A model of coalition capacity for effective public health interventions

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A model of coalition capacity for effective public health interventions

 

Author: Chan, Hin-wang Kevin
Title: A model of coalition capacity for effective public health interventions
Degree: Ph.D.
Year: 2009
Subject: Hong Kong Polytechnic University -- Dissertations.
Public health -- China -- Hong Kong.
Health promotion -- China -- Hong Kong.
Department: Dept. of Applied Social Sciences
Pages: xiv, 147 leaves : ill. (some col.) ; 30 cm.
Language: English
InnoPac Record: http://library.polyu.edu.hk/record=b2321021
URI: http://theses.lib.polyu.edu.hk/handle/200/4377
Abstract: Modern public health interventions often require mobilization beyond inter-institutional collaboration and extend into the community. Such movement calls for theories and empirical evidence that explain and illustrate the process of community mobilization. Arising from the conception that community is an active system that is not only involved in the maintenance of health interventions, but also in the planning and genesis of new public health interventions. The study of coalition in public health intervention provides an opportunity for examining how communities mobilize their resources into health promotion. The present study reviews an extensive list of theoretical and empirical research on health promoting coalitions and proposes an integrated framework that evaluates key domains of coalition capacity from a relational context. Capacity parameters are analyzed in terms of their structural coherence and their relationship with coalition outcomes (perceived coalition effectiveness) and members' collaboration (social networks) with the aid of qualitative structured focus group interviews, social network analysis, independent statistical model, and interdependent statistical models. From the coalition parameters surveyed and qualitative data from the focus group interviews, the coalition featured in this study (KTSHC) showed a high level of coalition capacity, perceived effectiveness, and members' collaboration. The observed capacity parameters were interdependent, exhibiting statistically significant correlation among each other. Network densities reported from this study were low relative to other health promotion coalitions, but compatible when compared to similar efforts on safety promotion. The coalition was distinctly characterized by a core-periphery structure in which the core comprised various members from several key organizations (healthcare professionals, local government representatives, central government delegates, and education professionals) and the periphery reached out to a variety of organizations and community representatives. Regression analysis on individual-level capacity parameters and network measures revealed that coalition effectiveness was primarily attributed to how core members appraise the style of leadership, assess the level of development, and utilize peripheral members on referrals of services and professional placements. Findings from this study shed lights on the structure and context of an internationally recognized mode of promoting community health in the form of Safe Community and Healthy City. These findings also have implications for studying the process of community health intervention from a relational perspective and contributed to the unfolding of processes and implementation underlying inter-sector collaboration on health promotion in the form of community coalition.

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