Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Feb;13(2):458-464.
doi: 10.4103/jfmpc.jfmpc_772_23. Epub 2024 Mar 6.

Community-based Advocacy Communication Social Mobilization (ACSM) intervention by empowering key community leaders: Evaluation using the RE-AIM framework

Affiliations

Community-based Advocacy Communication Social Mobilization (ACSM) intervention by empowering key community leaders: Evaluation using the RE-AIM framework

Reenaa Mohan et al. J Family Med Prim Care. 2024 Feb.

Abstract

Background: Based on the theme of World Tuberculosis (TB) Day 2018-"Wanted Leaders for TB free world," various studies and country-level project have witnessed how training leaders on TB has helped enhance TB awareness in the community. This study was conducted to evaluate the effectiveness of Advocacy Communication and Social Mobilization (ACSM) intervention strategy through key community leaders, using Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) framework.

Materials and methods: This study was undertaken by the Department of Community Medicine, Sri Manakula Vinayagar Medical College and Hospital (SMVMCH), Puducherry, in the field practice area of Primary Health Centre (PHC), Thirubuvanai. The STOP TB, ENGAGE-TB, and National TB Elimination Program (NTEP) guidelines were used for interventions. Key community leaders (KCL) list (N = 117) was obtained from Mannadipet commune panchayat and PHC. The study was conducted in four phases: phase 1 (baseline): quantitative data: proportion of presumptive TB cases from notification register; phase 2 (intervention): training program for staff nurses, auxiliary nurse midwife (ANM), Accredited Social Health Activist (ASHA), and Anganwadi workers (group activity), participatory rural appraisal (PRA) activity for self-help group (SHG) leaders, and health education session for religious leaders and ex-panchayat leaders; phase 3: strengthening of ongoing activity: health education session and active case finding for TB; and phase 4: end line: outcome of the intervention, evaluated using the RE-AIM framework.

Results: As an outcome of the intervention, there was a marginal increase (21 cases) in the proportion of presumptive TB cases when comparing before (2018) and after (2019) intervention. The proportion of presumptive TB cases identified and referred by KCL was 312. A total of 77 presumptive TB cases were identified through community-based active case finding (ACF). Two sputum samples (on the spot early morning) were collected and sent for Cartridge-based nucleic acid amplification testing (CBNAAT), of which three cases were positive.

Conclusion: This study was community led and involved leaders from diverse backgrounds, optimizing the chance of success. For sustainability, we have initiated TB support group.

Keywords: ACSM; PRA; RE-AIM; TB; key community leaders.

PubMed Disclaimer

Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Visual diagram showing phases of ACSM intervention
Figure 2
Figure 2
Trend analysis proportion of presumptive TB cases before (2018) and after (2019) intervention

References

    1. Central TB division India TB report 2020, national tuberculosis elimination programme. Ministry of health and family welfare, New Delhi. [[Last accessed on 2020 July 15]]. Available from: https://tbcindia.gov.in/showfile.php?lid=3538 .
    1. National strategic plan for tuberculosis: 2017-25 elimination by 2025. RNTCP. 2017. [[Last accessed on 2020 Oct 9]]. Available from: https://tbcindia.gov.in/WriteReadData/National%20Strategic%20Plan%202017... .
    1. Stop TB partnership. 2014. [[Last accessed on Jun 06]]. Available from: http://www.stoptb.org/news/stories/2014/default.as .
    1. ENGAGE-TB. World health organization. 2012. [[Last accessed on 2020 Jul 20]]. Available from: https://www.who.int/tb/areas-of-work/community-engagement/faqs/en/
    1. Paul S, Akter R, Aftab A, Khan AM, Barua M, Islam S, et al. Knowledge and attitude of key community members towards tuberculosis: Mixed method study from BRAC TB control areas in Bangladesh. BMC Public Health. 2015;15:52. - PMC - PubMed