Multilevel perspectives on community intervention: an example from an Indo-US HIV prevention project in Mumbai, India.
This paper explores the meaning and applicability of multilevel interventions and the role of ethnography in identifying intervention opportunities and accounting for research design limitations. It utilizes as a case example the data and experiences from a 6-year, NIMH-funded, intervention to prevent HIV/STI among married men in urban poor communities in Mumbai, India. The experiences generated by this project illustrate the need for multilevel interventions to include: (1) ethnographically driven formative research to delineate appropriate levels, stakeholders and collaborators; (2) identification of ways to link interventions to the local culture and community context; (3) the development of a model of intervention that is sufficiently flexible to be consistently applied to different intervention levels using comparable culturally congruent concepts and approaches; (4) mechanisms to involve community residents, community based organizations and community-based institutions; and (5) approaches to data collection that can evaluate the impact of the project on multiple intersecting levels.
Schensul
Stephen L
SL
Department of Community Medicine & Health Care, University of Connecticut School of Medicine, 263 Farmington Avenue, Farmington, CT 06030-6325, USA. schensul@nso2.uchc.edu
Saggurti
Niranjan
N
Singh
Rajendra
R
Verma
Ravi K
RK
Nastasi
Bonnie K
BK
Mazumder
Papiya Guha
PG
D000328:Adult; D002391:Catchment Area, Health; D003153:Community Health Services / Q000458:organization & administration*; D005114:Extramarital Relations; D005260:Female; D015658:HIV Infections / Q000453:epidemiology* / Q000517:prevention & control*; D006801:Humans; D007194:India / Q000453:epidemiology; D007391:International Cooperation; D008297:Male; D008393:Marriage / Q000706:statistics & numerical data; D011314:Preventive Health Services / Q000458:organization & administration*; D012307:Risk Factors; D012309:Risk-Taking; D012749:Sexually Transmitted Diseases / Q000453:epidemiology; D014481:United States / Q000453:epidemiology; D055815:Young Adult