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How Ready is the Community? The Importance of
Community Readiness for Sexual Violence Primary
Prevention(Part I of II)Lisa Fujie Parks,
MPH
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Opening Discussion

• 1. Using a few descriptive words, identify a
  community within which you are working to prevent
  sexual violence.

2. What form(s) of sexual violence are you
working to prevent (e.g., adult sexual assault,
child sexual abuse, young adult non-stranger
sexual violence, etc.) within this community?
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Opening Discussion, continued

• 3. Describe in a few words a prevention effort
  that has been particularly successful (e.g., peer
  education program, social marketing campaign,
  community meeting, policy change, etc.).

4. Describe in a few words a prevention effort
that was particularly unsuccessful.
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Objectives

• Understand what community readiness for
  prevention is and why it is a critical element
  of community-based primary prevention of sexual
  violence.
• Describe dimensions of readiness according to
  prominent community readiness models.
• Describe how to assess stages of readiness for
  primary prevention of sexual violence in a given
  community.

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What is Community Readiness for Prevention?
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First, What does ready mean?

• Ready (adjective)
• Prepared for action.
• Able to operate or perform.
• Readiness (noun)
• 1. The state of being willing, available, or
  ready.

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Scenario Are you ready?

• You are leaving tomorrow for a camping and
  kayaking trip with your family and friends,
  including your kids, their kids and your dog.
• So far, you have made a shopping list and brought
  out the camping gear from storage.

Polling Question
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• Community readiness is the degree to which a
  community is prepared for action to address a
  health issue (Oetting, et al, 1995).

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Community Readiness Models

• There are many community readiness models and
  tools
• Tri-Ethnic Prevention Research Center Community
  Readiness Model (http//www.triethniccenter.colost
  ate.edu/communityreadiness.shtml)
• Community Partner Institute Community Prevention
  Readiness Index (http//www.drugs.indiana.edu/spf_
  doc/CPI_Community20Prevention20Readiness20Index
  .doc)
• Goodman and Wandersman Community Key Leader
  Survey (http//captus.samhsa.gov/western/resource
  s/bp/step1/survey.cfm)

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Prevention is About Change

• Prevention is not a single event, like a camping
  trip.
• Prevention is fundamentally about change at the
  individual, family, community and societal
  levels.
• Change transformation, a shift from one state
  or set of conditions to another state or set of
  conditions
• How does change at these various levels occur?
• Over time
• Developmentally
• In complex and dynamic ways

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• Community readiness for prevention is
  about readiness to undergo complex and dynamic
  transformation over time to shift from one state
  or set of conditions to another state or set
  of conditions

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Related Theory Transtheoretical Model (Stages
of Change)

• Emerged from a comparative analysis of leading
  theories of psychotherapy and behavior change.
• Change implies phenomena occurring over time
  (small changes take a short amount of time,
  bigger changes take a longer amount of time).
• Rather than viewing change as a finite event, TM
  construes change as a process involving progress
  through five stages (Prochaska, Colleen and
  Evers in Glanz et al, 2002).

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Related Theory Transtheoretical Model (Stages
of Change)

• Five stages 1) pre-contemplation, 2)
  contemplation, 3) preparation, 4) action and 5)
  maintenance.

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How is Community Readiness related to Community
Development?
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Community Development

• a broad term applied to practices and academic
  disciplines to improve various aspects of local
  communities.
• Seeks to empower individuals and groups by
  providing the skills they need to effect change
  in their own communities to impact the
  underlying causes of sexual violence
• Rooted in a commitment to community specificity
  and community ownership

(Guy, 2007)
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Community Development

• Community development is by definition a process.
  Healthy communities, just like healthy
  individuals, are always in the process of
  learning and growing.

(Guy, 2007)
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Community Assessment Phase
Plan Development Phase
Community Readiness Assessment
B The New Reality What we want to happen. The
vision, goal, outcome!
A The Current Reality Whats happening now? The
status quo.
Community Development Plan
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Community Development Contribution Innovation
Decision-Making Process

• Stages for the innovation decision-making process
  include (Rogers, 1983)
• knowledge (first awareness of an innovation),
• persuasion (changing attitudes),
• decision (adopting the idea),
• implementation (trying it out), and
• confirmation (where it is used again or
  discontinued after initial trial).

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Community Development Contribution Social Action
Approach

• The social action approach focuses on group
  processes and stages involved with social action
  (Warren, 1978)
• stimulation of interest (recognition of need),
• initiation (development of problem definition and
  alternative solutions among community members who
  first propose new programs),
• legitimization (where local leaders accept the
  need for action),
• decision to act (developing specific plans which
  involve a wider set of community members), and,
• action (or implementation).

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Why is Community Readiness Critical to
Community-Based Primary Prevention of Sexual
Violence?
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What do these scenarios have in common?
Sexual violence prevention councils training
offer rejected Sexual violence not a problem
here, says API mental health agency
RCC initiates a Adolescent SV Prevention Council
and faces sharp resistance. Faith-leaders say,
Message conflicts with abstinence-only.
Grassroots group organizes forum to develop
community prevention strategies and few people
show. Invitees say Thanks for your great work.
We are focused on other issues.
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Why Assess Community Readiness?

• Often, change strategies are implemented in a
  community that isnt ready for such strategies,
  leading to failed efforts
• Examples?

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Discussion Question Why Assess Community
Readiness?

• By gauging the readiness of a community for
  change
• Strategies that fit the communitys current stage
  can be implemented
• Efforts can be made to increase readiness

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The Community Must Be Ready

• The community must be ready, was the conclusion
  that had the most support in a comprehensive
  review of the literature on community based
  prevention (Stith, et. al., 2006).
• Matching prevention efforts to a communitys
  level of readiness is essential for success.
• Interventions must be challenging enough to move
  a community forward in its level of readiness.
  However, efforts that are too ambitious are
  likely to fail because community members will not
  be ready or able to respond (Plested, et al
  2005).

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• In order to stand a chance of success,
  interventions introduced in a community must be
  consistent with the awareness of the problem and
  the level of readiness for change present among
  residents of that community and most important,
  the culture of the community.
• (Jumper-Thurman and Plested, 2000)

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• In conjunction with initiating prevention
  activities, community readiness for engaging in
  prevention must be addressed and strengthened so
  that rape prevention programs can build
  coalitions and mobilize the community and state
  for prevention.

(CDC, 2007)
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Ready for What?

• Community readiness models emphasize that
  initiatives should be designed to be responsive
  to the communitys level of readiness (i.e.,
  Ready for what? not Ready or not.

HIGH Readiness
MEDIUM

• Awareness in a climate of community
  responsibility
• Active engagement of multiple stakeholders

Awareness in a climate of, Its not my
responsibility.
LOW
Climate of denial What problem?
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What are the Dimensions of Readiness?
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Discussion Question

• Imagine a community thats at a high level of
  readiness for sexual violence primary prevention
  
• What about the community makes it so ready?
• What are the elements or strengths that are in
  place that aid in its readiness?

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Dimensions of Readiness

• Key factors influence a communitys readiness to
  take action. The six dimensions from the
  Tri-Ethnic Prevention Research Center are
• Community Efforts To what extent are there
  efforts, programs, and policies that address the
  issue?
• Community Knowledge of the Efforts To what
  extent do community members know about local
  efforts and their effectiveness, and are the
  efforts accessible to all segments of the
  community?

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Dimensions of Readiness

• Leadership To what extent are appointed leaders
  and influential community members supportive of
  the issue?
• Community Climate What is the prevailing
  attitude of the community toward the issue? Is
  it one of helplessness or one of responsibility
  and empowerment?

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Dimensions of Readiness

• Community Knowledge about the Issue To what
  extent do community members know about the causes
  of the problem, consequences, and how it impacts
  your community?
• Resources Related to the Issue To what extent
  are local resources people, time, money, space,
  etc. available to support efforts?

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Additional Dimensions to Consider

• Scan of literature on community readiness,
  community-based primary prevention and community
  assessment.
• Interviews 12 from researchers and practitioners
  experienced with primary prevention of sexual
  violence.
• Review and comparison of 6 community assessment
  models.
• Input from 2 researchers experienced with
  designing and implementing partnership-oriented
  demonstration projects.

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Potential to bring together a strong,
community-level-action-oriented coalition

• The success of a community SV prevention effort
  depends on a strong coalition, advisory group or
  network of diverse leaders who possess
  problem-solving skills and community influence
  and are able to take action.

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Community Cohesion

• Community cohesion allows for the recognition and
  coalescence of common values and goals for the
  community.
• A cohesive community is one where, there is a
  common vision and a sense of belonging the
  diversity of peoples backgrounds and
  circumstances is positively valued and strong
  and positive relationships are developed in the
  workplace, in schools and within neighborhoods.

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How Do You Assess Stages of Community Readiness?
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Community Readiness Assessment Steps

• Identify the issue
• Define the community
• Conduct a readiness assessment (key informant
  interviews, focus groups, surveys, community
  mapping, etc.) where you gather information to
  about the dimensions of readiness
• Score and analyze assessment findings
• -- THEN --
• Develop change strategies based on level of
  readiness

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Overall Level of Readiness

• Analyze dimension in relationship to each other
  to identify linked issues and themes.
• Draw conclusions about whether the community has
  a relative strength or weakness within each
  factor.
• Some factors will be stronger than others. The
  level of the weakest factor determines the
  communitys overall level of readiness. This
  factor needs to be strengthened before the
  community moves the next level of readiness.

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Stages of Readiness

• No awareness
• Denial/resistance
• Vague awareness
• Pre-planning
• Preparation
• Initiation
• Stabilization
• Confirmation/expansion
• High level of community ownership

1-3 Low level of readiness
4-6 Mid level of readiness
7-9 High level of readiness
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Stages of Readiness

• There are other scoring methods
• Methods of scoring and ranking levels of
  readiness can be developed or adapted
• Whats most important is for you to be thoughtful
  about what you are doing, draw on existing
  research and have (and document!) a solid
  rationale for your choices.

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Stage-Appropriate Interventions

• Stith and colleagues recommend that if the
  community determines they are not at least at the
  stage of preplanning, strategies to improve
  community readiness should be implemented before
  beginning a specific prevention program (Stith,
  et al, 2007).

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Design Stage-Appropriate Strategies

• Sexual abuse prevention council conducts a
  community readiness assessment for primary
  prevention of sexual violence with API mental
  health agency.
• The assessment reveals that the communitys (as
  defined as the agency) stage of readiness is 1.
  No Awareness.
• The council conducts research on prevalence of
  sexual violence in API communities and requests
  to have a meeting with key leaders in the
  organization.

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Design Stage-Appropriate Strategies

• The council presents the data.
• The initial meetings and the subsequent meeting
  process peaks the agencys interest.
• The two agencies partner to design a
  community-specific survey to learn more about the
  extent and dynamics of the problem in the
  community.
• These initial efforts lay the foundation for the
  development of an agency-specific action plan and
  a long-lasting partnership.

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Application to Sexual Violence Prevention

• We are experimenting and building this practice
  together.
• Be innovative! Document and share lessons learned
  to make a valuable contribution to the field of
  SV prevention.

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• The SV prevention field is still in the early
  stages of developing and fully researching
  effective models, particularly for primary
  prevention of sexual violence in communities.

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Next Week

• Learning objectives
• Explore dimensions of readiness within
  participants communities.
• Explore opportunities to infuse an understanding
  of community readiness into a community-based
  sexual violence primary prevention initiative.
• Explore strategies for strengthening dimensions
  of readiness to improve community capacity for
  engaging in sexual violence primary prevention.

Polling Question
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Please Think About

• Review the dimensions of readiness Do they make
  sense?
• To what extent are the dimensions of readiness
  present in your community? How do you know?
• Identify examples of challenges and successes
  from your work where analysis of a specific
  dimension or overall readiness might be (or have
  been) helpful
• And please email thoughts, musings, questions,
  etc. to lisafujieparks_at_gmail.com or call
  510-967-0369.

Polling Question
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Lisa Fujie Parks, MPHlisafujieparks_at_gmail.com510
-967-0369
Thank you!