Community organization
Community organization is a deliberate process in social work and civic engagement whereby residents of a defined area or group identify common problems, mobilize resources, and implement collective strategies to address them, aiming for improved local conditions through participatory action.[1][2] Emerging in the early 20th century amid urbanization and industrial challenges, it sought to coordinate charitable efforts and empower marginalized populations against institutional neglect.[3] The approach crystallized in the United States through Saul Alinsky's efforts in 1930s Chicago, where he organized the Back of the Yards Council to unite diverse ethnic workers in the meatpacking industry, securing concessions on wages, sanitation, and union rights via direct confrontation with employers and politicians.[4] Alinsky formalized these tactics in the Industrial Areas Foundation, emphasizing "power in numbers" through non-ideological, pragmatic organizing that built independent community institutions capable of sustained advocacy.[5] His methods, detailed in works like Reveille for Radicals (1946), prioritized relational networks, issue-based campaigns, and accountability "rules" to extract tangible gains, influencing subsequent movements in labor, housing, and civil rights.[6] While credited with amplifying disenfranchised voices and yielding localized victories—such as enhanced public services and policy shifts—community organization has drawn scrutiny for its adversarial style, which critics argue sows division, relies on fleeting mobilizations, and subordinates deeper structural analysis to short-term wins, often entrenching organizer-led hierarchies over genuine grassroots autonomy.[7][8] Empirical evaluations reveal variable outcomes: successes in boosting participation and health equity initiatives, yet persistent hurdles in scaling impact or countering entrenched power imbalances, with neoliberal funding constraints further diluting radical potential.[9][10][11]Core Concepts
Definition and Scope
Community organization is a structured process in which members of a geographic or interest-based community collaboratively identify shared problems, prioritize needs, mobilize resources, develop action plans, and implement strategies to effect change, often emphasizing empowerment and collective efficacy over external intervention.[12][13] This approach, rooted in social work and civic engagement practices, prioritizes democratic participation, where community members lead decision-making rather than relying on professional experts or government directives alone.[14][15] The scope of community organization encompasses both consensus-oriented activities, such as building broad coalitions for resource allocation, and conflict-based tactics, like advocacy against entrenched power structures to redistribute resources or influence policy.[16] It typically operates at the local level, targeting issues like housing, education, health disparities, or economic development, but can scale to influence regional or national policies through networked efforts.[17] Key principles include specificity of objectives to ensure focused outcomes, comprehensive planning involving assessment and evaluation, and universal participation to foster inclusivity and sustainability, adapting to the community's cultural and dynamic contexts.[18][19] Unlike broader community development, which may emphasize economic growth through external funding or infrastructure projects, community organization centers on internal capacity-building and resident-led agency to address root causes of social issues.[20][21] This practice distinguishes itself from mere philanthropy or administrative planning by requiring sustained collective action and accountability, with success measured by tangible improvements in community well-being rather than symbolic gestures. Empirical evaluations, such as those in health interventions, show it enhances resident skills and long-term resilience when principles like resource mobilization are rigorously applied, though outcomes vary based on external barriers like institutional resistance.[12][22]Distinctions from Related Approaches
Community organization emphasizes the deliberate process of mobilizing residents to build collective power and address shared concerns through participatory structures, distinguishing it from direct social services, which focus on individualized case management and remediation of personal issues without fostering group-level agency.[23] In contrast to charity or philanthropic approaches, which deliver resources or aid to alleviate symptoms of poverty or need but often reinforce dependency by bypassing community-led decision-making, community organization prioritizes developing indigenous leadership and organizational infrastructure for sustained self-determination.[24] Unlike social planning, which relies on expert-driven data analysis and technical interventions to formulate policy solutions often detached from grassroots input, community organization integrates broad-based participation to ensure solutions align with local priorities and build consensus or confrontation as needed.[25] It also differs from pure advocacy or lobbying efforts, which typically operate at institutional or elite levels to influence policy without necessarily cultivating widespread community involvement or organizational durability.[26] Community organization further contrasts with economic-focused community development initiatives, which may prioritize infrastructural projects, asset accumulation, or market-driven growth under professional guidance, whereas organization centers on power dynamics and relational processes to empower marginalized groups against systemic inequities.[14] This approach avoids the pitfalls of top-down non-governmental organization (NGO) models, which can impose external agendas, by insisting on bottom-up accountability and resident control to prevent co-optation or superficial engagement.[27]Historical Development
Early Foundations (19th-early 20th Century)
The rapid industrialization and urbanization of the 19th century disrupted traditional kinship and village-based support networks, prompting the emergence of formal mutual aid societies and cooperatives as foundational mechanisms for community self-organization. These groups, often formed by workers and immigrants, pooled resources for sickness, unemployment, and burial benefits while fostering collective action against exploitation. In England, the Rochdale Society of Equitable Pioneers established the world's first viable consumer cooperative in 1844, adopting principles of open membership, democratic governance, and equitable distribution of surplus, which influenced subsequent cooperative movements across Europe and North America.[28] By mid-century, similar societies proliferated in the United States among ethnic enclaves, such as Chinese huiguan associations that provided legal aid and economic mutual support amid discrimination.[29] The settlement movement, originating in late-19th-century Britain, represented a deliberate shift toward immersive community organization by bridging class divides through resident volunteers. Canon Samuel Barnett founded Toynbee Hall in London's East End in 1884, recruiting university-educated men to live among the working poor, offering classes, clubs, and advocacy to build local capacity and influence reforms like improved housing and sanitation.[30] This model emphasized experiential learning and neighborhood empowerment over paternalistic charity, inspiring over 30 settlements in Britain by 1900. In the process, residents organized tenants' associations and labor committees, demonstrating early tactics of grassroots mobilization tied to systemic change. In the United States, the movement gained traction during the Progressive Era, with Jane Addams and Ellen Gates Starr opening Hull House in Chicago's immigrant district in 1889, which by 1910 had expanded to include kindergartens, labor museums, and health clinics while incubating community-led initiatives like the first juvenile court and playground ordinances.[31] Hull House organized over 100 local clubs and cooperatives, training residents in civic participation and policy advocacy, which contributed to broader social work practices. By the early 20th century, settlements had spurred the creation of federated welfare councils and community chests, such as the 1913 Cleveland initiative that centralized funding for coordinated services, marking a transition from ad hoc aid to structured inter-agency collaboration.[32] These efforts highlighted community organization's dual focus on immediate relief and long-term empowerment, though critiques noted their occasional reliance on middle-class leadership.[31]Mid-20th Century Evolution and Key Figures
During the mid-20th century, community organization evolved from fragmented, reform-oriented initiatives of the early 1900s into formalized methods integrating social work professionalism, federal policy influences, and pragmatic activism, particularly in response to urban industrialization, postwar migration, and economic disparities affecting working-class and minority populations. By the 1940s, organizers increasingly emphasized systematic power-building over mere charity, with social work curricula incorporating community organization as a core practice method alongside casework and group work, as recognized by emerging standards from bodies like the Council on Social Work Education in 1952. This period saw the divergence of approaches: consensus-driven models focused on collaborative planning and resource allocation, while conflict-oriented tactics prioritized mobilizing resentment against entrenched interests to achieve tangible concessions.[33][34] Saul Alinsky (1909–1972) became a central figure in this evolution, establishing the Industrial Areas Foundation in 1940 to train professional organizers in constructing broad-based "people's organizations" from disparate ethnic and labor groups. His efforts in Chicago's Back-of-the-Yards neighborhood during the late 1930s extended into the 1940s and 1950s, where he facilitated alliances that secured union contracts, sanitation improvements, and recreational facilities, demonstrating how targeted confrontations could extract resources from corporations and politicians without relying on government dependency. Alinsky's 1946 book Reveille for Radicals codified these tactics, advocating "rubbing raw the sores of resentment" to galvanize action, a method he applied in over 30 communities by the 1960s, though it drew criticism from establishment social workers for its adversarial stance over cooperative ideals.[35][36] In contrast, Murray G. Ross advanced a theoretical foundation for community organization within social work, publishing Community Organization: Theory and Principles in 1955, which defined the process as communities democratically identifying needs, prioritizing objectives, and coordinating actions through inclusive participation rather than elite-driven planning. Drawing from Canadian community council experiences, Ross's framework influenced U.S. social welfare federations and emphasized evaluation of outcomes via democratic norms, gaining adoption in professional training programs amid postwar emphasis on preventive social services. This consensus model complemented Alinsky's by providing tools for sustaining gains post-conflict, though empirical assessments of long-term efficacy varied, with some studies noting higher persistence in mixed approaches.[37] By the late 1950s and into the 1960s, these strands converged in federal programs like the 1964 Economic Opportunity Act, which allocated $947.5 million for community action agencies employing organizing to empower the poor, reflecting mid-century optimism in local agency amid 22% urban poverty rates, though implementation often revealed tensions between participatory ideals and bureaucratic control. Key figures like Alinsky trained organizers for such entities, while Ross's principles informed planning components, marking a synthesis that expanded community organization's scope beyond local enclaves to national antipoverty strategies.[32]Late 20th Century Shifts
In the 1970s and 1980s, community organization in the United States shifted from federally dominated antipoverty programs of the Great Society era toward decentralized, nonprofit-led initiatives, driven by reduced federal funding under the Reagan administration and a emphasis on market-oriented self-reliance.[38] This period saw the proliferation of community development corporations (CDCs), which grew from isolated experiments in the 1960s—such as the Bedford-Stuyvesant Restoration Corporation established in 1966—to thousands of entities by the late 1990s, focusing on affordable housing production and neighborhood stabilization rather than broad social advocacy.[39] By 2002, approximately 8,400 CDCs operated nationwide, developing hundreds of thousands of housing units and attracting private investment to counter urban decay exacerbated by deindustrialization.[38] Key policy mechanisms facilitated this evolution. The 1974 Housing and Community Development Act introduced Community Development Block Grants (CDBGs), providing flexible local funding for housing and economic development in low-income areas, with housing comprising the primary use through the 1980s and 1990s.[38][39] In 1980, the Local Initiatives Support Corporation (LISC) was founded with $9.3 million from the Ford Foundation, scaling to $70 million by 1984 to support CDC projects; by inception through the early 2000s, LISC investments totaled $11.1 billion, enabling 277,000 affordable homes.[38] The 1986 Tax Reform Act eliminated certain real estate tax incentives but established the Low-Income Housing Tax Credit (LIHTC), which leveraged corporate investments to finance over 2.5 million affordable units by the 2010s, marking a pivot to public-private partnerships.[39] The 1990 HOME Investment Partnerships Program further directed funds specifically to nonprofits for housing rehabilitation.[38] Organizationally, CDCs professionalized, often attaining 501(c)(3) status amid tax policy changes and a decline in volunteer-led grassroots efforts, prioritizing tangible infrastructure over confrontational tactics associated with earlier Saul Alinsky-inspired models.[38] In the 1990s, comprehensive community initiatives (CCIs) emerged, integrating housing, education, and job training, though evaluations highlighted sustainability challenges due to fragmented funding.[38] Concurrently, consensus organizing gained traction as an alternative to conflict-based approaches, emphasizing relationship-building with power holders and mutual self-interest to achieve community goals, reflecting broader neoliberal influences favoring collaboration over antagonism.[40] Empirical outcomes included neighborhood stabilization in areas like Boston's Roxbury and Chicago's West Side, where CDCs reduced vacancy rates and spurred property value increases, though critics noted limited impact on deeper structural poverty without sustained public investment.[39]Theoretical Models
Locality Development Model
The locality development model, also known as the community development approach, emphasizes broad-based citizen participation to foster self-help and consensus-driven problem-solving within a locality.[41] Originating from Jack Rothman's 1968 framework in his article "Three Models of Community Organization Practice," this model posits that communities possess inherent capacities to identify needs, mobilize resources, and implement solutions when facilitated through democratic processes.[42] Rothman described it as a process-oriented strategy that prioritizes building organizational infrastructure and relationships over predetermined outcomes, assuming that diverse community involvement leads to sustainable empowerment.[43] Key principles include inclusivity, where a wide spectrum of residents—regardless of socioeconomic status—participate in decision-making to enhance mutual understanding and collective efficacy.[25] The model relies on the facilitator's role as an enabler, promoting skills like communication and leadership among locals rather than directing change externally.[44] It operates under the assumption that communities are not inherently powerless but require structured opportunities for interaction to overcome apathy or fragmentation, often through small-group discussions and volunteer-led initiatives.[26] Empirical applications, such as rural village programs highlighted in United Nations documentation, underscore its focus on enhancing local power structures via participatory governance.[41] Methods involve sequential steps: initial broad canvassing to gauge interests, formation of representative committees for goal-setting, and iterative action-reflection cycles to build capacity.[14] Techniques include workshops for skill-building, consensus-building forums, and linking residents to existing resources without imposing expert-driven plans.[45] This contrasts with more directive models by valuing process legitimacy, where success metrics center on increased participation rates and local leadership emergence rather than quantifiable outputs alone.[46] Critics note its idealistic premises may falter in highly polarized or resource-scarce settings, where consensus proves elusive without external incentives.[14] In practice, the model has informed programs like neighborhood associations in urban U.S. settings during the 1970s, where resident-led committees addressed issues such as park maintenance through collaborative funding efforts.[26] Longitudinal studies of such implementations reveal correlations between sustained participation and improved community cohesion, though causal links to broader socioeconomic gains remain debated due to confounding variables like external aid.[47] Rothman later refined the model in 1995 collaborations, integrating mixed strategies while retaining its core emphasis on endogenous capacity-building.[48]Social Planning Model
The social planning model, one of three frameworks outlined by social work scholar Jack Rothman in his 1968 article "Three Models of Community Organization Practice," emphasizes a rational, technical approach to addressing community problems through systematic data collection, analysis, and policy formulation.[25] This model views communities as requiring expert intervention to identify needs, allocate resources, and implement solutions, often prioritizing efficiency in service delivery over grassroots mobilization.[42] Rothman described it as a "deliberately planned, technical process of problem-solving with regard to substantive social problems," distinguishing it from more participatory locality development or confrontational social action models.[25] Key principles include reliance on empirical research, expert-led fact-finding, and consensus-building among professionals to define goals and evaluate outcomes.[49] Methods typically involve needs assessments, such as surveys or statistical analysis of social indicators like poverty rates or health disparities, followed by the development of formal plans for resource distribution, such as housing policies or welfare programs.[50] For instance, in urban settings, planners might use demographic data from the 1970 U.S. Census to design targeted interventions for low-income areas, aiming to prevent issues like juvenile delinquency through coordinated services.[41] This top-down orientation assumes that complex societal challenges, such as public health crises, are best resolved through objective, evidence-based strategies rather than broad citizen input, which can introduce inefficiencies.[51] While effective for technical problem-solving, such as streamlining resource allocation in response to quantifiable needs—evidenced by post-World War II community welfare councils that reduced service duplication by 20-30% in select U.S. cities—the model has faced criticism for overlooking power imbalances and local knowledge.[46] Empirical studies on community interventions, including those employing planning elements, show mixed results; for example, a 2009 analysis of Rothman's frameworks noted that social planning excels in stable environments but struggles with contentious issues requiring advocacy, as it underemphasizes conflict resolution.[47] Proponents argue its data-driven nature enhances accountability, with successes in programs like the 1960s War on Poverty's planning councils, which allocated federal funds based on rigorous assessments, leading to measurable improvements in service coverage.[16] However, over-reliance on experts can marginalize resident voices, potentially undermining long-term sustainability unless integrated with participatory elements.[41]Social Action Model
The social action model of community organization emphasizes the mobilization of disadvantaged groups to confront established power structures and demand systemic changes in resource allocation and decision-making authority. Developed as one of three core frameworks by Jack Rothman in his 1968 analysis of community practice, this model assumes that social problems stem from unequal power distributions, requiring adversarial tactics such as advocacy, protests, and negotiations to achieve redress.[41] Unlike consensus-building approaches, it views conflict as essential for redistributing power from "haves" to "have-nots," prioritizing short-term, tangible gains like policy reforms or service expansions over broad consensus.[25] Key strategies in the social action model include issue identification through community agitation, organization of mass actions to polarize antagonists and protagonists, and leveraging media and public pressure for leverage. Saul Alinsky, founder of the Industrial Areas Foundation in 1940, exemplified this through pragmatic tactics outlined in his 1971 book Rules for Radicals, such as "picking the target, freezing it, personalizing it, and polarizing it" to build countervailing power among low-income communities.[52] Historical applications include early 20th-century labor union campaigns and the 1960s civil rights movements led by groups like the Student Nonviolent Coordinating Committee, where sit-ins and boycotts forced institutional concessions. Practitioners act as advocates or activists, fostering leadership development while maintaining partisanship toward the client's interests.[44] Core principles underpin the model's task- and process-oriented goals: empowerment via collective efficacy, legitimacy through democratic participation, and multi-strategy flexibility combining education, litigation, and direct confrontation.[53] Empirical evidence from Alinsky's Chicago projects in the 1930s–1950s showed successes in securing housing and jobs, though outcomes often hinged on organizer skill in navigating backlash.[4] This model remains influential in contemporary advocacy, as seen in tenant unions and environmental justice campaigns, but demands high community cohesion to sustain momentum against resistance.[42]Contemporary Hybrid Approaches
Contemporary hybrid approaches in community organization integrate elements from traditional models—such as locality development's emphasis on consensus-building, social planning's data-driven strategies, and social action's advocacy tactics—to adapt to multifaceted contemporary challenges like public health crises, environmental degradation, and economic inequality. These methods recognize that rigid adherence to a single model often limits effectiveness in diverse, interconnected contexts, favoring flexible combinations that leverage community assets, empirical evidence, and multi-sector partnerships. For instance, since the late 1990s, practitioners have increasingly employed mixed strategies to enhance outcomes, as pure models rarely align with real-world complexities requiring both collaborative planning and confrontational mobilization.[13] Community partnerships and coalitions exemplify this hybridization, merging social planning's analytical tools with locality development's relational focus to address issues like substance use prevention or child welfare. In these structures, diverse stakeholders—residents, nonprofits, and government entities—conduct joint assessments, develop shared visions, and implement targeted interventions, as seen in coalitions formed under frameworks like the U.S. Substance Abuse and Mental Health Services Administration's community-based programs since 2000, which have mobilized over 500 such groups nationwide by 2020 to influence policy and service delivery.[13] Similarly, the Mobilizing for Action through Planning and Partnerships (MAPP) framework, launched by the National Association of County and City Health Officials in 2001 and updated as MAPP 2.0 in 2023, combines participatory assessments with strategic action planning, engaging over 1,000 U.S. communities in health improvement plans that integrate local data analysis with cross-sector advocacy.[54] Community-based participatory research (CBPR) represents another hybrid paradigm, blending social planning's rigorous inquiry with social action's empowerment and locality development's inclusivity to co-produce knowledge for systemic change. Originating in health disparities research in the 1990s, CBPR equitably involves community members in all research phases—from problem identification to dissemination—yielding interventions with higher sustainability, as evidenced by a 2018 meta-analysis of 60 studies showing improved health outcomes in marginalized groups through shared decision-making.[55] In communities of color, hybrids fusing Saul Alinsky's confrontational tactics with feminist relational models have gained traction since the early 2000s, prioritizing cultural relevance and long-term leadership cultivation over short-term wins, as proposed in analyses critiquing traditional frameworks for overlooking relational dynamics essential to sustained organizing.[56] These approaches underscore causal mechanisms where integrated strategies amplify impact by addressing both immediate needs and structural barriers, though empirical evaluations remain context-dependent and often highlight the need for skilled facilitators to navigate tensions between consensus and conflict.[13]Principles and Methods
Core Principles
Community organization rests on foundational tenets derived from mid-20th-century social work theory and practical applications, emphasizing collective self-determination over top-down intervention. These principles prioritize enabling residents to diagnose local problems, mobilize resources, and implement solutions, drawing from empirical observations of successful grassroots efforts rather than abstract ideologies. Key among them is participatory involvement, which posits that effective change requires active engagement of community members in decision-making to build ownership and sustainability, as external directives often fail due to lack of buy-in.[57][58] A second core principle is relationship-centered organizing, recognizing that mobilization depends on interpersonal trust and mutual understanding rather than isolated advocacy; organizers must map social networks and align actions with residents' lived realities to generate commitment, as evidenced in labor and neighborhood campaigns where relational ties predicted participation rates exceeding 70% in targeted groups.[59][60] Power dynamics analysis forms another pillar, involving assessment of institutional antagonists and allies to concentrate force on winnable issues; Saul Alinsky's framework, tested in 1930s Chicago back-of-the-yards organizing, stressed pragmatic confrontation—such as picketing or media leverage—to compel concessions, yielding tangible gains like union recognition without relying on moral suasion alone.[61][4] This approach underscores causal realism: power accrues from organized numbers and disruption potential, not inherent righteousness, with data from post-1960s studies showing higher success in issue-based coalitions versus diffuse movements.[57] Specificity in objectives and planning ensures feasibility, mandating clear, measurable goals tied to verifiable community needs—such as securing 500 signatures for a zoning variance by a set date—over broad utopian aims, which historically dissipate energy; classic texts like Murray G. Ross's 1955 analysis of Canadian community councils documented that planned, incremental wins built momentum, contrasting with unplanned efforts that stalled 80% of the time.[58][62] Finally, resource optimization and flexibility advocates leveraging indigenous assets—local leaders, venues, and knowledge—while adapting to contextual shifts, avoiding rigid models; empirical reviews of 1970s U.S. neighborhood associations found that flexible structures incorporating cultural norms sustained operations 2-3 times longer than imported templates, highlighting the pitfalls of one-size-fits-all strategies often promoted in academic literature despite variable local ecologies.[63][58] These principles, while rooted in progressive-era experiments, derive credibility from outcomes in diverse settings, including conservative rural mobilizations, rather than institutional endorsement alone.Practical Strategies and Tactics
Community organizers employ tactics centered on building relational networks, identifying local leaders, and mobilizing collective action to address identified issues.[64] These methods emphasize recruiting individuals with influence within their social circles to amplify outreach and sustain momentum.[65] Effective tactics include door-to-door canvassing, where organizers engage residents directly to gauge support and recruit participants, often yielding higher commitment levels than passive methods like flyers.[66] Power mapping constitutes a foundational tactic, involving the charting of decision-makers, allies, and opponents to strategize targeted engagement or confrontation.[67] In Saul Alinsky's approach, organizers prioritize self-interest as a motivator, selecting winnable issues to demonstrate efficacy and build credibility before escalating to broader conflicts.[16] Tactics such as petition drives and public hearings serve to aggregate voices and pressure authorities, with evidence indicating that combining cooperative negotiations with disruptive actions—like protests or boycotts—enhances outcomes by balancing incentives and costs for targets.[68] Leadership development training equips recruits with skills in facilitation, conflict resolution, and strategic planning, fostering autonomous action groups that persist beyond initial campaigns.[14] Media amplification tactics, including press releases and social media coordination, extend visibility, though organizers must verify claims to maintain trust, as unsubstantiated actions can erode community cohesion.[69] Evaluation of tactics through metrics like participation rates and policy changes ensures adaptability, with studies showing hybrid models integrating service provision alongside advocacy yield more durable impacts than pure confrontation.[70]Evidence of Effectiveness
Empirical Studies and Success Metrics
A meta-analysis of 131 randomized and non-randomized controlled trials found that community engagement interventions, often involving organizing elements, yielded positive effects on health outcomes among disadvantaged groups, with Cohen's d effect sizes of 0.33 for health behaviors, 0.16 for health consequences, 0.41 for self-efficacy, and 0.44 for social support.[71] These effects were observed across conditions such as substance abuse prevention, cardiovascular disease management, breastfeeding promotion, obesity reduction, and smoking cessation, though significant heterogeneity in study designs limited causal attribution, as 90% of comparators differed in multiple aspects beyond engagement.[71] In public health contexts, a rapid review of 24 articles identified benefits including policy changes in 13 cases, community capacity building in 16, and increased social capital in 11, with quantitative outcomes showing significant social capital gains in two studies and non-significant mental health improvements in two others.[72] However, the evidence base remains predominantly qualitative, with scarce rigorous quantitative data on broader social change outcomes like economic development or sustained power shifts.[72][73] Success metrics in these studies typically include measurable indicators such as vaccination rates, reduced disease incidence, and participant retention, but long-term sustainability is understudied, with potential publication bias and comparator issues confounding results.[71] Broader empirical evaluations of community organizing for non-health goals, such as neighborhood revitalization or education reform, reveal sparse formal evidence, often relying on self-reported or short-term gains rather than controlled longitudinal data.[73][70]| Outcome Domain | Effect Size (Cohen's d) | Number of Studies Contributing |
|---|---|---|
| Health Behaviors | 0.33 (95% CI: 0.26-0.40) | Multiple across 131 trials[71] |
| Health Consequences | 0.16 (95% CI: 0.06-0.27) | Multiple across 131 trials[71] |
| Self-Efficacy | 0.41 (95% CI: 0.16-0.65) | Multiple across 131 trials[71] |
| Social Support | 0.44 (95% CI: 0.23-0.65) | Multiple across 131 trials[71] |