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Health Promotion International 2004 19(3):289-298; doi:10.1093/heapro/dah303
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HEALTH PROMOTION INTERNATIONAL Vol. 19. No. 3 © Oxford University Press 2004. All rights reserved.

Organizational capacity for community development in regional health authorities: a conceptual model

Kathy Germann1 and Doug Wilson2

1Strategic Management and Organization, School of Business, and 2Department of Public Health Sciences and Centre for Health Promotion Studies, University of Alberta, Edmonton, Alberta, Canada

Address for correspondence: Kathy GermAnn, School of Business, Department of Strategic Management and Organization, University of Alberta, Edmonton, Alberta, Canada T6G 2R7, E-mail: kgermann{at}ualberta.ca

SUMMARY

The value of community development (CD) practices is well documented in the health promotion literature; it is a foundational strategy outlined in the Ottawa Charter for Health Promotion. Despite the importance of collaborative action with communities to enhance individual and community health and well-being, there exists a major gap between the evidence for CD and the actual extent to which CD is carried out by health organizations. In this paper it is argued that the gap exists because we have failed to turn the evaluative gaze inward—to examine the capacity of health organizations themselves to facilitate CD processes. This study was designed to explicate key elements that contribute to organizational capacity for community development (OC-CD). Twenty-two front-line CD workers and managers responsible for CD initiatives from five regional health authorities in Alberta, Canada, were interviewed. Based on the study findings, a multidimensional model for conceptualizing OC-CD is presented. Central to the model are four inter-related dimensions: (i) organizational commitment to CD, rooted in particular values and beliefs, leadership and shared understanding of CD; (ii) supportive structures and systems, such as job design, flexible planning processes, evaluation mechanisms and collaborative processes; (iii) allocation of resources for CD; and (iv) working relationships and processes that model CD within the health organization. These four dimensions contribute to successful CD practice in numerous ways, but perhaps most importantly by supporting the empowerment and autonomy of the pivotal organizational player in health promotion practice: the front-line worker.

Key words: Alberta; community development; front-line workers; organizational capacity


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