The LUKA Principle brings into focus important elements that have been identified by stakeholders as necessary in building a cohesive front to undertake the issue of health disparities. Within the United States, health disparities are often the result of multiple overlapping issues (not just individual beliefs or actions). Race or ethnicity, sex, sexual identity, age, disability, socioeconomic status, and geographic location all contribute to an individual’s ability to achieve good health.
The model grew out of the Commission’s experiences building the capacity of organizations in states that serve an emerging Latino community, as well as engaging community members to lead community mobilization efforts in their areas. It recognizes the importance of local, grassroots leadership in uniting communities and forming effective coalitions dedicated to improving living conditions and to addressing the HIV/AIDS epidemic and changing policy environment. The model also focuses on the need to systematically collect data to enhance and continuously update leaders’ and coalitions’ knowledge of the community, in order to inform actions. As such, the LUKA Principle is an iterative process of gathering information, engaging leaders, and taking actions to advocate for services and policies in working to reduce the impact of HIV/AIDS on the community.
Figure 1 below presents a visual representation of the model. Leaders build upon the initial identified needs, to bring together a coalition in Unity, this unified group then engage in a community assessment to gather in-depth Knowledge. The actors involved then formulate Actions based on the information. Once that process is complete, the coalition reassesses any changes that have occurred, within the social, political, and economic contexts that affect the population. Following the reassessment, the iterative process begins again, to once more plan actions that, if successful, impact the community’s living conditions. As shown in Figure 1, evaluation is a key part of each step of the process, with feedback loops established to help the organizers understand whether the action steps are proceeding as planned, and opportunities to assess progress along the way.
A key part of implementation of the LUKA Principle is an assessment of the community’s readiness for mobilization. That readiness depends on:
– The key players in the community, and whether those have changed over the years.
– The key issues of concern to the community at the moment.
– Opportunities to effect change.
The Commission has identified eight core elements of implementing the LUKA Principle:
2. Leadership assessment and development
3. Resource mapping
4. Stigma mapping
5. Leveraging resources
6. Understanding and addressing the individual, organizational and environmental barriers to accessing care
7. Understanding and addressing health disparities