Health Education Research, Vol. 9, No. 3, 385-396, 1994
© 1994 Oxford University Press
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The capacity-building approach to intervention maintenance implemented by the Stanford Five-City Project
Department of Health Behavior and Health Education, University of North Carolina at Chapel Hill CB # 7400, Rosenau Hall, Room 306, Chapel Hill, NC 27599
1Stanford Center for Research in Disease Prevention, Stanford University School of Medicine Palo Alto, CA 94304-1885
2Institute for Communication Research, Stanford University Stanford, CA 94305
3Monterey County Health Department Salinas, CA 93906
4Western Consortium for Public Health Sacramento, CA 94234-7320, USA
Increasingly, agencies supporting community health promotion interventions require participating communities and evaluators to specify how the intervention will be maintained once agency funding ends. The Stanford Five-City Project (FCP) implemented two different strategies to maintain its heart disease education program, with the second strategy designed to overcome the barriers to implementation that were encountered by the first. This paper provides a practice-oriented description of the initial ‘community network’ maintenance strategy of the FCP, the barriers that were encountered as this network strategy was implemented, the alternative ‘capacity-building’ strategy directed at local health educators and the successful implementation of this alternative. Also discussed are the community organization issues underlying the shift in intervention maintenance strategies and the specific components of the capacity-building strategy, including its focus on health educators, and its application of a training of trainers model and cooperative learning methods to provide professional development, technical assistance and other resources to a target group of community health educators. Our experience indicates that capacity-building is a viable method for intervention maintenance and that it may also facilitate efforts to disseminate model health promotion programs to communities lacking experience in community health promotion intervention.
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