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PS282 Exam Review 5-14.odt

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Wilfrid Laurier University
Colleen Loomis

CHAPTER 9 Prevention & Promotion – Key Concepts The Broad Street Pump • Cholera epidemic • John Snow ◦ Plotted homes in which 578 people had died from Cholera ▪ Plotted position on map of 13 street pumps ▪ Showed relationship between pump and cholera deaths • City removed Broad Street Pump and number of deaths subsided Lessons Learned 1. If you don't know how to cure a problem, you may still be able to prevent it 2. Do not need to know problem to prevent it; just need to understand some aspect of mechanisms through which problem was transmitted or sustained 3. Can prevent problem through changing some aspect of human behaviour 4. While individual behaviour change can contribute to prevention, complete prevention of a problem often relies on public action Rationale for Promoting Prevention • One-to-one Therapy • Instead of treating disorders, why not prevent them from occurring to begin with? • Treatment vs. Prevention TwoApproaches for Prevention • Preventing psychiatric disorders, problem behaviours, social problems ◦ Psychotherapy • Promoting competence, wellness, and capacity to address problems ◦ Cowen championed the term “wellness” as more fitting ▪ Overall health and quality of life become the goal PREVENTION MODELS Caplan's Model • Primary ◦ Given to entire populations when they are not in a condition of known need or distress ◦ Goal is to lower rate of new cases of disorders ▪ e.g.) Vaccinations, fluoridating water, providing decision-making skills • Secondary - “Early Intervention” ◦ Given to populations showing early signs of a disorder or difficulty ◦ Being “at risk” ▪ e.g.) Targeted at children who are shy or withdrawn, beginning to have academic difficulty • Tertiary - “Rehabilitation” NOT treatment ◦ Given to populations with a disorder with intention of limiting the disability ▪ Reducing its intensity and duration ▪ Preventing future reoccurence The US Institute of Medicine Report (IOM) • Universal Preventive Measures ◦ Administered to everyone in a given population ◦ Typically to populations that are not in distress ▪ Similar to Caplan's, “Primary Prevention” • Selective Prevention Measures ◦ Designed for people at above-average risk for developing behavioural or emotional disorders ▪ Risk may be based on environment / personal factors • i.e.) Low income, family conflict / low self-esteem ▪ Risk characteristics are associated with development of disorder, not symptoms of the disorder itself • Indicated Preventive Measures ◦ Directed towards individual people who are considered at high risk for developing disorder in the future ▪ Especially if they show early symptoms of the disorder but do not meet criteria for full-fledged diagnosis of mental disorder ◦ Self-esteem and mastery are main focus of mental health promotion ▪ With competence, self-efficacy, and individual empowerment Prevention and Promotion Concepts • Goal of merely preventing disorders was setting our sights too low ◦ Goal is to have people and families functioning to their fullest potential • Debate among prevention scientists and public policymakers about where emphasis on time and resources should be placed ◦ Prevention of disorder ▪ Advocates argue we are learning a great deal about how to prevent specific disorders • e.g.) Depression, suicide, conduct disorders, suicide • Research should be directed toward isolating and reducing the operation of risk factors most closely targeted with specific disorders ◦ Promotion of wellness and social competence ▪ Advocates note that many people are not in a state of sound psychological well-being despite not having specific disorders • Kauai Longitudinal Study ◦ Warner followed 698 multiracial children (every child born on that island) for 40 years ▪ 30% who experienced one or more risk factors • Prenatal or birth complications, poverty, family violence, divorce, or parents with psychopathology or law education ▪ Findings: • Children who experienced 4 or more risk factors in the first 2 years of life developed: ◦ Learning disabilities, behaviour disorder, delinquency or mental health problems before adulthood ◦ Lead to the Cumulative-Risk Hypothesis ◦ Focus on the 30% exposed to 4 or more risk factors and did NOT develop behaviour or learning problems ▪ 1 out of 3 grew to become competent, confident, caring adults • By age 40, none were unemployed or got in trouble with the law • Divorce, mortality and rates of chronic health were lower @ midlife than those of their same sex peers • Their educational and vocational accomplishment were equal to or even exceeded those of children who grew up in economically stable homes ◦ Focus on 70% who did not display resiliency ▪ Children exposed to 4 more risk factors all displayed significant behavioural and mental health problems by age 18 • Cumulative-Risk Hypothesis ◦ Hypothesis recognizes that almost all children can deal with one risk factor in their lives without increasing risk of negative outcomes ▪ Most children can handle up to 2 ▪ BUT, when you get up to 4 risk factors, chances of a negative outcomes increase exponentially • Resiliency ◦ Werner termed those who overcame multiple risk factors to be come “competent, confident, caring” resilient ◦ Refers to the ability of some individuals to overcome adverse conditions and experience healthy development ▪ Attributes of Individuals Associated with Resilience (see page 296) • Individual Differences • Relationships • Community Resources & Opportunities ◦ Maston & Powell emphasize that resilience arises from ordinary magic ▪ They overcome adversity through resources and relationships that are a part of normal, everyday life Goals • Decrease presence of risk factors and increase the presence of protective factors • Decrease prevalence of disorders and problem behaviours • Develop strengths, support positive development and promote resilience and thriving • Use research on specific risk and protective factors to ensure that everyone in a community has the chance to experience ordinary magic that helps people thrive ◦ e.g.) Communities That Care ◦ Search Institute's DevelopmentalAssets Model ▪ Address promoting healthy development of children and youth by changing the contexts of children's lives Examples of Prevention & Promotion Programs • The Search Institute ◦ Assess and develop programs to promote developmental assets ▪ Factors within the child or the child's environment that promote healthy child and youth development • InternalAssets include: ◦ Strong commitment to learning positive values, social competencies and a positive identity • ExternalAssets include: ◦ Supportive relationships, opportunities for prosocial involvement, clear boundaries and expectations for behaviour and opportunities for constructive use of time • Communities That Care ◦ Assess community needs/ resources and recommend evidence-based approaches Prevention Equations (p. 299 – 302) Both formulas indicate that risk is increased as a function of stressors and risk factors in the environment and decreased to the extent to which protective factors are enhanced • GeorgeAlbee – Individual-level Incidence of Disorders Stress + Physical Vulnerability Coping Skills + Social Support + Self-Esteem • Mariuce Elias – Environmental-level Incidence of Disorders Stressors + Environmental Risk Factors Positive Socialization Practices + Social Support Resources + Opportunities for Connectedness Do Prevention Programs Work? Yes, they do. • Considerations ◦ Does it work? How well do it work, for whom, under what conditions, and what are the mechanisms that account for its effects? • Two Types of Assessments & Limitations ◦ Meta-Analysis ▪ Compare statistical findings of all quantitative studies done on a given topic that meet certain methodological criteria • e.g.) Comparison of parent training programs and control groups in randomized field experiments, all of which used similar dependent variables • Computes effect size: ◦ Strength of the effect of that intervention (independent variable) on the chosen outcomes (dependent) ◦ Presented as a statistic between 1 and 0 ▪ Used for broad analyses of the effectiveness of prevention programs ◦ Best Practices Approach ▪ Includes qualitative analyses in addition to quantitative analyses ▪ Focus is on studying a specific type of program that has been empirically shown to be effective across multiple settings • Conducted through a review of available research, actual site visits, and qualitative research • Results of Two Types of Prevention Studies (Meta-Analysis) ◦ Durlak & Wells ▪ #1) Examined 177 primary prevention programs directed towards children and adolescents • 59% - 82% of participants surpassed the average performance in control groups ▪ #2) Examined 130 secondary prevention programs for children experiencing early signs of difficulty as persistent shyness, learning difficulties and anti social behaviour • Average participant was better off that 70% of the control group members • Cost-Effectiveness Analyses ◦ View prevention/ promotion programs as an investment and try to determine the return on that investment ◦ Compares several programs with similar goals to determine how economically efficient each program was in reaching that goal • Cost-BenefitAnalyses ◦ Do prevention programs result in an overall economic benefit for society? ◦ Benefits fall into two categories: ▪ Services the program participants will not need due to the success of the program • e.g.) Educational services, mental health services, physical health services ▪ Monetary benefits to society in terms of wages earned and taxes paid by program participants that they otherwise would not have earned or paid • Examples ◦ High Scope/ Perry Preschool Project ▪ Program designed to prevent conduct disorder and other behaviour disorders in adolescence • Program provided high-quality, academically based day care to children born into poverty ◦ 123 allAfrican-American children were enrolled at ages 3 and 4 ◦ Results collected when they reached the age of 40 ▪ Data collected from 97% of participants still living ▪ Cost-Benefits Analyses found that general public gained $12.90 for every $1 spent on the program ◦ Better Beginnings, Better Futures ▪ Goals: • Prevention ◦ To reduce emotional and behavioural problems in children • Promotion ◦ To promote the optimal development in children • Community Development ◦ To strengthen the ability of disadvantaged communities to respond to the needs of children and their families ▪ Key Outcomes: • Lower use of special education uses (Cost-Analyses) • Better High School grades • More regular exercise • Fewer poverty • Improved parental health ◦ Less alcohol consumption ◦ Less smoking ◦ Less clinical depression • Community neighbourhoods more cohesive • Saved $2.50 for every $1 invested Principles of Effective Prevention/ Promotion Programs (See page 304) • Theory-driven and evidence-based ◦ Programs have a theoretical justification, address risk and protective factors identified in research, and have empirical support of efficacy • Comprehensive ◦ Programs provide multiple interventions in multiple settings to address interrelated goals • Appropriately timed ◦ Programs are provided before the onset of a disorder, at an appropriate development stage for the participants, or during important life transitions • Socioculturally relevant ◦ Programs are culturally sensitive and incorporate cultural norms when appropriate • Behavioural and skills-based ◦ Programs include a strong behavioural component that focuses on the acquisition of specific skills and ensures opportunities for practicing those skills • Sufficient dosage ◦ Programs are of a sufficient length and intensity to ensure the desired effects and have booster sessions when appropriate • Positive relationships ◦ Programs specifically promote the development of positive relationships to provide mentoring and social support • Second-order change ◦ Programs include focus on changes in settings and communities, including changes in formal policies and specific practices and developing resources for positive development • Support for staff ◦ Programs provide appropriate training for staff and ongoing support to ensure effective implementation and evaluation • Program evaluation ◦ Programs have ongoing processes to ensure continual evaluation and improvement, assessment of outcomes, and assessment of community needs CHAPTER 10 Prevention and Promotion – Implementing Programs Program Implementation • 2 program implementation ◦ meta-analysis and best practices approach • Results of 2005 meta-analysis reviewed 46 drug prevention programs ◦ Target population: high-risk children and teens ◦ Intervention approach: multiple ◦ Results: effect sizes ▪ 0.02 mean effect size across all programs • Out of all 46 drug prevention programs, mean was 0.02 meaning it barely had an effect ▪ 21 programs with negative effect sizes • Means the control group was less likely to use drugs than the experimental group Why were initial prevention results not significant? • Differences in programs ◦ Emotional, theoretical • Methodological problems ◦ Some control groups had no intervention or access to anti-drug ▪ but control group had some source of intervention • from media • was not a true control group • Implementation variability ◦ how well the program was integrated into the day to day program ◦ different outcomes for where the programs were implemented ▪ e.g.) rich neighbourhood vs. poor neighbourhood • Results: effect size rose from 0.02 to 0.24 ◦ after controlling for these problems (differences, implementation variety, methodological problems) Well-implemented and well-designed prevention works! 4 Stages of Transferring Programs • Cookbook ◦ Step by step • Replication of programs ◦ Replicated by having staff rained in the methods used by program developers and then bringing these methods back to specific settings ▪ With some room for adaption to the setting • Adaption of Programs ◦ Taking programs and making them customized to the setting ◦ Ideally having the program developer as a consultant • Intervention/ Innovation ◦ Current modern day science ◦ Have evidence based programs that are sources of ideas and inspirations ▪ To create a program ideal to a setting but have theory ◦ Not replicated exactly ◦ Creating a program tailored to the unique circumstances at a given time yet using ideas gleaned from best practices literature 8 Issues in Implementation • Fidelity ◦ How closely is the design of the original program maintained? • Dosage/ Intensity ◦ How often and how frequently is the program presented? • Quality ◦ How well are the components of the program presented? • Participant responsiveness ◦ How engaged are the participants? • Program differentiation ◦ Were there clear theoretical and practical distinctions between this program and other interventions? • Monitoring of control conditions ◦ Were the control participants exposed to any other type of intervention • Program reach ◦ How many of the intended participants were actually enrolled in the program? • Adaptation ◦ What aspects of the program were adapted to fit the specific context of the setting? 4 Stages of Development and Implementation • “Scaling up” - The process of going from original development of an innovation to its wide- spread implementation 1. Experimental Development • Aprogram demonstrates its effectiveness under small-scale, optimal, highly controlled conditions compared to a control group 2. TechnologicalApplication • Demonstrates effectiveness under real-wold conditions, similar to the conditions for which it is eventually intended but still under guidance of its of its developers 3. Diffusion of Innovation • Adopted by other organizations or communities and demonstrates effectiveness under real-world conditions when not under the direct scrutiny and guidance of its developers • (5-step process) i. Knowledge ii. Persuasion iii. Decisions iv. Implementation v. Confirmation 4. Widespread Implementation • Diffusion stage brings the program up to few communities only • Implementation becomes widespread when a program continues to show effectiveness in a wide variety of settings and is transferred from its developers to new implementers, who in turn, conduct further program diffusion Implementation Models • Research to practice models ◦ Researchers and policy makers “push” communities and organizations to adopt evidence- based programs ◦ Ask: “We know what works, but how do we get it successfully adopted in real-life settings?” ◦ Top-down approach • Community-centred models ◦ Communities ask what kinds of programs work for the problems we are facing, and how can we adopt them for our community? ◦ Benefit is the fact that indigenous prevention efforts are likely to fit community capacity and community values in ways that programs developed under controlled research conditions cannot match ◦ Bottom-up approach An Integrative Model • Interactive Systems Framework for Dissemination and Implementation (ISF) ◦ Prevention Synthesis and Translation System ▪ Addresses fact that information promising prevention approaches is difficult to access ▪ Need for someone to find all the information, synthesize it and translate it into a form that is useful for potential developers ◦ Prevention Support System ▪ Providing training and technical support to adopters ▪ Addresses capacity of organizations and communities to successfully adopt new innovations ◦ Prevention Delivery System ▪ Describes the systems that are actually implementing the new program or innovation Factors Affecting the Implementation Process ◦ Community-level ▪ Include the current state of prevention theory and research ▪ We think about research at the intellectual community level ▪ Politics, funding, and policy considerations ◦ Provider characteristics ▪ Adopters' perceptions of the need for the program ▪ Adopters' assessment of their ability to implement the program ◦ Innovation characteristics ▪ Includes compatibility of the program with the setting ▪ Degree to which the program can be adapted to the needs of the setting ◦ The Prevention Delivery System: Organizational Capacity ▪ Positive work climate ▪ Norms supporting change ▪ Sharing decision-making process ▪ Open communication ▪ Strong leadership that is supportive of the program and the people directly implementing it • Research Support – Does this model work? ◦ Meta-Analysis ◦ Effect sizes 2 to 3 times larger ◦ Organizational capacity (11 of 23 factors) 8 Organizing Principles of Participatory Action Research (PAR) (Do not need to memorize!) • Identification and definition of a problem or area of concern (Think about first 3 together) ◦ Problems cannot be effectively address until they are widely identified as a problem ▪ Once problem is considered important, common understanding of problem needs to be developed ◦ The way a problem is defined has huge impact on what possible intervention will be considered • Assessment of resources and community/organizational capacity ◦ Know your organization ▪ Including it's people, goals, values, mission • Context ◦ Cultural traditions and norms, skills, goals and concerns of the individuals, historical issues ▪ Community and Organizational Capacity • Resources present in a setting that would be available to help implement new program or innovations ▪ Innovation-Specific Capacity • Motivation, skills, and resources necessary to implement program ▪ General Capacity • Skills, characteristics, and overall level of functioning necessary • Review of available research and potential programs or policies ◦ Evidence-Based ▪ No need to develop a program from scratch ▪ There is a wealth of research on effective prevention programs ▪ Address the Prevention Synthesis & Translation System of the ISF model ▪ Want to help bridge gap between research and practice by synthesizing info from research articles and presenting it in a useful format for public use ◦ Efficacy and Effectiveness ▪ Efficacy – the beneficial effects delivered by the program under optimal conditions ▪ Effectiveness – Effects of the program when delivered in real-world settings ◦ Core and Adaptive Components ▪ Core Components – Crucial to the identity and effectiveness of program and need to be transferred with fidelity and care ▪ Adaptive Components – May be altered to fit the social ecology or practical restraints of the new host setting • Also known as, “Key Characteristics” • Assessment of fit between the innovation and the setting ◦ No: If fit between program and organization not there, then you have to go back to identification and definition (Step 1) ◦ Yes: Ready to move on to next group of principles ◦ To gain approval, innovation must fit their values and identity • Training of personnel and development of supportive structures and processes ◦ Working with social and emotional supportive staff ◦ Looking for “small wins” ▪ Limited yet tangible innovations or changes that can establish a record of success and sense of momentum ▪ What they are doing right and how to encourage them ▪ Coach them and recognize their successes and get momentum moving • Development of evaluation activities for implementation processes and outcomes ◦ Looking at the process of how the program was implemented ◦ Outcomes: did our target intervention problem change? ▪ 4-step process • Identify Goals • Process Evaluation • Outcome Evaluation • Impact Evaluation • Implementation of the program and adaption based upon information gained ◦ Adopt it, Adapt it, Sustain it ◦ Program adaptation must be longitudinal in nature ▪ To be lasting, it must become part of that history and culture, not dependant on an influential leader ◦ Must be institutionalized ▪ Made a part of the settings's routing functioning • Repeat as appropriate ◦ May need to go back and tweak some steps Evaluate for Unintended Consequences • Iatrogenic Effects ◦ Unintended, negative consequences of an intentionally helpful intervention • E.g.) Scared Straight Program ◦ Intended to deter juveniles from crime ◦ Evaluation found program increased risk for arrest ▪ by unintentionally reinforcing attitudes and behaviours associated with criminality Cultural Diversity in Program Development • Every aspect of PAR cycle in program implementation must be informed by, and congruent with, the values of the community • Program theory and implementation must be based on cultural values at a deep structural level, not just a surface one ◦ Involves strong collaborative approach and active community involvement CASEL Findings (The Collaborative forAcademic, Social, and Emotional Learning) • Established to promote the adoption of Socio-Emotional Learning programs from preschool to high school ◦ Significant positive and negative outcomes ▪ Attitudes towards self and others, positive social behaviour, emotional distress, conduct problems, and academic performance • Findings of over 317 studies involving 324,303 elementary and middle school children ◦ Effect sizes were in small to medium range ▪ 0.60 for SEL skills ▪ 0.23 for conduct problems ▪ 0.28 for academic performance • Academic performance improved by 11 to 17 percentage points across all studies reviewed SAMHSAFindings (U.S. SubstanceAbuse and Mental Health Services Administration) • Focused on the prevention of child and adolescent substance abuse and all targeted high-risk youth • 5 years over 46 sites ◦ Results were extremely disappointing ▪ Mean effect size over all sites was on 0.02, almost zero ◦ Even more disappointing, at 21 of 46 sites, the effect sizes were negative ▪ Indicates that the comparison groups demonstrated less substance abuse than the participant groups after the intervention! ◦ Programs that were behavioural and skills based and based on coherent theory were among most effective ▪ Programs that provided just information about substance abuse were not effective • WHY? ◦ #1) At many of the sites, the control groups were not really control groups ◦ #2) Programs were implemented differently at different sites ▪ When they statistically controlled for these factors, estimated effect sizes rose to 0.24 CHAPTER 11 Empowerment and Citizen Participation Empowerment in Community Psychology • An intentional, ongoing process centred in a local community, involving mutual respect, critical reflection, caring, and group participation, through which people lacking an equal share of resources gain greater access to and control over those resources ◦ Accomplished with others, not alone Empowerment in Community Psychology • Empowerment involves: ◦ Gaining and exercising greater power ◦ Cognitive, emotional and behavioural components ◦ Mutual and reciprocal relationships in settings ◦ Multiple levels ▪ Empowerment does not necessarily transfer across all levels Empowerment & Citizen Participation • Empowerment is ◦ Contextual ▪ Complex, dynamic, changes over time, where you are, who you are ◦ Limited ▪ Empowerment of one group can be at the extent of another ▪ Have to be careful about what the expense it ▪ Empowerment doesn't always lead to real change • Citizen participation ◦ Decision making ◦ Voice in deliberation of community issues ◦ Participation as a means (a path to a goal) ▪ Participation is often encouraged to improve the quality of a plan or because citizens' commitment to a decision is often greater if they participated in making it ◦ As an end itself (a goal in itself) ▪ Citizen participation is often seen as an essential quality of a democracy Citizen Participation • Research on citizen participation suggests it ◦ Can increase quality of decisions in an organization ◦ Can promote effective leadership & goal achievement ◦ Issues ▪ Time • Less efficient ▪ Conflict • When someone jumps to a solution, someone may have conflict with it • May not lead to a better product but can improve quality ▪ Resources required at the outset What do we mean by power? • Who has it? • How does it fit in a social structure? • How is it used? • When is it used? • Why is it used? ◦ As a means?As an end itself? • How can it be abused? Types of Power • Power over ◦ Capacity to compel or dominate others – often through control of valued rewards or punishment ▪ e.g.) Professor, Boss • Power to ◦ Ability of individuals or groups to pursue their own goals and develop one's own capacities ▪ This can involve self-determination for each person • Power from ◦ To be able to resist the power or unwanted demands of others ▪ e.g.) Power to resist someone trying to persuade you • Integrative power/ People power ◦ Can be used as a tool for liberation ◦ Develop the capacity to work together, build groups, bind people together and inspire loyaly ◦ People have relationships together ▪ e.g.) Based on spiritual or moral principles Gaventa's Instruments of Social Power ◦ Control resources that can be used to bargain, reward and punish ▪ Same as “power over” ◦ Control channels for participation in decisions ▪ Having expert power • Based on perceived knowledge, skill, or experience of a person or group • e.g.) versus limiting citizen testimony ◦ Shape the definition of a public issue or conflict ▪ Communications in media ▪ Can be used to reinforce or break stereotypes ▪ Power to make one perspective seem normal and important while making another seen strange and irrelevant Promoting Citizen Participation & Empowerment – Personal Qualities ◦ Critical awareness ▪ emerges from our life experiences ▪ often life experiences about injustice, not privilege ◦ Participatory skills ▪ articulating a problem ▪ alternative visions ▪ advocating ones views ▪ finding useful support ▪ skills are context specific ◦ Sense of Collective Efficacy ▪ sense of = “my belief in what the group can change” ◦ Sense of Personal Participatory Efficacy ▪ what can I do? ▪ domain specific • e.g.) high self-efficacy in stats course but low in playing basketball ▪ long term view is nurtured by optimism • Characteristics of optimism (exam!!) ◦ accept diversity with humor ◦ celebrate successes ◦ Participatory Values and Commitment ▪ spiritual or moral commitment sustains citizen participation and empowerment ▪ deeply held values ◦ Relational Connections ▪ social support ▪ mentoring is important for sustained effort ▪ In the US 25 – 50% of neighbourhood programs are gone because there is no mentoring Power is best understood in relationships Empowering Practices & Settings • Empowering ◦ Foster member participation and sharing or power in group decisions and actions ◦ Empowers those within a setting ◦ Setting to setting ◦ Characteristics of an empowering setting ▪ Solidarity ▪ Member participation ▪ Diversity and collaboration ◦ Can be empowered and empowering • Empowered ◦ Exercise power in the wider community or society ◦ Influencing decisions and helping to create community and macro-system change ◦ relation to empowering ◦ Characteristics of an empowered setting ▪ Influence outside of setting ◦ Can be empowered but not empowering ▪ National RifleAssociation Features of Empowering Practices and Settings #1) Solidarity • Promoting a strengths-based belief system • Fostering social support • Developing leadership #2) Member Participation • Participatory niches & opportunity role ◦ create roles and tasks that offer opportunities for members to become involved and assume responsibility • Focus on tasks and goals • Make decisions inclusively • Rewarding participation ◦ Empowering community settings provide rewards for citizen participation that outweigh its costs #3) Diversity • Promote and value diversity ◦ Having several members from a disfranchised group, not just one token member • Foster intergroup collaboration ◦ Boundary spanning ▪ relationships can connect groups within an organization helping each other understand each other • e.g.) community psych and developmental psych students working together ◦ Processes for resolving conflicts ▪ if a group avoids conflicts, it is not empowering Comparing Empowerment & Citizen Participation • Similarities ◦ Decision making ◦ Collective action ◦ Context specific • Differences ◦ Behavioural ◦ Empowerment viewed as a broader process Study finding: Decreased political efficacy and increased feelings of political commitment CHAPTER 12 Community and Social Change Why Social Change? • Change is intertwined ◦ Individual level • Communities have a basic right to self-determination ◦ Community level ◦ Communities decide what is right for them ▪ Have boundaries that are someone permeable ▪ Use social science concepts and knowledge to help determine what their self- determination is • Applying science to social change ◦ Societal level ◦ Change happens all the time ◦ Need to recognize that community psychology is alternative paradigm for psychology ◦ see Debate Video (Social Change and Academia Part 1) ▪ What's the role of the therapist in activism and vice versa? ▪ We haven't created a just world – even with all this theorizing • e.g.) We know all this information and can't do anything to better communities ◦ Innocent people are still dying ▪ Research for justice ◦ Need solidarity methodology ▪ We cannot wait for perfect theories ▪ Reflection without action is useless ◦ Action without reflection can be dangerous ▪ We're after justice, not accountability Tools for Change • Encourages citizens to consciously examine and direct change processes ◦ Understand tool kits available to them to examine and direct change • Deliberate change efforts are needed ◦ Needed in order to ensure change is more effective ▪ e.g.) for stronger and healthier children PICO – Pacific Institute for Community Organizing * Low income communities came together and decided they needed to help empower their citizens by teaching them tool. Combine building strong interpersonal and community relationships with “pressure-group tactics” to influence government and community leaders • Cycle of Organizing (see slide diagram) ◦ Assessment ▪ Members of community meet 1-on-1 with citizens to define community issues and develop working partnerships that strengthen the group ◦ Research ▪ Meet as a whole to identify most pressing community issue based on 1-on-1 conversations with citizens ▪ Relate to ParticipatoryAction Research (PAR) ◦ Mobilization/Action ▪ Members meet to decide on an action plan and a person or office to be targeted to discuss community changes ◦ Reflection ▪ Returns to 1-on-1 relationships where the cycle began to evaluate outcomes and lessons learned A. Seven Community Organizing Techniques 1. Community Coalitions  Bring together a broad representation of citizens within a locality  Focus is at the organizational level • Bringing together different organizations to work on one issue ➢ e.g.) In Washington DC, issue of Syphilis amongAfricanAmerican's in the 90s • Coalition formed with physicians, dentists, schools, media, public service organizations  Coalitions' model of change tends to • Articulate a mission • Write action plans & build legitimacy • Seek funding • Implement programs 2. Consciousness Raising  Increasing citizens' critical awareness of social conditions & energizing their involvement • Social conditions ➢ e.g.) How many women are affected in society by Breast Cancer? • Energizing involvement ➢ Awareness to involvement ➢ Building relationships to 1 on 1 relationships to larger displays • e.g.) Films  Video (Raising Consciousness (1/2) – Richard Dawkins @ UC Berkeley - youtube) • Protests labelling children – use “people first” language ➢ e.g.) “Catholic child”, “Muslim child”, “Conservative”, “Liberal” • They are simply children of catholic, muslim, conservative and liberal parents • Strategies used to raise consciousness ➢ Draws parallels between two things that have shared characteristics ➢ Makes multiple points and not just one way of saying something ➢ Uses his celebrity power ➢ Humour – to make it safe (we can poke fun)  9 stages of community readiness • No awareness of the problem • Denial that its a local problem, even if problem elsewhere • Vague awareness of problem but without local efforts to address it • Preplanning and local information gathering about problem • Preparing strategies for community change, led by local team • Initiating programs or policy changes to address the problem • Establishing them to stay within local organizations (schools, local resources) • Maintaining strong program support, evaluation, and excellence 3. SocialAction  Identifies obstacles to empowerment and create constructive conflict to remove them  Based on • Need & resource assessments by citizens • Identifying weaknesses in the power structures ➢ Relates to empowerment  Social action tends to be • Grassroots action ➢ Starting from the bottom and growing up • Visible action in social arena ➢ Needs to be seen • e.g.) images of people protesting • Overt expression of power and protest • Video (Egypt) 4. Community Development  Aims to build up community resources  Uses collective action to promote: • Economic development (business and jobs) • Political development (community organizations to influence decisions) • Improving social environments (health, education, policing) • Improving physical environments (housing, transportation, city services)  Few efforts promote all at the same time  Video (Madagascar – Ho Avy) 5. Organization Consultation  Professionals work as consultants to make changes in an organization's policies, structure, or practices • To be considered a social change intervention, the work needs to involve organization's role in broader community/ society ➢ i.e.) not just improving working productivity ➢ Must be able to sustain the community over time to make a difference • If an organization's capacity to engage in social change is developed, it can continue to make a difference in the community 6. Alternative Settings  Creating a new resource when existing organizations, agencies or settings are not satisfactory  Often offered in contrast to “mainstream” options • e.g.) Mutual Help Organizations ➢ Developed in place of professional organizations ➢ People who have mutual experiences ➢ Women help centres  Can be difficult to sustain  Can have positive or negative affects on stigmatized individuals  Oxford House (video and in-text) • Alternative setting • Resident-managed recovering alcoholic houses ➢ Each house is self-supporting, therefore, everyone has to have a job to pay weekly shares ➢ Issue: Having an Oxford House in a nice neighbourhood • Breaks stigma – shows that recovering alcoholics is possible 7. Use of Technology  Internet & Social Media  Crowdsourcing • Grassroots, community organizing approach that collects information directly form community members regarding their own experiences in the community  Need to balance keeping community work local and recognizing global nature of problems B. TwoApproaches to Community Change • Community Betterment approach ◦ Top-down approach ▪ Work is initiated and directed by professionals • Community Empowerment model ◦ Bottom-up approach ▪ Community members have control over their situation C. 6 Elements of Effective Community Change Initiatives 1. Address multiple areas of action • Look at things holistically 2. Have sustained local control • If we want to change student behaviour, students need to be involved in which areas of action will take place 3. Develop external linkages & resources • We can't change things without being connected to the real world • Requires resources from outside community (exert knowledge, funding, political influence) • Interpersonal networks with persons outside the community • Organizational alliances with other organizations 4. Plausible theory of community change • Social science research and citizen participation working together 5. Effective intensity • Enough to make a detectable difference in everyday life 6. Long-term perspective • Initiatives that build slowly and steadily and have citizen input are likely to be sustained even if conditions change because their participatory base is solid D. Public Policy as a Social Change Strategy • Public policy work involves conducting research and seeking to influence public decisions, policies, or laws • However, policy making is not necessarily a rational process • E.g) Immigration, Crime Policy • Seeks to persuade with information and reasoned arguments but may involve confrontational approaches such as public action • It is a top-down approach • Involves framing how a social issue is understood ◦ Remember importance of problem definition when doing public policy work ◦ Offer alternative on how its being framed now ◦ Needs to be based on research and program evaluation ◦ It is not rational • Policy Concerns: ◦ Research and action, emphasis on multiple ecological levels, and participatory approaches to working with citizens Conclusion • Most change efforts require: ◦ Time: commitment, persistence, and creativity ◦ Strategy for sustainability ◦ Resources ▪ Persons ▪ Knowledge ▪ Financial ▪ Discovery of overlooked resources • Best understood as a set of principles that need to be tailored to local contexts & issues Community-Based Social Marketing AModel for Change Social Norms • Norms are rules for expected behaviour • These behaviours can exert influence ◦ e.g.) Being polite, saying “thank you!” ◦ Not smoking inside • Social norms refer to the behaviour of others ◦ Descriptive Norms ▪ Beliefs about what people do in a particular situation – keyword: is ◦ Injunctive Norms ▪ Beliefs about social approval or disapproval for a behaviour – keyword: ought Descriptive and Injunctive Norms in Energy Conservation • Study: Nolan, Schultz, Cialdini, Goldstein & Griskevicius, 2008 ◦ Smart Meter ▪ People got feedback on their bills, detailed information and comparisons between neighbours (the is) • Rebound Effect occurred ◦ E.g.) People who used 30% more continued to use more than their neighbours because they thought they could use what their neighbours weren't ▪ Began using smiley and sad faces to show what was good and bad usage • Result was that people began reducing their power usage Introspective Illusion • People think that they're logical and base their decisions off common sense rather than on social pressure to conform to other's behaviour • Research (Nolan. Et al. 2008) shows otherwise ◦ This error is called Introspective Illusion ▪ People thinking they're being logical without realizing the social pressure that actually is the basis for their decisions Social Diffusion • People change their behaviour based on what others are doing ◦ e.g.) Fashion in a group • Personal relationships are an important determining factor in changing behaviour ◦ e.g.) Roommates leaving the house looking alike • Credibility of the source ◦ e.g.) Celebrity endorsements Research Shows • Large scale campaigns focusing on education and awareness can be effective in changing attitudes, but rarely result in behaviour change ◦ e.g.) One-Tonne challenge ▪ Rick Mercer challenged people to reduce their carbon dioxide emissions by 1 tonne ▪ Campaign failed What is Social Marketing? • “Aprocess that applies marketing principles and techniques to create, communicate, and deliver value in order to influence target audience behaviours that benefit society as well as the target audiences” Social Marketing – Positive Behaviour Change • Eat 5 fruits and vegetables a day • Move right for signs and lights • Know your BMI • Immunize on time TypicalApplications • Improving health • Preventing injuries • Protecting the environment • Involving the community • Improving financial behaviour How Social Marketing Differs • Commercial Sector Marketing ◦ Typically goods and services ◦ For a profit ◦ Benefit of shareholders • Non-Profit Marketing ◦ Promoting services ◦ Supporting fundraising • Cause-Related Marketing ◦ Portion of sales go to a charity/ cause • Social Marketing ◦ Benefit society and the target audience How Social Marketing Differs • Social marketing typically has to deal with the market's core belief's and values, whereas business marketing generally deals with preferences and opinions • Social marketing has to work with (marketing) channels that are less well-defined and less motivated by money Why is it so difficult? We ask people to • Be uncomfortable • Risk rejection • Reduce pleasure • Give up looking good • Be embarrassed • Go out of their way • Spend more time • Spend more money Basics of Community-Based Social Marketing • Founded by Doug-McKenzie Mohr • Based upon research in the social sciences that demonstrates that behaviour change is often most effectively achieved through initiatives delivered at the community level that focus on removing barriers to an activity why simultaneously enhancing the activity's benefits • 5-Step Process 1) Select Behaviour ▪ Identify TargetAudience → Consider Impact & Probability of Behaviour → Make Sure Behaviour is Non-Divisible 2) Identify Barriers and Benefits ▪ Use Literature Review, Surveys, Focus Groups, etc. 3) Develop Strategy ▪ Enhance benefits, Reduce Barriers → Commitment, Prompts, Norms, Social Diffusion 4) Conduct a Pilot ▪ Collect Baseline Measurements → Implement Strategy → Collect Follow-Up Measurements 5) Evaluate Broad Scale Implementation ▪ Compare with Baseline Measurements → Communicate Results CBSM: Reduce the Juice Case Study • Mission: To empower youth to be agents of social change for the environment in their schools and communities Prompts • What is the biggest barrier to sustained behaviour change? • Most sustainable behaviours are most prone to one common barrier: FORGETTING! Prompts Should Be: • Self-explanatory • Noticeable • Close proximity to activity • Positive CHAPTER 5 Understanding Individuals within Environments Fun Theory • Fun is the easiest way to change people's behaviour for the better • Is it lasting change? Exemplary Community Programs That Created orAltered Ecological Contexts to Improve Quality of Life for Individuals 1. GROW a) Mutual help organization for persons with serious mental illness b) Deliberately limits the size of local chapters, creates leadership roles for all members and maximizes responsibility for group functioning • Illustrates benefits of an underpopulated setting Roger & Louise Barker Study: • Aimed to understand children's lives of children in ecological context • Systematic, naturalistic observations of all aspects of children's everyday lives ◦ Methods referred to as “Stream of Behaviour” • Were interested in patterns of behaviour characteristic of a setting regardless of which individuals were there ◦ “Behaviour Settings” - NOT simply a physical place ▪ Characteristics: • Place ◦ Based on natural settings • Time • Standing Behaviour Patterns ◦ People can change in a setting but behaviour may remain the same ◦ Some settings stood alone ▪ e.g.) Stores ◦ Others were settings within a setting ▪ e.g.) Aclassroom within a university ▪ 5 categories of behaviour setting ◦ Government ◦ Business ◦ Educational ◦ Religious ◦ VoluntaryAssociation ▪ Rules of Behaviour Settings • Program circuits ◦ Demand the overall behaviour in the setting ▪ e.g.) Ameeting has an agenda • Goal circuits ◦ Satisfy goals of individuals ▪ e.g.) Purchasing books at a store or attending lecture ▪ Control Mechanisms of Behaviour Settings • Deviation-countering circuits ◦ Correct individuals behaviour and train them to desire actions • Vetoing circuits ◦ Occurs when individuals are excluded from behaviour settings ▪ e.g.) Entrance exams or grade point cut-offs ◦ Examples of Rules & Control Mechanisms @ WLU ▪ e.g.) Don't walk on the hawk ◦ “Underpopulated Settings” – Study of “Manning” theory ▪ Study by Barker and Gump: Big School, Small School • Students in smaller schools twice as likely to participate in activities – also had perceived more responsibility to volunteer for activities ▪ Critical factor is the ratio of number of roles available compared to the number of individuals available to play those roles ▪ An optimally populated setting has as many or more players than roles ▪ Underpopulated setting has more roles than players • Increases member sense of responsibility for maintaing settings • Offers them chance to develop skills they otherwise might not have learned • Found in small schools Jim Kelly's Ecological Model Allows us to think about settings in different ways 1. Interdependence ◦ Multiple, inter-related parts ◦ Change in one part affects others ◦ Any change in the system will have multiple consequences ▪ Change efforts may be thwarted because concerns of interdependent components of the system were not addressed 2. Adaptation ◦ Two-way process ▪ Individuals cope with the constraints and demands of an environment and environments adapt to their members 3. Cycling of Resources ◦ Any system can be understood by examining how resources are used, distributed, conserved and transformed ▪ Personal resources • Individual knowledge, experiences, strengths ▪ Social resources • Occur in relationships among members, shared beliefs, values, formal rules, group events 4. Succession ◦ Purpose is to strengthen individuals adaptation of members to create a setting where members can have their needs met ◦ Interdependence is encouraged Moos Social Climate Psychological effects of environments are best assessed in terms of persons' perceptions of the environment and the meaning people attach to it • Occurs at the microsystem (social relationships) and organizational level • Assumes that settings will vary on how much they emphasize relationships, personal growth of settings members or maintenance in setting practices Three Primary Dimensions • Relationship ◦ Concerns mutual supportiveness, involvement and cohesion of members ◦ Looks for evidence of relationship qualities of each setting ◦ Family Environment Scale analyzes how cohesive and expressive they perceive their family to be and the extent of the conflict they perceive ◦ Classroom Environment Scale measures extent of involvement in class, support they perceive from their teacher and the extent of friendship they report among classmates ◦ Related to: ▪ Kelly's principles of “Interdependence” and “Cycling of Resources” • Personal Development ◦ Concerns whether individual autonomy, growth, and skill development are fostered in the settings ◦ Family Environment Scale subsections of emphasis on achievement, moral-religious concerns, recreation ◦ Classroom Environment Scale subsection of competition among students ◦ Related to: ▪ Kelly's principle of “Adaptation” • System Maintenance and Change ◦ Concerns settings' emphasis on order, clarity of rules and expectations, and control of behaviour ◦ Related to: ▪ Kelly's principles of “Adaptation” and “Succession” Seidman's Social Regularities • Proposed that settings be understood in terms of “social regularities” ◦ Defined as the routine patterns of social relations among the elements within a setting • Focus is not on individual personalities but on relationships between individuals • If settings change only the actors, it will promote only a first-order change • If social regularities are altered, second-order change results • Concepts: ◦ Patterns of power relationships ◦ Decision making ◦ Access to resources in settings Environmental Psychology Examines the influence of physical characteristics of a setting on behaviour • Environmental Stressors ◦ Noise ◦ Air Pollution ◦ Hazardous Waste ◦ Crowded Housing • Environmental Design ◦ Enclosed workspaces ◦ Windows ◦ Aspects of housing design Activity Settings (O'Donnel, Tharp, Wilson) • Takes subjective experiences and cultural meanings into account • Not simply a physical setting or behaviour of persons there ◦ It is the subjective meanings that develop there among the participants, especially intersubjectivity ▪ Beliefs, assumptions, values, emotional experiences shared by setting participants • KEY Elements: ◦ Physical settings ◦ Positions (riles) ◦ People and the interpersonal relationships they form ◦ Time ◦ Symbols that setting members create and use What is Ecological Context? • Physical and social aspects of environments that influence individuals • Persons and contexts influence each other • Seek to understand the interplay of ecological context and individual life and to find ways to create or alter contexts to enhance individuals' quality of life Ecological Psychology • The PURPOSE: to identify behaviour settings and to understand the physical features and social circuits that maintain them • Underpopulated Settings ◦ Ratio between number of roles and number of individuals ◦ Optimal vs. Underpopulated settings KEY Ecological Concepts Summarized • Kelly's Ecological Principles ◦ Interdependence, Adaptation, Cycling of Resources, Succession • Moos Social Climate Dimensions ◦ Relationships, Personal Development, System Maintenance and Change • Seidman's Social Regularities ◦ Patters of Power Relationships, Decision Making,Access to Resources in Settings • Barker's Ecological Psychology ◦ Behaviour Setting, Optimally Populated, Underpopulated • O'Donnell'sActivity Settings ◦ Intersubjectivity • Environmental Psychology ◦ Environmental Stressors, Environmental Design Neighbourhood Context Terms: • Neighbourhood Risk Processes ◦ Statistically correlated with such problematic individual outcomes as: ▪ Personal distress ▪ Mental Disorders or behaviour problems • Neighbourhood Protective Processes ◦ Strengths or resources associated with positive individuals outcomes • Distal ◦ Broader in scope and indirectly affect individuals • Proximal ◦ Affect individuals more directly and immediately Concepts/ Findings: • Distal Socioeconomic Risk Processes ◦ Involve social and economic or physical characteristics of a neighbourhood as a whole that are correlated with individual problems. e.g.) ▪ Mental health and behavioural problems ▪ Delinquency ▪ Cardiovascular health ◦ Residential Turnover ▪ In neighbourhoods with higher turnover, juvenile delinquency is more common ◦ Macro-system forces are often root causes ▪ e.g.) Unemployment • Risky Physical Environments ◦ Socioeconomic root processes also create hazardous physical environments ◦ Have a more direct (proximal) effect on individuals and families ▪ More likely to breath and drink polluted air and water ▪ Endure high levels of traffic noise ▪ Often lack sources of healthy food • Neighbourhood Disorder ◦ Another proximal approach that focuses on processes of neighbourhood violence and incivilities ▪ Noticeable signs of neighbourhood disruption that raise fears of crime • Litter, vandalism, graffiti ▪ Social incivilities include public drunkenness, gang activities and drug trade • Protective Processes ◦ Distal protective processes may include
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