Development, validation, and performance of a scale to measure community mobilization

Abstract

Rationale Community mobilization approaches (CMAs) are increasingly becoming key components of health programming. However, CMAs have been ill defined and poorly evaluated, largely due to the lack of measurement tools to assess mobilization processes and impact. Objective We developed the Community Mobilization Measure (CMM), composed of a set of scales to measure mobilization domains hypothesized to operate at the community-level. The six domains include: shared concerns, critical consciousness, leadership, collective action, social cohesion, and organizations and networks. We also included the domain of social control to explore synergies with the related construct of collective efficacy. Method A survey instrument was developed and pilot tested, then revised and administered to 1,181 young people, aged 18-35, in a community-based survey in rural South Africa. Item response modeling and exploratory factor analyses were conducted to assess model fit, dimensionality, reliability, and validity. Results Results indicate the seven-dimensional model, with linked domains but no higher order construct, fit the data best. Internal consistency reliability of the factors was strong, with ρ values ranging from .81 to .93. Six of seven scales were sufficiently correlated to represent linked concepts that comprise community mobilization; social control was less related to the other components. At the village level, CMM sub-scales were correlated with other metrics of village social capital and integrity, providing initial evidence of higher-level validity, however additional evaluation of the measure at the community-level is needed. Conclusion This is the first effort to develop and validate a comprehensive measure for community mobilization. The CMM was designed as an evaluation tool for health programming and should facilitate a more nuanced understanding of mechanisms of change associated with CM, ultimately making mobilizing approaches more effective.

Synergies, strengths and challenges: findings on community capability from a systematic health systems research literature review

“…Although the development of scales measuring community capability through numerous elements continues to evolve [4, 9, 92–94], health systems research engaged with community participation remains relatively untouched by these developments. Our review found the extent of information related to community capability reported by health systems research articles with rich accounts of community participation to be very low and often of poor quality.…”

What is the role of community capabilities for maternal health? An exploration of community capabilities as determinants to institutional deliveries in Bangladesh, India, and Uganda

“…While illustrative of the potential applicability of such community empowerment indices, the CCI does not address capabilities as they relate to health [17]. Lippman and colleagues recently developed an instrument to assess community mobilization in the context of HIV programming [18] that includes 7 domains. In Zambia, Underwood and colleagues measured and validated community capacity through 6 community-generated domains, to assess the roles of these domains in the context of health communication interventions focused on developing community capacity [19].…”

Community Mobilization for HIV Testing Uptake: Results From a Community Randomized Trial of a Theory-Based Intervention in Rural South Africa

“…11 This gap is partially due to poor attention to theoretical conceptualization and is also the result of a lack of validated measures of CM processes. 40 Using our validated CM measure 32 we were able to empirically test changes in reported community mobilization. Mean mobilization measures did not go up significantly over time in the intervention villages as was expected; this could represent a secular trend towards more disenfranchisement and growing disillusionment in the area (note that scores often dropped more excessively in the control than in the intervention villages), or simply a lack of power to detect effects with an n = 22.…”

“…Although the other domains, such as leadership, were not associated with HIV testing in this short intervention, this was also more difficult to cultivate in a short time frame. 10,32 …”

“…The mobilization measure (CMM), previously described and validated, 32 was used to quantify the 6 domains of mobilization and a combined or total CM score for every participant using standardized raw scores. Additionally, we aggregated individual responses on the survey into mean village mobilization scores for each community at baseline and endline.…”