Lippman Sheri A, Neilands Torsten B, Leslie Hannah H, Maman Suzanne, MacPhail Catherine, Twine Rhian, Peacock Dean, Kahn Kathleen, Pettifor Audrey
University of California, San Francisco, Center for AIDS Prevention Studies, Department of Medicine, San Francisco, CA, USA; MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
University of California, San Francisco, Center for AIDS Prevention Studies, Department of Medicine, San Francisco, CA, USA.
Soc Sci Med. 2016 May;157:127-37. doi: 10.1016/j.socscimed.2016.04.002. Epub 2016 Apr 4.
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.
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.
A survey instrument was developed and pilot tested, then revised and administered to 1181 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 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 0.81 to 0.93. 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.
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.
社区动员方法(CMAs)日益成为卫生规划的关键组成部分。然而,CMAs的定义不明确且评估不佳,这主要是由于缺乏评估动员过程和影响的测量工具。
我们开发了社区动员测量工具(CMM),它由一组量表组成,用于测量假设在社区层面运作的动员领域。这六个领域包括:共同关注、批判意识、领导力、集体行动、社会凝聚力以及组织和网络。我们还纳入了社会控制领域,以探索与集体效能这一相关概念的协同作用。
开发了一份调查问卷并进行了预测试,然后进行修订,并在南非农村的一项基于社区的调查中对1181名18至35岁的年轻人进行了调查。进行了项目反应建模和探索性因素分析,以评估模型拟合度、维度、信度和效度。
结果表明,七维模型(各领域相互关联但无高阶结构)与数据拟合最佳。各因素的内部一致性信度很强,ρ值范围为0.81至0.93。七个量表中的六个具有足够的相关性,以代表构成社区动员的相互关联的概念;社会控制与其他组成部分的相关性较小。在村庄层面,CMM子量表与村庄社会资本和诚信的其他指标相关,提供了更高层次效度的初步证据,然而还需要在社区层面进行该测量工具的额外评估。
这是首次开发并验证一种用于社区动员的综合测量工具的努力。CMM被设计为一种卫生规划评估工具,应有助于更细致地理解与社区动员相关的变化机制,最终使动员方法更有效。