IMPLEMENTING COMMUNITY HEALTH Types of Prevention
INTERVENTION
Purpose of Implementation:
 develop comprehensive, multifaceted
strategies to address the community health
needs
 enhance the community’s capability in
dealing with common conditions/problems in
the community
Role of the CH nurse
 to facilitate the process rather done to
directly implement the planned interventions
 actively encourage involvement in the
implementation strategies planning process
 collaborate with other sectors such as the
LGU and other agency
Level of intervention:
 think critically about the level at which you
are intervening and how your efforts can
make the most impact.
 will your strategy be clinically based, or will it
take place in the community?
 will you address the specific needs of
individuals or the community as a whole?
Level of Prevention:
Primary
o targeting an entire population to prevent a
problem by thinking upstream about the
social determinants of health and fostering
circumstances and environments that
promote health and well-being for all
Secondary
o targeting at-risk populations to prevent
escalation of a problem by identifying these
populations and trying to address risk
factors
Tertiary
o treating individuals diagnosed with the
problem through intensive, individualized
treatment or interventions
Traditional clinical prevention
o occurs in a clinical setting as part of a one-
on-one patient-clinician encounter –
includes vaccinations and screenings
Innovative clinical preventive interventions
o extend care from the clinical setting to the
community; prevention approaches in this
bucket include using community health
workers to support chronic disease
management
Total population or community-wide
interventions:
o target entire populations in a given
geographic area and are based outside of
clinical offices in communities, schools or
workplaces; accomplished though policy or
environmental changes
To move the needle on community health, it is helpful
to develop a comprehensive strategy that addresses
multiple facets of each health need. This requires
thinking of the big picture of health and the health
care system’s role in improving it.
A comprehensive approach includes:
a) Multiple strategies (e.g., educational,
environmental, policy, programmatic)
b) Various settings (e.g., schools, communities,
workplaces)
c) Multiple targets, including individuals, the
community at large and at-risk subgroups
d) Methods to address the medical and non-
medical factors that contribute to the health
issue
Some interventions may be promising but do not yet
have a body of data to qualify them as “evidence-
based.” This does not mean that such interventions
may not be beneficial. By implementing similar
interventions in your community and measuring
their success, you could contribute to building that
evidence base.
Defining your specific goals and objectives will help
focus the strategies. Make sure to set “SMART”
objectives:
Specific
Measurable
Achievable
Realistic
Time-bound
Tailor strategies to community culture
Strategies should be unique to your community
based on its needs, the demographics of individuals
in the community
Be aware of how the culture and environment of your
community fits with an intervention. This is an area
where engaging external stakeholders can be
extremely valuable, as they can provide guidance
regarding which strategies would be socially and
culturally acceptable.
Identify funding sources and opportunities
New interventions or strategies require resources—
both human and financial—to succeed. As you plan
your strategies, consider what funding you have
available and how it may need to be increased
through grant funding. Reflect on these questions:
How can this intervention be sustainably funded?
What funding within the hospital or health system
might be available? What grant opportunities are
available?
Does the health facility have a foundation that would
be interested in supporting this?
What community foundations may want to invest?
Are there community development financial
institutions that you could partner with?
How much of your community benefit spending can
go toward the strategy?
Are there any collaborative grant opportunities?
What in-kind resources from the hospital or
community can be tapped?
EVALUATION
Structure evaluation
o involves looking into the manpower and
physical resources of the agency responsible
for community
Process evaluation
o examining the manner by which assessment,
diagnosis, planning, implementation and
evaluation were undertaken
Outcome evaluation
o determining the degree of attainment of
goals and objectives
Standards of Evaluation
Utility
o the value of the evaluation in terms of
usefulness of results helps the group gain
insight into strengths and weaknesses of the
plan and the manner of its implementation
o helps provide a basis of utilizing the
community health process in dealing with
other community concerns in the future
Feasibility
o answers the question of whether the plan for
evaluation is doable or not, considering
available resources
o entails anticipation of how the results will be
received by different groups and how to avoid
possible misuse of the data derived from the
process
Propriety
o involves ethical and legal matters
o respect for the worth and dignity of the
participants in data collection should be given
into consideration
o the results of the evaluation should be
truthfully reported to give credit to where it
is due and to show the strength and
weaknesses of the community
o results should be furnished to everyone
entitled to them, especially the community
o transparency and accountability should be
observed in all financial matters related to
the community health action
Accuracy
o refers to the validity and reliability of the
results of evaluation.
o review of data gathered during evaluation
accompanied by corrective measures when
errors occur increases level of accuracy of
evaluation.
o Consider evaluation from the start

Evaluation can look at short- and long-term outcomes

as well as process metrics.

short-term measures are most likely to be process

measures (how many people used a service or
attended a program), while long-term outcomes will
monitor changes in health status — a process that
takes more time

Because these strategies will take time to make a

population level impact, secure funding sources that
will allow the strategy to be sustainable:

a) Document the implementation strategies

b) Document your implementation strategies,
including:
o Strategies for each need for each hospital
o Actions to address prioritized health needs
o Anticipated impacts of the strategies
o A plan to evaluate the impact of the
strategies