Center for AIDS Prevention Studies, Department of Medicine, University of California, San Francisco, San Francisco, California, United States of America.
PLoS One. 2013 Oct 11;8(10):e78208. doi: 10.1371/journal.pone.0078208. eCollection 2013.
Community mobilizing strategies are essential to health promotion and uptake of HIV prevention. However, there has been little conceptual work conducted to establish the core components of community mobilization, which are needed to guide HIV prevention programming and evaluation.
We aimed to identify the key domains of community mobilization (CM) essential to change health outcomes or behaviors, and to determine whether these hypothesized CM domains were relevant to a rural South African setting.
We studied social movements and community capacity, empowerment and development literatures, assessing common elements needed to operationalize HIV programs at a community level. After synthesizing these elements into six essential CM domains, we explored the salience of these CM domains qualitatively, through analysis of 10 key informant in-depth-interviews and seven focus groups in three villages in Bushbuckridge.
CM DOMAINS INCLUDE: 1) shared concerns, 2) critical consciousness, 3) organizational structures/networks, 4) leadership (individual and/or institutional), 5) collective activities/actions, and 6) social cohesion. Qualitative data indicated that the proposed domains tapped into theoretically consistent constructs comprising aspects of CM processes. Some domains, extracted from largely Western theory, required little adaptation for the South African context; others translated less effortlessly. For example, critical consciousness to collectively question and resolve community challenges functioned as expected. However, organizations/networks, while essential, operated differently than originally hypothesized - not through formal organizations, but through diffuse family networks.
To date, few community mobilizing efforts in HIV prevention have clearly defined the meaning and domains of CM prior to intervention design. We distilled six CM domains from the literature; all were pertinent to mobilization in rural South Africa. While some adaptation of specific domains is required, they provide an extremely valuable organizational tool to guide CM programming and evaluation of critically needed mobilizing initiatives in Southern Africa.
社区动员策略对于促进健康和接受艾滋病预防至关重要。然而，在确定社区动员的核心组成部分方面，几乎没有进行概念性工作，而这些组成部分是指导艾滋病预防规划和评估所必需的。
我们旨在确定对改变健康结果或行为至关重要的社区动员（CM）关键领域，并确定这些假设的 CM 领域是否与南非农村地区相关。
我们研究了社会运动和社区能力、赋权和发展文献，评估了在社区层面实施艾滋病规划所需的共同要素。将这些要素综合成六个基本的 CM 领域后，我们通过对布希克布鲁克（Bushbuckridge）三个村庄的 10 名关键知情人的深入访谈和 7 个焦点小组的定性分析，探讨了这些 CM 领域的相关性。
CM 领域包括：1）共同关注，2）批判意识，3）组织结构/网络，4）领导力（个人和/或机构），5）集体活动/行动，6）社会凝聚力。定性数据表明，所提出的领域涉及到由 CM 过程的各个方面组成的理论上一致的结构。从西方理论中提取的一些领域，对南非的背景适应性强，几乎不需要调整；而其他领域的翻译则不那么容易。例如，批判性意识能够共同质疑和解决社区挑战，这一功能按预期发挥作用。然而，组织/网络虽然必不可少，但运作方式与最初的假设不同——不是通过正式组织，而是通过分散的家庭网络。
迄今为止，在艾滋病毒预防方面，很少有社区动员工作在干预设计之前明确界定 CM 的含义和领域。我们从文献中提炼出六个 CM 领域；所有这些都与南非农村地区的动员有关。虽然需要对某些特定领域进行一定程度的调整，但它们提供了一个非常有价值的组织工具，可用于指导 CM 规划和评估南非南部急需的动员举措。
