Thrive: A framework for community-driven initiatives to address health disparities

Where we live, work, learn, and play impacts our life expectancy and also the quality and richness of our lives. Life expectancies differ across zip codes, with communities of color and low-income communities experiencing severe disparities. Using a Freierean model of community learning, the Tool for Health and Resilience in Vulnerable Environments (THRIVE) enables community-driven efforts to address community health and health equity. The THRIVE participatory action framework helps community residents to: 1) develop a shared understanding of the determinants of health, the intersections among clinical health outcomes, exposures, and behaviors, and how these are socially and environmentally determined; 2) assess their current state of the determinants of health and their impacts on health across the lifespan; and 3) translate the assessment output into a policy action plan to improve health equity. Since no two communities share the same conditions and resources, the resulting strategies and activities are highly specific to each community's social, political, and economic context. Since 2010 THRIVE has been implemented in eight sites across the US. The framework has been shown to help community residents prioritize those environmental factors that address health disparities. Moreover, residents were able to turn knowledge of determinants of health into actionable strategies to increase health for residents. As a practice-informed model of community change, THRIVE helps residents identify and prioritize activities and initiatives to increase health. As contexts differ from place to place, the robustness of the framework has enabled the development of solutions that are fully appropriate for each community.