Integrating an ecological approach into an Aboriginal community-based chronic disease prevention program: a...

Area of Science:

• Public Health
• Community Health
• Chronic Disease Prevention

Background:

• Public health emphasizes ecological approaches for chronic disease prevention.
• Limited research exists on integrating ecological approaches in community-based programs.
• This study evaluates an Aboriginal community-based cardiovascular disease (CVD) and type 2 diabetes prevention program.

Purpose of the Study:

• To assess the integration of an ecological approach in a community-based chronic disease prevention program.
• To evaluate the extent of ecologicalness across three intervention years.
• To identify intervention targets and strategies used in the program.

Main Methods:

• Utilized activity implementation forms, interviews with implementers, and participant observation over three years.
• Applied a standardized ecological coding procedure to analyze recruitment settings, intervention targets, and strategies.
• Ensured inter-rater reliability with Kappa = 0.76.

Main Results:

• 215 activities were implemented, primarily targeting individuals (IND), interpersonal (INT), and organizational (ORG) levels.
• Policy (POL) and community (COM) levels were least targeted.
• The program did not demonstrate increased ecological integration over time; networking strategies were least utilized.

Conclusions:

• Community commitment is evident through participant recruitment and targeting of IND, INT, and ORG levels.
• Enhanced inter-organizational collaboration and centralized planning are crucial for integrating an ecological approach.
• Short-term funding cycles conflict with the time needed for community capacity building for chronic disease prevention.