RSBCIHI has chosen a community-wide, risk-focused prevention strategy as its broad approach for the Native Community Challenge Program’s teen pregnancy Prevention Project. This strategy was chosen because of the weight and significance the research places on its effective, comprehensive design. This design develops strategies that are woven into the fabric of the community. The strategy also employs all of the prevention principles and uses interventions proven through research to work.
Community-wide project structures offer other advantages as well. Prevention efforts that involve the entire community reach and engage more people than individual recruitment alone. This strategy also promotes the widespread communication of consistent pro-social standards that research suggests is most effective. Community approaches affect the entire environment and are oriented toward changing community norms, values and policies (Bracht, 1990).
The project is designed using the “P” process theory that was propounded by the John Hopkins Center for Health Communication Programs. This approach is relevant when one is designing a program that aims at influencing behavior change and environmental change. The “P” Process aims at planning for continuity health communication programs that are community based in nature. The Native Challenge project provides services to Indian youth in schools and those who are dropouts from school while also serving adults on the reservations. This approach enables project implementers to have a workable sustainability plan. It enables staff to avoid deviations from established plans since evaluation is incorporated early on in the project’s implementation.
Finally this approach encourages community participation that in turn will lead to changes in behaviors, myths and misconceptions, attitudes, beliefs thereby creating a permanent environmental change. Such an approach is justifiable for use in our Native American population where certain counter productive values have been cherished for a long time. The rural nature of our area of operation needs a strategically designed program that will attract community support.
The five steps of the “P” Process can be illustrated as follows:
Step 1 Analysis: Understanding the problem of teen pregnancy. Know our target audience -- segment and profile. Reviewing existing programs and policies. Identifying leading organizations and assessing communication capacity or program delivery capacity.
Step 2 Strategic Design: Developing SMART objectives. Positioning our program to present a clear benefit to the target population of the need for behavior change. Following a proven behavior change model that has been proven to work through research. Selecting interventions, media and activities that are relevant to the culture of the people (cultural competency). Preparing a strategic design paper. Drawing up an implementation plan and budget. Planning for empowerment evaluation early on in the project.
Step 3 Message and Materials development, Pre-testing and Production: Developing Message Concepts, working in collaboration with health professionals who have experience in reproductive health to ensure medical accuracy. Working with communication professionals in designing our messages. Pre-testing and re-testing with intended audiences. Revising to satisfy audiences and gatekeepers.
Following the 7 C’s of Effective Communication:
- Command Attention
- Cater to the Heart and ear
- Clarify the Message
- Communicate a Benefit
- Create trust
- Convey a Consistent Message
- Call for Action.
Step 4 Management, Implementation and monitoring: Managing for results, training individuals, and building institutional capacity. Building a positive organizational climate. Establishing a coordinating group or advisory board. Focusing on dissemination. Monitoring the outputs, activities, and responding rapidly to feedback.
Step 5 Impact Evaluation: Designing evaluation early at the start of the project. Building on a proven behavior change model. Using different evaluation methodologies. Measuring cost-effectiveness. Sharing results in appropriate formats with stakeholders. (Source: www.jhuccp.org)