Expanding the Understanding of the Social Determinants of Health to Support Community Readiness for Change

This two year case study aimed to increase: 1) awareness of the social determinants of health, 2) understanding of community context and 3) organizational empowerment using participatory methods with a Rural Diabetes Community Coalition in Southeast Georgia. Guided by the ecological perspective, data was collected through qualitative inquiry. The methods used included an in-depth document review; Photovoice; key informant interviews; community coalition action planning; and follow up interviews. Findings from this study show an increased awareness of the social determinants of health through the document review, the Photovoice group discussions, and the coalition members' in-depth interviews. As a result of participation in Photovoice and community action planning, the community coalition members also displayed a broadened understanding of community context. Additionally, through the coalition's participation in the planning and implementation, there was a perceived increase in the coalition's organizational empowerment. The results describe a process which expanded the understanding of context and the social determinants to support their readiness for change. This is important because of the potential impact the community coalition and its members can have on addressing the social determinants of health associated with diabetes prevention and management in their county. Additionally, this research provides examples of lessons learned, an assessment of the community coalition using the community coalition action theory and potential research directions for community based participatory research and the social determinants of health.