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正在集中努力社区社会动员（CSM）战略作为一个强大的和可持续的手段，打击艾滋病毒流行病。然而，在实地，特别是在高流行率国家的最脆弱人群中，需要进一步发展社区服务经理的概念，包括审查动员的各个方面以及社区服务经理鼓励预防艾滋病毒的手段或途径。本研究旨在提高社区社会动员的概念理解（目标1），研究动员的层面，因为它们涉及到类似的结构在南非的情况下，创建一个措施的CSM，可用于评估CSM的变化（目标2），并最终测试CSM措施在一个大型的代表性调查的1,200人在25个社区（目标3）。这项建议将与国家卫生研究所资助的研究“现金转移和社区动员对南非年轻妇女的影响”（1 R 01 MH 087118 -01：PI，Pettifor）一起进行，该研究包括社区社会动员部分，以促进年轻人预防艾滋病毒。CSM的概念发展将通过进行形成性研究来完成，包括焦点小组讨论（FGD）和深入访谈（IDIs），以适应，完善和加强先前的工作概念化CSM的定义和维度，以适应南非农村的背景。我们将产生一系列特定背景的项目，以衡量CSM和试点测试的新措施中的100名年轻人在R 01干预社区。最后，我们将在R 01的大比例尺基线调查中检验CSM的度量。在初步测试和基线调查期间，将使用项目反应模型和调查数据的因子分析来评估量表性能的可靠性和有效性。关于概念化，维度，规模项目和规模性能的调查结果将公布使用或适应在未来的艾滋病毒预防措施。确定社区服务管理的各个方面，包括特定背景的组成部分，将有助于更好地规划未来的干预措施，有助于建立更好的社区动员措施，从而鼓励对社区服务管理战略进行更严格的评估。父R 01提供了一个独特的机会，研究的过程中，潜在的，社区社会动员的重要组成部分，在预防的进展是至关重要的。 公共卫生相关性：本研究的目的是发展一个概念性的定义和理解社区社会动员（CSM），在南非的背景下，动员的层面检查，并创建一个量化措施的CSM。这项研究还将在对南非25个社区的1 200名年轻人进行的一项大型代表性调查中测试CSM措施，该调查是NIMH资助的R 01“现金转移和社区动员对南非年轻妇女的影响”（1 R 01 MH 087118 -01：PI，Pettifor）的一部分。对社区社会动员进行深入研究，进一步发展概念，改进社区服务管理的衡量，将改进未来动员干预措施的设计和评价，这在艾滋病毒高流行率环境中尤为重要。

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.