Community Diversity Research 2022

Running head: COMMUNITY DIVERSITY
Health promotion and disease prevention
Name of the Student:
Name of the University:
Author Note:

COMMUNITY DIVERSITY 1
Module 1
Discussion 1: Defining and working with communities
According to Zakus and Lysack (1998), a community may be defined as a collection of
heterogeneous individuals organising themselves into specific groups working together
towards a collective goal and is characterized with a diversity, which forms the basis of
conflicts in the context of selecting their representatives.
As Australia has a diverse culture with inhabitants originating from countries whose native
language is not English. This results in linguistic diversities within a locality and variations in
cultural backgrounds and perceptions. Hence, the neighborhood cannot be attributed or
identified by a specific culture or language. The primary problems associated with this
diversity in health promotion is that the people of the community have different perceptions
and beliefs which are often conflicting with other cultural beliefs. Thus, outlining the
strategies for promoting health targeted towards a particular locality is difficult as the
lifestyle also varies. The key steps of Laverack’s ladder of community-based interaction for
the success of a health promotion program being from community readiness to community
participation, engagement, organization, development, capacity, action, and finally,
community empowerment (Laverack, 2007). The primary strategy for a successful health
promotion program in the locality is community readiness. It involves preparing the
community for collaboration with an external partner to unify the opinions of all the diverse
cultures and indicates a willingness among the people of the neighbourhood to interact
among themselves towards a common goal (Kostadinov et al., 2015).

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References
Kostadinov, I., Daniel, M., Stanley, L., Gancia, A., & Cargo, M. (2015). A systematic review
of community readiness tool applications: implications for reporting. International
journal of environmental research and public health, 12(4), 3453-3468.
Laverack, G. (2007). Health promotion practice: building empowered communities.
McGraw-Hill Education (UK).
Zakus, J. D. L., & Lysack, C. L. (1998). Revisiting community participation. Health policy
and planning, 13(1), 1-12.
Discussion 2: Community capacity building and empowerment
Labonte and Laverack (2001a), describe community capacity as a measure of “social and
organizational relationships with dynamic qualities rather than static properties”. The
description of community capacity acts as an additional challenge for the process of health
promotion, as it includes inculcating a capacity building relationship. The various domains of
community capacity building serve as useful guidelines for the operation of the program,
which requires monitoring or evaluation with the participants. Community empowerment
implies taking ownership and suitable actions to bring about necessary change in the
community and is requires the participation, involvement, or engagement of the members of
the community. Community empowerment targets the cultural, social, economic and
political factors underpinning health, and aims at building partnerships with other relevant
sectors in resolving health issues (Who.int, 2020). To foster community empowerment
successfully in the community or any community setting, it is essential for people to realize
that they are their own assets and the external agents act as catalysts for the community to
acquire power. A useful approach for incorporating these principles of community
empowerment can be to divide the participation of community among three fundamental

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agents of the locality, namely the residents, professionals and the local authorities to
segregate the work and distribute their contributions towards collectively improving the
quality of life and health. This enables the people of the community to assume power over
their role and takes responsibility for their contribution.
References
Labonte, R., & Laverack, G. (2001). Capacity building in health promotion, Part 1: For
whom? And for what purpose?. Critical public health, 11(2), 111-127.
Who.int. (2020). WHO | Track 1: Community empowerment. Retrieved 8 April 2020, from
https://www.who.int/healthpromotion/conferences/7gchp/track1/en/
Module 2
Discussion 1: Theories approaches and models of health promotion
Some of the most commonly used models and theories include the health belief model, social
cognitive theory, behavioral change model, health action model, the theory of planned
behavior and educational model. Each of these models and theories has its strengths and
limitations. In the context of cultural diversity, the advantage of the health belief model is
that it displays the importance of an individual’s personal beliefs and identifies correlations
among the effects of modifications in the perception of behavior (Green & Murphy, 2014).
However, Gottwald & Goodman-Brown (2012) highlights its limitation in assuming that the
process of making decisions is not influenced by social life, family, cultural surroundings and
political factors. Another popular theory, the social cognitive theory is beneficial as is very
comprehensive and takes into account environment, cognition and human behavior as a
whole. However, this theory lacks complete effectiveness as it is not well-organized and
based only on the dynamic interaction between environment, behavior and person and lacks

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clarity on the effect of each of these factors on the cultural identity of the person. To select
the most effective model and theory of health promotion, some essential ingredients must be
considered which include the particular health issue on focus, the population being addressed
and the settings under which the program is being implemented.
References
Gottwald, M., & Goodman-Brown, J. (2012). A guide to practical health promotion.
McGraw-Hill Education (UK).
Green, E. C., & Murphy, E. (2014). Health belief model. The Wiley Blackwell encyclopedia
of health, illness, behavior, and society, 766-769.
Discussion 2: Increasing awareness and skills in programs
The most effective strategies to increase awareness and motivate the people as well as
develop their skills in diverse communities will include a comprehensive approach
encouraging individuals in adopting and maintaining personal behaviors to prevent the spread
of diseases and promote health. One of these methods to address a broader population
includes the use of social media marketing and media communication. Social marketing
strategies can be via mediators, such as healthcare providers and interpersonal methods of
communication. It may also include methods of marketing such as promotion, message
placement in clinics and other health care settings, dissemination and community-level
outreach (Flora, Schooler & Pierson, 2018). Audience segmentation is a critical element of
this strategy to target the particular audience within a diverse community on the basis on
cultural, behavioral and socio-demographic differences and address specific health issues
concerned with that group. Another useful strategy includes the use of information
technology, which is rapidly growing over the past few years in health communication. It
includes digital aids and tools such as emails, mobile applications and other online services,

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which enhance patient self-care by facilitating communication between the patient and the
health expert. It is also useful in developing the skills of the people of the community, which
help them make informed decisions and promote equitable access to health care services
(Healthypeople.gov, 2020). These tools also increase the health literacy of the people of the
community.
References
Flora, J. A., Schooler, C., & Pierson, R. M. (2018). Effective health promotion among
communities of color: The potential of social marketing. In Social Marketing (pp.
353-373). Psychology Press.
Healthypeople.gov. (2020). Health Communication and Health Information Technology |
Healthy People 2020. Retrieved 8 April 2020, from
https://www.healthypeople.gov/2020/topics-objectives/topic/health-communication-
and-health-information-technology
Module 3
Discussion 1: Environment risk factors
Environmental interventions have been observed as promising methods to address the global
obesity epidemic. The roles of environmental and social factors in contributing obesity are
often considered undervalued. However, significant evidence suggests that identifying the
environmental determinants of obesity which include gender, race, ethnicity and
socioeconomic status is essential to understand the impact of the interventions accurately.
The rates of obesity are higher within individuals of low socioeconomic status (Albuquerque
et al., 2017). Consumption of energy-dense and foods with high calorie is often less
expensive and affordable and are preferred by a large section of the community. These food

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items combined with reduced physical activity is a significant contributor to obesity. Hence,
interventions addressing the nutritional intake require focus at various levels, which include
the community, family and individual levels (Gittelsohn & Trude, 2015). For instance, a
promotion program targeting obesity among children carried out at a local school focused on
spreading awareness among the students, particularly overweight, to avoid junk food and
increasing the physical activities at school. The effectiveness of the program was evaluated
by comparing the BMI of the children which denoted a fall in the average BMI value of the
overweight children. Thus, interventions such as increasing physical exercises and
incorporating healthy food habits are effective against obesity.
References
Albuquerque, D., Nóbrega, C., Manco, L., & Padez, C. (2017). The contribution of genetics
and environment to obesity. British medical bulletin, 123(1), 159-173.
Gittelsohn, J., & Trude, A. (2015). Environmental interventions for obesity and chronic
disease prevention. Journal of nutritional science and vitaminology, 61(Supplement),
S15-S16.
Discussion 2: chronic diseases surveillance and health-promoting settings
Diabetes is a significant public health concern in Australia and is growing at an exponential
rate (Harding et al., 2014). Monitoring the prevalence of diabetes by appropriate surveillance
systems is extremely important and is implemented in Australia by the National System for
Monitoring Diabetes. The monitoring of diabetes is followed by the guidance of continuum
of care for acute disorders outlines in Preventing Chronic Disease: A Strategic Framework.
This continuum of care extends to public health, identifies individuals susceptible to risk,
diagnosis and prevention, treatment and related health care services, disability care and
deaths. This surveillance system for monitoring diabetes is a suitable method as it involves

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collaborative and rigorous development of data by identifying gaps in the existing sources. It
is useful in monitoring the trends and differentials in the chronic disease diabetes by
providing data and reports on the indicators, incidences, management, treatment and health
outcomes of diabetic patients. It is also reliable as it promotes consistency in the methods,
statistical standards and definitions (Aihw.gov.au, 2020). Overall, such methods of
surveillance of chronic illnesses are suitable in the context of the impact and burden of the
illness, size of the people susceptible to risk and the effectiveness of the interventions
applied.
References
Aihw.gov.au (2020). Retrieved 8 April 2020, from
https://www.aihw.gov.au/getmedia/1ca4026c-38e6-49b1-b1c9-e4e04befe005/
nsmda.pdf.aspx?inline=true
Harding, J. L., Shaw, J. E., Peeters, A., Guiver, T., Davidson, S., & Magliano, D. J. (2014).
Mortality trends among people with type 1 and type 2 diabetes in Australia: 1997–
2010. Diabetes care, 37(9), 2579-2586.
Module 4
Discussion 1: Behavior change
The global action plan of World Health Organisation has outlined several objectives to be
fulfilled by the end of the year 2020. It consists of empowering the community and people by
evidence-based methods, approaches based on equity, involves universal coverage of health,
partnership and leadership, building national capacity, and creating an environment that
promotes health. It also discusses the role of Government and its responsibilities in promoting
and supporting national capacity for adequate quality research and development to prevent

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and control non-communicable diseases in the community (World Health Organization,
2019). This plan contradicts the ideals outlined by Laverack and Baum regarding professional
practice when behavioral change is applied to prevent diseases. It cannot be denied that
behavioral characteristics are critical in public health. For instance, it is estimated that the
count of people affected with type 2 diabetes will increase by 186 million by 2030 and the
most suitable response in understanding these trends consists of human behavior.
Nonetheless, individual human behavior is not the only factor driving these epidemics. The
most essential contradiction is that behavioral characteristics are dominated by the social
environment and any effort taken to alter it should thus involve consideration of the social,
economic and political factors which directly affect the health of the individuals irrespective
of the individual decisions and choices made by them on their own conduct (Van Wormer &
Besthorn, 2017).
References
Van Wormer, K., & Besthorn, F. H. (2017). Human behavior and the social environment,
macro level: Groups, communities, and organizations. Oxford University Press.
World Health Organization. (2019). Global action plan on physical activity 2018-2030: more
active people for a healthier world. World Health Organization.
Discussion 2: Behavior change versus empowerment
According to Tengland (2016), outlining the goals is critical in public health services and
promotion of health. The behavioral change approach is often compared with the
empowerment approach on the grounds of morality. The empowerment approach is
considered superior in many cases as it involves strengthening the entire community or the
individual to maintain healthy habits of living. However, many people consider good health
secondary to other goals in life, which also affects the well-being and promotion of health.

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The supporters of behavioral change approach seek to impact individuals in changing their
behavioral characteristics related to health, including quit smoking, exercising more
rigorously, eating healthy foods, consuming less alcohol, driving more carefully, avoiding
drugs or wearing helmets while riding bikes. Thus, the behavioral change approach has
certain moral issues that are better handled by the empowerment approach. Interventions of
the behavioral change approach targets the behaviors of individuals through coercion,
persuasion, information, and manipulation. Empowerment approach collaborates with the
participants required to facilitate the change (Cortez et al., 2017). Behavioral change
approach presents some ethical issues as it does not adequately respect the right to autonomy
of the participants involved and is associated with increasing risks of issues related to equity
in health. On the other hand, empowerment approach is respectful towards the right to
autonomy of the participants and provides the scope to decrease inequalities.
References
Cortez, D. N., Macedo, M. M. L., Souza, D. A. S., dos Santos, J. C., Afonso, G. S., Reis, I.
A., & de Carvalho Torres, H. (2017). Evaluating the effectiveness of an
empowerment program for self-care in type 2 diabetes: a cluster randomized
trial. BMC Public Health, 17(1), 41.
Tengland, P. A. (2016). Behavior change or empowerment: On the ethics of health-promotion
goals. Health Care Analysis, 24(1), 24-46.
Module 5
Discussion 1: Tertiary prevention
Community-based rehabilitation is an essential element in ensuring that communities and
concerned development sectors emphasize on activities that prevent disabilities in the

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community for both- individuals with or without disabilities. CBR is useful in providing
assistance to individuals with disabilities as well as their families and carers. This ensures
access to health care services promoting their health and preventing the occurrence of
conditions affecting general health or other complications in health (Millington & Marini,
2014). CBR enables access to the disables people and their family members in accessing
information regarding their health and available services that prevent the progression of these
health conditions, lower their risk of developing health issues informing and educating on
healthy standards of living and behaviors. Besides, CBR helps people with disabilities in
social inclusion by involving them to participate in several prevention programs such as
immunization that decreases their risks of developing complications and impairments to the
existing conditions. CBR programs also work in collaborations with various sectors including
health to address the health issues, extend education on the issue and provide support for
prevention activities. Along with routine preventive care, individuals with disabilities also
require specialized, targeted measures as their vulnerability to the community health issues
are higher than the rest and require specific interventions (Iemmi et al., 2015).
References
Iemmi, V., Gibson, L., Blanchet, K., Kumar, K. S., Rath, S., Hartley, S., ... & Kuper, H.
(2015). Community‐based rehabilitation for people with disabilities in low‐and
middle‐income countries: A systematic review. Campbell Systematic Reviews, 11(1),
1-177.
Millington, M. J., & Marini, I. (2014). Families in rehabilitation counseling: A community-
based rehabilitation approach. Springer Publishing Company.

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Discussion 2: Rehabilitation and injury prevention
Self-Management (SM) is considered as a useful method in limiting the progression of health
effects and improving the individual’s quality of life. It presents a shift in ideology from the
conventional concept of patients as passive recipients of treatment to a rational concept of
empowering patients for effective management of their health. Self-management enables
patients with chronic illnesses to manage their own condition, with minimum direct
professional help for maximum periods. These practices of self-management are advised by
health professionals and include taking medication on time and staying fit. It also includes
activities promoting mental well-being like meditation and relaxation. Self-management also
allows patients be actively involved in planning their treatment which includes collaborative
decision-making. The chief stakeholders essential for self-management practices include
health professionals, family and the patients (Boger et al., 2015). For instance, evidence
suggests that in stroke care, the health professionals considered patient independence, in the
context of the goals they sought for their recovery goals essential in the outcome of self-
management. Stroke health professionals also acknowledged that self-management support
enables the affected individuals more independence and more self-controlled. The outcome of
self-management valued by the stakeholders is crucial for long-term management of chronic
diseases (Woodman et al., 2014).
References
Boger, E., Ellis, J., Latter, S., Foster, C., Kennedy, A., Jones, F., ... & Demain, S. (2015).
Self-management and self-management support outcomes: a systematic review and
mixed research synthesis of stakeholder views. PloS one, 10(7).

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Woodman P, Riazi A, Pereira C, Jones F (2014) Social participation post stroke: a meta-
ethnographic review of the experiences and views of community-dwelling stroke
survivors. Disability and Rehabilitation, 36, 2031–43.
Module 6
Discussion 1: Emergency responses
A bottom-up or top-down approach is adopted by communities for their preparedness and
response to emergencies such as disasters. The top-down approach involves methods which
are products of organizations that are not a part of the community and primarily designed to
obtain higher precision and objectivity. In contrast to the top-down approach, the bottom-up
methods are generally employed for qualitative data and require similar input from non-
experts and experts. This approach has a higher sensitivity to the local perceptions of disease
preparedness as well as the specific conditions bearing it (Schoch-Spana et al., 2019). Top-
down approaches are more appropriate in addressing large-scale interventions by high-
ranking authorities and include programs such as Go4 Fun to child weight loss, Munch and
Move in preschools and centers for child care. On the other hand, bottom-up approaches
begin from the local, individual levels such as conducting workshops in gardens of schools
and healthy urban planning with the help of local authorities. Community plays an essential
role in each of these approaches. Community plays a large-scale and more focused role in
top-down approach, requiring more resources and effective management and monitoring
systems. In contrast, the role of community in bottom-up approach is more specific towards
the underlying social factors and is flexible. The goals and outcomes are however unclear
(Butler et al., 2015).

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References
Butler, J. R. A., Wise, R. M., Skewes, T. D., Bohensky, E. L., Peterson, N., Suadnya, W., ...
& Bou, N. (2015). Integrating top-down and bottom-up adaptation planning to build
adaptive capacity: a structured learning approach. Coastal Management, 43(4), 346-
364.
Schoch-Spana, M., Gill, K., Hosangadi, D., Slemp, C., Burhans, R., Zeis, J., ... & Links, J.
(2019). Top-down and bottom-up measurement to enhance community resilience to
disasters.
Discussion 2: Community involvement
Community engagement is extremely significant in times of public health emergencies. It
involves making the people involved understand the risks they are susceptible to, and include
them in planning acceptable response actions (Schoch-Spana, Selck & Goldberg, 2015).
Community empowerment involves strengthening the skills and cultural beliefs of the people
at risk to control the health issue or disaster and preparing them to fight against it. It enables
the people if the community to move towards a better change. Capacity building includes
collaborations among emergency preparedness and response (EPR) programs, local public
environmental health (EH), and the communities to enhance the abilities of the people to
coordinate with first responders in times of emergency responses.
The various steps in involving the community in preparedness and disaster prevention include
informing about the government policies to the people of the community, taking consultation
from the community members in the process of developing suitable government policies,
building community understanding and awareness, and partnering with the members to
develop options as well as advise recommendations. An essential step is sharing leadership

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and to empower the people of the community in decision-making for implementing and
managing the change (Who.int, 2020).
References
Schoch-Spana, M., Selck, F. W., & Goldberg, L. A. (2015). A national survey on health
department capacity for community engagement in emergency preparedness. Journal
of Public Health Management and Practice, 21(2), 196-207.
Who.int. (2020). Community Engagement Module B5. Retrieved 9 April 2020, from
https://www.who.int/risk-communication/training/Module-B5.pdf