From targets to ripples: tracing the process of developing a community capacity building appraisal tool with remote Australian indigenous communities to tackle food security

Food insecurity, which relates to food availability, access and use, contributes to the disadvantage experienced by Indigenous Australians [1] and an excessive burden of preventable chronic disease [2] and undernutrition in children [1]. Many factors relating to the physical, economic, political and socio-cultural environments contribute to food insecurity [1] making it a highly complex and dynamic issue with no simple solution [3]. Approaches to address food security that are multi-sectoral, involve the whole-of-society, and are contextually relevant have been endorsed [4] and evidence suggests that nutrition improvement is more likely if issues are widely understood, discussed and owned by the people and organisations for whom behaviour change is intended [5].

One way of facilitating a community collaborative effort to tackle community food security and achieve improved nutrition is to encourage the formation of multi-sector groups with representation of relevant community agencies and interests [6–8]. These collaborative efforts serve as forums to connect people with diverse talents, ideas, capacities and shared concerns [9, 10] and to utilise these to identify needs, make decisions, and set up mechanisms to effect change within community organisations and service agencies [9]. The rationale for these multi-sector groups is that through providing the conditions to enhance capacity in areas such as participatory planning and decision-making, community networking, participation and commitment, outcomes will be better realised and maintained.

Evidence however on the effectiveness of multi-sector groups in improving community-level outcomes is limited and mixed [7, 11, 12]; attention has been focused on the more intermediate benefits of multi-sector groups in fostering community capacity as important precursors to system level change. In this respect investment in achieving goals of community capacity need to run parallel to achieving program goals or health outcomes [13]. Goodman et al. [14] indicate that failure to invest in building the conditions of community capacity may prevent or attenuate program outcomes. Understanding the characteristics of community capacity and how to enhance these assets could therefore support a multi-sector group to achieve its desired outcomes.

MacLellan-Wright et al. [15], Rifkin et al. [16], Gibbon et al. [17] and Laverack [18] made valuable contributions to the evolution of capacity development models and to investigating participatory processes which actively engage communities to evaluate their capacity. Similarly to Jackson et al. [10], these authors suggest that capacity measures be developed in consultation with the community and be adapted to the uniqueness of each community and setting [10]. In the context of remote Indigenous Australia, Laverack et al. [19] applied a model of capacity development previously used in Fiji [20] to assess capacity development with health action teams in three communities. The model comprised nine capacity development constructs with adaptations made to the interpretations of these to suit the cultural setting.

Through a review of capacity development models including the model used by Laverack et al. [19], we previously described a set of capacity development constructs common to the models reviewed [21]. These constructs included a sense of community, an assets-based approach, leadership, participatory decision-making, partnerships, learning opportunities and skill development, a development pathway (including planning and evaluation processes), resource mobilisation, and communication (see Additional file 1: Table S1).

Remote Indigenous Australia is uniquely different from many other social and cultural contexts. This difference stems from a combination of factors including its recent history of European invasion, colonisation and oppression, preservation of multiple languages and retention of traditional governance structures and cultural practices despite the influences of the dominant Western worldview. There is poor understanding in the literature of the characteristics of community capacity that may affect program implementation and program outcomes in this unique context, although community ownership, community participation and leadership have been identified as important elements of successful health-related initiatives [22].

We had the opportunity to explore the characteristics of community capacity and develop a tool through the Good Food Systems, Good Food for All Project (GFS) that commenced in 2009. This project was a whole food system-focused initiative undertaken with four Indigenous communities. The project aimed overall to develop an approach through community level multi-sector food-interest groups to address food security through encouraging local organisations and groups to enhance their programs and services.

Working within this overall project, we aimed to assess the relevance and meaning of the common capacity development constructs in the context of the perspectives and worldviews of community members in remote Indigenous Australia; and through this, develop a tool for the purpose of multi-sector food-interest groups to foster capacity development. We set out to determine (i) if the literature-derived community capacity constructs were important in helping to reflect on community capacity; (ii) if the characteristics associated with each of the constructs differed from that in the literature; (iii) if there were gaps between literature- and community-derived characteristics; and, (iv) if the constructs were useful in appraising community capacity. This paper aims to describe this process.

Arising from the process outlined above, this section describes the specific meanings attributed to each of the constructs, and the changes from the labelling of the literature review construct to those determined by participants.

This study is important because it contributes to the very limited published literature on the way in which capacity appraisal models may need to be modified to suit different contexts. We found that the constructs commonly used to appraise community capacity development were well accepted by both Indigenous and non-Indigenous people involved in planning and service provision in four remote Indigenous Australian communities and could be used to identify areas in need of strengthening. The specifics of each construct however differed from those derived from the literature yet were similar across the four communities and had particular meaning for those involved. This finding strengthens the proposition of Labonte and Laverack [25] that there are key features of capacity development that are transferable across different communities but that differences in specifics are likely to be contingent on the social and cultural context of those involved [25]. For example, we found that some elements commonly associated with the construct ‘sense of community’ in the literature [14], such as a feeling of belonging and a sense of caring and sharing among people in the community, were identified in this study, whereas recognising community history, culture, language, and issues of identity and place, also associated with sense of community in the literature [26] were not explicitly stated by participants. This by no means infers that these elements are not important in the context of remote Indigenous Australia, but that in this study they were considered in a different way. In the four study-communities, Indigenous culture and languages predominate and elders are the custodians of these to ensure their survival. Indeed a central role was ascribed to elders in six of the 11 constructs in the proposed model thus ensuring the integrity and spirit of cultural values in the functions of the food-interest group and providing the path for success. The concept of community ownership as referred to by participants in itself in many ways related to embracing cultural values and identity and ensuring cultural safety to enable full participation of community members. These differences in specifics reinforce the importance of developing particular measures of success for each construct in consultation with the community to capture the uniqueness of each community and the relevant characteristics that are important to community capacity [10].

There are very complex rules around relationships in the Indigenous Australian context that determine processes of engagement, and relationships are prioritized and viewed as the cornerstone to working effectively as a collective. A common thread to each of the constructs was the relationships between the people involved both with each other and with the wider community. It was clear that participants recognized that improving food security and nutrition in the community required the involvement of different players representing both the community groups and community services. Who exactly these people should be was a focus of each of the four community food-interest groups and often a sticking point and seen as an obstacle to making headway when it was felt that the “right people” were not yet involved. Bound in the “who”, are those who can provide the leadership, knowledge and know-how to support the group to realise its goals. This is synonymous with the view of Butterfoss ([9], p 328) that “the key asset of any coalition is its members, and the role of the coalition is to mobilise effectively members’ commitment, talents, and assets to effect change” [9]. Investing time in identifying the roles and responsibilities of the group, mapping these with key group members and how they relate among themselves, understanding the cultural governance structures of the community and keeping the rules of engagement transparent are likely to be paramount to forming a solid structure on which capacity can be further developed in the study context.

We also found that those constructs featuring strongly in other capacity development models in the literature [21] such as learning opportunities, skills development and resource mobilization were not prominent in this study. In contrast, the constructs receiving less emphasis in the literature such as community ownership, commitment to action, and communication were prominent in this study and together with leadership and strong voice, seemed to receive most attention when participants appraised their own community capacity. These constructs have previously been observed as important indicators of community capacity when used with other non-Western or marginalised populations [10, 27].

Strategies identified to strengthen these focused on actively seeking the engagement of elders and the support of the community through home visits and making the actions of the group visible to the rest of the community. These strategies were similar to those reported by Laverack et al. when assessing capacity development with Indigenous people in Northern Queensland [19]. ‘Buy-in’ and support of communities seemed pivotal to the functioning of the food-interest groups. This focus may have also been indicative of the relatively early stage of establishment that defined each group [8] and the need to set the conditions to then be effective in achieving outcomes. Ongoing dialogue with the community and demonstration of activity seemed to be a pathway to gaining community ownership and support. This is particularly salient, as the emphasis we observed that food-interest groups placed on visible activities such as cooking demonstrations or campaign days, may have been more directed to achieving the interim step of community support and effective relationship building in the establishment stage of the food-interestgroup than in solely promoting healthy eating.

Chino et al. [26] highlight that it is often wrongly assumed that members of Indigenous communities can immediately begin to resolve an issue, whereas in contrast these authors suggest robust attention needs to be paid to the processes required to build trust and achieve effective relationships and communication. However the reality is that often funding conditions and program timelines drive practices which tend to place more emphasis on achieving outcomes often to the neglect of relationship building [28]. The Indigenous people participating in this study not only had to navigate the continually changing and sometimes unfamiliar terrain of Aboriginal-non-Aboriginal relationships, but also the cultural relationships that strictly prescribe processes of communication. Similarly the non-Aboriginal participants were often finding their way in unfamiliar territory. We found time and resources and an appreciation of the complexity of social and cultural relationships were needed to support this process [26] and yet these processes in many instances are under-valued or have not been elucidated. The features of successful interventions in Aboriginal and Torres Strait Islander settings have involved local people, formed effective partnerships, trusting relationships and community support [22]. A reorientation to approaches to food security in the remote Indigenous context where community capacity goals are considered in parallel with outcome goals, or at least as genuine incremental goals along the way, may well help to lay a more solid foundation for improved practice in service delivery and program sustainability [13]. In fact, provision of adequate time to allow for these basic foundations to be established might help to address the limited observable effects of projects and programs currently experienced in remote Indigenous Australia. The community capacity appraisal model evolving from this study provides a process on how to approach this.

In this study we started with a set of literature-derived capacity development constructs and sought to assess the relevance and meaning of these from the perspectives and worldviews of community members in four Indigenous communities. This could be seen to be a limitation, since had we taken an entirely inductive approach to developing a set of constructs building on Indigenous ‘ways of knowing’ , the model may have evolved differently but with less opportunity to compare with those developed elsewhere. Step 2 did however employ an inductive process of inquiry and through this process we found commonalities between participant-derived and literature-derived constructs. The shift from target to ripple is a clear example of needing to view the world from that of the people involved. The ripple concept that was identified by participants in this study is similar to the ‘spider web’ approach for visually presenting capacity development used in Nepal and other non-Western contexts [16, 17, 29]. We found that the ripple scoring process stimulated rich dialogue around each construct. A strength of the subjective process we used in collectively appraising constructs is that it does not confine people’s consideration of the construct and allows new perspectives to emerge. To reduce subjectivity in assessing community capacity, Laverack [18] developed a process of ranking constructs [18]. As greater insight is acquired on the meaning of community capacity in the context of remote Indigenous Australia, a similar process to strengthen rigor in appraising capacity development over time, could be employed while maintaining scope for discussion and divergent views to be voiced.

At this stage, a clear limitation to assessing the relevance of literature derived constructs to a particular cultural and social context is that there is no internationally agreed set of components or standard definition of constructs from which to base an assessment, and this acts as a limit to subsequent comparison between contexts. At present, comparisons in construct characteristics across different cultural and social contexts therefore need to be made with caution as the meanings and specifics ascribed to the different constructs may differ particularly if developed in-situ.

There are other potential limitations to the proposed model from this study that could be addressed through further research. We developed this model with the involvement of four remote Indigenous communities and a diverse group of stakeholders with various roles in the food system that to some extent represents the diversity observed across communities. Community capacity however is a complex concept that has many dimensions and it is likely that we have not fully captured these – for example, the views of community capacity from the other Indigenous group in Australia, Torres Strait Islander communities, have not been captured. We tested the appraisal process in-situ with a food-interest group that had been meeting at least every three months for nearly two years. Further testing with other community groups could provide insight into the relevance of different constructs at different stages of capacity development. Whether the model when operationalized to evaluate community capacity picks up on the most important aspects of community capacity pertinent to what is needed to support improvements in food security and nutrition needs to be tested. The robustness of the constructs over time to support capacity development also need testing in addition to the reliability of the ripple scoring process with involvement of different people in the food-interest group. This later point is particularly pertinent as the composition of the food-interest group, which we found to be relatively fluid, can easily change the power balance and impact on the active engagement of different people, and of Indigenous people particularly. Research is also warranted on the benefits of assessment of capacity building over the long-term and the extent to which capacity development can be associated with positive outcomes. Further research in the area of capacity development appraisal would benefit from researchers clearly stating the specifics of constructs used for each cultural and social group for which they have been adapted and applied.

In conclusion, this study contributes to the relatively limited literature on appraisal of capacity development that has been undertaken with Indigenous communities. It suggests an approach for ascribing context specific meanings to a set of capacity development constructs. The embedding of reflection on the capacity development constructs proposed in our model, in the setting up and maintenance of multi-sector groups, and a particular emphasis on the building of relationships in the early stages of establishment rather than a sole focus on health-related outcomes, can be regarded as incremental process-type outcomes and consequently have potential to contribute to stronger results in the long run. Practically, the model could be used initially to support the establishment of a multi-sector group, for example, in terms of considering the composition of the group and the relationship of the group with the community, and then later to reflect on the functioning of the group in being able to effect change. The use of the ripple tool described in this study provides an effective visual tool for the group to reflect on and track its development over time. Although the appraisal of capacity takes time and resources, we believe it appears well worthwhile to enhance the strengthening of community capacity in order to tackle complex issues such as food security that require a multi-sector approach.