title: Understanding the black box: a systematic review of the measurement of the community mobilization process in evaluations of interventions targeting sexual, reproductive, and maternal health.
abstract: Community mobilization (CM) interventions are often used to improve sexual, reproductive, and maternal health (SRMH). This systematic review provides an overview of CM indicators used in evaluation and then focuses on the use of linking constructs-those measures of the process of CM between programmatic outputs and outcomes. We identified 108 English-language articles evaluating 86 CM interventions that target SRMH. Content analysis was used to code CM indicators into five categories: qualitative descriptions of CM; participation, diffusion and community action indicators that measure tangible, programmatic outputs; and linking constructs that capture the process of moving from participation to empowerment. Fifty-five (64.0%) interventions include a CM indicator. Diffusion indicators are most common (56.4%); linking constructs are least common (20.0%). We found 23 linking constructs used in evaluations of 11 interventions, with limited information on psychometric properties available. Three evaluations report positive relationships between linking constructs and condom use, one of which was significant in multivariate analysis. To better understand how CM leads to improved outcomes, we recommend increasing the measurement of linking constructs in evaluations of CM interventions. Research should focus on developing and validating new linking construct indicators and better disseminating existing measurement tools.
authors.affiliation: MANILA Consulting Group, Inc., 1420 Beverly Road Suite 220, McLean, VA 22101, USA; CARE USA, 51 Ellis Street, Atlanta, GA 30303, USA. Electronic address: lara.altman@gmail.com.
authors.forename: Lara
authors.initials: L
authors.lastname: Altman
authors.affiliation: MANILA Consulting Group, Inc., 1420 Beverly Road Suite 220, McLean, VA 22101, USA; George Warren Brown School of Social Work, Washington University in St. Louis, Campus Box 1196, One Brookings Drive, St. Louis, MO 63130, USA. Electronic address: sebertkuhlmanna@slu.edu.
authors.forename: Anne K Sebert
authors.initials: AK
authors.lastname: Kuhlmann
authors.affiliation: CARE USA, 51 Ellis Street, Atlanta, GA 30303, USA. Electronic address: cgalavotti@care.org.
authors.forename: Christine
authors.initials: C
authors.lastname: Galavotti
mesh_terms: D003256:Community Participation; D005260:Female; D006293:Health Promotion / Q000379:methods / Q000592:standards; D006801:Humans; D008297:Male; D000068097:Maternal Health; D015397:Program Evaluation; D060728:Reproductive Health
keywords: Community action; Community health care; Evaluation studies; Information dissemination; Linking constructs; Maternal health; Reproductive health; Systematic review