Health Promotion International, Vol 13, 211-222, Copyright © 1998 by Oxford University Press
L Neuhauser, M Schwab, S Syme, M Bieber and S King Obarski
With the rapid rise in health care costs, it has become imperative that
departments of health services find effective and affordable ways to
prevent disease and promote health. During the past 20 years, most of the
major educational interventions in the US designed to prevent disease by
changing behavior have not been as successful as expected. At the same
time, there is increasing evidence that community participation, a central
feature of the 'new public health', is a powerful component of the programs
that have been successful. In this paper, we describe and evaluate an
intervention that heavily involves the community. The Wellness
Guide is a comprehensive health promotion guide developed with
community participation to improve the wellness knowledge, attitudes and
behaviors of recipients. 100 000 copies of The Guide
in English and a Spanish adaptation, La Guía del
Bienestar, were distributed to California participants in the US
government nutrition program for low-income mothers and children (Women,
Infants and Children Supplemental Nutrition Program, or WIC). Interviews
from three population-based samples (n = 1189, 1889
and 672, respectively) were used to compare the knowledge and attitudes of
recipients and non-recipients of The Guide from
pre-distribution to 8 months post-distribution, and to assess recipients'
behavior changes. Eight months after distribution, 86% of recipients
reported having read all or part of The Guide, and 74%
had retained it. Recipients displayed significantly improved
wellness-related knowledge and attitudes compared with non-recipients, and
26% of recipients reported having modified their behavior because of
The Guide. Results demonstrate that a booklet of this
type, developed with extensive community participation and which addresses
a broad range of health-related issues, can significantly improve people's
wellness knowledge, attitudes and behaviors and contribute to state-wide
health promotion.Keywords: community participation;
evaluation; health promotion; wellness
ARTICLES
Community participation in health promotion: evaluation of the California wellness guide
University of California at Berkely, USA; University of California at Los Angeles, USA; Corresponding author address: The Wellness Guide Project, School of Public Health, 140 Warren Hall 7360, Berkeley, CA 94720-7360, USA
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