Keeping the Spirit of Community Partnerships Alive in the Scale Up of HIV/AIDS Prevention: Critical Reflections on the Roll Out of DEBI (Diffusion of Effective Behavioral Interventions)
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DEBI, or the Diffusion of Effective Behavioral Interventions is the largest centralized effort to diffuse evidence-based prevention science to fight HIV/AIDS in the United States. DEBI seeks to ensure that the most effective science-based prevention interventions are widely implemented across the country in community-based organizations. Thus, this is a particularly timely juncture in which to critically reflect on the extent to which known principles of community collaboration have guided key processes associated with the DEBI rollout. We review the available evidence on how the dissemination of packaged interventions is necessary but not sufficient for ensuring the success of technology transfer. We consider additional principles that are vital for successful technology transfer, which were not central considerations in the rollout of the DEBI initiative. These issues are: (1) community perceptions of a top-down mode of dissemination; (2) the extent to which local innovations are being embraced, bolstered, or eliminated; and (3) contextual and methodological considerations that shape community preparedness. Consideration of these additional factors is necessary in order to effectively document, manage, and advance the science of dissemination and technology transfer in centralized prevention efforts within and outside of HIV/AIDS.
KeywordsCommunity partnerships HIV/AIDS prevention interventions Diffusion of Effective Behavioral Interventions (DEBI) Technology transfer Power relations
This research was supported by center grants P50-MH43520 and P30-MH43520 from NIMH to the HIV Center for Clinical and Behavioral Studies, Anke A. Ehrhardt, Ph.D., Principal Investigator, and by NRSA training grant T32-MH19139, to Behavioral Sciences Research Training in HIV Infection. The authors gratefully acknowledge the members of the Community Collaboration Core, Directed by Robert Remien, Bruce Rapkin and Joyce Hunter. We are also appreciative to the CDC for their correspondence with us on the issues discussed in the paper and to the CHAMP Network (Community HIV/AIDS Mobilization Project) that provided us with dialogues with dozens of additional individuals from CBOS, health departments, service providers, and ASOs around the country on this topic. On this latter point, special thanks are given to Julie Davids and Sean Barry from CHAMP.
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