Many public health professionals and other stakeholders are charged with improving health in their communities, often despite having limited time or resources for doing so. Evidence-based community interventions are an important part of the toolbox for improving public health.1 The term “evidence-based community interventions” is sometimes used indiscriminately; however, it createsmisunderstanding and potentially leads to the use of interventions that will not achieve their intended outcomes. To ensure understanding of what exactly constitutes an evidence-based community intervention, this chapter will begin by considering the composite parts of the term. It will then discuss the value of using evidence-based community interventions, and identify how they fit into community health improvement planning and decision making. The final section of this chapter will identify where readers can find information about evidence-based community interventions.
WHAT CONSTITUTES A COMMUNITY?
The traditional definition of “community” has been a group of people, with some common ties, living in the same geographic or geopolitical area, such as a neighborhood, town, or county.2 Within the field of public health, community is typically understood more broadly to also include other groups of people who share common interests or characteristics (e.g., age, race, ethnicity, religion, or culture), or who participate together in activities within a particular setting (e.g., work, school, or a recreational setting).3–5 A community therefore consists of a population group along with the place, venue, unit, or virtual platform where the population group’s activity takes place.3 Communities may be as diverse as states, counties, neighborhoods, rural areas, health systems, worksites, places of worship, schools, the military, specific racial ethnic groups, and online groups, among others. Those involved in developing and evaluating community interventions need to pay close attention to whether interventions may work better or differently in some communities than others.
WHAT IS AN INTERVENTION AND WHAT TYPES OF INTERVENTIONS CAN BE USED IN COMMUNITIES TO IMPROVE HEALTH?
The wide range of types of communities is matched by the diverse types of interventions that can be used within communities. Interventions are actions taken to improve a situation or to have some other intended effect on an outcome of interest.6 In public health, community interventions focus on changing the behavior of individuals, or helping individuals to maintain desired behaviors, with the ultimate goal of improving the health and well-being of as many people as possible within that community. Community interventions can aim to change behavior directly, or they can aim to change it indirectly by creating conditions that encourage behavior change. The socio ecologic model posits that behavior is determined by factors or conditions across five levels.7 Community interventions can focus on one or more of these five levels—(a) the intrapersonal level (aiming to directly change characteristics of individuals such as knowledge and behavior); (b) interpersonal (aiming to effect individual-level behavior change by changing how individuals interact with each ...