This study presents an effort to adapt the community readiness model to a multi-community intervention to reduce youth ac 30cess to tobacco. The background of the original community readiness model is outlined, and a behaviorally based adaptation specific to tobacco sales and tobacco possession enforcement is presented. Data on behaviorally based readiness ratings for 11 communities are presented. Correlational analyses indicate a significant relationship between ratings for sales enforcement readiness and the number of tobacco compliance checks conducted by the local police departments. The relationship between possession enforcement readiness and the rate of citations issued was in the expected direction, but was not significant. The results indicate that the behavioral adaptation of the community readiness model can: (a) provide a conceptual heuristic to understand community dynamics; (b) increase responsiveness to each community's unique needs; (c) measure changes over time; and (d) inform future intervention strategies with the community. [Article copies available for a fee from The Haworth Document Delivery Service: 1-800-HAWORTH. E-mail address: <[email protected]> Website:<https://www.HaworthPress.com" xmlns:xlink="https://www.w3.org/1999/xlink">https://www.HaworthPress.com> © 2002 by The Haworth Press, Inc. All rights reserved.]
Increasingly, community-based prevention efforts are being called upon to deal with a number of issues related to mental, physical, and social well-being (Donnermeyer, Plested, Edwards, Getting, & Littlethunder, 1997; Howard-Pitney, 1990). These issues include problems related to substance abuse, sexually transmitted diseases, domestic violence and child abuse, criminal activity, homelessness, and depression, among others. The increasing popularity of locally oriented prevention strategies is a result of the demonstrated effectiveness of community approaches in areas such as health promotion, crime and delinquency prevention, and community development (Kumpfer, Whiteside, Wandersman, & Cardenas, 1997). With the proliferation of community-based efforts comes a shift in emphasis from individual factors toward the overall health and social ecology of the community (Goodman, Wandersman, Chinman, Imm, & Morrissey, 1996; Howard-Pitney, 1990). No longer solely focusing on individual-level behavior change, community-based prevention efforts have begun to consider the social and cultural contexts in which individual behaviors occur. Toward this end, there is a growing consensus that effective prevention efforts have 31similar underlying themes: They use a systematic approach, employ multiple methods, encourage collaboration among community groups, and consider community-level processes that contribute to normative change (Edwards, Jumper-Thurman, Plested, Oetting, & Swanson, 1999; Goodman et al., 1996; Levine, 1998). Together, these themes hold promise in revealing community dynamics critical to the success of burgeoning local preventive interventions.
As community-based prevention efforts continue to gain exposure, however, an increased awareness of the challenges associated with local approaches must be brought to bear. While the benefits of implementing successful community-based prevention programs are compelling, it is by no means a given that simply establishing such a program within a community foretells success. Many programs fail as a result of poor planning, lack of potency in changing community norms, or insufficient preparation of program staff (Edwards et al., 1999). Even after a local prevention program has been implemented, many other factors threaten its effectiveness and longevity. Some programs, for example, are not based on sound information or tested scientific theories (Donnermeyer et al., 1997), while others run out of funding before they are able to achieve desired ends.
Some of the challenges to implementing community-based programs are related to the unique characteristics of the communities themselves. Each community is comprised of its own attitudes, values, resources, history, political climate, strengths, and weaknesses (Edwards et al., 1999). These contexts can affect the trajectory of a local prevention effort, particularly when they are not considered during the planning and implementation of a program. When the characteristics of the community do not support the goals of the program, prevention programs may have to overcome additional hurdles in achieving their goals. For example, a community program whose goal is to reduce unwanted pregnancies by introducing a controversial method of birth control may be met by resistance if the attitudes and values of the community are inconsistent with the program's approach. Such a program may be doomed to failure, or, at least, a reduced set of desirable outcomes. Prevention programs can improve their chances for success through appropriate planning that takes into account the unique characteristics that distinguish communities from one another; they can then adapt program goals and methods based upon the nature of those characteristics.
Given the impact that community-level factors often have upon the effectiveness of locally based interventions, and because of the increased implementation of these interventions, there has been a need to 32articulate systematically the challenges that are present when establish ing a program that intends to deal with a community-specific problem (Edwards et al., 1999). There has also been a need to develop methods to overcome these challenges and make progress toward the goals of the program. Community readiness theory, developed by Oetting et al. (1995), was developed to meet these needs (Donnermeyer et al., 1997; Edwards et al., 1999; Edwards, Jumper-Thurman, Plested, Oetting, & Swanson, 2000; Jumper-Thurman, Plested, Edwards, & Oetting, 1998; Plested, Smithman, Jumper-Thurman, Oetting, & Edwards, 1999; Plested, Jumper-Thurman, Edwards, & Oetting, 1998). These research ers note that the community readiness model can be used to assess a community's readiness for prevention programming. This assessment, in turn, provides a basis for understanding the relationship between community dynamics and the program and suggests methods to over come prevention hurdles based upon the assessment (Plested et al., 1999).
Although the original community readiness model was developed for use with alcohol and drug abuse prevention programs, the broader aim in its creation was in suggesting methods in which the assessment of community readiness can be applied to a variety of community-based prevention efforts (Oetting et al., 1995).