Community Empowerment Middle Range Theory in Nursing Care

Afza.Malik GDA

 Nursing Care and Community Empowerment Theory

Community Empowerment Middle Range Theory in Nursing Care

Community Empowerment Middle Range Theory,Purposes of Theory Concept of Theory,Model of Theory,Theory Applications,Conclusion.

Community Empowerment Middle Range Theory

    The middle-range theory of community empowerment was developed by Cynthia Armstrong Persily and Eugenie Hildebrandt (2003). This theory evolved from participatory action research (Hildebrandt, 1994, 1996) and is an amalgamation of theories related to community development and empowerment. 

    It is based on the premise that improving the health of people rests in programs that enable active participation of members of the community to take responsibility for their own health (Persily & Hildebrandt). 

    Community development is embedded in models advocating the development of strength and confidence of community people while they are working on problems they have identified (Persily & Hildebrandt).

Purposes of Theory

    The purpose of the theory is to provide a framework for interventions at individual and community levels; it "explicates for nursing the direct transfer of knowledge and expertise from nurse professionals to lay people to promote health" (Persily & Hildebrandt, 2003, p. 111). 

    The theory offers a community involvement process to augment the knowledge and health care decision making potential of persons living in the community,

Concept of Theory

    There are three major concepts in the theory. The concepts are: involvement, "a linking of people in the community to identify needs, resources and barriers;" lay workers, "trained persons who share backgrounds with persons in the community;" and reciprocal health, "actualization of inherent and acquired human potential" (Persily & Hildebrandt, 2003, pp. 113-114).

Model of Theory

    A model of the middle range theory of community empowerment is depicted as the involvement of lay workers in the promotion of health (Persily & Hildebrandt, 2003, p. 117). When considered together, the concepts explain the potential for empowerment of community people through the involvement of lay workers in promoting reciprocal health. 

    Lay workers in the community work with health care professionals to increase access and extend opportunities to promote health. This partnership of lay community members with professional providers offers opportunities to facilitate community involvement and attain reciprocal health.

    Hildebrandt (1994) applied the theory in participatory action studies in South Africa with an exploratory descriptive design aimed at meeting the health needs of black South Africans in a township setting. Indigenous lay workers diminished the barriers of disruption, race, and language. 

    Identified needs were: health knowledge, diagnostic screening, literacy training, and food through gardening. 

    Findings of the study revealed that lay workers and health care personnel effectively responded to basic human health needs with all age groups in the community; it took a considerable investment of time and resources to introduce community involvement; and it was fitting to empower lay people in the promotion of community health.

Theory Applications

    Application of the theory of community empowerment in advanced practice nursing offers widespread opportunities to promote health. 

    Some applications include: organizing lay community members to become involved in strategies to provide access to health care clinics to empower persons who have difficulty with transportation in rural areas, educating lay resource mothers to be involved in the care of empowering pregnant women during and after delivery , and involving older lay members of the community in different community roles to empower frail elder persons who live alone (Persily & Hildebrandt, 2003, p. 121).

    Each of these applications of the theory offers the potential to increase community competence and empower the community through the process of structuring community participation with lay workers to promote reciprocal health. 

    This theory offers a beginning foundation for future development through practice and research. Use of the theory in advanced nursing practice provides opportunities to develop the potential of a community by realizing achievement of outcomes that empower reciprocal health for individuals and groups. 

    Identifying research questions related to the theory can structure the design of studies that will test and refine the theory.


    This theory should be a part of the education of undergraduate and graduate students to enhance the awareness of community empowerment. Teaching students to apply theory in practice will give direction to their care and advance their understanding of theory based practice.

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