Readiness for Community-based Bicycle Helmet Use Programs: A Study Using Community-and Individual-level Readiness Models
Understanding community context is as important to develop effective community-based injury prevention programs as assessing attitudes and behaviors among individuals. Readiness of a community toward community efforts to promote bicycle helmet use and of individuals to use bicycle helmets were examined in a northern Colorado town in the United States, using a semi-qualitative approach. Community readiness and individual readiness to prevent injuries through use of bicycle helmets differed across groups. The findings provide a better understanding of interactions between community perceptions and individual attitudes and behaviors. Further, target groups for improving bicycle helmet use were identified.
[Show abstract] [Hide abstract] ABSTRACT: Background: A systematic review characterised and synthesised applications of the Community Readiness Tool (CRT) and synthesised quantitative results for readiness applications at multiple time points. Methods: Eleven databases in OvidSP and EBSCHOhost were searched to retrieve CRT applications. Information from primary studies was extracted independently by two researchers. Results: Forty applications of the CRT met inclusion criteria focussing on 14 different health and social issues. The community of interest was most often defined solely on the basis of its geographical location (52.5%). Most studies used the CRT to plan (85%) and/or evaluate programs (40%). The CRT protocol was modified in 40% of studies. Six applications evaluated readiness at multiple time points, however limited reporting in primary studies precluded any synthesis of results. Applications identified methodological rigour, contextual information and community engagement as strengths, and time and resource costs as limitations. Conclusions: The CRT is well suited for planning and evaluating complex community health interventions given its flexibility to accommodate diverse definitions of community and issues. CRT applications would benefit from improved reporting; reporting recommendations for use of the CRT are outlined.0Comments 1Citation
- "It was less common to find applications of non-geographic communities brought together by a shared interest. Where shared interests were utilised, they included sexual orientation , cycling , or use of a community health centre . As illustrated inTable 1, the CRT was applied to a broad range of issues highly relevant to public health. "
[Show abstract] [Hide abstract] ABSTRACT: To build on a growing interest in community-based obesity prevention programs, methods are needed for matching intervention strategies to local needs and assets. We used the Community Readiness Model (CRM), a structured interview guide and scoring system, to assess community readiness to act on childhood obesity prevention, furthering a replication study of a successful intervention. Using the CRM protocol, we conducted interviews with 4 stakeholders in each of 10 communities of similar size, socioeconomic status, and perceived readiness to implement a community-wide obesity prevention intervention. Communities were in California, Florida, Illinois, Massachusetts, New York, North Carolina, Pennsylvania, and Tennessee. The 4 stakeholders were the mayor or city manager, the school superintendent, the school food service director, and a community coalition representative. Interviews were recorded and professionally transcribed. Pairs of trained reviewers scored the transcriptions according to CRM protocol. The CRM assesses 9 stages of readiness for 6 dimensions: existing community efforts to prevent childhood obesity, community knowledge about the efforts, leadership, community climate, knowledge about the issue, and resources. We calculated an overall readiness score for each community from the dimension scores. Overall readiness scores ranged from 2.97 to 5.36 on the 9-point scale. The mean readiness score, 4.28 (SD, 0.68), corresponds with a "preplanning" level of readiness. Of the 6 dimensions, community climate varied the least (mean score, 3.11; SD, 0.64); leadership varied the most (mean score, 4.79; SD, 1.13). The CRM quantified a subjective concept, allowing for comparison among 10 communities. Dimension scores and qualitative data from interviews helped in the selection of 6 communities for a replication study.0Comments 14Citations
- "The CRM stages of " preplanning " and " preparation, " which roughly parallel " preparation " in the transtheoretical model, are the earliest stages in which a community would likely be able to implement the intervention within the project time frame. Public health interventions have addressed various issues using the CRM (eg, substance abuse , bike helmet use , obesity prevention [32,33]). "
- [Show abstract] [Hide abstract] ABSTRACT: Bicycle helmet use from elementary school to high school was examined using retrospective reports collected from 166 students at a university in northern Colorado. Bicycle helmet use in elementary school was a common practice, especially among students born after 1980. However, a rapid decline in bicycle helmet use in junior high school and high school was reported. Students with higher perceived norm of family bicycle helmet use wore helmets more often in junior high school and high school than students with a low family norm. Growing up in the bicycle-friendly community was positively associated with consistent bicycle helmet use.0Comments 7Citations