Assessing Community Readiness Research Articles

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.

Look before you leap: assessing community readiness for action on science and health policy issues

This practice insight focuses on lessons learned while completing a research project designed to compare the relative effectiveness of three communication strategies in rural communities relative to motivating citizens to take action on a public health issue, specifically Type 2 diabetes. Our main arguments are: 1) Engaging citizens in any type of communication related to public health or science action requires first assessing a community's readiness for that action; and 2) Community readiness — rather than communication methodology — is the better predictor of citizens' participation in collective or individual actions on public health and science issues.

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

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

Evaluation of community readiness for change prior to a participatory physical activity intervention in Germany.

SummaryA lack of communities’ readiness for change is reported as a major barrier toward an effective implementation of health promoting interventions in community settings. Adding an alternative readiness assessment approach to existing research practice, this study aimed to investigate how a selected community could be evaluated in-depth regarding its readiness for change based on multiple key informant perspectives, with the intention of using this knowledge for the preparation of improved local physical activity (PA) interventions for men above 50 years of age. We conducted semi-structured face-to-face key informant interviews with stakeholders and relevant persons from a local German community (N = 15). The interview guide was based on a comprehensive summary of community readiness dimensions. After verbatim transcription, we conducted thematic analysis to synthesize the complex results regarding community readiness related to PA. The data supported that the community disposed of a variety of resources regarding PA and showed signs of readiness for change. However, a certain degree of saturation regarding PA programs existed. The need for health enhancing PA interventions for men was only partly recognized. The local authority considered PA to be particularly important in the context of mobility and traffic safety. Including multiple stakeholders contributed to a balanced and in-depth assessment of community readiness and was helpful for determining starting points for tailored PA interventions due to the detection of complex relationships and structures. The study delivers preliminary evidence that a qualitative multi-perspective community readiness assessment adds value to quantified single-perspective readiness assessment research practice.

Using the Community Readiness Model to Assess American Indian Communities Readiness to Address Cancer Prevention and Control Programs.

Cancer disparities continue among American Indian and Alaska Native (AI/AN) populations while they have decreased among other racial and ethnic groups. No studies were found that utilized the Community Readiness Model (CRM) to ascertain the readiness of Tribal and American Indian organizations to participate in cancer research and cancer prevention and control initiatives. The Partnership for Native American Cancer Prevention conducted an assessment of the status of American Indian communities' readiness to implement activities for prevention, early detection, and treatment to improve AI/AN cancer rates. The assessment was a component of the Community Outreach Core of the grant. Thirty-four key Informants participated in the interview process. The Community Readiness Assessment (CRA) provided a baseline assessment of community partners' readiness to participate in cancer research and programming. Despite years of cancer intervention programs, the communities were classified as being in the early stages of readiness [1-5] of the nine-stage model. Additionally, findings showed low levels of awareness of previous or ongoing cancer research. The findings in prevention and control efforts indicated a need for technical assistance and funding to support community projects in prevention and control. This supported the implementation of a community grants initiative. They also indicated that communities were not ready to conduct research, despite ongoing cancer related research in at least two communities. Communication tools and social media methods and messages were developed to increase awareness of cancer as a health concern and cancer research in the community. The CRM informed these and other engagement activities to meet the appropriate stage of readiness for each Tribe/community, and to build their capacity to participate in cancer research and programming activities.

A qualitative assessment of the perceptions and attitudes towards commercial tobacco policies and education among tribal communities in California

ABSTRACT Background: California has the largest American Indian and Alaska Native (AIAN) population in the United States and faces several commercial tobacco related disparities. This study assessed current interest, readiness, and knowledge regarding commercial tobacco control policies in California Tribal communities. Objectives: A community readiness assessment was conducted in California Tribal communities to understand commercial tobacco policies that included: Tobacco 21 (California State, and now federal, law restricting commercial tobacco sales to age 21 and over), tobacco tax, smoke-free worksites on Tribal lands, smoke-free households, and smoke-free indoor and outdoor areas in multi-unit housing. Methods: Twelve Tribal communities participated in focus groups and interviews between 2016–2019. Content analysis was utilized to code and data were analyzed using ATLAS.ti software. Results: A total of 165 community members participated (65% female), with most expressing support for unwritten, community-based “small p” policies, (e.g., placing signage to create a smoke-free perimeter). However, there was little to no support for “big P” policies (e.g., written ordinances on smoke-free casinos, smoke-free housing). Support for tobacco product taxation varied. The importance of Tribal sovereignty and the need for tobacco prevention and cessation programs for youth were two additional topics that emerged. Conclusions: Participants supported Tribal policies and wished for outsiders to respect Tribal sovereignty in this regard. Communities are currently working to raise awareness about the dangers associated with commercial tobacco use and would benefit from the responsiveness of future funders to these requests.

Community Readiness – are municipalities prepared to prevent obesity in childhood and youth?

Abstract Background Essential for the success of prevention efforts is the readiness to address a health problem (community readiness). Aim of this study is to analyze the stage of community readiness for the prevention of childhood obesity in municipalities using the Community Readiness Model (CRM). Based on this, strategies will be developed to improve community readiness for the prevention of obesity in childhood and youth. Methods A systematic literature review (SLR) was conducted in the databases PubMed, LIVIVO, Cochrane and Google Scholar to identify studies that used the CRM for the prevention of childhood obesity. In order to assess community readiness, the CRM, a structured interview guide and scoring system, was used. Following the CRM protocol, guided interviews were conducted with key informants that were identified in a modified stakeholder analysis. The transcribed interviews were analyzed by two scientists following the CRM scoring system. Results The SLR revealed 270 hits. In 28 international studies the CRM has been applied to childhood obesity prevention, predominantly in the Anglo-American language area. In Germany, no studies could be identified using the CRM for the prevention of childhood obesity. Key informant interviews (n = 28) were conducted in five Bavarian municipalities from January to April 2021. The key informant sample comprised administration departments, health and educational facilities. Conclusions The CRM enables a multidimensional analysis of a municipality's material and immaterial infrastructure. In workshops with the participating municipalities the results of the community readiness assessment will be reflected. The aim is to develop an action plan with strategies to increase the stage of readiness and support prevention efforts in order to address childhood obesity. Key messages The CRM provides a theoretical basis to understand and improve community readiness. It enables the analysis of assets and weaknesses that can influence obesity prevention in municipalities.

Social media influencer marketing to build a counter-narrative for promoting sexuality education

Abstract Background A recent cross sectional community readiness assessment carried out in Islamabad, Pakistan indicated that the community is at the denial or resistant stage for implementing school-based sexuality education in Pakistan. The resistance was attributed to lack of awareness and prevalent misconceptions regarding sexuality education. This study aims at qualitatively exploring strategies for targeting misconceptions and increase awareness regarding sexuality education with stakeholder involvement. Methods 35 in-depth interviews and a focus group discussion was conducted to discuss the results of the readiness assessment comprising of community members, researchers, NGO representatives, and social media influencers. Discussion guide included topics on engagement strategies, intervention modes of delivery, target audience, misconceptions, community support, and optimizing sexuality education in local context. Qualitative content analysis was conducted for analyzing the data. Results Results indicate that current community support is usually passive in nature and digital or social media platforms are mostly used to talk about sexuality education. Participants believed social media can be used as a platform for disseminating information by involving social media influencers with careful narrative building around sexuality for rebranding the topic, as talking about sexuality is seen as a taboo in the society. Targeting misconceptions through counter narratives and scientific evidence was considered as a way forward for increasing community acceptability and readiness. Violence, staying safe, and age appropriateness were identified as some of the key features of sexuality education that need to be highlighted for garnering community support. Conclusions For promoting sexuality education in Pakistan, it is essential to tackle resistance by sensitizing the community and digital social media platforms offer an opportunity to do this through influencer marketing. Key messages Digital and social media offer an opportunity for promoting sexuality education in conservative settings like Pakistan. Social media influencer marketing might be useful in building counter narrative and for community engagement.

Assessment of community readiness to respond to flooding in contemporary Metropolitan Kano

Assessment of community readiness to respond to flooding in contemporary Metropolitan Kano

OPREVENT2 Community Action Component to Promote Healthy Policy, Systems, and Environments With Native American Communities: Process Evaluation and Lessons Learned

Abstract Objectives To assess the implementation of the Community Action Component (CAC) of OPREVENT2, which aimed to promote healthy food and physical activity policies, systems, and environments (PSE) with six Native American communities. Methods OPREVENT2 examined the impact of a multi-level, multi-component obesity prevention intervention in six tribal communities in the Southwest and Midwest regions of the US (Three randomly selected to receive the intervention first, three to receive second). The CAC was designed to identify and develop PSE changes in partnership with community partners. We developed the following implementation standards prior to the intervention: we aimed to hold monthly meetings that were ≥1 hour and recruited ≥10 participants representing different stakeholder groups (health staff, store employee, tribal leader, school teachers/staff, and community members). We used measures of frequency to evaluate the extent that we met established reach, dose delivered, and fidelity standards. Results CAC meetings used participatory approaches to discuss ways to use PSE changes to encourage healthy eating and physical activity in stores, schools, worksites, and communities. Overall, we achieved high dose delivered; we held one monthly meeting on average that ranged 60–120 minutes. Reach varied by community; on average we attained 64%, 101%, 479% of the participants. Meetings were attended most often by community members, health staff, and tribal leaders, with low participation from store employees or school teachers/staff. Whenever possible, CAC meetings were planned with existing meetings to enhance reach to encourage sustainability and enable collaboration with community partners. Future interventions could develop a tribal council resolution to encourage other stakeholder groups to attend and promote sustainability of intersectoral work at an earlier stage. Assessing community readiness could assist in developing strategies to promote PSE changes that are tailored to each community. Conclusions The inclusion of CAC complements community-based obesity prevention strategies in Native American communities and can achieve moderate to high reach, dose-delivered, and fidelity. Funding Sources National Heart, Lung, and Blood Institute.

A Cross-Sectional Community Readiness Assessment for Implementing School-Based Comprehensive Sexuality Education in Islamabad, Pakistan.

Evidence indicates that school-based sexuality education empowers children and adolescents with the skills, values, and attitudes that will enable them to appreciate their health and well-being, nourish respectful social and sexual relationships, understand their rights, and to make informed choices. Owing to organized community resistance and prevalent misconceptions, promoting sexual and reproductive health has been challenging, especially in conservative settings like Pakistan. This study aimed at systematically exploring communities’ perceptions regarding implementing school-based comprehensive sexuality education by conducting a cross-sectional community readiness assessment in Islamabad, Pakistan. A total of 35 semi-structured interviews were conducted with community key informants. Following the guidelines of the community readiness handbook, the interviews were transcribed and scored by two independent raters. The results indicate that, overall, the Islamabad community is at stage two of community readiness, the denial/resistance stage. Individual dimension scores indicate that knowledge of efforts, resources for efforts, knowledge about the issue, and leadership dimensions are at the denial/resistance stage. Only community climate was rated at stage three of community readiness, the vague awareness stage. This indicates that, for promoting sexuality education in the Pakistani context, it is essential to tackle resistance by sensitizing the community and the stakeholders through awareness campaigns.

Low level of community readiness prevails in rural northwest Ethiopia for the promotion of institutional delivery.

Introductionthe health benefits of institutional delivery with the support of skilled professional are one of the indicators of maternal health status which have an impact on the health of women and new coming generation. Despite these benefits, many pregnant women in Ethiopia are not actively bringing delivery at health facility. This study was aimed at determining the readiness level of community for promoting child birth at health facility.Methodsa population-based cross-sectional study was conducted. We interviewed 96 key informants using a semi-structured questionnaire adapted from the community readiness assessment model and translated to Amharic language. The key informants were purposively selected in consultation with the district health office to represent the community. The interviews were transcribed verbatim and survey scores were matched with the readiness stage of 1 of the 9 for the five dimensions using the assessment guidelines.Resultsthis study placed nine kebeles at stage 3 (vague awareness), which indicates the need for more institutional delivery service strategy programming; efforts of the community were not focused and low leadership concern and one kebele was in stage 2 (denial/resistance). Six kebeles were placed at high level of readiness i.e. in stage 7 (stabilization), indicating actions are sustained by the local managers or opinion leaders.Conclusionevidence derived from the present study can be used to match intervention tactics for promoting health facility child birth service utilization to communities based on their level of readiness.

Assessing Community Readiness to Engage in Diversity and Inclusion Efforts

Social scientific research has demonstrated that increasing racial or ethnic diversity can reduce overall levels of social solidarity in a community. Yet many community development organizations, including Extension, are deeply committed to creating a broader sense of cohesion in rural communities. This article highlights a recent interagency effort, known as the Welcoming Communities Assessment, to assess a community's readiness for inclusion. The Welcoming Communities Assessment helps community members gain a baseline, action-oriented understanding of how inclusive different sectors of their community are for immigrants, refugees, and people of color. This article describes the assessment's context, design, analysis, and implementation.

Community readiness for childhood obesity prevention programs: findings from an urban population in Iran.

This study aimed to examine the Iranian local communities' readiness stage to engage with childhood obesity prevention programs for late primary school children in districts 2 and 16 of Tehran as the representatives of high and low socio-economic districts, respectively. First, a Delphi approach was conducted to assess the socio-cultural necessity/appropriateness and adequacy of the community readiness model and its dimensions as a planning basis for childhood obesity prevention program(s) in Iran. Then, the community readiness interview guide's translation, modification, content and face validity were performed. Finally, 66 interviews with key informants were conducted and scored to assess community readiness. The socio-cultural necessity/appropriateness and adequacy of community readiness model and its dimensions were confirmed by Delphi participants and two questions were added to the interview guide. Content and face validity of the interview guide were at acceptable levels. Assessment of the community readiness based on the key informants' perspective showed that the overall mean readiness score of targeted local communities was 4.61 ± 0.54 and 4.22 ± 0.26 in high and low socio-economic districts, respectively, corresponded to 'preplanning stage'. The highest score was 5.00 ± 0.48 correspond to the 'preparation stage', which belonged to girls' schools in district 2. Small differences were found in the readiness stage of local communities by sex and socio-economic status of schools. The results highlight the need to increase community awareness, gain their support to recognize childhood obesity as a priority, address cultural misconceptions and improve the obesity prevention programs to achieve a higher level of readiness.

Community Readiness for Child Maltreatment Prevention: The Challenge of a Brief Assessment.

In this paper, we address the assessment of community readiness (CR) for the prevention of child maltreatment in the context of a community survey. A mail survey was administered to 222 service providers and 54 supervisors and managers from 35 different organizations serving children and their families in four Canadian communities. Eleven items from the short version of the Readiness Assessment for the Prevention of Child Maltreatment (RAP-CM) were used, in combination with questions assessing knowledge of family support programs offered in the community and a measure of inter-agency collaboration. Findings show that a consistent and valid indicator of "Lack of knowledge of the environment" can be derived from the RAP-CM items and used for screening key informants. Overall, CR appears mixed in the communities studied, the weakest dimensions of which are the will to address the problem and the dynamism of informal social resources. Leadership emerges as a major gap that needs to be addressed.

Is My Community Ready? The Community Readiness Model and its Exemplary Application in Community-Based Health Promotion

The German Prevention Act adopted in 2015 strengthens setting-based prevention approaches. The aim of this work was the presentation of the Community Readiness Model as an instrument for determining needs and improving health-promoting structures in the community setting, using the example of the promotion of physical activity in older adults. The needs assessment in the context of the model implementation was carried out by Community Readiness assessment, in which guided interviews on health promotion topics were conducted with key persons in communities. The community's stage of readiness was determined based on the interview results, and appropriate public health measures were derived from the respective stage. In our example, the model was adapted to the topic of promoting physical activity among older community-dwelling adults. The assessment was carried out in 2015 in 23 communities in Northwestern Germany. Illustrations such as spider web diagrams and geographical distributions are used to present the assessment results. The Community Readiness approach is a model that enables in-depth assessment as well as targeted development of local structures and capacities. Our experience shows that the method can be implemented well in Community Readiness assessment. The main advantages of this approach are its systematic nature and the analysis of local strengths and weaknesses as a prerequisite for community-specific interventions.

Urban American Indian Community Health Beliefs Associated with Addressing Cancer in the Northern Plains Region.

American Indians residing in the Northern Plains region of the Indian Health Service experience some of the most severe cancer-related health disparities. We investigated ways in which the community climate among an American Indian population in an urban community in the Northern Plains region influences community readiness to address cancer. A Community Readiness Assessment, following the Community Readiness Model, conducted semi-structured interviews with eight educators, eight students, and eight community leaders from the American Indian community in Omaha's urban American Indian population and established the Northern Plains region community at a low level of readiness to address cancer. This study reports on a subsequent qualitative study that analyzed all 24 interview transcriptions for emergent themes to help understand the prevailing attitude of the community toward cancer. A synthesis of six emergent themes revealed that the community's perceptions of high levels of severity and barriers, paired with perceptions of low levels of susceptibility and benefits, lead to low levels of self-efficacy, all of which are reflected in minimal cues to action and little effort to address cancer. These findings, interpreted through the lens of the Health Belief Model, can inform the development of more community-based, comprehensive, and culturally appropriate approaches to address the multilevel determinants of health behaviors in relation to cancer among American Indians in the Northern Plains region.