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Introduction: Empowering communities in low-resource settings to implement evidence-based interventions (EBI) is a primary health care priority. Because most implementation models are inappropriate for limited-resource communities, we adapted the Community Implementation Model (CIM) from a model developed in South Africa to disseminate a hospital-based EBI.

Objective: Our implementation research tests the use of CIM to guide community scale-up of a peer-group HIV-prevention EBI.

Methods: We used the 3-stage CIM (Preparing, Rolling-out and Sustaining) in rural communities of southern Malawi, where adult HIV prevalence is 16%. Collaborating with the health system and community leaders, we trained master trainers to train community peer-group leaders. We developed a multimedia toolkit containing training videos, adult and youth intervention manuals and materials, and benchmarks scoring forms. The yes/no benchmark items guide implementation and assess progress throughout the 3 stages: Preparing, Rolling-out and Sustaining.

Results: Using the toolkit, two communities established Coordinating Committees. Eleven health workers trained 32 peer-group leaders who provided the EBI to 800 adults and youth, completing Preparing and Rolling-out, and entering Sustaining. Using the toolkit, communities conducted peer-groups, maintained fidelity and evaluated progress. Benchmark scores demonstrated achievement of target scores at 6- and 12-months. Coordinating Committees shared results with health system and local leaders to petition for continued funding.

Conclusions: With initial researcher support, low-resource communities used CIM to implement an HIV-prevention EBI. CIM is an effective strategy to empower communities to implement EBIs and provide objective evidence of progress for government officials and policy-makers to evaluate, promote and fund effective programs.