Assessing Community Readiness for Change in the Nashville Hispanic Community Through Participatory Research

What is the Purpose of this Study?

• • To assess the degree of readiness for health-related changes among two key groups of Hispanic people living in Nashville. The researchers carried out this assessment by taking a participatory research approach and using community readiness model.

What is the Problem?

• • Places, such as Nashville, that have Hispanic populations that used to be small but have grown quickly in recent years are sometimes called “new-growth communities.” These communities lack the service infrastructure found in longer established centers of Hispanic population (such as New York and Los Angeles). As a result, the new-growth communities usually must adapt to adequately serve the particular needs of this new population.

• • A community’s readiness for change is the degree to which it is prepared to take action on an issue. Actions undertaken at the local level prove more effective when they are aligned with a given community’s readiness for change. In this study, a university researcher and the leader of an Hispanic community center collaborated to assess the readiness of two segments of Nashville’s Hispanic population to develop local initiatives to improve health among the areas’ Hispanic residents. The two segments were ordinary Hispanic people and leaders of local Hispanic organizations.

What are the Findings?

• • Both ordinary residents and local leaders perceived a high level of interest in and concern about health issues among members of Nashville’s Hispanic community. However, the ordinary people were less knowledgeable about existing community efforts to improve the health of Hispanic residents than the organizational leaders were.

• • In the community readiness model, readiness for change ranges from stage 1 (no awareness) to stage 9 (high level of community ownership). In this study, the leaders of local organizations evinced a higher stage of readiness for change (stage 5, preparation) than the ordinary Hispanic residents did (stage 4, preplanning). The organizational leaders had already reached a stage that indicated readiness to take action, whereas that degree of readiness for action was not shown by ordinary members of the Hispanic community.

• • This study is one of only a handful to show that it is feasible to apply the community readiness model with a fairly new Hispanic community, and to do so using a participatory research approach.

Who Should Care Most?

• • Members of Hispanic communities, especially those in centers of new growth for this demographic group.

• • Leaders of organizations that serve Hispanic people, particularly in new-growth communities.

• • Researchers and public health policy makers who want to work with Hispanic communities to plan effective local health initiatives.

Recommendations for Action

• • It is important to organize Hispanic community members who are directly affected by a given health issue to participate on a high level in planning and implementing related initiatives. There are two basic reasons for this: (1) Such inclusion will help to build support for the initiative within the Hispanic community, and (2) It will help to ensure that the initiative reflects the culture and context of the target population, their particular needs and interests.

• • Community-level efforts to address a specific issue must be tailored to suit that community’s stage of readiness for change regarding that issue.

• • Once a participatory research team has identified a given community’s stage of readiness for change, it can develop and implement appropriate initiatives to address local health problems.

• • Our recommendations for Nashville at the preplanning stage included the following:

  1. 1 Ensure the participation of local Hispanic community groups in health-improvement efforts and focus strongly on capacity-building and leadership development.

  2. 2 Review existing efforts in the community to determine appropriate subgroups within the Hispanic population on which to focus health-improvement efforts and to identify unmet needs among those subgroups.

  3. 3 Provide information about the issue by organizing presentations within local Hispanic neighborhoods. Also, use media channels aimed at both the Hispanic community and the general community.

  4. 4 Conduct community meetings to discuss issues, prioritize goals, and start developing strategies.

  5. 5 Meet with leaders of the general community to win their...