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The
Community
Psychologist

Volume 53   Number 1 Winter 2020

Special Feature: Case Studies of Community Collaborations

Edited by Robert Guitierrez, Arrupe College of Loyola University Chicago

Community psychology prides itself on the diverse positioning of community psychologists within complex systems. Understanding and addressing social issues requires not only an appreciation of the ecological landscape but a willingness to engage and collaborate with diverse stakeholders. These collaborations are integral to the field’s relevance and impact. Community psychology is based in part on the idea that true change is not only aided by broad inclusion of relevant community members but requires it to be truly impactful and just. While this type of approach introduces many additional layers of work and potential challenges it is what allows us to be part of authentic social change.

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This special feature section was developed with the intention of reflecting on a variety of community collaborations to better understand the challenges, successes, and lessons learned from countless people hours of deliberation, communication, and hard work. Authors range from community members, to outside researchers, to the gray in-between range that many of us find ourselves operating in. While each case history has its unique set of characters, context, and goals they reinforce larger themes of community collaboration.

These cases highlight the struggle to make community collaboration authentic and empowering, marrying the goals and talents of diverse stakeholders, and navigating the everchanging landscape that applied community work entails. By sharing and reflecting on the real-world experiences of professionals working in a wide range of settings we can better appreciate both the application of community psychology’s core values and the inventiveness, tact, and connection with community needed to actualize the former in our work.

The Researcher is not the Expert: Negotiating Roles and Responsibilities in the Muslimah Project

Written by Brianna Hunt and Ciann L. Wilson, Wilfrid Laurier University; and Ghazala Fauzia, Fauzia Mazhar, and Usma Bhutto, Coalition of Muslim Women of Kitchener Waterloo

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From the first meeting of the research team, The Muslimah Project was a collaborative endeavor. Driven by the common goal of understanding the impacts of intersectional discrimination on the mental health and employment precarity of Muslim women, one MA student, her research supervisor, and a small group of remarkable community leaders began the day as strangers and ended as colleagues. During their first meeting, The Muslimah Project research team collaborated to draft a successful proposal for Toronto’s Women’s College Hospital 15k Challenge, a (recently discontinued) program that provided small grants to community-based research projects aimed at improving women’s health in Ontario, Canada. With a small budget in hand and ambitious goals in mind, the collaborative project was born.

At Wilfrid Laurier University, collaborative, community-based research drives the Community Psychology program. For a number of years, members of the Coalition of Muslim Women of KW (CMW) have been eager community partners on student internships and other community-university related research partnerships intended to improve the lives of Muslim women in Kitchener-Waterloo, Ontario, Canada. In collaboration with researchers, community leaders from the CMW drove the success of The Muslimah Project: Exploring Intersections of Belonging, Mental Health, and Wellbeing for Muslim Women in Waterloo Region. The central research objective of the project was to center the voices of Muslim women in a comprehensive investigation of their experiences of discrimination and sense of belonging, and the resulting impacts on their mental health, work, social, and family life. Towards this end, our team conducted five focus groups with Muslim women across Waterloo Region.

Challenges

University-community partnerships are often fraught with varied and complex tensions. Early in The Muslimah Project, the research team began the important process of negotiating roles and responsibilities of team members. Throughout this negotiation, many pertinent and challenging questions arose. Here, we will share some of the challenges that The Muslimah Project research team faced, and how we successfully navigated the landscape of collaborative, community-based research. 

As a collaborative project, the meaningful involvement of both CMW members and academic researchers in all stages of the project was crucial. However, many aspects of the CMW’s role were undetermined at the commencement of The Muslimah Project, leading to ambiguous role definition. Negotiation of roles necessitated careful consideration of a variety of factors, including how visible involvement would strengthen recruitment and data collection processes throughout the project, as well as limitations that CMW’s involvement may pose.  In particular, the team had to consider the unique contributions that CMW members offered as registered clinicians, able to offer counselling support to participants, while recognizing the potential for the CMW’s position as a well-known, socio-politically involved community-based organization to create barriers for participants in this study.

Given that two academic researchers on the project team identified as non-Muslim, cis-gendered women, a non-racialized MA student and a racialized research supervisor, it was also incredibly important that the roles of outsider researchers were clearly defined and communicated throughout each stage of the project. While defining these roles, the research team considered how the involvement of community outsiders may create barriers to honest information sharing among participants. Due to the prevalence of ongoing and historical exploitative research that harms marginalized communities, including religious minorities and people of colour, the research team understood the possibility that participants may not feel comfortable sharing their unique experiences with outsiders. As a community-centered project, the comfort and safety of participants was an essential aspect of The Muslimah Project, and the importance of addressing these questions was underscored throughout each step of the research process.

Other challenges that arose in the planning stages of The Muslimah Project involved specific desires and visions for the growth of research team members and the outcome of the project. As a team, we considered what strengths and capacities each member could harness and develop throughout the design of the study. For members of the CMW, developing strong skills in academic research, writing, and presentation was an important aspect of the collaborative project.  As a team, we worked together to create a project that would provide opportunities for meaningful academic involvement for all researchers and community leaders involved in The Muslimah Project.

Finally, the harmonization of objectives and desired outcomes of The Muslimah Project was an important aspect of collaboration that the research team was careful to prioritize. In discussion, the team determined that project outputs should have scholarly impact as well as tangible impact within the community. As a team, we discussed project outputs regularly, speaking freely about the alignment of academic and community objectives.

Response

Successful navigation of role negotiation within The Muslimah Project was facilitated by the time commitment demonstrated by all members of the research team. Perhaps more than any other single factor, the willingness to share time in conversation contributed to the collaborative nature with which project decisions were made, standing out as an essential aspect of the project’s success and each team member gaining experience and skills throughout the project process. Some concerns surrounding role negotiation of CMW members involved the extent to which the presence of CMW members during data collection may dissuade participants from sharing criticisms of CMW. When these concerns were raised within the team, we came together in conversation, and formulated an appropriate solution. During focus groups, CMW members remained on-call to offer counselling support to study participants when necessary but did not take a leadership role in the collection of data. Further, during data collection, researchers explained that the role of CMW members was to provide resources and support the project’s success, rather than evaluate any participant responses in advance of the results coming from the research data.

The process of role definition for non-Muslim researchers necessitated ongoing collaborative conversation with other research team members and was characterized by reflexive practices throughout each stage of the project. Along with personal reflexive practices, recruitment was conducted in partnership between academic researchers and CMW leaders. In order to address the possibility of participant discomfort during recruitment, a Muslim community leader acted as the first point of contact for participants, who were then introduced personally to non-Muslim research team members. Prior to each focus group conversation, non-Muslim researchers named their status as community outsiders, acknowledging and sharing their own unique positionality as a white student researcher and a Black research supervisor, and their roles as learners (rather than experts) within the research process.

Shared goals between research team members were an essential aspect of effective collaboration throughout the project. Understanding that Muslim community members should not be represented in academic spheres solely by community outsiders, academic researchers on The Muslimah Project team had a genuine desire to support the involvement of CMW members within academic spaces. As such, we worked as a team to ensure the involvement of CMW members in publications, conference presentations, and other knowledge mobilization outputs from the project. Finally, we wanted to ensure that project outputs were meaningful within Muslim communities in Waterloo Region and beyond. To this end, we worked together to host a community forum that brought together local leaders from a variety of sectors, including local health care professionals, non-profit employees, and local planners and decision makers. Together, our efforts resulted in meaningful knowledge mobilization within Waterloo Region. 

Reflection

As researchers and community leaders, it is incredibly important to remember that not all challenges facing collaborative research teams are the result of research partnerships and processes. Barriers to genuine and meaningful community-academic collaboration posed at the administrative and institutional levels are often cumbersome and obstructive. Throughout The Muslimah Project, we encountered a number of barriers that could potentially have a negative impact on community-based collaborative work. For example, when applying for research funds, many funding bodies require the submission of formal Curricula Vitae, an uncommon requirement outside of academia. When submitting an article for publication, formal affiliations are often required for all authors, disregarding the possibility that authors may be community members. Many academic conferences sport high registration fees that are inaccessible for community leaders and collaborators. These represent just a few institutional barriers facing community-based research collaboratives.

As The Muslimah Project team, we were fortunate to receive a small grant that prioritized community-level outputs, allowing us to invest in the creation of an accessible project video and the hosting of our community forum. The recent dissolution of this granting program marks the end of an important facilitator for Canadian community-based research focused on the health of vulnerable communities such as diverse women. As researchers, it is important that we continue to advocate for the accessibility of funding and programming that facilitates collaborative, community-driven research, understanding the value of community involvement in research.

Over the course of The Muslimah Project, we were able to create a flourishing academic-community partnership and establish meaningful relationships based on respect for the skills and contributions of each team member, greatly facilitating the project's success in garnering important insights into the experiences of Muslim women in Waterloo Region. Community leaders’ enthusiasm and willingness to be involved throughout the research process, to help with recruitment, provide counseling support for participants, and spearhead knowledge dissemination worked together with academic researchers’ commitment to true collaboration through genuine and sustained engagement to create a successful research partnership. Our collaboration fostered mutual respect, power sharing, and a sharing of resources and expertise that made this project possible.

If you wish to contact members of the Muslimah team, feel free to contact Dr. Ciann L. Wilson at ciwilson@wlu.ca or The Coalition of Muslim Women of KW at cmw.kw.info@gmail.com

The Midwest Human Rights Consortium: Fostering a Transdisciplinary, Interinstitutional, Community-Engaged Collaborative for Forensic Asylum Assessments

Written by Minal Giri, Refugee Immigrant Child Health Initiative (RICHI) and Illinois Chapter of The American Academy of Pediatrics (ICAAP); Ida Salusky, DePaul University; Maria J. Ferrera, Depaul University and Coalition for Immigrant Mental Health; and Mary Elsner, Illinois Chapter of the American Academy of Pediatrics (ICAAP) and Refugee Immigrant Child Health Initiative (RICHI)

Background

Unaccompanied immigrant children have accounted for an ever-increasing number of migrants entering the US. In 2014, the Department of Homeland Security (DHS) apprehended and detained 68,000 such minors; these numbers soared from the previous year(s) due to the Central American child migrant crisis (Gramlich & Noe-Bustamante, 2019; O’Conner, Batalova & Bolter, 2019). In response, the government established detention camps along the border to act as a deterrent. Both child rights and human rights advocates have challenged the treatment of unaccompanied immigrant children within the US legal system. The U.S. government assumes responsibility and guardianship of unaccompanied immigrant children it takes into custody. After crossing the U.S. border, minors seeking asylum are often detained in less than optimal environments where the most basic needs (i.e. food, water, warmth, sanitation and physical safety) are not consistently met (Linthicum, 2019; Moore, 2019; Sanchez, Cohen & Eldeib, 2019). The more recent practices of separating children from their caregivers is traumatizing and associated with toxic stress (Shankoff et. al., 2011), which can lead to a host of lifelong health problems.

Medical and psychological forensic assessment of trauma and its impact on current functioning is critical evidence that can strongly affect the outcome of unaccompanied children’s asylum cases (Lustig, Kureshi, Delucchi, Iacopino & Morse, 2007; Scruggs, Guetterman, Meyer, VanArtsdalen & Heisler, 2016). Moreover, these professional assessments are often vital in obtaining necessary services for these children, including appropriate education, medical or psychological treatment, and suitable residential care; all of which can enable children to re-establish a sense of safety, security and healthy caregiver attachment when neurocognitive development has been impacted by the stress of repeated trauma (Ford, 2011; Ford, Chapman, Conner & Cruise, 2012; Carrion & Wong, 2012). In thinking about the needs of such highly vulnerable and traumatized children, there are then three priorities: 1) assisting unaccompanied minors seeking asylum through a complex justice system to facilitate their ability to establish legal status in this country; 2) placing them in stable homes with appropriate caregivers; and 3) connecting them to appropriate psychological and educational services. Healthcare providers can assist in the ongoing process of stabilization and trauma recovery by performing empirically based psychological and medical forensic evaluations to objectively corroborate trauma histories and abuse related to asylum claims. When medical and mental health providers are able to corroborate these findings through a forensic evaluation, applicants have a much greater chance of receiving asylum or other forms of legal relief (McKenzie et. al., 2018).

Challenge

Chicago is a major metropolitan area where unaccompanied minors are placed by the Office of Refugee Resettlement (ORR). Chicago is a center of legal, medical, and social service resources, and several legal nonprofits and for-profit law firms work with the children in asylum proceedings on a pro bono basis. Chicago has several shelters with an approximate 500-bed total capacity for housing unaccompanied children. Currently, there are a small number of volunteers trained to perform trauma-informed psychological and medical forensic assessments that can be used to support minors in asylum and visa cases. Historically, when lawyers working with children and families in Chicago and its surrounding area ascertained that their client might benefit from an evaluation, no formal referral process existed to help identify a medical and/or mental health professional to address the need. Lawyers often rely on informal channels to identify qualified professionals. This places an undue burden on a small number of individuals. Children consequently may often end up not receiving a forensic evaluation that could help their asylum case. There is a need for training more professionals to perform evaluations and to refine a process for referral coordination. Further, there is an overarching need to educate the legal community about the impact of trauma on a child’s development. Often, attorneys representing immigrant children and families are themselves not aware of how a psychological or medical forensic evaluation and affidavit of support may greatly benefit their client’s asylum claim.

Response to Challenge

In response to the need for a coordinated referral network and increased training in medical and psychological forensic asylum assessments, a diverse group of practitioners, academics, and non-profit leaders and administrators recently formed the Chicago-based Midwest Human Rights Consortium (MHRC). Housed within the Illinois Chapter, American Academy of Pediatrics, the founders conceptualized MHRC as an interinstitutional, interdisciplinary initiative aiming to develop a more formal process for both referrals for forensic assessments for immigrant children and families as well as a training center for practitioners committed to providing pro-bono medical and psychological forensic assessments. Engaging in a transdisciplinary approach, MHRC includes professionals who come from immigrant communities themselves and recognize the importance of inclusive, community-engaged and cross-disciplinary collaboration between clinical and community psychologists; pediatricians and other physicians; attorneys/legal advocates; social workers and other mental health practitioners; and community-based organizational staff and activists.

Key areas in the development of MHRC include: 1) Training and Mentorship-building a knowledgeable, professional workforce to perform forensic asylum assessments by training individual health care providers through formal conferences, close mentorship, ongoing case discussions and peer support. 2) Education and Asylum Clinic Building –developing and implementing best practices, cultivating partnerships with medical schools and clinical psychology programs who are working with students, interns, and residents in the creation of asylum clinics throughout the greater Chicago region. 3) Outreach and Support -actively reaching out to local legal, medical, and social service organizations as part of our Consortium to ensure that we align our goals with their clients’ needs. 4) Ongoing Partnership Development-on a national level, we are defining our relationship with Physicians for Human Rights (PHR) as a Midwest regional partner. 

Early Challenges of Collaboration

One of the challenges we have confronted involves developing training guidelines for conducting medical and psychological forensic assessments. While broad guidelines do exist for the assessment of torture (e.g. Physicians for Human Rights Guidelines; Istanbul Protocols) there is no universal standard around specific assessment criteria when working with asylum seekers who may have experienced trauma that does not qualify as torture. Further complicating this, different disciplines have different standards for what constitutes a “valid” assessment. For example, clinical psychologists tend to use empirically validated and structured measures. Physicians receive varying degrees of training in abuse, neglect, and mental illness. Pediatricians, for example, are taught basic guidelines around recognizing and diagnosing child abuse and neglect in children during their residency training. Some general background in mental health assessment and diagnosis is incorporated into all primary care residency training. As a network, we are collectively gathering best practices that would inform our own training guidelines.

We are in the early stages of establishing a formal referral network and developing a one stop shop for legal organizations who represent unaccompanied asylum seekers. While we have a growing volunteer network and database of mental health and medical practitioners who have indicated that they either have training and are willing to perform evaluations with mentorship, we are still in the process of developing systematic criteria to determine when a volunteer has the capacity to independently perform evaluations. It is imperative that individuals providing forensic evaluations understand ethical standards and guidelines that set these types of assessments apart from other types of biopsychosocial and medical evaluations. We are engaged in discussions regarding the ethics of privacy and consent as we build our referral system.

Reflection

We are growing as an organization as we add both working professionals and those in training to our roster of potential evaluators and identify those practitioners who are already skilled in conducting forensic evaluations. Our organizational structure is continuing to evolve as we slate working groups to address complex training and ethical issues and define the responsibilities of our member organizations through formal legal agreements. We are also navigating dissimilar models and approaches undertaken by our member organizations to deliver these evaluations. Further resources will contribute to the development of the Consortium as the first US centralized regional network comprising often competing institutions in this serious and important cooperative mission. We hope that our work contributes to creating more streamlined access to forensic asylum assessments through the MHRC referral network and our training and policy initiatives.

References

Carrion, V.G. & Wong, S.S. (2012). Can traumatic stress alter the brain? Understanding the implications of early trauma on brain development and learning. Journal of Adolescent Health, 51(2), S23-S28.

Ford, J.D. (2011). Assessing child and adolescent complex traumatic stress reactions. Journal of Child and Adolescent Trauma, 4, 217-232.

Ford, J.D., Chapman, J., Conner, D.F. & Cruise, K.R. (2012). Complex trauma and aggression in secure juvenile justice settings. Criminal Justice and Behavior, 39(6), 694-724.

Gramlich, J. & Noe-Bustamante, L. (2019, November 1). What’s happening at the U.S.-Mexico border in 5 charts. Pew Research Center. Retrieved from: https://www.pewresearch.org/fact-tank/2019/11/01/whats-happening-at-the-u-s-mexico-border-in-5-charts/

Linthicum, K. (2019, March 29). U.S. border authorities hold migrant families in a pen under an El Paso bridge. Los Angeles Times. Retrieved from: https://www.latimes.com/world/mexico-americas/la-na-asylum-migrants-el-paso-camp-20190329-htmlstory.html

Lustig, S.L., Kureshi, S., Delucchi, K.L., Iacopino, V. & Morse, S.C. (2007). Asylum grant rates following medical evaluations of maltreatment among political asylum applicants in the United States. Journal of Immigrant and Minority Health, 10(1), 7-15.

McKenzie, K.C., Bauer, J. & Reynolds, P.P. (2018). Asylum Seekers in a Time of Record Forced Global Displacement: the Role of Physicians. Journal of General Internal Medicine DOI: 10.1007/s11606-018-4524-5.

Moore, R. (2019, July 26). Border patrol argues child treatment at Clint migrant faculty not as described, gives access to Texas station. The Washington Post. Retrieved from: https://www.washingtonpost.com/immigration/border-patrol-argues-child-treatment-at-clint-migrant-facility-not-as-described-gives-access-to-texas-station/2019/06/26/69f1b754-9879-11e9-916d-9c61607d8190_story.html

O’Conner, A., Batalova, J. & Bolter, J. (2019, August 15). Central American Immigrants in the United States. Migration Policy Institute. Retrieved from: https://www.migrationpolicy.org/article/central-american-immigrants-united-states

Sanchez, M., Cohen, J.S. & Eldeib, D. (2019, July 11). Immigrant children sent to Chicago shelters are traumatized and sick, in some instances with chicken pox or tuberculosis. Pro Publica. Retrieved from: https://www.propublica.org/article/heartland-chicago-shelters-immigrant-children-sick-traumatized

Scruggs E., Guetterman, T.C., Meyer, A.C., VanArtsdalen, J. & Heisler, M. (2016). An absolutely necessary piece: A qualitative study of legal perspectives on medical affidavits in the asylum process. Journal of Forensic and Legal Medicine, 44, 72-78.

Shonkoff, J., Garner, A., Siegel, B., Dobbins, M., Earls, M., & Garner, A. et al. (2011). The Lifelong Effects of Early Childhood Adversity and Toxic Stress. PEDIATRICS129(1), e232-e246. doi: 10.1542/peds.2011-2663.

Community Collaborations with Saving Lives, Inspiring Youth: A Community-Based Cross-Age Peer Mentoring Program

Written by Cynthia Onyeka, Kevin Miller, Chana Matthews, Amzie Moore, Katherine Tyson-McCrea, and Maryse Richards, Loyola University Chicago

Scholar-community collaborations offer an opportunity to conduct translational research that is both useful and respectful to the population of study (Foster-Fishman, Berkowitz, Lounsbury, Jacobson & Allen, 2001). When projects involve an intervention targeted towards a marginalized community, it is even more important to perform the research with such regard. Community-based interventions are more likely to find sustained success with community members as part of the service and research team. However, tensions between researchers and practitioners may present challenges with this work (e.g., researchers devaluing practitioner insights, practitioners and community members concerned about past histories of mistreatment of research subjects), particularly in marginalized communities experiencing systemic oppression. This case study aims to recognize community collaborator challenges, contributing factors, and solutions from Saving Lives, Inspiring Youth (SLIY), a community-based participatory cross-age peer mentoring program based in the south and west sides of Chicago. Specifically, we present challenges navigating a partnership with our community collaborators at a SLIY mentoring site on the west side of Chicago in 2017.

Background on the Collaboration Project

The SLIY mentoring program was part of a 4-year longitudinal project examining the effectiveness of community-based cross-age peer mentoring (continued relationships between a younger mentee and older youth from the same community) to reduce negative outcomes related to violence exposure among high-risk Black American and Latinx youth. The overarching aim of the study was to identify the risk and protective factors related to youth exposed to high levels of community violence while working to increase positive youth development and resilience outcomes. Research staff from Loyola University Chicago’s Risk & Resilience Lab and the Empowering Counseling Program (directed by Dr. Maryse Richards and Dr. Katherine Tyson-McCrea, respectively) helped direct, coordinate, and evaluate mentoring programming at each site. The program utilized community partnerships with neighborhood schools and community agencies to recruit high school mentors and elementary school mentees, host after-school mentoring programming, and supervise mentoring relationships (Richards et al., 2017). High school mentors were trained by SLIY staff prior to being matched with their mentee(s).

Description of Challenges Faced

Although broadly fruitful and meaningful to our youth participants, one SLIY site in particular encountered a number of obstacles throughout its course given the contexts of high poverty and high community violence in which programming took place. SLIY operated a mentoring program on Chicago’s West side at Hickamore Elementary (school name changed to protect the confidentiality of all participants) between 2017 and 2018. The mentoring program at Hickamore consisted of teenage mentors from a neighboring high school traveling to the mentoring site to mentor their elementary student mentees. In comparison to other SLIY mentoring sites, Hickamore experienced a large amount of structural violence due to long-standing social inequalities evident in the city of Chicago. Structural violence describes the harming of people through unjust economic, political, and social institutions unable to meet persons’ basic needs for food, clothing, health care, education, inclusion, and safety (Koher & Alcock, 1976). This was evidenced through the fact that 43.1 percent of households in Hickamore’s community lived below the federal poverty line (which itself is not adequate for subsistence in Chicago) (City of Chicago Public Health Statistics, 2013). Additionally, the spike in Chicago's homicide rate during the summer of 2016 ranged between 50-75 per 100,000 in Hickamore’s community, which is over ten times the national rate (4.9 per 100,000; Diebel, Norda, & Kretchmer, 2018). This phenomenon existed with concurrent increased media attention negatively targeting urban young people, thus creating a city-wide perception of black and brown adolescents as pathological and dangerous (Gallagher & Shapiro, 2017).

For the first three months of programming at Hickamore, SLIY staff found it was difficult to establish buy-in from our community collaborators (a teacher and the assistant principal) at Hickamore, due to the effects of the structural violence. They indicated a mistrust of research due to the reputation of exploitation research has in many low-income communities of color. Also, our community collaborators expressed hesitation about allowing high school students on campus afterschool because of their fear that the Black youth might cause more chaos and even violence in the school, particularly given the surge of violence in the city. The community collaborators reduced the weekly mentoring sessions by 25%, due to a scarcity of resources (i.e., classroom availability, funding for security guards after school). This push back was acknowledged by our high school mentors, many sharing that they felt as though they were not welcome at the mentoring site. As such, SLIY staff were presented with a dilemma: how to establish and maintain successful mentoring relationships between mentors and mentees with the limited support by our community collaborators in a context of high structural violence.

SLIY Staff Response to the Challenge

SLIY’s approach to remediate the community collaboration challenge was threefold. First, it was necessary for SLIY staff at Hickamore to consider the context in which our programming took place and how it impacted the community collaborators. SLIY staff recognized that community collaborators were highly stressed and experienced compassion fatigue and symptoms of secondary stress trauma. Specifically, community collaborators often had to cope with the chronic violence exposure while working with youth who were direct victims of such exposure (i.e., drastically reducing their concern or capacity to be empathetic to those impacted by traumatic events or experiences; Adams, Boscarino & Figley, 2006). Moreover, it became clear that as the public awareness of community violence increased, so did the distrust of black and brown teens, resulting in negative perceptions of SLIY high school mentors.

Second, while understanding the socio-ecological context surrounding the mentoring program was important, it was imperative for SLIY staff to also acknowledge and build on community strengths. SLIY staff sought to include participatory methods to center the youths’ voices and built a program framework that relied heavily on the youth and community partnership. SLIY staff provided continuous trauma and leadership training to mentors, which allowed mentors to approach our community collaborators as youth leaders who have love and care for their mentees. The mentors formulated a plan to address the perception that they were not to be trusted within the mentoring site and facilitated discussions with school staff that demonstrated their commitment and compassion. With the support and training from SLIY staff, youth mentors were empowered to be leaders by a participatory framework, which allowed them to highlight their own strengths and address the effects of structural violence.

Finally, SLIY staff recognized that the mentoring site was severely under resourced and facilitated an open dialogue in which both parties were able to express their concerns and needs. For example, a SLIY staff member coordinated consistent meetings with the assistant principal to address concerns and collaborate on decisions.  By forming empathic relationships with community collaborators within a highly stressed environment, SLIY staff flexibly balanced program needs with ecological challenges.  This was exemplified by a negotiation between SLIY staff and community collaborators in which the daily programming time was increased by 25%, ensuring that the mentor and mentee needs were better addressed. Involving youth mentors in the direct design and implementation of the program, as well as using community collaborators and school staff as support liaisons and experts allowed SLIY to overcome and eradicate many of the aforementioned barriers.

Reflection Response Effectiveness

Critically considering community context while utilizing a participatory approach allowed SLIY staff to help build trust between community collaborators, mentors, and staff. SLIY staff at Hickamore were able to establish a partnership with community collaborators to not only assuage research stigma but amplify youth mentor voices in the process. By increasing transparency between community collaborators and youth mentors, SIY staff were able to ensure mentor decision-making capabilities were actualized, while empowering and securing a seat at the table for the high school mentors. By the second semester of the mentoring program, SLIY programming at Hickamore was met with increased approval by community collaborators. Mentors continued to develop leadership capacities and skills, and many of them later became youth co-researchers and co-presenters at conference presentations.  In conclusion, it remains imperative to utilize a strengths-based approach to meet community collaborators’ fears and resistance with understanding, compassion, and willingness to compromise. Doing so can foster dialogue among participants, staff, and community collaborators so they can discover each other’s’ strengths and the benefits of productive teamwork.

This project was supported by Grant # 2014-JU-FX-0003 awarded by the Office of Juvenile Justice and Delinquency Prevention, Office of Justice Programs, U.S. Department of Justice. The opinions, findings, and conclusions or recommendations expressed in this publication are those of the author(s) and do not necessarily reflect those of the Department of Justice. For additional information about this project, please feel free to contact Cynthia Onyeka at oonyeka@luc.edu.

References

Adams, R. E., Boscarino, J. A., & Figley, C. R. (2006). Compassion Fatigue and Psychological Distress Among Social Workers: A Validation Study. The American Journal of Orthopsychiatry, 76(1), 103–108.https://doi.org/10.1037/0002-9432.76.1.103

City of Chicago Public Health Statistics (2013). Retrieved from https://data.cityofchicago.org/Health-Human-Services/Chicago-poverty-and-crime/fwns-pcmk/data

Diebel, J., Norda, J., & Kretchmer, O. (2018, September 17). Overview of Chicago, Illinois (City). Retrieved fromhttps://statisticalatlas.com/place/Illinois/Chicago/Overview

Foster-Fishman, P. G., Berkowitz, S. L., Lounsbury, D. W., Jacobson, S., & Allen, N. A. (2001). Building Collaborative Capacity in Community Coalitions: A Review and Integrative Framework. American Journal of Community Psychology, 29(2), 241–261.https://doi.org/10.1023/A:1010378613583

Gallagher, J. J., & Shapiro, E. (2017, January 3). 762 Homicides Mark Chicago’s “Out of Control” Violence. Retrieved November 17, 2019, from ABC News website: https://abcnews.go.com/US/chicagos-control-violence-produces-762-homicides-2016/story?id=44402951

Karcher, M. J. (2005). The effects of developmental mentoring and high school mentors' attendance on their younger mentees' self‐esteem, social skills, and connectedness. Psychology in the Schools, 42(1), 65-77.

Kohler, G., & Alcock, N. (1976). An Empirical Table of Structural Violence. Journal of Peace Research, 13(4), 343–356.https://doi.org/10.1177/002234337601300405

Quimby, D., Richards, M., Santiago, C. D., Scott, D., & Puvar, D. (2017). Positive Peer Association Among Black American Youth and the Roles of Ethnic Identity and Gender. Journal of Research on Adolescence: The Official Journal of the Society for Research on Adolescence. https://doi.org/10.1111/jora.12363

Richards, M., Tyson-McCrea, K., Rice, C., DiClemente, C., Deane, K., & Quimby, D. (2017). Bulletin prepared for the Office of Juvenile Justice and Delinquency Prevention (OJJDP), Department of Justice. 

Learning from Communities after Armed Conflicts: A Training Program on Community-Based Psychosocial Accompaniment in Ayacucho-Peru

Written by Miryam Rivera-Holguín and Tesania Velázquez, Pontificia Universidad Católica del Perú (PUCP)

Following our experience of strengthening capabilities at the community level (Rivera-Holguín, Velázquez, Custodio, Corveleyn, 2018), the PUCP Research Group of Community Psychology is taking part in a joint training program with grassroots social organization of human rights in Ayacucho. In this experience we are building on key aspects of linking research-theory to praxis. The module “Community based accompaniment during the search process for disappeared persons” will be delivered in Ayacucho and Huánuco in 2019-2020 as part of “Specialization Course in Participation Strategies for the Search for Missing Persons” organized by Instituto de Derechos Humanos (IDEHPUCP). 

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In this module, we are aiming for a bottom-up format of training, namely, starting from the expertise of the social leadership of ANFASEP (National Association of Relatives of Kidnapped, Detained and Disappeared Persons of Peru), to unfold their praxis of community base psychosocial accompaniment that they had when providing supports to women and families after the Peruvian internal armed conflict between 1980-2000. This conflict left devastating social effects: 69,000 dead, 600,000 displaced, more than four thousand burial sites, thousands of orphans, raped women, broken communities, etc. and especially affected families and communities that historically have been exposed to dynamics of inequality, exclusion and discrimination (TRC, 2003).

After the conflict, family and community organization were one of the first coping strategies that rose from the victims themselves (accompany and support each other in the different moments of their struggles). They started to draft strategies of self-organization and networking, forming grassroots organizations, and learned how to confront the political and military authorities to look for their disappeared parents, husbands, siblings, etc. These grassroots organizations have been looking for their disappeared family members during the last 35 years, at the same time they have been advocating for truth, justice, and reparation. Later, when transitional justice processes like TRC were put in place, social organizations were active throughout the process. Also, during judicial proceedings, they have proposed local practices to accompany the identification of burial sites, exhumations, identification of remains, delivery of human remains, burial ceremonies, and other mourning services.

The training project aims to build together with grassroots organizations on the identification of techniques, methods, and tools that they have been using during all these years in order to put them in dialog with Community Psychology approaches (theories and methods) and to disseminate this know-how with other grassroots organizations. This training program aims to highlight how local organizations use their values, traditions and cultural identifications as resources and main strengths to build their social support and networks. Moreover, how they activate inner process of empowering themselves to carry on participatory processes and community mobilization.

The training program will start in Ayacucho, where 20 participants from grassroot organizations affected by the armed conflict will participate, namely: Anfasep (National Association of Relatives of Kidnapped, Detained and Disappeared Persons of Peru), Aprohvip (Provincial Association of Orphans and Victims of Political Violence), Afavip (Association of Families Affected by Political Violence) and other family members of victims from Cayara and Acocro. The team of trainers include community psychologists with experience in handling sensitive cases of people exposed to collective violence and human rights abuses. A community-based approach will be considered along all the course, especially if dilemma situations or sensitive cases rise during the course. 

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The main selected topics are based in the community mental health model (Rivera-Holguín, Velazquez, Custodio, Corveleyn, 2018) and have been organized in five sessions, which includes participatory activities, dynamics, and ad hoc exercises. Main contents to be included are:

  • Session 1. Introduction to psychosocial and community supports in the search of disappeared persons: Validating their own experiences and identifying the practices they have put into place (Beristain, 2012; Rivera-Holguín, Velázquez, & Morote, 2014).
  • Session 2. Basic elements of the psychosocial and community accompaniment process: identify and strengthen the skills, resources and capacities that have been practiced (Velázquez, Rivera-Holguín & Custodio, 2017).
  • Session 3. Community mobilization in the search of disappeared persons: identify the different levels that have allowed the social, community and political process (Uprimny, 2009, Rivera-Holguín, Pérez, Hildenbrand, Custodio, Vargas, Baca, Corveleyn, De Haene, 2019).
  • Session 4. Identification and acknowledgement of the emotional and social burden that involves their participation in organizations and actions in the processes of psychosocial and community accompaniment (Sánchez, 2015; Velázquez, Rivera-Holguín, & Custodio, 2015).
  • Session 5. Lessons learned and challenges, policies and dialogues with the State and other organizations in the search for social justice (Jave, 2018; Prilleltensky, 2001).

Participatory concepts and methodologies will be included, as well as individual and group evaluation processes throughout the training process. The mainstreaming of experiential techniques, peer support, and lessons learned (systematization) will be considered as main training tools. Along with inviting participants to take leading roles in all the modules in order to keep their active involvement and to prevent the Peruvian tendency to prioritize academic knowledge over local knowledge.

Opposite to traditional training programs, facilitators will challenge their strategies to build on/from the community knowledge to the academia, and to match/translate the praxis used by Quechua people into concepts and methods that can be systematized as learnings and later on disseminated on different platforms.  This training program aims to strengthen the community mobilization of social human rights organizations, and seeks to contribute not only to their recognition and welfare, but to the construction of public policies based on participation, that is to say, it is about building policies with the communities, which favors sustainability (Bishop, Vicary, Browne, & Guard, 2009).

We are happy to further discuss our proposal, if you had similar experiences before or have suggestions please contact us to share your thoughts, challenges or suggestions, for sure will enrich our experience. Feel free to write us: mriverah@pucp.pe and tvelazq@pucp.pe.

References

Beristain, C.M. (2012). Acompañar los procesos con las víctimas. Atención psicosocial enlas violaciones de derechos humanos. Colombia: Fondo de Justicia Transicional, Programa Promoción de la Convivencia y PNUD.

Bishop, B.; Vicary, D. Browne, A. & Guard, N. (2009) Public Policy, Participation and the Third Position: The Implication of Engaging Communities on their Own Terms American Journal Community Psychology, 43, 111–121. DOI 10.1007/s10464-008-9214-8.

Comisión de la Verdad y Reconciliación (2003). Informe Final. Lima: CVR.

Jave, I. (Coord.) (2018). Organizaciones de víctimas y políticas de justicia: construyendo un enfoque humanitario para la búsqueda de personas desaparecidas. Lima: Instituto de Derechos Humanos de la Pontificia Universidad Católica del Perú y Ford Foundation.

Prilleltensky, I. (2001). Value-based praxis in Community Psychology: Moving toward social justice and social action. American Journal of Community Psychology, 29(5), 747-779.

Rivera-Holguín, M., Velázquez, T. & Morote, R. (2014). Participación y fortalecimiento comunitario en un contexto posterremoto en Chincha, Perú. Revista Psicoperspectivas 13(2),144-155.

Rivera-Holguín, M.; Velázquez, T.; Custodio, E., Corveleyn, J. (2018). Improving community mental health for people affected by political violence in Ayacucho, Perú. Journal of Prevention & Intervention in the Community 46(1), 1-13.

Rivera-Holguín, M.; Pérez-Sales, P.; Hildenbrand, A.; Custodio, E.; Vargas, G.; Baca, N.; Corveleyn, J.; De Haene, L. (2019). Psychosocial and community assessment to family members of victims of enforced disappearance and extreme violence in Peru: Informing International Courts of Human Rights. Torture Journal 29(1), 16-33. https://irct.org/assets/uploads/Torture%20Volume%2029-1%20complete5-18-37.pdf

Sánchez, A. (2015). ‘Nuevos’ valores en la práctica psicosocial y comunitaria: Autonomía compartida, auto-cuidado, desarrollo humano, empoderamiento y justicia social. Universitas Psychologica, 14(4), 1235-1244.

Uprimny, R. (2009). Transformative reparations of massive gross human rights violations: between corrective and distributive justice. Netherlands Quarterly of Human Rights, 27(4), 625-647.

Velázquez, T., Rivera-Holguín, M. y E. Custodio (2017). Aportes y reflexiones de la formación en psicología comunitaria PUCP en tres regiones del Perú. Revista de Psicologia de la PUCP. Vol. 35 (1), 193-224. http://revistas.pucp.edu.pe/index.php/psicologia/article/view/16099

Velázquez, T., Rivera-Holguín, M., & Custodio, E. (2015). El acompañamiento y el cuidado de los equipos en la Psicología Comunitaria: Un modelo teórico y práctico. Psicología, Conocimiento y Sociedad, 5(2), 307-334. Disponible en: http://revista.psico.edu.uy/index.php/revpsicologia/issue/view/46

Tensions and Rewards in Community-Engaged Scholarship: A Case Study

Written by Erin E. Toolis, State University of New York at Old Westbury and Heather E. Bullock, University of California Santa Cruz

Community-university partnerships can play a crucial role in promoting economic justice by leveraging the local expertise and relationships of community leaders, the knowledge of key stakeholders, and the research skills of students and faculty. We offer a case study of the challenges and strengths of such partnerships by examining a collaborative research project conducted by the Blum Center on Poverty, Social Enterprise, and Participatory Governance and the Community Action Board of Santa Cruz County. We focus specifically on some of the research hurdles we confronted.   

Collaborating to Develop a New Community Needs Assessment 

Across the United States, community action agencies were established as part of the Economic Opportunity Act of 1964. Community action agencies seek to alleviate poverty through a broad range of service and advocacy programs geared toward increasing low-income individuals’ and families’ access to housing, employment opportunities, immigration services, and other vital resources. "Maximum feasible participation" – the engagement of low-income people, themselves, in program decision making - is among the most unique, participatory features of community action agencies. 

To gather input from people experiencing poverty, community action agencies routinely conduct community needs assessments. In Santa Cruz County and other counties across the country, this process often involves holding town-hall style “poverty hearings” in which individuals share their experiences at community events and staff members listen, record notes, and identify areas for action. For their 2017-18 assessment, however, the Community Action

Board of Santa Cruz County (subsequently abbreviated as CAB) decided to try a new approach. Emphasizing equity and cultural humility, they sought to improve the breadth and depth of information gathered by engaging community members who often go unheard yet are deeply affected by poverty. To strengthen the capacity and rigor of their data collection efforts, CAB invited UCSC’s Blum Center to serve as a consultant on their community needs assessment and assist with identifying key challenges and core community assets in the fight against economic injustice.

Rather than hold general “poverty hearings,” eleven focus groups or “listening circles” were organized with targeted low-income groups, including unhoused community members, immigrants, youth, women, farmworkers, dayworkers, DACA youth, senior citizens, and LGBTQ+ community members. As researchers, our responsibilities included refining focus group questions, training CAB board members and volunteers in focus group facilitation, recruiting and training a team of bilingual, bicultural research assistants to take notes, developing a toolkit to provide to all participants, and data analysis. 

We identified the following major needs in our community related to poverty: access to jobs and higher wages, housing insecurity and rent burden, barriers to accessing resources, discrimination and prejudice, and health challenges. The most prominent assets voiced by participants included community and family support and pride, availability of social services, internal, spiritual, and relational wealth, and access to legal rights assistance. CAB drew on these findings to craft their county-wide community action plan (visit https://cabinc.org/2018-2019-community-action-plan/).

Research Challenges

This process, while mutually rewarding, was not without challenges. Not surprisingly, differences between standard academic research practices and the realities of on-the-ground community work with marginalized populations was among our greatest challenges. The project timeline stands out as a prime example of these differences. The organization’s fast-paced timeline, necessitated by the community development block grant deadline, did not align with the university’s academic calendar or the competing obligations juggled by the research center’s limited staff. Some focus groups, for instance, had to be scheduled during the university’s spring break and finals week, making it difficult for student notetakers to attend. The timeline also limited our ability to seek external funding to aid with project expenses and to recruit and train research assistants. The accelerated process of designing a research plan and obtaining IRB approval also constrained our ability to work with certain groups. As a result, we were unable to collect or analyze data from two listening circles involving minors and incarcerated individuals. 

Many listening circle participants were undocumented immigrants and there was considerable concern about the safety and protection of participants’ identities, however, this also created complexities with data collection. Informed consent, in particular, was a sticking point. With limited familiarity with research protocols, some members of our partner’s team regarded informed consent as intimidating and unnecessary. Similarly, audio-recording focus group discussions was viewed as problematic. Balancing our commitment to uphold ethical research guidelines with a sensitivity to confidentiality concerns, exacerbated by the national political climate around immigration and recent raids by Immigration and Customs Enforcement in the local community, required thoughtful consideration. When necessary, we obtained oral informed consent and refrained from audio-recording discussions, instead relying on trained research assistants to take notes on laptops.

Participant recruitment and focus group facilitation was largely carried out by volunteers with connections to CAB and the target communities (e.g., the LGBTQ+ community center). Likewise, the meetings were held at diverse venues that were contingent on CAB’s connections and the needs of the community. This strategy resulted in inconsistencies across facilitators, who differed in their levels of preparation and experience leading small group discussions, and inconsistencies across settings, some of which were well suited for focused, sensitive conversations and others which were not. Additionally, the project’s participation rate likely suffered due to limited participant incentives and the precarious living situations of potential informants, who had to weigh participation with other pressing demands on their time. One listening circle, which took place at a day worker center, lost all but one participant when a paid work opportunity arose right before the conversation. Another listening circle held at a community center with seniors had to be shortened because it intersected with their planned mealtime. These important practical considerations, driven by basic needs, financial limitations, and time constraints, sometimes resulted in trade-offs with procedural consistency.  

Drawing Upon Partnership Strengths to Navigate Research Challenges

Frequent, honest, intentional dialogue between research partners was essential to successfully navigating these challenges. Both partners were also committed to learning from each other. For example, prior to data collection, a CAB member visited the university and trained the research team in cultural humility, a guiding principle of the community needs assessment, and participated in a team building activity modeled after an icebreaker from the focus group protocol. Members of the research team attended CAB’s day-long board retreat, meeting organizational staff from across the Board’s programs and gaining a historical understanding of the community action plan process. The research team also provided training in focus group facilitation for CAB’s leaders. These exchanges built mutual appreciation and deep respect for the expertise each partner brought to the collaboration and fostered a common understanding of the team’s shared values and goals.  

Functioning flexibly and efficiently in a fast-paced project was also aided by a clear division of each partner’s responsibilities. The researchers were able to contribute their expertise in research methodology, data collection, and data analysis. A team of 25 trained bilingual undergraduate research assistants helped to make the task of collecting data possible, while a team of four graduate students worked quickly to analyze the data. Dedicated CAB staff and volunteers contributed their extensive knowledge of and connections in the community. This enabled recruitment and scheduling of participants and focus group facilitators and reservation of sites at which to hold listening circles. This division of responsibilities was informed by honest communication about each partner’s strengths and limitations. 

Ultimately, our shared commitment to promoting equity and prioritizing the well-being and perspectives of marginalized community members enabled this project to remain on track. When asked to complete feedback forms on each focus group, student researchers enthusiastically expressed their appreciation for the opportunity to learn from community members. Due to their high level of investment, student research assistants were often open to accommodating evening and weekend commitments and last-minute scheduling changes. Despite the busy schedules of both partners, the team made time to express gratitude to one another, celebrate the project’s successes, and jointly share findings with the public. CAB and UCSC’s Blum Center co-presented insights gained from our approach to assessing community needs at the annual California Community Action Partnership Association conference. CAB also invited students to attend their open house and formally recognized the UCSC Blum Center at a public release of the findings. 

Final Thoughts

For partnerships among university researchers, nonprofit organizations, and low-income community members to thrive, an understanding of the broader institutional, economic, and political affordances and constraints of each partner is crucial. In the context of rising economic inequality, anti-immigrant policies, and funding cuts to social services (including the federal budget’s proposal to eliminate Community Development Block Grants, which fund Community Action Agencies), researchers must be sensitive to the complex, ever-changing circumstances “on the ground.” Despite the research trade-offs we faced in terms of methodological control and precision, the ability to be flexible, communicate openly, and divide responsibilities clearly and efficiently resulted in a highly successful, impactful project that has been positively received by diverse stakeholders. Ultimately, this innovative community needs assessment was strengthened by our collaboration and each partner’s unique contributions, skills, and knowledge.  

Improving Pathways to Safety for 2SLGBTQ Survivors of Gender-Based Violence

Written by Ellis Furman, Wilfrid Laurier University and Springtide Resources

Gender-based violence (GBV) is a term that encompasses forms of physical, psychological, or sexual violence perpetrated against an individual or group on the basis of gender or gender norms (Status of Women Canada, 2017; Reed, Raj, Miller, & Silverman, 2010). Forms of GBV include, but are not limited to economic violence, intimate partner violence, sexual abuse, sexual assault and rape, sex trafficking, sexual harassment and intimidation, and bullying based on failure to conform to perceived gender roles (Status of Women Canada, 2017).

Research suggests that Two-Spirit (a term used by Indigenous communities to describe another gender role that is accepted within their societies), lesbian, gay, bisexual, transgender, and queer (2SLGBTQ) communities are disproportionately impacted by GBV compared to their heterosexual and cisgender counterparts (Barrett & St. Pierre, 2013; Dank, Lachman, Zweig, & Yahner, 2014; Langenderfer-Magruder et al., 2016). Higher rates of GBV among 2SLGBTQ communities can be attributed to unique layers of violence rooted in homophobia, transphobia, and sexism (Carvalho, 2011; Craig, Austin, & McInroy, 2014). As a result, 2SLGBTQ people experience higher rates of traumatic events and are at greater risk for developing symptoms of post-traumatic stress disorder, depression, and anxiety, as well as experiencing suicidality and isolation (Henry, Perrin, Coston, & Calton, 2018).

My past and ongoing research has examined the barriers experienced by 2SLGBTQ survivors of violence seeking to access services and support, and the glaring gaps in service provision to support this community (Furman, Barata, Wilson, & Fante-Coleman, 2017). I found that the current services offered to support those impacted by GBV are not designed to include and address the forms of oppression faced by the 2SLGBTQ community in general, and the situation is exacerbated by the omission of  transgender people (Guadalupe-Diaz & Jasinski, 2017), people of colour (Meyer, Dietrich, & Schwartz, 2008), Two-Spirit, and Indigenous peoples who appear at the fringe of service access (Lehavot, Walters, & Simoni, 2009). In 2015, I was hired as a summer student to develop and deliver 2SLGBTQ inclusion trainings to GBV service providers in Toronto. I began working for Springtide Resources, a registered charity that develops and implements programs aimed at responding to the growing prevention, intervention, and educational needs of those working toward ending GBV. During the evaluation of the trainings, I realized that GBV organizations require more guidance and support to transform their services to meaningfully include 2SLGBTQ survivors of violence.

To examine the ways in which GBV organizations can reconfigure their services to be more inclusive, the Improving Pathways to Safety for 2SLGBTQ Survivors of Violence (ImPath) community-based research project was conceived. From 2018-2019, I was the research coordinator for the ImPath project, where we partnered with five violence against women (VAW) agencies that committed to an ongoing process of learning how to strengthen their approaches to effectively support 2SLGBTQ survivors. Each partnership involved Springtide Resources conducting an audit of 2SLGBTQ inclusion and accessibility of partner agencies. The underlying questions guiding this research were: a) what are VAW agencies’ strengths and barriers in serving 2SLGBTQ survivors? and b) what are the target areas that these agencies need support in strengthening to improve service provision for 2SLGBTQ survivors? Multiple methods were utilized to gather different types of data to answer the research questions. The data collection methods used in this research included an online anonymous survey, focus groups, and individual interviews at each of the partner agencies.  Findings from this project revealed that the process of becoming more inclusive will look different for each agency committing to this process. Findings specific to each agency were shared in the form of a final report and presented to explain the recommendations that emerged, accompanied by additional training modules depending on agency availability.

Description of the Challenge Faced         

An advisory committee was formed to involve community members in guiding and providing feedback on all aspects of the ImPath project. In August 2018, 10 individuals were recruited for an advisory committee comprised of 2SLGBTQ individuals who either identify as GBV survivors or who have supported 2SLGTBQ survivors in navigating service access. The initial advisory committee consisted of nine individuals all with varying sexual orientations, gender identities, and intersecting social identities (including but not limited to Black, Indigenous, People of Colour, Disabled, Newcomers, Refugees, and people living in poverty). Advisory committee meetings were held once per month from September 2018 until June 2019. Meetings were originally planned to focus on different aspects of the research process, for example: determining which VAW agencies to recruit for participation and providing ongoing feedback on data collection materials such as the online survey and focus group questions.

It was realized early-on that despite targeted recruitment strategies, advisory committee members each had different ideas of what their participation would look like. After a few advisory committee meetings, I recognized that I never actually asked members what kind of role they would enjoy getting involved with based on their strengths and interests. By the time the project team conducted check-in meetings with each advisory committee member as a mid-project evaluation, members began to slowly drop-out of their roles, such that the final committee was comprised of only four individuals. It became clear that 1) most advisory committee members were not interested in providing feedback on research aspects of the project, and 2) I was likely not presenting very engaging opportunities for collaboration and feedback. Further, advisory committee members expressed being more interested in the knowledge mobilization activities that would be developed after the completion of the ImPath project. 

An Explanation of the Team’s Response to Said Problem

From the mid-project evaluation of the advisory committee, I reflected on the reality that advisory committees have been romanticized in community-based research. I needed to reconfigure what the purpose of the advisory committee would be in order to retain and harness the strengths of remaining members. Two smaller groups were then formed for the remainder of the project. The first group involved committee members wanting to be part of the project because of the sense of community, honoraria, and food offered. While the second group was more interested in learning how to analyze qualitative data. The project coordinator continued to host monthly advisory committee meetings for group one, and I started facilitating data analysis sessions for group two. The monthly meetings continued to serve as a space to share a meal, talk about peoples’ experiences, and build community with other 2SLGBTQ young people. The collaborative data analysis sessions developed into a tremendous opportunity for skill-building. Sessions were so successful, that I was lucky enough to be able to hire two advisory committee members to assist me in data analysis for a separate community-based research project this past summer.

Reflection on the Effectiveness of the Response

My main learning from this solution is that the inclusion of an advisory committee comprised of individuals with lived experiences was critical to the success of this project. However, it is important to ensure that committee members feel they are respected by the project team and that they are contributing in meaningful ways. It is clear from this experience that participation can vary depending on project goals and community members’ interests and willingness to engage. In the evaluation of the advisory committee, members expressed that they were happy with the smaller working group structure and recommended this strategy for future research projects. In the context of GBV, it was difficult for most of the advisory committee members to participate beyond sharing their experiences with others. Thus, the solution of shifting the way advisory committee can look and operate became a refreshing way to meet the needs of marginalized community members within the context of a project driven by sensitive subject matter. Providing committee members with agency to participate in a way that felt good for them truly made this process more enjoyable.

Another key learning was the importance of building-in opportunities for ongoing reflection and evaluation. These components were  imperative to  identify and address the barriers to advisory committee participation. Future projects must ensure that there is adequate funding to facilitate meaningful involvement of members, by compensating them for their time, transportation, and potential childcare needs, in addition to accommodating any accessibility requirements.

Overall, by including 2SLGBTQ survivors of GBV in the process of guiding this research project ensured that we were asking effective questions geared towards the enhancement of service provision. Based on the results from the ImPath project, I am continuing to work with three of the partner agencies to continually develop implementation and evaluation plans informed by site-specific recommendations.

References

Barrett, B. J., & St. Pierre, M. (2013). Intimate partner violence reported by lesbian-, gay-, and bisexual-identified individuals living in Canada: An exploration of within-group variations. Journal of Gay & Lesbian Social Services, 25(1), 1–23. doi:10.1080/10538720.2013.751887

Carvalho, A. F., Lewis, R. J., Derlega, V. J., Winstead, B. A., & Viggiano, C. (2011). Internalized sexual minority stressors and same-sex intimate partner violence. Journal of Family Violence, 26, 501–509. doi: 10.1007/s10896-011-9384-2

Craig, S. L., Austin, A., & McInroy, L. B. (2014). School-based groups to support multiethnic sexual minority youth resiliency: Preliminary effectiveness. Child and Adolescent Social Work Journal, 31(1), 87–106. doi:10.1007/s10560-013-0311-7

Dank, M., Lachman, P., Zweig, J. M., & Yahner, J. (2014). Dating violence experiences of lesbian, gay, bisexual, and transgender youth. Journal of Youth and Adolescence43(5), 846-857. doi: 10.1007/s10964-013-9975-8

Furman, E., Barata, P., Wilson, C., & Fante-Coleman, T. (2017). “It's a gap in awareness”: Exploring service provision for LGBTQ2S survivors of intimate partner violence in Ontario, Canada. Journal of Gay & Lesbian Social Services, 1-16. doi: 10.1080/10538720.2017.1365672

Guadalupe-Diaz, X. L., & Jasinski, J. (2017). “I wasn’t a priority, I wasn’t a victim”: Challenges in help seeking for transgender survivors of intimate partner violence. Violence Against Women23(6), 772-792. doi: 10.1177/1077801216650288

Henry, R. S., Perrin, P. B., Coston, B. M., & Calton, J. M. (2018). Intimate partner violence and mental health among transgender/gender nonconforming adults. Journal of Interpersonal Violence, 00(0), 1-26. doi: 0886260518775148

Langenderfer-Magruder, L., Whitfield, D. L., Walls, N. E., Kattari, S. K., & Ramos, D. (2016). Experiences of intimate partner violence and subsequent police reporting among lesbian, gay, bisexual, transgender, and queer adults in Colorado: Comparing rates of cisgender and transgender victimization. Journal of Interpersonal Violence31(5), 855-871. doi: 10.1177/0886260514556767

Lehavot, K., Walters, K. L., Simoni, J. M. (2009). Abuse, mastery, and health among lesbian, bisexual, and Two-Spirit American Indian and Alaska Native women. Cultural Diversity & Ethnic Minority Psychology, 15(3), 275-284. doi:10.1037/a0013458

Meyer, I. H., Dietrich, J., & Schwartz, S. (2008). Lifetime prevalence of mental disorders and suicide attempts in diverse lesbian, gay, and bisexual populations. American Journal of Public Health98(6), 1004-1006. doi: 10.2105/AJPH.2006.096826

Reed, E., Raj, A., Miller, E., & Silverman, J. G. (2010). Losing the “gender” in gender-based violence: The missteps of research on dating and intimate partner violence. Violence Against Women16(3), 348-354. doi: 10.1177/1077801209361127

Status of Women Canada. (2017). It’s Time: Canada’s Strategy to Prevent and Address Gender-Based Violence. Retrieved from: https://www.swc-cfc.gc.ca/violence/strategy-strategie/GBV_Fact_sheets_5.pdf

Trust, Momentum, and Readiness: Trust-Building in Police-Community Partnerships

Written by Brittany S. Cook, Wandersman Center; Kassy Alia Ray, Serve & Connect; and Abraham Wandersman, Wandersman Center

Background 

7.Cook._Photo_B._Cook.jpgEstablished in 2018, Serve & Connect is a 501(c)3 non-profit organization based in South Carolina, with the mission to ignite positive change and strengthen communities through building positive police and community partnerships. Serve & Connect often focuses on communities with large disinvestment and with histories of mistrust and is currently functioning as a facilitator for the development of a coalition in the North Columbia community. The North Columbia community is primarily African American and is often recognized for many negative outcomes including high rates of violent crime, poverty. Two-thirds of adults report adverse childhood events including emotional abuse, parental separation/divorce, and parental substance use. Moreover, the community has a history of distrust of police, in part due to the frequent police presence because of violent crimes. With Serve & Connect as a catalyst, members of police departments, local service organizations, educational institutions, state agencies, faith-based organizations, and community members have formed the North Columbia Youth Empowerment Initiative (NCYEI), a coalition centered on improving youth safety and empowerment in the community.

Description of the challenge faced

Serve & Connect has developed a comprehensive, evidence-informed, community-centered model for promoting safety, resilience, and well-being called COMPASS, to facilitate positive community level change through effective community collaboration. COMPASS is based on principles of empowerment evaluation (Fetterman & Wandersman, 2005), where community voice is paramount. The four phases of COMPASS are:

7.Cook._FIGURE_1.jpg

Using COMPASS, Serve & Connect is supporting the development of NCYEI and the processes used to understand and build relationships within the community, as well as the readiness of stakeholders at different levels of readiness to begin working together towards shared goals (Hajjar et al., 2020). However, fostering engagement in collaboration and moving towards action is a challenging and non-linear process, particularly in a community that has a history of distrust.

Team’s response

Wandersman (2009) outlined “four keys to success” when addressing social change interventions: theory, implementation, support, evaluation. Through the COMPASS work in North Columbia, Serve & Connect has identified challenges within each of the four keys and employed strategies to address those challenges. 

Theory challenge. NCYEI identified a need for a unified vision, along with goals and an understanding of existing resources and relationships available to the community.

Theory solution. A community visioning day event was held during which community partners, community members, and police came together to discuss the vision for the initiative and resources and relationships that could be leveraged.  This was an essential step for the theory of change within the COMPASS model.

Theory evidence of success. Out of conversations and activities at the community visioning day, a community model for North Columbia was developed (see below).

7.Cook._FIGURE_2.jpg

Beyond development of a community model, participants in the visioning day event engaged in a mapping exercise that provided additional themes about the relationships and connections within the community. Networking was reported as a particularly valuable part of the event, and some community members reported that it was the first opportunity they had to really sit down and get to talk with a police officer on a personal level.

Implementation challenge. Trust in the NCYEI (and involved police) by the North Columbia community needed to be built. Community members voiced attitudes of “here today, gone tomorrow.”

Implementation solution. A summer series of events was held to provide fun and casual opportunities for police and community residents to interact. The summer series was strategically held each week for four weeks, alternating between two high need housing complexes in the community. This allowed the NCYEI and engaged police to meet residents where they lived and demonstrate consistency. These events involved fun activities including a water fight, cookout, and sports.  

Implementation evidence of success. Attendance in NCYEI weekly meetings spiked directly following the summer series (time point 22 in the figure below) as several neighborhood leaders became engaged in NCYEI through the summer series and began regularly participating in meetings. The community leaders actively recruited other residents to come to meetings. This shift, towards an even more community-led coalition, resulted in the ability to move more strategically towards actions to address community needs.

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Support challenge. Community conversations led to a recognition that NCYEI steering committee members needed to develop a shared understanding of the historical context regarding police and community partnerships and build internal trust.

Support solution. Serve & Connect facilitated the scheduling of the Welcome Table SC, hosted by the South Carolina Collaborative for Race & Reconciliation housed at the University of South Carolina. The Welcome Table is a process designed to help create relational trust, unity, teamwork, and cohesiveness through a group of community members who want to improve racial relations and other problems in their communities. Many of the formal steering committee members elected to participate.

Support evidence of success. Participants completed a survey about their experience in the Welcome Table. Positive changes in trust and perceived personal power of steering committee members through the Welcome Table process were reported. As one NCYEI steering committee members put it: “I have more power because of the connections I have made.” 

Evaluation challenge. Serve & Connect intended to administer a survey to measure the readiness and existing relationships of community partners and residents in North Columbia to further understand the community’s needs and tailor supports. However, resident NCYEI members cautioned that a formal survey was culturally inappropriate and could inhibit trust building.

Evaluation solution. “Dot surveys” were conducted at community events. Questions were placed on large pieces of paper, and community members placed a sticker, or dot, next to the responses they most agreed with. Additionally, strategic listening sessions were held to provide residents and police opportunities to voice their concerns, needs, and hopes for the community and police-community relationships.

Evaluation evidence of success. Overall, the adapted method demonstrated good response rates and useful information about the community’s feelings of hope, trust, safety, and resource access. Qualitative feedback about a particular event garnered some of the most powerful support for the dot survey method. One community resident responded to the question what did you like best about today’s event? by stating that her favorite thing was that “Right away, you wanted to know what I thought [with the dot survey].”

Reflection

Building collaboration for social change takes time and is a complex process. By identifying and addressing challenges in theory, implementation, support, and evaluation through the COMPASS initiative, Serve & Connect has been able to begin building trust within the North Columbia community. The intentional focus on trust and relationships within each of the four keys has allowed increasing momentum in NCYEI to build. Residents are engaging with police, sharing their voice, and being empowered to take ownership of NCYEI.

For more information about Serve & Connect and the COMPASS initiative in North Columbia and other communities, please contact Brittany Cook at: Brittany.s.cook@wandersmancenter.org or Kassy Alia Ray at: kassy@serveandconnect.net.

Reference

Fetterman, D. M., & Wandersman, A. (Eds.). (2005). Empowerment evaluation principles in practice. Guilford Press.

Hajjar, L. Cook, B. S., Domlyn, A., Ray, K. A., Laird, D., & Wandersman, A. (2020; in press). Readiness and Relationships are Crucial for Coalitions and Collaboratives: Concepts and Evaluation Tools. New Directions for Evaluation

Wandersman, A. (2009). Four keys to success (theory, implementation, evaluation, and resource/system support): High hopes and challenges in participation. American Journal of Community Psychology, 43, 3–21.

Innovative Communication as a Panacea for Community-Based Research: A Case Study on the NoMa Plan

Written by Rubayat Jesmin, Binghamton University

It is now generally accepted that community-based research (CBR) is a preferred approach for exploring social issue(s) related to a particular community especially when other traditional methods may fall short of identifying and assessing the push and pull of conflicting and competing agendas and perspectives (McIntyre, 2008; Hacker, 2013; Savin-Baden & Major 2013; Jason & Glenwick, 2016). Consequently, general purpose of any such community-based collaboration is to change at least an aspect of a prevalent social environment - the system or mechanism, social norms, community practices, and so on (McIntyre, 2008; Hacker, 2013; Savin-Baden & Major 2013; Jason & Glenwick, 2016).

This paper aims to assess the NoMa Plan as a case study of a CBR i.e., how a CBR is applied in the ground, challenges faced, and the strategies adopted to overcome those barriers.

The NoMa Plan: Setting the Base of a Meaningful Partnership

The North of Main Street (NoMa), Binghamton, Broome County, New York, USA is a traditionally working-class neighborhood. Although the majority of NoMa residents are white, it is considered as one of the most diverse and poorest communities in Broome County (US Census Bureau, 2017). The NoMa, like other neighborhoods with similar characteristics, has faced many challenges including unsuitable waste disposal and management, inadequate civic facilities (such as community center, park), illegal activities, and so on (Draft NoMa Plan, 2017; Safe Streets, n.d.). This degraded the image of the neighborhood in the past.

Within this context, in collaboration with Binghamton University’s “Neighborhood Heritage and Sustainability Project” and neighborhood organization Safe Streets, the NoMa Plan was developed with extensive involvement of residents, local business leaders, and city staff (NoMa, n.d.). The planning committee included representation from these diverse stakeholder groups. The goal of this neighborhood plan is to have improved integrity and environment (both social and natural) in the locality. The community-driven initiatives for the betterment of the locality started a couple of decades back in the NoMa area. The notable community-driven initiative evolved from the 1990s with the formation of the “Safe Streets” to protect the neighborhood from illegal activities (Safe Streets, n.d.).

For this study, data were collected from both primary sources (e.g., interviews and participant observations) and secondary sources (literature review and publicly available data). Participation was voluntary.

Embrace Challenges - Both Foreseen and Unexpected

One of the major challenges that a CBR usually faces is the longer time taken to build rapport (including trust and confidence) between the researcher and the community (Hacker, 2013; Savin-Baden & Major 2013; Jason & Glenwick, 2016). The framers of the NoMa Plan faced such a time-consuming issue in case of bringing all the stakeholders on board during the planning and designing processes. From the beginning, the project has opted for involving the residents and neighborhood organizations alongside concerned authorities, academics, and businesses. Thirty long interviews, twenty short, ad hoc interviews, discussions in the sideline of a series of public events (such as Fall Festival and community dinner) and numerous participant observations helped the planners to identify the neighborhood concerns and develop strategies for action.

On the other hand, a community development initiative has to balance the need for long-term, sustainable solutions with the day-to-day realities which may require prompt decision-making and/or short-term action (Ravitz, 1982). The goal of the NoMa Plan was to identify the priorities of residents. It, therefore, contains both the ‘landscape’ issues and some critical present-day concerns of the residents. The Plan incorporated means and ways to address the identified issues and concerns including how to improve the residents’ quality of life and create prospective scope mainly in terms of earning opportunities. Following this, it includes strategies that can be implemented immediately as well as longer-term strategies that need further analysis and discussion.

Furthermore, several CBR have identified inadequate responses from the participants to be another major challenge (McIntyre, 2008; Savin-Baden & Major, 2013). Initially, the NoMa project also faced slow responses from the grassroots participants - not everyone participated in all the meetings, nor many residents showed up in different activities as expected. The situation improved during the later phase of the drafting process once the framers managed to build the required inter- and intra-group trust and confidence.

Lessons Learned.

The Project has already accomplished some tangible achievements, such as obtaining the Mansion at Walnut Street as a dedicated community center; enhanced safety and image building of the Main Street by placing “Child-At-Play”, “Stop for Pedestrians” and other necessary road signs; painting crosswalks; and ensuring regular surveillance for speeding and double parking; the greening of the streets by clearing the garbage, planting and replacing street trees; organizing more community-engaging events such as Fall Festival and Community Café; and, last but not the least, establishing a dedicated website. In brief, the NoMa Plan has helped the locality to advance in achieving social bonding and environmental protection. The other aim of the NoMa Plan is economic development, which is under process through discussions with local businesses.

The NoMa Plan is a strategic document to restore the neighborhood’s image and improve the quality of living. The formulation of the draft Plan is the outcome of collaborative aspiration and initiative, which followed a bottom-up approach. The framers of the Plan opted for inclusive participation from all stakeholders and they applied various methods for this purpose (Draft NoMa Plan, 2017). This inclusiveness was also ensured by adapting several innovative communication methods. The planning committee meetings, for example, were held on Saturday mornings within the neighborhood to accommodate residents’ work schedules, and their movement and other conveniences. During the initial phase, the Project also hosted two well-attended neighborhood lunch meetings to discuss the strengths and challenges facing the neighborhood as well as the participants’ aspirations on how to bring about necessary changes. Furthermore, the project organized a series of public events where people from the neighborhood and across the city came together. Alongside mingling and having fun during Fall Festivals, for example, people shared their concerns and aspirations about the locality. The project also organized a summer bike repair day and giveaway. This attracted the NoMa residents and some of them were then recruited to participate in the “Planning in the Park” forum. All of these helped the planning committee in data collection and analysis to develop the NoMa Plan containing both immediate-, medium-, and long-term actionable strategies. Later, the project organized two more public meetings to gather additional feedback on the draft plan. These meetings were held on weekends – one over lunch and another over dinner.

Both conventional and innovative methods were applied for the dissemination of information/notice on project activities. The neighborhood organization Safe Streets delivered information via their existing email list. Posters were placed in key sites with wider public appearances such as the Walnut Street Park and the USA Market. Another age-old technique that proved to be quite effective was placing flyers underneath the doors of every home in the neighborhood. This might appear to be a trivial attempt in this era of technological advancement, but it worked for the NoMa residents many of whom do not have access to technology because of their socio-economic status. Some marginalized residents admitted that they had felt being ‘a part of the process’.

Concluding Remarks

The formulation of the NoMa Plan followed the underlying tenets of a CBR. It adopted a collective commitment in investigating some common issues, engagement at both individual and collective levels to reflect on identified issues, a joint decision to take individual and/or collective actions for a useful solution that benefits the people involved, and the co-knowledge production (McIntyre, 2008; Hacker, 2013; Savin-Baden & Major 2013; Jason & Glenwick, 2016). In brief, the Draft NoMa Plan is an outcome of a concentrated, collaborative effort.

Like some other CBR, the NoMa Plan has taken a considerable amount of time to build a meaningful partnership. Nevertheless, the Plan is very much relevant to the local community and has community ownership. It has helped to build the trust required to conduct and implement such a CBR. And, both conventional and innovative communication tools and techniques have helped to shape that trust and confidence between the researchers and the community.

References

Draft NoMa Plan. (2017). Unpublished document.

Hacker, K.A. (2013). Community-based participatory research. Thousand Oaks, CA: SAGE.

Jason, A. L. & Glenwick, D. S. (2016). Handbook of Methodological Approaches to Community-Based Research. New York: Oxford University Press.

McIntyre, A. (2008). Participatory Action Research. Thousand Oaks, CA: Sage (Qualitative Research Methods Series 52)

Neighborhood Heritage & Sustainability Project (n.d.). Retrieved from: https://sustainableneighborhood.org/2017/09/25/559/

NoMa (n.d.). Retrieved from: https://nomabinghamton.wordpress.com/portfolio/noma-welcome/

Ravitz, M. (1982). Community development: Challenge of the eighties. Community Development, 13 (1), 1–10. doi:10.1080/15575330.1982.9987137

Safe Streets (n.d.). Retrieved from: https://www.facebook.com/safestreetsbinghamton

Savin-Baden, M. & Major, C. (2013). Qualitative research: The essential guide to theory and practice. New York: Routledge.

United States Census Bureau. (n.d.). 2017 American Community Survey. Retrieved from: https://data.census.gov/cedsci/all?q=Binghamton%20city,%20Broome%20County,%20New%20York&table=DP05&tid=ACSDP5Y2017.DP05&g=0600000US3600706607&vintage=2017&cid=DP05_0001E&layer=countysubdivision&lastDisplayedRow=15

Inclusion and Collaborative Design: School-Based Health Centers (SBHC)

Written by Christine Robinson, University of Pennsylvania

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SBHCs, as outlined, are a policy and systems innovation that promotes inclusion. This model, open and accessible to all students in a school, sends a noticeable message of equity, everyone matters. This SBHC prototype intentionally integrates identity, culture, enhanced personal narratives, and a concrete approach to support positive adolescent development. High school graduation is a landmark, signifying one’s ability to navigate a complex institutional system and achieve a certain level of proficiency. It is a benchmark on the road to successful adulthood. The collaboration with community nonprofits and the emerging shared-staffing model provides organizational enhancement, assists in academic attainment, improves health outcomes, and affirms belonging, a crucial developmental attribute for historically marginalized youth.

The Challenge

Several of the health concerns adolescents address are grounded in the social determinants of health and driven by broader social and contextual inequities (Brindis, Loo, Adler, Bolan, & Wasserheit, 2005). In Massachusetts, thousands of students are immigrants and refugees from many countries and personally affected by traumatic transitions. During a tumultuous move to the US, interim education is often nonexistent. The ravages of war, refugee status, family displacement, racist stereotypes, foster care, abuse, neglect, and death, are too familiar in these young lives. After a year of negotiation with nonprofit leaders representing the various racial, ethnic, and linguistic groups in each city, we invited partnership to improve youth outcomes. Nonprofits agreed to help by assisting in the translation of a baseline survey to Haitian Creole, Khmer, Cape Verdean Creole, Spanish, Laotian, and Vietnamese. African American nonprofits were included acknowledging the importance of identity. Evidence from multiple disciplines indicates that inequality can signal to young people that they are unlikely to be able to attain parity with peers (Browman, Destin, Carswell, & Svoboda, 2017).

Collaborative Response to the Challenge of Inclusion

In establishing the first cohort of clinics, we aligned services and staffing with physical and mental health needs, as shown by baseline student survey results. Data were collected from a customized CDC Youth Risk Behavior Survey, a recognized instrument with proven validity and reliability. Questions reflecting the specific interests and concerns of youth and families in the various cities were added. These customized surveys provided a means to collect data about cultural attitudes; all students in attendance on the days of administration were included. Lived experiences of youth on health and a range of health risk behaviors, including homelessness, tobacco, alcohol, and mental health concerns, were gathered. Data were analyzed separately for each school, yielding unique profiles. The analysis provided insight into student realities and perceptions and indicated the need for culturally inclusive staffing arrangements.

Community nonprofits were invaluable in gathering baseline data as many of the teens were not literate, and some languages are spoken and not written. Nonprofit staff assisted in the development of a response process for one-on-one administration with teens who needed help with reading, completing the answer sheet, and translation of various concepts. Through this iterative process, the staff of the nonprofits agreed to continue to work in SBHCs through a range of customized shared staffing agreements. For example, nonprofit staff from nearby agencies came to the schools to provide counseling, translation services, homework help, and support. Youth, mentored by people who shared their identity as exemplified by a shared language, culture, immigration experience, race/ethnicity, religion, and traditions in a time of significant transition, improved academic and health outcomes, and built social cohesion. The nonprofits agreed to participate in a complex referral network, providing a range of services and supports accessible to youth and their families. The staff of the same cultural, racial/ethnic, and linguistic backgrounds bring unique insights, credibility, expertise, and lived experience, easing a rough transition to an unfamiliar environment (Alegría, Ali, & Fuentes, 2019; Fuligni and Tsai, 2015).

Health conditions, anxieties, and behaviors are tightly aligned with cultural identities; re-location is an added stress amid the ongoing developmental tension of adolescence. For example, loss and grieving are treated differently in various cultures. Many youths had experienced the loss of their country of origin, family separation, family members who had been killed, tortured, or injured in war, or family members who struggled to cope with physical and psychological disabilities. These types of challenges compromise one’s ability to focus on academic matters, no matter how gifted a student is (Alegría, Green, McLaughlin, & Loder, 2015). The culturally informed SBHC model provided a familiar language and supportive adults, invaluable to these young scholars. Nonprofit staffs were both support providers and a bridge to families. Family engagement is essential throughout adolescence (National Academy of Sciences, 2019). Public schools are tested to add more culturally fluent staff; it is not unusual for schools to have more than 50 languages spoken, a conundrum for any school system. The knowledge of language and culture was a vital lifeline facilitating routine tasks such as homework completion with a highly nuanced understanding of family disruption and underlying struggles in some young lives.

Reflection on the Effectiveness of the Response

Effective SBHCs were able to move toward inclusion within a process of positive change incorporating the context of diversity (Trickett, 1996). Transformational leadership exemplifies skills of mediation, compromise, and pluralistic teambuilding, thereby creating a model of inclusive school culture, a template for all students to emulate (Day, Gu, & Sammons, 2016). Yet, the professional identities of health and education staffs in the SBHC, worldviews, power differentials, and community tensions are a factor.

  1. Mixed loyalties: SBHC shared staff navigated allegiance to the SBHC, their home organizations, and often to racial or ethnic communities.
  2. Model impacts school culture: The collaboration with community nonprofits resulted in the inclusion of authentic perspectives, voice, and language in schools. Inclusion affirmed student culture and required a stretch of school culture.
  3. Diversity of models: SBHCs varied across each district, bringing to the fore diverse capacities, and models. The clinics are comparable but not identical.
  4. Limited resources and agility: It was crucial to have staff familiar with languages, cultures, immigration, and refugee challenges to support high school completion as public schools generally lacked this capacity. The shared staffing model tested staff to become nimble, familiar with multiple organizational structures, including the SBHC, nonprofits, host school, and in cases, the partnering health care systems. Staff was compensated, but member organizations were asked to contribute to community wellbeing with no direct compensation.
  5. 5.    Power Inequity: Real collaboration requires equal power. Yet, the power dynamics between educational institutions and health institutions are tense at times. Many emerging nonprofits representing historically marginalized populations provide invaluable service but have yet to attain equal respect in the civic space. Though revered by the local community, they lack prestige. The relegation to a contractual status evinces inequity.
  6. Culture of Collaboration: The “culture of collaboration” within most SBHC skirts organizational and structural power dynamics. Redressing inequities in the broader community is a goal; however, the SBHC work is siloed, seen as a means of providing care, protection, and a vital bridge for vulnerable lives. The part-time nature of the staff renders them less powerful.

These findings support the necessity to expand inclusive culturally and linguistically appropriate school-based health services. Integrating health services into schools improves access to care that will enhance youth outcomes. However, the process of inclusion, which reflects the increasing diversity of the US, is challenging. This case study demonstrates that it is possible to build institutions premised on the bedrock that everyone matters.

Please feel free to contact the author: Christine Robinson: crrobinson624@gmail.com

References

Alegría, M., Alvarez, K., Ishikawa, R. Z., DiMarzio, K., and McPeck, S. (2016). Removing obstacles to eliminating racial and ethnic disparities in behavioral health care. Health Affairs, 35(6), 991-999.

Alegría, M., Ali, N., & Fuentes, L. (2019). Strategies for promoting patient activation, self-efficacy, and engagement. In M. Williams, D. Rosen, & J. Kanter, (Eds) Treatment for ethnic and racial minority clients. Eliminating race-based mental health disparities: Promoting equity and culturally responsive care across settings (p. 61-78). Oakland, CA:  New Harbinger Publications.

Alegría, M., Green, J. G., McLaughlin, K. A., and Loder, S. (2015). Disparities in Child and Adolescent Mental Health Services in the U.S. William T. Grant Foundation Inequality Paper. New York, NY: William T. Grant Foundation. Available: https://wtgrantfoundation. org/library/uploads/2015/09/Disparities-in-Child-and-Adolescent-Mental-Health.pdf.

Allison, M. A., Crane, L. A., Beaty, B. L., Davidson, A. J., Melinkovich, P., and Kempe, A. (2007). School-based health centers: Improving access and quality of care for low-income adolescents. Pediatrics, 120(4), e887-e894.

Brindis, C. D., Loo, V. S., Adler, N. E., Bolan, G. A., and Wasserheit, J. N. (2005). Service integration and teen friendliness in practice: A program assessment of sexual and reproductive health services for adolescents. Journal of Adolescent Health, 37(2), 155-162.