Currently, no standardized outcome monitoring system exists for community based organizations (CBOs) to monitor the outcomes of their community-level HIV prevention interventions. The goal of this project is to understand the nature and extent of evaluation activities conducted by CBOs during the implementation of community-level HIV prevention interventions, and to develop recommendations for outcome monitoring guidelines of those interventions. Recommendations will be disseminated to the CDC and to CBOs conducting community-level interventions.

 

Community-level HIV prevention interventions, in contrast with interventions seeking to change the behavior of an individual or small groups, focus on promoting HIV prevention behavior by changing the norms of an entire community. Different models of community-level interventions have been shown in the US to be a very cost-effective way of reaching large numbers of people at risk of acquiring HIV. Currently, there are four proven-effective models for delivering community-level interventions endorsed through the Diffusion of Effective Behavioral Interventions (DEBI) program at the CDC. These models are the Mpowerment Project, Popular Opinion Leader, Community Promise, and Real AIDS Prevention Program. Each intervention was developed for different target populations and each uses different methods to change community norms. Although these models were shown to be effective when originally developed and evaluated, little attention has been directed to developing feasible ways to evaluate them when they are implemented in the community. For example, the Mpowerment Project, one of the four DEBIs, has multiple interrelated components, including small groups; formal outreach at community venues; organization of community events; a small publicity campaign; and a community space where the project is housed and where men can congregate. The Mpowerment Project uses concepts and methods regarding personal and community empowerment, community building, diffusion of innovation, and peer influence and outreach to change the norms about safer sex. Through empirical, scientific research, the Mpowerment Project has shown to be effective in reducing rates of unprotected anal sex among young gay/bisexual men in well-funded, controlled studies conducted in different US cities. When CBOs implement the model in their communities, however, evaluation has been limited to process evaluation, primarily because CBOs do not have the resources or expertise to conduct valid outcome evaluations. The aim of this project is to develop outcome monitoring recommendations to help CBOs evaluate their community-level interventions.