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Biomedical subjects

R Labonte

Publications and source records attributed to R Labonte.

At least 19 recordsLinked to original sources
PubMed2000

A planning framework for community empowerment goals within health promotion.

Health promotion often comprises a tension between 'bottom-up' and 'top-down' programming. The former, more associated with concepts of community empowerment, begins on issues of concern to particular groups or individuals, and regards some improvement in their overall power or capacity as the important health outcome. The latter, more associated with disease prevention efforts, begins by seeking to involve particular groups or individuals in issues and activities largely defined by health agencies, and regards improvement in particular behaviours as the important health outcome. Community empowerment is viewed more instrumentally as a means to the end of health behaviour change. The tension between these two approaches is not unresolvable, but this requires a different orientation on the part of those responsible for planning more conventional, top-down programmes. This article presents a framework intended to assist planners, implementers and evaluators to systematically consider community empowerment goals within top-down health promotion programming. The framework 'unpacks' the tensions in health promotion at each stage of the more conventional, top-down programme cycle, by presenting a parallel 'empowerment' track. The framework also presents a new technology for the assessment and strategic planning of nine identified 'domains' that represent the organizational influences on the process of community empowerment. Future papers analyze the design of this assessment and planning methodology, and discuss the findings of its field-testing in rural communities in Fiji.

Community Health Planning↗
PubMed1999

A story/dialogue method for health promotion knowledge development and evaluation.

Arguments have been made in favour of a constructivist or postpositivist approach to health promotion knowledge development and program evaluation, but little has been articulated about what such an approach would look like. This article describes a 'story/dialogue method' that was created with and for practitioners in response to their concerns that much of their practice did not lend itself to a positivist, or conventional, methodology. Derived from constructivist, feminist and critical pedagogical theory, and with roots in qualitative methods, the method structures group dialogue around case stories addressing particular generative practice themes. While intended for practitioner training, organizational development and evaluation, the method to date has been used primarily for training purposes. This article describes the method, provides an example of its application, and discusses its strengths, weaknesses and relevance to health promotion.

Anecdotes as Topic↗
PubMed1999

Social capital and community development: practitioner emptor.

Social capital has become the latest 'flavour of the month'. There is considerable disagreement over what the term means, and calls for theorising and measurement of the construct. Health promoters, among others, are being challenged to re-construct their efforts around this still contested idea. Social capital doesn't exist, but is being created by those aspects of social relations particular theorists or researchers choose to study in its name. The choice of these relations is directed by ideology. To those aligned more with neoliberal, market-driven ideology, social capital is a means to the end of economic growth, something that can pick up the slack of privatised or reduced public services. To those aligned more with social justice and communitarian ideology, social capital is an end in itself, requiring the defence of strong, egalitarian state intervention into market practices that create inequalities. Community development is one of many state interventions used to buffer market-generated inequalities. Social capital may be a useful concept for practitioners, researchers and policy makers in bring the missing 'social' into economic and fiscal policy debates. But its use should be approached cautiously as a construct of potential strategic value. It should not confuse all of the previous 'good' work undertaken in the name of empowerment and community capacity.

Australia↗
PubMed1996

Delivering the goods, showing our stuff: the case for a constructivist paradigm for health promotion research and practice.

This article argues that there has been a tendency to empower the "conventional" positivist paradigm in health promotion research, often at the expense of confounding or ignoring much of health promotion practice. This article argues further that a "constructivist" research paradigm not only has the potential to resolve some of the tensions between research and practice in health promotion but also is inclusive of knowledge generated by the conventional paradigm. The usefulness of a constructivist paradigm is demonstrated through the use of four practice-based case examples drawn from actual community-based health promotion efforts. The congruence of a constructivist paradigm with the health promotion principles of empowerment and community participation are discussed. Finally, this article argues for the acceptance of the legitimacy of knowledge generated from the constructivist paradigm and concludes that this paradigm is more suited to the goals of current health promotion.

Community Participation↗
PubMed1994

Health promotion and empowerment: reflections on professional practice.

Recent reformulations of health promotion focus on empowerment as both a means and an end in health promotion practice. Both concepts, however, are rarely examined for their assumptions about social change processes or the potential of community groups, professionals, and institutions to create healthier living situations. This article attends to some of these assumptions, expressing ideas generated during 6 years of professional training workshops with over 2,500 community health practitioners in Canada, New Zealand, and Australia. The article first argues that health promotion is not a social movement but a professional and bureaucratic response to the new knowledge challenges of social movements. As such, it has both empowering and disempowering aspects. The article analyzes empowerment as a dialectical relation in which power is simultaneously given and taken, and illustrates this in the context of health promotion programs. A model of an empowering professional (institutional) health promotion practice is presented, in which linkages among personal services, small group supports, community organizing, coalition advocacy, and political action are made explicit. Practice examples are provided to illustrate each level of the empowering relation, and the article concludes with a brief discussion of the model's educational and organizational utility.

Canada↗
PubMed1988

Health promotion: from concepts to strategies.

Just 20 years ago, health promotion was a little understood aspect of healthcare. Although still secondary to disease treatment, especially in hospitals, it now has gained a great deal of support. A number of charters, frameworks and reports have been put forth in the last several years which have tried to establish that social conditions and personal actions are also important in determining health, not only physicians and sophisticated medical equipment. Community leadership, consisting of collective discussion, decision making and action is the key. Two successful groups illustrate how social action can produce beneficial results, and how professionals and agencies can help communities put health promotion into operation.

Canada↗