DOI

Summary
This short study aims to provide a community based intervention approach to reducing health disparities particularly involved with the reduction of HIV disparities. In doing so the authors have prepared a 13 step process designed to simplify the intervention process. The science related to intervention development has been found to be under performing and is showing up as an issue in individual, community, system and policy interventions.

 

Successful intervention projects to date are presented in table 1. To demonstrate an example, some of these interventions include:

‘Brothers Leading Healthy Lives – Increase consistent condom use among African American/Black college men’.
‘HOLA en Grupos – Increase condom use and HIV testing among Latino gay, bisexual, and other MSM and Latino transgender women’.




Methods used in this study include community-based participatory research (CBPR). This was done to collect data from community members who have experienced the research topic at hand. The research also drew data from various sources of literature and conference presentations.




The 13 steps are as follows:

Expand the partnership.
Intervention team established
Gather existing literature and data.
Assess community needs, priorities, and assets.
Generate and refine intervention priorities.
Evaluate and incorporate appropriate theory.
Design an intervention conceptual or logic model.
Create objectives and craft activities and materials.
Hone and pretest all activities and materials.
Administer intervention pilot.
Note process of implementation during the pilot.
Gather feedback and preliminary outcomes data from those who conducted and participated in the pilot.
Edit the intervention based on feedback and findings.

Relevance for Complex Systems Knowledge
This study is relevant to community development and complex systems. It demonstrates the use of CBPR for the collection of relevant valuable data from ‘lived experiences of community members’.  

The 13 steps describe what Rhodes et al. believe to be a guiding tool for intervention development for health disparities. This model could applied in different fields with some modifications.

General highlights of the 13 steps

Community involvement was expanded by aiming for participation from Latino men involved in local recreational soccer leagues (1). Intervention teams should be made up of a broad and diverse representation of participants – community members, organisation representatives and academic researchers (2). Literature should be sought from other relevant community projects with an aim of obtaining diversified data relevant to the specifics of the study (3). All relevant and specific data may not be attainable from the literature review so tailored assessments of the community needs, priorities and assets is required in this instance. Rhodes et al. used photovoice. It is defined here as ‘photovoice enables participants to record and reflect on community strengths and concerns through photographs that they take and group discussion triggered by these photographs’. More on this on page 496 (4). Facilitating discussion behavioural, educational and communication theory is key to the process (6). Designing a conceptual or logical model is integral to visually represent links among factors of the system. The model allows participants to logically understand some of the immediate, intermediate and long term outcomes (7).

 

Rhodes et al. state again that interventions are greatly informed by lived experiences of community members.

 

Point of Strength
Rhodes et al. state that there is a major need to produce evidence-based strategies for the implementation of intervention strategies. They provide a solution to this gap in knowledge.




The photovoice method was used here with success and may be useful for other community based research.




The 13 step process is easily followed and appears to be easily transferable to other projects. Rhodes et al. state that the methods and process may be repeated for other health issues and for other community engagement projects with similar success.