A sustainable community coalition conceptual framework for organisational stakeholders to manage alcohol misuse as a risk factor of HIV infection

Abstract

The overall aim of this study was to construct and describe a conceptual framework that can serve as a frame of reference for organisational stakeholders to sustain a community coalition to manage alcohol misuse as a risk factor of HIV infection in a specific community in the North West Province, South Africa. A Participatory Action Research (PAR) design that was qualitative and theory generative in nature was followed in this study. A phased approach with specific objectives aligned to the PAR cycle, namely observe (Phase One), reflect (Phase Two), plan (Phase Three) and act (Phase Four), was followed. These phases were actualised through an exploratory, descriptive and contextual research design, guided and theoretically influenced by critical theory. Data in Phase One were collected through 10 key informant interviews. Data were collected in Phases Two to Four through 10 dialogue meetings. Data collected in the four phases were used to construct and describe the conceptual framework that was evaluated by five experts in the field of mental health and substance misuse for refinement (Phase Five). Thematic data analyses was done to identify emerging themes. Key issues identified were that the community is characterised by fragile community coalitions that hamper the management of alcohol misuse as a risk factor of HIV infection. Factors to be considered to sustain the coalition were identified as sharing a common vision, promoting a trusting relationship, formalising the coalition, transformational leadership, strengthening organisational unity, and access to financial resources. This research adds knowledge in the field of mental health and substance misuse by providing a sustainable community coalition conceptual framework for organisational stakeholders to manage alcohol misuse as a risk factor of HIV infection. The conceptual framework could be used to inform policy, further research, education and improve practice in the field of mental health and substance misuse. Although the study was limited to a specific geographical area of a community in the North West Province, South Africa, the findings can be adapted to fit a specific setting.