Assessing Community Readiness for Prevention
Available from: Paula Louise Griffiths
- "The community’s knowledge of the issue within the Charnwood Borough might also be increased if the evaluations of local initiatives were publicised more [14,17]. For example, if community members know that those attending initiatives found them to be enjoyable, others may also be encouraged to participate. "
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ABSTRACT: Childhood overweight and obesity is a global public health concern. For girls in particular, being overweight or obese during pre-adolescence (aged 7-11 years) has intergenerational implications for both the mother and her future offspring. In the United Kingdom (UK) there is increasing interest in community targeted interventions but less is known about how to tailor these approaches to the needs of the community. This study applied the Community Readiness Model (CRM), for the first time in the UK, to demonstrate its applicability in designing tailored interventions.
Community readiness assessment was conducted using semi-structured key informant interviews. The community's key informants were identified through focus groups with pre-adolescent girls. The interviews addressed the community's efforts; community knowledge of the efforts; leadership; community climate; community knowledge of the issue and resources available to support the issue. Interviews were conducted until the point of theoretical saturation and questions were asked separately regarding physical activity (PA) and healthy eating and drinking (HED) behaviours. The interviews were transcribed verbatim and were firstly analysed thematically and then scored using the assessment guidelines produced by the CRM authors.
Readiness in this community was higher for PA than for HED behaviours. The lowest scores related to the community's'resources' and the'community knowledge of the issue'; affirming these two issues as the most appropriate initial targets for intervention. In terms of resources, there is also a need for resources to support the development of HED efforts beyond the school. Investment in greater physical education training for primary school teachers was also identified as an intervention priority. To address the community's knowledge of the issue', raising the awareness of the prevalence of pre-adolescent girls' health behaviours is a priority at the local community level. Inconsistent school approaches contributed to tensions between schools and parents regarding school food policies.
This study has identified the readiness level within a UK community to address the behaviours related to overweight and obesity prevention in pre-adolescent girls. The focus of an intervention in this community should initially be resources and raising awareness of the issue within the community.
BMC Public Health 12/2013; 13(1):1205. DOI:10.1186/1471-2458-13-1205 · 2.26 Impact Factor
Available from: Lynne Millar
- "High levels of inter-rated reliability between scorers had been reported by the developers (92%) however consistency among respondents was not necessarily expected as each has a unique perspective of the situation. The interviews were scored using descriptive statements on anchored scales (Oetting et al., 1995) and awarded a final RTC score (Plested et al., 2006). This final score corresponded to one of the nine stages of community readiness (Table 1). "
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Community capacity building is a promising approach in reducing childhood obesity. The objective was to determine changes in capacity over a 3 year intervention (2005-2008) in schools and whether greater increases in capacity were associated with greater decreases in overweight/obesity.
"It's your Move!" (IYM) was an obesity prevention project, in 12 Australian secondary schools (5 intervention; 7 comparison), that aimed to increase community capacity to promote healthy eating and physical activity. Capacity was assessed pre/post intervention using the 'Community Readiness to Change (RTC)' tool. Comparisons from baseline to follow-up were tested using Wilcoxon Signed-Ranks and results plotted against changes (Newcombe's paired differences) in prevalence of overweight/obesity (WHO standards).
RTC increased in intervention schools (p=0.04) over time but not for comparison schools (p=0.50). The intervention group improved on 5 of 6 dimensions and the three intervention schools that increased three levels on the RTC scale each had significant reductions in overweight/obesity prevalence.
There were marked increases in capacity in the intervention schools and those with greater increases had greater decreases in the prevalence of overweight/obesity. Community-based obesity prevention efforts should specifically target increasing community capacity as a proximal indicator of success.
Preventive Medicine 02/2013; 56(6). DOI:10.1016/j.ypmed.2013.02.020 · 3.09 Impact Factor
Available from: Tracy Schroepfer
- "The CRA development team chose Prochaska, DiClemente, and Norcross's (1992) concept of an individual's psychological readiness to address addiction behaviors and the stages for doing so. Recognizing that a community's stages of readiness were likely more complex than that for individuals, the team built on these stages using two processes from the community development research and literature: the innovation decision-making process and social action (Oetting et al., 1995). The first process, innovation of decision making, explains the five stages individuals go through when undertaking new practices, and the second process, social action, looks at the stages groups go through in doing so. "
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ABSTRACT: The Community Readiness Model is an innovative and widely embraced approach to determining a community's stage of readiness to address a particular community issue and match that stage with an appropriate intervention. The current study used this approach in five communities experiencing cancer health disparities. In each community, leaders were interviewed and their qualitative data scored to determine the community's stage of readiness. Two methods of triangulation, investigator and interdisciplinary, were used to increase the scoring process's rigor. In order to gain a deeper understanding of the consensus portion of the scoring process, these meetings were content analyzed. The results have important implications for scoring team composition, provide insight into consensus reaching strategies, and offer recommendations for addressing potential challenges.
Journal of Community Practice 07/2009; 17(3-3):269-290. DOI:10.1080/10705420903118385
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