ASSESSING FACTORS INFLUENCING PARTICIPATION AND DISSEMINATION IN COMMUNITY-BASED PUBLIC HEALTH COALITIONS: AN EXPLORATION OF SOCIAL CHANGE

• Main Author: Morris, Chad Tyler
• Format: Others
• Published: UKnowledge 2009
• Subjects: Communicative Action|Public Health Coalition|Participation|Public Health Partnership|Health Promotion; Anthropology
• Online Access: http://uknowledge.uky.edu/gradschool_diss/720; http://uknowledge.uky.edu/cgi/viewcontent.cgi?article=1723&context=gradschool_diss

The community-based public health coalition has proliferated in public health practice since the 1970‘s as a favored means of achieving community participation in public health promotion. There is concern, however, that many contemporary coalitions are not particularly inclusive, and that population health indicators fail to demonstrate significant improvement in health outcomes resultant from coalition practice. This dissertation research was designed to critically examine participation and dissemination of coalition-derived ideas through ethnographic study of five community-based participatory public health coalitions in the United States. The research answers calls from public health scholars to improve upon the coalition theory base and to contribute a useful theory of dissemination of public health interventions. At the same time, the research contributes to anthropological calls for better understanding of mechanisms that discourage the participation of all stakeholders. The research uses a theoretical model – Habermas‘ Theory of Communicative Action – that sees participation and dissemination as linked phenomena. The research was designed to contribute to an existing theory of coalition function, Butterfoss and Kegler‘s Community Coalition Action Theory. Qualitative evidence of communicative action was gathered through participant observation of coalition meetings and semistructured interviews with a purposive sample of members of each study coalition. Data were compared across coalitions and across respondent categories to determine variation in diversity of coalition participation and forms of coalition-derived communicative action; as well as indicators associated with motivation for coalition participation, barriers to participation, and dissemination of ideas both in coalition meetings and to broader discourse communities outside the coalition. The results of this applied research include the creation of a typology of diversity of coalition participation, improved understanding of differences in motivation for coalition participation between members in- and outside of the social services sector, the identification of collateral idea exchange as a key coalition outcome, and means of overcoming barriers to participation and dissemination. In addition to representing contributions to theory within anthropology and public health, these results have been shared with leaders of each of the study coalitions.