Barbara A. Plested

Community readiness: Research to practice

Communities are at many different stages of readiness for implementing programs, and this readiness is to be a major factor in determining whether a local program can be effectively implemented and supported by the community. The Community Readiness Model was developed to meet research needs, (e.g., matching treatment and control communities for an experimental intervention) as well as to provide a practical tool to help communities mobile for change. The model defines nine stages of community readiness ranging from “no awareness” of the problem to “professionalization” in the response to the problem within the community. Assessment of the stage of readiness is accomplished using key informant interviews, with questions on six different dimensions related to a communitys readiness to mobilize to address a specific issue. Based on experiences in working directly with communities, strategies for successful effort implementation have been developed for each stage of readiness. Once a community has achieved a stage of readiness where local efforts can be initiated, community teams can be trained in use of the community readiness model. These teams can then develop specific, culturally appropriate efforts that use local resources to guide the community to more advanced levels of readiness, eventually leading to long-term sustainability of local community efforts. This article presents the history of the development of the model, the stages of readiness, dimensions used to assess readiness, how readiness is assessed and strategies for change at each level of readiness.

COMMUNITY READINESS AND PREVENTION PROGRAMS

Community norms and values are important factors affecting the support of community-based development efforts. This is particularly the case when the programs are prevention efforts, including drug education programs. The purpose of this article is to describe a way to measure the readiness of a community to support drug prevention education. The readiness scale was based on the classic community development models of the social action process (Beal, 1964) and the innovation decision-making process (Rogers, 1994). Development of the scale was based on construction of 45 anchor rating statements for five dimensions of a prevention program and nine stages of community readiness. The community readiness scale was designed for use by community development practitioners working in the field of prevention, through key informants interviews with selected community leaders. Results from 45 communities indicated a bi-modal distribution of readiness levels. Implications of the results and experiences in developing ...

Readiness for Drug Use Prevention in Rural Minority Communities

An assessment of community readiness for drug use prevention in rural communities indicated that most rural communities are at relatively low stages of readiness. Minority communities were particularly low in readiness, with only 2% having functioning drug prevention programs. Rural communities at different levels of readiness require different types of programs to increase readiness, i.e., communities at the no awareness stage require analysis of the historical and cultural issues that support tolerance of drug use, those at the denial and vague awareness stages need specific information about local problems, and communities at the preplanning and preparation stages need information about effective programs, help in identifying resources, and assistance with staff training. In addition, building and maintaining effective programs requires continued evolution of readiness through the stages of initiation, stabilization, confirmation and expansion, and professionalization. Revised and updated scales and methods for assessing community readiness are provided.

COMMUNITY READINESS AND HEALTH SERVICES

Community readiness theory is a practical tool for implementing changes in community health services. The theory provides methods for assessment, diagnosis, and community change. First, community key informants are asked semi-structured questions that provide information about what is occurring in the community in relation to a specific problem. The results evaluate readiness to deal with that problem on six dimensions; existing efforts, knowledge about the problem, knowledge about alternative methods or policies, leadership, resources, and community climate. The eventual result is a diagnosis of the overall stage of community readiness. There are nine stages, tolerance or no awareness, denial, vague awareness, preplanning, preparation, initiation, institutionalization or stabilization, confirmation/expansion, and professionalization. Each stage requires different forms of interventions in order to move the community to the next stage until, eventually, initiation and maintenance of health services programs and policies can be achieved. [Translations are provided in the International Abstracts Section of this issue.]

Inhalant abuse among American Indian, Mexican American, and non-Latino white adolescents.

The abuse of volatile solvents, or inhalants, is an enduring problem among adolescents although a number of factors obscure the nature and extent of this drug using behavior. The data presented here indicate that a number of social and perceptual correlates of inhalant use operate similarly across Mexican American, American Indian and non-Latino white adolescents. Peer factors appear to dominate, although they are somewhat less important for Mexican American and Indian youth. Increased perception of harm reduces inhalant use for all groups. Of particular significance in the findings here are the continued increase of inhalant use among females compared to males and the strong pattern of decreases in inhalant use among American Indian adolescents over the last decade. A number of implications for increased effectiveness of prevention are discussed.

The Community Readiness Model: A Complementary Approach to Social Marketing

The Community Readiness Model is a theory-based model that is strategic in nature. It is designed both to assess and to build a community’s capacity to take action on social issues. It partners well with social marketing research by providing a framework for assessing the social contexts in which individual behaviour takes place and by measuring changes in readiness related to community-wide efforts. This article describes the theoretical roots of the model and describes how the model can be used as a tool for formative research, programme evaluation and as a catalyst for community mobilisation.

Community readiness: the journey to community healing.

Abstract Community readiness is a research-based theory that provides a basic understanding of the intervention process in communities. This theory allows us to accurately describe the developmental level of a community relative to a specific issue or problem. In order to move the community toward implementing and maintaining efforts that are effective and sustainable, community mobilization must be based on involvement of multiple systems and utilization of within-community resources and strengths. Successful local prevention and intervention efforts must be conceived from models that are community-specific. culturally relevant, and consistent with the level of readiness of the community to implement an intervention. The community readiness model is an innovative method for assessing the level of readiness of a community to develop and implement prevention programming. It can be used as both a research tool to assess distribution of levels of readiness across a group of communities or as a tool to guide prevention efforts at the individual level. This tool has proven useful in addressing a gamut of problems ranging from health and nutritional issues to environmental and social issues. The model identifies specific characteristics related to different levels of problem awareness and readiness for change.

A SURVEY OF ATTITUDES AMONG DRUG USER TREATMENT PROVIDERS TOWARD THE TREATMENT OF INHALANT USERS

This study assessed the attitudes of drug user treatment program directors towards the problem of inhalant “abuse.” In 2000, surveys were mailed to directors asking about treatment success and prognosis for inhalant users, level of neurological damage incurred by users, availability of treatment resources, their programs policies toward admission of users, and staff training needs for inhalant use. Two open-ended questions queried their assessment of barriers to treatment and subjective feelings about the topic of inhalant use. Five hundred and fifty responses were received. Findings show that program directors perceive a great deal of neurological damage incurred through inhalant use and have a general pessimism about treatment effectiveness and recovery. The respondents also felt that there were insufficient resources for inhalant user treatment and that special staff training in the area was needed. The majority of the directors indicated that they have or would treat inhalant users. Implications for future research and policy change are discussed.

Prevalence of American Indian Adolescent Tobacco Use: 1993–2004

Tobacco use rates for American Indian adolescents are examined and compared to rates for non-Indian youth. The data are taken from an ongoing surveillance project of substance use among Indian youth and the Monitoring the Future Project for the years 1993 to 2004. Sample sizes are in the range of 14,000 to 17,000 for non-Indian youth and 600 to 2400 for Indian youth. Tobacco use is considerably higher for Indian youth; however, these rates are following the national trends of significant reductions over the past three years. Indian youth manifested a lower perception of harm from regular tobacco use, which may, in part, account for their higher levels of use. Indian females have had slightly higher rates of lifetime and daily smoking rates than males in the past but recent trends indicate a narrowing of this gap.

Disparities in young adolescent inhalant use by rurality, gender, and ethnicity.

Inhalant use is of increasing concern as rates appear to be rising among young adolescents and gender differences narrowing. Data from 20,684 Mexican American and White non-Hispanic seventh- and eighth-grade males and females from the Western United States and 15,659 African American and White non-Hispanic seventh- and eighth-grade males and females from states in the southeastern United States collected via in-school surveys from 1996 to 2000 were analyzed using a variety of statistical techniques including multilevel modeling. Questions addressed in the study included: Does inhalant use vary by level of rurality? What effect does the ethnic composition of the community have on inhalant use and does this effect differ by an individuals ethnicity? Do males use more inhalants than females and does the level of use by males and females differ by individual ethnicity, ethnicity of the community, or level of rurality? Do males and females of different ethnicities initiate inhalant use at different ages? Limitations of the study and implications of findings for prevention are discussed and areas of future research are suggested. This study was funded by the National Institute on Drug Abuse.