Using a Community Health Development Framework to Increase Community Capacity A Multiple Case Study Whitney R. Garney, PhD, MPH; Monica Wendel, DrPH; Kenneth McLeroy, PhD; Angela Alaniz, BS; George Cunningham, PhD; Billie Castle, MPH; Monique Ingram, MPH; James Burdine, DrPH The Physical Activity and Community Engagement Project utilized a comparative case study to understand how a theoretical framework called community health development (CHD) influences community capacity. Three rural communities (cases) developed interventions using a CHD framework. Researchers collected qualitative evidence measuring capacity and the CHD process for more than 3 years. Patterns identified seven capacity constructs relevant to CHD, including community history, civic participation, leadership, skills, resources, social and interorganizational networks, and critical reflection. Community health development focuses on population health improvement and strengthening community capacity. As such, it helps communities address local priorities and equips them to address future issues. Key words: community health, obesity, physical activity/exercise, qualitative methods T HE CONCEPT of community is complex, with a long history of how “community” has been framed and operationalized over time. From a the- oretical perspective, scholars have attempted to con- struct a defnition of community that represents its multidimensional aspects. 1 In 1975, Hunter 2 de- fned comminutes as (1) functional spatial units that meet basic needs for sustenance; (2) units of pat- tered social interaction; and (3) symbolic units of collective identity. Almost 20 years later, Eng and Parker 3 expanded the defnition of community to add a focus on producing political change. To oper- ationalize the concept more practically, researchers developed a typology that focuses on communities as setting, target, resource, or agent. 1 As the concept of community has evolved, re- searchers have developed various approaches for Author Affiliations: Department of Health and Kinesiology, Texas A&M University, College Station (Drs Garney and Cunningham); University of Louisville, School of Public Health, Louisville, Kentucky (Dr Wendel and Mss Castle and Ingram); and Center for Community Health Development, Texas A&M Health Science Center School of Public Health, College Station (Drs McLeroy and Burdine and Ms Alaniz). The Center for Community Health Development is a member of the Prevention Research Centers Program. Funding was made pos- sible (in part) by cooperative agreement number 1U48 DP001924 from the Centers for Disease Control and Prevention. The authors declare no conflict of interest. Correspondence: Whitney R. Garney, PhD, MPH, Department of Health and Kinesiology, Texas A&M University, TAMU 4243 College Station, TX 77843 (wrgarney@tamu.edu). Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved. DOI: 10.1097/FCH.0000000000000135 community-based work to ensure that communities have a meaningful voice in projects. 4 Community organizing surfaced in the 1800s as a way to co- ordinate efforts for new immigrants in the United States. 5 Since then, mobilizing efforts have ad- vanced into more topic-oriented approaches, such as community development, which capitalizes on communities as an agent of change. Community development is a broad term referring to activ- ities aiming to mobilize and equip residents to strengthen or improve conditions in their commu- nity. Community development often targets a par- ticular outcome, such as community health develop- ment (CHD), which uses community development processes to improve population health. 6 Simply stated, the process of CHD engages com- munities to (1) identify local issues and resources, (2) develop creative ways to address local issues with available resources, and (3) implement sustain- able health improvement strategies. 6 As Burdine and colleagues 6,7 stated, CHD helps mobilize com- munities to solve their own health-related problems. It focuses on addressing community-prioritized is- sues and in the process, builds local capacity by helping communities obtain skills to address their health issues in a contextually appropriate way. CHD guides sustainable health improvement by starting where people are. 8 Previous studies using CHD principles have addressed access to mental health services, community socioeconomic status, and coordination of health and human services. 9,10 THEORETICAL CONSIDERATIONS The CHD is an interdisciplinary, community- driven framework used to mobilize local resources Copyright © 2017 Wolters Kluwer Health, Inc. Unauthorized reproduction of this article is prohibited. 18 Family and Community Health January–March 2017 ■ Volume 40 ■ Number 1