PS 282 Community psych

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Colleen Loomis

First order change: alters, rearranges, replaces members of a group to resolve some aspects of a problem Second order change: changing the relationships, roles, goals of the individuals Context minimization error: underestimating the importance of context in a persons life Community psychology: quality of life for individuals, communities, and societies are linked. Integrating research with action to understand and enhance the quality of life for individuals, communities and societies Participant conceptualizer: involved in community processes while attempting to understand and explain them Core values in community psych: Individual and family wellness, sense of community, respect for human diversity, social justice, citizen participation, collaboration, community strength and empirical grounding. Individual Family Organization Localities (exo or macro) Macro Broad Street pump: Cholera in UK, tens of thousands die, many believe it is spread by miasma (bad air). John Snow suggests epidemic is related to food or water, handle of Broad street pump removed and epidemic slows to a halt. George Albee: can’t train enough for one on one, not effective in all cultures, preventing disorders, promoting competence and wellness. Prevention methods: Caplan’s model: Primary- give to entire population Secondary- give to at risk population Tertiary- groups with existing disorders US institute of medicine: Universal- everyone Selective: people at risk/characteristics of disorder Indicated: high risk and showing early systems Cumulative-risk hypothesis: children can deal with 1 or 2 risk factors but 4+ has negative outcomes Resiliency: being able to overcome Promotion: helps people function to fullest potential Prevention and promotion programs: search institute, communities that care Best practice approach: multiple intervention for interrelated goals, theory driven and evidence based, appropriately timed, social covenant, skills and behavior based, sufficient dosage, positive relationships, second order change, support for staff and program evaluation. 2005 meta analysis: US drug prevention programs for children and teens using various approaches. Effect size was 0.02, almost nothing. 21 programs had negative effect size: control group did better than intervention group. Programs were all different- behavioural and skills based more effective than others. There were method problems with the control group as they got messages from other places about drugs. Factors were controlled for and effect size rose to 0.24. Showing that: WELL IMPLEMENTED AND WELL DESIGNED PREVENTION WORKS! 4 stages(evolutions) of transferring program (moving a program to other settings) 1. Cookbook approach- follow recipe 2. Replication of programs- but not quite produce the exact thing 3. Adaptation of programs-taking a replication and changing it based on the setting 4. Intervention/innovation- source of idea/inspirations 8 issues in implementation 1. Fidelity- 2. Dosage/intensity 3. quality 4. Participant responsiveness 5. Program differentiation 6. Monitoring of control conditions 7. Program reach 8. adaptation 4 stages of development of implementation 1. Experimental development 2. Technological application 3. Diffusion of innovation 4. Widespread implementation 5 step process of diffusion 1. Knowledge 2. Persuasion 3. Discussion 4. Implementation 5. Confirmation Implementation methods: Research to practice models- researchers and policy makers push communities and organizations to adopt evidence based programs (top down) Community centered models: communities ask what kinds of programs work for the problems we are facing and how can they work for our community (bottom up) Integrated model (ISF): 3 systems: prevention synthesis and translation system (provides information about available programs), prevention support system (training and technical support and organizational capacity) and support delivery system (actually implementing the program). 4 factors: community level, provider characteristics, innovation characteristics and the prevention delivery organizational system. -meta-analysis: effect size 2 to 3 times larger, organizational capacity 11 of 23 factors Organizational capacity: amount of people that can be supported by a program- causes difficulty 8 organizing principles of participatory action research (PAR) not just studying if it changes but acting to make it change 1. Identification of problem (must be widely identified, common shared definition of the issue, defining what is the preventable phenomenon and the mechanisms that can do that) 2. Assessment of resources and community organizational capacity (motivation and skills) 3. Review of available research and potential programs or policies (knowing what works and what doesn’t work and why) 4. Assessment of fit between the innovation and setting 5. Train staff,Support the staff, emotionally, recognize small wins and successes 6. Evaluate the process 7. Implement the process 8. Repeat as necessary Evaluate for unintended consequences: (Iatrogenic effects): unintended harmful consequences of an intentionally helpful intervention Example: 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 implementation: PAR 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, strong collaborative approach needed. Better beginnings and better futures: policy implications for early childhood development. It is an overall approach to strengthen children and communities, created by government, run by parents, educators. It is evidence based, support for team members, help other communities try it too. Contains a timeline. Support from 3 government ministries. Needs in school support. Bower: KISS (key integrative social support) families, school AID (Ailing in difficulty institutions) short term assistance, guidance counselors, outpatient mental health ICE (illness correctional endeavors) provided by psychiatric hospitals, prisons, long term health care With loving KISSS early in life there will be less need for AID and ICE Developmental rights: right to conditions that allow them to grow in a healthy manner Developmental assets: psychosocial protective factors among youth, families, school, and communities that have been found in research to promote healthy child and youth development Prenatal/early infancy: first time mothers whose children are at risk because the mothers are low income or young Multi-component programs: worked on multiple goals through involving resources within the family and also outside it, such as peers, school and community resources Social emotional literacy: builds skills in left and right frontal lobes and right hemisphere as lack of stimulation can cause children to be behind academically and socially Perry Preschool project: multicomponent comprehensive education in poorer communities, reduces arrests, children do better in school Interpersonal Cognitive problem solving: preschool curriculum to help children identify their own problems and get opportunities to solve them themselves. Teachers “dialogue” with students rather than “telling”. Social decision making/ social problem solving: build self control, showed less likelihood to use tobacco and alcohol Second Step: violence prevention, teach social and emotional skills preschool to grade 9, increases in prosocial activity in school Life skills training: knowledge, motivation and skills to resist influences to use tobacco, alcohol and other drugs Empowering + Citizen Participation Empowerment: intentional ongoing process centered 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. Sports as empowerment- activity for its own sake is not empowering but with different analysis, critical reflection it may become empowering Cognitive/affective component- feeling empowered affects being empowered, but may not lead to change in decision “placating” Behavioral components: active component, group participation Multiple levels, may not be transferable Contextual Empowerment of one group could be at the expense of another group Citizen participation: decision making, voice in deliberation of community issues, means to an end, an end itself. Can increase quality of decision making in organization, can promote effective leadership and goal achievement. Conflict almost guaranteed to occur. Citizen participation will require more money initially. Power: Power over: capacity to compel or dominate others, control resources, typically accomplished by coercion, is in structure of organization Power to: power of a group to have freedom to control one’s own goals, self-determination, persuasion by persuasion Power from: ability to resist the demands of others or protest of resistance of a system Integrative power: “people power” working together, loyalty, social sources, networks, can be used as a tool of social liberations ex. Boycotts, labour union strikes Gaventa’s instruments of social power, power can be used to: control resources, control channels for participation in decisions (based on perceived notions of expert) , shape definition of a public issue or conflict Qualities of empowered and engaged persons: Critical awareness (understanding how power and sociopolitical forces affect your life, dialogue with others), participatory skills (articulating, advocating, identifying and cultivation of resources, strategic planning, finding and using social support, learning to share leadership and power), sense of self efficacy (believing in one’s own ability to participate), sense of collective efficacy (feeling that working together works to change), Participatory values and commitment (those who mobilize a local organization and maintain it are related to deeply set values and traditions), relational connections (bonding and bridging ties) Empowering: member participation, sharing of power, particular setting Empowered: wider community or societal influence, relation to empowering, settings influencing other settings, may or may not be empowering for its members United way- what gets measured gets done, all funding is traced and results are measured Results based accountability, document progress Role of evaluation in social intervention: Evaluation can document what is working, where improvement is needed and what is working Can determine responsible use of public resources Gain competitiveness in obtaining grant funding of particular models over others Establishing trust with stakeholders Justify use Logic of program evaluation:  Outcomes, did the program work?  Process, why did a program work or not work? Theory failure or implementation failure  Systematic examination of causal assumptions, underlying connections a bc  Logic model: graphic representations of how a program is expected to work; portray the connections believed to exist, crucial in development, implementation and evaluation. Helps to understand how conditions (distal or proximal problems, or settings, factors that contribute to a need for intervention. This context must be clearly and specifically defined, including available resources), activities (may be more than one, feasible given the condition) ,outcomes(measured in a change of knowledge and attitudes, skills and abilities, or change in organizational practice or a law) and impacts (reduction or increase in rates of problem or desired behavior, eventual sustained result of implementation) are connected Needs assessment, program planning, implementation, evaluation Goals & outcomes, process evaluation (while program is being delivered, can’t be done after, index of accountability), outcome evaluation (aspect of time, when to do the evaluation, is planned from the very beginning of the project and can be as important as funding, money for evaluation is budgeted), impact evaluation (beyond outcomes, long-term effects of program) Outcome evaluations: self-report, parent/ teacher/ authority figure ratings, key informant (leader in the program) and observation (researchers, qualitative or quantitative data). Evaluations and implementation: should be during and ongoing, barriers may include outsider evaluations creating an “us vs. them” mentality, evaluation process may seem to complex Empowerment evaluation: strategy, provide program stakeholders with tools for assessing the
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