Reconsidering community-based health promotion: Promise, performance, and potential

Cheryl Merzel, Joanna D'Afflitti

Research output: Contribution to journalReview articlepeer-review

Abstract

Contemporary public health emphasizes a community-based approach to health promotion and disease prevention. The evidence from the past 20 years indicates, however, that many community-based programs have had only modest impact, with the notable exception of a number of HIV prevention programs. To better understand the reasons for these outcomes, we conducted a systematic literature review of 32 community-based prevention programs. Reasons for poor performance include methodological challenges to study design and evaluation, concurrent secular trends, smaller-than-expected effect sizes, limitations of the interventions, and limitations of theories used. The effectiveness of HIV programs appears to be related in part to extensive formative research and an emphasis on changing social norms.

Original languageEnglish (US)
Pages (from-to)557-574
Number of pages18
JournalAmerican journal of public health
Volume93
Issue number4
DOIs
StatePublished - Apr 1 2003

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

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