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This study uses the concept of readiness to intervention for evaluating and improving primary health care. The concept of community readiness examines the interaction between community context and program design and implementation. The main idea is that effectiveness of social intervention depends on the preparation of the community for social change. The original model (Edwards et al., 2000) proposes nine different stages of readiness for implementing programs, from “no awareness” to “professionalization”. However, we could interpret readiness also as a continuum and identify different profiles or types (Chazdon & Lott, 2011; Holgado & Maya Jariego, 2012; Maya Jariego et al., 2010). In this paper we present a classification of primary health centres in Andalusia (Spain) according to three dimensions of community readiness.
The research was based in three different strategies. First, 81 social workers from primary health care centres in Andalusia were interviewed and completed a 18 items scale on social participation, community adjustment and professional implication in health centres. Second, 40 health centres were observed, taking information on the professional role of social workers and organizational issues, as well as applying a survey both to compare the view of social workers and other health professionals. Finally, 10 case studies were deployed examining through in-depth interviews the interaction between the organizational and the community contexts in health care programs’ implementation.
Three levels of community readiness were identified, conducing respectively to sensitization activities, community organizing strategies and application of evidence-based programs. Cluster analysis allowed the identification of three different profiles of community readiness in primary health care centres in Andalusia: reactive, technical-aid and community approach. The interaction between organization and community processes is discussed.