Goal / Mission

Asian Pacific Partners for Empowerment Advocacy and Leadership (APPEAL)’s goal was to provide a way for communities to assess their capacity for engaging in equity-centered policy change. APPEAL developed the Stages of Community Readiness Model, a framework for assessing and evaluating tobacco control in the diverse Asian American and Pacific Islander (AAPI) communities. This readiness model can be applied to other types of systems level change outside of commercial tobacco including cancer prevention and control and healthy eating active living initiatives.

Description

The APPEAL Community Readiness Model provides a framework for which communities can assess their readiness to engage in different aspects of tobacco control or other health equity issues. The readiness model was developed and adapted from the Transtheoretical Model of assessing individual behavioral change. APPEAL’s Community Readiness Model provides a continuum on which a community can move from a pre-contemplation (thinking about change) stage to a maintenance stage in relation to addressing tobacco control issues. This model helps to identify stage-appropriate technical assistance and training (TAT) needed to support the movement of a community along the continuum of change. Used for assessment purposes, this model is intended to be fluid, dynamic, and adaptable with great benefit particularly in the areas of capacity building and infrastructural development.

The Community Readiness Model has been used to assess the readiness of many local Asian American, Native Hawaiian, and Pacific Islander (AA and NH/PI) communities in the U.S. and the Pacific Islands. It has also been adapted for other communities of color (including Puerto Rico) and other vulnerable priority populations such as LGBTQ+ and low socioeconomic communities.

The APPEAL Community Readiness Model has been very useful in creating a baseline assessment of a community’s readiness level on comprehensive tobacco control and then documenting incremental change observed. As a simple self-assessment tool, it allows communities to identify their priority areas and document success.

Implementation Process

The Community Readiness Model can be implemented using the following steps:

• Adapt readiness questions to organization or community needing assessment
• Distribute readiness model questions to participants for assessment
• Provide an assessment of capacity building using the APPEAL Community Readiness Model – scoring with rubric
• Using the five stages of readiness, categorize the organization’s programming, policy, and leadership and assess the infrastructures and communities from precontemplation and contemplation to preparation, action, and maintenance
• Score an organization and evaluate results for areas of need
• Tailor interventions and changes using assessment to identify areas of need and involving coordination and collaboration of communities and priority population input
• Work with APPEAL to implement changes

Contact APPEAL for more information about identifying the stage of readiness a community is currently working at and work with APPEAL to propose the appropriate technical assistance, training and resources for the community to access. This is especially important for infrastructural development issues such as financial resources, staffing, and representation on local and national tobacco control coalitions.

Impact / Results / Accomplishments / Outcomes 

The APPEAL Model allows communities to diagnose, then address their unique needs through appropriate technical assistance, training, and resources. The APPEAL Model benefits both communities and funders through its ability to better understand their readiness to conduct tobacco control and have realistic expectations on the outcomes of those efforts.

The APPEAL Readiness model describes the elements of readiness for AAs and PIs, particularly those addressing research and data issues, current applications of the model in specific AAPI ethnic communities, and the lessons learned thus far regarding the model’s applicability to, and support of, the development of AAPI tobacco control efforts nationally.

Lessons Learned

The success of the APPEAL Community Readiness Model can be applied and adapted through the following lessons learned:

• The implementation process is dependent on an organization’s level of capacity building and leadership development. Both are essential in achieving tobacco control policy change and health equity within Asian American, Native Hawaiian, and Pacific Islander communities. Before communities can comprehensively address tobacco, they need to develop community readiness and capacity on tobacco control.
• Any assessment of community readiness using  the APPEAL Community Readiness Model requires a methodical, disciplined, step-by-step approach to analyze each of the five stages of readiness which include: categorizing the organization’s programming, policy, and leadership and assessing the infrastructures and communities from precontemplation and contemplation to preparation, action, and maintenance. Continual reassessment is a critical component of the APPEAL Community Readiness Model.
• Access to technical assistance, training and resources for communities is needed in most instances. Groups such as APPEAL can provide an informed assessment of community readiness to achieve change with a level of objectivity and expertise in the APPEAL Community Readiness Model. Facilitation by APPEAL in the implementation process provides for a more coordinated shift toward readiness at each level.
• Coordination of efforts at all levels of the readiness model can more easily lead to change. In receiving technical assistance, training, and resources communities seeking change in tobacco influences within their communities were able to address important infrastructural development issues such as financial resources and staffing needs. In addition, these communities were able to increase representation on local and national tobacco control coalitions.
• For the broad strategy of infrastructure building, communities should consider where they stand in terms of having tobacco competent organizations and staffing available, the inclusion of AA, NH, and PI tobacco issues in mainstream coalitions, and leadership development.

The APPEAL Readiness Model translates beyond the priority populations focused on by APPEAL. Ongoing work with indigenous communities at the tribal and  state level and tobacco and data work through Advocacy and Data dissemination to achieve Equity for Priority populations on Tobacco (ADEPT) partners and National Network collaborations with cross-cultural and multiethnic coalitions serving Black, Latino, and LGBTQ plus communities add value to healthy community policy change.

About this Promising Practice (Contact information)

1. Organization(s): Asian and Pacific Islander American Health Forum – Roxanna Bautista, Amy Wong;  Asian Services in Action, Inc. – May Chen, Cheryl Owens; Charles B. Wang Community Health Center – Kenny Kwong;  Papa Ola Lōkahi – Lisa Kaanoi, Lorrie Ann Santos, JoAnn Tsark; Washington API Families Against Substance Abuse – Anita Hidalgo, Elaine Ishihara, Lee Tanuvasa
2. Primary Contact(s):  Rod Lew, MPH – APPEAL staff, [email protected] Asian Pacific Partners for Empowerment, Advocacy, and Leadership (APPEAL), 2255 Morella Avenue, Suite 208, Pleasant Hill, CA 94523
3. Authors: Asian and Pacific Islander American Health Forum – Roxanna Bautista, Amy Wong; Asian Services in Action, Inc. – May Chen, Cheryl Owens; Charles B. Wang Community Health Center –  Kenny Kwong;  Papa Ola Lōkahi – Lisa Kaanoi, Lorrie Ann Santos, JoAnn Tsark;  Washington API Families Against Substance Abuse: Anita Hidalgo, Elaine Ishihara, Lee Tanuvasa
4. Topic(s): Asian American Health, Community Health Readiness, Technical Assistance, Pre-contemplation, Community Readiness, Tobacco Control, Cessation, Health Equity.
5. Source: Lew R, Tanjasiri SP, Kagawa-Singer M, Yu JH. Using a stages of readiness model to address community capacity on tobacco control in the Asian American and Pacific Islander community
6. Date of Publication: Winter-Spring, 2001
7. Date of Implementation: 2001
8. Location: California & Washington
9. More details (web address for study):
   1. https://pubmed.ncbi.nlm.nih.gov/11720416/
   2. https://appealforhealth.org/programs/capacity-building/stages-of-readiness-model/
   3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1447834/
   4. https://psycnet.apa.org/doiLanding?doi=10.1037%2F0022-006X.51.3.390
   5. https://appealforhealth.org/resources/promising-practices/appeal-community-readiness-model/
   6. https://acsjournals.onlinelibrary.wiley.com/doi/10.1002/(SICI)1097-0142(19981015)83:8+%3C1818::AID-CNCR29%3E3.0.CO;2-X 
   7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3846162/
   8. https://healthequityamericas.usc.edu/resources/institutes-agencies-organizations/
   9. APPEAL Readiness Matrix
   10. APPEAL Readiness Subcategories
10. Target Audience: Community Based Organizations, Researchers, Policy Advocates