Measuring Community Readiness for Implementing Preventive Interventions in Colombia and Chile

Introduction

The increasing use of evidence-based preventive interventions in Latin America has produced a concomitant need for implementation systems to deliver these interventions with fidelity and sustainability. A key challenge to this need is measuring the readiness of these communities to develop science-based approaches to intervention implementation. This study examined measures of community readiness as a multidimensional construct measured by several indicators of local prevention coalition functioning and the broader prevention system environment. Accurate assessment of community readiness will allow for targeting issues to better prepare communities for prevention initiatives and ultimately ensure high-fidelity implementation of evidence-based preventive interventions.

Method

This study assessed measures of community readiness from three sources: two waves of data from 9 communities (5 in 2013 and 4 in 2016) in Colombia and one wave of data (2015) from 4 communities in Chile. All communities in this study were preparing to install adaptations of the Communities That Care (CTC) prevention system (called Comunidades Que Se Cuidan) at time of data collection. Measures of community readiness were adapted from the CTC Coalition Board Interview and the CTC Community Key Informant Survey, and translated into Spanish by study investigators. Respondents (ns = 50, 65, and 61, respectively) consisted of key informants from a variety of community sectors (e.g., civic, educational, and law enforcement), all of whom were in positions of leadership (e.g., mayors, police chiefs, principals) or had specialized knowledge of prevention-related activities in their respective communities.

Results

A total of 18 constructs were assessed across the three sources of data. In general, measures of community readiness demonstrated acceptable levels of internal consistency. For example, coefficient alphas were >.70 for Norms Against Drug Use, Leader Efficacy, and Community Organization. However, a few measures (e.g., Openess to Change, Community Support, and Organizational Conflicts) did not indicate adequate measurement, with coefficient alphas < .50. Nonetheless, examination of item-level responses for these measures proved valuable for understanding potential obstacles to community readiness (e.g., 49% of all respondents reported that the majority of people in their respective communities do not believe that adolescent prevention programs are effective). Interclass correlation coefficients (ICCs) for measures with internal consistency > .70 were generally large (i.e., > .10).

Conclusion

Results of this study demonstrate the viability of conducting quantitative assessments of community readiness for systematic implementation of evidence-based prevention programs. Although additional research is warranted to determine why some measures did not perform as expected, the majority of assessed measures showed moderate or high internal consistency, and notable variation among communities. These findings lay the foundation for empirical assessment of community readiness and provide a mechanism for identifying areas to improve readiness for implementing preventive interventions internationally.