Administrator self-ratings of organization capacity and performance of healthy community development projects in Taiwan

Objective: To examine the relationship between the capacities of various community organizations and their performance scores for healthy community development. Design: This cross-sectional study was conducted by examining all community organizations involved in the Taiwan national healthy community development project. Sample: Of 213 administrators contacted, 195 (a return rate of 91.6%) completed a self-administered questionnaire between October and November 2003. The research instrument was self-developed and based on the Donabedian model. It examined the capacity of the community organizations and their performance in developing a healthy community. Results: The average overall healthy community development performance score was 5.0 on a 7-point semantic differential scale, with the structure variable rated as the lowest among the 3 subscales. Community organization capacities in the areas of funding, resources committed, citizen participation, and certain aspects of organizational leadership were found to be significantly related to healthy community development performance. Each of the regression models showed a different set of capacities for the community organization domains and explained between 25% and 33% of the variance in performance. Conclusions: The study validates the theoretical relationships among the concepts identified in the Donabedian model. Nursing interventions tailored to enhance resident citizen participation in order to promote community coalitions are strongly supported.