For purposes of this report, community is defined as any group of people who share geographic space, interests, goals, or history. A community offers a diversity of potential targets for prevention and is often conceived of as an encompassing, proximal, and comprehensive structure that provides opportunities and resources that shape people’s lifestyle (McIntyre and Ellaway, 2000). A community also offers the potential for pooling resources and for collaboration among community-based organizations, some of which are affiliates of state and national organizations that can channel resources to them in support of local initiatives and the evaluation of their innovations (Kreuter et al., 2000).

A distinction can be made between community-based prevention and community-placed prevention, or community interventions versus interventions in communities (Green and Kreuter, 2005), although both take a population-based approach. Community-based activity involves members of the affected community in the planning, development, implementation, and evaluation of programs and strategies (Cargo and Mercer, 2008). An example of this type of prevention effort is community-based participatory research, in which academic researchers—who are usually in control of the decisions on the research question, design, methods, and interpretation of results—invite or concede at least an equal partner role to community members in formulating, conducting, and interpreting the research. It is important to note that rarely are all members of a community involved and that for those who are, the level of involvement can vary tremendously.

Community-placed activities, on the other hand, are developed without the participation of members of the affected community at important stages of the project. While the program may be centrally planned, effort is expended to generate community support. An example of the community-placed approach is the YMCA diabetes prevention program that is being implemented in partnership with YMCAs across the country, some with more tailoring to the localities than others (Ritchie et al., 2010).

Although there are distinct differences between these two approaches to prevention, for purposes of this report key domains for valuing (discussed in Chapter 3) are common to both approaches. Therefore, the term “community-based prevention” is used to encompass both community-placed and community-based prevention programs, policies, and strategies.

IMPORTANT FEATURES OF COMMUNITY-BASED PREVENTION

Over the past 50 years public health practice and research have contributed to developing and analyzing the characteristics that distinguish community-based prevention from other forms of action. Community-based prevention interventions focus on population health and, in addition,



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