Institute for Community Research, 2 Hartford Sq. W., Ste. 100, Hartford, CT 06106, USA and Planned Parenthood of Southern New England, 345 Whitney Ave., New Haven, CT 06511, USA.
Health Educ Res. 2013 Jun;28(3):375-91. doi: 10.1093/her/cyt051.
The most effective woman-initiated method to prevent HIV/sexually transmitted infections is the female condom (FC). Yet, FCs are often difficult to find and denigrated or ignored by community health and service providers. Evidence increasingly supports the need to develop and test theoretically driven, multilevel interventions using a community-empowerment framework to promote FCs in a sustained way. We conducted a study in a midsized northeastern US city (2009-2013) designed to create, mobilize and build capacity of a community group to develop and implement multilevel interventions to increase availability, accessibility and support for FCs in their city. The Community Action and Advocacy Board (CAAB) designed and piloted interventions concurrently targeting community, organizational and individual levels. Ethnographic observation of the CAAB training and intervention planning and pilot implementation sessions documented the process, preliminary successes, challenges and limitations of this model. The CAAB demonstrated ability to conceptualize, plan and initiate multilevel community change. However, challenges in group decision-making and limitations in members' availability or personal capacity constrained CAAB processes and intervention implementation. Lessons from this experience could inform similar efforts to mobilize, engage and build capacity of community coalitions to increase access to and support for FCs and other novel effective prevention options for at-risk women.
最有效的女性预防 HIV/性传播感染的方法是女用避孕套（FC）。然而，FC 往往难以找到，并且被社区卫生和服务提供者贬低或忽视。越来越多的证据支持需要制定和测试基于理论的、多层次的干预措施，使用社区赋权框架，以持续的方式促进 FC 的使用。我们在美国东北部的一个中等城市进行了一项研究（2009-2013 年），旨在建立、动员和增强一个社区团体的能力，以制定和实施多层次的干预措施，增加他们所在城市的 FC 供应、可及性和支持。社区行动和宣传委员会（CAAB）设计并同时试行针对社区、组织和个人层面的干预措施。对 CAAB 培训和干预规划以及试点实施会议的民族志观察记录了这一模式的过程、初步成功、挑战和局限性。CAAB 展示了概念化、规划和启动多层次社区变革的能力。然而，小组决策中的挑战以及成员可用性或个人能力的限制，限制了 CAAB 的进程和干预措施的实施。从这一经验中吸取的教训可以为动员、参与和增强社区联盟的能力提供信息，以增加高危妇女获得和支持 FC 以及其他新的有效预防选择的机会。
