Unpacking the strategies that improve the health of residents and neighborhoods in a complex, community-level intervention

The outcomes of complex and multidimensional public health prevention efforts at the community level are often difficult to ascertain. This session will explore the extent to which a multidimensional prevention program made any difference in the health of a community, and identify the strategies that contributed most to program outcomes. In 2004, the Alameda County Public Health Department and the City of Oakland brought together community groups, community based organizations, schools and residents to form the City County Neighborhood Initiative (CCNI). The purpose was to fight growing poverty, violence and health problems in Oakland, beginning with two pilot neighborhoods. Over eight years, the program model has focused on community organizing, linking organizations, sharing resources, developing resident leadership and addressing environmental conditions. Evaluation results show that the CCNI has made progress on many of its goals. Residents have become more empowered, as demonstrated by increasing levels of leadership, greater involvement in neighborhood activities, and stronger linkages with each other, community groups and institutions. Neighborhoods have improved, as indicated by an increase in health-promoting resources, decreased crime, increased disaster preparedness and increased traffic safety. City and County institutions have also become more responsive to community requests for services. The findings show that several CCNI strategies have been particularly effective in increasing community health: 1) ensuring strong community resident leadership base from the start; 2) having a clear theory of change which delineates how to incorporate community organizing into violence prevention activities; and 3) coordinating and aligning resources among program partners.