HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS REGISTER		Author Keyword(s) Vol Page [Advanced]

This Article Full Text Full Text (PDF) Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this link to a friend Similar articles in this journal Similar articles in PubMed Add article to my folders Download to citation manager Request Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Nilsen, P Search for Related Content PubMed PubMed Citation Articles by Nilsen, P

The theory of community based health and safety programs: a critical examination

Correspondence to:
MrP Nilsen
Department of Health and Society, Division of Social Medicine and Public Health Science, Linköping University, SE-58183 Linköping, Sweden; nilsen{at}uptown.se

ABSTRACT
This paper examines the theoretical underpinning of the community based approach to health and safety programs. Drawing upon the literature, a theory is constructed by elucidating assumptions of community based programs. The theory is then put to test by analyzing the extent to which the assumptions are supported by empirical evidence and the extent to which the assumptions have been applied in community based injury prevention practice. Seven principles representing key assumptions of the community based approach to health and safety programs are identified. The analysis suggests that some of the principles may have important shortcomings. Programs overwhelmingly define geographical or geopolitical units as communities, which is problematic considering that these entities can be heterogeneous and characterized by a weak sense of community. This may yield insufficient community mobilization and inadequate program reach. At the same time, none of the principles identified as most plausible appears to be widely or fully applied in program practice. The implication is that many community based health and safety programs do not function at an optimum level, which could explain some of the difficulties in demonstrating effectiveness seen with many of these programs.

Keywords: community-based approach; characteristics; theory; assumptions; practice