Assessing Community Readiness Research Articles

Physical activity to address mental health in a remote Australian community: community readiness assessment

Purpose The mental and physical health of those residing in Australian rural and remote communities is poorer compared to major cities. Physical health comorbidities contribute to almost 80% of premature mortality for people living with mental illness. Leisure time physical activity (LTPA) is a well-established intervention to improve physical and mental health. To address the physical and mental health of rural and remote communities through LTPA, the community’s level of readiness should be first determined. This study aims to use the community readiness model (CRM) to explore community readiness in a remote Australian community to address mental health through LTPA. Design/methodology/approach Individual semi-structured interviews were conducted using the CRM on LTPA to address mental health. Quantitative outcomes scored the community’s stage of readiness for LTPA programmes to address mental health using the CRM categories of one (no awareness) to nine (high level of community ownership). Qualitative outcomes were thematically analysed, guided by Braun and Clark. Findings The community scored six (initiation) for community efforts and knowledge of LTPA programmes and seven (stabilisation) for leadership. The community’s attitude towards LTPA and resources for programmes scored four (pre-planning), and knowledge of LTPA scored three (vague awareness). Originality/value To the best of the authors’ knowledge, this is the first Australian study to use CRM to examine community readiness to use LTPA to improve mental health in a remote community. The CRM was shown to be a useful tool to identify factors for intervention design that might optimise community empowerment in using LTPA to improve mental health at the community level.

Assessment of Community Readiness to Address Malnutrition in Rural Southwest Guatemala

AbstractBackgroundMalnutrition is prevalent throughout southwest Guatemala, where >40% of children suffer from chronic undernutrition. Evidence supports that assessing a community's awareness and readiness to address malnutrition is a critical first step in improving the success of a nutrition intervention program. The objective of this study was to apply the community readiness model (CRM) to assess community readiness to address childhood malnutrition in a rural southwest region of Guatemala.MethodsThirteen key respondents of varied social roles and demographics residing in the region were interviewed. Interview questions related to addressing malnutrition were from the following predefined dimensions: Community Efforts, Community Knowledge of Efforts, Leadership, Community Climate, Community Knowledge, and Resources for Efforts. Interview recordings and notes were analyzed and scored according to the CRM guidelines, and a standardized analysis was conducted.ResultsThe overall community readiness score was 4.26 (preplanning: awareness of the issue). Community Efforts had a total score of 5 (Preparation: preparing to take action on the issue). Community Knowledge of Efforts, Community Climate, Community Knowledge, and Resources for Efforts Dimensions each had a total score of 4 (Preplanning: awareness of the issue). The overall score for the Leadership dimension was 2 (Denial/resistance: belief that the problem does not exist within the community). These scores demonstrate clear recognition for action to address childhood malnutrition as a problem. However, efforts to combat childhood malnutrition are not yet focused nor detailed for community action.ConclusionsThis rural southwest region of Guatemala recognizes that childhood malnutrition is a problem. However, efforts to address malnutrition are not yet focused or detailed enough to have measurable impact in addressing this issue. For the region to advance the stage of community readiness, it is essential to enhance knowledge of dietary strategies aimed at improving nutrition for children and increase engagement from local leadership.

286 Partnering and engaging in Indiana Communities through listening sessions and data sharing: successes of Connection IN Health

OBJECTIVES/GOALS: Participants will be able to identify how partnering with state health departments for a CTSA initiative assists in meeting shared goals by building infrastructure and sharing resources and list key components of a successful county engagement process that can be replicated. METHODS/STUDY POPULATION: Connections IN Health is a collaborative project with the Indiana Clinical and Translational Sciences Institute, Indiana Department of Health, Indiana University Simon Comprehensive Cancer Center, and community partners. We address chronic disease in Indiana with coalition-based engagement at the grassroots level, and partnering to provide technical assistance, resources, connections and evidence-based strategies to address the health challenges. Our methods of county engagement include surveying the broad community, conducting listening sessions with key community stakeholders, compiling, analyzing and sharing data, collaborating with existing local coalitions, assessing community readiness and suggesting evidence-based practices to implement. RESULTS/ANTICIPATED RESULTS: As a result of county engagement, local coalitions have current, local data to drive their efforts in improving local health rankings and outcomes. Community partners in eight counties have selected and implemented evidence-based strategies to manage and/or prevent diabetes, cardiovascular disease and/or stroke. Some examples include: starting a community garden with cooking classes in a food desert to provide fresh produce and nutrition/cooking knowledge, creating a mobile kitchen on hand for organizations to use to provide education and cooking skills, providing a passport for wellness at existing community events with food samples and health screenings and offering evidence-based educational programming such as Dining with Diabetes and Be Heart Smart. DISCUSSION/SIGNIFICANCE: Moving county health coalitions to evidence-based programming that has the greatest likelihood for success is a critical translational sciences challenge. Our rigorous and well defined approach yields significant improvement in local health coalition activities, sustaining their activities through long-term trusted relationships.

Using an adapted community readiness assessment to inform Vision Zero and safe systems action

Fatal and serious crashes on our roadways remain a persistent public health crisis. Vision Zero, based on the principles of a Safe Systems approach, is an initiative that has grown in popularity in the United States in the past decade. While the importance of cross-sector collaboration and the need for a supportive community culture in order to realize community change is well established, such tools and frameworks have not been applied as commonly for road safety initiatives as in other fields. We adapted and utilized the Community Readiness Assessment (CRA) tool, a well-established model within public health for assessing and informing community-based interventions in seven Vision Zero communities in one U.S. state. Three communities assessed were determined to be at an overall readiness level of four out of nine, or at a “preplanning” level and four of the communities scored a level of three, or at a “vague awareness” level. However, levels of readiness across the six dimensions measured varied, with community-related dimensions (e.g., community climate) scoring lower than readiness levels for stakeholder knowledge, leadership, and resources. Additionally, communities with more advanced stages of implementation had higher readiness scores, on average. Assessment results provided unique insights to inform next steps for local initiatives, particularly related to discrepancies between the readiness of the wider community and the readiness of leadership and available resources. Therefore, the CRA represents a potentially beneficial tool for communities pursuing Vision Zero initiatives.

Can universities catalyze social innovation to support their own rapid decarbonization? Assessment of community and governance readiness at the University of California

Universities aspire to lead on sustainable energy transitions, yet progress toward reducing their own emissions has been challenging. We assessed barriers and opportunities for engagement of University of California (UC) campus communities in stimulating more deliberate and rapid campus energy transformation, and our findings highlight the complexity of the socio-technical and governance systems that limit potential for transformative change for decarbonization. Through surveys, interviews, focus groups, and content analysis, we found strong interest among students, faculty, and staff in advancing decarbonization. We found a preference for local and on-campus solutions such as energy efficiency, behavioral change, renewable-energy production, and electrification, and much less support for market offsets and non-local investments. We also found that students and faculty had limited knowledge and sense of agency regarding campus-based decarbonization programs and options, which is consistent with the limited availability of data and information about these programs beyond the few who are directly involved. Weaving our findings with insights from social-innovation theory, we propose an action research agenda that conceives of university operations and governance systems as loci for socio-technical energy transition experiments. In alignment with higher education's long-standing commitments to catalyzing social innovation, opening university energy operations and governance to inclusive, community-led collaborative experimentation has strong potential to create the conditions necessary to produce the social innovation so desperately needed for energy system transformation within universities and beyond.

Community Readiness Assessment of the "Take TIME for Your Child's Health" Intervention.

Take TIME (Tobacco-free, Injury-free, Moving daily, Eating healthy) was an early intervention strategy targeting community readiness to support healthy lifestyles for young children in Uxbridge, Canada. This study aimed to assess the effectiveness of Take TIME using the Community Readiness Model adapted for childhood obesity prevention. Six interviews were completed in Uxbridge, before and after the intervention, with purposively selected community leaders in education, political, business, religious, not-for-profit, and healthcare fields. Each interview was rated independently by two scorers. Interview content was scored (scale from 1 to 9, with 1 being no awareness and 9 being a high level of community ownership) according to the Community Readiness Model criteria on six dimensions, with overall readiness calculated as the mean score of all dimensions. T-tests compared readiness by time-point and between communities. Overall community readiness significantly improved (p = 0.03) in Uxbridge from pre-intervention (3.63 ± 1.14 vague awareness) to post-intervention (5.21 ± 0.97 preparation). Seven interviews were also completed with leaders in the matched town of Rockwood, Canada which served as the control community. Rockwood readiness was close to the Uxbridge post-intervention score (5.35 ± 1.11). Results indicated increased awareness and leadership support post-intervention in Uxbridge, but further improvements in community knowledge, formalized efforts, and additional leadership support are desired. Take TIME increased community readiness to support healthy lifestyles for young children and may be useful to other communities at similar stages, given its theoretical alignment with the community readiness model. Future research should investigate the impact of Take TIME in demographically diverse communities and appropriate interventions to move communities from the preparation to the action stage.

Assessing Community Readiness to Develop a Socioculturally Relevant Intimate Partner Violence Prevention Program.

The prevention of intimate partner violence (IPV), the most prevalent form of gender-based violence, requires initiatives grounded in the values and norms of members of a given community. As part of an ongoing effort to develop a socioculturally responsive prevention program, we assessed levels of readiness to address IPV in an Asian Indian community in the midwestern USA. Consisting of six focus groups (n = 28), individual interviews (n = 6), and surveys (n = 189) of diverse community leaders and members, the assessment indicated that, while there was only vague awareness of IPV in the community as a whole, some limited segments of the community had a higher degree of readiness to address IPV. Capitalizing on the readiness and commitment of selected individuals, we developed a health communications campaign and implemented it in phases. We discuss methodological issues and lessons learned in assessing community readiness, including implications for study design and future research.

Psychometric evaluation of the Malay version of the Individual Community-Related Empowerment scale among older adults in Malaysia.

Malaysia is projected to become an aged country by 2030, with the older age group comprising 10 percent of the total population. To address this demographic shift, comprehensive plans and initiatives are being implemented at various levels, ranging from the government to local communities. A crucial aspect of these efforts is community empowerment, which requires a reliable and validated tool for measurement. This study aimed to validate the Individual Community Related Empowerment (ICRE) scale in alignment with the national language of Malaysia. This cross-sectional study was conducted from May to December 2019. Back-to-back translation from the English to Malay version of the ICRE scale was done. A total of 328 older persons aged 60 years old and above who attended clinics and understood Malay had been randomly selected. Exploratory factor analysis (EFA), particularly Principal Component Analysis (PCA) with Varimax rotation and Kaiser Normalization, was performed in this study using IBM SPSS version 27 Amos graphic. The findings revealed that the Malay version of the Individual Community Related Empowerment (ICRE-m) scale consists of five components: self-efficacy, intention, participation, motivation, and critical awareness, which collectively accounted for 92.3% of total variance. All five components demonstrated Cronbach's alpha values greater than 0.7, indicating the reliability of the selected items for field studies. The ICRE-m scale is acceptable for field studies and valid for measuring individual-related community empowerment. Nurses and other healthcare professionals can employ this scale specifically within the Malay-speaking population, particularly in the Asian region. Future studies on community empowerment among older individuals can utilize this tool to assess community readiness for participating in community health interventions.

Assessing Community Readiness for Payments for Ecosystem Service Schemes for Tropical Primary Forest Protection in the Democratic Republic of Congo

Primary forest conservation is essential for limiting climate change, for meeting conservation objectives, and the Sustainable Development Goals. Schemes that compensate communities for forgone extractive uses are important policy tools, but effective deployment demands an understanding of local deforestation drivers and host communities’ preferences. We use Q-methodology to reveal discourses present in three communities in the Democratic Republic of Congo. Our results reveal three factors with a common emphasis on forest conservation and preferences for compensation in the form of social investments, rather than cash. The main contrasts were in attitudes towards farming. The first discourse, we call conservationist—open to ideas, displayed a commitment to learning better practices for community material benefit in service of forest conservation. The second discourse, which demonstrated greater confidence in their capacity to support livelihoods from farming, we call aspirational artisans. The third, which was acutely aware of the impact of their farming on forest conservation, we called passive, conflicted farmers. We also demonstrate an aspiration for the continued development of farming amongst participants, which although still correlated with preferences for forest conservation, may lead to compensation schemes inadvertently stirring future land use tensions if design does not reconcile agricultural development and conservation.

Represent: A community engagement roadmap to improve participant representation in cancer early detection research: An Oregon case study.

While authentic and sustained community involvement in the research process is critically important to making new technologies and interventions effective and socially acceptable, there is uneven participation across sociodemographic, racial, and ethnic communities in many research areas, including cancer early detection research. Currently, 18% of cancer in the United States impacts Hispanics and Latinos, this population accounts for < 10% of research participants. Understanding barriers and facilitators to cancer early detection research is imperative to the ultimate success of this research. Therefore, the objectives of this study were to: understand Hispanic and Latino community perspectives in participation in cancer early detection research; and identify sustainable and mutually beneficial approaches to community engagement and involvement. The Oregon Case Study, led by Oregon Health & Science University's Community Outreach, Research and Engagement (CORE) in partnership with colleagues at Vocal, a partnership between Manchester University NHS Foundation Trust and the University of Manchester and Cambridge University, adopted a participatory research approach to better understand participation in cancer early detection research from the perspectives of Oregon's Hispanic and Latino community members. We implemented two evidence-based community engagement models, the Community Engagement Studio and the Community Readiness Assessment Model. Using a facilitated format prescribed by each community engagement model, community members helped us to answer two research questions: (1) What methods help us increase participation of underrepresented communities in cancer early detection research?; and (2) How can we build trust between researchers and underrepresented communities within cancer early detection research? Quantitative (i.e., descriptive statistic) and qualitative (i.e., thematic analysis) analytic methods were used to measure and assess community knowledge, leadership, beliefs, and resources regarding participation in cancer early detection research. A total of 36 Hispanic and Latino community members participated in the two community engagement models. We identified three emergent themes pertaining to participation in cancer early detection research that include: low-level awareness of cancer early detection research and opportunities for research participation, structural barriers to research participation, and uncertainty of the benefits of research participation. Our approach, using two evidence-based community engagement models, yielded valuable insights about perceptions of research participation for Hispanic and Latino community members. These findings, synthesized into three key themes, led to actionable recommendations to increase research participation.

Documenting tribal community readiness to support substance abuse prevention

Documenting community readiness to support substance abuse prevention in tribal communities is needed to maximize the impact of prevention programming. Semi-structured interviews with 26 tribal community members from Montana and Wyoming served as the primary data source for this evaluation. The Community Readiness Assessment was used to guide the interview process, analysis, and results. This evaluation found that community readiness was vague, meaning most community members recognize it as a problem, but there is little motivation to do anything about it. There was a significant increase in overall community readiness between 2017 (pre) and 2019 (post). Findings underscore the need for continued prevention efforts targeted at a community’s readiness to address the problem and move them to the next change stage.

Abstract TP62: Community Readiness Assessment Of Pre-hospital Telestroke Services In The Ambulance

Background: We are implementing telemedicine in the ambulance to help retain more stroke patients in rural community hospitals and improve thrombolytic treatment times. Our objective was to assess community acceptability of prehospital telestroke services in rural communities on Oahu and identify patient-centered goals. Methods: Data were collected through a mixed method survey on Oahu using a short Likert-scale questionnaire followed by a semi-structured interview. Data were summarized by descriptive and inferential statistics. Comparisons between rural and urban groups were made by chi-square analysis and Wilcoxon rank-sum two-tailed test. Rural communities were defined as those with &gt;45 min drive time to a Comprehensive Stroke Center. Interviews were transcribed, coded, and analyzed using inductive and deductive methods. Results: Responses were collected from 263 Oahu residents (66.0% female; 47.3% age 35-64; 51.0% rural residents) who were representative of the island population (39.3% Asian; 32.4% Native Hawaiian/Pacific Islander; 44.3% White) and 29 interviews were conducted. Most respondents were comfortable using telemedicine in the ambulance (65.1%) and believed that it would improve the emergency care they receive (65.6%). Most respondents would feel more comfortable staying at their local hospital if they have access to a specialist by telemedicine (74.7%). There were no significant differences between rural and urban respondents’ impressions of telemedicine. Compared to urban respondents, rural respondents were less confident in their local hospital being capable of providing high quality medical care (67.4% rural vs 83.0% urban, p &lt; 0.01) or stroke care (65.9% vs 83.9%, p &lt; 0.001) and more likely to believe they would receive better stroke care outside of their local area (53.1% vs 36.0%, p &lt; 0.05). Conclusions: Most respondents support use of prehospital telemedicine. Rural residents were less likely to perceive their local hospital could provide high quality stroke care and had a less favorable impression of using telemedicine to avert EMS bypass of the local hospital. These findings suggest a potential misalignment of the project goal with some patients’ goal to use EMS to bypass rural hospitals for stroke care.

Assessment on the Current State of Survivor-Focused Cancer Care in Southwestern Indiana

Background/objective: In 2019, the Commission on Cancer (CoC) released updated standards for 2020. The 2020 standards deliberately focused on improving long-term outcomes and quality of life for survivors. The new standards went one step further and introduced requirements for staffing and programming to meet these goals. This study aims to qualitatively assess the current state of survivorship-focused care through direct interviews with survivors, community leaders and healthcare providers in Evansville, Indiana.&#x0D; Methods: This is a qualitative study to understand survivorship care in southwestern Indiana. We conducted qualitative interviews with healthcare providers, community leaders, as well as survivors with an overall goal of learning what the needs and barriers are in providing or receiving long-term care. Our team worked to analyze qualitative data from the interviews to identify common themes within this community, as well as to compare the viewpoints and experiences of survivors with healthcare providers and community leaders. This study design is based on the Tri-Ethnic Center for Prevention Research model for implementing a community readiness assessment, and is the first step in a long-term appraisal of survivorship-focused care in the southwestern Indiana region.&#x0D; Results: From this early assessment, it is determined that although awareness and efforts exist to address long-term survivorship care, there is room for improvement. Survivors and providers alike recognize gaps that exist in the transition of care, in patient education, and in awareness of and access to available resources.&#x0D; Conclusion and potential impact: This study provides key information that will be utilized to further assess the readiness of the community of survivors and care providers. The themes drawn from this assessment will be utilized to determine high-impact areas for improvement in care, analyze availability of relevant resources, and to address barriers to care and resources.

Adapting the Community Readiness Model and Validating a Community Readiness Tool for Childhood Obesity Prevention Programs in Iran.

It is critical to assess community readiness (CR) when implementing childhood obesity prevention programs to ensure their eventual success and sustainability. Multiple tools have been developed based on various conceptions of readiness. One of the most widely used and flexible tools is based on the community readiness model (CRM). This study aimed to adapt the CRM and assess the validity of a community readiness tool (CRT) for childhood obesity prevention programs in Iran. A Delphi study that included 26 individuals with expertise in 8 different subject areas was conducted to adapt the CRM into a theoretical framework for developing a CRT. After linguistic validation was conducted for a 35-question CR interview guide, the modified interview guide was evaluated for its content and face validity. The quantitative and qualitative analyses were performed using Stata version 13 and MAXQDA 2010, respectively. The Delphi panelists confirmed the necessity/appropriateness and adequacy of all 6 CRM dimensions. The Persian version of the interview guide was then modified based on the qualitative results of the Delphi study, and 2 more questions were added to the community climate dimension of the original CRT. All questions in the modified version had acceptable content and face validity. The final CR interview guide included 37 questions across 6 CRM dimensions. By adapting the CRM and confirming linguistic, content, and face validity, the present study devised a CRT for childhood obesity prevention programs that can be used in relevant studies in Iran.

Using an Adapted Community Readiness Assessment to Inform Vision Zero and Safe Systems Action

Using an Adapted Community Readiness Assessment to Inform Vision Zero and Safe Systems Action

Assessing community readiness for overweight and obesity prevention among Ghanaian immigrants living in Greater Manchester, England

AimThis study assesses community readiness to prevent overweight/obesity among Ghanaian immigrants in Greater Manchester, England.Subject and methodThe Community Readiness Model (CRM) was applied using a semi-structured interview tool with 13 key informants (religious and other key community members) addressing five readiness dimensions. A maximum of 9 points per dimension (from 1 = no awareness to 9 = high level of community ownership), was assigned, alongside qualitative textual thematic analysis.ResultsThe mean readiness score indicated that the study population was in the “vague awareness stage” (3.08 ± 0.98). The highest score was observed for community knowledge of the issue (4.42 ± 0.99) which was in the pre-planning phase, followed by community climate (vague awareness; 3.58 ± 0.62). The lowest scores were seen for resources (denial/resistance; 2.70 ± 0.61) and knowledge of efforts (no awareness; 1.53 ± 0.44). Findings identified structural barriers, including poor living conditions as a result of poorly paid menial jobs and high workload, contributing to the adoption of unhealthy lifestyle behaviours. Socio-cultural factors such as fatalism, hereditary factors, and social status were associated with acceptance of overweight.ConclusionDespite recognising overweight/obesity as an important health issue in these communities, especially among women, it is not seen as a priority for targeting change. To help these communities to become more ready for interventions that tackle overweight/obesity, the focus should initially be to address the structural barriers identified, including reducing poverty, alongside designing interventions that work with these structural barriers, and thereafter focus on the socio-cultural factors.

Understanding community resistance to sexuality education and exploring prospective implementation strategies in Pakistan: A content and network analysis of qualitative data.

Providing comprehensive sexuality education (CSE) in schools is a work in progress in many countries throughout the world. In some countries, the journey is just beginning; in others, investments in this field have been made for many years. It is and has been difficult in Pakistan to implement and promote reproductive health, women’s empowerment, and CSE. In Pakistan, previous implementation efforts revealed the critical role of community influencers in propagating misleading information about the initiatives, inciting organized community resistance, and provoking backlash. This paper looked at several aspects of community resistance, as well as approaches for overcoming the resistance for increasing community engagement in the implementation of CSE in Islamabad, Pakistan. To analyze community perceptions of CSE implementation in Islamabad, the community readiness assessment (CRA) questionnaire was adapted. Questions and prompts for discussion included leadership, current initiatives, community knowledge, resource availability, community support, and implementation strategies. A total of 35 in-depth interviews were conducted. Data was analyzed and interpreted using qualitative content analysis to explore community perspectives that contribute to resistance around CSE, as well as implementation options. Using inter-code relationship data, network analysis was conducted to provide a graphical representation of the analyzed qualitative data. The study reveals community resistance to CSE being implemented in schools. Misconceptions, a lack of awareness, a lack of priority, and the lack of dedicated resources are just a few of the primary implementation challenges to consider when implementing CSE in practice. Network analysis identified, based on modularity class, five distinct clusters of highly connected nodes/codes: non-governmental organizations (NGOs), misconceptions, resources and policy, strategies and community support, and personal social and health education (PSHE) and current efforts. In conservative environments and when confronted with resistance, innovative marketing and rebranding are critical for priority setting and community engagement, especially when developing curriculum and implementing CSE. Some of the suggested strategies for implementation include community sensitization through strategic awareness campaigns, involving already established infrastructure and NGOs, endorsement by all major stakeholders, particularly decision-makers, and the use of creative digital platforms for better dissemination.

The Level of Beef Cattle Farmers’ Readiness for Livestock Intensification Program Surrounding Baluran National Park Area

Wild grazing is the main problem faced by Baluran National Park (BNP) management. Sidomulyo Hamlet contributed to wild grazing by the cattle number of 2,220 heads. The research aims to assess the community readiness for the intensification program to reduce wild grazing in BNP and formulate alternative strategies to program successfully. The study was conducted in Sidomulyo Hamlet, Sumberwaru Village, Situbondo Regency, from June to October 2021. The location was chosen purposively, considering that it is one of the hamlets directly adjacent to the BNP. The method used a qualitative approach using Community Readiness Model by interviewing 12 key informants, consisting of the representative of BNP management, local government, and local farmers. Data were collected through interviews using a semi-structured questionnaire under Community Readiness Model Handbook. Data were analyzed using Community Readiness Assessment. The results showed that the community readiness score related to the livestock intensification program was 4.43. The level of beef cattle community readiness at the preplanning stage, the program is still in the initial planning stage, aiming to increase awareness of the farmer community with ideas that can reduce the problem. Alternative strategies that should be carried out are: introducing information about the problem, communicating with community leaders, reviewing the efforts made to determine targets and success rates, conducting focus group discussions to discuss the problem and develop strategies, and increasing media exposure. Keywords: Baluran National Park, Community Readiness Model, conservation, wild grazing

Assessing community readiness to reduce consumption of sugary drinks in remote Aboriginal and Torres Strait Islander communities: A useful tool for evaluation and co-design.

There is a need for culturally appropriate methods in the implementation and evaluation of Aboriginal and Torres Strait Islander health programs. A group of Indigenous and non-Indigenous practitioners culturally adapted and applied the Tri-Ethnic Research Centre's Community Readiness Tool (CRT) to evaluate change in community readiness and reflect on its appropriateness. Aboriginal community-controlled health service staff informed the cultural adaptation of the standard CRT. The adapted CRT was then used at baseline and 12-month follow-up in three remote communities in the Cape York region, Queensland, Australia. Program implementation occurred within a pilot project aiming to influence availability of drinking water and sugary drinks. The adapted CRT was found to be feasible and useful. Overall mean readiness scores increased in two communities, with no change in the third community. CRT interview data were used to develop community action plans with key stakeholders that were tailored to communities' stage of readiness. Considerations for future application of the CRT were the importance of having a pre-defined issue, time and resource-intensiveness of the process, and need to review appropriateness prior to implementation in other regions. The adapted CRT was valuable for evaluating the project and co-designing strategies with stakeholders, and holds potential for further applications in health promotion in remote Aboriginal and Torres Strait Islander communities. SO WHAT?: This project identified benefits of CRT application not reported elsewhere. The adapted CRT adds a practical method to the toolkits of health promotors and evaluators for working in partnership with Aboriginal and Torres Strait Islander communities to address priority concerns.

Rurality and readiness: Addressing substance use via a community‐level assessment

AbstractCounselors serve diverse clients who may experience substance use issues and contributing factors such as generational poverty and isolation. A rural region of a state with legalized marijuana engaged in an assessment of community readiness to address the use of alcohol, tobacco, marijuana, and other substances. Scoring and thematic analysis of interviews with 30 community members resulted in scores for five readiness dimensions and themes concerning contributors to and detractors from readiness. Recommendations for counselors span prevention, intervention, and advocacy to support individuals, families, and organizations seeking to promote awareness and addiction recovery, particularly in the context of rural poverty.