfassung Hintergrund Communities That Care (CTC) ist ein Ansatz zur Übertragung präventionswissenschaftlicher Grundlagen in die kommunale Präventionspraxis. Mittels Schulungen und Tools unterstützt CTC Kommunen beim Aufbau lokaler Netzwerke zur Förderung der psychosozialen Gesundheit von Kindern und Jugendlichen. Bürgerbeteiligung, intersektorale Zusammenarbeit, wissenschaftsbasierte Prävention, Monitoring und Qualitätsentwicklung sind zentrale Elemente von CTC. Ergebnisse aus den USA legen nahe, dass die Wirkung von CTC auf Gesundheitsverhalten durch fünf intermediäre Outcomes vermittelt wird. Der Beitrag stellt erste Ergebnisse der Studie „Effektivität des kommunalen Präventionssystems Communities That Care“ (CTC-EFF) vor, die die Effektivität von CTC für Deutschland untersucht. Daten und Methoden Die CTC-EFF-Studie ist eine quasiexperimentelle Studie. Einbezogen sind 21 Kommunen, die CTC einführen (IK) und 21 a priori gematchte Vergleichskommunen (VK), die diesen hinsichtlich demographischen, wirtschaftlichen und kriminalstatistischen Merkmalen ähneln. 2021 wurden Befragungen mit 192 kommunalen Schlüsselpersonen (u. a. Amts- und Einrichtungsleitungen) durchgeführt. Bivariat wurde untersucht, ob sich die Befragten von IK und VK hinsichtlich acht soziodemographischer Merkmale, ihrer Einschätzungen zu Präventionszusammenarbeit, intersektoraler Kooperation, finanzieller Unterstützung, Rückhalt in der Bevölkerung sowie Übernahme wissenschaftsbasierter Prävention unterscheiden. Ergebnisse Die Befragten aus IK und VK unterscheiden sich in den soziodemographischen Merkmalen mit Ausnahme der Hochschulzugangsberechtigung (IK: 86 % vs. VK: 96 %) nicht signifikant. Auch werden Präventionszusammenarbeit, intersektorale Kooperation, finanzielle Unterstützung und Rückhalt in der Bevölkerung von den Befragten nicht unterschiedlich eingeschätzt. Eine Ausnahme bildet die Übernahme wissenschaftsbasierter Prävention. Schlussfolgerung Das Matching führte weitgehend zu Baseline-Äquivalenz in den untersuchten Merkmalen. Der kleine Vorsprung der IK gegenüber den VK in der Übernahme wissenschaftsbasierter Prävention ist plausibel, da die IK vor der Erhebung bereits erste Schulungen und Implementationsschritte vollzogen hatten.
Abstract Background Building community capacity is an essential health promotion approach, which refers to the characteristics of communities that affect their ability to identify and address social and public health problems. Despite general agreement about certain capacity domains and frameworks, there is no comprehensive and consistent assessment of community capacity. Therefore, the aim of this scoping review is to identify the domains and methods used to assess community capacity related to community-based prevention and health promotion. Methods A scoping search was performed on 06/02/2022 via PubMed, Web of Science, and Science Direct, with supplemental searches via Google Scholar. The review included studies published in English from 1990 to 2022 that explicitly described how community capacity was assessed in health promotion and prevention interventions. Furthermore, studies had to meet at least two of the three following criteria for capacity assessment: a theoretical foundation, a participatory approach, or a field test of the assessment tool. Results From 4779 records, 38 studies were included after applying exclusion criteria. Nineteen studies used mixed, eleven qualitative and eight quantitative methods to assess community capacity. The various domains used to assess community capacity were identified and reassembled into nine comprehensive domains: community participation , knowledge and skills , resources, leadership , community power , sense of community , collaboration , critical awareness and problem-solving , and community structure . The review also identified four sub-domains, which include commitment , communication , shared values and goals , and sustainability . Discussion This scoping review provides an overview of the domains and methods used to assess community capacity, which can facilitate the development of a comprehensive approach to capacity assessment in future research.
Abstract Background Community capacity is defined as the characteristics of communities that affect their ability to identify and address social and public health problems. Building community capacity has developed into a well-recognized health promotion approach. Despite general agreement about certain capacity domains and frameworks, there is no comprehensive and consistent assessment of community capacity. The aim of this review is to identify a) domains and b) methods used to assess community capacity related to community-based prevention and health promotion. Methods A systematic search was performed on 06-01-2022 via PubMed, Web of Science, and Science Direct, with supplemental searches via Google Scholar. Studies in English, from 1990 to 2022, that explicitly described how community capacity was assessed in health promotion and prevention interventions, were included. Furthermore, studies had to meet at least two of the three following criteria for capacity assessment: a theoretical foundation, a participatory approach, or a field test of the assessment tool. From 3,086 records, after exclusion criteria were applied, 38 studies were included. Nineteen studies used mixed, eleven qualitative and eight quantitative methods. The various domains to assess community capacity were identified and reassembled into nine comprehensive domains: community participation, knowledge and skills, resources, leadership, community power, sense of community, collaboration, critical awareness and problem-solving , and community structure . Additionally, four sub-domains were found: commitment, communication, shared values and goals , and sustainability. Discussion This review provides an overview of community capacity domains and assessment methods, thus facilitating the development of a comprehensive approach to capacity assessment in future research.
