Reclaiming the social in community movements: perspectives from the USA and Brazil/South America: 25 years after Ottawa

Health protection and territorial health organization: The figure of the family and community nurse (IFeC)

BACKGROUND

The improvement of health represents a goal for all countries in the world in a global way and, compared to earlier stages of development, there is a significant focus by the public health system on community and home-based services in particular.

OBJECTIVE

This objective was reaffirmed during the last World Health Summit (May 2021), at which the leaders of the G20 countries, together with other member states, signed the "Declaration of Rome".

METHODS

The paper contains the study of the impact that the COVID-19 pandemic has determined on the organization of the health system, through the study of the data provided by the main national and international organizations in the health field.

RESULTS

It emerged that the field of personal, family and community care are certainly an area of growth for nursing, which also in the European context, is showing an increase importance given to services and care activities outside the hospital and home in particular. In all of this, the roles that nurses can assume are differentiated and articulated.

CONCLUSIONS

In the complexity of this perspective, families and community seem to emerge as a point of reference for a nursing care that is certainly going through a decisive moment in the slow, but inexorable path towards the emancipation of its disciplinary status and the development of its ability to provide new, original and autonomous responses to the needs of the assisted population.

A review of assessment indicators used by Healthy Municipalities and Communities Program in Latin America and the Caribbean region

The Healthy Municipalities and Communities Strategy (HMCS) was developed by the Pan American Health Organization in 1990. Evaluation and monitoring are fundamental components of health promotion policies. The aim of this study is to explore the indicators used in Latin America and the Caribbean (LAC) countries to assess the performance of HMCS. We searched MEDLINE, EMBASE, LILACS, BVSDE and Google Advanced Search for documents published between January 2000 and April 2016. We included only documents with assessment indicators of the strategy. All articles were independently assessed for eligibility by pairs of reviewers. We classified the indicators with a supporting framework proposed by O’Neill and Simard (Choosing indicators to evaluate Healthy Cities projects: a political task? Health Promot Int 2006, 21, 145–152.). Local level indicators figured far more prominently among countries and were distributed both in projects and specific activities. Regarding the evolution of the HMCS, indicators were reported in the five levels of analysis (local projects and activities, provincial, national and international networks). Empowerment was represented through the presence of active community organizations and different methods of community participation (forums, open hearing and participation maps). Public policies (such as for tobacco cessation) and bylaws adherence and changes in school’s curricula regarding healthy eating were frequently mentioned. However, this review demonstrated that impact indicators related to lifestyle changes or built environment are not clearly defined and there is a lack of indicators to measure progress in achieving change in long-term outcomes in LAC. We highlight the importance of designing validated indicators for measuring the impact of health promotion policies in partnership with each country involved.

An evidence-based framework on community-centred approaches for health: England, UK

Community participation is a central concept for health promotion, covering a breadth of approaches, purposes and activities. This paper reports on a national knowledge translation project in England, UK, which resulted in a conceptual framework and typology of community-based approaches, published as national guidance. A key objective was to develop a conceptual framework linked to sources of evidence that could be used to support increased uptake of participatory methods across the health system. It was recognized that legitimacy of community participation was being undermined by a scattered evidence base, absence of a common terminology and low visibility of community practice. A scoping review, combined with stakeholder consultation, was undertaken and 168 review and conceptual publications were identified and a map produced. A 'family of community-centred approaches for health and wellbeing' was then produced as way of organizing the evidence and visually representing the range of intervention types. There are four main groups, with sub-categories: (i) strengthening communities, (ii) volunteer and peer roles, (iii) collaborations and partnerships and (iv) access to community resources. Each group is differentiated using key concepts and theoretical justifications around increasing equity, control and social connectedness. An open access bibliography is available to accompany the framework. The paper discusses the application of the family of community-centred approaches as a flexible planning tool for health promotion practice and its potential to be used as a framework for organizing and synthesizing evidence from a range of participatory methods.

Shared Participatory Research Principles and Methodologies: Perspectives from the USA and Brazil-45 Years after Paulo Freire's "Pedagogy of the Oppressed"

The trajectory of participation in health research by community social actors worldwide has been built on a history of community participation from the Ottawa Charter Health Promotion call for community mobilization, to the emancipatory educational philosophy of Paulo Freire, to social movements and organizing for health and social justice. This paper builds on this history to expand our global knowledge about community participation in research through a dialogue between experiences and contexts in two prominent countries in this approach; the United States and Brazil. We first focus on differences in political and scientific contexts, financing, and academic perspectives and then present how, despite these differences, similarities exist in values and collaborative methodologies aimed at engaging community partners in democratizing science and knowledge construction. We present three case studies, one from the U.S. and two from Brazil, which illustrate similar multi-level processes using participatory research tools and Freirian dialogue to contribute to social mobilization, community empowerment, and the transformation of inequitable societal conditions. Despite different processes of evolution, we observed a convergence of participatory health research strategies and values that can transform science in our commitment to reduce health and social inequities and improve community wellbeing.