CD02-003 Abstracts
Community Capacity and Diabetes Care: Hispanic Appalachians
ANDERSON, MARY KatHERINE
DESCRIPTION (provided by applicant):The purpose of this study is to examine the process of building community capacity in an underserved, Hispanic community in Southern Appalachia through adaptation and implementation of multi-level interventions for diabetes prevention. This Hispanic community has already identified that diabetes and access to health care are problems that must be addressed. The investigators will engage with the community in participatory action research (PAR) to address these diabetes-related health concerns and reduce the burden of diabetes, while aiming at the goal of increasing the community's health in the broadest sense. The research will contribute to scientific knowledge through empirical investigation of the development and maintenance of health supportive policies and environments at the individual, family, aggregate, and community levels. Community competence will be measured as well as the functioning of a coalition that includes researchers and Hispanic community members. A novel approach, the Composite Case Model (CCM), will be used as a vehicle to allow the coalition and the community to focus on aggregate and community concerns related to diabetes. The CCM will also be used for community education and testing of the design and implementation of coalition programs. The reduction in diabetes burden will be measured at all levels of prevention - primary, secondary, and tertiary.
Garden of Eden
BAKER, ELIZABETH
DESCRIPTION (provided by applicant): Garden of Eden will utilize a participatory action research approach to develop, implement and evaluate a multilevel intervention to increase physical activity and consumption of fruits and vegetables and decrease fat consumption. Garden of Eden will incorporate: individual behavior change, change in social support for healthy eating and physical activity, and changes in community infrastructures to ensure access to healthy options (a neighborhood-based grocery store and opportunities for physical activity). The effectiveness of the program will be evaluated using process, impact and outcome evaluations. The process evaluation components will include focus groups, suggestion boxes, and documentation of activities (e.g., grocery sales, number of physical activity sessions held, number of policy meetings held and attendance). In terms of impact and outcome evaluation, a quasi-experimental cohort design will be used that will allow for pre and post intervention assessment of the various objectives
Participatory School-Based Health Center Research
BRINDIS, CLAIRE
DESCRIPTION(provided by applicant): The "School-Based Health Center (SBHC) Participatory Research" project will utilize new student and school staff participatory research methods to conduct student health research. The project builds on a five-year history of collaborative evaluation research of eight SBHCs in Alameda County. Through this participatory effort, UCSF and the SBHCs have developed and implemented an evaluation that measures prioritized student and client health outcomes. This proposed project will increase the capacity of not only the SBHCs, but also Student Research Teams and Coordinated School Health Teams to engage in the research process to improve health programs, to disseminate findings, and to translate the findings into programmatic recommendations that can be widely disseminated. The anticipated outcomes of the project are to: 1) Improve the capacity of SBHCs, students, and schools to engage in participatory research, 2) Improve the quality and breadth of school health programs, and 3) Improve client and student health outcomes.
Flint Fathers and Sons Evaluation Project
CALDWELL, CLEOPatRA
DESCRIPTION(provided by applicant): The purpose of this project is to evaluate the effectiveness of an innovative, theoretically-based preventive intervention designed to enhance mediating (i.e., parental monitoring, parent-child communication, parental role modeling) and moderating (i.e., racial identity, racial socialization, social support, self-efficacy) factors in reducing or preventing substance use and violent behavior among non-resident African American fathers and their preadolescent sons. The intervention is also designed to prevent early sexual initiation among sons and to examine the effectiveness of increasing the quality of father-son relationships (i.e., father involvement, father-son closeness) and promoting positive health behaviors (i.e., physical activity) as strategies for preventing youth problem behaviors. This culturally-based intervention was developed using a community-based participatory approach involving collaboration between several community-based organizations in Flint, MI, the Genesee County Health Department, the University of Michigan School of Public Health, and non-resident African American fathers and sons who participated in focus groups and pilot tests of the intervention. One hundred fifty intervention and 150 comparison group families will be recruited into the study. To date, 94 families have participated in the project. The significance of this study is that it involves urban non-resident African American fathers more fully in the lives of their preadolescent sons who are at risk for experiencing a number of negative health outcomes. The family environment is vital to the health and well-being of adolescents. Yet, most projects do not include family members in youth preventive interventions. Involving parents is advantageous for several reasons, including developing parenting skills helpful to the adolescent and gaining insights about the program which will allow them to support the child long after the intervention ends. Thus, influencing the attitudes and behaviors of parents, especially non-resident African American fathers, is an important step towards sustainability of positive intervention effects for the child.
Participatory Research of an Empowerment Evaluation System
CHINMAN, MatTHEW
DESCRIPTION(provided by applicant): Based on established theories of traditional and empowerment evaluation, results-based accountability, and continuous quality improvement, the framework Getting To Outcomes: Methods and Tools for Planning, Evaluation, & Accountability (GTO) is a participatory model emphasizing collaboration between prevention experts and local practitioners. The GTO model is designed to enhance the prevention competencies of providers while also empowering them to adequately address all aspects of planning, implementation, and evaluation of their prevention strategies themselves. This project will use a participatory research approach to compare two substance abuse prevention coalitions using GTO with two similar coalitions who are not. The impact of using the GTO model on prevention competencies and participation in the research process will be assessed with a survey administered to about 700 members of the four coalitions before GTO implementation and 24 months later. This data will then be linked to the evaluation data of individual coalition programs to determine GTO's association with health outcomes. Standardized assessment techniques that require community input will be used to track GTO utilization. Results will illustrate how the model improves prevention competencies and program-level health outcomes.
Building Capacity to Assist Head Start Children with Asthma
CLARK, NOREEN
DESCRIPTION (provided by applicant): A randomized waitlist control study will be conducted in six Head Start agencies with 585 children with asthma to assess a collaborative and innovative approach to family education where agency staff also are enabled to support family efforts to manage asthma. It is expected that compared to control schools, caretakers and children participating in the program will exhibit: higher levels of asthma management, lower levels of asthma symptoms, higher levels of caretaker quality of life, and lower levels of emergency department visits and hospitalizations. Further it is expected that the intervention prototype as refined by the community partners will: provide a process for building Head Start organizational capacity to manage chronic conditions such as asthma; provide a framework for working in community partnerships; provide a manageable method for identifying children who might benefit from the family asthma management program that can be introduced widely in Detroit Head Start programs; serve as the basis for convening area Head Start personnel to develop a dissemination plan; and provide a procedures guide for implementing the intervention in additional Head Start agencies.
Evaluation of Asthma Prevention Education in Large Housing Development
CONNELL, DAVID
DESCRIPTION (provided by applicant): The proposed project aims to assess the impact of a multi-faceted intervention designed to reduce the effects of asthma among residents of multi-unit housing developments in Boston's inner city Roxbury community. This project will evaluate the relative impact of intervention on (1) resident's asthma management knowledge and behavior; (2) housing unit environmental quality; (3) use of emergency room services and hospitalizations related to asthma care; (4) medical costs of asthma care; and (5) quality of life. The project will recruit a treatment group from among residential populations of three housing developments. A comparison sample will be recruited from similar nearby housing developments. The treatment units are managed by Urban Edge, a project partner specializing in management of rehabilitated inner city housing. They will receive orientation regarding asthma triggers and remedial strategies, air quality testing of their units, use of project vacuum cleaners and other mitigation-related supplies (including insect control devices and measures), and ongoing education about asthma and other home environmental hazards. Data analysis will determine if those in the T group experienced fewer hospitalizations or emergency room visits for asthma, fewer asthma episodes, reduced medical costs associated with asthma, and a reduction in absenteeism from school or workplace.
Participatory Action for Healthy Lifestyles
DAVIS, SALLY
DESCRIPTION (provided by applicant): The University of New Mexico Prevention Research Center is developing, implementing, and evaluating an integrated multi-level model entitled Participatory Action for Healthy Lifestyles (PAHL). This prospective study will investigate the dissemination, diffusion, and utilization of a school-based nutrition and physical activity intervention—Pathways, a recently completed multi-site randomized control field trial established to address health disparities and the alarming increase in obesity and related diseases among American Indians. A participatory approach was used to develop this culturally appropriate and theory-based intervention for third, fourth, and fifth grade students and their families. The current study, PAHL, is establishing three training and technical assistance field centers—one each at the local tribal level, the state level, and the regional level. Strategic Participatory Planning Teams are being established and maintained at each level, and participate in all aspects of the participatory research process. Train-the-trainer sessions are offered for Community Action Teams to implement the Pathways program. Community Action Teams then develop participatory research action plans for disseminating Pathways in their communities. They also participate in developing a plan for evaluating the overall project. A multi-disciplinary, multi-ethnic research team is partnering with communities to develop a participatory model for dissemination and utilization that will be a useful tool for other researchers and communities trying to bridge the gap between science and practice.
Project Access: Caring for the Uninsured
DeHAVEN, MARK
DESCRIPTION (provided by applicant): The community-based participatory prevention project, "Project Access: Caring for the Uninsured," was initiated in 1998 to increase health care access for the uninsured working poor of Dallas County, Texas. By creating an inclusive and comprehensive organizational and administrative infrastructure, Project Access has coordinated existing community-based health clinics, volunteer primary and specialty care physicians, local hospitals and pharmacies, and faith-based organizations to care for the uninsured. The present project investigates the effect of Project Access on reducing unnecessary emergency room use and improving functional health status among the working poor. The hypothesis is that the patients enrolled in Project Access will have significantly fewer non-emergent ER visits and hospitalizations than those not enrolled, and that their health care costs will be significantly lower. The community care coordination provided through Project Access is also being tested for its effectiveness in increasing recommended cancer screening, identifying and better managing patients with diabetes, and identifying underlying mental disease and improving access to services for the mentally ill. The final component of the project is a partnership with local congregations, which provides opportunities fro developing healthy lifestyles through health promotion programs in local congregations. By integrating primary, secondary, and tertiary preventive services with community-based health promotion activities, the project promotes healthy lifestyles among uninsured patients in a way that helps create a healthy community.
Shape Up Somerville: Eat SMART, PLAY HARD
ECONOMOS, CHRISTINA
DESCRIPTION (provided by applicant): This study will demonstrate using measures of effectiveness, the feasibility of partnering with the community to create, disseminate, implement and evaluate Shape Up Somerville: Eat Smart. Play Hard., a community-based environmental change intervention to prevent obesity in culturally diverse, high-risk, early elementary school children. Based on formative work with parents, children, teachers, school food service, school officials, and community members, a community-wide campaign will be developed with targeted environmental change strategies for early elementary school children within the before-, during-, and after-school environments reinforced by changes within the home and community to support behavioral action and maintenance. The intervention targeting children will bring the energy equation into balance by offering numerous physical activity options that total up to 125 kcals per day and by improving the composition of the food served and the dietary options, particularly snack foods, available throughout the day. This study will measure awareness and participation of the partners and residents within the community. In addition the temporal change in BMI z-score will be monitored internally in 700 Somerville children and externally in 1000 control children from 2 demographically-matched communities for one year and will be compared to the change in BMI z-score in children participating in Shape Up Somerville with children from control communities over the one-year intervention and for one year of follow up. If successful, Somerville will serve as the model community that paves the way for cost-effective nationwide environmental action to prevent obesity at the community level.
Men as Navigators for Health
ENG, EUGENIA
DESCRIPTION (provided by applicant): The long-term objectives of this proposal are to address the priorities of our 3 coalition partners to improve chronic disease and sexual health outcomes among African American and Latino men through multi-level interventions designed to influence two factors that contribute to gender and racial health disparities: a) male gender socialization that promotes men's high risk attitudes and behaviors, and b) organizational culture that promotes institutionalized racism. Aim 1: Translate, disseminate, and evaluate the health impact of a Lay Health Advisor (LHA) natural helper model among men of color. The health outcomes focus will vary across counties based on the priorities of each community Coalition. Aim 2: Implement and evaluate a technical assistance model for developing long-term, culturally competent systems of care in two health departments. Aim 3: Develop and evaluate a surveillance system of methods and indicators for local health departments to monitor: a) health status, health care system utilization, and related psychosocial factors among individuals, and b) cultural competence of their own system of care and that of other organizations. This study will use existing community, health department, and university partnerships to provide the Navigators and their Project Coordinators with skills and strategies needed to promote: lifestyle change among individual men; organizational change; and community-level policy change aimed at developing culturally competent systems of services. Evaluate the impact of the Navigators on health behaviors associated with chronic disease (physical activity, diet, smoking, use of preventive health and early detection services) and sexual health (use of condoms and STD screening services), on social and civic organizations, and on community-level policies aimed at developing culturally competent systems of services. Build on prior cultural diversity training provided by the NC Office of Minority Health to the health department partners of each community Coalition to design a more intensive technical assistance approach. Building on the experience gained implementing Aim 2, a "tool box" will be developed of new methods and indicators for an organization to engage other agencies in delivering culturally competent systems of service that are responsive to the public health needs of the diverse citizens of their county. There will be an evaluation of these cultural competency tools in a sample of community health centers, departments of parks and recreation, and city police departments.
School-Base Obesity Prevention Program
FOSTER, GRAY
DESCRIPTION (provided by applicant): The proposed research aims to evaluate the effects of a school-based nutrition policy initiative on prevalence, incidence and remission of overweight (BMI > 95th percentile). It is a partnership between the Food Trust, the School District of Philadelphia and the University of Pennsylvania. Participants are approximately 1500 students from ten schools in grades four through eight. Half of the schools were randomized to a comprehensive School Nutrition Policy Initiative (SNPI) based on CDC's Guidelines to Promote Lifelong Healthy Eating. The SNPI is a community-based intervention administered by the Comprehensive School Nutrition Policy Task Force that is comprised of 40 individuals representing the public and private sectors. The goal of the SNPI is to change the school environment to: support healthy eating, increase physical activity, and decrease the prevalence of childhood overweight and diet-related diseases. The remaining study participants are in five control schools, matched for ethnicity, SES, and type of food service. Most students are African American and qualify for free and reduced meals at school (household income < 185% of the poverty level adjusted for household size). Assessments of weight, height, intake, activity, inactivity and eating disorder symptomotology are being conducted at baseline and 1 and 2 years.
Poder es Salud / Power for Health
FRAQUHAR, STEPHANIE ANN
DESCRIPTION (provided by applicant): The goal of Poder es Salud/Power for Health is to increase the capacity of members of the African American and Latino communities in Multnomah County, Oregon, to identify health issues and address health promotion and disease prevention, through the intervention of Community Health Workers (CHWs) who use Popular Education. By focusing on the implementation of an approach to conducting participatory research and program development, Poder es Salud/Power for Health will indicate how to increase participation of community members in defining the research questions, conducting and analyzing the research, and interpreting and applying the research findings. Poder es Salud/Power for Health assesses the impact of the participatory approach in these two communities by measuring change in the level of community social capital
The specific aims of Poder es Salud/Power for Health are as follows:
- To identify culturally-specific elements of an effective CHW intervention in the African American and Latino communities;
- To identify supportive policies and environments that allow CHWs and community members to effectively identify and address health issues; and
- To determine how social capital both influences and results from an effective participatory approach to identifying and addressing health promotion and disease prevention.
Outcomes of Poder es Salud will include enhanced understanding about how to involve community members in identifying and addressing health problems, improved ability to use the CHW model to promote health and prevent disease, and better understanding of the relationship between social capital and this participatory approach.
Tobacco Intervention as American Indian Hope and Honor
HORN, KIMBERLY
DESCRIPTION (provided by applicant): This three year multi-level participatory research project will be directed at individual youth, family, and community levels. As identified and supported by community leaders, the overall goal is to enhance the capacity of North Carolina American Indians to "promote hope and honor" among its youth: hope for a bright future and honor for their bodies, minds, and culture. Consistent with community needs, the avenue by which this will be accomplished includes reducing adolescent tobacco addiction and associated risk factors of depression, low educational attainment, and other drug use. Because smoking among American Indian youth, families, and communities continues to rise at epidemic rates, the intended impact of this project is to: 1) "ready" the community to reduce youth smoking by fostering a favorable environment for youth tobacco intervention and education; 2) empower the community to make informed and meaningful data-driven decisions about tobacco cessation and education programming needs and gaps and tobacco-related health risks; 3) provide access to effective, culturally-tailored youth cessation; 4) facilitate family education and support for youth smoking cessation; and 5) enable the community to sustain the cessation and education programs beyond the funding period via policy and practice changes. This project will also further community capacity to generate a model of university-community partnering that can be used to address other health behaviors.
Promoting Healthy Eating in Detroit
KIEFFER, EDITH
The principal goal and expected outcome of this multi-level community-based participatory project is to develop and sustain supportive community environments and policies aimed at increasing access to, and use of, healthy foods by residents of eastside and southwest Detroit. The primary participants in the interventions are state, regional, community and neighborhood organizations who will engage in Promoting Healthy Eating in Detroit (PHED) activities designed to influence their policies and practices in ways that increase the supply of, and demand for healthy foods. PHED aims to: 1) engage a Steering Committee (SC) comprised of organization leaders and community members in planning, implementing and evaluating PHED activities that build on community assets and are appropriate to the cultural and linguistic needs of African American and Latino community residents; 2) increase the supply of healthy food at the community level by: developing and sustaining weekly neighborhood mini-markets that sell fresh produce at wholesale prices; increasing the number of stores and restaurants that offer healthy foods; increasing the number of community organizations that implement healthy food policies for community events; and promoting access to, and use of, farmers markets by community residents; and 3) increase demand for healthy foods at the community-level by: conducting healthy food demonstrations and establishing healthy eating support groups in community organization and other neighborhood sites; and disseminating culturally and linguistically tailored healthy eating educational materials, and healthy food access information through community channels. PHED is evaluated in accordance with community-based participatory research principles, including SC involvement in all aspects of the evaluation design and implementation. A case study design, employing project documentation, participant observation, key informant interviews and group discussions will be employed to address both process and outcome evaluation questions across project aims.
Health-e-AME Faith Based Physical Activity Initiative
LAKEN, MARILYN
DESCRIPTION (provided by applicant): The study will evaluate a physical activity program through a randomized trial with a "delayed" control group design in the 520 AME churches of the 7th Episcopal District in South Carolina. The goal is to increase moderate intensity physical activity by at least 15% through a variety of approaches grounded in theoretical models developed in collaboration with the church members and implemented in churches that choose to participate in the program. A planning committee composed of church representatives and faculty with expertise in physical activity programs and program evaluation will select the program the church wishes to implement. Satisfaction of church members will be evaluated and change in physical activity will be assessed.
Retention and Productivity of Community Health Leaders
MARLOTTE, C. KEVIN
DESCRIPTION (provided by applicant): California State University, Long Beach and University of Southern California are collaborating with two programs: the GEMS Project in the San Gabriel Valley; and the Partnership for the Public's Health (PPH) project in Long Beach. Both of these projects involve community residents who have volunteered to be "health leaders" in an effort to improve community health. These "health leaders" have been trained to provide health education, linkages to community health programs and/or health insurance programs, and advocacy. A community-based, participatory research study will be conducted to: 1) evaluate the impact of monetary vs. non-monetary incentives on retention, participation, productivity, and satisfaction with a group of community volunteer health leaders participating in the PPH project; 2) study the "natural history" of health leader retention, participation, and satisfaction among GEM health leaders compared to the PPH health leaders with whom incentives will be manipulated; 3) develop, implement, and evaluate a community-wide participatory intervention designed to increase knowledge about health-related activities among traditionally hard-to-reach or underserved residents through the facilitation of home and/or community-based educational sessions presented by the health leaders; 4) evaluate the level of community awareness about the availability of local resources, health leader educational sessions, and program recognition generated through outreach and distribution of role-model story publications through the PPH project over time in the target Long Beach communities and in comparison to the GEM project. To date, pretest data have been collected from approximately 75 health leaders. The first cohort of health leaders in Long Beach have also received additional training on two topics they chose, "Parents Talking to Their Children About Sex" and "Mental Health" and are providing workshops and one-on-one education to their friends, neighbors, and other community members. The second cohort of health leaders is currently receiving additional training on "Nutrition and Exercise" and "Parents Talking to Their Children About Sex." Pre-intervention community awareness surveys have also been conducted in Long Beach and the San Gabriel Valley. The first six-month follow-up health leader surveys and community awareness surveys are being conducted.
DARE to be You Bridge Program
MILLER-HEYL, JAN
The DARE to be You (DTBY) Family-School Bridge project targets the crucial transitional time when youth enter kindergarten and first grade. Parents, children, and teachers will participate together in a minimum of 11 weeks (20 hours) of Bridge workshops to (1) enhance the relationships between school and family, in a community context, to improve educational success and therefore reduce the potential for multiple problem behaviors and (2) enhance both family and classroom management skills, thereby improving environments to promote self-efficacy, self-management skills, improve family relationships, and developmental level of the child. These are intermediate resiliency factors linked with reducing use of tobacco, abuse of alcohol and other drugs, and violence. The project will be tested in two culturally diverse sites: rural Navajo communities in the southwest located in the Shiprock, New Mexico area, and a tri-ethnic community (White, Hispanic and Native American) in southwestern Colorado. In both of these sites, poor relationships and lack of trust between families and schools create barriers that have long term effects on the cognitive and emotional development of children.
Nutrition Friendly School Certification Process Pilot Study
NEUMANN, CHARLOTTE
DESCRIPTION (provided by applicant): The Nutrition Friendly School certification process will include the minimum criteria for certification, a self-evaluation tool, implementation plan, and an empowerment evaluation plan. The goal of this pilot study is to actively engage the school community to prevent overweight in elementary school aged children through a multi-level participative intervention that facilitates coordinated changes in the school environment in the following areas: nutrition education, physical education, health services, food services, school policy, staff wellness, psychosocial services, and family/community involvement. The Nutrition Friendly school certification process and self-evaluation tool will be developed by school community stakeholders in collaboration with UCLA. Then, the research team will collaborate with selected schools to assist with the self-evaluation and development of an implementation plan to achieve Nutrition Friendly school certification. Schools will then implement their developed plan and be eligible to be certified as Nutrition Friendly when they fulfill the minimum requirements for a Nutrition Friendly school. A total of 1029 students in 8 intervention and 2 control schools will be selected for data collection. Several different types of data collection measuring the process and outcomes of the pilot study are planned at both baseline and post intervention.
Model for Improving Care Delivery and Health Outcomes in a Medicaid Community-Based Program
PHILLIPS, VICTORIA
DESCRIPTION (provided by applicant): The purpose of this project is to establish a sustainable, culturally appropriate, skills-based, training program to equip community-based caregivers, aides, social workers, and families, with evidenced-based strategies to deal with dementia-related problem behaviors (DRPB). The intervention setting is the Community Care Services Program (CCSP), Georgia's Medicaid home care program. CCSP clients are generally poor, elderly, severely functionally impaired, minority and female. Caregivers, formal and informal, are also predominantly minority and female. The proposed intervention uses a multi-level approach to address the complex, health-related problem of dementia caregiving. The specific aims of the proposal are: 1) to create the evidence-based, Advanced Problem Behavior Protocol for use by CCSP caregivers; 2) to integrate the Advanced Problem Behavior Protocol into current CCSP assessment practices; and 3) to train care managers and supervisors to train family members and aides in how to implement protocol-guided responses to DRPB. The protocol will be evaluated through a randomized, controlled trial of caregivers and clients. Outcomes to be monitored included: level of reported burden among all caregivers, levels of depression among informal caregivers, rates of turnover among aides, rates of institutionalization among clients and the overall cost effectiveness of the intervention.
CAST-Plus: A Suicide Prevention Community Partnership
RANDELL, BROOKE
DESCRIPTION (provided by applicant): Cast-Plus: A Community Suicide Prevention Partnership is a multi-site effectiveness trial of Cast-Plus. CAST-Plus is an indicated prevention program for suicide-vulnerable youth. The intervention addresses one of society’s most disturbing trends: the co-occurrence of suicide-risk behaviors, anger/aggression, and depression among youth. CAST-Plus extends and augments the efficacious school-based Competence & Support Training (CAST) program for potential high school dropouts who are at risk for suicide with an innovative parent component. Parents CARE (P-CARE) is a promising program currently being tested through funding from NINR and CDC. P-CARE includes home visits where parents learn to talk with teens about suicide and help teens practice mood management and healthy decision-making. CAST is delivered during the school day, providing a "dose" of social network support and life skills training that has proven effective in reducing suicide-risk behaviors in this population. P-CARE is delivered at home or a location of the parent’s choice and is designed to augment and support youth skills training and enhance support resources. This approach is designed to reduce known risk factors and enhance protective, mediating factors within individual, family, school and peer contexts. The study will examine the critical features that account for adoption and implementation across sites when communities select best practices and attempt to institutionalize these efforts on behalf of youth in their communities. The sample will consist of 1152 suicide vulnerable, youth in grades 9-12. Individual students' antecedent, mediating and outcome dimensions are measured; process measures will assess the implementation of the parent and school programs including measures of exposure, participation, receptivity and implementation fidelity. Latent growth models will be used to examine variance/covariance structures and changes in outcomes and to test the hypothesized mediating intervention effects.
Capacity Building Effectiveness in Four Safety Coalitions
SCUTCHFIELD, F. DOUGLAS
DESCRIPTION (provided by applicant): This evaluation/intervention project will investigate the effectiveness of community safety coalitions' efforts to prevent injuries. The specific aims of this study are to: a) Investigate the relationship between the characteristics of an injury prevention coalition and the quality of its injury prevention program; b) Investigate the relationship between organizational social capital, coalition structure and processes, and the outcome of improved community awareness and knowledge of injury prevention; c) Evaluate the effectiveness of a training program designed to increase coalition capacity to conduct injury prevention assessment, to develop planning, and to implement programs; and d) Develop a logic model or critical pathway that outlines the stages that a successful coalition must proceed over time. The Kentucky Injury Prevention and Research Center will partner with injury prevention coalitions in four counties: Barren, Metcalfe, and Madison County, Kentucky and Holmes County, Ohio. Two of the coalitions will receive training interventions to increase their ability to plan, implement, and assess local injury prevention programs. The two intervention coalitions that received the training will be compared with control coalitions to measure the effect that the training had on increasing coalition capacity to prevent injuries. The safety coalition's ability to plan effective injury prevention programs will be evaluated through a number of quantitative and qualitative methods, including key stakeholder interviews, coalition member surveys, and population based surveys of the community. Results of this project will contribute to an understanding of community building through participatory research for injury prevention.
Participatory Research for Physical Activity Promotion
SHARPE, PatRICIA
DESCRIPTION (provided by applicant): The specific aims for this project are to apply principles of participatory, community-based research to design, implement, and evaluate a social marketing intervention to promote physical activity in partnership with a community coalition and a parks and recreation department; evaluate the intervention's impact on physical activity behaviors and attitudes compared to a matched comparison county; and investigate the added impact of social marketing within a community with an ongoing initiative to influence policy and environmental supports for physical activity. Project planning will be conducted in partnership with a Community Advisory Board drawn from the Sumter County Active Lifestyles committee, which is a community-based coalition, and a Project Steering Committee of community members to be convened specifically for the project. The key dependent variables of physical activity level and walking behavior will be measured with the physical activity questions from the Behavioral Risk Factor Surveillance Survey so that comparisons to state and national prevalence data can be made. Formative evaluation (consumer research) will include focus groups, interviews, and community meetings in the intervention county. Process evaluation will include pedometer monitoring of participants in walking promotion activities, a pretest/posttest assessment of attitudes and behaviors of -1000 walking promotion participants, content analysis of archival data in each community, and content analysis of project activity logs, field notes, and meeting minutes.
Building Community Response to Emergent Drug Use
SINGER, MERRILL
DESCRIPTION (provided by applicant): This study seeks to integrate ethnographic and epidemiological methods to implement a community-based system for tracking street drug use patterns, assessing their potential HIV and other health risks, and implementing and evaluating local public health responses. This 3-year study has: 1) implemented an ongoing and systematic ethnographic monitoring of emergent street drug use behaviors and social contexts using direct field observation and key informant interviewing with both active drug users and frontline care/service providers; 2) launched the first of three waves of focused survey data collection to assess the distribution and sociodemographic and behavioral correlates of ethnographically identified emergent drug-related risks; and 3) developed a community response team of health and mental health care, drug treatment, community education, and HIV prevention/care providers, as well as public health officials and researchers, to review ethnographic and epidemiological findings and to develop and implement needed public health responses to emergent risk patterns (e.g., education campaigns, modified treatment patterns, new outreach strategies, specific intervention models); and 4) launched a process and outcome evaluation of the project. In its first round of surveys, the Drug Monitoring study examined the extent, ingredients and social context for an emergent drug involving a component embalming fluid and known variously on the street as "dust," "wet," or "illy." In-depth interviews revealed "wet/dust" to be a widespread and popular drug with African-American and Puerto Rican young people age 18-32. Urine and toxicological testing of residue in discarded drug bags revealed that PCP was a frequent ingredient of "dust," which is believed on the street to be comprised of marijuana or mint leaves soaked in embalming fluid, cooked until the substance resembles a black powder. Epidemiological interviews also found frequent use of ecstasy by street drug users, and identified a positive statistical association between prescription drug abuse and ever having a drug overdose. The second round of surveys will continue to broadly monitor emergent drug patterns across the demographically disparate urban areas, especially among younger adults and women, and through focused data collection and ethnographic interviews specifically examine the depth of diffusion, user perceptions, and health risks associated with ecstasy and prescription drug abuse.
Neighborhoods on the Move
SUMINSKI, RICHARD
DESCRIPTION (provided by applicant): The specific aims of the proposed study are as follows: conduct in-depth assessments of neighborhood resources for and rates of physical activity, recruit community members to form an ongoing leadership council, develop a neighborhood-based physical activity program (Neighborhoods on the Move), implement and operate Neighborhoods on the Move, assess the effects of Neighborhoods on the Move on physical activity participation and characteristics of the physical environment that could influence physical activity, e.g., access to programs, and use FORECAST METHODS to evaluate community organizational change in support of Neighborhoods on the Move. Data obtained from focus groups, community forums, key informant interviews, and additional needs assessments will be used by project coordinators and the leadership council to tailor Neighborhoods on the Move programs to meet the needs of the treatment neighborhood. Neighborhoods on the Move components will include efforts to increase access to physical activity opportunities (after school programs, church-based programs, walking clubs), improve the quality of existing programs, promote safe physical activity behavior settings, disseminate information about physical activity opportunities, and build neighborhood support for a physically active lifestyle. Coalition groups and the leadership council will assist with the implementation and maintenance of Neighborhoods on the Move. Neighborhood volunteers will be trained to organize and conduct Neighborhoods on the Move programs. Outcomes will be compared between the treatment and control neighborhoods. In addition, the extent to which existing community organizations successfully progress through stages of organizational change in support of Neighborhoods on the Move will be measured at this time.
Youth Empowerment Strategies
SYME, LEORNARD
DESCRIPTION (provided by applicant): This proposal, Youth Empowerment Strategies (YES!), is for an innovative after school program for underserved children living in West Contra Costa County, CA. The YES! program will commence when children are in grade 5 and will work with them through grade seven, across the social and developmental transition into middle school. Modeled on principles of individual and community capacity building and participatory research, the ultimate goal of YES! is to help vulnerable children have healthy, fulfilling lives and a sense of hope for the future, by promoting critical thinking, problem-solving, social action and civic participation, and by helping children identify and build on their individual, group and neighborhood assets. The specific aims of YES! are to test the hypotheses that Photovoice, empowerment education, and other participatory research approaches will (1) influence empowerment at the individual, group, and community levels, and (2) influence children's health attitudes and behaviors. In the first year of YES!, the focus will be on developing children's individual communication and group work skills, as well as on developing an understanding of critical thinking. Approaches to be used in this first year will include Photovoice, during which students use cameras to document things important to them in their own lives. In the second year, YES! program students will develop a deeper and more meaningful capacity for critical dialogue, reflection, and social action. Collaboration with the local health department's Healthy Neighborhoods Project will further facilitate the students' use of tools, such as community asset and risk mapping, as a basis for study and action. In the third year, students will identify community leaders with whom they would like to undertake community projects.
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Page last modified: July 22, 2008
Content source: Office of the Chief Science Officer (OCSO)
