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Biomedical subjects

B Checkoway

Publications and source records attributed to B Checkoway.

8 recordsLinked to original sources
PubMed1994

Health education and community empowerment: conceptualizing and measuring perceptions of individual, organizational, and community control.

The prevailing emphasis in health education is on understanding and changing life-style choices and individual health behaviors related to health status. Although such approaches are appropriate for some health problems, they often ignore the association between increased morbidity and mortality and social, structural, and physical factors in the environment, such as inadequate housing, poor sanitation, unemployment, exposure to toxic chemicals, occupational stress, minority status, powerlessness or alienation, and the lack of supportive interpersonal relationships. A conceptual model of the stress process incorporates the relationships among these environmental factors, powerlessness (or conversely empowerment), social support, and health status. The concept of empowerment has been examined in diverse academic disciplines and professional fields. However, there is still a lack of clarity on the conceptualization of empowerment at different levels of practice, including its measurement, relationship to health, and application to health education. The purpose of this article is to address these issues as they relate to the concept of community empowerment. It provides a definition of community empowerment that includes individual, organizational, and community levels of analysis; describes how empowerment fits within a broader conceptual model of stress and its relationship to health status; and examines a series of scales that measure perceptions of individual, organizational, community, and multiple levels of control. The article concludes with broad guidelines for and barriers to a community empowerment approach for health education practice.

Adaptation, Psychological↗
PubMed1982

The empire strikes back: more lessons for health care consumers.

A previous article in this journal analyzed the efforts of health care consumers to organize around the Health Systems Agency in east central Illinois. This article continues the account by describing how local providers organized in response to these initiatives, elected their own slate to the local HSA board, and caused consumers to reconsider their participation in health planning. Among the conclusions drawn is that health planning operates in an imbalanced political arena in which providers can mobilize powerful resources to defeat consumer action.

Community Participation↗
PubMed1982

Public participation in health planning agencies: promise and practice.

Federal legislation provided an opportunity for health planning to "catch up" with the expanding citizen participation movements of recent years. Although the literature on health planning is mounting, there as yet has been no comprehensive, systematic effort to inventory the status of participation on a national scale. This note reports on a national study of Health Systems Agencies designed to inventory the participation objectives and methods in use, identify major participants and obstacles, and analyze impacts and factors influencing practice in the field. Among the findings are that agencies have favored "safe" participation methods that satisfy minimum federal requirements and provide information and public relations without transfer of power to consumers; and have broadened the base of participation in planning without mobilizing consumers or reducing the dominance of providers, who remain the most active, organized, and influential participants.

Community Participation↗
PubMed1981

Representation of providers on health planning boards.

PL 93-641, The National Health Planning and Resources Development Act of 1974, called for broad representation of health care providers, in addition to consumers, on Health Systems Agency (HSA) governing boards. Analysis of data submitted to the U.S. Department of Health, Education, and Welfare by the HSAs indicated that HSA provider board members are not representative of the overall provider work force or general population. Direct providers outnumber indirect providers by roughly seven to one. Physicians and hospital-nursing administrators are overrepresented, and nurses and other provider groups underrepresented, in relation to their numbers in the work force. Evidence also shows that HSA provider board members are mostly white males, although nonwhites and females are significantly represented in the work force and population.

Administrative Personnel↗
PubMed1980

Community organizing lessons for health care consumers.

This article analyzes the efforts of health care consumers to organize independently of, but with reference to, the Health Systems Agency in east central Illinois. Beginning with a tactical investigation which disclosed a lack of effective public participation, consumers formed an organization which conducted a series of community forums to provide information and generate publicity about local health care issues, sponsored training workshops for consumer leaders and HSA board members, worked to delay the final designation of the agency, and organized to take control of the local HSA board. They recruited a large number of new HSA members, enlisted provider and consumer candidates to run for the board, conducted a vigorous election campaign, and finally claimed a majority of seats. Among the conclusions drawn are that health care planning cannot be considered apart from a context of politics, and that community organization is important for consumers wishing to exercise power.

Community Participation↗