A rural community moves closer to sustainable obesity prevention - an exploration of community readiness pre and post a community-based participatory intervention

Abstract

BackgroundUnderstanding levels of community readiness can result in prevention efforts that align with communities’ ability and capacity for change and, therefore, be more effective and sustainable. Our study aimed to use baseline (pre-intervention) community readiness scores to assist with the development of obesity prevention strategies, and to assess changes in community readiness over time (pre/post- intervention), to provide evidence of intervention impact.MethodOur study was located in a rural and remote area of Victoria, Australia. Community readiness was part of a broader obesity prevention intervention designed to create healthier food and physical activity environments through the combination of systems thinking and collaborative community-led solutions. Interviews were conducted using the community readiness to change tool in 2016 (pre) and 2018 (post) with a community representative sample. Baseline data informed the development of community relevant strategies and the pre/post results formed part of the overall evaluation.ResultsThe tool generated both quantitative and qualitative (quotes) data. A final readiness score was calculated that corresponded to one of the nine stages of readiness. Four of the five domains of the community readiness to change tool showed statistically significant improvements over time (p < 0.05): knowledge of effort, knowledge of issue, community climate, and leadership. The resources domain that did not improve pre/post intervention.ConclusionCommunity readiness to change interviews, pre- and post- intervention, provided essential information related to the appropriate targeting and pitch of the prevention strategies, as well as providing an overall evaluation of the positive movement in the community’s readiness to implement change.

How Many Key Informants Are Enough? Analysing the Validity of the Community Readiness Assessment

“…The authors reported that the number of interviews per community varied between one and 33 (mean = 7.3, SD = 5.9, median = 6, six studies provided no information on the number of interviews per community), with 15% of studies using less than the recommended four interviews per community. This is in line with studies published since 2013 that followed the recommendations of the CR handbook and conducted an average of four to eight interviews per community (e.g., in [15][16][17][18][19]). However, Kesten et al.…”

How many key informants are enough? Analysing the validity of the community readiness assessment

“…The authors reported that the number of interviews per community varied between one and 33 (mean = 7.3, SD = 5.9, median = 6, six studies provided no information on the number of interviews per community), with 15% of studies using less than the recommended four interviews per community. This is in line with studies published since 2013 that followed the recommendations of the CR handbook and conducted an average of four to eight interviews per community (e.g., in [ 15 – 19 ]). However, Kesten et al [ 20 ] used the concept of theoretical saturation (i.e., no new concepts are expected by conducting more interviews) to determine the necessary number of interviews for assessing CR for overweight and obesity prevention in pre-adolescent girls.…”

The Action Plan and Strategy Development for the Community Readiness Improvement for Tackling Childhood Obesity (CRITCO) Study

“…Therefore, applying dimension-specific strategies is the key to success and ensuring any prevention program (7,9). Although some cross-sectional studies indicated the feasibility of CRM to assess community readiness in the field of CO (16)(17)(18)(19)(20)(21)(22)(23)(24), available evidence regarding applying the readiness level data to explore tailored interventions for addressing CO is limited. In this regard, SaludABLEOmaha's study in 2011 -2013 used CRM as an initiative approach to increase the readiness of American residents in the Midwestern Latino community to address adolescent obesity (21).…”

“…In this regard, SaludABLEOmaha's study in 2011 -2013 used CRM as an initiative approach to increase the readiness of American residents in the Midwestern Latino community to address adolescent obesity (21). Also, two more studies in the US and Australia entitled "childhood obesity prevention program" (COPP) and "It is Your Move" (IYM) used the readiness level data to access changes in community readiness (22,24).…”