{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T07:48:36Z","timestamp":1791532116049,"version":"4.3.4"},"reference-count":42,"publisher":"BMJ","issue":"8","license":[{"start":{"date-parts":[[2020,8,21]],"date-time":"2020-08-21T00:00:00Z","timestamp":1597968000000},"content-version":"unspecified","delay-in-days":20,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["1P20 GM125498-01"],"award-info":[{"award-number":["1P20 GM125498-01"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000865","name":"Bill and Melinda Gates Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]},{"name":"United Kingdom Department for International Development"},{"name":"Bill and Melinda Gates through the Global Good Fund"},{"name":"Age International"},{"DOI":"10.13039\/100006641","name":"UNICEF","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006641","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Glob Health"],"accepted":{"date-parts":[[2020,6,15]]},"published-print":{"date-parts":[[2020,8]]},"abstract":"<jats:p>Documentation of structured community engagement initiatives and real-time monitoring of community engagement activities during large-scale epidemics is limited. To inform such initiatives, this paper analyses the Community Led Ebola Action (CLEA) approach implemented through the Social Mobilization Action Consortium (SMAC) during the 2014\u20132016 Ebola epidemic in Sierra Leone. The SMAC initiative consisted of a network of 2466 community mobilisers, &gt;6000 religious leaders and 42 local radio stations across all 14 districts of Sierra Leone. Community mobilisers were active in nearly 70% of all communities across the country using the CLEA approach to facilitate community analysis, trigger collective action planning and maintain community action plans over time. CLEA was complemented by interactive radio programming and intensified religious leader engagement.<\/jats:p>\n                  <jats:p>Community mobilisers trained in the CLEA approach used participatory methods, comprised of an initial community \u2018triggering\u2019 event, action plan development and weekly follow-ups to monitor progress on identified action items. Mobilisers collected operational and behavioural data on a weekly basis as part of CLEA. We conducted a retrospective analysis of &gt;50 000 weekly reports from approximately 12 000 communities from December 2014 to September 2015. The data showed that 100% of the communities that were engaged had one or more action plans in place. Out of the 63 110 cumulative action points monitored by community mobilisers, 92% were marked as \u2018in-progress\u2019 (85%) or \u2018achieved\u2019 (7%) within 9 months. A qualitative examination of action points revealed that the in-progress status was indicative of the long-term sustainability of most action points (eg, continuous monitoring of visitors into the community) versus one-off action items that were marked as achieved (eg, initial installation of handwashing station). Analysis of behavioural outcomes of the intervention indicate an increase over time in the fraction of reported safe burials and fraction of reported cases referred for medical care within 24 hours of symptom onset in the communities that were engaged.<\/jats:p>\n                  <jats:p>Through CLEA, we have demonstrated how large-scale, coordinated community engagement interventions can be achieved and monitored in real-time during future Ebola epidemics and other similar epidemics. The SMAC initiative provides a practical model for the design, implementation and monitoring of community engagement, integration and coordination of community engagement interventions with other health emergency response pillars, and adaptive strategies for large-scale community-based operational data collection.<\/jats:p>","DOI":"10.1136\/bmjgh-2019-002145","type":"journal-article","created":{"date-parts":[[2020,8,24]],"date-time":"2020-08-24T02:50:12Z","timestamp":1598237412000},"page":"e002145","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":93,"title":["Community engagement in outbreak response: lessons from the 2014\u20132016 Ebola outbreak in Sierra Leone"],"prefix":"10.1136","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4419-9536","authenticated-orcid":false,"given":"Jamie","family":"Bedson","sequence":"first","affiliation":[{"name":"Restless Development Sierra Leone, Freetown, Sierra Leone"},{"name":"Consultant to the Bill and Melinda Gates Foundation, Seattle, Washington, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7206-8042","authenticated-orcid":false,"given":"Mohamed F","family":"Jalloh","sequence":"additional","affiliation":[{"name":"FOCUS 1000, Freetown, Sierra Leone"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danielle","family":"Pedi","sequence":"additional","affiliation":[{"name":"Bill and Melinda Gates Foundation, Seattle, Washington, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saiku","family":"Bah","sequence":"additional","affiliation":[{"name":"Restless Development Sierra Leone, Freetown, Sierra Leone"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katharine","family":"Owen","sequence":"additional","affiliation":[{"name":"GOAL, Freetown, Sierra Leone"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allan","family":"Oniba","sequence":"additional","affiliation":[{"name":"FOCUS 1000, Freetown, Sierra Leone"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Musa","family":"Sangarie","sequence":"additional","affiliation":[{"name":"BBC Media Action, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James S","family":"Fofanah","sequence":"additional","affiliation":[{"name":"Restless Development Sierra Leone, Freetown, Sierra Leone"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammed B","family":"Jalloh","sequence":"additional","affiliation":[{"name":"FOCUS 1000, Freetown, Sierra Leone"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Sengeh","sequence":"additional","affiliation":[{"name":"FOCUS 1000, Freetown, Sierra Leone"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7952-0660","authenticated-orcid":false,"given":"Laura","family":"Skrip","sequence":"additional","affiliation":[{"name":"Epidemiology, Institute for Disease Modeling, Bellevue, Washington, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5464-654X","authenticated-orcid":false,"given":"Benjamin M","family":"Althouse","sequence":"additional","affiliation":[{"name":"Epidemiology, Institute for Disease Modeling, Bellevue, Washington, USA"},{"name":"Information School, University of Washington, Seattle, Washington, USA"},{"name":"Biology, New Mexico State University, Las Cruces, NM, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurent","family":"H\u00e9bert-Dufresne","sequence":"additional","affiliation":[{"name":"Vermont Complex Systems Center, University of Vermont, Burlington, Vermont, USA"},{"name":"Computer Science, University of Vermont, Burlington, Vermont, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2020,8,23]]},"reference":[{"key":"2025073015095042000_5.8.e002145.1","unstructured":"IFRC . 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