Increasing the use of evidence-based programs (EBPs) in community settings is critical for improving health and reducing disparities. Community-based organizations (CBOs) and faith-based organizations (FBOs) have tremendous reach and trust within underserved communities, but their impact is constrained by limited staff capacity to use EBPs. This exploratory study sought to identify design and delivery considerations that could increase the impact of capacity-building interventions for CBOs and FBOs working with underserved communities. Data come from a community-based participatory research project addressing cancer disparities in Black, Latino, and Brazilian communities from Greater Boston and Greater Lawrence, Massachusetts. We conducted four focus group discussions with program coordinators in CBOs and FBOs (n = 27) and key informant interviews with CBO and FBO leaders (n = 15). Three researchers analyzed the data using a multi-stage coding process that included both prefigured and emergent codes. Key design considerations included embedding customized capacity-building interventions into community networks with local experts, supporting ongoing engagement with the intervention via a range of resources and communication channels, and addressing resource constraints. Regarding the contextual factors that should influence capacity-building intervention content, participants highlighted resource constraints, environments in which EBP use is not the norm, and challenges linking available programs with the multi-level barriers to good health faced by community members. Overall, the study highlights the need for integrated, long-term capacity-building efforts developed in partnership with, and ultimately sustained by, local organizations.

Key considerations for designing capacity-building interventions to support evidence-based programming in underserved communities: a qualitative exploration.

The purpose of this CDC-funded project was to better understand how behavioral data were used in HIV prevention community planning, and use this knowledge to develop and evaluate tools for increasing the use of data in HIV prevention planning. HIV prevention community planning represents one of many efforts, in a variety of health and human service areas, to formulate plans and policies that are evidence-based and reflective of community input. The attention to evidence-based planning and the incorporation of community input both reflect desires for transparency and accountability in the planning and provision of services to address public needs. HIV prevention community planning represents just one example of the efforts to put these principles into action. Despite the history of other planning mechanisms which have tried to integrate grassroots input with research evidence, there are surprisingly few legacies in the literature from these efforts. Indeed, the published literature on these planning programs is very limited. While there is a huge research literature on judgment and decision making, there has been relatively little effort to integrate this with community-oriented planning efforts. This project represents a first step in this direction.

Decision making for HIV prevention planning: organizational considerations and influencing factors.

Assessments of community planning in Massachusetts and Texas were used to develop tools for increasing the use of data by HIV prevention community planning groups (CPGs) and prevention providers while also increasing participation of CPG members. Barriers to data use included organizational problems in CPGs (e.g., lack of clear procedures, distrust of peers and leadership) and technical assistance needs for CPG members and researchers who provide data. The absence of data relevant to local epidemics was another barrier. Specific linkages are provided between the assessments of these needs and the development of a technical assistance tools (e.g., websites, templates for data presentation, experiential involvement in data use) and strategies for organizational change in CPGs, as well as efforts to better use available data and create or identify new sources of local data.

/pdf/bridging-data-and-decision-making-development-of-techniques-2ullhc51s0.pdf

Bridging data and decision making: development of techniques for improving the HIV prevention community planning process.

The Texas Department of Health and University of Texas Southwestern staff, using formative assessment data, developed a set of innovative methods and tools to increase the use of behavioral and epidemiologic data in decision-making about HIV prevention interventions by HIV prevention community planning groups (CPGs) and HIV prevention providers. Semistructured interviews, mail surveys, meeting observations, and content analysis of funding proposals were used to measure the results of the multifaceted intervention. Compared to baseline measures, CPG members reported that data played a more central and desired role in their decision-making. HIV prevention providers exposed to the project’s materials were more likely to choose evidence-based interventions to conduct. The tools and structural intervention methods of this project were diffused and had an impact on the use of behavioral data by community planning groups and HIV prevention providers. The structural interventions were not sufficient without the additional effect of the trained peers acting as advocates and intervention innovators.

After the innovation: outcomes from the Texas behavioral data project.

HIV prevention community planning groups were formed to increase stakeholder participation and develop evidence-based comprehensive HIV prevention plans. To date, it is not well understood what factors affect group behavior as the planning group prepares for data-informed decision making. In this observational case study, the authors videotaped 18 meetings of a community planning group (CPG) to observe how a group's behavior changes over time in response to modifications in its structure and function. Discussions on authority and conflict were common, particularly during presentations on prioritized populations and interventions. Changes in the frequency of data-informed discussions were not statistically significant. Observed group conflict may have been an unintended consequence of efforts to improve equity. The authors suggest that formal and informal mechanisms to manage conflict and agreed-on procedures for decision making should be incorporated into the technical assistance offered to CPGs. Future s...

/pdf/longitudinal-observation-of-an-hiv-prevention-community-36v7n4272h.pdf

Longitudinal Observation of an HIV Prevention Community Planning Group (CPG)

A formative assessment was conducted with Texas HIV prevention community planning group (CPG) members, prevention provider staff, and supervisors of those staff to better understand how to enhance their use of epidemiologic and behavioral data in the selection and prioritization of prevention interventions. Semi-structured interviews, mail surveys, and content analysis of funding proposals were used to determine the current use of these data, their perceived value, and the most trusted sources for data. CPG members, prevention provider staff, and supervisors valued information from their peers and networking most, and made more use of socially available information than they did research or systematically collected assessment data. CPG members wanted more local data and data on specific sub-populations of interest. Prevention providers viewed the utility of behavioral data as limited, and were primarily concerned with the pragmatic aspects of fielding interventions; however, this group also expressed an interest in rapid community assessment methods and learning more about new and effective prevention interventions. These results led to the development of training and technical assistance materials.

Formative assessment of use of behavioral data in HIV prevention: Texas.

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Formative assessment of use of behavioral data in HIV prevention: Texas.

After the innovation: outcomes from the Texas behavioral data project.