IMPLEMENTING A COMMUNITY-BASED PROGRAM WITHIN A VOLUNTARY HEALTH ORGANIZATION.
Contributors: University of Virginia.
Published: 1991
Number of pages: 313
Subjects: Health Sciences, Nursing.; Health Sciences, General.
Description: Implementing new health programs poses numerous challenges for organizations accepting this responsibility. Yet little is known about how this process is experienced by the persons directly involved, how the innovation is adapted, or the organizational attributes facilitating this process. The purpose of this study was to address these gaps in knowledge by describing how a community-based program was implemented for the first time within a voluntary health organization. The program was the Bone Up On Arthritis (BUOA) program, a self-care education program consisting of six lessons that can be used at home. Trained volunteers called Community Coordinators (CCs) assist participants as needed.

A multiple-site case study approach was used to examine three Arthritis Foundation (AF) chapters who volunteered to pilot test the BUOA program. One chapter implemented the program in an inner city setting while two chapters used rural settings. Textual data generated from two site visits, telephone interviews, and documents were content analyzed. Individual case studies, written as chronological narratives, were validated by key informants and a cross-case analysis was conducted.

Findings from this study confirmed the utility of organizational diffusion models which depict the implementation process as fluid and nonlinear in nature, and dominated by contextual considerations rather than the innovation itself. Cross-site propositions revealed that before an organization adopts an innovation for use in a community, the fit between the innovation, organization, and community is considered. During this time, larger organizations place greater emphasis on examining the innovation rather than the resources it requires. Smaller organizations direct more attention to the required resources. Organizational and community contexts shape the way an innovation is implemented; each AF chapter adapted BUOA to better meet their needs. Implementation strategies varied according to the nature of the community, although each chapter employed strategies that were successful in the past. Volunteers who recognized benefits for themselves and others, and who volunteered freely, were more likely to fulfill their roles. Yet without ongoing communication with organizational members, volunteers were likely to feel detached from the implementation process.
Notes: Source: Dissertation Abstracts International, Volume: 53-01, Section: B, page: 0203.

Thesis (PH.D.)--UNIVERSITY OF VIRGINIA, 1991.

School code: 0246.