Community readiness theory is a practical tool for implementing changes in community health services. The theory provides methods for assessment, diagnosis, and community change. First, community key informants are asked semi-structured questions that provide information about what is occurring in the community in relation to a specific problem. The results evaluate readiness to deal with that problem on six dimensions; existing efforts, knowledge about the problem, knowledge about alternative methods or policies, leadership, resources, and community climate. The eventual result is a diagnosis of the overall stage of community readiness. There are nine stages, tolerance or no awareness, denial, vague awareness, preplanning, preparation, initiation, institutionalization or stabilization, confirmation/expansion, and professionalization. Each stage requires different forms of interventions in order to move the community to the next stage until, eventually, initiation and maintenance of health services programs and policies can be achieved.

Community Health Services↗

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Readiness for drug use prevention in rural minority communities.

An assessment of community readiness for drug use prevention in rural communities indicated that most rural communities are at relatively low stages of readiness. Minority communities were particularly low in readiness, with only 2% having functioning drug prevention programs. Rural communities at different levels of readiness require different types of programs to increase readiness, i.e., communities at the no awareness stage require analysis of the historical and cultural issues that support tolerance of drug use, those at the denial and vague awareness stages need specific information about local problems, and communities at the preplanning and preparation stages need information about effective programs, help in identifying resources, and assistance with staff training. In addition, building and maintaining effective programs requires continued evolution of readiness through the stages of initiation, stabilization, confirmation and expansion, and professionalization. Revised and updated scales and methods for assessing community readiness are provided.

Community Health Planning↗

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Recommendations to bridge rural/urban drug-use(r) research and practice.

This article presents recommendations developed by a group of United States drug-use(r) researchers interested in rural and urban research and practice who met in Lexington, Kentucky, in October 1996. Overall, there was consensus about the importance of better understanding the urban/rural drug and alcohol use/dependency continuum. It was emphasized that drug and alcohol use/dependency are chronic and relapsing disorders. Definitions of rural and urban are most important, and different definitions may be associated with factors that are masked by population density. Specific recommendations are presented in the following areas: Rural Factors, Epidemiology, HIV/AIDS, Treatment and Other Services, Migration, Youth, Protective Factors, Systems Perspective, Measurement, Confidentiality, Criminal Justice, Research, Policy Research, Economic Factors, Service Providers, and Managed Care.

HIV Infections↗