Course: Community-Oriented Primary Care

General

General
Community - Oriented Primary Care Homepage
This Community-Oriented Primary Care introductory course (COPC) provides a model for integrating primary care services into communities, and targets health-related concerns with active community participation. All parts of this training are free, including registration, learning, testing, and a certificate of completion. This course is intended for physicians, nurses and allied health professionals in training and in practice.

This Community-Oriented Primary Care course is co-sponsored by the American Association of Public Health Physicians, the American College of Preventive Medicine, Global Health through Education, Training and Service (GHETS), the University of Gezira, and sponsored in part by the Annenberg Physician Training Program. The course uses competencies adapted from the University of Nebraska and the George Washington University COPC MPH concentrations. The course uses resources from accredited, world-class organizations such as the American Journal of Public Health, the DC Area Health Education Center, the University of Kansas Community Tool Box, and the World Health Organization. The course was inspired by the vision of David Egilman, MD, MPH and the course developers are: Tess Bird, MSc; and Nicolas Druar. Our Advisory Group is: Pyser Edelsack, MSW; David Egilman, MD, MPH; Jack Geiger, MD, MSciHyg; Jaime Gofin, MD, MPH; Ravinder Mehta, MD; and Jane Frances Namatovu, BDS, MMED, FAMMED/COMM PRACT.

For a publication on this course’s efficacy, see “Building Public Health Capacity through Online Global Learning,” (2018), Open Praxis, to see more research related to NextGenU.org’s educational model, check out NextGenU.org’s publication page. Subscribe to our newsletter to be notified of future updates, new courses, and to be part of our community.

There are two components to this course. The first component involves completing the modules and which provide:
1. A basic introduction to Community Oriented Primary Care principles and practice;
2. Strategies to define and characterize the community;
3. A rationale for prioritization and for assessing the community in detail;
4. Skills to develop a plan for a COPC intervention and evaluation, and community organizing;
5. An understanding of COPC in the contemporary, globalized world.
In order to receive a certificate of completion, you will need to also complete the second, skills-based component of the course, which requires you to identify a mentor who works in the field of health services, but she/he does not necessarily have to have prior experience with COPC, who will serve as your main liaison to this community.

The results of your assessments will be provided to you, and we can report your testing information and share your work with anyone you request (school, employer, etc.). The evaluation you provide at the course’s conclusion will help us improve the training for future students. We hope you find this Lifestyle Medicine course a wonderful learning experience!

Approximate time for the required readings in this course is 19 hours at an average rate of 144 words/minute; in addition, there are required activities as described above. The course requires completion of peer and mentored activities. At the end of each lesson, there is a practice quiz. At the end of the course, after you’ve completed each lesson, quiz, and activity, you’ll have access to a final exam, and a chance to assess the training. Once you’ve passed that last test, you will be able to download a certificate of completion from NextGenU.org and our course’s co-sponsoring organizations (listed above). We keep all of your personal information confidential, never sell any of your information, and only use anonymized data for research purposes, and we are also happy to report your testing information and share your work with anyone (your school, employer, etc.) at your request. We hope that you will find this a rewarding learning experience, and we count on your feedback to help us improve this training for future students.

Engaging with this Course:

You may browse this course for free to learn for your personal enrichment; there are no requirements.

To obtain a certificate
- Show in the registration fields that you have the appropriate prerequisites to be certified. For this course you should have a degree that allows you to practice in primary care.
- Complete all the reading requirements.
- Complete all quizzes and pass with a 70% with unlimited attempts..
- Complete 4 peer activity and associated certification quizzes.
- Find a mentor and complete the 3 required mentor activities.
- Successfully complete the final exam with a minimum of 70% and a maximum of 3 attempts.
- Complete the self and course evaluation forms.
To obtain credit
- Complete all requirements listed above for the certificate.
- Your learning institution or workplace should approve the partner-university-sponsored NextGenU.org course for educational credit, as they would for their learner taking a course anywhere.
To obtain a degree co-sponsored with NextGenU.org, registrants must be enrolled in a degree program as a student of a NextGenU.org institutional partner. If you think that your institution might be interested in offering a degree with NextGenU.org contact us.

We hope that you will find this a rewarding learning experience, and we count on your assessment and feedback to help us improve this training for future students.

Next Steps
- Complete the registration form.
- Begin the course with Module 1: Introduction to COPC Principles and Practice. In each lesson, read the description, complete all required readings and any required activity, and take the corresponding quizzes.
*This course is sponsored in part by the Annenberg Physician Training Program: Abstinence-based Recovery from Addictive Disease. Click here to see curricular threading related to mental health disorders.
Module 1: Introduction to COPC Principles and Practice
Competency covered in this module:
- Describe, analyze, and integrate the conceptual framework, methodology, and principles of COPC.
Click here for the brief module introduction
- Module 1 will act as a foundation for the rest of the course, providing you with an introduction to the principles and philosophy of COPC. You will first learn about the history and the experience of COPC through resources written by leading experts in the field. You will then learn to identify and discuss the meaning as well as the scope of the five COPC principles. In addition, you will be able to recognize the six steps in the COPC process*. The five principles form the underlying practice of COPC and should be engaged with in every step of the process. Although subsequent modules will take you through the six steps in the COPC process, it is through their associated peer and mentored activities that you are encouraged to consider the implementation of these principles in your practice.
  
  This module requires that you identify a local community of your choice and establish a relationship with one of its members, who will become your community mentor. This relationship should be maintained throughout the entire course. The community mentor should be someone who works in the field of health services within the community you have chosen, but s/he does not necessarily have to have prior experience with COPC.
  
  Please note that the five principles and six steps in the COPC process may vary slightly between resources. For the purpose of this training, the principles and steps in the COPC process are as follows:
  
  THE FIVE PRINCIPLES OF COPC*
  
  Responsibility for a defined population
  
  Care based on identified health needs at the population level
  
  Prioritization of health needs
  
  Implementation of an intervention program covering all stages of the health/illness continuum and impacting on the prioritized conditions
  
  Community involvement
  
  * From The Social Medicine Portal. A full description of the principles of COPC from Dr. Jaime Gofin and Dr. Rosa Gofin can be found in the book, The Essentials of Global Community Health (2010, Publisher: Jones & Bartlett Learning).
  
  THE SIX STEPS OF COPC
  
  Community definition
  
  Community characterization
  
  Prioritization
  
  Detailed assessment of the selected health problem
  
  Intervention
  
  Evaluation
  
  * From AHEC Curriculum, Program Office of the District of Columbia Area Health Education Center.
Module 1: Lesson 1: Introduction to COPC
Learning Objectives:

Upon completion of this lesson, you will be able to:
- Understand the history and practice of COPC.
- Discuss the meaning and scope of the Five Principles of COPC.
- Analyze the methodology of the Six Steps of COPC.
- Understand the definition and meaning of community and the value of community participation within the COPC process.
Approximate time required for the readings for this lesson (at 144 words/minute): 3 hours.

Click here to start this lesson
13 URLs, 1 Assignment, 2 Forums
- Required Learning Resources and Activities
- On “A Practice of Social Medicine” by Sidney and Emily Kark (30 mins) URL
  Download the PDF file. Then, read the entire article titled "On “A Practice of Social Medicine” by Sidney and Emily Kark." Dr. Jaime Gofin, a colleague and member of the Kark team, elaborates on their work and also offers further context and historical information.
- Community-Oriented Primary Care: A Path to Community Development (15 mins) URL
  Read the entire article titled "Community-Oriented Primary Care: A Path to Community Development." Dr. H Jack Geiger details COPC in Mississipi in the United States during the 1960s, another important era for understanding COPC today.
- Community-Oriented Primary Care: Historical Perspective (47 mins) URL
  Read this article, titled "Community-Oriented Primary Care: Historical Perspective." It offers a good overall summary of COPC from a historical perspective and will give you a basic theoretical understanding of COPC.
- Dr. Jaime Gofin on Community Oriented Primary Care (COPC) (10 mins) URL
  Read this entire summary of an interview titled "Dr. Jaime Gofin on Community Oriented Primary Care (COPC)" to understand the principles of COPC in context.
- Community-Oriented Primary Care: New Relevance in a Changing World (7 mins) URL
  Scroll down and read the section titled "COPC Defined" for a general understanding of the COPC process. This process will be referenced throughout the course.
- Community Oriented Primary Care (COPC) Curriculum (45 mins) URL
  Scroll down and under the heading titled "Activities and Modules" click on the link titled "Module 1 - Introduction to COPC". Read through the slides for a general understanding of the COPC process. Lecture notes are available for download.
- What Is Community? An Evidence-Based Definition for Participatory Public Health (44 mins) URL
  Read the entire article titled "What Is Community? An Evidence-Based Definition for Participatory Public Health" for an evidence-based definition of community.
- Mentored Activity: Identifying a Community and a Community Mentor Assignment
  
  In this individual exercise, you will identify a local community of your choice and establish a relationship with one of its mentors.
  Step 1: Read the article from MacQueen et al. (2001) titled “What Is Community? An Evidence-Based Definition for Participatory Public Health.” This article defines community as: “a group of people with diverse characteristics who are linked by social ties, share common perspectives, and engage in joint action in geographical locations or settings.” Using what you know about communities, identify a community you would like to work with. This may be a community you know well (such as the neighborhood or village you grew up in) or one that you do not know that well but is close by to where you currently live. It might also be a clinic or school.
  Step 2: Identify a community mentor within the community you chose, whom you will be in contact with throughout the entire course. The community mentor should be someone who works in the field of health services, but she/he does not necessarily have to have prior experience with COPC. Throughout this course, as you become more knowledgeable about COPC, your community mentor will serve as your main liaison to this community, helping you to understand its needs and concerns.
  Step 3: Ask your mentor to register with NextGenU and supply them with a copy of the "COPC community mentor guide."
  Step 4: Write an attestation stating that you have secured a mentor, and submit it for your mentor to grade.
- PMA1-Module 1: Lesson 1: Peer and Mentor Activity Forum
  
  In this activity, you will interact with your mentor to understand the community and its needs and share your findings with your peers
  Step 1: Set up a time to speak with your community mentor about your community of choice. Prior to that meeting read the lecture notes titled “Collecting Ethnographic Data: The Ethnographic Interview” for a better understanding of how to interview your community mentor.
  Step 2: Conduct the interview. Have your mentor show you around the community and introduce you to some of its members. In this exercise (and throughout the entire course) it is crucial that you broaden your knowledge-base and listen to the experiences of your mentor and the needs of the community. You will need to cover the questions outlined below plus any additional questions you may have.
  
  What is your mentor's role in the community?
  
  What are the health problems the community has?
  
  What are the most important needs of the community?
  Step 3: After the meeting, summarize the interview in 250 to 500 words (it may help to take notes during your interview). Answer the questions above and describe your chosen community. Explain why you chose this mentor and why her or his perspective is useful. If you have personal connections to the community (such as growing up there or having a family member who lives there), explain those as well. Also, be sure to describe what you did not expect or what surprised you about the community.
  Step 4: Submit your assignment for peer review by clicking “add a new discussion topic” below and completing the fields.
  Step 5: Review the work of one of your peers by asking yourself the questions listed below and comment on their post stating that their post meets these requirements.
  
  Did my peer describe their chosen community? Did they describe their mentor and their involvement within the community?
  
  Did my peer detail the most important needs and health problems of the community?
  
  Did my peer explain why they chose this mentor and why her/his perspective on the specific community is useful?
  
  Did my peer explain their personal connections to the community (if any)?
  
  Did your peer summarize the interview in 250-500 words?
- Quiz: Module 1 Lesson 1
  Restricted Not available unless:
  The activity Course Registration is marked complete
  The activity Pre-Test is marked complete
  
  To access the quiz, click on the name of the quiz provided above. On the following screen, click the "Preview quiz now" button to respond to the questions
- Additional Learning Options
- A Practice of Social Medicine (98 mins) URL
  Download the PDF file. Then, read this book chapter (reproduced in Social Medicine) titled "A Practice of Social Medicine." Sydney and Emily Kark are the original pioneers of the COPC approach.
- Community-Oriented Primary Care: The Missing Link (10 mins) URL
  Read the article titled "Community-Oriented Primary Care: The Missing Link." This article explores what it means to be a community-oriented practitioner.
- Pioneering Community-Oriented Primary Care (22 mins) URL
  Read the article titled "Pioneering Community-Oriented Primary Care". This commentary reviews the work of Sydney and Emily Kark. It is derived from a memorial lecture given by Professor M. Susser for Sydney Kark.
- Community-Oriented Primary Care: An Examination of the US Experience (10 mins) URL
  "Community-Oriented Primary Care: An Examination of the US Experience" looks at 7 COPC case studies in the United States and examines the diversity of the principles and lessons learned.
- Commentary: In Search of Innovative Approaches to International Health (17 mins) URL
  Read the article titled “Commentary: In Search of Innovative Approaches to International Health" for further examples and a better understanding of Kark's original philosophy. This article written by the founders of COPC, reviews the community health program at Aga Khan University in Pakistan from a historical context.
- Handout 4-3: An Overview of Community-Oriented Primary Care (9 mins) URL
  Read "Handout 4-3: An Overview of Community-Oriented Primary Care" for an overview and definition of COPC.
- Discussion Forum Questions
  Discuss the term “community” with your peers online and based on what you studied in this module, post your own definition of community. You should comment on at least one other posting, and if someone comments on your posting, you should respond back to them.
Module 2: Defining and Characterizing the Community: Identifying Needs and Resources
Competencies covered in this module:
- Define a community for the purpose of clinical care at the community level.
- Plan an assessment of health needs in a community, using available data for the collection and analysis of health information.
Click here for the brief module introduction
- Module 2 will provide an overview, of how to define and characterize communities as well as of how to assess health needs, through online readings and community involvement. You will also develop an understanding of what constitutes a community with regard to a health intervention. You will then learn about community diagnosis, the utility of geographic information systems, and the essential role of epidemiology in COPC. You will likewise develop an understanding of what types of health problems a community might face, including the social, political, and environmental determinants of health. Finally, you will engage with your community mentor and other members of the community to define and characterize your community. By the end of this module, you should feel comfortable identifying community concerns and needs based on community input and mapping the available resources for addressing those concerns.
Module 2: Lesson 1: Defining and Characterizing the Community
Learning Objectives:

Upon completion of this lesson, you will be able to:
- Learn how to define and characterize communities using various techniques and resources.
- Understand the use of epidemiology in the assessment of health conditions.
- Learn how to identify problems as well as how to locate assets and resources within a community.
- Consider why and how initiatives should address the social, environmental, and other determinants of health.
Approximate time required for the readings for this lesson (at 144 words/minute): 5 hours.

Click here to start this lesson
13 URLs, 1 Assignment, 2 Forums, 1 Quiz
- Required Learning Resources and Activities
- Community Oriented Primary Care (COPC) Curriculum (45 mins) URL
  Scroll down and under the heading titled "Activities and Modules" click on the link titled "Module 2 - Defining the Community". Read through the slides in order to describe and understand the community. Lecture notes are available for download.
- Chapter 3. Section 2. Understanding and Describing the Community (3 mins) URL
  Read the two introductory paragraphs and the section titled "What is a community?". It summarizes how to define a community.
- Chapter 3. Section 2. Understanding and Describing the Community (50 mins) URL
  Read down from the section titled "What do we mean by understanding and describing the community?". It summarizes how to characterize the community.
- Geographic Retrofitting: A Method of Community Definition in Community-Oriented Primary Care Practices (26 mins) URL
  Read this article titled "Geographic Retrofitting: A Method of Community Definition in Community-Oriented Primary Care Practices." This article describes how geographic retrofitting in combination with geographic information system (GIS) technology can be used to help define the community and assist in interventions.
- Application of Epidemiology in Community Oriented Primary Care (32 mins) URL
  Read this article titled "Application of Epidemiology in Community Oriented Primary Care." This article, although one of the earliest articles used in this course, is one of the few available articles that specifically addresses which components of epidemiology should be utilized in COPC.
- Chapter 17. Analyzing Community Problems and Solutions (32 mins) URL
  In "Chapter 17: Analyzing Community Problems and Solutions" click on the link titled “Section 3. Defining and Analyzing the Problem”. Read the content under the heading "Main Section". Look at the examples illustrated under the “Examples” tab in order to understand how to identify, define, and analyze community health problems. Then, click on the link titled "Section 4. Analyzing the Root Causes of Problems: The "But Why?" Technique”. Again, read the content under the heading "Main Section" and look at the examples illustrated under the “Examples” tab in order to understand how to (i) identify, (ii) define, and (iii) analyze community health problems. The Community Tool Box is a valuable resource and will be referenced throughout this course.
- Chapter 3. Section 8. Identifying Community Assets and Resources (26 mins) URL
  In "Chapter 3: Section 8. Identifying Community Assets and Resources" read the content under the heading "Main Section" to understand methods for the identification of community assets and resources.
- About social determinants of health (9 mins) URL
  Read the World Health Organization’s webpage titled "About social determinants of health". Click on the "Key concepts" links and read the content to further your understanding of the global social determinants of health.
- Chapter 17. Section 5. Addressing Social Determinants of Health and Development (63 mins) URL
  Read the content of "Chapter 17. Section 5. Addressing Social Determinants of Health and Development" under the heading "Main Section" for a general overview. Being aware of social determinants of health is crucial when involving the community and analyzing health indicators/problems.
- Mentored Activity: Defining and Characterizing your Community Assignment
  
  In this activity, you will connect with three members of the community you are working with to develop the first two steps of the COPC process: “Defining and Characterizing the community”.
  Step 1: With the help of your community mentor, identify at least two other key informants who live and work in the same community and ask them if they would be willing to be interviewed. Explain that you are a NextGenU student taking a course on Community-Oriented Primary Care, and that you would like to interview them in order to learn more about the health issues within the community. During these interviews we suggest that you explain what you have learned about COPC and the process you used in identifying this individual. Each of the three interviews (two with community members AND one with your community mentor) should be at least 15 minutes in length and include the follow key questions:
  What needs, weaknesses, and strengths do you see in the defined community?
  What do you think are the major problems within the community that need to be resolved?
  What do you think are the most important health concerns and needs in the community?
  What are some of the social determinants that influence health in the community?
  Step 2: Write a 200-300-word summary of each interview you had with each key informant (it may help to take notes during your interviews, or record them if you have permission to do so). Answer the questions above, and summarize any additional information or advice you received from the interviewees. Be sure to include a brief summary about your key informants, as well as a description of their current area of work. You will use the information obtained in these interviews to write the upcoming peer activity.
  Step 3: Submit your summary below and let your mentor know that it is ready for grading.
- Module 2: Lesson 1: Peer Activity: Defining and Characterizing your Community Forum
  In this activity, you will use the information previously acquired through readings, from your mentor and key informants, to define your community. Please note: You will use this information afterward to complete your project proposal in Module 4.
  Step 1: Define and characterize your community using the information you obtained
  through the required readings, from your mentor, and/or from the key informants interviewed in the mentored activity in this module. You can also gather information from official published or unpublished resources from governments and local agencies, hospitals and clinics, and international organizations such as the World Health Organization (WHO) and the United Nations. The definition of your community should clarify the boundaries of the community and should also include maps.
  Step 2: Summarize your findings in 600 to 800 words, be sure to include: the geography of the community, demographic and social features of its population health, social, and other services available to members of the community the health status of its members.
  Step 3: Submit your assignment for peer review by clicking “add a new discussion topic” below and completing the fields.
  Step 4: Review the work of one of your peers by asking yourself the questions listed below and comment on their post stating that their post meets these requirements.
  Did my peer define and characterize their community in 600 to 800 words?
  Does my peer show evidence that she/he utilized and understood the required readings in the module, and that they conducted community-specific research?
  Did my peer include a community definition, including clarified boundaries?
  Did my peer address the geography of the community, the demographic and social features of its population, health, social, and other services available to members of the community, and the health status of its members?
- Quiz: Module 2: Lesson 1
  To access the quiz, click on the name of the quiz provided above. On the following screen, click the "Preview quiz now" button to respond to the questions
- Additional Learning Options
- Chapter 3. Section 16. Geographic Information Systems: Tools for Community Mapping (58 mins) URL
  Read the content in "Chapter 3. Section 16. Geographic Information Systems: Tools for Community Mapping" under the heading of "Main Section" for an introduction to GIS and how it can be used in community mapping and diagnosis. View the PowerPoint slides, by clicking on the link, if further understanding is needed or desired.
- GIS and Public Health at CDC (5 mins) URL
  Explore this website titled "GIS and Public Health at CDC" to further understand the uses of GIS, as described in the previous resource.
- 2. Assessing Community Needs and Resources URL
  Scroll through the section titled "2. Assessing Community Needs and Resources." This resource is an outline that provides links for assessing community needs and resources. Although you already read the section titled "Understanding and Describing the Community" as a required reading, feel free to click on any other section link to learn more about topics you are not confident with.
- Welcome to the Health Indicators Warehouse (HIW) (5 mins) URL
  Explore the website titled the "Health Indicators Warehouse (HIW)" to examine the list of health indicators in various communities in the United States. Think about how these indicators might change in different parts of the world.
- Discussion Forum Questions (optional)
  Discuss with your peers methods to define and characterize the communities that you are each working with. Consider the following questions:
  
  Why is it important to define the community?
  
  What tools are useful when characterizing communities and why?
  
  Moreover, if members in the forum:
  
  Have any previous knowledge regarding epidemiology or geographic information systems they should share their experience with the group.
  
  Have previous experience diagnosing community health issues, they should describe whether their previous experiences are similar or different to COPC?
  
  You should comment on at least one other posting, and if someone comments on your posting, you should respond back to them.
Module 3: Prioritization and Detailed Assessment: Preparing for your Intervention
Competencies covered in this module:
- Justify the need for the prioritization process in COPC, and define objective criteria to be used for the selection and determination of methods to discuss process and decision.
- Gather best-practices models for community-based interventions and the necessary quantitative and qualitative information for implementation in the focus community.
Click here for the brief module introduction
- Module 3 will continue with the COPC process following your definition and characterization of your chosen community. You will begin to understand the importance of prioritizing health concerns in the COPC process. The COPC process is a cyclical progression involving repetition of each of its six steps. Each step tends to focus on a single priority health issue or several closely related ones. You will engage with your community mentor to prioritize health concerns and provide a detailed assessment of the selected health issue. By the end of this module, you should feel quite comfortable prioritizing a health concern in a community as well as using the necessary qualitative and quantitative information to design a community-based intervention.
Module 3: Lesson 1: Preparing for your Intervention
Learning Objectives:

Upon completion of this lesson, you will be able to:
- Understand the prioritization process of health conditions in the development of COPC.
- Provide a detailed assessment of the selected health condition.
- Consider the COPC process in action (as in the Jerusalem example).
- Gather information to design a promising intervention utilizing community input.
Approximate time required for the readings for this lesson (at 144 words/minute): 5 hours.

Click here to start this lesson
9 URLs, 1 Assignment, 1 Quiz, 1 Forum
- Required Learning Resources and Activities
- Community Oriented Primary Care (COPC) Curriculum (30 mins) URL
  Scroll down and under the heading titled "Activities and Modules" click on the link titled "Module 3 - Identifying Health Problems". Read through the slides in order to learn how to identify health problems. Lecture notes are available for download.
- Improving the Use of Research Evidence in Guideline Development: 2. Priority Setting (28 mins) URL
  Read the article titled "Improving the Use of Research Evidence in Guideline Development: 2. Priority Setting." This article describes a broad spectrum of criteria for setting priorities and suggests those that should be used.
- Chapter 3. Section 15. Qualitative Methods to Assess Community Issues (48 mins) URL
  Read the web page to learn about qualitative methods to assess the health condition.
- Strengthening Nonprofits: A Capacity Builder’s Resource Library - Conducting a Community Assessment (30 mins) URL
  Read the section titled "Step 3: Collect Data" to learn how to conduct a community assessment.
- The Jerusalem Experience: Three Decades of Service, Research, and Training in Community-Oriented Primary Care (19 mins) URL
  Read the article titled "The Jerusalem Experience: Three Decades of Service, Research, and Training in Community-Oriented Primary Care" in order to gain a better understanding of how the COPC process works (as in the Jerusalem example). Examine Figure 1 which clearly illustrates the COPC cycle.
- Chapter 19. Section 1. Criteria for Choosing Promising Practices and Community Interventions (57 mins) URL
  In "Chapter 19" read the content of "Section 1. Criteria for Choosing Promising Practices and Community Interventions" under the "Main Section" and "Checklist" tabs. These pages from The Community Tool Box provide a comprehensive overview of criteria as well as qualitative and quantitative methods you should consider when designing an intervention, . Furthermore, this resource provides information on locating other current interventions and quantitative and qualitative methods.
- Chapter 19. Choosing and Adapting Community Interventions (73 mins) URL
  In "Chapter 19. Choosing and Adapting Community Interventions" read the content of the "Main Section" tab for both “Section 4. Adapting Community Interventions for Different Cultures and Communities” and “Section 5. Ethical Issues in Community Interventions.” These sections will help you think about how culture and ethical issues can affect community interventions. These issues are critical elements to consider especially for an outsider working in a foreign community. However, they are also important factors to keep in mind when working within your own community.
- Mentored Activity: Prioritization and Detailed Assessment of the Selected Health Problem Assignment
  In this activity, you will work on the third step “Prioritization of Needs” and fourth step “Detailed Assessment of the Selected Health Problem” of the COPC process
  Step 1: Read the description of “Prioritization of Needs” that can be found on the District of Columbia AHEC website Since many communities have various health needs and restricted resources, it is important to prioritize those requirements and make an objective selection of a health concern. Also, read the description of “detailed assessment” that can be found on the DC (District of Columbia) AHEC website. Read the DC AHEC document on “Detailed Assessment”.
  Step 2: Develop a set of questions and interview community members in order to gather information about the selected health condition. Your set of questions might include how it affects daily lives, how people feel about the condition, what they witness in the community, etc.
  Step 3: Discuss with your mentor the health needs of the community and the methods to prioritize them, also, discuss with your mentor the assessment of the selected health condition.
  Step 4: Write a 100 to 200-word description of the prioritization of health concerns in your community. Include why you decided to prioritize in this way in your description. You should engage the help of community members in your project wherever possible.
  Step 5: Write a detailed 600 to 900-word text assessing the health condition in your defined community. Your assessment must include:
  A definition of the population (all or certain sub-groups)
  Assessment of health status, determinants and outcomes related to the specific condition
  Methods of data collection (are they valid and reliable?)
  Limitations of the collected and available data (e.g., what questions remain?)
  Step 6: Submit one document with your assignments for the third step “Prioritization of Needs” and fourth step “Detailed Assessment of the Selected Health Problem” of the COPC process to get feedback from your mentor.
  Please note: You do not need to submit your text for peer review, but feel free to get feedback from your mentor. However, you will use what you wrote to complete your project proposal in Module 4. As such, make sure you save your assignments for this activity.
  The document is in an Office file format. If you do not have Office software click here for a list of all plugins.
- Quiz: Module 3 Lesson 1
  To access the quiz, click on the name of the quiz provided above. On the following screen, click the "Preview quiz now" button to respond to the questions.
- Additional Learning Options
- Chapter 18. Deciding Where to Start (72 mins) URL
  In "Chapter 18. Deciding Where to Start" read the content under the heading “Main Section" of both “Section 1. Designing Community Interventions” and “Section 2. Participatory Approaches to Planning Community Interventions.” These webpages in the ‘Community Tool Box’ outline the methods to construct a community intervention as well as the participatory approaches to planning one.
- Chapter 5: Assessing Evidence and Information (90 mins) URL
  Use "Chapter 5: Assessing Evidence and Information" as an additional resource to read more about the different types of research (qualitative and quantitative), the measures of risk, and the associated bias. Please note that the source is not written from a COPC perspective but can act as a supplement to develop a better understanding about evidence collection and analysis.
- Discussion Forum Questions (optional)
  Discuss online with your peers the different ways in which you could get the community involved at each of the six steps of the COPC process. You should comment on at least one other posting, and if someone comments on your posting, you should respond back to them.
Module 4: Implementing the COPC Approach
Competency covered in this module:
- Demonstrate the ability to plan and develop all the stages of a systematic COPC intervention considering evidence based interventions.
Click here for the brief module introduction
- Module 4 prepares you to design and possibly implement a COPC project in the community that you have been working with. Implementation of the project is not required for completion of this course, but it is encouraged. In order to complete the course, you will only be asked to write a project proposal for an intervention in your community. Before you write your project proposal, you are encouraged to think critically about your role as a healthcare provider and identifying key community members as well as available resources. Consider all that you have learned in the course so far, and reference back to the readings and learning activities from prior modules. Some of these learning activities will be used in your proposal. You will also learn methods for evaluating and reassessing your initiative. Finally, you will write a project proposal with the help of your community mentor and NextGenU peers.
Module 4: Lesson 1: Implementing the COPC Approach
Learning Objectives:

Upon completion of this lesson, you will be able to:
- Understand COPC intervention design and setup.
- Consider your role as a health care provider within the community.
- Identify key community members.
- Use available resources to develop a plan that follows the six steps of the COPC process.
- Consider methods for evaluating your initiative and the importance of reassessment.
- Describe how to approach different community problems to develop a plan following the COPC process.
Approximate time required for the readings for this lesson (at 144 words/minute): 3 hours.

Click here to start this lesson
12 URLs, 2 Forums, 1 Quiz
- Required Learning Resources and Activities
- Community oriented primary care in Tshwane District, South Africa: Assessing the first phase of implementation (42 mins) URL
  Read the entire article. Ensure you examine Table 3 which outlines the stages of the COPC implementation process.
- Being Community-Responsive Physicians: Doing the Right Thing (33 mins) URL
  Read and study the article titled "Being Community-Responsive Physicians: Doing the Right Thing." It is a qualitative study that examines how family physicians respond to community needs in either community health centers or fee-for-service practices in Toronto, Ontario, Canada. Consider what experiences and challenges you might face as a physician.
- Chapter 18. Section 3. Identifying Targets and Agents of Change: Who Can Benefit and Who Can Help (15 mins) URL
  In "Chapter 18. Section 3. Identifying Targets and Agents of Change: Who Can Benefit and Who Can Help" read the content under the "Main Section" and "Examples" tabs in order to help identify potential agents of change in the community where you are working.
- Training and Application of Community-Oriented Primary Care (COPC) Through Family Medicine in Catalonia, Spain (30 mins) URL
  Read the article titled "Training and Application of Community-Oriented Primary Care (COPC) Through Family Medicine in Catalonia, Spain" for a sense of how to teach COPC to other residents and how to cooperate with an established national health system. This article details how and why COPC was successful in Catalonia, Spain.
- Community Oriented Primary Care (COPC) Curriculum (18 mins) URL
  Scroll down and under the heading titled "Activities and Modules" click on the link titled "Module 4 - Developing and Monitoring Interventions". Read through the slides to learn how to evaluate an intervention. Lecture notes are available for download.
- Use of Clinical Indicators to Evaluate COPC Projects (25 mins) URL
  Read the article titled "Use of Clinical Indicators to Evaluate COPC Projects." Understand some of the potential methods and problems associated with the evaluation of COPC projects based on clinical indicators.
- A Primary Care Approach to Substance Misuse URL
  Read the entire page.
- Health Care Systems and Substance Use Disorder URL
  Read from the beginning of the article until the heading "The Promise of Integration."
- Peer Activity: Project Proposal Forum
  
  In this activity, you will design and propose a small COPC project with the help of your community mentor, following the six principles of COPC, that pertain to the community that you have chosen to work with. You will not be required to implement this project, but rather to design a feasible plan that could be carried out by either yourself or someone else in the future. Communicate with your mentor and peers throughout the development of your proposal, discussing challenges, next steps, and general questions of interest. This proposal may help members of the community you have been in contact with by outlining problems and a potential plan of action. A final copy of your proposal should be given to your community mentor. Keep in mind that you have already written portions of this proposal as part of the peer and mentored assignments completed in Modules 2 and 3. You may re-use these prior assignments as is or revised as needed. However, you are required to combine all of these assignments into one full project proposal.
  Step 1: When writing your project proposal, please follow the outline detailed below, answering each of the questions posed. There are three parts to include in your proposal. Within each part, there are specific elements to address, and these are outlined below:
  Community assessment and diagnosis
  Intervention plan
  Method of evaluation.
  
  PART ONE: COMMUNITY ASSESSMENT AND DIAGNOSIS (1500-2100 words total)
  1.1) Define and characterize the health needs and available resources of the community in question (600-800 words).
  You can use the portion of the essay that you wrote in Module 2 which answers the question “How would you define and characterize this community?” You may revise your original essay as needed. Your proposal should consider methods of community diagnosis, Geographic Information Systems (GIS), epidemiology, and the social determinants of health. In addition, include an outline of the community assets and resources.
  1.2) Describe how you would prioritize the needs of the community. Explain your answer in 300-400 words.
  You can use what you wrote for the mentored activity “Prioritization” in Module 3. You may revise your original essay as needed. Considering the first mentored activity in Module 3, discuss the method of prioritization in your specific community. Explain why you decided to prioritize in this way and identify the selected health condition. Engage community members whenever possible.
  1.3) Assess the selected health condition (600-900 words)
  You can use what you wrote for the mentored activity: “Detailed Assessment of Selected Health Problems” in Module 3. You may revise your original essay as necessary. Include any additional research on the selected health condition. Engage your mentor and other community members whenever possible.
  PART TWO: INTERVENTION PLAN (300-500 words total)
  With regard to your specific health priority in your specific community, design an intervention strategy with the help of your mentor, peers, and community members (300-500 words). Utilize the DC AHEC document on “Intervention” and the CTB chapter on “Deciding Where to Start” as additional guides. Within your project plan, including responses to all of the following:
  Preliminary Research
  2.1) Outline the work carried out by the health service and other organizations thus far.
  
  2.2) Outline the work carried out by the community thus far.
  
  2.3) Describe what methods you will use or have used to engage the community. Describe how you will or how you have identified key personnel and stake-holders. Describe the level of involvement and willingness of the community to engage with you. Describe some of the challenges and benefits of community involvement.
  Objectives
  2.4) Indicate one to two short-term objectives, one to three intermediate objectives, and one long-term objective for the plan.
  
  2.5) Describe at least one activity or action for each one of the objectives outlined above. Provide the references that demonstrate the effectiveness of the activities or actions.
  Necessary Resources
  2.6) List the resources (personnel, materials and equipment) that would be needed to carry out your intervention.
  
  Budget
  2.7) Outline a realistic, estimated budget to carry out your intervention.
  
  Timeline
  2.8) Estimate the time required to accomplish your intervention.
  
  Accountability
  2.9) Describe how the gathered information will be communicated to different members of the team and community.
  
  PART THREE: METHOD OF EVALUATION (250-300 words total)
  Utilize the DC AHEC document on “Evaluation” and the CTB resources on evaluation as additional guides. Your plan should contain 250-300 words. Ensure that your plan addresses each of the points outlined below.
  3.1) Describe the methods of surveillance and evaluation that will best suit the activities or actions. Be sure your answer considers not only the community in question, but resources, preliminary data, and the project proposal outlined above.
  3.2) Describe how the steps will be assessed.
  Step 2: Submit your assignment for peer review by clicking “add a new discussion topic” below and completing the fields.
  Step 3: Review the work of one of your peers by asking yourself the questions listed below and comment on their post stating that their post meets these requirements.
  Does my peer's proposal include each stage of the COPC process by clearly answering each of the numbered elements in all three parts of the Proposal Activity?
  Does my peer's proposal include a well-researched and developed community assessment and diagnosis?
  Does my peer's proposal include preliminary research as well as the methods required for involving the community?
  Does my peer's proposal contain clearly defined objectives, a realistic budget, a resource list, a time frame, and a strategy for communicating the gathered information to the community?
  Does my peer's proposal describe methods for evaluation?
  Is my peer's proposal both feasible and logical?
- Quiz: Module 4 Lesson 1
  To access the quiz, click on the name of the quiz provided above. On the following screen, click the "Preview quiz now" button to respond to the questions.
- Additional Learning Options
- Patients and Community Together : A Family Medicine Community-Oriented Primary Care Project in an Urban Private Practice (19 mins) URL
  Read the article titled "Patients and Community Together", which details a COPC approach in an urban private practice in the United States, if you are either working in a urban community in the United States or are interested in encouraging community involvement in a private practice setting elsewhere.
- A Community-Oriented Primary Care Demonstration Project: Refining Interventions for Cardiovascular Disease and Diabetes (28 mins) URL
  "A Community-Oriented Primary Care Demonstration Project" details another example of COPC in an African-American community in the Southeastern United States. Read this if you are either working with similar communities or if the priority health needs, in your chosen community, are diabetes or cardiovascular disease.
- 12. Evaluating the Initiative URL
  Read the content under the heading "Outline" in the chapter titled "12. Evaluating the Initiative." This resource provides links to other chapter sections. Click on these links to gain an overall understanding of what is involved in the evaluation of an initiative. Use this resource as a reference as you read the other materials in this section and follow any links toward topics that you do not understand or would like to know more about.
- Community Health Assessment and Group Evaluation (CHANGE) Action Guide: Building a Foundation of Knowledge to Prioritize Community Needs (60 mins) URL
  Read the guide.
- Discussion Forum Questions (optional)
  Use the discussion forum to ask your peers about any concerns or problems you may be having with your project proposal. You should comment on at least one other posting, and if someone comments on your posting, you should respond back to them.
Module 5: Explore the Skills Involved in Community Organizing
Competency covered in this module:
- Apply appropriate methods to promote community participation in the development of COPC.
Click here for the brief module introduction
- In Module 5 you will learn about community organizing. Although “community organizing” as presented herein is not necessarily a part of the classical COPC model, this information is valuable for involving the community (and others) in the COPC process. In this module, you will (i) develop an understanding of community organizing, (ii) consider the values and motivations behind organizing, and (iii) learn about community organizing strategies. This module does not include a peer/mentored activity; instead it proposes questions for discussion in the optional online forum.
Module 5: Lesson 1
Learning Objectives:

Upon completion of this lesson, you will be able to:
- Understand the basics of community organizing
- Consider the values and motivations for organizing
- Understand the methods of community organizing
Approximate time required for the readings for this lesson (at 144 words/minute): 2 hours.

Click here to start this lesson
6 URLs, 1 Quiz, 1 Forum
- Required Learning Resources and Activities
- Marshal Ganz Web Module on Organizing: Topic 1: What is Organizing? (5 mins) URL
  Read this webpage titled "Topic 1: What is Organizing?" This resource is a part of Marshall Ganz’s Web module on ‘organizing’ given at Harvard University.
- Marshal Ganz Web Module on Organizing: Topic 4: Why We Organize: Values, Motivation, and Narrative (61 mins) URL
  Scroll down the webpage titled "Topic 4: Why We Organize: Values, Motivation, and Narrative" until you reach the heading "Key Readings." Open and read the first key reading titled "Organizing Notes chapter on motivation."
- Marshal Ganz Web Module on Organizing: Topic 5: How We Organize: Resources, Strategy, and Power (75 mins) URL
  Scroll down the webpage titled "Topic 5: How We Organize: Resources, Strategy, and Power" until you reach the heading "Key Readings." Open and read each of the three key readings: "Organizing Notes," "The Bible," and "Ganz's Harvard course readings on strategy organizing."
  
  Please note: to obtain the text for "The Bible" reading, scroll down and select ‘1 Samuel’ in the ‘Entire Bible’ menu and keep the ‘King James Version’ as the Bible version choice. Click on ‘17’ to access the correct chapter. Each verse is its own paragraph. Read paragraphs 4 to 49.
- Quiz: Module 5 Lesson 1
  To access the quiz, click on the name of the quiz provided above. On the following screen, click the "Preview quiz now" button to respond to the question.
- Additional Learning Options
- Marshal Ganz Web Module on Organizing: Topic 1: What is Organizing? (35 mins) URL
  Watch the two Lecture Videos under "Topic 1: What is Organizing?"
- Marshal Ganz Web Module on Organizing: Topic 4: Why We Organize: Values, Motivation, and Narrative (22 mins) URL
  Under "Topic 4: Why We Organize: Values, Motivation, and Narrative" watch the first Lecture Video titled "Ganz's video vignette on motivation." Also find some of the suggested readings on your own to read.
  
  Please note: RealPlayer is required for viewing these videos.
- Marshal Ganz Web Module on Organizing: Topic 5: How We Organize: Resources, Strategy, and Power (99 mins) URL
  Watch the two Lecture Videos under "Topic 5: How We Organize: Resources, Strategy, and Power" and find some of the suggested readings on your own to read.
  
  Please note: RealPlayer is required for viewing these videos.
- Discussion Forum Questions (optional)
  Based on your project proposal, answer any or all of the following questions:
  
  What motivates you to do the work your project requires?
  
  What motivates the people participating in your project? What feelings are being expressed or challenged? What 'barriers of belief' are being broken, and by whom?
  
  How would you engage individuals who are not motivated (if applicable)?
  
  How did you get interested in this project? Why does the project matter to you? Why should the project matter to anyone else?
  
  What are people in the community saying about your project/organization?
  
  You should comment on at least one other posting, and if someone comments on your posting, you should respond back to them.
Module 6: Considering COPC in Global Health
Competency covered in this module:
- Evaluate and analyze the challenges on COPC programs.
- Assess the conceptual and practical factors to take into account the applicability of COPC.
- Recognize the socio-economic, cultural, environmental, political and health policy elements that could challenge the application of COPC and develop alternative community-oriented application solutions.
- Communicate the principles and features of the practice of COPC to lay populations, to health professionals, and to other related audiences.
Click here for the brief module introduction
- In Module 6, you will learn about the benefits of COPC in the contemporary, globalized world and the integration of COPC into a larger health system. You will also learn about the various forces that affect global health and may influence COPC practice. In addition, you will develop methods to communicate the principles and stages of COPC to lay populations, other students, and health professionals through the analysis of case-studies and the preparation of a presentation summarizing what you have learned in the course.

Module 6: Lesson 1: COPC in Global Health

Learning Objectives:

Upon completion of this lesson, you will be able to:

Consider contemporary COPC in a globalized world.
Understand the importance of integrating community-oriented interventions into larger health systems.
Recognize the social, economic, cultural, environmental, political, and health policy elements that may influence COPC practice.
Develop an understanding of case-studies and reviews of community-oriented health services.

Approximate time required for the readings for this lesson (at 144 words/minute): 2 hours.

Click here to start this lesson

14 URLs, 1 Quiz, 1 Assignment, 1 Forum

Required Learning Resources and Activities
Community-Oriented Primary Care: New Relevance in a Changing World (35 mins) URL
Read the entire article except the section titled "COPC Defined". This article reviews the evolution of COPC, evaluates some of the "pitfalls and paradoxes" and amendments to COPC, and notes potential future roles for COPC. Now that you have engaged with a local community, this article helps us understand the greater significance of COPC in the world.
Community-Oriented Primary Care (COPC) and the Affordable Care Act: An Opportunity to Meet the Demands of an Evolving Health Care System (16 mins) URL
Read the entire article to learn about COPC and the health care system.
What We Mean by Social Determinants of Health (45 mins) URL
Read the article titled "What We Mean by Social Determinants of Health." This paper was the inaugural speech presented at the Eighth European Conference of the International Union of Health Promotion and Education. It reviews the bigger picture, or i.e. more systematic components and power relations that affect the social determinants of health as well as health inequities.
Community-Oriented Primary Care in Action: A Dallas Story (22 mins) URL
Read the article titled "Community-Oriented Primary Care in Action: A Dallas Story." This paper details one of the largest urban COPC models in the United States. The authors conclude that the COPC model can be implemented in other urban areas.
Towards Unity for Health Utilising Community-Oriented Primary Care in Education and Practice URL
Click on the PDF icon to download the article titled "Towards Unity for Health Utilising Community-Oriented Primary Care in Education and Practice". Read the entire article. This paper looks at how COPC can be used by a global health organization that is interested in strengthening health systems.
Quiz: Module 6 Lesson 1
To access the quiz, click on the name of the quiz provided above. On the following screen, click the "Preview quiz now" button to respond to the questions.
Additional Learning Options
A Systematic Review of the Evidence on Integration of Targeted Health Intervention into Health Systems (63 mins) URL
Read the article titled "A Systematic Review of the Evidence on Integration of Targeted Health Intervention into Health Systems." This article explores the integration of health interventions into larger health systems and gives an evidence-based analysis of integration in different countries. Consider what challenges a COPC approach might face from greater health systems and competing health interventions.
The Fiji Islands Health System Review (19 mins) URL
Read the following sections: "2.2 Overview of the health system" and "2.3 Historical background." Also read in section "5.3 Primary and ambulatory care" the part titled "Village (or Community) Health Workers."
The Philippines Health System Review (13 mins) URL
Read section "6.3.1 Health Service Delivery."
Direct Household Payments for Health Services in Asia and the Pacific: Impacts and Policy Options (54 mins) URL
Read the "Executive Summary" or the entire document.
Mongolia Health System Review (15 mins) URL
Read section "5.1 Public Health."
An Anthropology of Structural Violence (90 mins) URL
Read the article by Paul Farmer titled "An Anthropology of Structural Violence." The "Comments" section found at the end of the article, is optional. This paper focuses on Farmer's work in Haiti and is one of the key analyses of structural violence in a contemporary global health setting, It is important to understand the greater structural implications which affect health and health care.
Call for Global Health-Systems Impact Assessments (8 mins) URL
Scroll down the webpage and read the section titled "Call for Global Health-Systems Impact Assessments." This article details a potential method for evaluating the impact of health interventions on health systems.
The Community-Oriented Primary Care Experience in the United Kingdom (20 mins) URL
Read the entire article titled "The Community-Oriented Primary Care Experience in the United Kingdom." This article looks at the primary care approach in the UK as part of the National Health Service system.
Roots, Shoots, but Too Little Fruit: Assessing the Contribution of COPC in South Africa (15 mins) URL
Read the article titled "Roots, Shoots, but Too Little Fruit: Assessing the Contribution of COPC in South Africa". The COPC movement in South Africa is unique due to its interruption by apartheid. Consider the implications of greater politics on the success of health interventions.
Mentored Activity: COPC in the Contemporary World (optional) Assignment
This activity is meant to foster continued community input and encourage you to value not only the experience of the community but your community mentor as well. After reading the required resources in this module discuss what you learned from them with your community mentor.

Your mentor may also be interested in reading the articles before your discussion, so be sure to ask ahead of time. If your mentor has not read the resources, give adequate context; alternatively, simply ask your mentor any questions you may have about the resources. For instance, you can simply explain some of the global issues introduced and then ask what your mentor thinks about them. Be sure to listen to your community mentor carefully and respect their opinions. However, feel free to share your own opinions. The idea here is to engage in a conversation that allows you and your mentor to discuss complex issues on egalitarian grounds even if you both come from very different backgrounds. Do not be surprised if the conversation naturally veers away from the readings.

MCQ Writing Activity (optional) Forum

Choose any three learning resources from the entire course. Create one multiple-choice question (MCQ) for each of the three resources. Please use this table with the following columns to keep your information organized:

Module Name	Lesson/ Competency	Resource Name	Resource URL	Question	Response Choices	Answer	Source Quote
Insert the Name of the Module	Insert the name of the lesson or competency the MCQ addresses	Insert the Name of the resource the MCQ is derived from	Insert the URL of the resource the MCQ is derived from	Insert the Question	Insert the response choices separated by a semi-colon (;)	Insert the full correct answer	Insert the source quote that clearly supports the correct answer
Example Question Below
Module 1: Welcome to UBC	Lesson 1: Geography Competency: Know the geographic details of UBC's Vancouver campus	About UBC	http://www.ubc.ca/about/	How far is the UBC's Vancouver campus from the heart of downtown Vancouver?	10 minutes; 30 minutes; 50 minutes; 70 minutes;	30 minutes	The largest campus is 30 minutes from the heart of downtown Vancouver, a spectacular location that is a 'must-see' for any visitor to the city — where snow-capped mountains meet ocean, and breathtaking vistas greet you around every corner.

Post your completed question chart in a discussion post below.

Final Exam

Click here to start Final Examination
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  To take the final exam, you must complete all quizzes and complete all the required activities. The final exam consists of 49 questions, and you will have 49 minutes to complete it. When the time is over, you will have two minutes to submit your attempt before it expires, and your progress is discarded. You will not be able to answer additional questions in the grace period.
  To access the exam, click on the name of the exam provided above. On the following screen, click the Preview quiz now button to respond to the questions.
Course and Self Evaluation & Certificate

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- Feedback URL
- Course Evaluation Questionnaire
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