Thursday, April 10, 2014

Community Psychologists in Healthcare

THEory into ACTion

A Bulletin of New Developments in Community Psychology Practice
April, 2014

by
Mary C. Benton, Seattle

     Recently I had the opportunity to speak with three community psychologists–William Neigher, Ph.D., Sharon Johnson-Hakim, Ph.D. and Chris Kirk, Ph.D. Their situation is unique in that they are all employed as community psychologists working at the same place, Atlantic Health System, in New Jersey (www.atlantichealth.org). This is in large part due to the shared vision of healthcare between Neigher, Vice President and Chief Strategy Officer, and the President and CEO of Atlantic Health System, Joseph Trunfio, Ph.D. Trunfio trained as a clinical psychologist but completed a postdoctoral fellowship in community psychology with SCRA’s first President, Robert Reiff.  Neigher and Trunfio, along with many of the board of trustees and others at Atlantic Health System, believe that communities play a vital role in their own personal well-being. 



     This belief is reflected in the recent change in Atlantic Health System’s vision statement, which now reads “Empower our communities to be the healthiest in the nation.” It is also demonstrated in the mission statement of the organization, which is to “Deliver high-quality, safe, affordable care within a healing culture” (Neigher & Hakim, 2012). The phrase, “within a healing culture,” emphasizes the complexity of patient well-being and recognizes that settings and contexts matter.  It acknowledges that patient health is best viewed from an ecological, multi-layered approach. It also posits that health care staff work together with patients and their families in order to affect real change in patients’ well-being.

     The importance of communities’ involvement in their own patient healing is also reflected in the change in the vision statement of Atlantic Health, from a focus on applying top clinical care to one that emphasizes community psychology principles of prevention and health promotion. These changes do not simply reflect a change in wording or a new marketing campaign, but rather a fundamental shift in the way the health system sees itself and defines its role. The goal now is to develop a “line of sight” understanding between each Atlantic Health System employee’s job and the vision and mission of the organization. This “line of sight” mentality was eloquently demonstrated to Neigher earlier in his career when visiting a nursing facility operated by his friend, Dr. Sidney Greenwald. When introduced to an elderly gentleman with a mop and bucket, Dr. Greenwald asked the gentleman, “Tell my friend Dr. Neigher what you do here.” To which he replied, “I’m in infection control.” He then demonstrated how he cleaned toilets to prevent residents from getting sick (Neigher, 2011).  The elderly man’s role was seen as integral to the success of the nursing facility.

     Drs. Neigher, Kirk and Johnson-Hakim are working to develop a variety of innovative programs consonant with the principles of community psychology, aimed at shifting the focus from one centered on disease to well-being. Additionally, the concept of empowerment rings true in their work; one such avenue where they apply an empowerment perspective is health literacy. Defined as the “degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions” (Ratzan & Parker, 2000), health literacy has great implications for health status. For example, those with lower levels of health literacy demonstrate less ability to read labels, take medications correctly, and among seniors, poorer health status (Agency for Healthcare Research and Quality, 2011).  In an effort to empower and minimize the confusion of being a patient, Atlantic Health System developed a Health Literacy Task Force in order to create a more health literate healthcare system (Kirk & Neigher, 2013).

     Besides community and hospital based programming, Drs. Neigher, Kirk, and Johnson-Hakim are involved in a line of applied research around adaptability (Neigher & Hakim, 2012).  Instead of focusing solely on healing patients and returning them to their previous state before illness or injury, Atlantic Health System wants to foster more adaptable patients. They have developed an Adaptability model which is operationally defined as the ratio of an individual’s resilience to their vulnerability. Many times health circumstances are beyond a person’s control, but what is in their control is how they adapt and cope with those circumstances. Currently, a study using a large sample of joint replacement patients is examining the predictive validity of the Adaptability model.  The objective is to develop a valid and reliable measure that can be utilized and administered by an individual’s physician each time they visit a healthcare facility. Over time, the use of such an instrument would provide a life course perspective of an individual’s adaptability, and allow providers and community agencies to intervene earlier. In addition, the model could be used by organizations or communities, measuring their adaptability and/or creating interventions to increase adaptability to events such as terrorist attacks or natural disasters.

     As evidenced, a lot of exciting work is being conducted by community psychologists at Atlantic Health. Furthermore, as Neigher remarked, with the passage of the Patient Protection and Affordable Care Act (2010), now is a very good time to be a community psychologist, especially in the field of healthcare. The skills that community psychologists have are precisely those skills that are paramount for successful implementation of the Affordable Care Act. And while most positions are not advertising for community psychologists as such, the skills and expertise necessary are very often ones that we have. The challenge for community psychology and community psychologists is to translate our language into the lexicon of the employer, which is often very medically focused. The experiences of community psychologists at Atlantic Health System have shown how effectively this can be done. 

References

Agency for Healthcare Research and Quality (2011). Health Literacy Interventions and Outcomes: An Updated Systematic Review.  Washington D.C.: Agency for Healthcare Research and Quality, 2011.

Kirk, C. M. and Neigher, W. D. (2013). Community psychology and the future of healthcare. Global Journal of Community Psychology Practice, 4(4), 1-9. http://www.gjcpp.org/en/article.php?issue=16&article=82

Neigher, W. D. (2011). Invited address to the 2011 SCRA Biennial Conference accepting the Distinguished Contribution to Practice in Community Psychology [2010]. Global Journal of Community Psychology Practice, 2(3), 1-15. http://www.gjcpp.org/en/resource.php?issue=8&resource=62

Neigher W. D. & Hakim, S. M. (2012). Creating a sustainable “healing culture” throughout a healthcare system: Using community psychology principles as a guide.  Global Journal of Community Psychology Practice, 2(3), 1-25. http://www.gjcpp.org/en/article.php?issue=8&article=36

Patient Protection and Affordable Care Act, PL 111-148, March 23, 2010. http://www.hhs.gov/healthcare/rights/law/

Ratzan,  S.C. & Parker R. M. (2000). Introduction. In: National Library of Medicine Current Bibliographies in Medicine: Health Literacy. NLM Pub. No. CBM 2000-1. Selden CR, Zorn M, Ratzan SC, Parker RM, Editors. Bethesda, MD: National Institutes of Health, U.S. Department of Health and Human Services.

This is one of a series of bulletins highlighting the use of community psychology in practice. Comments, suggestions, and questions are welcome. Please direct them to Bill Berkowitz at william_berkowitz@uml.edu 

Thursday, April 3, 2014

Cesar E. Chavez: Social Justice Advocate

     March 31st marks what would have been Cesar Chavez's 87th Birthday. In a recent statement from the White House, President Barack Obama declared 3/31 a Cesar Chavez Day, calling Americans to observe this day to honor Cesar’s legacy.

     As an advocate for the farm workers Cesar led the creation of their first union, United Farm Workers of America (UFW), facilitating access to better working conditions, such as rest periods, access to toilets, clean drinking water, and protection against pesticide exposure. Additionally, they gained access to healthcare through a joint union-employer fund and a pension plan. As Cesar said it: "We cannot seek achievement for ourselves and forget about progress and prosperity for our community...Our ambitions must be broad enough to include the aspirations and needs of others, for their sake and for our own".


     Today, we continue to find challenges in our localities that require approaches that enhance solidarity and propel better life conditions for our communities. May Cesar’s life continue to inspire us in advocating for those who struggle the most and generating the necessary structures for improving community’s quality of life.

     If you’d like to get a better look at Cesar Chavez life and the UFW movement, you can watch PBS Documentary The Struggle in the Fields, or the recent released film Cesar Chavez.


Cesar Chavez Foundation. (2012). Historic Victories for Union. Retrieved from: http://www.cesarechavezfoundation.org/_page.php?code=001025000000000&page_ttl=Years+of+adversity&kind=1

Chicano! PBS Documentary - The Struggle In The Fields

Riojas. R. (2011). The Life and Legacy of Cesar Chavez. Retrieved from: https://vimeo.com/15930287

The White House Office of the Press Secretary. (2014, March 28). Presidential Proclamation - - Cesar Chavez Day, 2014. Retrieved from: http://www.whitehouse.gov/the-press-office/2014/03/28/presidential-proclamation-cesar-chavez-day-2014

United Farm Workers. (2006). Education of the Heart- Quotes by Cesar Chavez. Retrieved from: http://www.ufw.org/_page.php?menu=research&inc=history/09.html


United Farm Workers. (2006). Our vision. Retrieved from: http://www.ufw.org/_page.php?menu=about&inc=about_vision.html

Thursday, March 27, 2014

Friday, March 21, 2014

Community Psychology Topical Interest Group hosts AEA's blog

By Ann Webb Price, Ph.D.

The Community Psychology Topical Interest Group or CP TIG is a group of community psychologists and community practitioners within the American Evaluation Association (AEA). The group was established three years ago to provide a professional home to those who share the values of community psychology within AEA. You can learn more about the TIG at http://comm.eval.org/CommunityPsychology/Home/

One of the many things AEA does is to sponsor a blog called AEA 365. AEA members post a blog each day that highlights specific techniques, resources, and tips for evaluators. The following week (March 23-28), the CP TIG is hosting AEA 365 blog and guest bloggers will be discussing evaluability assessment. The blog series should prove to be illustrative with evaluators such as former AEA president Deb Rog, Jim Altschuld (author of the Needs Assessment kit through Sage), Rob Fischer, Co-Director of the Center on Urban Poverty and Community Development at Case Western Reserve University-CWRU, and Julianne Manchester, Principal Investigator for the National Training and Coordination Collaborative (CWRU) sharing their views on conducting evaluability assessments.

Be sure and check out our postings at http://aea365.org/blog/ and share them with your friends and colleagues. You can learn more about AEA at www.eval.org If you are member of AEA already, please select the Community Psychology TIG on your membership page.

Thanks!


Sunday, March 16, 2014

Working to Reduce Alcohol-Related Health Risks and Increase Residents’ Quality of Life in Milan


THEory into ACTion

A Bulletin of New Developments in Community Psychology Practice

March, 2014



Giovanni Aresi
Università Cattolica del Sacro Cuore (Catholic University of Milan)

Dawn X. Henderson
Winston-Salem State University

There are a number of risks associated with alcohol consumption among young adults, thereby presenting an important issue to tackle in community psychology. Since 1995, more than 100 articles have been published in the American Journal of Community Psychology and Journal of Community Psychology addressing alcohol-related issues among youth and their communities.  Expanding how community psychology frames this issue in an international context is highly relevant to practitioners and the field.   

For several years, Giovanni Aresi (a doctoral student at the Catholic University of Milan) has been working to design prevention and intervention programs to address young adults’ alcohol abuse. Currently, he is involved in a project aimed at mobilizing stakeholders and community members in designing and implementing interventions to reduce young adults’ alcohol-related health risks and promote residents' quality of life in the Ticinese nightlife entertainment district in Milan.  Aresi serves as the principal investigator of the project, which includes a team of undergraduate psychology students under the guidance of Dr. Elena Marta (Social and Community Psychology full professor at Catholic University of Milan) and Dr. David Chavis (University of Maryland Baltimore County and Community Science CEO).

Since inception, the project has used a multi-phase mixed methods design to engage stakeholders and community members. For example, Aresi used interviews with residents to help cultivate relationships. The project then engaged a team of stakeholders (i.e., members of health service organizations, nightlife prevention professionals, bar and club managers, and neighborhood association representatives) to conduct a context analysis, which served as a critical step in identifying the most relevant alcohol-related risks and consequences at the local level. Surveys were also administered to more than 340 residents to obtain perceptions of the district and young adults. A preliminary report was developed and shared with stakeholders through focus groups.  Preliminary findings include:

  • Belongingness depends upon the dominant activity in the setting. Stakeholders indicated that there is an active community during the day but a loss of a sense of belongingness at night when young people spend time in bars or in the streets.
  • Residents and media have different views of the setting [or district]. Although many residents perceived their district as a ‘dirty environment’ they did not perceive it as ‘noisy’ and ‘unsafe.’ These perceptions contradict descriptions of the district by local media.
  • Different subgroups within the setting stereotype each other. Quotes were shared in the report from residents and young nightlife goers and reinforced stereotypes each group had about each other.  The team then engaged members in a discussion on how these stereotypes impact relationships among residents in the district.

Some implications for community practice include:

  • The use of Social Reconnaissance (SR; Martini & Torti, 2003):  Used in community practice and organizing in Italy, SR engages stakeholders and community members in assessing readiness for change and creating a needs assessment. Analysis and interpretation of data is guided from the perspective of stakeholders through interviews, focus groups, and group meetings to promote coalition building.
  • Use of Multi-Methods: The integration of interviews and focus groups with quantitative data collection (household surveys to over 340 residents) provide multiple perspectives of the phenomena and are highly important in triangulating findings to support valid and useful results.
  • Use of Community-Based Participatory Research. Community members are active participants throughout the research phase (from the definition of the measures of the surveys to the participation in the interpretation of results).  More importantly, as active participants in the research process the stakeholders are valued and integral in shaping deliberate action or developing solutions to the problem.   

Collectively, this project builds on community strengths and assets and takes into account the specific social, cultural and geographical context of the district.  There are challenges though, which include trying to address when to present the results to the community (whether to present rough data or more defined results) and what level of complexity non-academics can comprehend with or without training. Regardless of challenges, the team is bringing stakeholders and researchers together to move towards social action.

 

Work Cited:

Martini, E. & Torti, A. (2003), Fare lavoro di comunità: riferimenti teorici e strumenti operativi. [Working with communities: theoretical perspectives and operative tools] Roma Carocci editore.

 

Related Journals:

American Journal of Community Psychology (2013) Volume 51

Journal of Community Psychology (1999; 2013) Volume 27; Volumes 41

 

This is one of a series of bulletins highlighting the use of community psychology in practice. Comments, suggestions, and questions are welcome. Please direct them to Bill Berkowitz at Bill_Berkowitz@uml.edu.

 

Friday, March 7, 2014

Can Random Acts of Kindness Strengthen Communities?

This past weekend was the third Annual Melee of Kindness (AMOK). Playfully named after a word synonymous with craziness ( and technically defined as a psychological disorder characterized by random acts of mass violence), AMOK is actually devoted to random acts of kindness. Promoted by the nonprofit Random Acts, AMOK encourages people throughout the world to perform acts of kindness in their local community.

It's a cute idea, but can it be more? As community psychologists, we typically look for ways to strengthen communities that are locally grounded, systematic, and sustainable. Some decry one-day volunteer events (such as those promoted by businesses to promote "team-building"), for their ability to engender good feelings in one-shot volunteers without actually creating any kind of lasting effects.

I understand this critique, though I have seen examples of short-term events that have long-lasting impacts. For example, hackathons devoted to social betterment, such as the Hackathon for Social Good, bring together programmers and designers for a concentrated period of time to develop innovative technological solutions to challenges faced by nonprofits. Although sustained work is needed to maximize the usefulness of apps and other products developed during these events, mass participation and the short-term intense nature of hackathons can lead to innovations that wouldn't otherwise occur.

As far as Random Acts is concerned, it's worth mentioning that AMOK is just one event in an ongoing effort to promote random acts of kindness. However, this still begs the question, do random acts of kindness actually do any good?

Without minimizing the importance of sustained well-funded multilevel approaches to preventing social problems and strengthening communities, I'd like to make a case for the virtues of promoting kindness (and randomness), and particularly for the approach adopted by Random Acts.

(1) Random acts of kindness may increase recipient's sense of informal social support and social connectedness. The importance of social support cannot be underestimated. The One Strong Ohana child maltreatment prevention campaign, which I've mentioned previously, promotes seemingly "random acts" of kindness towards families, such as offering to babysit or pick up groceries for a neighbor. These small acts increase a sense of social support, which is a proven protective factor against child abuse and neglect. Informal social ties are essential to individual and community well-being, and even small acts can go a long way toward increasing the sense that people can rely on their neighbors. For instance, Carlos Luis has written about the "suspended coffee" concept, whereby people pay in advance for a cup of coffee or a meal that could be claimed later by anyone who needs it. This concept has taken off around the world, and may be a way to promote solidarity and social cohesion.

(2) Random Acts (the organization) repeatedly emphasizes taking action in your community and "transforming your neighborhood." Unlike other one-day events (such as the "team-building" corporate volunteer events alluded to previously), this approach encourages people to engage deeply with their own communities, to seek out problems that need to be fixed, and to take action that may lead to long-lasting community change.

(3) Engaging in random acts of kindness in one's own community may promote a sense of influence, one of the core elements of psychological sense of community. This may be enhanced when several people work together and accomplish something that they may not have otherwise thought possible, promoting a sense of empowerment and collective efficacy which could potentially lead to future collective action. It may also raise awareness about community problems that are otherwise ignored, which, when combined with an increased sense of collective efficacy could potentially lead to larger scale change. For instance, a group of people who spend a day reaching out to homeless members of their community may become more deeply aware of the problem of homelessness, and continue to work together or become involved in existing efforts to effect policy changes that could address this problem.

(4) The organization provides a global platform and makes extensive use of social media to document and share local experiences. This can promote intercultural dialogue and creates a shared history among participants, locally and globally, devoted to community betterment.


(5) It's refreshing to engage with a nonprofit whose primary request is not to donate or sign a petition, but to simply do something positive. Random Acts does ask for donations, which it uses to fund project proposals put out by participants. However, it is currently run entirely by volunteers, affording it a certain amount of freedom from the dilemma faced by nonprofits that feel a tension between remaining true to their mission and keeping their staff employed. Though Random Acts is only a few years old, and will likely find itself struggling with that tension if it continues to grow in the next few years, the fact that people can "participate" without ever actually even having any contact with the organization provides a unique experience for would-be volunteers.

Also, they really are cute. Seriously, they're adorable. Co-founded by actor and social media overlord Misha Collins, whose childhood experiences with homelessness and the unexpected generosity of strangers inspired this organization's inception, Random Acts is full of dedicated people who genuinely want to make the world better in every random way they can. This includes unpaid staff who work tirelessly to maintain the site and organize events, one of whom wrote about how her experiences have convinced her of the real potential of this approach, "It started with what sounds like an almost too simplistic mission: we can change the world through small acts of kindness, But I actually believe that to be true." It also includes groups working together to clean neglected community spaces or raise funds for local nonprofits, and individuals snowblowing their neighbor's yards or even taping quarters to vending machines.

In addition to AMOK and other projects, Random Acts is associated with another annual event with the unruly acronym GISHWES, which stands for the "Greatest International Scavenger Hunt the World Has Ever Seen." Surprisingly, it actually lives up to the hubris of its name, having attained multiple Guinness World Records for being the world's largest scavenger hunt. GISHWHES includes a list of activities that range from the randomly kind (e.g. "grab a friend and go donate blood or platelets", "perform a stealth act of kindness for someone at work"), to the just plain random (e.g. "make a wig from your own hair", "create a portrait made entirely of Skittles", "dress up like a stormtrooper and fold laundry").

I'll admit that the merits of making Skittles portraits may seem small when considering the overwhelming and pervasive problems faced by people across the globe. However, I personally believe that kindness, silliness, and art are undervalued as potentially transformative forces in a world dominated by competition for money and power. Then again, that's just how I roll...

-----
Gina Cardazone - University of Hawai`i, Mānoa

Thursday, February 27, 2014

Why I Think You Should Join SCRA's Community Psychology Practice Council

by Olya Glantsman, Ph.D. 
DePaul University

I was first introduced to Community Psychology in 2001. What immediately drew me to the field were its preventive perspective and action orientation. Though I have spent the majority of my career thus far in the academic setting, I have always been amazed by the practical aspect of the field. In 2011, while still a graduate student, I attended a roundtable by the members of Community Psychology Practice Council’s (CPPC). I was impressed by the enthusiasm of the session’s members and by the graduate students’ involvement.

It is hard to imagine a more welcoming group. I have been a member of the Practice Council since 2011 and it has been nothing but a wonderful experience. On the monthly calls we discuss current work and new initiatives in our field. CPPC is also a great source for networking and monthly peer consultation calls help new and seasoned practitioners alike understand the intricacies of working with communities. Another unique aspect of this group is its value of the students’ perspectives and how easy it is for students to get involved. In fact, many of the leadership positions in CPPC are often occupied by graduate students and early careers.

The CPPC provides one with a myriad of opportunities to get involved. In the past couple years I have been involved with a number of projects including the CP Practice blog, the monthly THEory into ACTion Bulletins, the Online Learning, and the Summer Institute Initiatives. In January, I represented the council at the SCRA’s annual Mid Winter Meeting and I could not be more proud of not only the group’s many achievements, such as the Summit at the Biennial or the Annual Mini-Grants initiative, but the people, who year-after-year make all this possible.

Whether you are an undergraduate student trying to learn more about what Community psychologists do or a graduate student trying to explore the possibilities that await you upon graduation, whether you are an early career trying to get more involved in the field or an academic wanting to understand the realm of practice, or even a seasoned practitioner who would like to be exposed to the work of others or share your experiences, I would highly encourage you to join the Practice Council by emailing me at oglantsman@gmail.com

Brief History of the Group:
The Practice Council was born out of 2005 Biennial Conference at Champaign. The 1st Practice Summit occurred at the 2007 Biennial Conference in Pasadena and hosted over 100 participants. In 2008, Community Psychology Practice Work Group became SCRA Council of Community Psychology Practice and holds a formal seat on the SCRA Executive Committee with full voting rights. Since July, 2005, the group holds monthly meetings every 3rd Friday at 2pm (EST). In March 2013, the group began holding monthly peer consultation calls as practice share and support. Learn more about the CPPC here: http://scra27.informaticsinc.net/what-we-do/practice/


Olya Glantsman is a recent graduate from DePaul University’s Community Psychology doctoral program. Since 2001, she has been working at DePaul’s Center for Community Research. One of her life-goals is to raise awareness about the field of Community Psychology. She is currently a coordinator of the Undergraduate Concentration in Community Psychology at DePaul University, a co-coordinator of the CP Practice Blog and CPPC’s representative to the Executive Committee.