Community Health and Disease Prevention Essay Example

  • Category:
  • Document type:
  • Level:
  • Page:
  • Words:

13Community Based Interaction in Health Promotion

Community Based Interaction in Health Promotion

Institution/ Semester

Community Based Interaction in Health Promotion

The Community-based interaction plays a great role towards establishing an improved health system in different communities and this is seen in the approaches that it uses such as establishing action research methodologies that effect social changes in communities. This is a participatory approach that entails deepening the knowledge that people already have some of the problems they face in relation to healthy living and so on (Carr, 2008). Besides imparting knowledge on the communities, the Community-based interaction also plays the role of changing and improving the participant’s behavior and practices towards improving health in the modern world. With effective implementation of the knowledge that communities are given through the CBI, then the communities and its participants are able to improve both their own health standards and those of others since they will have also been impacted with knowledge on how to do research on health problems affecting the community.

Laverack’s Ladder of Community Based interaction

Laverack’s ladder of community-based interaction begins with community readiness and culminates into community empowerment. In this model, communities participates and develop the capacity of the community towards taking actions that will yields to effective development of the community in many aspects (Laverack, 2007). This implies that communities must develop skills, organize abilities and resources that will enable them to act towards this positive change. According to this theory that enables the community to take responsibility towards making a difference, the terminologies “capacity, empowerment, social capital and social cohesion” have all been used for similar things.

This area of health promotion does not seem to have enough theories that can be implemented to make a difference thus Laverack’s ladder is the most effective so far because they suggest several domains of community capacity which are crucial for health promotion programs (Clark, 2002). The areas of health promotion programs within Laverack’s ladder theory are; participation, leadership, problem assessment, organizational structures, resource mobilization, program management among others. This are of study suggests that particular domains fir particular situations and assessment of capacity is a very particular issue since many practitioners assess the capacities to be developed such as; research skills, funding application skills, and leadership skills in accordance to the needs of the programme.

Community Health and Disease Prevention

Fig 1: Table showing Laverack’s Ladder of Community-Based Interaction

Levels of Community-Based Interaction in Health Programs

The levels of community-based interaction in health programs are organized in the following manner; from community empowerment which is includes social and political action, then to community action which simply has community control, to community capacity, community development, community organization, then to community engagement, community participation, and finally to community readiness (Laverack, 2007).

Type 2 Diabetes

The preventable health concern that I will focus on in my research is type 2 diabetes.

This is a long-term metabolic disorder that is mainly characterized by relative lack of insulin, high blood sugar, and insulin resistance in the body(Thomas, 2013). It mainly occurs through lack of exercise and the results of obesity. The most common prevention measures of this disease are; no smoking, managing cholesterol levels, regular physical activities, managing blood pressure, and maintaining healthy weight.

Community Health and Disease Prevention 1

Fig 3: Image showing Type 2 Diabetes

Theories on Health Behaviors

There are few models that professional base their interventions on in modern behavioral medicine. The most common theories are such as; health belief model, education model, planned behavior theory and social cognitive theories among others. In this research, the model that I will emphasize on towards educating the society about type 2 Diabetes is the Health Belief Model (HBM).

Models and Approaches of Health Promotion

Health Belief Model (HBM)

This is a model that is psychological and attempts to predict and explain different health behaviors. This is often done through understanding the beliefs and attitudes that an individual holds towards a specific disease (Jacobs, 2010). This model was discovered in the 1950s by a certain psychologists Kegels, Rosenstock and Hochbaum who were working in the Public Health Services of the U.S. Through this model, it is assumed that the beliefs and attitudes of the person suffering from a certain disease affects them and has consequences that reflect their behaviors. This model also explains why people know the possible health hazards of their behaviors can affect them such as smoking and so on but they still go ahead and continue with the behavior.

A person who has been suffering from specific cognitive illusions continues to live with their behavior despite the statistics that prove that they might have shorter lifespan or any other quality of life issues because in their subconscious mind, they will want to believe that they are exceptions to these possible negative outcomes (Thomas, 2013). One of the advantages of this model is that it helps an individual of the health choice that they need to make and it provides the knowledge that their actions need not be only on rational thoughts, but also on their habits, emotions, personal preference and social conditioning and so on. It also provides an individual with knowledge on the best health habits to embrace and the social learning health methods towards curbing their disease.

The limitation of this model is that it is limited in providing solutions to health care risks and this means that it cannot offer solutions based on environmental, personal and social factors that contribute to the health condition. It helps in coming up with effective social and educational awareness programs towards changing the behaviors of individuals, but it is unable to offer long-lasting solutions to various diseases.

Education Approach

This approach focuses on behavioral changes that affect the health of individuals suffering from certain preventable diseases in the society. It teaches individuals to change certain behaviors that endanger their health through persuading these individuals to embrace preventive health services and take responsibility of their own health (Donson, 2010). The education approach mainly focuses on behavioral applications towards learning health practices and an educational approach that promotes healthy living. One of the benefits of this approach is that it provides knowledge and information to a person or people in a community suffering from certain preventable diseases like type 2 Diabetes and so on.

It also provides an individual with grounds in which they can make positive decisions towards improving their health (Glanz, 2008). The outcomes of an individual is often based on their voluntary choice which may not necessary favor the decisions of the health promoter and the approach does not motivate or persuade users to follow a particular direction. This approach does not have many limitations but the most common one is that an individual’s voluntary behavior change might be affected by either economic or social factors in a community. The approach also assumes that the behavioral changes of the user through increased knowledge will automatically result to positive behavior change (Sochting, 2014).

Community Health and Disease Prevention 2

Fig 3: Table showing an Educational Approach Model

The Ladder of Community-Based Interaction towards Prevention of Type 2 Diabetes

The ladder of community-based interaction provides a framework from community readiness, to participation, to engagement, organization, development, capacity building, collective action, and finally community empowerment.


This is the state of how well prepared the community is towards engaging themselves in a partnership with an outside agent in implementing a programme. Reaching to this stage simply means that the community has undergone a series of stages to develop and implement programmes that are effective (Laverack, 2007). This change is not actually the challenges and difficulties that the community has met in the process of implementing a programme effectively, but the level of preparedness to accept the changes to be implemented in the community. Their readiness simply means that they are also willing to interact with an outside agent and not necessarily focusing on the previous history of the participation between the members of the community. This readiness is often measured by an outside agency through the use of interviews and questionnaires to obtain important information.


Community participation simply builds and expands the relation between people in the community with the intentions of attaining knowledge on the bold needs of the community through discussing people’s ideas and experiences (Pereira, 2013). In practice, this is actually the representation of the majority by few members of the community. This is because not every member of the community is able to participate in the workshops and other meetings related to the development of the community. Representation of members to attend these meetings can be through a selection of a representative by the community or through a written submission to a specific committee.

Often times, this selection process can become hectic especially when individuals view the process as selection for power position or when other people feel that they are selected for passive activities since these participations can become empty and frustrating. This selection helps those that are in power or have authority to claim that their decision considered the needs and ideas of every other member present, hence helping to maintain the status quo to the advantage of the members (Kim, 2014). The process of participation is also closely linked to community cohesiveness, competence and other concepts that reflect a collective ability for interaction and connectedness between the community members.


This takes the participation of community members a step further through identifying people who can offer solutions to some of the problems that community is facing. There are a number of community engagement models such as; public participation model, asset-based social economy model, community-democracy model, consultation and the community-organizing model (Ragin, 2015). This is a collaborative process that often revolves around an outside agency such as an NGO and the community itself and it has the following steps; listening and communication, needs assessment, participation and working together in partnership.

Listening and communication

Community engagement is enhanced by people becoming more informed about the issues that are affecting them, and how they can become part of the solutions to these problems. Lack of understanding these problems can simply be addressed through giving clearer and more accurate information to the targeted people within the community (Ogden, 2008). Listening and communications more than just informing the community about issues and offering a one-way channel like mass media to provide information and so on.


Participation as discussed earlier, is one of the basic steps of the community towards offering solutions to problems affecting them and it also allows people in the community to become involved in the activities that influence their health and lives at large. However, while individuals have the capability of influencing the direction and develop relationships that promote a heightened interdependency among members (Kim, 2014). Working in partnership provides a better social and political environment towards expected developments in a community. At this level, community-based interaction progresses from simply being participatory to a more systematic and action-oriented.


A community that is oriented towards taking measurable actions is able to organize and mobilize itself towards shared goals. Through the organization of the community, it is easy to come up with decisions that that effective and actually offer long-lasting solutions to the problems in the community(Jeffries, 2012). In the process of organization with Laverack’s ladder theory, it is believed that people could reduce diseases and increase their quality of life and so on. Community organization was one of the means to empowerment of people in the community through a number of factors such as; better leadership, resource mobilization, and interpersonal relationships. Organization development, when it is linked to a collective struggle, becomes easily seen by those that are working with communities that have a legitimate model that can improve the health lives of people in the community.


Community development is among the earlier rungs of the ladder that goes further to provide means in which outside agencies can use to enable the community in improving their lives. This is through activities and interventions such as education, technical support and skills training. Community development is also linked to distribution of resources, infrastructural, political, economic and social development. In this process, the community identifies and reinforces those aspects of their lives which are improving health (Glanz, 2008). The project towards creating awareness of type 2 diabetes will allow the community to develop its own action plans and activities for implementation as well as being involved in the day-to-day running of the project, and was funded as part of a boarder government initiative toward community development.

Community capacity is a concept that has been recently developed than the concept of community development to provide a systematic approach towards building assets and attributes of a community within the design of a programme. This has been possible through the complex interpretation of this concept (Jacobs, 2010). The ‘domains’ of community capacity, which are similar to community empowerment are the areas of influence that allow communities to better mobilize and organize themselves toward political and social change. These ‘domains’ include problem assessment, participation; critical reflection; organizational structure; resource mobilization; links to others; programme management; and the overall role of the agent. Community empowerment and community capacity are two different overlapping processes that use the ‘domains approach’ to build communities that are more capable.

Whereas community capacity builds the assets and the attributes of people, community action on the one hand, is the resolution of their concerns to take specific actions to achieve self-identified goals (Donson, 2010). Communities have ownership of the issues that affect them and can control whoever identifies these issues to be addressed in the programme. Community control and community action are the basis for self-determination that gives people the purpose and direction to improve their live. It often begins when people come together to address the local concerns such as; public transport needs, for a short period and so on.


In conclusion, all the mentioned steps of Laverack’s Ladder are important towards ensuring that the issue of Type 2 diabetes has been solved in the community. The health promotion models namely Health Belief Model (HBM) and the Education Approach Model (EAM) are also essential towards providing a solution to this problem.


Carr, S., Lhussier, M., Wilkinson, J., &Gleadhill, S. (January 01, 2008). Empowerment evaluation applied to public health practice. Critical Public Health, 18, 2, 161-174.

Clark, C. C. (2002). Health promotion in communities: Holistic and wellness approaches. New York: Springer Pub. Co.

Dobson, K. S. (2010). Handbook of cognitive behavioral therapies. New York, NY: Guilford Press.

Glanz, K., Rimer, B. K., &Viswanath, K. (2008). Health behavior and health education: Theory, research, and practice. San Francisco, CA: Jossey-Bass.

In Kim, D. ., In Singhal, A., & In Kreps, G. L. (2014). Strategies for developing global health programs.

Jacobs, G. (January 01, 2010). Conflicting demands and the power of defensive routines in participatory action research. Action Research, 8, 4, 367-386.

Jeffries, P. R., &Battin, J. (2012). Developing successful health care education simulation centers: The consortium model. New York: Springer Pub. Co.

Laverack, G. (2007). Health promotion practice: Building empowered communities. Maidenhead: Open University Press.

Ogden, J. (2008). Essential readings in health psychology. Maidenhead, Berkshire, England: McGraw Hill/Open University Press.

Pereira, M. A. (2013). Nutrition and type 2 diabetes: Etiology and prevention. Boca Raton: Taylor et Francis/CRC Press.

Ragin, D. F. (2015). Health Psychology, 2nd Edition: An Interdisciplinary Approach to Health. Hoboken: Taylor and Francis.

Thomas, M. C., & Baker IDI Heart & Diabetes Institute. (2013). Understanding type 2 diabetes: Fewer highs, fewer lows, better health.

Söchting, I. (2014). Cognitive Behavioral Group Therapy: Challenges and Opportunities. Hoboken: Wiley.