Can Community Engagement Promote Healthy Aging?

Volume 2, Number 5 May, 2013

                                                 THEory into ACTion

       A Bulletin of New Developments in Community Psychology Practice
(This article has been cross-posted at APA’s Psychology Benefits Society blog)

Can Community Engagement Promote Healthy Aging?

Agnieszka Hanni, MA and Suzette Fromm Reed, PhD

As the lifespan of an average person increases in the nation, the retirement age remains the same (U.S. Social Security Administration, 2013). The repercussions of this discrepancy go beyond the economic strain of the nation as retired community members are at more risk of falling victims to age-related decline. Post-retirement stagnation and social withdrawal often lead to increased incidence of neurodegenerative diseases, such as Alzheimer’s disease and other forms of dementia. Community engagement and mental and physical stimulation may serve a protective role in maintaining functioning of aging community dwellers (Willis & Schaie, 2009). This suggests an opportunity for community psychologists to design and build programs that can maximize the potential benefits for older adults and the communities in which they reside. This approach may further set the stage within community psychology for beginning to reduce the stigma associated with growing old portrayed in Western cultural values – an issue ignored by most of psychology (Sheung-Tak & Heller, 2009).

Decreases in functioning resulting from diminishing activity following retirement may eventually lead to premature loss of independence of older adults – a consequence that has an effect on individuals, families, and entire communities. Fortunately, researchers exploring factors leading to successful aging have demonstrated that environmental stimulation can lead to maintenance or even improvement in functioning (Willis & Schaie, 2009). For instance, Carlson et al. (2009) found that older adults demonstrated increased brain activity following participation in an intergenerational program designed to help elementary school children with their reading skills and conflict resolution. This effect was still measurable six months after the completion of the study. The involvement of older adults in this research simultaneously incorporated social engagement as well as physical and mental stimulation. In another study, participating older adults underwent training targeting specific abilities: memory, reasoning, and speed of processing (Willis et al., 2006).  Results demonstrated positive long-term effects of training on the targeted abilities of the sample of older adults. Consequently, the notion of the benefits of engagement late into old age presents a chance for community psychologists to emphasize the importance of remaining active beyond retirement. The positive effects of those types of programs and opportunities have the potential to not only impact the health of the retirees but also the broader communities in which they reside.

        Participation in community life may increase sense of community through civic engagement. According to Rappaport (1987), greater civic engagement may be a protective factor, as it can lead to higher sense of community which, in turn, can stimulate increased activity. Brodsky, O’Campo, and Aronson (1999) found that older adults already tend to report higher sense of community as compared to their younger counterparts, regardless of the length of residence in a particular community. This knowledge may be useful in designing community interventions that maximize and engage older adults. Additionally, Berkman (2001) found that health promotion is not only an individual concern, but that it is a family and community matter. He encouraged professionals to base interventions on the network of already existing social relations as those connections form the desirable basis for sustained behaviors of community dwellers. He proposed that the actions of an individual are likely to be influenced by the values that the community sets for its members.

         Similarly, Moos (2003) focused on evaluating the importance of social context and its potential to affect behavioral choices. He pointed to the dynamic reciprocal relationship of individuals within communities, while examining how the interplay of those forces can be used as protective factors in promoting wellness. He referenced “powerful settings” (p. 1) to indicate the potential of positive effects of community characteristics on the wellbeing of their inhabitants and suggested that interventions incorporating meaningful relationships, continuous personal enhancement, and stimulating nature may have the highest potential to serve a protective role against personal decline and stagnation. Not surprisingly, older adults tend to enjoy caring for their neighbors and friends in informal ways even more than they enjoy formal volunteering (i.e. community activism; Martinez, Crook, Kim, & Tanner, 2011).Thus, older adults benefiting from this approach to wellness may feel more empowered to continue to lead independent lifestyles and to regularly contribute to their own communities by taking advantage of specifically designed programs (i.e. volunteering with local libraries or community organizations, working with the youth through intergenerational programs).

        Within the field of community psychology, individual empowerment goes beyond the personal sense of control, as it emphasizes community connectedness, participation, and relationship building – all of which have the potential to support the wellbeing of older adults (Rappaport, 1987). Prevention of the negative age-related effects on retired older adults’ health and independence should be grounded in these values.  Designing community-wide interventions focusing on the mutual benefits of individuals and their entire communities will encourage a paradigm shift in how we approach post-retirement decline.

This is part 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.

References

Berkman, L. F. (1995). The role of social relations in health promotion. Psychosomatic Medicine, 57, 245-254.

Brodsky, A., O’Campo, P., & Aronson, R., (1999). PSOC in community context: Multi-level correlates of a measure of psychological sense of community in low-income, urban neighborhoods. Journal of Community Psychology 27(6) 659-679.

Carlson M. C., Erickson, K. I., Kramer, A. F., Voss, M. W., Bolea, N., Mielke, M., McGill S., Rebok, G. W., Seeman, T., & Fried, L. P. (2009). Evidence for neurocognitive plasticity in at-risk older adults: The Experience Corps Program. Journal of Gerontology, Series A, 64(12), 1275-1282.

Cheng, S. T. & Heller, K. (2009). Global aging: Challenges for community psychology. American Journal of Community Psychology, 44, 161-173.

Martinez, I. L., Crooks, D., Kim, K. S., & Tanner, E. (2011). Invisible civic engagement among older adults: Valuing the contributions of informal volunteering. Journal of Cross-Cultural Gerontology, 26(1), 23-37.
Moos, R. H. (2003). Social Contexts: Transcending their power and their fragility. American Journal of Community Psychology 31(1/2) 1-13.

Rappaport, J. (1987). Terms of empowerment/exemplars of prevention: Toward a theory of community psychology. American Journal of Community Psychology, 15(2), 121-148.

Willis, S. & Schaie, K. (2009). Cognitive training and plasticity: Theoretical perspective and methodological consequences. Restorative Neurology and Neuroscience [serial online], 27(5), 375-389.

Willis, S. L., Tennstedt, S. L., Marsiske, M., Ball, K., Elias, J., Koepke, K. M, et al. (2006). Long-term effects of cognitive training on everyday functional outcomes in older adults. Journal of the American Medical Association, 296, 2805-2814.

U.S. Social Security Administration (2013). Life Expectancy for Social Security. Retrieved from http://www.ssa.gov/history/lifeexpect.html

Maps are our friends

Sharon Hakim, Wichita State University

My love for maps outdates my love for Community Psychology.  As a young child, I would look forward to road trips, down the shore or just to the store, because of the chance it afforded me to page through the large, multi-state atlas we kept in our car.  Poring over maps, reading the symbols, computing distances between major cities/landmarks — this could keep me busy for hours.  (Why my parents never allowed us to take the atlas into the house, I don’t know; it would have made a great babysitter).

Now, over 20 years later, I am still fascinated with maps, and I've found multiple uses for them in my community based work.  For example, for the past two years I've been working with the Wichita Health and Wellness Coalition — a group of individuals, from various sectors both public and private, who have come together with the goal of improving the health status of Wichita residents.  The group takes a built-environment approach, and maps have been key to helping the group both identify issues/barriers to healthy eating/physical activity, and present the data back to the community in an accessible way.  We've mapped almost everything: stores that sell fresh fruits and vegetables, transit routes, bike pathways, parks and centers for physical activity, routes kids walk to school, etc. 

Maps are really great tools to “sum up” what we know.  Putting this information in visual form usually evokes some strong reactions or feedback. For example, we've had people ask questions related to issues of equity, because the map clearly shows that some parts of town have 3 full-service grocery stores on a single corner, and other neighborhoods have only convenience stores.     These “aha” moments and insights into policy changes come more frequently when you layer data.  For example, presenting data on food deserts, car ownership, and stores that sell fresh fruit and vegetables on one map clearly illustrates the problem that low-income families have in accessing fresh fruits and vegetables.  Additionally, visually displaying the information also allows people to add in things we overlooked, such as neighborhood and church gardens.  Lastly, maps are familiar —  people may shy away from numbers and p values, but can relate to images of their neighborhood or streets they walk every day. 

Interested in using community mapping as a tool?  Your map doesn't have to be complicated to be helpful.  Start small, with a specific neighborhood or a radial area around your organization.  And heads up - data collection for mapping tends to be physical.  A lot of driving (or walking) around and noting exact locations.  It’s a tedious process, but a crucial one.  Not only does it give you the most accurate information, but it gives you a chance to engage community members, who will definitely say something when they see you scribbling notes on a clipboard about the condition of a bus stop, per say.  In this way it’s both data collection and awareness building. 

Once you have the data, there are many free mapping programs that you can use, from simple to complex.  If you’re just starting out, I would recommend using Google Maps, because it is probably a program you are already familiar with.  Benefits to Google Maps include allowing more than one person to store/enter/edit maps, and direct address recognition.  (To create a custom map on Google maps, go to “My Places,” then click, “Create Map.”)  If you are looking to use national/state data, various organizations maintain their own mapping tools - such as USDA’s Economic Research Service or the US Census.  There you can customize data you are interested in, for a specified geographical area; the limitation is, since they are public sites, they won’t let you upload your own, locally collected data.

Finally, if you want to have a map that combines local data that you collect with these national data-sets  it would be worth checking out an organization you may be working with - such as a university or even a community group (for example, the YMCA of the USA makes free web-based GIS software available to all of its affiliates), may have access to GIS software (web-based or otherwise).  GIS is harder to work with (not always intuitive), but it allows you to layer data in interesting ways.   My advice for those of you about to undertake a GIS project is to make sample maps with “fake” data first.  This will give you some insight into how to collect your local data in a way that will make it easy to integrate into your mapping program.

Next time I’m planning on writing about my favorite community-based maps.  Communities have gotten really creative about how they choose to represent themselves and their assets.  If anyone has done an interesting map lately, please let me know! (Spoiler Alert: One of my all time favorite maps is of pumpkins set on the steps at Halloween). 

Where oh where have all the grassroots gone?

Where oh where have all the grassroots gone?

Tom Wolff, Tom Wolff & Associates, Amherst, Massachusetts    May 2013

In my trainings on coalition building and community development to non-profit human service and health providing organizations  I always emphasize the importance of engaging those most affected by the issue - sometimes called the grassroots communities. Depending on the focus of the work this can mean:  youth, immigrants, communities of color, survivors of domestic violence, the LGBT community, etc. We cannot do authentic community work without their voices at the table as shared decision makers. In my experience when we do not have them at the table we develop programs that are more likely to be ineffective.

At the start of my trainings I often explore this issue using an experiential tool called ‘Stand and Declare’. I place a statement on the screen and ask participants to go to one of five stations around the room that are marked strongly agree, agree, neutral, disagree, and strongly disagree. They then talk about why they chose that position. One statement I have used in this exercise for almost a decade is "In our community work we always engage those most affected by the issue and they willingly come to the table and participate actively”.

Working with these non- profit providers over the years I have always received more ‘disagree’ than ‘agree’ statements. The grassroots approach has never been the way that the mainstream of  health and human services have functioned in the last decades. However, recently in the group discussions that follow I have seen a very disturbing trend. Increasingly there are fewer and fewer people who not only disagree but who do not actually even try to engage the grassroots anymore. Although most folks seem to still agree that we "should" do this, in fact very few even try to engage the most affected community.

This is very disturbing for those of us who believe that this is the basic building block of any authentic community building effort in the non-profit, health sectors and beyond. How can we design programs for communities without having them at the table?

One advocate for this grassroots approach is Barbara Ferrer, the Commissioner of Public Health for the City of Boston. She puts it this way: “The role of a public health department is to create a space for residents to come together to define a problem, to define the solutions, and then enter into a dialogue with us—not the other way around. Not we define the problem, we define the solution, and then we invite you in to help us implement the solution, which is what we’re most comfortable doing.”

The ones who succeed at this tell us consistently that there are a series of efforts that we must make to adapt our practices so that the community can come to the table. These include: holding the meeting in the evenings, providing child care and transportation, feeding the group, providing translation services if needed, and even providing a stipend (a coupon for a local grocery store etc.).

So what is happening? Why don't we seemingly do this anymore?

-          Maybe we don't want to share power and no one is pressuring us to do it.

-          Or is it that government and foundation funders seem to demand this kind of involvement less  
often ( in the past it was the serious demands from funders that often drove the nonprofits to bring  
the grassroots to the table). In one state the Sexual Assault Prevention Coalition coordinator told
me that her Rape Prevention Education Grant to the CDC was turned back to her because she
used the phrase “grassroots”. She was told to remove the word if she wished funding.

-          Could it be that the adaptations above (transportation, baby sitters, etc.) are too much to provide?
So it becomes more difficult than the nonprofit world wants?

-          Or is it the arrogance of the helping world is growing during tighter financial times, especially as we
have more large mega-agencies and fewer small community non-profits

 -          Maybe we settle for the usual suspects who are the gatekeepers (i.e. the easy to reach minister)
rather than do the hard work of identifying and recruiting the grassroots community.

I know very well that a small handful of people in the non-profit human service and health world are doing terrific work at still engaging the grassroots community and we should identify and celebrate those efforts (maybe on these pages)

On the other hand if you also have seen this negative trend what is your guess as to why it is happening?

And what can we do about it?   What have you observed?

Ask an Advisor Wants Your Questions

Many blog readers know by now about the Community Tool Box (http://ctb.ku.edu), which has been creating and disseminating practical information about community development online for almost two decades. And many of you may know about the Ask an Advisor feature of the Tool Box, which allows a user anywhere in the world to ask a question about community life  and receive a personalized answer from a volunteer advisor.


What you may not know is that Ask an Advisor is not just open for business – we actively welcome your business. Within our limits, we want as many people as possible to take advantage of this unique skill-building service as we can. So please help spread the word about Ask an Advisor through your colleagues and professional networks – and keep those questions coming in.


To see guidelines,  and examples  of  questions Ask an Advisor can answer, go to http://ctb.ku.edu/en/AskAnAdvisor.aspx, and click on “View Ask an Advisor Questions/Answers” at the top right of the page. Then double-click any question to find the Advisor’s response.


 We’re glad to answer any questions you may have about our Ask an Advisor service, including how you might get involved as an advisor yourself. Contact me at Bill_Berkowitz@uml.edu.


   Many thanks, and yours in community,

                  Bill Berkowitz
                  For the Community Tool Box Team

How Sequestrable Are You?

by Leonard Jason, Madison Sunnquist, Suzanna So, and Sarah Callahan

DePaul University

6 Protective Factors That Can Help Prevent Child Abuse And Neglect

Children have the ability to thrive even in the face of the most difficult circumstances.

The presence of supportive adults is one of the most important factors that can help children cope with harsh circumstances. Unfortunately, in most cases of child maltreatment, the traumatic experiences of abuse or neglect are happening due to the actions (or inactions) of parents. These are very people whose support children need most to overcome difficulties.

Most parents who abuse or neglect their children are not the kinds of one-dimensional villains that exist in popular media images. While there are cases of real life cruelty that rival the most horrific movies, the vast majority of maltreatment in the U.S. occurs in the form of neglect. Often, the parents who expose their children to harm are themselves under a great deal of stress.

Increasingly, child maltreatment prevention programs are adopting strengths-based approaches that not only decrease the likelihood that abuse or neglect will occur, but also encourage healthy development.
Here in Hawaii, I’m working with the Hawaii Children’s Trust Fund (http://hawaiichildrenstrustfund.org/) and Joyful Heart Foundation (http://www.joyfulheartfoundation.org/) on their One Strong ‘Ohana (OSO) campaign (http://www.onestrongohana.com). The One Strong ‘Ohana campaign is focused on six protective factors that can help to promote positive parenting and prevent child maltreatment.

(1) Social connections
(2) Nurturing and attachment
(3) Knowledge of parenting and child development
(4) Parental resilience
(5) Social and emotional competence of children
(6) Concrete supports for parents

Here’s a video they created highlighting the first protective factor. Parents who have a strong support system are less likely to abuse or neglect their children.

A key aspect of this campaign is that it is not only targeted at parents that may be at risk for maltreatment. Rather, it is meant to spread awareness that there are things that everyone can do that can decrease the likelihood that child maltreatment will occur. On their website, OSO offers 10 tips for how anyone can support parents and caregivers. These include things that anyone can do, such as offering to pick up groceries or watch the kids for a couple of hours, or even simply letting parents know you are there for them. They may seem like small acts, but when added up, these actions can make a huge difference for an overwhelmed parent.

Gina Cardazone - University of Hawai`i, Mānoa

(This article has been cross-posted at APA’s Psychology Benefits Society blog)