Paediatrics (RCH) - Theses
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ItemMeasurement of 'community readiness' for the prevention of adolescent substance abuse: a pilot study in four Australian regional communities( 2009)Health promotion and public health research increasingly recognise that a range of community organisation and attitudinal factors are important to a community’s level of readiness, or capacity, to undertake effective prevention activity required to reduce population rates of adolescent substance abuse. Although the importance of tailoring community capacity building to readiness levels is acknowledged, little research has been done to date, to develop a systematic framework for measuring readiness in Australia. Equally in Australia where national and state government drive public health drug policy and programme development, their interaction and support of community level interventions and efforts has not been widely examined. This methodological study of 100 telephone interviews with 60 community practitioners (15 in each community) was conducted to identify and assess the specific attitudinal, systemic and resource characteristics of four regional communities in order to extend their capacity or readiness to address adolescent substance abuse within their community. The study provided the opportunity to assess the feasibility, reliability and validity and utility of two North American questionnaires that had been developed to provide quantitative measurement of community readiness. Additional questions were included to try and gauge to what extent state government engaged with, and responded to, the four regional communities in the planning and initiation of prevention activity. Examination of this domain would also contribute to the understanding of state and community engagement with community empowerment. Each of the readiness questionnaires appeared comprehensible within the Australian context, requiring only minor modifications to wording and format to obtain reliable responses from community practitioners. Community readiness ratings for the four communities were consistent across the two instruments with each questionnaire assessing some overlapping and some distinct domains. The comparison of results from the two community readiness survey instruments suggested some advantages for the TECPR instrument in its slightly higher face validity to key informants and its ability to significantly discriminate the total readiness scores for the four communities. Analysis revealed some associations between the two readiness assessment methods; supporting the view that they were assessing some common underlying dimensions but also that they each provided some unique information. Analysis of the additional questions related to community empowerment suggested that the two assessment methods each contributed unique information in predicting local perceptions of community empowerment. It is concluded that each questionnaire has the potential to elicit detailed and reliable data concerning community-readiness, which can be quantitatively analysed; and is not unduly time-consuming or burdensome to the researcher or the respondents. One of the questionnaires holds particular merit for communities where research expertise in not available. Measurement of community readiness appears feasible in the Australian context opening opportunities for improved planning and evaluating of community development initiatives aimed at preventing adolescent substance abuse.