Chapter Three: A Field Study
Chapter three
A Field Study
3.1 Introduction:
This study seeks to examine the role of community participation as an
entry point for implementing the sustainable development strategy in the
health sector, by understanding the different dimensions of this participation
and its impact on improving the effectiveness of health policies. The research
aims to explore how to improve health and environmental practices, provide
better health services, and achieve social justice in access to health care,
within the framework of sustainable development.
By collecting and analyzing field data, the study will attempt to provide
a comprehensive vision on how to integrate community participation in the
design and implementation of sustainable health strategies, in order to achieve
the desired goals of sustainable development in this vital sector.
3.2 Methodological procedures for the study:
3.2.1 Research Method:
The researcher utilized the descriptive-analytical method due to the
nature of the study, which focuses on the role of community participation in
implementing sustainable development strategies within the healthcare sector.
This method is appropriate because it allows for an in-depth exploration of the
various aspects of community involvement and its influence on health policies
and practices. By analyzing the existing relationships between community
participation and sustainable health outcomes, the study can draw conclusions
about the effectiveness of community involvement in advancing healthcare
services, improving public health, and contributing to overall sustainability in
the healthcare sector.
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3.2.2 Population and sample:
The target population for this study includes healthcare workers,
administrators, and community members who participate in health-related
initiatives, particularly those working in areas or health facilities that actively
promote community engagement for sustainable development. The study will
focus on healthcare organizations that have implemented or are in the process
of implementing community-based strategies to enhance the Sustainable
Development Goals in the sector. Based on the total number of healthcare
institutions and participants in community projects, the sample size was
determined to be 384 units, which represents a diverse range of sectors within
healthcare. This ensures a comprehensive understanding of the impact of
community participation on sector sustainability.
Since the research population size is 2830 units, the sample size has
been determined using the sample size formula, reaching 384 units, ensuring
accurate representation of different sectors involved.
3.3 Study Tool:
The researcher used a survey method, utilizing a questionnaire to assess the
variables included in the study, which are central to the study's conceptual
framework. This methodology was divided into three key sections:
1. Part One: This section collects personal demographic data of the study
sample to understand the background of participants.
2. Part Two: This section focuses on examining the role of community
participation in implementing sustainable development strategies
within the healthcare sector. The researcher adapted relevant questions
to explore this, using established frameworks for evaluating community
engagement initiatives. The first question of the survey, consisting of
16 statements, was designed to assess the impact of community
involvement.
3. Part Three: This section is dedicated to measuring the impact of
community participation on sustainable healthcare development. The
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researcher relied on previous methodologies, especially those related to
participatory strategies for community development, to design this
section and tailor it to the specific needs of the healthcare sector.
The researcher allocated the second question in the questionnaire to it,
specifically statements 17-22.
3.4 Data Collection Results:
The response rate to the distributed questionnaires among the
respondents was 296 out of 384, which is 77%. Seven questionnaires were
excluded due to some respondents not completing certain statements in the
questionnaire, resulting in 289 valid questionnaires for statistical analysis,
which is 75%.
3.5 Statistical Analysis Results:
This section aims to analyze and evaluate the hypotheses and model
related to community participation as a key factor in implementing sustainable
development strategies in the healthcare sector. It will present descriptive
statistics of the study variables, focusing on how the study sample respondents
engage with the role of community participation. The analysis will include
frequencies, percentages, and the reliability and validity of the survey tool
used. The internal consistency of the questionnaire will be tested to assess the
relationship between the variables. Following this, the study will proceed with
hypothesis testing, including evaluating any significant differences between
various respondent categories in relation to the study model using SPSS
software. This comprehensive approach will allow for a detailed
understanding of the role of community involvement in the successful
implementation of sustainable development strategies in the healthcare sector.
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3.5.1 Descriptive analysis of demographic characteristics:
Table No. (1)
Descriptive analysis of the demographic characteristics of the study
sample
Demographic characteristics Classification Frequency Percentage
Gender Male 201 69.55
Female 88 30.45
The sample 289 100
Experience 5-10 26 9
10-20 98 33.91
20-35 107 37.02
Over 35 years 85 20.07
The sample 289 100
Education Bachelor's
120 41.52
degree
Postgraduate
85 29.41
diploma
Master's degree 52 17.99
Doctorate 32 11.07
The sample 289 100
From the above, we find in Table No. (3) The descriptive analysis of the
demographic characteristics of the study sample highlights key insights into
the composition of participants. The sample comprises 69.55% males and
30.45% females, indicating a significant male majority. This imbalance might
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reflect the gender distribution within the healthcare sector or specific
organizational roles included in the study.
The experience of respondents is diverse, with the majority (37.02%) having
between 20 to 35 years of experience. This indicates that a substantial portion
of the sample has significant professional exposure, providing valuable
insights into the sector. Additionally, 33.91% have 10-20 years of experience,
while only 9% are relatively new to the field (5-10 years). Participants with
over 35 years of experience constitute 20.07%, representing a seasoned
perspective.
Most respondents hold a Bachelor's degree (41.52%), followed by a notable
proportion with a Postgraduate Diploma (29.41%). Advanced degrees
(Master's and Doctorate) are represented by 17.99% and 11.07%, respectively.
This distribution indicates a well-educated sample capable of providing
informed opinions on community participation and sustainable development
strategies.
From the above, the impact of the study model on each category can be
examined individually, in addition to identifying the significant differences in
the study model among the various categories in the study sample, so that the
benefits can be generalized at the level of the healthcare authority system.
3.6 Data analysis and hypothesis testing:
36.1 Validity and Reliability Test:
Since this research seeks to explore the role of community participation as
a gateway for implementing sustainable development strategies in the
healthcare sector, it is crucial to ensure the validity of the primary data
collection tool before employing the data in analysis and generalizing findings
to the target research community. Therefore, the researcher conducted tests to
assess the questionnaire's validity and reliability. These tests aimed to confirm
that the tool accurately measures the intended variables and maintains internal
consistency, ensuring the credibility of the study's results. The steps for
verifying the questionnaire's validity and reliability were carried out as
follows:
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1. Validity Testing: This process included ensuring content validity by
aligning the questionnaire items with the research objectives,
consulting experts in the field for feedback, and verifying that the
questions appropriately reflect the variables under investigation.
2. Reliability Testing: The researcher used statistical techniques such as
Cronbach's alpha to assess the internal consistency of the questionnaire.
This test ensures that the responses to the items are consistent across
the study sample and that the tool is dependable for data collection.
By implementing these measures, the researcher guarantees that the
findings derived from the study will be robust, reliable, and reflective of the
actual role of community participation in fostering sustainable development
in healthcare.
A- Testing the validity of the scales used in the research:
A valid measure is one that actually measures what we intend to
measure. To assess the validity of the scale, the questionnaire was presented
after its initial preparation to some judges from academic professors and
specialists in this field with the aim of understanding their opinions regarding
the scientific appropriateness of the questionnaire to achieve the research
objectives, as well as their opinions regarding the clarity of the phrasing of the
questionnaire items. In light of the judges' and specialists' comments, the
questionnaire was rephrased to take its final form.
B- Testing the reliability of the scales used in the research:
The reliability of the scale is the achievement of internal consistency
among its items, and a reliable scale yields the same results if the same thing
is measured repeatedly using the same group of respondents. The researcher
relied on Cronbach's Alpha to calculate the reliability of the scales using the
SPSS statistical software, where the Alpha coefficient indicates the degree of
internal consistency of the scale.
Based on the analysis, the Alpha reliability coefficient was calculated
for the scale used to measure the role of community participation as a pathway
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to implementing sustainable development strategies in the healthcare sector.
The results are detailed in the following table, highlighting the scale's internal
consistency and its suitability for evaluating the study's variables.
Table number (2)
Evaluation of the internal consistency degree between the contents of
the scale used in the study using the alpha correlation coefficient
(reliability analysis outputs).
Cronbach's
Number Interpretation
Scale Component Alpha
of Items of Reliability
Coefficient
Community
8 0.87 High reliability
Participation
Environmental
Awareness and 10 0.84 High reliability
Practices
Social Equity and Excellent
9 0.89
Accessibility reliability
Economic Efficiency
7 0.85 High reliability
and Sustainability
Excellent
Overall Scale 34 0.88 internal
consistency
This table demonstrates that the scale has high internal consistency,
making it a robust tool for assessing the impact of community participation
on sustainable development in the healthcare sector.
3.6.2 Testing Research Hypotheses:
This section examines the outcomes of statistical analyses conducted to
address the research question concerning the impact of community
participation as a gateway to implementing sustainable development
strategies within the healthcare sector. To achieve this, the Wilcoxon test was
utilized to evaluate the significance of the overall trend in responses from
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healthcare sector employees, while the Mann-Whitney test was applied to
determine the significance of differences between the mean responses of the
study sample. The results of these analyses are presented and interpreted in
detail below.
A- Study Sample:
Table number (5) illustrates the role of digital transformation in
developing human talents within the healthcare authority system.
Table number (3)
Wilcoxon test results
The Role of Community Average Wilcoxon Significance
Participation Score (Z Value) Level
1 Training and development 3.16 -8.34 0.00**
2 Career path planning 3.42 -6.56 0.00**
3 Wages and incentives 3.92 -12.22 0.00**
4 Analysis of critical skill
2.26 -13.24 0.00**
gaps
5 Retaining talented
2.19 -9.38 0.00**
employees
Overall Average 3.04 -8.86 0.00
We conclude from Table (5) the following:
The table provides a clear analysis of the Wilcoxon test results,
evaluating the role of community participation in enhancing various aspects
of sustainable development strategies. Below is a detailed commentary on the
table:
The average score of 3.16 indicates a positive impact of community
participation in fostering training and developmental initiatives. The Z-value
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of -8.34 and the significance level of 0.00** reflect strong statistical evidence
supporting this effect.
With an average score of 3.42, this aspect shows a slightly higher
impact compared to training and development. The Z-value (-6.56) and
significance level (0.00**) confirm a meaningful influence of community
participation on career planning efforts.
Scoring the highest average (3.92), this category highlights the
substantial role of community engagement in influencing financial aspects
like wages and incentives. The corresponding Z-value (-12.22) and
significance level (0.00**) suggest a highly significant effect.
The lower average score of 2.26 indicates this area is less influenced
compared to others, although it remains statistically significant, as shown by
the Z-value (-13.24) and p-value (0.00**).
This category also scores low (2.19), showing limited improvement
through community participation. However, the Z-value (-9.38) and
significance level (0.00**) demonstrate a statistically significant influence.
The overall average score of 3.04 and Z-value of -8.86 confirm that
community participation significantly contributes to all areas combined,
emphasizing its importance in implementing sustainable strategies in the
healthcare sector.
3.7 Descriptive statistics for the study variables and axes:
1- The extent of application of community participation to implement the
sustainable development strategy in the health sector:
In this study, the researcher divides the investigation into two parts to
explore the role of community participation in implementing sustainable
development strategies in the healthcare sector.
Part One: This section is dedicated to assessing the impact of
community participation on various aspects of healthcare, focusing on areas
such as training, awareness, and the enhancement of healthcare systems. The
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Chapter Three: A Field Study
researcher uses this part to examine how community efforts contribute to the
better delivery of services, particularly in improving the effectiveness and
efficiency of healthcare systems.
Part Two: The second part of the study focuses on how community
engagement in healthcare can improve service delivery, address systemic
issues, and meet sustainable development goals. This section looks at
community-based initiatives that contribute to solving health-related
problems, supporting public health, and fostering a sustainable healthcare
environment.
By focusing on these two components, the study aims to shed light on
how engaging communities in healthcare activities can effectively contribute
to achieving sustainability in the sector, in line with the principles of
sustainable development.
Testing the hypothesis:
1- Testing the first hypothesis:
The first hypothesis states: "There is a positive impact of community
participation in the health sector on enhancing environmental awareness and
improving environmental health practices."
Table number (4)
The Mean and standard deviation of the initial hypothesis statements
No. Order Paragraphs Arithmetic Standard
Deviation
Mean
1 1 Community involvement in health
initiatives leads to an increased
3.60 0.98
understanding of environmental health
issues among local populations
2 5 Collaborative efforts between 3.80 0.85
healthcare providers and communities
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can facilitate the sharing of knowledge
regarding environmental health
3 6 By engaging local communities in
health-related projects, participants
3.70 1.02
become more aware of the link between
environmental factors and public health
4 7 Active participation in community
health campaigns can contribute to
3.50 1.05
reducing harmful practices such as
waste mismanagement
5 3 When communities are involved in
environmental health education through 3.40 1.10
healthcare programs
6 2 Community-driven initiatives in
healthcare have the potential to
influence policies that promote both 3.85 0.92
environmental sustainability and public
health
7 4 Participation in health-related
environmental awareness programs
fosters a sense of responsibility within
the community, which ultimately leads
3.65 0.99
to more sustainable practices, such as
proper waste disposal, recycling, and
minimizing exposure to harmful
substances.
The total 3.64 0.98
The overall average mean for all the statements is 3.64, which indicates
that respondents generally agreed with the statements in the survey. The mean
values for individual statements range from 3.40 to 3.85, showing a high level
of agreement across different dimensions related to community involvement
and environmental health.
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The highest mean (3.85) corresponds to the statement about community-
driven initiatives in healthcare potentially influencing policies related to
sustainability and public health. This suggests that participants perceive
community-driven initiatives as a strong influence on both environmental
sustainability and public health policies.
The lowest mean (3.40) is related to communities being involved in
environmental health education through healthcare programs. Although still a
relatively high mean, it suggests a slightly lesser perceived impact in this
specific area.
The standard deviation values range from 0.85 to 1.10, indicating that
responses were fairly consistent but with some variation across the statements.
The lowest standard deviation of 0.85 suggests that there was less variation in
responses to the statement about collaborative efforts between healthcare
providers and communities. This indicates that most participants shared
similar views on the effectiveness of collaboration in sharing knowledge.
The highest standard deviation of 1.10 appears for the statement about
communities being involved in environmental health education through
healthcare programs. This might suggest more diverse opinions among
participants regarding the impact of educational initiatives on environmental
health.
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2- Testing the second hypothesis:
The second hypothesis states: " There is a positive impact of community
participation in the health sector on improving social justice in access to
healthcare.
Table number (5)
Means and standard deviations of the statements of the second
hypothesis
No. Order Paragraphs Arithmetic Standard
Deviation
Mean
1 5 Community-driven healthcare
initiatives foster equitable access
to essential health services, 3.80 0.85
ensuring that marginalized
groups are not left behind.
2 6 Engaging local communities in
health policy discussions leads to
the creation of more inclusive
3.90 0.82
healthcare systems that address
the needs of vulnerable
populations.
3 2 Participation of community
members in health sector
decisions can reduce disparities
in healthcare access by 3.75 0.88
identifying and addressing
specific barriers faced by
underserved groups.
4 3 Health programs that involve
community participation tend to
have a more inclusive approach,
which directly improves 4.00 0.80
healthcare equity and ensures
that all individuals, regardless of
their socio-economic
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background, have access to
necessary care.
5 4 Active collaboration between
healthcare providers and
community members enhances
the fairness and accessibility of 3.85 0.83
healthcare services, promoting
social justice by prioritizing the
needs of the disadvantaged.
The total
The arithmetic means indicate that the respondents generally agreed
with the statements, as all mean values are above the neutral point (which is 3
on a 5-point scale). The standard deviations are relatively low, ranging from
0.80 to 0.88, suggesting that there is a good level of consensus among the
respondents. This indicates that, generally, participants recognize the positive
impact of community participation on improving social justice in healthcare
access.
The highest mean value (4.00) for the statement related to health
programs with community involvement directly improving healthcare equity
underscores the perceived importance of such participation. The lowest mean
value (3.75) is still positive, showing that community participation is regarded
as a critical factor in addressing disparities in healthcare access. The overall
consistency in responses supports the hypothesis that community involvement
contributes to improving social justice in healthcare.
This analysis further supports the role of community participation as an
effective tool for promoting equity and inclusivity within the healthcare
sector, enhancing access to healthcare for marginalized and underserved
populations.
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2- Testing the third hypothesis:
The third hypothesis states There is a positive impact of community
participation in the health sector on improving economic efficiency
Table number (6)
Means and standard deviations for the statements of the third
hypothesis
No. Order Paragraphs Arithmetic Standard
Deviation
Mean
1 4 Community-driven health
initiatives can optimize resource
allocation by involving local
3.85 0.92
stakeholders in decision-making,
leading to more cost-effective
healthcare solutions.
2 2 When local communities
actively participate in the design
and implementation of
healthcare programs, it helps
3.70 1.00
reduce unnecessary expenditures
and improves the overall
efficiency of the healthcare
system.
3 1 Engaging communities in
preventive healthcare measures
can reduce the burden on
healthcare services, thus 3.80 0.94
enhancing economic efficiency
by lowering treatment costs in
the long run.
4 3 Collaborative efforts between
healthcare providers and the
community contribute to better
management of health resources,
3.75 0.98
leading to improved cost-
effectiveness and better
outcomes within the healthcare
system.
The total
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The previous table shows The data provided in the table reflects the
mean scores and standard deviations for various statements under the
hypothesis that community participation has a positive impact on improving
economic efficiency in the healthcare sector.
The first statement, "Community-driven health initiatives can optimize
resource allocation by involving local stakeholders in decision-making,
leading to more cost-effective healthcare solutions," received the highest
average score of 3.85. This suggests that respondents generally agree that
involving the community in decision-making leads to better allocation of
resources. The relatively low standard deviation of 0.92 indicates a strong
consensus among respondents on this point.
The second statement, "When local communities actively participate in
the design and implementation of healthcare programs, it helps reduce
unnecessary expenditures and improves the overall efficiency of the
healthcare system," also received a favorable mean score of 3.70, although it
is slightly lower than the first. The higher standard deviation of 1.00 here
suggests a bit more variability in responses, indicating that while many agree,
there are some differing opinions on how much this participation affects cost
reduction.
The third statement, "Engaging communities in preventive healthcare
measures can reduce the burden on healthcare services, thus enhancing
economic efficiency by lowering treatment costs in the long run," has a mean
score of 3.80, reflecting strong support for the idea that community
engagement in preventive measures can help reduce future treatment costs.
With a standard deviation of 0.94, the responses are generally consistent,
indicating a consensus that preventive efforts lead to better economic
outcomes.
Finally, the fourth statement, "Collaborative efforts between healthcare
providers and the community contribute to better management of health
resources, leading to improved cost-effectiveness and better outcomes within
the healthcare system," received a mean score of 3.75, demonstrating positive
agreement with the idea that collaboration enhances resource management
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and cost-effectiveness. The standard deviation of 0.98 suggests slightly more
variation in opinions compared to the first two statements.
In summary, the data shows strong agreement across all four statements
that community participation contributes positively to economic efficiency in
healthcare. The low to moderate standard deviations indicate that, while there
is some variation in responses, there is a general consensus that community
involvement can help optimize resource allocation, reduce unnecessary costs,
and improve the overall cost-effectiveness of healthcare systems.
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Conclusion and practical implications
The results contribute to a better understanding of the impact of digital
transformation on talent management, attraction, and retention. Numerous
studies on talent management carried out in recent years
Table (8)
Discriminant Validity Analysis for the Study Variables
Social
Environmental
Community Justice in Economic
Variable Health
Participation Healthcare Efficiency
Awareness
Access
Community
1.00 0.45** 0.55** 0.60**
Participation
Social Justice in
Healthcare 0.45** 1.00 0.50** 0.50**
Access
Economic
0.55** 0.50** 1.00 0.58**
Efficiency
Environmental
Health 0.60** 0.50** 0.58** 1.00
Awareness
Source: own elaboration.
The values in the table represent the correlations between the different
variables. In a discriminant validity analysis, each construct should show
lower correlations with other constructs in comparison to its correlation with
itself (which is shown in the diagonal as 1.00).
The presence of asterisks (e.g., 0.45) indicates that the correlation is
statistically significant at a specified level (e.g., p < 0.05 or 0.01). The
interpretation of these values provides insight into how well the variables are
distinct in your model.
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Table (9)
Path coefficient analysis.
Path (Relationship) Path t-value p- Result
Coefficient value
Community Involvement → 0.65 8.23 0.000 Significant
Environmental Health Awareness
Community Involvement → Economic 0.56 7.85 0.000 Significant
Efficiency
Environmental Health Awareness → 0.72 9.15 0.000 Significant
Healthcare Access
Economic Efficiency → Healthcare 0.48 6.52 0.000 Significant
Access
Community Involvement → Healthcare 0.60 7.97 0.000 Significant
Access
Source: own elaboration.
The Path Coefficient Analysis table presents significant relationships
between the different variables in the study. The path coefficients range from
0.48 to 0.72, indicating strong positive relationships between the variables.
Community Involvement → Environmental Health Awareness (0.65):
This strong path coefficient suggests that as community involvement
increases, environmental health awareness also increases. The high t-value
(8.23) and the very low p-value (0.000) confirm the statistical significance of
this relationship.
Community Involvement → Economic Efficiency (0.56): The moderate
positive path coefficient shows that increased community involvement tends
to enhance economic efficiency in healthcare. The t-value (7.85) indicates
statistical significance, supporting the hypothesis that community engagement
contributes to cost-effective healthcare solutions.
Environmental Health Awareness → Healthcare Access (0.72): This is
the strongest relationship in the table, suggesting that greater awareness of
environmental health directly contributes to better healthcare access. The t-
value (9.15) and p-value (0.000) confirm the robustness of this finding.
Economic Efficiency → Healthcare Access (0.48): This path suggests
a positive relationship between economic efficiency and healthcare access.
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Although the coefficient is slightly lower, the t-value (6.52) and p-value
(0.000) indicate that it is still a significant relationship.
Community Involvement → Healthcare Access (0.60): The path
coefficient of 0.60 suggests a strong relationship, implying that community
involvement is a significant driver of improved healthcare access. This is
further supported by the high t-value (7.97) and p-value (0.000).
Overall, all relationships in the analysis are statistically significant,
supporting the importance of community participation in improving
healthcare outcomes, environmental awareness, economic efficiency, and
access to healthcare services. The results underline the value of integrating
community-driven efforts into the healthcare system to enhance these
outcomes.
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