Rhodes Scott D, Daniel-Ulloa Jason, Wright Shauntá S, Mann-Jackson Lilli, Johnson David B, Hayes Norman A, Valentine Jo A
From the Department of Social Sciences and Health Policy and the CTSI Program in Community Engaged Research, Wake Forest School of Medicine, Winston-Salem, NC.
University of Washington, Bothell, School of Nursing and Health Studies, Bothell, WA.
Sex Transm Dis. 2021 Jan;48(1):49-55. doi: 10.1097/OLQ.0000000000001267.
Community Approaches to Reducing Sexually Transmitted Disease (CARS), a unique initiative of the US Centers for Disease Control and Prevention, promotes the use of community engagement to increase sexually transmitted disease (STD) prevention, screening, and treatment and to address locally prioritized STD-related social determinants of health within communities experiencing STD disparities, including youth, persons of color, and sexual and gender minorities. We sought to identify elements of community engagement as applied within CARS.
Between 2011 and 2018, we collected and analyzed archival and in-depth interview data to identify and explore community engagement across 8 CARS sites. Five to 13 interview participants (mean, 7) at each site were interviewed annually. Participants included project staff and leadership, community members, and representatives from local community organizations (e.g., health departments; lesbian, gay, bisexual, transgender, and queer-serving organizations; faith organizations; businesses; and HIV-service organizations) and universities. Data were analyzed using constant comparison, an approach to grounded theory development.
Twelve critical elements of community engagement emerged, including commitment to engagement, partner flexibility, talented and trusted leadership, participation of diverse sectors, establishment of vision and mission, open communication, reducing power differentials, working through conflict, identifying and leveraging resources, and building a shared history.
This study expands the community engagement literature within STD prevention, screening, and treatment by elucidating some of the critical elements of the approach and provides guidance for practitioners, researchers, and their partners as they develop, implement, and evaluate strategies to reduce STD disparities.
社区减少性传播疾病方法（CARS）是美国疾病控制与预防中心的一项独特倡议，它促进利用社区参与来加强性传播疾病（STD）的预防、筛查和治疗，并解决在经历性传播疾病差异的社区（包括青年、有色人种以及性和性别少数群体）中按当地优先次序排列的与性传播疾病相关的健康社会决定因素。我们试图确定CARS中应用的社区参与要素。
在2011年至2018年期间，我们收集并分析了档案和深入访谈数据，以识别和探索8个CARS站点的社区参与情况。每个站点每年对5至13名访谈参与者（平均7名）进行访谈。参与者包括项目工作人员和领导层、社区成员以及当地社区组织（如卫生部门；女同性恋、男同性恋、双性恋、跨性别和酷儿服务组织；宗教组织；企业；以及艾滋病毒服务组织）和大学的代表。使用持续比较法对数据进行分析，这是一种扎根理论发展方法。
出现了12个社区参与的关键要素,包括参与的承诺、伙伴灵活性、有才能且值得信赖的领导、不同部门的参与、愿景和使命的确立、开放沟通、减少权力差异、解决冲突、识别和利用资源以及建立共同历史。
本研究通过阐明该方法的一些关键要素，扩展了性传播疾病预防、筛查和治疗领域的社区参与文献，并为从业者、研究人员及其伙伴在制定、实施和评估减少性传播疾病差异的策略时提供指导。
