Developing an Implementation Strategy for Improving Community Readiness for Deployment of Prevention Interventions in Latin America and the Caribbean

To protect youth development in Latin America and the Caribbean (LAC), authorities and practitioners have invested in the implementation of prevention interventions such as Communities That Care (CTC). Nonetheless, implementation has faced many challenges. The objectives of this dissertation were to: (1) identify existing assessments of community readiness and strategies designed to build readiness for youth-focused prevention interventions; (2) consult with local implementers to explore existing barriers and facilitators to prevention system delivery; and (3) develop a broad implementation strategy to build community readiness for CTC implementation in the region.

We first conducted a systematic review of community readiness instruments and community readiness building strategies. Fifty-five publications met inclusion criteria, identifying 28 different assessments and 26 unique strategies. There was a preference for the Community Readiness Model as an assessment tool. CTC was identified among the most used strategies.

We then conducted five group interviews with 19 implementers working with CTC in LAC, focusing on barriers and facilitators to implementation. We identified three main themes (prevention system preparation, implementation, and sustainability) and six subthemes (sociopolitical context, community readiness, prevention system delivery, availability of prevention interventions, stakeholder support, and resources for implementation).

Finally, we designed a broad implementation strategy to assist LAC adopters and implementers in the deployment of CTC, using data from the systematic review and group interviews. Determinants of adoption/implementation were community knowledge, leadership and support from stakeholders, available resources, and local climate and context for implementation. Methods and strategies were proposed to address each one.

This dissertation contributes to future CTC implementation efforts in LAC contexts, with the potential to inspire the design of strategies for implementing other prevention interventions.