Community Level Intervention
Community Level Intervention combines community organization and social marketing – a strategy that takes a systems approach. Its foundation is an assumption that individuals make up large and small social networks or systems. Within these social networks or systems, individuals acquire information, form attitudes, and develop beliefs. Also, within these networks, individuals acquire skills and practice behaviors.
The fundamental program goal of Community Level Intervention is to influence specific behaviors by using social networks to consistently
deliver HIV risk reduction interventions. Although the intervention strategy is community-based, Community Level Interventions target specific populations – not simply the community in general. The client populations have identified shared risk behaviors for HIV infection and also may be defined by race, ethnicity, gender, or sexual orientation.
In order to influence norms that support HIV risk reduction behavior, Community Level Interventions are directed at the population, rather than at the individual. The primary goal of these interventions is to improve health status by promoting healthy behaviors and changing those factors that negatively affect the health of a community's residents. A specific intervention may take the form of persuasive behavior change messages, or it may be a skills-building effort. Whatever its form, an intervention achieves reduced HIV risk by changing group norms to improve or enhance the quality of health for members of the client population. These norms may relate to condom use, contraceptive use, or needle-sharing. They may also focus on diagnosis and treatment of sexually transmitted diseases or HIV-antibody counseling and testing.
It takes time to change social norms. Social norms cannot be changed quickly or at the same rate that knowledge acquisition or skills
development can occur. Change occurs as a result of sustained, consistent intervention efforts over time. The intervention must be implemented thoroughly throughout the social networks. A firm grounding in behavioral theory is essential to the development and implementation of Community Level Interventions.
Community-based needs assessment is critical to the development and implementation of Community Level Interventions. This phase is important for identifying and describing structural, environmental, behavioral, and psychological facilitators and barriers to HIV risk reduction. To successfully conduct this intervention, a program must identify the sources for and patterns of communication within a social network. Peer networks must be defined and described.
Note: Community Level Intervention is referred to as Community Intervention Programs in Program Announcement #300.
The following questions should be considered in designing community level interventions:
- Who are the gatekeepers to the client population?
- What are the important points of access?
- What are the appropriate and relevant risk-reduction messages, methods,
- What are the linguistic and literacy needs of the client population? A needs assessment should yield this vital information.
For further reading on the developmental steps of Community Level Intervention, see Cooperative Agreement for Human Immunodeficiency Virus (HIV) Prevention Projects Program Announcement and Notice of Availability of Funds for Fiscal Year 1993.
A variety of methods exists for collecting the answers to these questions.
It is recommended that programs select the method that is most appropriate for their professional orientation (e.g., social work, health education).
Whatever method is chosen, it is critical that the formative activity be community-based and as collaborative as possible with the client population.
The information gathered during the formative phase provides the foundation on which an effective program can be built. Completing this activity should result in culturally competent, developmentally appropriate, linguistically specific, and sexual-identity-sensitive interventions that promote HIV risk reduction.
Members of existing and relevant social networks can be enlisted to deliver the interventions. Other peer networks may also be created and mobilized to provide intervention services. This, of course, means volunteer recruitment and management. Community Level Intervention strategies offer opportunities for peers to acquire skills in HIV risk reduction and, in turn, reinforce these abilities when the peers become the teachers of these same skills to others.
In this manner, Community Level Interventions become community-owned and operated; thus, they are more likely to be sustained by the community when the program activity is completed. Social norms changed in this way are likely to have a long-lasting and effective impact upon HIV risk reduction.
Go to The Role of Public
Information in HIV/AIDS Prevention