Keeping the Spirit of Community Partnerships Alive in theScale Up of HIV/AIDS Prevention: Critical Reflections on the RollOut of DEBI (Diffusion of Effective Behavioral Interventions)

摘要

DEBI, or the Diffusion of Effective BehavioralInterventions is the largest centralized effort to diffuseevidence-based prevention science to fight HIV/AIDS inthe United States. DEBI seeks to ensure that the mosteffective science-based prevention interventions are widelyimplemented across the country in community-basedorganizations. Thus, this is a particularly timely juncture inwhich to critically reflect on the extent to which knownprinciples of community collaboration have guided keyprocesses associated with the DEBI rollout. We review theavailable evidence on how the dissemination of packagedinterventions is necessary but not sufficient for ensuring thesuccess of technology transfer. We consider additionalprinciples that are vital for successful technology transfer,which were not central considerations in the rollout of theDEBI initiative. These issues are: (1) community percep-tions of a top-down mode of dissemination; (2) the extentto which local innovations are being embraced, bolstered,or eliminated; and (3) contextual and methodological considerations that shape community preparedness. Con-sideration of these additional factors is necessary in orderto effectively document, manage, and advance the scienceof dissemination and technology transfer in centralizedprevention efforts within and outside of HIV/AIDS.