Welcome!

Considerations for Rural Research: A Community Based

Practice Research Model Approach

Presenter: Holly Hatt on

September 10, 2010

Today’s Presentation Discuss challenges in doing research in rural

communities

Present the Community-Based Practice Research Model (CBPR)

Provide an illustration for using “data” to help all key players involved in the CBPR model

Lake County: Case study video

Introduction Working with community organizations

collaborative research adds another dimension Considerations of ethical issues

Researchers must be open to understanding communities’ values and priorities when conducting research collaboratively with community organizations.

This presentation provides considerations for conducting community engaged research.

Duality of Program Implementation and

ResearchScience looks for truth, practice looks

for what works. What works is true, and what is true works.

-Guy Steuart, 1963

To start with can be diffi cult to get funding to achieve

Rural Success Grants for rural projects assume deficit

Poor counties + fewer resources = poor outcome

Is this assumption valid?

A strengths-based approach and beyond

What can the rest of the world learn from the success of rural child welfare programs?

What’s in the literature? Approach

Litt le recognition of rural continuum (metro-non-metro) Largely qualitative

Outcomes Few rural-urban comparisons One finding suggest diff erent rural and urban roles for

child welfare Resources

Greater rural poverty Poorer access to transportation and health care

Policy and Practice Professionalism is one focus—real or perceived

diff erence?

To foster partnerships between communities

and educational institutions…… Build on each other’s strengths

Develop roles as change agents improve family outcomes

Our Question

What does “authentic community participation in research” mean to you?

What is a “community?” The term is commonly used but seldom defined.

For this presentation the working definition of

community is:

“A group of people who are linked by social ties and

share common perspectives or interests and may also

share a geographic location.”

Necessary Conflict of CBPR By whom research is to be conducted (Which groups come to

the table?)

For whom research is to be conducted (Which issues get to the table?)

How research is to be conducted (Which groups shape awareness of the issues?)

Which Groups Come to the Table to form a Community Partnership?

University at the Table Investigators from Social Work Education

Community Outreach Specialist

Ethnographer

Graduate Students

Funder at the Table

For example: National: SAMSHA

Local: First Five

Community & Agency at the Table: Formati ve Phase Community Advisory Group

AOD worker/counselor

Parent partners

Family Team Meeting Facilitator

Attorneys

Child social worker

Processing assistant at County Health Department

Nurse at County Health Department

Social worker at shelter for battered women

Job trainer at Community Action Agency

High School counselor

Which Issues Get to the Table?

University Issues that Get to the Table: for example

Methamphetamine abuse takes on special significance in child welfare

Numerous implications for policy and practice Families with parents who abuse substances are oft en affected

by: complex and diffi cult problems such as unemployment, poverty, poor housing homelessness, domestic violence, involvement with the

criminal justice system and mental health problems

(Connell-Carrick, 2007; Green, Rockhill, & Furrer, 2006). In addition, federal legislation designed to address the urgency

of children lingering in foster care, policies that do not fully understand challenges of recovery

Community Issues that Get to the Table

Child entering CWS for maltreatment due to Meth abuse

Increased crime rates

High substance abuse rates and not enough treatment programs

University Control

Shared University/

Community Control

Community Control

CBPR

Challenge of Research/Community Relationships

Shared University/

Community Control

What should researchers do when::

Community values are different from those

of the researchers and conflict with the

planned research methodology

Members of community partner organizations have different perceptions of what constitutes “risk”

Releasing research results may stigmatize

an entire community

Some standard research protocols

may not be acceptable to community organizations and agencies

Control groups

Different treatments or interventions provided to groups

Random assignment of participants

CBPR

None A Lot

cooperation coordination collaboration partnership

Continuum of Community Participation

(adapted from Winer and Ray 2000)

Evolution of a Participatory Partnershippre-partnership

Getting to know each other

partnership

Working to achieve mutually valued objectives

Partnership

Developing and implementing research/programs together

Mullinix BB, 2000

Rationale for CBPR Complex health and social problems ill-

suited to “outside expert” research History of research abuse and mistrust:

“helicopter” or “drive-by” research Increasing community and funder demands

for community-driven research Disappointing results in intervention

research Increasing understanding of importance of

local and cultural context/external validity Increasing interest in use of research to

improve best practices/best processes

Power of Community as Co-Investi gator

[T]he opportunity…for communities and science to work in tandem to ensure a more balanced set of political, social, economic, and cultural priorities, which satisfy the demands of both scientific research and communities at higher risk.

-John Hatch et al., 1993

CBPR: What it is and isn’t

CBPR is an orientation to research changes the role of researcher/agency and researched

CBPR is not a method or set of methods Typically thought of as qualitative

Fewer epidemiologic examples, but promising

CBPR goal is to influence change in community health, norms, systems, programs, policies

Values and Principles of CBPR Recognizes community as self-determining unit

Builds on strengths and resources

Facilitates partnership in all research phases

Promotes co-learning and capacity building

Seeks balance between research and action

Disseminates findings and knowledge to all

Involves long-term process and commitment

Israel, Schulz, Parker, Becker, Al len, Guzman, “Criti cal Issues in developing and fol lowing CBPR principles,” Community-Based Parti cipatory Research in Health, Minkler and Wallerstein, Jossey Bass, 2000.

Challenges in researcher-community relati onships

Nuances of parti cipati on and community consent (who is parti cipati ng/who is not)

Power and privilege: Who sets the research questi on? Who has power of knowledge?

Historical research abuse/stereotyping/racism (predominance of white academics)

Be willing to face the reality of negative history

Challenges in researcher-community relati onships

Challenge of academic vs. community time: publishing versus taking action

Challenge of CBPR cyclical and iterative process; research goals are not always known at the beginning of work

Challenge of research team having necessary skills, i.e., cultural humility, listening, sharing decision-making

CBPR/Community Engagement Steps: 1. Building Partnerships

Self-Reflection Our own intenti ons, capaciti es, and liabiliti es Our insti tuti on’s strengths and liabiliti es

Identify Potential Partners (representing who?) Negotiate Health Issues (how evolve) Create and Build Participatory Structures between

Academia and Community Principles Decision-making Control of budgets and data

2. Identi fy Research Questi ons and Methods

Difference between community outreach and CBPR

Where do questions come from: community or academy or both?

Initial participation by Advisory Committee and then RCT?

Continual participation throughout which informs and changes intervention?

3. Participatory Data Collection

Participatory Process that is most used

Train community interviewers, survey data collectors, focus group facilitators

Job opportunities for community

Enables better response rate

Issues of confidentiality

5. Participatory Dissemination

Accountability to communities and to community protection

Community reports (print/videos/etc) Academic publishing issues (especially

for junior faculty)

Wallerstein, N.., Duran, B., Minkler, M., Foley, K., Developing and Maintaining Partnerships, Methods in Community Based Parti cipatory Research, Israel, B., et al (eds). San Francisco, Jossey Bass, 2005

Benefits of CBPR Increases accurate and culturally sensitive

interpretation of findings; Facilitates effective dissemination of

findings to impact public health and policy; Increases translation of evidence-based

research into sustainable community change Provides resources and benefits to

communities Joins partners with diverse expertise Increases research trust

Your questions: Can you provide examples of how adopting CBPR research

would alter: Client relati onships

Systems of practi ce in agencies

Community interventi ons or policies to help achieve opti mal outcomes for children

Common Pitfalls of Program Implementation

Shoot Aim Ready

Implement Plan No Results

When Is CBPR NOT for You?

Is Opportunism and Self-Interest Driving the Agenda?

Does Your Research Team Have the Necessary Skills? Cultural Competence

Communication Skills

Listening Skills

Sharing Power/Control Over Decisions

When Is CBPR NOT for You?

Do Ethical Considerations Related to Burden and Benefits to the Community Outweigh Potential Research Benefits? Time

Burden to the Community

Research Results Will Provide Minimal Benefi t to the Community

7Dependency Drug Court: A Collaborati ve Approach for

Families Involved in Child Welfare

A Multidisciplinary Treatment Model That Exemplifies The

Community Research Partnership: In Lake County

7

Northern California Regional Partnership Grant

Promoting Safe and Stable Families

The Northern California Regional Partnership Grant (RPG) for Promoting Safe and Stable Families is comprised of four-county cohort: Butte, Lake, Tehama, and Trinity. The data presented in this report was collected on clients enrolled in the grant project in each of the four-county cohort.

The RPG grant has funded one staff position for each of the four-county cohort, training and leadership by UC Davis Extension and Susan Brooks

Funding

Sample

There were 450 adults served across the four-county cohort, along with 617 children. A total of 327 cases (comprised of adults and children) were served during this time period.

Collecting Data Staff from each county’s Child Welfare Services

Department have utilized the California Child Welfare Services Case Management System (CWS/CMS) for collecting and reporting Child Welfare data.

Staff from Butte County have provided leadership to help each county retrieve data from the CWS/CMS system through use of Business Objects reports in order to produce the data reflected in this report.

Collecting Data

Additionally to the Child Welfare data,

Data from each of the Four-County Alcohol and Drug programs

Each county Alcohol and Drug program reports data to the California Outcomes Measurement System (CalOMS).

Management Information System (MIS) that collects client service uti lization data.

Who are the team members?

Children and Family Services (CFS)/ Child Welfare Social Worker

Alcohol and other Drug Counselor

Residenti al and Outpati ent treatment providers

Dependency Court Judge and Court Coordinator

Family Team Meeti ng Facilitator

Parent Engagement Facilitator

Nurturing Parent Program Group Facilitator

Northern California Training Academy, UC Davis

The Benefit of Coming Together

For the professionals in Lake County: The entire team meets on a weekly basis to

review all clients who are scheduled to appear in Drug Court that day, as well as any “add on” clients who have been asked to appear.

In collaborating, the team is able to provide updated and accurate information to the Judge, as well as recommendations and solutions for obstacles that the client is experiencing.

Coming together allows everyone to bring their own expertise to the table, and ensure everyone is on the same page to better benefit the client.

Experienced some challenges collecti ng reliable data over ti me

from each of the four counti es

Diffi culties with tracking information

Different programs and types of implementation

Differing policies and standards

Attrition

Confidentiality issues

Lake County: Case Study Video

An evaluation method for exemplifying the Community Based Participation Research Model

THANK YOU!!!