# Situation: A team of public health nurses organizes a low-income farming barangay using Community Organizing Participatory Action Research (COPAR). The team has already completed its site selection and courtesy calls. Looking back over the whole organizing effort, a supervisor asks the nurses to arrange these activities in the order in which they are done in COPAR. 1. Conduct the community study together with the residents 2. Train members of the organization as community health workers 3. Set the criteria for choosing the site to be organized 4. Elect officers and set up committees with bylaws Which order is CORRECT?

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=627179  
> language: ko  
> subject: Nursing Practice I — Community Health Nursing

## 문제

Situation: A team of public health nurses organizes a low-income farming barangay using Community Organizing Participatory Action Research (COPAR). The team has already completed its site selection and courtesy calls.

Looking back over the whole organizing effort, a supervisor asks the nurses to arrange these activities in the order in which they are done in COPAR.
1. Conduct the community study together with the residents
2. Train members of the organization as community health workers
3. Set the criteria for choosing the site to be organized
4. Elect officers and set up committees with bylaws
Which order is CORRECT?

## 보기

1. 3, 1, 4, 2 **✔ 정답**
2. 1, 3, 4, 2
3. 3, 4, 1, 2
4. 3, 1, 2, 4

**정답: 1**

## 해설

Setting site-selection criteria belongs to pre-entry. The community study done with residents belongs to entry. Electing officers and forming committees with bylaws belongs to organization-building. Training members as community health workers is part of the continuing education of sustenance and strengthening. The phases run in that order.

## 심화 해설

COPAR Phase Sequence

The correct order is 3, 1, 4, 2. COPAR is a sequential, community-driven process, and each activity belongs to a distinct phase that builds on the previous one. The key to answering this type of item is recognizing that the organizing effort moves from preparation, to immersion, to formal structure, and only then to sustained capacity-building.

Setting the criteria for choosing the site is a pre-entry activity. Before any organizing can begin, the team must define what makes a community appropriate for COPAR—factors such as felt need, accessibility, safety, and willingness of local leaders. This is a preparatory step done by the nurse team, not yet with full resident participation.

Conducting the community study together with the residents marks the entry phase. Here the nurses begin building rapport and gathering data with the people, not merely about them. This participatory assessment is what distinguishes COPAR from a traditional survey. The participatory research principle is consistent with the sequenced use of photovoice and concept mapping described in the neighborhood health study, where residents first shared their lived experience and then were actively involved in organizing that information [2]. In COPAR, the community study serves the same function: it grounds the organizing effort in the community’s own reality before formal structures are imposed.

Electing officers and setting up committees with bylaws belongs to organization-building. Once the community study has generated shared awareness and a core group of active residents, the community is ready to formalize its structure. This step gives the organization legitimacy, defined roles, and a mechanism for decision-making. The Ghana Health Service experience illustrates why this sequencing matters: when community-based primary health care is scaled up, decision-making must account for perspectives at each organizational level, and a clear structure is needed before training and service delivery can be sustained [3].

Training members as community health workers is part of sustenance and strengthening, specifically the continuing education component. This occurs after the organization exists and has identified its health priorities. The training is not a one-time event but an ongoing process that keeps the community organization functional and responsive. The cluster-randomized trial of community mobilisation with women’s groups in Jharkhand and Orissa supports this placement: the intervention relied on Accredited Social Health Activists (ASHAs) who were already embedded in the community and then facilitated women’s groups through a structured, participatory cycle . The health workers’ capacity was built to support an ongoing mobilisation process, not as a prerequisite for forming the group itself.

| Phase | Activity in the Item | Core Purpose |
| --- | --- | --- |
| Pre-entry | Set criteria for site selection | Determine community readiness and fit before entry |
| Entry | Conduct community study with residents | Build trust and gather participatory baseline data |
| Organization-building | Elect officers and form committees with bylaws | Formalize structure, roles, and decision-making |
| Sustenance and strengthening | Train members as community health workers | Develop ongoing local capacity for health action |

Watch out! A common error is placing training before organization-building. But in COPAR, training community health workers is a strengthening activity that assumes an organized group already exists to receive and apply that training. Key point! The sequence is not about which activity is most important—it is about which activity logically must come first for the next one to succeed. Site criteria precede entry, entry precedes formal structure, and formal structure precedes sustained capacity-building.References (research sources)

- [2]Concept mapping of photovoices: sequencing and integrating methods to understand immigrants' perceptions of neighborhood influences on health.Research articleHaque N, Rosas S (2010) · DOI: 10.1097/FCH.0b013e3181e4bbf0

- [3]Developing organizational learning for scaling-up community-based primary health care in Ghana.Research articleAwoonor-Williams JK, Phillips JF (2022) · DOI: 10.1002/lrh2.10282

## 임상 시나리오

COPAR Phase SequenceOrdering organizing activities from preparation to sustainability
The organizing effort follows a sequential flow: pre-entry, entry, organization-building, then sustenance and strengthening. Each phase builds on the previous one.

Setting site selection criteria is a pre-entry activity done by the nurse team before community immersion.

Conducting the community study with residents marks the entry phase, grounding the effort in the community's own reality.

Electing officers and forming committees with bylaws belongs to organization-building, creating formal structures.

Training members as community health workers is part of sustenance and strengthening, focused on continuing education and capacity-building.

CautionDo not initiate formal organization structures or training before the participatory community study is completed; skipping the entry phase undermines the community-driven principle of COPAR.

## 핵심 개념

- **Pre-entry Phase** — Initial COPAR phase where the team prepares, including setting site selection criteria and conducting courtesy calls.
- **Entry Phase** — COPAR phase focused on building rapport and conducting a participatory community study with residents.
- **Organization-building Phase** — COPAR phase where formal community structures are established, including electing officers and creating bylaws.
- **Sustenance and Strengthening Phase** — Final COPAR phase focused on capacity-building and continuing education, such as training community health workers.

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