Volume 1, No. 3

Alfredo F.X.O. Obure, Erick O. Nyambedha, Erick O. Nyambedha, Boniface O. Oindo

Interpersonal Influences in the Scale-up of Male Circumcision Services in a Traditionally Non-circumcising Community in Rural Western Kenya

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Promoting male circumcision (MC) is now recognized as an additional, important strategy for the prevention of heterosexually acquired HIV infection in men, and plans are underway to scale-up this intervention especially in non-circumcising communities, with generalized HIV pandemic. This qualitative study identifies and characterizes the role of social and interpersonal factors in the scale-up of MC services in a rural non-circumcising community in western Kenya. Twenty-four sex-specific focus group discussions were conducted with a purposive sample of Luo men and women (15-34 years). Peer and youth groups, girlfriends and women, parents, and cultural political, religious, school leaders were identified as key influences in the scale-up of MC services. The study concludes that social and interpersonal forces create opportunities and constraints for scaling up the MC intervention. Planners of MC projects should therefore harness the power of informal networks and social structures to enhance community engagement, motivate behaviour change and increase demand for MC services.

Joyce Hunter, David Lounsbury, Bruce Rapkin, Robert Remien

A Practical Framework for Navigating Ethical Challenges in Collaborative Community Research

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To effectively mobilize community-based organizations (CBOs) and international non-governmental organizations (NGOs) in research, important ethical issues must be addressed. A memorandum of understanding (MOU) approach, providing a framework and a tool to be used for establishing effective community-research partnerships, was developed by the Community Collaboration Core (CCC) of the HIV Center for Clinical and Behavioral Studies. Aims of the CCC include: (1) Initiating and sustaining successful partnerships in HIV prevention research in areas of sexuality, gender, mental health, and of mutual benefit to communities; (2) Advancing the science of collaboration among researchers, practitioners, and government in HIV prevention. Developed and assessed over a two-year period by researchers, CBO/NGO and public health representatives, this MOU can be used by potential research and community partners to address the most important issues early in a collaborative research project. Clarifying essential roles, responsibilities, and relationships, establishing trust and transparency in that process, can guide collaborators in planning the important steps for beginning and sustaining an ethical and successful research project.

N. Andrew Peterson, Paul W. Speer, Christina Hamme Peterson

Pathways to Empowerment in Substance Abuse Prevention: Citizen Participation, Sense of Community, and Police Responsiveness in an Urban U.S. Setting

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Community-based substance abuse prevention initiatives often rely on the empowerment of community residents. Few studies, however, have examined predictors of empowerment in substance abuse prevention contexts. This study tested a path model that included two environment-related variables (i.e., residents’ awareness of community substance abuse problems and perceived incivilities in their community), two variables representing residents’ perceptions of their community (i.e., sense of community and perceived police responsiveness to drug crime) and citizen participation as predictors of the intrapersonal component of psychological empowerment. The model was found to provide a good fit to the data from a random sample of urban residents (n=283) who participated in an evaluation of a National Institute of Justice community policing initiative in the Southwestern United States. Findings suggest that empowerment-based interventions aimed at preventing substance abuse and its related harmful consequences should incorporate activities that specifically address sense of community and police responsiveness to drug crime. Limitations and directions for future research are discussed.

Kaye Lundburg, Carol R. Ignacio, Cheryl M. Ramos

The Mobile♥Care Health Project: Providing Dental Care in Rural Hawai'i Communities

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This paper reports on the Mobile♥Care Health Project (MCHP), a project of the Office for Social Ministry (OSM) of the Roman Catholic Diocese of Honolulu (referred to subsequently as “Diocese”), which aimed to increase access to dental care for the underserved on the Island of Hawai'i. This paper describes the history of the project, challenges encountered in its development, short and long term goals set and accomplished, and the community-based dental care programs that were established as a result of the MCHP initiative.