Jomella Watson-Thompson

A framework for community mobilization to promote healthy youth development

In community mobilization to prevent youth violence, local people take action to create conditions under which youth are healthy and safe. This manuscript outlines a framework for supporting and evaluating community mobilization to promote healthy youth development as an approach to preventing youth violence. The framework highlights 12 key community processes to facilitate change and improvement. A descriptive case study of the Ivanhoe Neighborhood Council Youth Project (INCYP) is used to illustrate the application of this framework in an inner-city, predominantly African-American neighborhood in Kansas City, Missouri. Data are presented on community change (i.e., new or modified programs, policies, and practices) facilitated by the INCYP between 2001 and 2003, as an intermediate measure used to assess the mobilization effort. The INCYP facilitated 26 community changes during the project period, and was an effective catalyst for mobilizing the community to support change in outcomes and conditions that support healthy youth development. This case study suggests the importance of early and ongoing engagement of youth as change agents in the community mobilization effort.

Differential effects of strategic planning on community change in two urban neighborhood coalitions.

Community coalitions represent a promising approach for addressing the interrelated and multiply- determined issues affecting urban neighborhoods of concentrated poverty. The literature suggests a number of community processes that may affect coalition efforts to change and improve communities. This study uses an interrupted time-series design to examine the effects of a strategic planning intervention on community change in two urban neighborhoods in the Kansas City metropolitan area. Results showed that strategic planning was associated with increased rates of community change in the two urban neighborhood coalitions. Under appropriate conditions, such as the presence of consistent leadership, strategic planning may be a particularly effective mechanism for stimulating community change and addressing locally-determined goals in urban neighborhoods.

Using Communities of Practice to Support Implementation of Evidence-Based Prevention Strategies

Communities of practice are important for supporting multisectoral engagement to address community problems. In this study, communities of practice were used to support implementation of the Strategic Prevention Framework in Kansas. The findings reveal that communities of practice were used at local and state levels, and communities used integrated technology to facilitate collaboration. Additionally, the findings indicate that communities of practice facilitated practice changes across communities. These findings support previous research related to communities of practice, while demonstrating the need for increased exploration in how communities of practice can support the implementation of evidence-based prevention strategies within and across communities.

Enhancing the capacity of substance abuse prevention coalitions through training and technical assistance.

Community capacity may be enhanced through intermediary supports that provide training and technical assistance (TA). This study used a randomized pre/posttest design to assess the impact of training and TA on coalition capacity. Seven community coalitions from the Midwest participated in the 2-year study, which included 36 hours of training, followed by monthly TA calls to support action planning implementation for prioritized processes. Collaborative processes most commonly identified as high-need areas for TA were Developing Organizational Structure, Documenting Progress, Making Outcomes Matter, and Sustaining the Work. Based on a coalition survey, the average change for processes prioritized through TA across all seven coalitions was .27 (SD = .29), while the average change for non-prioritized processes was .09 (SD = .20) (t(6) = 4.86, p = .003, d = 1.84). The findings from this study suggest that TA can increase coalition capacity for implementing collaborative processes using a participatory approach.

A case study of use of data for participatory evaluation within a statewide system to prevent substance abuse.

Although evaluation is considered an essential component of community health initiatives, its function requires actual use of the data to inform practice. The purpose of this case study was to examine how often and in what ways practitioners in a state system for substance abuse prevention used participatory evaluation data. To assess uses of data, interviews and surveys (N = 13) were conducted with practitioners. Questions focused on the frequency of use for several functions of evaluation data. Results showed that 77% of participants reported using their data within the past 30 days to review progress of the initiative, and 64% had used the data to communicate successes or needed improvement to staff. Fewer participants indicated they had used the data to communicate accomplishments to stakeholders (54%) or to make adjustments to plans (38%). This study suggests that participatory evaluation data can have multiple functions and uses for community health practitioners.

An Empirical Case Study of the Effects of Training and Technical Assistance on Community Coalition Functioning and Sustainability

The case study analyzes the effects of training and technical assistance on the amount of community changes facilitated by members of a community coalition to prevent adolescent substance use. The study examines the sustainability of these changes in the community over time. The coalition implemented a Community Change Intervention that focused on building coalition capacity to support implementation of community changes—program, policy, and practice changes. Over the 2-year intervention period, there were 36 community changes facilitated by the coalition to reduce risk for adolescent substance use. Results showed that the coalition facilitated an average of at least 3 times as many community changes (i.e., program, policy and practice changes) per month following the intervention. Action planning was found to have accelerated the rate of community changes implemented by the coalition. After the intervention there was increased implementation of three key prioritized coalition processes: Documenting Progress/Using Feedback, Making Outcomes Matter, and Sustaining the Work. A 1-year probe following the study showed that the majority of the community changes were sustained. Factors associated with the sustainability of changes included the continued development of collaborative partnerships and securing multiyear funding.

Conceptualizing a Public Health Prevention Intervention for Bridging the 30 Million Word Gap

Early childhood experience is a social determinant of children’s health and well-being. The well-being of young children is founded on their relationships and interactions with parents and family members in the home, caregivers, and teachers in early education, and friends and families in the greater community. Unfortunately, the early language experience of infants and toddlers from low-income families is typically vastly different than children from middle- and higher-income families. Hart and Risley (Meaningful differences in the everyday experience of young American children. Brookes, Baltimore, 1995) described a “30 Million Word Gap” experienced by age four for children from poor families compared to economically advantaged families as measured by the number of words delivered by adults in the home to their children. This discrepancy between groups is associated with a deficit in vocabulary growth over time (Hart and Risley in Meaningful differences in the everyday experience of young American children. Brookes, Baltimore, 1995; in The social world of children learning to talk. Brookes, Baltimore, MD, 1999; in Am Educ (Spring), 1–9. http://isites.harvard.edu/fs/docs/icb.topic1317532.files/09-10/Hart-Risley-2003.pdf, 2003), and readiness when they enter preschool and kindergarten compared to their more advantaged classmates. The purpose of this paper is to conceptualize a population-level public health prevention approach to research addressing the harmful impacts of the Word Gap. The approach includes use of evidence-based practices to improve children’s language environments to foster their early language and literacy learning in early childhood. After a brief review of the Word Gap, we discuss four aspects: a conceptual framework, a community leadership team as driver of the local intervention, evidence-based language interventions for reducing the gap and promoting child language, and the measurements needed. Implications are discussed.

Examining the contributions of a community coalition in addressing urban health determinants

ABSTRACT Community coalitions facilitate changes in community outcomes and conditions by addressing issues and determinants of health and well-being. The purpose of the present study was to examine the process of a community coalition, the Ivanhoe Neighborhood Council (INC), in addressing community-prioritized urban health determinants aimed at improving living conditions in a neighborhood in Kansas City, Missouri. Using an empirical case study design, the implementation of the community change framework supported through the Kauffman Neighborhood Initiative is examined. The results suggest that the INC was effective in implementing 117 community changes, and these changes were associated with modest improvements in targeted outcomes related to housing and crime. A 10 year follow-up probe indicates that the majority of recurring community changes were sustained. The results indicate that the comprehensive community initiative was important in facilitating community change that may have contributed to improvements in addressing urban health determinants.

Improving community readiness for change through coalition capacity building: Evidence from a multisite intervention

Often, community coalitions are facilitators of community-level changes when addressing underage drinking. Although studies have shown that enhancing coalition capacity is related to improved internal functioning, the relationship between enhanced capacity and community readiness for change is not well established. The present study used a pretest-posttest design to examine whether enhancing coalition capacity through training and technical assistance was associated with improved community readiness and coalition-facilitated community-level changes. Seven Kansas communities engaged in an intensive capacity building intervention through implementation of the Strategic Prevention Framework. The results indicated strong correlations between increased coalition capacity, changes in community readiness stages, and the number of community changes facilitated. The results suggest that strengthening coalition capacity through training and technical assistance may improve community readiness for change and enable the implementation of community-wide program and environmental changes.

Supporting a Community-Based Participatory Evaluation Approach to Violence Prevention in Kansas City

Disparities in rates of firearm-related homicide exist for some segments of the population and by geographic area. There are interrelated factors across multiple social–ecological levels that increase the risk of violence for some individuals and groups, which may suggest the importance of comprehensive community intervention approaches for addressing violence. Participatory approaches can aid in the implementation of community interventions by engaging community and researcher partners in collaboratively addressing community-identified concerns. The purpose of the present study is to demonstrate the application of a participatory evaluation framework used to support the Aim4Peace Violence Prevention Project in Kansas City, Missouri. The study presents data from the second year of program implementation to examine the contributions of the program in addressing violence.