An agency capacity model to facilitate implementation of evidence-based behavioral interventions by community-based organizations.

The Centers for Disease Control and Prevention (CDC) implemented the Diffusion of Effective Behavioral Interventions Project to disseminate evidence-based behavioral interventions to community-based HIV prevention providers. Through development of intervention-specific technical assistance guides and provision of face-to-face, telephone, and e-mail technical assistance, a range of capacity-building issues were identified. These issues were linked to a proposed agency capacity model for implementing an evidence-based intervention. The model has six domains: organizational environment, governance, and programmatic infrastructure; workforce and professional development; resources and support; motivational forces and readiness; learning from experience; and adjusting to the external environment. We think this model could be used to implement evidence-based interventions by facilitating the selection of best-prepared agencies and by identifying critical areas of capacity building. The model will help us establish a framework for informing future program announcements and predecisional site visit assessments, and in developing an instrument for assessing agency capacity to implement evidence-based interventions.

The evolution of the CDC HIV prevention capacity-building assistance initiative.

As the HIV/AIDS epidemic neared the end of its first decade in the late 1980s, the US Centers for Disease Control and Prevention (CDC) recognized the disparate impact on racial and ethnic minority communities. In response, a program was initiated to build capacity to prevent the further spread of HIV and other STDs in these communities. Since that time, the program has expanded in scope, intensity of efforts, and funding. Today, the CDC's Capacity Building Assistance (CBA) Initiative serves communities across the nation by building community, organizational, and HIV prevention program/intervention capacity designed to reduce the number of new HIV infections among at-risk populations. This article focuses on the history and evolution of these efforts, lessons learned, and how these were used to develop the current, more responsive system. A conceptual framework is presented that describes the taxonomy of CBA services designed to (1) enhance organizational infrastructure; (2) enhance HIV prevention interventions; (3) strengthen community capacity; and (4) strengthen community planning. It includes language and definitions, approaches and mechanisms for delivering capacity-building services, and a Web-based request-and-referral system that serves as the foundation for tracking, monitoring, and ensuring the delivery of appropriate, efficient, and culturally competent CBA.

Reputationally strong HIV prevention programs: lessons from the front line.

Although HIV prevention researchers have conducted numerous controlled outcome studies to evaluate the effectiveness of theory-based interventions aimed at reducing HIV risk behaviors, many HIV risk reduction interventions are conducted not by researchers but by staff in local health departments or community-based organizations (CBOs). Despite their widely recognized role in slowing the spread of HIV, very few attempts have been geared toward understanding the programmatic and organizational characteristics of their HIV prevention efforts. The Centers for Disease Control and Prevention's Characteristics of Reputationally Strong Programs project identified and profiled 18 innovative, community-based, HIV prevention programs viewed by community partners as successful. The aim was to determine common features of the programs that could be widely applied to improve HIV prevention research and programs. Results indicated that several common intervention characteristics and organizational characteristics, including agency support and staff commitment, played significant roles in the success of reputationally strong programs.