Healthy Communities Dissemination Conference Stress Mobilization, Empowerment

Seeking to engage, mobilize, and empower communities in the promotion of healthy lifestyles, the Constanta/Louisville partners hosted the National Healthy Communities Conference September 23-24 in Constanta, Romania. The purpose of the meeting was to share the Healthy Communities model with health professionals and educators, criminal justice specialists, law enforcement personnel, teachers, and local NGO representatives from throughout Romania, specifically in terms of the partnership's experience with the process and how it relates to domestic violence and sexually transmitted infection (STI) prevention programs.

Approximately 120 participants—including community leaders involved in the partnership and local stakeholders from various levels of the healthcare sector with special interest in community-based initiatives—convened at the two-day event to hear how the Constanta/Louisville partners have engaged the community to address health-related issues identified by the local population. The presentations focused on lessons learned and ways to approach and implement the Healthy Communities model.

The conference began with opening remarks from Stelian Dutu, president of the Constanta County Council; Mihai Horga, director of the Romanian Ministry of Health's Department for Family and Social Assistance; Virginia K. Judd, executive director of The Humana Foundation in Louisville and US partnership coordinator, Denny Robertson, USAID/Romania mission director; Vasile Sarbu, dean of the Medical School at Ovidius University; James P. Smith, AIHA executive director; and Shirley Willihnganz, acting provost at the University of Louisville. Daniel Verman, head of the Constanta Public Health Directorate's Health Promotion Department and CEE coordinator of the Constanta/Louisville partnership, facilitated the event. Day one was spent detailing the Healthy Community process using the Constanta/Louisville approach as a model.

Bernice Bennett (center) takes a break with Loti Popescu and Daniel Verman between sessions at the Healthy Communities Dissemination Conference in Romania. (Photo: Suzanne Grinnan)

Discussing the mobilization of the local community, Dutu said that "society cannot prosper unless the family unit is healthy, and to create a healthy society, we must engage all its members." Sarbu furthered these thoughts by saying that when we think of health, we often think of one-on-one relationships with doctors, but that "what has been created in Constanta is a community working together to treat the ailments of its citizens. It is a model that we will replicate in other parts of the country."

Providing an overview of the AIHA Healthy Communities model that has been implemented by 7 partnerships during the past seven years, Bernice Bennett, AIHA senior program officer, defined the concept of "Healthy Community" and illustrated how AIHA has used the model to mobilize stakeholders on the local level throughout the NIS and CEE. In her talk, Bennett stressed that AIHA has been engaging and empowering stakeholders, decision-makers, and local citizens through its partnership programs since 1995 as part of an effort to enhance the delivery of community-based health services, and has transform healthcare by providing communities with the tools to take charge of their own health. She also noted key factors that influence community health, including political, social and economic, lifestyle, and environmental issues, and stressed the importance of the active involvement of medical schools and businesses, local health departments, civic and non-governmental organizations, as well as residents, in developing programs that respond to the constantly changing healthcare needs of a community.

During his talk, Agis Tsouros told participants that the Healthy Communities model gives a voice to citizens in decisions that affect their health. (Photo: Suzanne Grinnan)

In addition, Bennett talked about the development and implementation of community intervention strategies and partnership building involving multiple sectors of the community.

Following Bennett's talk, Agis Tsouros, regional advisor for the Healthy Cities program and head of the Center for Urban Health at WHO, explained how the Healthy Communities approach is being adopted by cities and towns all over Europe and how these communities have become part of a larger network called Healthy Cities. Recapping Bennett's comments, he said that the model is important because it "gives a voice to citizens in decisions that affect their health," while explaining that to "create a movement at the local level, it is important to get the attention and direct involvement of the local government for two reasons: because they are in a position to create partnerships and alliances around public health sectors and because they are close to the citizens." He went on to list the four main elements of a community mobilization methodology:

• explicit political commitment;
• a structure to manage change with strong leadership by champions of the cause;
• a goal that allows you to involved different sectors in one issue and to develop a common language; and
• networking and alliance building.

Following Tsouros's overview of the community mobilization process, Loti Popescu, coordinator of the STI program and Healthy Communities Project at the Constanta Public Health Directorate's Health Promotion Department, and Michael Silvers, director of the Jefferson County Health Department, discussed methods for identifying local health needs. In her talk, Popescu described the use of focus groups in the Healthy Communities process. She discussed the criteria for selecting valid ideas stating that focus groups "help us understand the deeper aspect. Sometimes we treat things too quickly because we assume we understand them because they are well known. But this is not always true." Popescu also cited advantages—the fact that the media can influence adaptation of new behaviors, reach a large population, and promote health messages frequently—and disadvantages—costs, difficulty adapting to "special needs" audiences, and limited distribution to rural area—to using the mass media to engage communities.

Other presentations examined the roles of volunteerism, law enforcement, and the justice administration in the process of developing healthy communities, and explored various strategies for developing and sustaining initiatives. In particular, attendees heard about the domestic violence prevention, treatment, and prosecution and STI prevention initiatives implemented by the Constanta/Louisville partners.

For the second day, conference participants signed up for one of three workshops—the domestic violence implementation program, STI implementation program, or fundraising—where they spent time learning about each aspect of the Constanta/Louisville approach in depth.

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