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Overview
Reasons for Evaluating HIV Prevention Community Planning and the Development
of Comprehensive HIV Prevention Plans
Community Planning Steps to Be Evaluated
Collecting and Applying Evaluation Data on the Community Planning Process and Development of Plans
References and Resources
Overview
HIV prevention community planning was designed to serve as the building block
for all HIV prevention efforts within jurisdictions and across the country. When
HIV prevention community planning is implemented as intended, it produces a
sound, need-based, comprehensive HIV prevention plan that should guide health
departments (and, ideally, all funding organizations in a jurisdiction) in the
allocation of funds for HIV prevention interventions in their jurisdictions.
Additionally, the comprehensive HIV prevention plan is expected to guide the
design of interventions funded by health departments to ensure correspondence
between interventions and strategies in the plan. This aspect of community
planning is the focus of core objective 5 (see Table 2.1), which is discussed at
length in Chapter 5.
The quality and relevance of HIV prevention interventions–and their ultimate
potential for reducing risk behavior and HIV transmission–hinge, in part, on the
quality of the comprehensive HIV prevention plan governing funding decisions.
Therefore, it is essential that a strong process be used to produce the plan.
However, while experts agree that it is difficult to assess whether a particular
plan is “good,” it is possible to determine if the process used to produce it
adhered to CDC guidelines and if it was deemed fair and appropriate by
participants in the process.
Purpose of this Chapter
This chapter provides a general framework for use by community planning
groups (CPGs) and health departments as they seek to evaluate the HIV prevention
community planning process in their jurisdictions. This chapter also discusses
the nature of community planning and reasons for evaluating the initiative and
features guidance for collecting evaluation data that will benefit a wide
variety of stakeholders.
Systematic collection and analysis of community planning evaluation data
allows CPGs and health departments to:
- Document the extent to which HIV prevention community planning core
objectives are achieved
- Determine the factors affecting implementation of HIV prevention
community planning
- Apply the findings to improve the planning process as needed
- Generate concrete information that can be used to inform stakeholders of
progress
Sample surveys for obtaining input about the planning process from all CPG
members and co-chairs are provided in the appendix. While the documents in the
appendix are actual surveys that could stand alone, grantees may choose to
integrate the core questions with existing data collection methods. Regardless
of the method employed, it is suggested that all CPG members and co-chairs
respond, in a confidential manner, to the questions on an annual basis. It is
also suggested that the questions be administered at the end of a given planning
year (i.e. after the letter of concurrence/nonconcurrence has been signed) or at
the beginning of the subsequent year.
Although some grantees may be concerned about the subjective nature of some
of the questions, these questions honor the participatory nature of community
planning in that they are designed to obtain input from voting CPG members and
co-chairs to provide them with an opportunity to share their perspectives on the
implementation of the initiative. To address concerns about subjectivity,
grantees may want to expand on the findings by acknowledging the contextual
factors that might influence responses and by supplementing the data with
findings gleaned through other evaluation methods.
It is extremely important that the surveys be regarded as one of many ways
to evaluate the planning process. Data solicited through the surveys can be
used by health departments and CPGs to supplement other evaluation activities so
that the CPG, health department, and other stakeholders gain as complete a
picture as possible of the planning process and development of the comprehensive
HIV prevention plan.
Nature of HIV Prevention Community Planning
CDC’s HIV prevention community planning initiative was introduced in an
effort to improve HIV prevention activities nationwide. The initiative requires
that CDC-grantee health departments convene community planning groups (CPGs),
which are responsible for developing comprehensive HIV prevention plans that
address all HIV prevention needs in the grantee’s jurisdiction. According to CDC
guidelines, members of CPGs should represent state and local agencies,
nongovernmental organizations, and communities and groups affected by HIV. As
laid out in the five core objectives of HIV prevention community planning (Table
2.1) CPGs are expected to:
- Employ a participatory process to set priorities based on the needs of
the community
- Identify community-appropriate, science-based interventions for meeting
those needs.
Table 2.1
| Five Core Objectives of HIV Prevention Community Planning |
- Foster the open and participatory nature of the community
planning process.
- Ensure that the community planning group(s) reflects the
diversity of the epidemic in the jurisdiction, and that experts in
epidemiology, behavioral science, health planning, and evaluation
are included in the process.
- Ensure that priority HIV prevention needs are determined based
on an epidemiologic profile and a needs assessment.
- Ensure that interventions are prioritized based on explicit
consideration of priority needs, outcome effectiveness, cost
effectiveness, social and behavioral science theory, and community
norms and values.
- Foster strong, logical linkages between the community planning
process, plans, applications for funding, and the allocation of CDC
HIV prevention resources.
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Reasons for Evaluating HIV Prevention Community Planning and the Development
of Comprehensive HIV Prevention Plans
Because CPGs are mandated to update their comprehensive plans each year, it
is helpful to evaluate the process for producing and revising plans each year
(even though many of the issues are ongoing and not confined to specific years)
to determine its effectiveness and compliance with CDC guidelines. Data derived
from evaluations of the process provide health departments, CPGs, CDC, and other
stakeholders with explicit information about whether the initiative is being
implemented as intended and is achieving its objectives. The evaluation
activities discussed here allow CPGs to:
- Monitor their progress
- Identify strengths and weaknesses in the planning process
- Determine ways to improve the planning process
- Provide feedback to local, state, and national stakeholders
- Report data to stakeholders in a systematic way, allowing for assessment
of trends and identification of technical assistance and resource needs
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Community Planning Steps to Be Evaluated
As stated earlier, community planning guidance assumes that if the following
steps of community planning are implemented as intended, the process will lead
to the creation of a comprehensive plan that accurately targets needs in the
jurisdiction with effective approaches for reducing risk behaviors that lead to
HIV transmission. Based on the five core objectives, the primary steps of
community planning include:
- Recruiting group members who are representative of the groups affected
by the epidemic
- Ensuring that the planning process is open and participatory
- Conducting a needs assessment, resource inventory, gap analysis, and
intervention inventory
- Compiling an epidemiologic profile
- Prioritizing needs and target populations based on the needs
assessment and epidemiological profile
- Developing a comprehensive HIV prevention plan that reflects those
priorities
- Selecting and funding activities that correspond to the plan (this is
the responsibility of the grantee health department)
Clearly, each step in the process affects and builds on the others. Thus,
each step can be examined individually to ensure that it provides a sound foundation for the subsequent
steps.
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Collecting and Applying Evaluation Data on the Community Planning Process and Development of Plans
Evaluation of the steps listed in the previous section requires a two-stage
process: 1) assessing the planning process to determine if the steps have been implemented and 2)
determining the quality of implementation. Assessing quality, in this instance, is primarily a
subjective endeavor. Therefore, the two sample surveys in the appendix allow for the collection of two types
of data. First, co-chairs are asked to recount the actual steps taken to fulfill each objective and to
provide their opinions on members’ ability to participate in each step in the process. Second, CPG
members are asked for their perspectives on the quality and, in essence, the appropriateness, of those
steps. Table 2.2 outlines the suggested procedures for data collection and application.
Another use of the data obtained through the surveys is internal evaluation
of the planning process. It is recommended that health departments and CPGs
employ and assess the surveys in conjunction with an analysis of community
planning documents and other data. Table 2.3 depicts the core objectives,
ways to measure progress in meeting the objectives, and options for
communicating findings locally to improve the process.
Table 2.2
| COMMUNITY PLANNING EVALUATION DATA COLLECTION |
ISSUES PERTAINING TO COLLECTION AND REPORTING OF DATA |
- The health department provides evaluation surveys to all CPG
co-chairs and voting members.
|
It is suggested that the forms be provided as soon as possible after
the letter of concurrence/nonconcurrence is signed. This could be at the
end of the year that is being evaluated or at the beginning of the
following year. |
- CPG co-chairs and voting members complete the
surveys.
|
The surveys could be completed during a meeting or at the discretion
of members. The choice of methods should be based on the ease of
completion as well as on the likelihood that completed surveys will be
provided to the health department. |
- CPG co-chairs and voting members provide the
completed surveys to a designated individual (such as one of the
co-chairs or a health department employee).
|
The person collecting the surveys should ensure the confidentiality
of members’ responses. |
- The health department uses the data in the surveys to supplement
other community planning evaluation activities.
|
Other community planning evaluation activities might include
document review, exit interviews with departing members, other surveys
of members, and members’ evaluations of each CPG meeting. |
Table 2.3
| Evaluating the HIV Prevention
Community Planning Process |
| Core Objectives |
Data Sources |
Use of Findings |
- Foster the open and participatory nature of the community
planning process.
|
- Presence of written policies or documentation of:
- Member recruitment, nomination, and selection
- Meeting attendance and procedures
- Orientation procedures
- Conflict resolution procedures
- Input from non-CPG members
- Facilitation of member participation
- Member training
- Survey of CPG members’ perspectives on the process
|
- Modifying efforts for recruiting, selecting, training, and
supporting CPG members
- Determining how to improve the open and participatory nature of
planning
- Modifying efforts to obtain input from non-CPG members
|
- Ensure that the community planning group(s) reflects
the diversity of the
epidemic in the jurisdiction, and that
experts in epidemiology, behavioral science, health planning, and
evaluation are included in the process.
|
- Process for ensuring parity, inclusion, and representation
- Listing of groups represented by CPG members
- Listing of groups not represented
- Listing of types of expertise represented
- Listing of types of expertise not represented
- Participants’ perspectives on representation and the extent of
experts’ involvement
- Survey of CPG members’ perspectives on categories listed above
|
- Determining if the CPG’s membership reflects the diversity of
the epidemic in the jurisdiction and has adequate
expertise
- Modifying by-laws as needed to increase representation
- Adjusting group composition as needed
|
- Ensure that priority HIV prevention needs are
determined based on an epidemiologic profile and a needs assessment.
|
- Presence of written procedure for prioritizing needs
- Procedure for reviewing unmet needs and justifying priority
needs
- Presence of needs assessment, epidemiologic profile, resource
inventory, gap analysis
- Use of epidemiologic profile and needs assessment for
identifying interventions and populations
- Survey of CPG members’ perspectives on the quality and use of
epidemiologic profile and needs assessment and on prioritization of
needs
|
- Improving data collection and documentation to address
unanswered questions
- Improving procedures for using data to determine HIV prevention
needs
|
- Ensure that interventions are prioritized based on
explicit consideration of priority needs, outcome effectiveness,
cost effectiveness, social and behavioral science theory, and
community norms and values.
|
- Procedure for selecting interventions
- Procedure for prioritizing interventions
- Survey of CPGs’ perspectives on selection and prioritization of
interventions
|
- Improving the process for selecting proposed interventions
- Modifying the process for prioritizing interventions
|
- Foster strong, logical linkages between the community
planning process, plans, applications for funding, and allocation of
CDC HIV prevention resources (Evaluation of core objective 5 is
discussed at length in Chapter 5)
|
- Extent to which the plan reflects documents used for, and
decisions made during, the planning process
- Extent to which the CDC funding application reflects the plan
- Extent to which RFPs, contracts, and funded programs correspond
to plan
- Survey of CPG members’ perspectives on the extent of linkages
between the process, plan, application, and funding
|
- Improving linkages between planning, the plan, the CDC
application, and resource allocation
- Providing feedback to stakeholders regarding implementation of
the plan
- Determining which strategies in the plan are not implemented by
funded programs
- Determining which strategies in the plan could or should be
supported by non-health-department funds
|
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References and Resources
Academy for Educational Development (AED). Handbook for HIV Prevention
Community Planning. Washington, DC: AED, 1994.
Academy for Educational Development. Review of Core Objectives: The First
Year of HIV Prevention Community Planning. Washington, DC: AED, 1995.
Academy for Educational Development. Self-Assessment Tool for Community
Planning Groups. Washington, DC: AED, 1995.
Academy for Educational Development. Review of Core Objective #5: Linkages
in the Second Year of HIV Prevention Community Planning. Washington, DC: AED, 1996.
AIDS Action Foundation. A Survey of the HIV Prevention Community Planning
Process. Washington, DC: AED, 1995.
AIDS Action Foundation. Case Studies of the Relationship of HIV Prevention
Plans to Health Department Cooperative Agreement Applications for CDC Funding.
Washington, DC: AED, 1996.
Battelle. HIV Prevention Community Planning Case Studies, 1995.
Butterfoss, F.D., Goodman, R.M., and Wandersman, A. Community coalitions for
prevention and health promotion: factors predicting satisfaction, participation, and
planning. Health Education Quarterly 1996; 23:65-79.
Centers for Disease Control and Prevention. Supplemental Guidance on HIV
Prevention Community Planning for Noncompeting Continuation of Cooperative Agreements for HIV
Prevention Projects. Atlanta: Centers for Disease Control and Prevention, 1993.
Centers for Disease Control and Prevention. Announcement 300: Cooperative
Agreements for Human Immunodeficiency Virus (HIV) Prevention Projects Program Announcement
and Availability of Funds for Fiscal Year 1993. Atlanta: Centers for Disease
Control and Prevention, 1993.
Centers for Disease Control and Prevention. HIV Prevention Community
Planning Year One Progress: In-Depth Review Reports. Atlanta: Centers for Disease Control
and Prevention, 1995.
Centers for Disease Control and Prevention. Summary of Major Findings from
Year One of HIV Prevention Community Planning. Atlanta: Centers for Disease Control and
Prevention, 1995.
Centers for Disease Control and Prevention. Summary of Process and
Findings, External Review of FY 96 HIV Prevention Continuation Applications and
Comprehensive HIV Prevention Plans. Atlanta: Centers for Disease Control and
Prevention, 1996. Centers for Disease Control and Prevention. Summary of
Process and Findings, External Review of FY 97 HIV Prevention Continuation
Applications and Comprehensive HIV Prevention Plans. Atlanta: Centers for
Disease Control and Prevention, 1997.
Centers for Disease Control and Prevention. Summary of Major Findings from
Years Two and Three of HIV Prevention Community Planning. Atlanta: Centers
for Disease Control and Prevention, 1997.
Centers for Disease Control and Prevention. Table of Projected
Expenditures for HIV Prevention: Announcement #706. Atlanta: Centers for
Disease Control and Prevention, 1997.
Centers for Disease Control and Prevention. Cooperative Agreements for
Human Immunodeficiency Virus (HIV) Prevention Projects Program Announcement and
Availability of Funds for Fiscal Year 1998 (Announcement 99004). Atlanta:
Centers for Disease Control and Prevention, 1998.
Goodman, R.M., Speers, M.A., McLeroy, K., et al. Identifying and defining the
dimensions of community capacity to provide a basis for measurement. Health
Education Behavior 1998;25:258-278.
Holtgrave, D.R., Valdiserri, R.O. Year one of HIV prevention community
planning: A national perspective on accomplishments, challenges, and future
directions. Journal of Public Health Management Practice 1996;2(3)1-9.
Kegler, M., Steckler A., McLeroy, K., and Malek, S.H. Factors that contribute
to effective community health promotion coalitions: a study of 10 project ASSIST
coalitions in North Carolina. Health Education Behavior 1998;25:338-353.
National Alliance of State and Territorial AIDS Directors (NASTAD). NASTAD
HIV Prevention Community Planning Bulletin. Washington, DC: NASTAD, May
1997.
Schietinger, H., Coburn J., and Levi, J. Community planning for HIV
prevention: Findings from the first year.” AIDS & Public Policy Journal
1995;10(3)140-147.
United States Conference of Mayors. HIV Prevention Community Planning
Profiles: Assessing Year One. Washington, DC: United States Conference of
Mayors, 1995.
United States Conference of Mayors. HIV Prevention Community Planning
Profiles: Assessing the Impact. Washington, DC: United States Conference of
Mayors, 1996.
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