Toward Understanding Community Mobilization for HIV Prevention in the African Con

描述(由申请人提供)：越来越多的艾滋病毒预防专家将工作重点放在社区社会动员(CSM)战略上，将其作为抗击艾滋病毒流行病的一种强大和可持续的手段。然而，需要在实地进一步发展CSM的概念，包括审查动员的层面以及CSM鼓励艾滋病毒预防的手段或途径，特别是在高流行率国家的最脆弱人口中。这项研究的目的是增进对社区社会动员的概念性理解(目标1)，检查动员的各个方面与南非范围内类似结构的关系；创建可用于评估社区社会管理变化的CSM衡量标准(目标2)；最后在对25个社区的1 200人进行的大型代表性调查中测试CSM衡量标准(目标3)。这项提议将与NIMH资助的研究“现金转移和社区动员在南非年轻妇女中的影响”(1R01MH087118-01：PI，Pettifor)结合进行，该研究包括一个社区社会动员部分，以促进在年轻人中预防艾滋病毒。将通过开展形成性研究，包括重点小组讨论(FGD)和深入访谈(IDI)来完成CSM的概念发展，以便调整、完善和加强先前的工作，使CSM的定义和维度符合南非农村的情况。我们将生成一系列特定于背景的项目来测量CSM，并在R01干预社区的100名年轻人中试行测试新措施。最后，我们将在R01的大比例尺基线调查中检验CSM的测量。在试点测试和基线调查期间，将使用项目反应模型和对调查数据的因素分析来评估量表的信度和效度。关于概念化、维度以及量表条目和量表绩效的研究结果将公布，以供在未来的艾滋病毒预防倡议中使用或适应。确定社区卫生管理的各个方面，包括针对具体情况的内容，将有助于更好地规划未来的干预措施，改进社区动员措施，并因此鼓励对社区卫生管理战略进行更严格的评估。家长R01提供了一个独特的机会，在预防方面取得重大进展的背景下，研究社区社会动员的过程、潜力和重要组成部分。 公共卫生相关性：这项研究旨在发展社区社会动员(CSM)的概念定义和理解，检查南非背景下的动员的维度，并创建CSM的量化衡量标准。这项研究还将在对25个南非社区的1,200名年轻人进行的大型代表性调查中测试CSM措施，该调查是由NIMH资助的R01“南非年轻妇女现金转移和社区动员的影响”的一部分(1R01MH087118-01：PI，Pettifor)。对社区社会动员进行深入检查，促进概念发展和改进CSM的衡量，将改进未来动员干预措施的设计和评估，这在艾滋病毒高流行环境中尤为重要。

DESCRIPTION (provided by applicant): Increasingly HIV prevention specialists are focusing efforts on community social mobilization (CSM) strategies as a powerful and sustainable means of combating the HIV epidemic. However, further conceptual development of CSM, including examination of the dimensions of mobilization and the means or pathways through which CSM encourages HIV prevention, is needed in the field, particularly among the most vulnerable populations in high prevalence countries. This study aims to improve the conceptual understanding of community social mobilization (Aim 1), examining the dimensions of mobilization as they relate to similar constructs within the South African context; create a measure of CSM that can be used to evaluate changes in CSM (Aim 2); and finally to test the CSM measure in a large representative survey of 1,200 people in 25 communities (Aim 3). This proposal will be conducted in conjunction with the NIMH funded study "Effects of cash transfer and community mobilization in young South African women," (1R01MH087118-01: PI, Pettifor) which includes a community social mobilization component to promote HIV prevention among young people. The conceptual development of CSM will be accomplished by conducting formative research, including focus group discussions (FGDs) and in-depth-interviews (IDIs) in order to adapt, refine, and enhance prior work conceptualizing the definition and dimensions of CSM to fit the rural South African context. We will generate a series of context specific items to measure CSM and pilot test the new measure among 100 young people in the R01 intervention communities. Finally, we will test the measure of CSM in the large scale baseline survey of the R01. The scale performance will be evaluated for reliability and validity during the pilot test and the baseline survey using both item response modeling and factor analysis on the survey data. Findings regarding conceptualization, dimensionality, and the scale items and scale performance will be published for use or adaptation in future HIV prevention initiatives. Identifying the dimensions of CSM, including context specific components, will permit better planning of future interventions, allow building improved measures of mobilization in a community, and, as a result, encourage more rigorous evaluations of CSM strategies. The parent R01 provides a unique opportunity to study the process, potential, and vital components of community social mobilization in a context where strides in prevention are critical. PUBLIC HEALTH RELEVANCE: This study aims to develop a conceptual definition and understanding of community social mobilization (CSM), examine of the dimensions of mobilization in the South African context, and to create a quantitative measure of CSM. This study will also test the CSM measure in a large representative survey of 1,200 young people in 25 South African communities, being implemented as part of the NIMH funded R01 "Effects of cash transfer and community mobilization in young South African women," (1R01MH087118-01: PI, Pettifor). Performing an in- depth examination of community social mobilization, furthering conceptual development and improving measurement of CSM will improve the design and evaluation of future mobilizing interventions, which are particularly important in high HIV prevalence settings.