Providing communication-related and community-based strategies to help improve health outcomes for diverse groups and communities is the aim of a chapter titled "Community-Based Health Interventions" in the third edition of “The Routledge Handbook of Health Communication.”

Written by SC&I Ph.D. student Taylor Goulbourne, Assistant Professor Charles Senteio, Professor Kathryn Greene, and Professor Itzhak Yanovitzky, the chapter also provides insights on the future directions of health communication scholarship in this context.

The chapter explains the “shift from the traditional focus on communication as a tool for information transmission and translation toward a deeper consideration of the role of communication mechanisms and processes in building the capacity of communities to organize, coordinate, and collectively promote the types of social and structural changes that are necessary to address health disparities,” Goulbourne said. 

The goal of their research, Goulbourne explained, was to review the public health and health communication literature in the context of interventions to improve community health and synthesize and share their findings. From their review, they identified four general conceptions of community-based interventions. These view community as either a setting, a target, a resource, and/or an agent.

Further, their findings also revealed that many health communication tactics only view community as a setting -- as the place or space where the intervention is implemented. The authors take a different approach by integrating health communication with the other three conceptions of community-based health interventions as well.

These three conceptions can be understood this way: community as a target means creating broad structural changes in public policy and/or modifications to the environment. Community as resource refers to mobilizing a community’s resources and assets to strategically prioritize and promote health. Community as agent means building and supporting the capacities of communities.

Through their review of the literature, Goulbourne said, they also identified three broad groups of community-based health interventions.

The first group, Goulbourne said, includes “strategies seeking to improve access to and/or utilization of health information. This can include health information technology interventions that seek to empower individuals to ask questions, communicate concerns, and change their health behavior by providing tools to track, manage and interpret personal health metrics.”

The second group “is community norms-based health communication interventions. This can involve strategies that seeks to influence or otherwise leverage community culture to promote individual and population health.”

The third group “is communication community capacity-building interventions that seek to build, leverage, or augment a community’s communication infrastructure. This can lead to population-level health improvements by enabling community members access to health information, facilitating meaningful engagement with health information via social interactions, and promoting health-related change at the community level.”

By viewing the literature this way, Goulbourne said, their chapter synthesizes potential communication-related community-based strategies to improve health outcomes for diverse groups and communities and serves as an invaluable resource for healthcare professionals, policymakers, scholars, and students who apply health communication strategies to their work.

A key takeaway for laypeople and practitioners, Goulbourne said, centers on the chapter’s view of using communication as a tool for social and structural changes.  

Some of the specific recommendations the chapter outlines for laypeople and practitioners includes the suggestion that laypeople and practitioners should consider using the existing formal and informal communication channels and networks that communities already use to interact with one another to exchange and discuss health-related information (i.e., town hall meetings, public libraries, barbershops, churches, etc.) instead of creating new communication channels or networks.

This is because Goulbourne explained, existing channels and networks are already considerate of and tailored to community health-related norms, attitudes, and beliefs. For example, she said, many diverse groups and communities need better access to timely, relevant, and credible health information. The “Interventions That Build Community Communication Capacity” section of the chapter outlines the specific strategies laypeople and practitioners can use to build, leverage, or augment these existing communication channels and networks.

Practitioners could also consider implementing a mix of communication strategies to improve community health, Goulbourne said.  “In the ‘HIT Interventions’ section, for example, we discuss how health information technology interventions can really benefit from a mix of communication strategies that not only provide community members with the tools to better manage their health but also leverages existing community networks to provide social support.”

Finally, Goulbourne said, the “Community Norms-Based Health Communication Interventions” section of the chapter provides insights on message design strategies practitioners can implement.

The authors plan to continue their research, and Goulbourne said a potential direction of their future work could, for example, “involve determining how to effectively and efficiently engage with communities using these three broad groups of strategies.”

Goulbourne said she plans to conduct further research beyond the group’s findings provided in the chapter by working to develop a communication theory of community engagement that organizes the communication strategies discussed in the chapter on a community engagement continuum. She hopes to interview practitioners who regularly interact with diverse groups and communities to learn more about how practitioners engage with these communities, and update her theory so that it not only aligns with research but also with practice.

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Photo: Courtesy of Taylor Goulbourne