Sept 10 Building Capacity of Communities

Question 1

Social Planning

Answer 1

Task oriented, problem solving, usually outside expert but does not have to be

Question 2

Social Action

Answer 2

Task and process oriented. Enhancing solving problems from within, and attempt concrete changes in power dynamics (i.e. training locals/community members)

Question 3

Power (5 things)

Answer 3

1. Marginalized communities are vulnerable to exploitation 2. world view is not neutral, value driven (Public health views are NOT neutral, have specific view) 3. those receiving intervention have diff values, norms, rewards. 4. Views of more powerful is seen in outcome (oppressive - bulldozer approach). 5. power dynamics between all (community leader, funding agency, evaluator)

Question 4

Historical definitions of Empowerment

1. What is powerlessness? Subjectively
2. What is powerlessness? Objectively

Answer 4

Opposite of powerlessness (lack of control over destiny)

1. learned helplessness and external locus of control (medicaid choice, taxes, taking the bus)
2. people may lack economic and political power, living in resource deprivation and internalize this as feeling of powerlessness (social service system)

Question 5

Broad Definition of Empowerment

Answer 5

people gain control of their lives - participating with others to change their social and political realities. Communities having equity and capacity to solve its problems through increased participation of its members in activities and increased control over determinants of health

Question 6

Empowerment Framework

Answer 6

Agency - groups ability to make purposeful choices (able to envision and choose options)
Opportunity Structure - institutional context within which “actors” live and work (rules of game influences choices and interactions)

Question 7

Empowerment Education

Answer 7

Education is not neutral - people bring issues and teacher brings agendas. Involves people in group efforts to identify problems, critically analyze cultural and SES roots of problems. Develop strategies to effect positive changes (every classroom is different)

Question 8

Examples of Empowerment Education

Answer 8

Coping skills, communication, decision making, peer training, media and social policy analysis was taught. What emerged was community pride.

Question 9

Critical Characteristics of Empowerment Process

Answer 9

Individual empowerment, bridging social ties (people you meet and classmates that helped you during school), synergy (the interaction or cooperation of two or more organizations is greater in sum than in separate effects)

Question 10

Capacity Focused

Answer 10

Community development works and sustains only when local community people are committed to investing in themselves and their resources. Identifying assets - individual, org, and structural is important

Question 11

(inventory) Individual capacity

Answer 11

skills, talents, and abilities, incomes, labeled people, individual businesses, home-based enterprises

Question 12

(inventory) organizational capacity

Answer 12

citizen orgs, assns of businesses, financial institutions, cultural orgs, communication orgs, religious orgs

Question 13

Examples of private or non-profit orgs

Answer 13

police, hospitals, social services, schools, libraries, parks, physical resources

Question 14

Outcome Questions for measuring Perceived Capacity

Answer 14

I have control over decisions that affect my life…my community has influence over decisions that affect my life….I can influence decisions that affect my community…by working together, people in my community can influence decisions that affect the community

Question 15

Map of Community Capacity

Answer 15

label primary, secondary and potential building blocks, use of GIS, small group tasks and come together as a larger group, sit down with community members and leaders (to assess which orgs effective at asset development and discuss how build bridges to resources outside community)

Question 16

Community Health Governance Model

Answer 16

Collaborative process important to address problems and identify assets, participatory collaborative process, strengthen capacity to solve problems that affect health and wellbeing-capacity of multiple stakeholders

Question 17

Leadership and management is needed to…3 things

Answer 17

1. promote active and broad participation 2. ensure broad based influence-promote diverse resource base 3. facilitate productive group dynamics - foster meaningful discourse (mediator), combine skills and resources

Question 18

Guiding perspective of CBPR (definition)

Answer 18

Community-based participatory research for health is a collaborative approach to research that equitably involves all partners in the research process and recognizes the unique strengths that each brings to the research

Question 19

CBPR approach (4 things)

Answer 19

1. involves partners in the research process, 2. research of important to the community, 3. aim of combining knowledge and action for social change to improve community health and eliminate health disparities 4. includes capacity building

Question 20

Participation (4 things)

Answer 20

1. true participation involves having an equal say, ownership, and active roles in the project 2. levels of participation vary by level of ownership 3. participation and control are never static 4. principles for each project recognize specific local context

Question 21

CBPR - who is representing the community? (4 things)

Answer 21

1. varies by community and heterogeneous within community 2. leaders not always representative 3. understanding community culture helps to approach and work with representatives 4. stakeholders - power relations within community, isms may still apply, resource allocation needs to be understood

Question 22

CBPR - how do ‘isms place a role? (4 things)

Answer 22

1. power and privelege influence relationships- lack of involvement of commitment by community may result 2. may subvert project process or hinder collaboration to exert control 3. professional roles may create boundaries 4. lack of trust - extendning olive branch may be seen as meddling opr trying to take control or ownership

Question 23

Rhetoric Vs. Reality of community participation (5 things)

Answer 23

1. an emphasis on CAPACITY as opposed to DEFICIENCY approach 2. informality that can give professionals impression of being inefficient or unorganized 3. community stories - communication strat to reach back into common hx and indiv exp for knowledge about truth/direction for future 4. incorp of celebration, tragedy, and fallibility into life of community 5. all encompass a sense of connectedness - social space/environment

Question 24

Tokenism (2 things)

Answer 24

1. citizens somewhat involved but not heard and advice/input not incorporated 2. professionals decide what to focus on in terms of health issue, get community to take ownership of professionally defined health agenda and convince community to take responsibility for and carry out activities w/o them being in decision process

Question 25

Participation (4 things)

Answer 25

1. citizens heard and their needs and concerns are responded to 2. they may negotiate and engage in trade offs of research/promotion activities 3. community is a part of agenda setting, defining problems, and developing solutions 4. professionals see themselves as co-learners

Question 26

Cultural Humility (Participation)

Answer 26

commitment to self-evaluation and self-critique to redress power imbalances and develop and maintain mutual respectful and dynamic parternships with communities

Question 27

The process of Partnership Development and Maintenance (5 things)

Answer 27

1. truly value participatory research 2. networks* 3. listen 4. acknowledge power dynamics in community 5. relationships established (“Authentic” community members)

Question 28

DARE

Answer 28

Who DETERMINES the goals of the project?
Who ACTS to achieve them?
Who RECEIVES the benefits of the actions?
Who EVALUATES the actions?

Question 29

Lessons Learned (4 things)

Answer 29

1. Goals refined and improved relevance will improve outcomes, 2. intervention is more interesting and relevent to the population, 3. community is more willing to sustain in tailored to their needs, 4. potential for future grands with community commitment.

Question 30

Lessons Learned - Obstacles (3 things)

Answer 30

1. takes mroe time to build relationships 2. do not forget to engage “authentic” community members 3. conflict with other agendas

Question 31

Ethics of CBPR (3 things)

Answer 31

1. Current ethics regulations are too narrow (based on biomedical research, using “subjects”) 2. what os subjective/objective is often not questioned in traditional research, yet judgment and subjectivity a part of process from the beginning 3. b/c no ONE way of doing CBPR, poses challenge to create ethical guidelines

Question 32

Ethical Issues (3 things)

Answer 32

1. Authenticity of partnerships (covered by ladder) 2. Conflicting Loyalties - trust established and immediate concerns of people get #1 attention, other health concerns may be having saliency 3. Funding source dilemmas - disease focus priorities may not be same as community needs, seeking non-gov’t sources may need to asking something not comfortable with

Question 33

Ethical Issues - Unanticipated consequences (4 things)

Answer 33

1. others hurt or stereotyped by health education 2. empowering - training leaders may cause leaders to be indoctrinated in your way of thinking to point that no longer legitimate or trusted by community 3. also leadesr may use skills to manipulate others or leave others out 3. Act locally, think globally –larger implications of activities

Question 34

(Ethics) - 1. Favorable risk-benefit ratio 2. Respect for participants

Answer 34

minimize risks and increase potential benefits. most reasearch in social and behavior does generally does not benefit the participant 2. CBPR can lead to confidentiality and privacy issues especially in a rural area