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Assessing Community Leadership: Understanding Community Capacity for Health Improvement

Castle, Billie PhD, MPH; Wendel, Monica DrPH, MA; Kelly Pryor, Brandy N. PhD; Ingram, Monique MPH

Journal of Public Health Management and Practice: July/August 2017 - Volume 23 - Issue - p S47–S52
doi: 10.1097/PHH.0000000000000587
Research Articles

Objective: The purpose of this study was to pilot a quantitative instrument to measure aspects of community leadership within an assessment framework.

Design: The instrument includes 14 Likert-type questions asking residents how they perceive leaders within 5 sectors: Louisville Metro Council/Mayor's Office, the faith community, education, business, and the civic sector.

Setting: Louisville/Jefferson County, Kentucky, has a population of about 743 000 residents. Respondents were asked to examine leadership within West Louisville, an economically deprived area of the city made up of 9 contiguous neighborhoods. This area is predominantly African American (78% compared with 22% in Louisville Metro), with an overall poverty rate of 43% (compared with 18% in Louisville Metro), and unemployment rate of 23% (compared with 8% in Louisville Metro). Residents of West Louisville are looking to leadership to address many of the inequities.

Participants: Twenty-seven participants representing 7 community sectors completed the survey, of whom 90% work in West Louisville.

Main Outcome Measure(s): The instrument measured local perceptions of leadership strength, effectiveness, trust, communication, community building, and leadership development.

Results: The majority of respondents agree that strong leadership exists across the 5 sectors, with variation regarding perceptions of the quality of that leadership. City leadership within the Mayor's Office and Metro Council is largely viewed positively, while the growing tensions within the education sector were reflected in the survey results.

Conclusion: The perception of community leadership is important to understanding local community capacity to improve health and also inclusivity of community voice in the assessment and community improvement processes. Results from such assessments can offer useful information for strengthening community capacity and sustaining relationships needed to enact progressive and equitable solutions to address local issues. Leaders in a variety of settings can utilize this instrument to improve their community as well as their practical approaches towards leadership and equity.

Health Promotion and Behavioral Sciences, University of Louisville, Louisville, Kentucky (Drs Castle, Wendel and Kelly Pryor); Center for Health Equity, Louisville Department of Public Health and Wellness, Louisville, Kentucky (Dr Kelly Pryor); and Office of Public Health Practice, University of Louisville School of Public Health and Information Sciences, Louisville, Kentucky (Ms Ingram).

Correspondence: Billie Castle, PhD, MPH, Health Promotion and Behavioral Sciences, University of Louisville, 485 East Gray St, Louisville, KY 40222 (billie.castle@louisville.edu).

Funding for this study was made possible, in part, by the Centers for Disease Control and Prevention (CDC) through Cooperative Agreement no. U01CE002711. The views expressed in this publication do not necessarily reflect the official policies or views of the CDC or the Department of Health & Human Services, nor does the mention of trade names, commercial practices, or organizations imply endorsement by the US Government.

The authors declare no conflicts of interest.

As a core function of public health, assessment is the foundation for developing policy and ensuring access to essential services across the population.1 In communities, assessment is similarly the foundation of the community health development process for planning and implementation of interventions both to improve health and to build community capacity.2,3 A shift in perspective from community needs assessment to an approach that includes both issues and resources captures critical information about the capacity of a community to enact change to address local priorities. Having an adequate understanding of local resources and capacity is paramount to strategizing and planning responsive, sustainable interventions.

In a typical assessment process, data collected regarding community assets are constrained by the agenda of the entity sponsoring the activities. Community resources manifest in various ways; a common perspective is financial or material capital, but communities should also recognize the potential of their human, intellectual, social, and political capital. Cutting across these categories, leadership is an aspect of community capacity critical to a community's ability to address its own issues.4,5 In many assessments, however, information regarding local leadership is qualitative or focuses on perspectives of leaders rather than data about leadership.

Leadership is an important dimension of community capacity, particularly the presence, quality, and mechanisms of leadership—including communication skills, judgment, trust-building, reflection, visioning, and development of new leaders within communities.5,6 Using these qualities, the purpose of this study was to pilot a quantitative instrument to measure several aspects of community leadership within an assessment framework.

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Background

Capacity is often used interchangeably with concepts such as community empowerment, competence, and readiness,4 but this discounts each concept's unique contribution to community development. Goodman and colleagues state that “capacity reflects a community's potential for addressing presenting health issues.”4(p.260) Key dimensions of community capacity include leadership, civic participation, skills, access to resources, social networks, sense of community, community history and values, and critical reflection.4 Within this framework, leadership is vital to the success of communities,7 as it influences how problems are prioritized, mobilization of community change activities, and creation of opportunities for citizen participation.5

Bass states that “there are almost as many definitions of leadership as there are persons who have attempted to define the concept.”8(p.7) He defines leadership as “the interaction between two or more members of a group that often involves a structuring or restructuring of the situation and the perceptions and expectations of members and that it occurs when one group member modifies the motivation or competencies of others in the group.”9(p.19) Leadership has also been defined as the art of influencing an individual or group, regardless of the rationale.10 However, regarding communities, the rationale or ultimate objective is important. Hemphill and Coons11 define leadership as the behavior of an individual when he or she is directing the activities of a group toward a shared goal. Similarly, Jaques and Clement state that “leadership is that process in which one person sets the purpose or direction for one or more other persons and gets them to move along together with him or her and with each other in that direction with competence and full commitment.”12(p.4) Common across these definitions are leaders' behavior and ability to influence others.

In communities, leadership is often measured on the self-reported characteristics of identified leaders and not how the community perceives those leaders. How do we assess leadership without understanding the perspectives of those being led? Whether a person is honest affects his or her influence less than whether those around him or her perceive him or her to be honest. Thus, a community's perception of leaders is equally important as characteristics of the leader.

Communities with greater capacity tap the talents of those who are well connected within and across diverse communities, along with those who have power.5 Leadership development is also critical, as “older” leaders move on and need to turn over responsibilities. Capacity is enhanced by diverse leadership in a community,4 which includes multiple voices and acknowledges diverse experiences. Leadership both mobilizes communities and promotes positive collaboration within and outside the community.13

Many leadership instruments were reviewed for this study, but most measured the perceptions of leaders. Finding consistent measures that captured residents' perceptions of the presence and quality of leadership and mechanisms for developing new leaders proved difficult. In her dissertation study, Ricketts'10 instrument included revised questions from the Organization Leadership Assessment, measuring some of what this study aimed to capture; however, her survey was distributed to community leaders themselves. Our research team built upon these questions and revised them to measure the perception of leadership from local residents.

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Methods

The current study was a component of an assessment of community capacity conducted by the University of Louisville Youth Violence Prevention Center. The Center's Steering Committee created a roster of key informants working in organizations who serve the area of West Louisville to participate in the leadership survey. The organizations identified represented 11 sectors—civic organizations, community activists, community-based organizations/nonprofit organizations, faith-based organizations, health service providers, higher education, human services providers, Jefferson County Public Schools (JCPS), Louisville Metro Government, the media, and West Louisville businesses.

The data collection protocol was submitted for review and approval from the University of Louisville institutional review board. After approval, potential participants were sent an initial recruitment e-mail with an information sheet describing the purpose of the survey and a link to the survey. Follow-up e-mails were sent to potential participants twice at 2-week intervals. The Web-based survey was administered through Qualtrics.

The survey included 14 questions regarding perceptions of leaders within 5 sectors—Louisville Metro Council/Mayor's Office, the faith community, education, business, and the civic sector. It is important to note that, in 2003, the city of Louisville and Jefferson County merged and formed a city-county merger; therefore, the official name of the consolidated city-county government is the Louisville/Jefferson County Metro Government or Louisville Metro Government (LMG). The local health department functions within LMG; therefore, it is included in the Louisville Metro Council/Mayor's Office. In the future, the instrument could include a sector specific to public health leaders if they operate separately from local government. The questions were measured using a 4-point Likert scale ranging from “strongly agree” to “strongly disagree.” Results, including frequencies and central tendencies, were analyzed using SPSS Statistics 22 statistical software.

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Results

Of the 100 individuals recruited for the survey, 27 individuals responded to the survey (response rate 27%). Of the 11 sectors identified to participate in the survey, participants represented 7 sectors: individuals who work in community based/nonprofit organizations represented majority of respondents (34.6%), followed by representatives from JCPS (23.1%), civic organizations (11.5%), faith-based organizations (11.5%), health service providers (7.7%), community activist (3.9%), human services providers (3.9%), and other (3.9%). The majority (63%) of survey participants self-reported as black or African American, which corresponds with the demographic of West Louisville (78%); the remaining participants identified as white or European American (37%). Five (18.5%) participants reside in West Louisville, whereas the majority of the participants (88.9%) work in West Louisville. Participants have lived in their community for an average of 17.5 years. Results from the survey are presented in the Table. The mean score and combined frequency for “strongly agree” and “agree” are presented for each question.

TABLE

TABLE

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Louisville Metro Council/Mayor's Office

Respondents feel that there is strong (88.9%) and effective (70.4%) leadership within the Louisville Metro Council/Mayor's Office. They indicated that leadership within the Louisville Metro Council/Mayor's Office is a receptive listener (74.1%), which also translates to the perception that these leaders are accountable and responsible to others (77.8%). Respondents expressed that the Louisville Metro Council/Mayor's Office communicates clear plans/goals for the community (70.4%) and takes appropriate action when needed (70.4%). They also responded that leaders in this sector put the needs of the community ahead of their own (70.4%).

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Faith community

Respondents were positive in their perception of faith leaders. Those surveyed indicated that formal leaders are more influential than informal leaders (77.8%) and that they can trust these leaders (66.7%). Of all the sectors, respondents more often agreed that the faith community leaders practice the same behavior they expect from others (70.4%). In addition, respondents agreed that leaders within the faith community facilitate the community building (63%). Respondents feel that the faith community puts the needs of the community ahead of its own (63%) and takes appropriate action when needed (63%). Of all the sectors, the faith community provides the most opportunities for all to develop their full potential (59.3%).

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Education sector

Respondents agree that there is strong leadership within the education sector (63%), but most did not agree that leadership in this sector was effective or trusted, nor did they agree that these leaders helped develop leadership in the community. Respondent agreed that leaders within the education sector communicate clear plans/goals for the community (63%) and take appropriate action when needed (55.6%). However, respondents indicated that the education sector does not give community members the power to make important decisions (11.1%).

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Business sector

Within the business sector, respondents agreed that there is strong leadership (70.4%) and that the leaders are formal rather than informal (66.7%). They indicated that leadership is effective within this sector (63%) and takes appropriate action when needed (63%). Survey responses suggest that business leaders are accountable and responsible to others (59.3%) and receptive listeners (51.8%).

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Civic sector

Respondents agreed that there is strong leadership within the civic sector (63%), that it is effective (55.6%), and that it facilitates community building (63%). Regarding the perceptions of the behavior of the leaders and the extent to which they build community, the responses were positive but by relatively narrow margins. For example, 51.9% of respondent agreed that people trust civic leaders and 55.6% agreed that they put the needs of the community ahead of their own and practice the same behavior they expect from others.

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Discussion

Regarding leadership in West Louisville, the majority of respondents agree that strong leadership exists across the 5 sectors; however, substantial variation exists regarding perceptions of the quality of that leadership. City leaderships within the Mayor's Office/Metro Council is largely viewed positively, with the lowest levels of agreement around the extent to which these leaders give community members the power to make important decisions and provide opportunities for all to develop their full potential. This is instructive for city leadership as it works to engage residents meaningfully in the work of community improvement. Leadership in the faith community is seen positively, but respondents did not agree that these leaders communicate clear plans/goals for the community. Perception of leadership within the education sector was the poorest, which reflects ongoing tension and controversy within both JCPS and the University of Louisville. Respondents indicated that strong leadership exists within the business sector but perhaps these leaders were less focused on the rest of the community. Likewise, the civic sector is perceived as having strong leadership but indicates that the most influential leaders are not necessarily those in formal leadership positions.

Examining the results by characteristic rather than sector is also valuable in understanding the community's perception of leadership overall. Respondents felt most strongly about the presence of leadership in each sector, with the majority indicating leadership as effective and trustworthy for all sectors except for education. More notably, respondents disagreed regarding questions of leadership development, including giving community members power to make important decisions, encouraging each person to exercise leadership, and providing opportunities for all to develop their full potential. These results illustrate both leadership strengths in the community and opportunities for growth to build community and mobilize residents around common goals.

Understanding the community's perception of local leadership is important to community assessment in that it provides insight into who communities feel they can work with effectively to improve the community as well as if they feel that local leadership has their best interest. It is important to improvement planning and most of all health and social equity because it amplifies voices that are usually silenced throughout the planning and improvement process. Leaders may go on thinking they are doing what is best for the community; however, community members may see it differently and therefore outcomes are impacted. If local leaders truly want to work with communities, they need to understand where they stand within the community, so they can work to improve those areas as well as build sustainable relationships that will contribute to enacting change to address local priorities.

As with any study, limitations are an important consideration. First, this was a pilot survey using items previously untested. The response rate was reasonable, but the final sample was not large enough to calculate psychometric properties of the survey items. A larger data set may yield similar results; however, with any survey or data collection, researchers should account for the current social climate of the target area. For example, if there are local tensions brewing between the community and the education sector, leaders within this sector may not be perceived well because of current actions. This goes for all sectors. If the priorities of the community do not align with those of the sectors assessed, we would see variation in responses based on the local context. In addition, despite the research team's effort, several key sectors are not represented among respondents; thus, the interpretation of the findings should acknowledge that.

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Implications for Policy & Practice

  • Despite the limitations, this study is useful locally and within the discipline.
  • Locally, the findings provide leaders in each sector a snapshot of how they are perceived in West Louisville, a portion of the community that needs leaders' commitment and attention.
  • The instrument can be applied in a variety of settings. Local governments, community serving organizations, public health leaders, federally qualified health centers, or any entity that works within the community to improve health outcomes can distribute the survey assessing community leadership.
  • The instrument is important to community health improvement because not only does it improve leadership but it also provides leadership with the opportunity to be more reflexive in the process of building community capacity based on community feedback.
  • As we move toward promoting more equitable solutions to improving health, this assessment of leadership based on community members' perceptions aligns the current practice with important principles of inclusivity and equity in the assessment and community improvement processes.
  • In addition, distributing the survey on a biannual or annual basis provides a measurement tool of not only health status but also community relationships/perceptions.
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References

1. National Center for Environmental Health. Core Functions of Public Health and How They Relate to the 10 Essential Services. Atlanta, GA: Centers for Disease Control and Prevention; 2016. https://http://www.cdc.gov/nceh/ehs/ephli/core_ess.htm. Accessed November 14, 2016.
2. Burdine JN, McLeroy K, Blakely C, Wendel ML, Felix MRJ. Community-based participatory research and community health development. J Prim Prev. 2010;31:1–7.
3. Felix MR, Burdine JN, Wendel ML, Alaniz A. Community health development: a strategy for reinventing America's health care system one community at a time. J Prim Prev. 2010;31:9–19.
4. Goodman RM, Speers MA, McLeroy K, et al Identifying and defining the dimensions of community capacity to provide a basis for measurement. Health Educ Behav. 1998;25:258–278.
5. Wendel ML, Burdine JN, McLeroy KR, Alaniz A, Norton B, Felix MR. Community capacity: theory and application. Emerg Theor Health Promot Pract Res. 2009;2:277–302.
6. Canadian CED Network. Municipal capacity development program. http://municipalcapacity.ca/municipal-resources/resource-materials. Published 2006. Accessed November 14, 2016.
7. Wendel M, Alaniz A, Kelly B, et al Capacity building in rural communities. In: Rural Populations and Health: Determinants, Disparities, and Solutions. San Francisco, CA: Jossey-Bass Wiley; 2012:215–235.
8. Bass BM. Stodgill's Handbook of Leadership. New York, NY: Free Press; 1981.
9. Bass BM, Stogdill RM. Bass & Stogdill's Handbook of Leadership: Theory, Research, and Managerial Applications. New York, NY: Simon & Schuster; 1990.
10. Ricketts KG. The importance of community leadership to successful rural communities in Florida, University of Florida; 2005.
11. Hemphill JK, Coons AE. Development of the leader behavior description questionnaire. Leader Behav Description Meas. 1957;6:38.
12. Jaques E, Clement SD. Executive Leadership: A Practical Guide to Managing Complexity. Oxford, England: Wiley-Blackwell; 1994.
13. El Ansari W, Oskrochi R, Phillips CJ. One size fits all partnerships? What explains community partnership leadership skills? Health Promot Pract. 2010;11(4):501–514.
Keywords:

assessment; community capacity; leadership

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