The Community Readiness Model

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Native American, Alaska Native, Native
Hawaiians Using Community Readiness to Advance
HIV/AIDS Prevention
Advancing HIV/AIDS Prevention in Native
Communities (HAPP)
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Our target audience

• CDC funded Community Based Native Organizations
• State Health Boards
• Native Health Boards
• Indian Health Service Regional Offices
• And other organizations or tribes serving Native
  communities

We offer our Capacity Building Assistance to
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What HAPP offers on this project
Our first goal is to increase the capacity of an
organization or community to implement HIV/AIDS
prevention by offering

• Community Readiness Assessment
• Provision of a Readiness Diagnostic
• Readiness Workshop
• Community Readiness Action Plan
• Social Marketing Strategies
• Follow Up with Technical Support

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Our second goal is to utilize those tools to
strengthen community capacity for raising
awareness about early detection/testing for
HIV/AIDS

• Assist with development of culturally specific
  and community specific Social Marketing
  Strategies
• Assist with linking and networking to resources
• Follow Up with Technical Support

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Mobilizing the Community
The Community Readiness Model (Plested, Thurman,
Edwards and Oetting) Colorado State University
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The purpose of community readiness is to provide
communities with the stages of readiness for
development of appropriate strategies that are
more successful and cost effective
Purpose of Community Readiness
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What exactly IS theCommunity Readiness Model
(CRM)

• A model for community mobilization and change
• It has nine stages of readiness
• It measures six dimensions (or aspects) of a
  community
• Each dimension has a stage of readiness
  associated with it
• Each readiness stage has specific interventions
  that work most effectively for that stage
• Integrates culture into the prevention process
• Trying to implement something when a community is
  not
• ready to do can be costly in both human and
  financial
• resources, i.e., a waste of time and money

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Why Use Community Readiness?

• Mobilizes a community into action while building
  community ownership
• Utilizes existing resources, de-emphasizes
  reliance on money as THE answer
• Provides a tool for evaluation of efforts
• Requires no outside experts YOU are the
  expert for your community/organization!
• Creates a community vision which translates into
  a higher degree of sustainability
• Provides the structure for culturally-appropriate
  strategies

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Why is it important to integrate culture into
prevention and intervention?

• Culture . . .
• determines how we interpret issues that concern
  us, or symptoms that affect us or our community
• determines how we seek care and support
• determines how we communicate our concerns to
  others
• determines how we react to and respond to
  education and intervention
• should also influence how prevention or
  intervention is delivered

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• Dimensions of
• Community Readiness

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Dimensions Of Community Readiness

• A. Community Efforts (Programs, activities,
  policies, etc.)
• B. Community Knowledge of the Efforts
• C. Leadership (includes appointed leaders and
  influential community members)
• D. Community Climate
• E. Community Knowledge About the Issue
• F. Resources for Prevention Efforts (people,
  time, money, space, etc.)

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• Stages of
• Community Readiness

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(No Transcript)
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1 - No Awareness

• Issue is not generally recognized by the
  community as a concern
• Its just the way things are!
• Issue may be overlooked or ignored
• Behavior may be expected of one group and not
  another

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2 - Denial / Resistance

• Some recognition by some community members
  that the behavior is a concern
• Little or no recognition locally
• Feeling that nothing needs to be done locally
• Its not our concern!
• We cant do anything about it!

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3 - Vague Awareness

• General feeling by at least some in the
  community that there is a local concern and that
  something should be done about it
• No immediate motivation
• No identifiable leadership
• Community climate does not motivate action
• Issue and causes are stereotyped

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4 - Preplanning

• Clear recognition by some in the community that
  it is a local problem and something
  should be done about it
• Identifiable leadership, but efforts are not
  focused or detailed
• Discussion, but no real planning
• Climate is beginning to acknowledge the necessity
  of addressing the problem

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5 - Preparation

• Planning is going on and focuses on details
• General information about local problems and pros
  and cons of efforts
• Leadership is active and energetic
• Resources (people, money, time, etc.) are
  actively being sought
• Community climate offers modest support

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6 - Initiation

• Information is available to justify the efforts
• Activity and action is underway, but still viewed
  as a new effort
• Staff are being trained
• Great enthusiasm in leaders, as limitations and
  issues have yet to be met
• Improved attitude in community members is
  reflected by continued modest support

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7 - Stabilization

• One or two efforts are running, supported by
  administrators/community decision-makers
• Programs and activities are viewed as stable
• Staff are trained and experienced
• No in-depth evaluation of effectiveness as yet
• Climate supports activities

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8 - Confirmation / Expansion

• Standard efforts are now in place and leadership
  supports expanding and improving services
• Efforts are being evaluated and modified
• New efforts are being developed, resources are
  being sought to serve more groups
• Climate may challenge specific efforts, due to
  increased knowledge, but remains supportive

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9 High Level Of Community Ownership

• Detailed and sophisticated knowledge of
  prevalence, risk factors, and causes exist
• Efforts target general populations with programs
  serving specific risk factor and/or high
  risk groups
• Staff are highly trained and cross trained
• Leadership and community involvement is high
• Evaluation to modify programs and policies
• Community holds efforts accountable to needs

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Remember!!A Communitys Readiness is based on
the Communitys truth

• Communitys Truth vs The Reality
• Perception is reality
• Sometimes the two truths are different
• Community Readiness scores are based on the
  communitys truth example leadership

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Process For Using The Community Readiness Model
Identify Issue
Define Community
Conduct Key Respondents Interviews
Score to Determine Readiness Level
Develop Strategies/Conduct Workshops
Community Change!
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Each Dimension Receives A Community Readiness
Stage Score
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Example of a Community Diagnostic

• Dimension A Efforts
• 6 Initiation
• Dimension B Knowledge of efforts
• 4 Preplanning
• Dimension C Leadership
• 3 Vague Awareness

• Dimension D Climate
• 3 Vague Awareness
• Dimension E Knowledge of issue
• 2 Denial
• Dimension F Resource
• 5 Preparation

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Each Community Readiness Score has Strategies
that are most effective at that level
Following are some examples Of the types of
activities that Communities have told us
are Most effective at those stages
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1 - No Awareness
Goal Raise awareness of HIV/AIDS
Strategies

• Identify potential supporters
• Visit with them, one on one
• Present at existing and established small groups
• Use the Indian Grapevine
• Search for online resources (posters, educational
  information) that can be duplicated or ordered
• Phone calls to friends - inform others, get them
  excited and solicit their support be
  creative!

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2 - Denial / Resistance
Goal The issue does exists in this community
Strategies

• Continue strategies from previous stage
• Meet with people who are likely to provide
  HIV/AIDS services (medical, substance abuse, etc)
• Distribute flyers, brochures, educational info
  (information must be brief and concise)
• Put information in church bulletins, tribal
  newsletters, etc. Choose places where they are
  likely to be seen
• Remember that media must be low intensity but
  visible

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3 - Vague Awareness
Goal Community can make positive changes
Strategies

• Continue strategies from previous stage
• Attend/have booth at special events potlucks,
  dances, health fairs, tribal holidays etc.
  where you can distribute your information
• Identify all potential local data sources,
  programs and efforts
• Focus on topics that the community may be more
  ready to address that relate to HIV infection
  underage drinking, meth use, STDs or substance
  use
• Publish newspaper editorials/articles and
  creative media consistent with community
  visibility - things that might be read

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4 - Preplanning
Goal Develop concrete strategies

• Establish a working group focused on HIV/AIDS
  prevention
• Share local data and information that you have
  gathered with key people who might support
  your cause
• Use media for newspaper articles/posters
• Conduct informal surveys about what people know
  about HIV/AIDS resources and needs
• Identify Best Practices, effective curricula,
  DEBIs, and other programs which may be
  appropriate for Native audiences

Strategies
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5 - Preparation

• Remember to always continue strategies from
  previous stage
• Organize and present local statistics, local
  efforts, and survey information to the community
  through tribal newsletter, local newspaper,
  radio, cable television, dinners, etc. (Compile
  the facts local statistics,  local stories,
  emotional cost to the community, consequences to
  the community, future impact on the community,
  financial cost to the community)
• Begin searching for potential funding for
  prevention and resources for HIV testing through
  tribe, state, federal, foundations, etc.)
• HIV/AIDS basic information can be presented to
  tribal councils, department staff, county work -
  NETWORK

Goal Gather pertinent information
Strategies
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6 - Initiation
Goal Provide community specific information

• If local data sources are non-existent or
  unreliable, plan how to begin accurate local
  data collection
• Inform other community providers and leaders
  through multi-disciplinary meetings, tribal
  council, in-service trainings, etc. and talk
  about the progress of your efforts
• Network with existing resources to enhance your
  referral system
• Sponsor or co-sponsor larger community events
• Plan publicity efforts associated with start up
  of activity, program or efforts.
• Begin discussion about basic evaluation efforts

Strategies
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7 - Stabilization
Goal Stabilize efforts or establish programs
Strategies

• Remember again, always continue strategies from
  previous stage
• Plan community events to maintain support for
  HIV/AIDS efforts and testing
• Introduce evaluation results through multiple
  media sources
• Review efforts/activity progress on a quarterly
  basis
• Maintain business and other support for the
  effort/activity
• Increase and further develop media exposure to
  reach community, use evaluation data

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8 Confirmation And Expansion

• Formalize networking with MOCs, MOUs or other
  collaborative agreement
• Publish a localized resource directory (HIV,
  health, etc.)
• Expand community awareness through speakers
  bureaus, events, media, etc.
• Continue to maintain and report trends from data
  base
• Continue to survey and solicit public opinion
• Utilize evaluation to improve efforts and provide
  feedback to community and other professionals

Goal Expand and enhance services
Strategies
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9 - High Level Of Community Ownership

• Keep your community informed about your efforts
• Diversify funding resources, identify new sources
• Maintain and expand local business and community
  support
• Continue to track evaluation data trends for
  grant writing to expand program
• Work on related issues

Goal Maintain momentum, grow and use whats
learned
Strategies
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Ways in which the CRM has been Applied

• Drug Use
• Alcohol Use
• Intimate Partner Violence
• Child Abuse
• Head Injury
• Environmental Trauma

• Transportation Issues
• Cultural Competency
• HIV / AIDS
• Suicide
• Environmental / Weather Conditions
• Animal Control Issues..and many more

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Successes of Community Readiness

• Its been used in over 1,000 communities
  throughout the United States
• Its been used Internationally as well as
  Nationally
• The manual is being translated into both Chinese
  and Spanish
• Its been used in the context of research,
  evaluation, and grass roots efforts
• It has been the focus of over 25 published
  articles in this country and others.

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Who Can Use the Model?

• Any individual or group who wants to effect
  healthy change in a community
• concerned citizens
• professionals
• administrators
• Evaluators who need to assess progress pre and
  post
• Project Directors who want to increase the
  potential of effectiveness in their strategies
• Organizations who want to look at organizational
  or system readiness to deal with an issue

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Community Readiness Training and Technical
Assistance Team

• Barbara Plested
• bplested_at_aol.com
• Pamela Jumper Thurman
• pjthurman_at_aol.com
• Martha Burnside
• martha.burnside_at_colostate.edu
• Andrea Israel
• andrea.israel_at_colostate.edu
• Irene Vernon
• irene.vernon_at_colostate.edu

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HIV /AIDS Prevention ProjectWebsite

• www. happ.colostate.edu

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The Great Law of the Six Nations Iroquois
Confederacy

• In our every deliberation we must consider the
  impact of our decision on the next seven
  generations.