STUDENT VOICES | Service Learning and Community Engagement in Graduate Social Work Classrooms: One Student’s Perspective

JCES_Logos

Christian J. Messer Gaitskill

Screen Shot 2015-10-26 at 3.51.48 PM

Appalachian Ohio is a unique community with a rich history, which presents both strengths and challenges for community engagement initiatives. This paper describes a service-learning project that offered cultural diversity training to professionals in Appalachia as a foundational component of a social work program focus on community engagement. Service learning in social work classrooms has been examined for many years (Bringle & Hatcher, 1996; Lemieux & Allen, 2007; Lowe & Clark, 2009; Mink & Twill, 2012; Mitschke & Petrovich, 2011). By definition, many service-learning projects necessarily involve community engagement.

Integral to this paper is the definition of community engagement. The Carnegie Community Engagement Classification defined community engagement as “the collaboration between institutions of higher education and their larger communities (local, regional/state, national, global) for the mutually beneficial exchange of knowledge and resources in a context of partnership and reciprocity” (Campus Compact, 2015, para. 4). Community engagement involves students spending time in their larger communities, with the broad goal of both learning and having a positive impact.

Texas Tech University defined service learning as “a pedagogy that links academic study and civic engagement through thoughtfully organized service that meets the needs of the community” (Lowe & Clark, 2009; Texas Tech University, 2002, para. 2). Service learning, an active form of community engagement, can be used in the social work classroom in a variety of ways, including in the promotion of hands-on experience within the safe context of academic supervision.

Primarily, the literature in the area of service learning reflects instructor analyses of student projects in bachelor of social work classrooms (Lowe & Clark, 2009; Mink & Twill, 2012). However, there is limited literature available regarding the experiences of a Master of Social Work (MSW) student, from the student’s perspective. This article seeks to share an MSW student’s perspective regarding a service-learning project conducted in an agency in Appalachian Ohio, as well as describe the impact to the overall community.

I work as a guardian ad litem (GAL) for Court Appointed Special Advocates for Clermont Kids (CASA), in Clermont County, Ohio Juvenile Court. I have worked with the abuse, neglect, and dependency docket in that court since February of 2011. This work with families in difficult situations is extremely rewarding. In order to serve as a GAL, I was required to attend a 40-hour training. In addition, I am required to complete 12 hours of continuing education each calendar year. I am also currently a MSW graduate student in Kentucky.

Upon entering a graduate level social work class in multiculturalism, I learned that service-learning projects would comprise one of our focus areas for the course. Furthermore, each student would be allowed to pick an agency with which to work. One of the ways in which social workers can expand their cultural competence is to learn about their own culture and the experiences of others in that culture (Clay, 2010). Therefore, I chose to complete my project by expanding my knowledge of the culture of poverty experienced by Appalachian people. This community experiences poverty at a rate of 111.5% of the poverty rate of the United States overall (Appalachian Regional Commission [3], n.d.).

The broad focus of my project was a Culture of Poverty and Appalachian Cultural History training class that I developed and taught for other GALs at CASA. The purpose of this class was to provide an in-depth look at the population served by GALs in that area, the Appalachian community. This paper discusses the project completed, and advocates for the implementation of service learning as an effective means of community engagement in graduate social work classrooms.

CASA is an organization of community volunteers that advocate for the best interests of children in the foster care system (CASA for Clermont Kids, 2015; Royalty, 2014.) The concept behind CASA came about in response to children “slipping through the cracks” of the legal system (Royalty, 2014). In many instances, “slipping through the cracks” indicates that a child’s case has not received proper attention, and that child may be at increased risk as a result. GALs in Ohio are appointed by a judge to advocate for the best interests of a child by making recommendations to the court in the form of a written report (CASA for Clermont Kids, 2015). The major advantage of having a CASA GAL appointed on a case is the more individualized attention the CASA volunteer can provide to each case, as they typically only work on one to two cases at any time.

This branch of CASA works exclusively in an Appalachian county, but does not always have workers who may identify as Appalachian (Royalty, 2014). Clermont County, Ohio serves as the most western border of Appalachia in Ohio (Appalachian Regional Commission [1], n.d.). In 2010, Clermont County had a population of 197,363 with a per capita income of $34,786 (Appalachian Regional Commission [2], n.d.). For 2010, the unemployment rate in Clermont County was 9.7%, with 18,790 people living below the U.S. Federal Poverty Guidelines for 2007—2011. This indicates that, in 2010, Clermont County had a poverty rate of 9.6% (Appalachian Regional Commission [2], n.d.).

CASA for Clermont Kids served 232 children in 2013 (Royalty, 2014), all of them from Clermont County. While many of the clients served by CASA are among those included in the lowest income families in the county, many of the GALs come from more middle class or upper middle class backgrounds (Royalty, 2014). This creates an obvious disconnect between the experiences of the families served and those serving them. For this reason, it was determined that a community need would be filled by educating GALs about the culture of poverty and Appalachian culture and history.

For my project, rather than risk the possibility of revealing confidential information regarding real clients, I made the decision to use a case example from the popular documentary “The Wild and Wonderful Whites of West Virginia” Video excerpts from the documentary were used in the training class. One of the people featured was Susan White, who discovered she was pregnant after stabbing her boyfriend with a knife. Susan had a problem with prescription painkillers, and the baby also subsequently tested positive for painkillers at birth. The documentary shows Susan crushing and snorting pills in the hospital prior to her release after childbirth. Local authorities were notified, and the child was placed in the custody of the local children services agency (Taylor & Nitzberg, 2010).

I chose to use this example because an overwhelming majority of the cases in which CASA becomes involved have an element of substance abuse listed as the primary reason for the removal of the child. Clermont County is currently experiencing an epidemic of heroin abuse. From January through June 2014, 68 children were removed from their homes and placed in the custody of Clermont County Children’s Services. Of those, 47% of the cases were related to substance abuse (Royalty, 2014). Every case that I have handled in my time with CASA has been either directly or indirectly related to substance abuse in some way.

After choosing the video excerpts, I began building a PowerPoint presentation that included a general discussion of poverty, situational versus generational poverty, and a brief history of the exploitation of Appalachian populations and the prevalence of negative Appalachian stereotypes in popular media. I then related all of this information back to the ways in which GALs can support Appalachian families to promote the reunification of the family following a child’s removal from the home.

A fundamental tenet of service learning is that it should be mutually beneficial, with “…two main goals- enhancing student learning and civic responsibility while also providing a benefit to the local target community” (Mitschke & Petrovich, 2011, p. 97). In concurrence with this standard, this project was both beneficial to the community as well as myself. Nine practicing GALs participated in this training, which equals roughly 20% of the CASA GALs in the county at that time. Those who attended the training class completed a survey based on their experiences, and reported that they felt more comfortable working with a population with which they were previously unfamiliar. This is a benefit to the local target community, as the professionals gained knowledge of the population with which they work.

As for the impact on me as a student, I learned how valuable it can be to share information in a formal agency setting. I was excited and honored to be able to share a topic I am passionate about with a group of individuals whose primary goal is to improve outcomes for children in our county. I have been able to see the long-term effects of this training in questions from participants that I have received since the training. Being able to get out in the community and impact a population that holds a special place in my heart allowed me to see the struggles Appalachian populations must face in working with people who do not understand their culture. It was a very enlightening experience that I may not have had without the opportunity this project afforded me to become further engaged in the community in such a deep way.

Looking back on my experiences with this class project, there are several things I would change for a future project. Because we were allowed so much freedom in picking our projects and agencies, it would have been nice to have one semester’s worth of advanced notice of the project. That would have allowed students to really think about the projects they would like to complete, and if not already affiliated with an agency, to identify and partner with an agency that appeals to the student’s area of interest. One semester to partner with an agency, get a project approved, and complete the actual project seemed a bit rushed.

Additionally, this project assignment would have been more beneficial to the target population of children and families if more CASA GALs had attended, and if this training class had been offered to all guardians working in Clermont County. Participants were offered the opportunity of earning three credit hours toward their yearly-required 12 hours. However some other type of incentive, such as a drawing for a gift card or books, may have made a difference in the attendance numbers, thereby potentially making a larger impact on the community.

Following my experience with this project, I decided that more work needed to be done with regard to the impact of the training class. Because “service learning in social work education is a pedagogical approach in need of more rigorous evaluation research to advance knowledge and to inform practice in the field” (Lemieux & Allen, 2007, p. 321), I approached my advanced research professor as well as the professor who assigned the original service-learning project about conducting a study on the overall effectiveness of the training. They both agreed to further develop and evaluate this project, and the continued project is an ongoing effort.

After completing this project, I feel that the impact of service-learning projects on both MSW students and the larger community is greatly beneficial. Organizations have the ability to benefit from a knowledge base they may not otherwise be able to access. Furthermore, it allows students to work on a project and immediately see the benefit in real-life situations. Because both of these combine to help create stronger communities and more civic-minded professionals, I feel that service-learning projects that incorporate a strong community engagement emphasis should be part of the educational experiences of MSW students across the country.

References

Appalachian Regional Commission (1). (n.d.). Poverty rates in Appalachia, 2007–2011. Retrieved from http://www.arc.gov/research/MapsofAppalachia.asp?MAP_ID=76.

Appalachian Regional Commission (2). (n.d.). Socioeconomic data: Clermont County, Ohio. Retrieved from http://www.arc.gov/reports/socio_report.asp.

Appalachian Regional Commission (3). (n.d.). Poverty rates, 2008-2012. Retrieved from http://www.arc.gov/reports/custom_report.asp?REPORT_ID=55.

Bringle, R.G., & Hatcher, J.A. (1996). Implementing service learning in higher education. Journal of Higher Education, 67, 221–239.

Campus Compact. (2015). Carnegie community engagement classification. Retrieved from http://www.compact.org/initiatives/carnegie-community-engagement-classification/?zoom_highlight=community+engagement#Description.

CASA for Clermont Kids. (2015). About us. Retrieved from http://casaforclermontkids.org/?page_id=30.

Clay, R. A. (2010). How do I become culturally competent? gradPSYCH Magazine, 8(3), 24. Retrieved from http://www.apa.org/gradpsych/2010/09/culturally-competent.aspx.

Lemieux, C.M., & Allen, P.A. (2007). Service learning in social work education: The state of knowledge, pedagogical practicalities, and practice conundrums. Journal of Social Work Education, 43(2), 309–325.

Lowe, L.A., & Clark, J. (2009). Learning about social work research through service-learning. Journal of Community Engagement and Scholarship, 2(1), 50–59.

Mink, T. & Twill, S. (2012). Using service-learning to teach a social work policy course. Journal of Community Engagement and Scholarship, 5(1), 5–9.

Mitschke, D.B., & Petrovich, J.C. (2011). Improving social work students’ understanding of health and social justice knowledge through the implementation of service learning at a free community health clinic. Journal of Human Behavior in the Social Environment, 21(1), 97–108.

Royalty, A. (2014). Personal interview with the executive director of CASA for Clermont Kids. February 4, 2014.

Taylor, S., & Nitzberg, J. (2010). “The wild and wonderful Whites of West Virginia.” United States: New Video Group.

Texas Tech University. (2003). Definitions and guidelines. Retrieved from http://www.tltc.ttu.edu/servicelearning/definition.asp.

Acknowledgements

The author would like to thank Dr. Willie Elliott for assigning such an inspiring project, as well as for his unwavering support and discussion. I would also like to thank Dr. Jessica Averitt Taylor for her continued support, guidance, direction, and advice. Behind any great student are great teachers and mentors. I have some of the best. And to Dr. Patricia Friel: For everything.

About the Author

Christian J. Messer Gaitskill completed her master of social work degree at Northern Kentucky University in May 2015. She received her B.S. in paralegal technology from the University of Cincinnati.

Academic-Community Partnerships: Effectiveness Evaluated Beyond the Ivory Walls

Rosemary M. Caron, Jessica D. Ulrich-Schad, and Catherine Lafferty

Screen Shot 2015-10-26 at 3.51.48 PM

Abstract

Community-based participatory research (CBPR) has furthered our understanding of the working principles required for academic-community partnerships to address persistent public health problems. However, little is known about how effective these partnerships have been in eliminating or reducing community-based public health issues. To contribute to the literature in this area, the authors conducted a survey of U.S. schools and programs in public health and community groups working with these academic partners to: (1) identify the most common local public health issues addressed; (2) examine the characteristics of the partnership and the actual or perceived benefits and challenges for each partner; (3) assess the perceived effectiveness of the partnership and their evaluation techniques; and (4) analyze the intent to continue or dissolve the partnership and the associated factors that influence this decision. The authors provide recommendations that can improve the development, functioning, and effectiveness of academic-community collaborations aimed at addressing a variety of public health concerns.

Introduction

Winslow (1920) defined public health as:

        …the science and art of preventing disease, prolonging life and promoting physical health
and efficacy through organized community efforts for the sanitation of the environment,
the control of community infections, the education of the individual in principles of
personal hygiene, the organization of medical and nursing services for the early
diagnosis and preventive treatment of disease, and the development of the social
machinery which will ensure every individual in the community a standard of living
adequate for the maintenance of health; … (p. 183).

Winslow’s critical work still accurately reflects the mission of public health today. An essential, modern tool in fulfilling the public health mission is the academic-community partnership. Academiccommunity partnerships are relationships between community organizations and academic institutions with the goal of building the community’s capacity to address community-level issues, including public health matters that may affect a population’s quality of life (Lesser & Oscos-Sanchez, 2007; O’Fallon & Dearry, 2002). By engaging multiple stakeholders with common interests in a specific community, these partnerships are better equipped with the financial resources, human and social capital, and organizational resources to address local public health concerns (Green, Daniel, & Novick, 2001; Chaskin, Brown, Venkatesh, & Vidal, 2001).

However, there is limited evidence of the effectiveness of academic-community partnerships in alleviating the public health concerns they seek to address (El Ansari & Weiss, 2006; El Ansari, Phillips & Hammick, 2001; Kreuter, Lezin, & Young, 2000; Wallerstein & Duran, 2006). There have been many studies that document the purpose, or goals, of such partnerships and the best practices required for effective partnerships, but few either systematically or empirically evaluate the impacts of these interventions on public health outcomes. Some studies have assessed the perceived effectiveness of programs in alleviating public health concerns, but even fewer use experimental or quasi-experimental research designs to rigorously test program effectiveness. The studies that have assessed the effectiveness of academic-community partnerships are often focused on a select number of health concerns, lack a truly experimental design in their evaluations, and focus on a small number of communities or particular sub-populations.

The lack of evidence about the effectiveness of academic-community partnerships in addressing public health matters stems in part from the difficulties associated with disentangling the effects of other factors from the effects of the partnerships themselves. For example, it is difficult to discern, without using experimental evaluative methodologies, whether the practices implemented by the collaborations themselves or other extraneous factors, such as changing social norms, economic fluctuations, availability of resources, etc. are having a greater effect. It is also challenging to evaluate the effectiveness of some programs because public health benefits can take a long period of time to be realized (Eisinger & Senturia, 2001; Israel, Schulz, Parker, Becker, Allen, & Guzman, 2005). Additionally, because local contexts matter in communitylevel research, it can be challenging, and time and resource consuming, to use comparative research methods (e.g., control and experimental groups) to assess program outcomes. Finally, what is defined as an indicator of collaboration success is sometimes up for debate (El Ansari, et al, 2001; Wallerstein & Duran, 2006). Specifically, El Ansari et al. (2001) consider the primary challenges confronting the evidence on effective collaborative efforts to include: the diversity of perspectives, multiplicity of conceptual facets, difficulty in measurement of notions, selectivity of macro- or micro-evaluation, variety of proximal or distal indicators, array of short and long-term effects, assortment of individual-level or collective outcomes, measuring a moving target, suitability of randomized controlled trials, and requirement of mixed methods evaluation.

CBPR is a common method implemented by academic and community partners to address community-level issues. It is defined as:

        …a collaborative approach to research that equitably involves all partners in the
research process and recognizes the unique strengths that each brings. CBPR begins
with a research topic of importance to the community, has the aim of combining
knowledge with action and achieving social change to improve health outcomes
and eliminate health disparities (W.K.Kellogg Foundation, 2001).

CBPR has furthered our understanding of the working principles required for academic community partnerships to address persistent public health problems together. However, little is known about how effective these academic-community partnerships, particularly those using CBPR, are at eliminating or reducing community-based public health issues. To contribute to the literature in this area, we conducted an online survey of both academic and community partners throughout the U.S. to evaluate: (1) the development and functioning of academic-community partnerships that address public health issues; and (2) the perceived effectiveness of academic-community partnerships in reducing public health issues pertinent to their community. By conducting a survey of both academic and community partners, we gain a better understanding of the local public health issues being addressed, the characteristics of partnerships working to address these issues, including whether the partnership utilizes CBPR principles, and most importantly, whether or not the partnerships have been able to alleviate public health concerns. The overall purpose of this work is to: (1) inform the development and functioning of new collaborative relationships between communities and academic institutions aimed at addressing important community-based issues; and (2) provide recommendations that can improve the effectiveness of academic-community collaborations in solving a variety of public health concerns.

Methods

Survey Sample and Design
Survey Sample and Design To assess the effectiveness of academic-community partnerships in addressing public health concerns, we developed and conducted a formal, online, anonymous survey of directors of all Council on Education for Public Health (CEPH)-accredited schools and programs of public health, as well as leaders of community organizations. Based on an extensive literature review of academic-community partnerships addressing local public health issues, survey questions were prepared regarding the development, functioning, and effectiveness of such partnerships. The surveys were pilot tested among a small group (n=10) of academicians in the public health field and community organization representatives (n=10) across the country. The reviewers provided feedback on survey content and length that improved the content validity of our survey instrument before its implementation. Appendices A and B include the survey instruments for academic and community partners, respectively.

Sampling Methodology
The e-mails for directors of schools and programs of public health were collected from the CEPH website and individual accredited public health program and school websites. The sample of academic partners included 48 directors of CEPH-accredited schools and 82 directors of CEPH-accredited programs in public health in the U.S. The sample of community partners was compiled by sending announcements on publicly available and moderated CBPR listservs for academic-community partnerships. The survey was created by employing SurveyMonkey, an electronic survey tool. The invitation letter to participate in the survey was e-mailed to each director and posted on the CBPR listservs. If directors or community representatives were unable or unwilling to participate, we asked them to refer us to other representatives of their school/organization who were knowledgeable about the partnership(s) their school/organization was involved in. The respondents accessed the survey by clicking on a hyperlink that would open the electronic survey. The participant’s responses were downloaded and saved to space designated on the University of New Hampshire’s server. The survey took ten to fifteen minutes to complete. We used skip logic to allow respondents to skip over questions that they determined were irrelevant to their situation. Therefore, the denominator for responses to each question only reflects respondents that chose to answer that question.

The survey was implemented during the Spring 2012 semester, traditionally a busy time for academic institutions. The survey remained accessible for respondents to complete for ten weeks. Every two weeks a reminder was e-mailed to directors who had not yet taken the survey. Reminders to complete the survey were also posted every two weeks on the CBPR listservs for leaders of community organizations.

Survey Instrument
The study was approved by the Institutional Review Board at the University of New Hampshire. The survey was comprised of 25 various question types including closed- and open-ended questions. While the general content of the survey questions for the academic and community partners were equivalent, question wording varied for appropriateness and context. The survey was divided into six sections comprised of questions that attempted to: (a) identify the local public health issues being addressed; (b) examine the characteristics of the partnership; (c) assess the actual or perceived benefits and challenges for each partner; (d) determine the perceived effectiveness of the partnership; (e) assess the methodology implemented by the partnership to determine its success; and (f) analyze the intent to continue or dissolve the partnership and the associated factors that influence this decision.

Data Analysis
Data from the completed surveys were downloaded and analyzed using Statistical Package for Social Sciences, version 17.0, and Microsoft Excel 2007. Quantitative responses were evaluated using descriptive statistics. Qualitative analysis was used to evaluate open-ended response questions. The text from these responses was examined using content analysis software, QSR NVivo, version 9. Nueundorf (2002) defines content analysis “…as the systematic, objective, quantitative analysis of message characteristics.” This method codes the text into manageable categories by theme. Specifically, the responses to the following survey questions were quantified via percentages: identification of partners for both academic institutions and community organizations; main public health issue the partnership is addressing; role of the partner in the partnership; utilization of CBPR principles in the partnership; method of conflict resolution implemented; type of activity necessary to sustain the partnership’s work; the types of activities utilized to address the public health issue in the community; partner’s perception of a positive outcome in their community as a result of their partnership; perception of the effectiveness of the partnership; challenges encountered by the partnership; and whether or not the partners planned to continue their partnership. Qualitative analysis for the following survey questions were analyzed via thematic identification: positive outcomes of the partnership; the evaluation of the perceived effectiveness of the partnership; challenges encountered by the partnership; and lessons learned to date from the academic-community partnership. Both quantitative and qualitative results are presented throughout the results section.

Results

One hundred and seventy one survey responses were received: 131 respondents represented academic partners and 40 respondents represented community partners.

Academic partners identified that their community partners (multiple communities in some cases) primarily came from non-profit organizations (55.4%), community coalitions (55.4%), community advisory boards (42.1%), and local health departments (32.2%). Community partners identified that their academic partners (multiple academic partners in some cases) primarily came from schools of public health (47.4%), medical schools (34.2%), programs of public health (23.7%), and departments of community health (26.3%). Academic and community respondents identified chronic disease (15.2%), childhood obesity (11.7%) and access to healthcare (7.0%) as the top three public health issues their partnerships were working to address.

The majority of respondents (academic partners, 69.0%; community partners, 66.7%) reported serving in the role of “convener” for the development of their specific academic-community partnership. Using a closed-ended survey question, about two-thirds of academic partners (72.2%) reported that their partnership operated via CBPR principles, whereas only one-third (33.3%) of community partners reported that their partnership operated via these participatory principles. One academic partner reported that CBPR principles were used in their partnership, “…but not in all phases” of the work. One community respondent stated that “Although academics tend to think in specific content areas, community members think in terms of the whole health of their neighborhoods. Academics interested in this type of work really need to understand this.” Furthermore, one-third (33.3%) of community partners engaged in an academic-community partnership reported not knowing about CBPR principles. One community partner reported that “The answer is yes and no [to using CBPR principles] due to the fact that the academic-community partnership does not have a clear understanding of CBPR; and [how to take] the community on as an equal partner.” In addition, academic (79.5%) and community partners (61.8%) reported that for conflicts that arose in their partnership, consistent attempts by both partners via face-to-face communication were the main method of resolution. Lastly, for both partners, applying for grants offered by federal agencies was the primary method by which to obtain the resources necessary to conduct their work (academic partner, 68.2%; community partner, 76.5%). Application to funding opportunities from private foundations and organizations was another common approach to acquire the necessary resources (academic partner, 51.8%; community partner, 50.0%).

Table 1 presents the types of activities academic-community partnerships utilized to address public health issues in their community. The most common activities included the use of surveys (60.2%), focus groups (57.9%), interviews (61.4%), and working with healthcare providers (52.0%). Other activities (28.7%) included conducting community forums, implementing leadership training, and intervention development and evaluation.

        When academic and community partners were asked whether or not they perceived a positive outcome in their community as a result of their partnership, both partners believed there was a greater awareness of the public health issue in the community (academic partner, 79.2%; community partner, 76.5%), as well as opportunities for funding (academic partner, 53.8%; community partner, 47.1%) as a result of their work (Table 2). Other positive outcomes identified by academic and community partners included new legislation, policy development, grant writing skills, peerreviewed publications, and increased participation community-wide in addressing public health issues. Several respondents reported that their academic-community partnership resulted in an actual outcome of the public health issue being addressed in their community. For example, “… teen pregnancy rates have gone from 50% to 20% [among] high school girls in 4 years”; “declaration of city as HIV disaster area”; “increased screening of children for lead exposure”; and a “measurable decrease in substance use in the community in question.”

Table 1. Representative activities academic community partnerships engage in to address public health issues
Table 1. Representative activities academic community partnerships engage in to address public health issues
Table 2. Percentage of respondents who report positive partnership outcomes
Table 2. Percentage of respondents who report positive partnership outcomes

        Table 3 illustrates the challenges encountered by academic and community partners. Both partners identified a lack of financial resources (academic partner, 70.2%; community partner, 70.6%), lack of time for the project (academic partner, 51.0%; community partner, 52.9%), and building infrastructure (academic partner, 38.5%; community partner, 29.4%) as the main challenges experienced by their partnership. Additional themes that academic and community partners identified as being challenges to their work included the geographic distance between the academic institution and the community, institutional risk, sustaining involvement, attrition, and lack of acknowledgement of community-based work for academic promotion. One academic respondent shared a specific challenge: “…it’s hard to find academic partners who are adequately trained in community engagement, who are culturally competent, and who are able to utilize principles of CBPR and PAR [participatory action research] in a truly collaborative way. Most academic partners remain hierarchical, and some of our more visionary partners are junior faculty who face significant pressure from their tenure committees to stick to ‘traditional’ research (particularly for fields outside of public health).”

        Using an open-ended survey question, academic and community partners were asked to identify how they evaluate the effectiveness of their partnership. Several themes emerged regarding evaluation methods utilized by the partnerships including the number and extent to which partners were involved as determined by their attendance at meetings, types of stakeholders with whom partners were sharing information, increased utilization of services by community members, number of requests to develop partnerships with new partners, and partnership sustainability and retention.

Table 4 presents the overall perceived effectiveness of the respondents’ academic-community

Table 3. Percentage of respondents who report challenges in partnerships
Table 3. Percentage of respondents who report challenges in partnerships

partnership. The majority of academic and community partners reported that they perceived their partnership to be “somewhat effective” (academic partner, 54.8%; community partner, 55.9%) or “very effective” (academic partner, 24.0%; community partner, 23.5%) at addressing public health issues in their community. One academic respondent stated an actual improvement as a result of their partnership, “We have been able to enhance the knowledge, skills, abilities and competence of our public health workforce. We have also been able to strengthen partnerships between community members. We have been able to build trust of the academic institution in the community. We have been able to bridge public health and primary care.”

Academic and community partners reported that they planned on continuing their partnership in the future (academic partner, 90.6%; community partner, 82.7%). The majority of respondents reported that their partnership had either met some of the objectives it had established (academic partner, 62.1%; community partner, 41.4%) or they were still in the process of meeting their objectives (academic partner, 23.2%; community partner, 31.0%). One academic respondent stated, “Our goal is to establish academic/community partnerships that are on-going, not just based on one project….” Another community respondent stated an actual outcome: “I’d like to say [our goals have been] completely reached, but that would imply there’s nowhere to go from here, which is impossible. We’ve exceeded the goals we’ve set for ourselves at this point, but are always creating new ones.”

        Academic and community participants were asked to describe the lessons learned to date from their respective academic-community partnership. The overarching theme that emerged from the participants’ responses was the importance of implementing the working principles of CBPR. Other themes included the role of funding, effective communication, adaptability among partners, partners as co-learners, and working from a common ground and towards a common goal. Table 5 highlights these main themes. The academic

Table 4. Effectiveness of academic-community partnership at addressing public health issues in the community
Table 4. Effectiveness of academic-community partnership at addressing public health issues in the community
Table 5. Representative Activities Academic Community Partnerships Engage in to Address Public Health Issues
Table 5. Representative Activities Academic Community Partnerships Engage in to Address Public Health Issues

community partners were also asked about how their partnership could be more effective. Both partners agreed that accessing more financial resources (academic partner, 55.1%; community partner, 44.8%); accessing more human resources (academic partner, 44.9%; community partner, 34.5%); and spending more time on the project (academic partner, 36.7%; community partner, 17.2%) may improve their effectiveness.

Discussion

“They are very time intensive but the outcomes/ improvements can be very rich and long-lasting.” – Community Respondent

Recent research has evaluated the effectiveness of community partnerships in addressing public health concerns. These studies have focused on issues such as cancer and heart disease, reducing tobacco use (Green, Daniel, & Novick, 2001) and increasing vaccination rates (Coady et al., 2008). Evaluation of the effectiveness of community organizations that partner with academic institutions to address local public health issues are beginning to appear with more frequency in the peer-reviewed literature. One example includes work conducted by Ndirangu, Yadrick, Bogle, & Graham-Kresge (2008) that assessed the effectiveness of academiccommunity partnerships involved in implementing nutrition interventions in three communities in the Lower Mississippi Delta. A second example is work conducted by Levine, Bone, Hill, Stallings, Gelber, Barker, Harris, Zeger, Felix-Aaron, & Clark (2003) that provides evidence for empirically evaluated positive outcomes of academic-community partnerships in a four year randomized clinical trial investigating the effectiveness of a health center partnership in decreasing the blood pressure levels among an urban African-American population.

Despite the difficulties surrounding the rigorous evaluation of the interventions implemented by academic-community partnerships, our work contributes to this body of knowledge by examining the development and functioning of such partnerships that address public health issues, as well as evaluating their perceived effectiveness in reducing specific public health issues pertinent to the community.

Our findings highlight that academiccommunity collaborations are comprised of partners that represent multiple aspects of academia (e.g., departments, schools, institutes) and community (e.g., community-based organizations, community advisory boards, health departments). Each partner views the public health issue in the community through a different lens based on their experience, knowledge, skills, and ability. Thus, we propose that each partner involved in the collaboration should have a clear understanding of the expectations and governance of a multi-stakeholder partnership. To facilitate this proposal, we recommend that CBPR principles be implemented when such partnerships are just forming so that potential misunderstandings may be avoided at a later stage of the work. Training and the practice of the CBPR principles of open communication, trust, and mutual respect for the knowledge, expertise and resources of all partners involved takes time to develop so training on these working partnership principles should be instituted early (Wallerstein & Duran, 2006). Similarly, Maurana & Goldenberg (1996) reported principles they found essential for their academic-community partnership experience in improving the health of residents in Ohio. These principles include leadership, partnership, and empowerment among all participants (Wallerstein & Duran, 2006).

Every community is different and we propose that more can be accomplished in addressing community-based public health issues by utilizing the strengths within that community. Academiccommunity partnerships represent a part of the “village” it takes to improve community health and we recommend that the time necessary for such relevant collaborations to foster should be built into the academic-community partnership development process. The amount of “time” it takes for such a collaboration to function will vary community by community due to the dynamic nature of the population and the existing public health issues.

A majority of academic-community partnerships reported that they were “somewhat” or “very effective” in addressing public health issues in their community. Examples of their effectiveness included “a greater awareness” of the public health issue in the community. We recommend that implementing a measure of effectiveness be considered by such partnerships that are conducting time- and labor-intensive work. We argue that raising the awareness about a public health issue is often the first step needed to initiate sustainable change and should be viewed as a milestone in the progression and evaluation of the academiccommunity partnership’s work. Certainly a sustained intervention that reduces or eliminates the public health issue of concern would also be considered a great success (for example, the significant decrease in the teenage pregnancy rate as reported by one respondent; and the increase in lead screening rates among children as reported by another respondent), but it is important to acknowledge and evaluate those accomplishments that may not appear major at first glance.

It is also important to note that these varied academic-community partnerships reported their work as being “somewhat” or “very effective” in the face of barriers also experienced by the private and not-for-profit sectors, i.e., a lack of financial resources, a lack of time for the project, and a lack of building infrastructure (e.g., memorandum of understanding, standard processes, communication methods). There are no easy solutions to these barriers that are far too common. However, we propose that a consistent pooling of resources, in terms of building on the strengths and talents of multiple stakeholders could be productive. Maurana and Goldenberg (1996) report that based on their academic-community partnership experience, they worked to diversify their funding sources and have complemented their academic institution’s resources with the community’s resources so they are a united team applying for limited grant dollars.

We propose that academic-community partnerships hold great potential for expanding the breadth of public health issues that are able to be addressed at the local level. Public health is a very broad and diverse discipline and such collaborations could focus on matters related to land use management, workforce development, and community revitalization initiatives. However, as one academic respondent mentioned, academic institutions often do not acknowledge this community-based work because of the time needed to produce a peer-reviewed result that may not coincide with the academician’s schedule for academic promotion. Seeing the potential for such academic-community partnerships to improve the quality of life for populations, we recommend that academic institutions need to reconsider the value placed on such work and adjust the promotion schedule for those faculty engaged in academiccommunity partnerships. Maurana and Goldenberg (1996) report, in their experience, “…a restructured reward system that values professional service and applied research” outside of their academic institution was developed. As the outcomes of such unique and productive partnerships become more visible, we anticipate more academic institutions will adopt a similar approach.

Academic-community partnerships reported several means by which to assess the effectiveness of the partnership itself. Most partners reported several basic measures including the number of attendees at meetings, contributions of partners while at these meetings, extent of information disseminated, etc. We encourage academic-community partnerships to engage in a regular assessment of their partnership in addition to the evaluation that occurs with the established public health intervention the partnership has implemented. We propose that regular evaluation of the partnership itself will allow for adjustments in the operating principles, if necessary, and should contribute to the partnership’s sustainability. The partners should develop an assessment tool for their partnership that is right for them — a “one size fits all” evaluation tool would not be appropriate but general components may include an assessment of the knowledge and utilization of CBPR principles by all involved partners.

Although the findings from this exploratory analysis provide valuable insight into the characterization of academic-community partnerships working on public health issues, several limitations to this work should be noted. The sampling bias associated with a non-probability sampling technique limits the generalizability of the findings from this study to other academic-community partnerships. Missing data occurred randomly across the surveys. In addition, the results were limited by the cross-sectional study design and compliance to the authenticity of self-reported information. Similar to other studies, our work, in many instances, was challenged by collecting data that pertained to the perceptions of individual partners. Despite these limitations, our findings have been appropriately qualified and we propose they provide valuable insight into the development, functioning, and effectiveness of academic-community partnerships that address public health issues.

As academic and community collaborations become increasingly common for addressing challenging public health concerns, we propose that evaluating the effectiveness of academiccommunity partnerships should include an evaluation of the partnership itself. We argue that the process of partnering is just as important as the public health intervention’s outcome. This partnership evaluation should move beyond the ivory walls and also encompass the community’s benchmarks for success. Furthermore, our findings provide some evidence that using CBPR principles in the partnership may be beneficial, and the results emphasize the need for funding, communication, and flexibility when conducting complex yet rewarding work. Future research should include the empirical evaluation of whether the collaborations themselves are actually having the desired effect on the public health concerns they were developed to help alleviate.

References

        Chaskin, R.J., Brown, P., Venkatesh, S., & Vidal,
A. (2001). Building community capacity. New York:
Aldine de Gruyter.

Coady, M. H., Galea, S., Blaney, S., Ompad,
D. C., Sisco, S., & Vlahov, D. (2008). Project VIVA:
A multilevel community-based intervention to
increase influenza vaccination rates among hardto-reach
populations in New York City. American
Journal of Public Health, 98(7), 1,314–1,321.

Eisinger, A., & Senturia, K. (2001). Doing
community-driven research: A description of Seattle
Partners for Healthy Communities. Journal of Urban
Health: Bulletin of the New York Academy of Medicine,
78(3), 519–534.

El Ansari, W., Phillips, C.J., & Hammick, M.
(2001). Collaboration and partnerships: Developing
the evidence base.Health and Social Care in the
Community, 9(4), 215–227.

El Ansari, W., & Weiss, E.S. (2006). Quality of
research on community partnerships: developing
the evidence base. Health Education Research, 21(2),
175–180.

Green, L., Daniel, M., & Novick, L. (2001).
Partnerships and coalitions for community-based
research. Public Health Reports, 116(1), 20–31.

Israel, B.A., Schulz, A.J., Parker, E.A., Becker,
A.B., Allen, A.J., III, & Guzman, J.R. (2005). Critical
issues in developing and following community based
participatory research principles. In M. Minkler &
N. Wallerstein (Eds.), Community-based participatory
research for health (pp. 53–76). San Francisco: Jossey-Bass.

Kreuter, M.W., Lezin, N.A., & Young, L.A.
(2000). Evaluating community-based collaborative
mechanisms: Implications for practitioners. Health
Promotion Practice, 1(1), 49–63.

Lesser, J., & Oscos-Sanchez, M.A. (2007).
Community-academic research partnerships with
vulnerable populations, Annual Review of Nursing
Research, 25(1), 317–337.

        Levine, D.M., Bone, L.R., Hill, M.N., Stallings,
R., Gelber, A.C., Barker, A., Harris, E.C., Zeger,
S.L., Felix-Aaron, K.L., Clark, J.M. (2003). The
effectiveness of a community/academic health
center partnership in decreasing the level of blood
pressure in an urban African-American population.
Ethnicity and Disease, 13, 354–361.

Maurana, C.A., & Goldenberg, K. (1996). A
successful academic-community partnership to
improve the public’s health, Academic Medicine,
71(5), 425–431.

Minkler, M., & Wallerstein, N. (eds.). 2011.
Community-based participatory research for health: From
process to outcomes. San Francisco: John Wiley &
Sons.

Ndirangu, M., Yadrick, K., Bogle, M.L., &
Graham-Kresge, S. (2008). Community-academia
partnerships to promote nutrition in the Lower
Mississippi Delta: Community members’
perceptions of effectiveness, barriers, and factors
related to success, Health Promotion Practice, 9(3),
237–245.

Nueundeorf, K.A. (2002). The content analysis
guidebook. Thousand Oaks, CA: Sage Publications.

O’Fallon, L.R., & Dearry, A. (2002). Communitybased
participatory research as a tool to advance
environmental health sciences, Environmental Health
Perspectives 110(Supplement 2), 155–159.

Wallerstein, N.B. & Duran, B. (2006). Using
community-based research to address health
disparities, Health Promotion Practice, 7(3), 312–323.

Winslow, C.E.A. (1920). The untilled field of
public health, Modern Medicine 2, 183-191.

W.K. Kellogg Foundation Community Health
Scholars Program (2001). Accessed http://depts.
washington.edu/ccph/commbas.html.

Acknowledgement

The authors would like to express their gratitude to the directors of schools and programs of public health and community leaders for taking the time to participate in the survey.

About the Authors

Rosemary M. Caron is an associate professor in the Department of Health Management and Policy in the College of Health and Human Services at the University of New Hampshire. Jessica D. Ulrich-Schad is a doctoral candidate in the Department of Sociology in the College of Liberal Arts at the University of New Hampshire. Catherine Lafferty is an honors graduate of the Department of Health Management and Policy in the College of Health and Human Services at the University of New Hampshire.

Delivering Value to Community Partners in Service-Learning Projects

Shannon B. Rinaldo, Donna F. Davis, and Josh Borunda

Screen Shot 2015-10-26 at 3.51.48 PM

Abstract

Service learning is a pedagogy wherein students engage in providing a service to the community that is linked to the academic objectives of a course. There are multiple stakeholders in the service-learning experience, including students, instructors, and community partners. A significant body of research investigates experiences of students and instructors, exploring the impact of service learning on student learning and describing how to effectively design service-learning courses. While community partners are indispensable stakeholders in service learning, there are only a few studies that examine their experiences and needs. The present study addresses this weakness in our understanding by conducting a qualitative study that examines the value of service learning to community partners. Findings describe the service-learning experience from the viewpoint of community partners and report the dimensions of value created for our community partners.

Introduction

Service learning engages students in course-related community service and enhances the classroom learning experience by requiring students to participate in activities that integrate course material with volunteer service (Petkus, Jr., 2000). Zlotkowski (1996) distinguished service learning from traditional internships by defining service learning as an experienced-based pedagogy that serves a community need and requires student reflection on the project. The structure and reflective component have been said to offer students “an effective curricular balance” (Post, Kundt, Mehl, Hudson, Stone, & Banks, 2009, p.18) to enhance ethics and values of a given area of study. Student tasks associated with service learning range from volunteering time with a community organization’s clients to crafting business strategy with the organization’s administration (Burns, 2011; Geringer, Stratemeyer, Canton, & Rice, 2009). Thus, service learning offers a valuable opportunity for students to implement their new skills in a real-world environment while also learning the importance of volunteerism (Astin, Sax, & Avalos, 1999; Burns, 2011).

Student learning outcomes associated with service learning include developing the ability to apply basic course-related concepts, honing skills for problem solving, learning to work within a team, and developing an appreciation for diverse needs and challenges of organizations (Klink & Athaide, 2004). Previous research demonstrates the value of service learning for students’ mastery of course concepts (e.g., Astin & Sax, 1998; Carson & Domangue, 2012; Hagenbuch, 2006; Shaw, 2007) and development of moral sensibilities (e.g., Warnell, 2010; Wilson, 2011). In addition, previous research provides guidance to instructors who wish to implement service learning in their courses (e.g., Klink & Athaide, 2004; Metcalf, 2010; Petkus, Jr., 2000), and examines the importance of matching community partner goals with project goals (Lester, Tomkovick, Wells, Flunker, & Kickul, 2005).

For students and faculty, the value of service learning can be measured in terms of students’ knowledge, skill, and attitude development as well as their satisfaction with the experience. However, it is possible to create value for students and faculty not only in successful service-learning projects, but also in projects that are unsuccessful in meeting all pre-stated goals. For example, Furlow (2010) reported on lessons learned in a class project where students designed a website for local businesses devastated by Hurricane Katrina. Gaining media attention for the website failed, but students were still enlightened by many aspects of the project, including the analysis of communication difficulties that led to the failure.

Service-learning projects require substantial investments from community partners who are typically involved throughout the course in planning, implementing, and evaluating the project (Conville & Kinnell, 2010; Schwartz & Fontenot, 2007). Projects that fail to meet the needs of community partners, or do not add value in other ways, may discourage future engagement. In contrast, projects that are valuable to community partners can result in positive word-of-mouth that broadens the base of potential community partners and strengthens the viability of service learning. Given the importance of community engagement to service learning, it is surprising to find that service-learning research continues its heavy emphasis on student learning and pedagogy at the expense of community impacts (Vernon & Ward, 1999; Sandy & Holland, 2006). Thus, instructors are left with little insight on how to engage community partners in ways that deliver value, even though the ongoing commitment of our community partners is critical to the success of the service-learning pedagogy.

The purpose of this research is to contribute to the existing community engagement literature by examining the value of service learning from the perspective of community partners. To that end, we report the results of a qualitative study aimed at answering two questions: (1) What is the nature of our community partners’ experiences in service-learning projects? (2) What is the value of service learning for our community partners? We begin with a review of the literature that examines the role of the community partner. Next, we describe our research method, and then we present our results. We conclude with a discussion of the implications of findings for designing service-learning courses that deliver value to community partners.

Community Partners in Service Learning

A defining characteristic of service learning is student engagement in activities that meet actual needs of the community partners (Campus Compact, 2003). Participating in a service-learning project involves extensive preparation for the community partner and the instructor prior to beginning the project. Together, they define objectives for student learning, design a structure for interaction between students and the community partner, and select assessment methods to monitor success. Then, students engage with the community partner to discover, define, and meet the community partner’s needs. The final component of the project, student reflection, takes place both while the project is ongoing and after the project is complete. Reflection encourages students to link the project with course concepts and to consider the importance of the project (Campus Compact, 2003).

The groundbreaking study by Vernon and Ward (1999) focused exclusively on the community partner in service learning. Using a multi-method research design, they examined the views of community partners related to service learning. Their findings indicated that community partners experience both benefits and challenges in working with service-learning students, and that agency personnel desire more coordination and communication on the part of their campus counterparts. They concluded that campuses are advised to move away from the “charity model approach” of service learning toward a social change paradigm in which the campus and community are equal partners (Vernon & Ward, 1999, p. 36).

Community partner benefit is mentioned in studies that consider the viewpoints of multiple stakeholders in service learning. For example, Hagenbuch (2006) collected data from community partners in his investigation of how service learning contributes to student benefit. Likewise, Lester et al. (2005) measured community partners’ perceptions of global benefits for both students and their organization’s clientele. Benefits of service-learning projects are described as mutual between community partners and students (Geringer, Stratemeyer, Canton, & Rice, 2009), where at a minimum students gain workplace skills and partner organizations gain access to those skills and knowledge. Most studies regarding service learning do not consider the financial benefit of service-learning projects, but Schwartz and Fontenot (2007) reported that the cash benefit to Habitat for Humanity equaled $3700 after marketing students worked to develop a fundraiser.

More recently, scholars have turned their attention to the nature of relationships between community partners and universities. Miron & Moely (2006) found that community partners reported higher levels of benefits to their agencies when they took a more active role in service-learning projects. Similarly, Sandy and Holland (2006) examined community partners’ views of campus-community partnerships and reported that community partners revealed a “surprising depth of understanding and commitment to student learning” (p. 30). Clayton, Bringle, Senor, Huq, & Morrison (2010) reminded us that “the terms ‘relationship’ and ‘partnership’ are not interchangeable” (p. 5). Stewart and Alrutz (2012) echoed their concern by urging universities to engage in transformative relationships with their community partners, rooted in shared understanding and reciprocity, rather than one-off, transaction-based projects. In transformative relationships, community partners decide jointly with instructors what the learning outcomes and service activities should be in order to simultaneously address classroom objectives and the needs of the community partner. This theoretical lens shifts the notion of service learning. Instead of one-way flows from universities to community partners, this theoretical lens advocates reciprocal resource flows between equal partners.

While it is clear in the literature that service learning has value for community partners, the nature of that value and its contributing factors are less clear. The goal of the current study is to develop an understanding of the value of service learning for community partners. The following section describes the research method employed to give voice to community partners’ views on the value of service learning.

Method

We designed a qualitative study to examine the value of service learning to community partners. The study involved in-depth exploration and comparative analyses across diverse experiences (i.e., different types of community partners, multiple instructors, various courses) to fully describe the phenomenon (Creswell, 2007; Strauss & Corbin, 1998). Theoretical sampling was used to identify community partner informants. The aim of theoretical sampling is to “maximize opportunities to compare events, incidents, or happenings to determine how a category varies in terms of its properties and dimensions” (Strauss & Corbin, 1998, 202). Sample size is determined as the study progresses. The goal is to reach theoretical saturation, that is, the point where reports of the phenomenon are redundant and analysis of additional data would offer no new theoretical insight.

Sample

Nine community partners participated in the study. All nine community partners engaged in service-learning projects conducted at the same southwestern university within a 12-month time frame. Service learning is a point of distinction for the university, which is listed on the Carnegie Classification for Community Engagement and the President’s Higher Education Community Service Honor Roll. While all community partners participated in service learning at the same university, the projects spanned multiple disciplinary areas: three in business, two in art, two in family studies, one in architecture, and one in nutrition.

The sample comprised key community partners from three organizations providing social services for children, three agencies supporting families in crisis, an arts community, a food facility, and a hospital foundation, for a total of nine organizations. Five of the nine organizations are affiliated with national service organizations. The organizations range in size from 6 to 41 employees and serve as few as 18 corporate clients and as many as 12,000 individual clients per year. Community partners held managerial positions and served their organizations for an average of 11 years, with a range of 2 to 23 years. Four projects were discrete projects conducted in one semester, four were ongoing relationships spanning multiple semesters, and one was a new relationship expected to continue for more than one semester.

Data Collection and Analysis

A semi-structured interview protocol guided interviews (see Appendix A). Interviews were conducted face-to-face at the community partner’s office and ranged from 30 to 45 minutes. All interviews were audio-recorded and transcribed verbatim. A content analysis of interview transcripts was conducted to categorize descriptions of community partners’ service-learning experiences. Content analysis is a research method for the objective, systematic analysis of verbal data (Berelson, 1952; Kassarjian, 1977). Pre-defined codes were developed by the three-member research team, and coding rules were established to ensure consistency in the coding process. The interview protocol supplied 10 categories used in the content analysis. During the coding process, an 11th category emerged — the benefits of service learning to students — that was subsequently defined and coded in all transcripts (Table 1). The unit of analysis was a complete sentence; each unit could be coded under multiple categories.

Each transcript was independently coded by two members of the research team. The researchers were trained in the use of a software tool specifically designed for coding, indexing, and searching qualitative data (NVivo, 2010). The software tool ensured systematic organization of the data, consistent application of codes throughout the coding process, and the ability to retrieve entire categories of content. A training transcript was independently coded by all three researchers, and category definitions were subsequently refined as needed to assure clarity of category definitions and consistency in coding. Overall, the coders achieved 86% agreement across the nine transcripts. Although there is no absolute threshold for the level of inter-rater reliability, agreement in excess of 70% is deemed reliable (Kurasaki, 2000). Differences were reviewed and resolved by consensus.

The research team applied standards for rigor in interpretive research to evaluate the trustworthiness of the data (Lincoln & Guba, 1985). The four criteria of the trustworthiness approach (i.e., credibility, transferability, dependability, and confirmability) correspond to the objective measures used in confirmatory, hypothesis-testing research (i.e., internal validity, external validity, reliability, and objectivity). Credibility was ensured through the use of member checks in which researchers’ interpretations were examined and confirmed by community partners. Transferability was accomplished by collecting data from multiple types of agencies, projects, and disciplines. The use of software for reliable storage and systematic coding of data, tests of inter-rater reliability in coding, and the use of written protocols in data collection and data analysis provide evidence for dependability of findings. Confirmability was addressed through the use of multiple researchers to minimize bias.

Results

The Community Partner’s Experience

Interviews began with a grand tour question that allowed community partners to describe a specific service-learning experience, from beginning to end. Their responses depicted a step-wise process of five stages that progress from initial contact through the wrap-up of a project.

Stage 1 — initial contact. Community partners were asked directly about their motivations for engaging in service learning and involvement during the course of the service-learning experience. In some cases the projects were initiated by the community partner. For some, the impetus was school loyalty: “I graduated in the architecture department and so I went back to a couple of [instructors] that I had. … I requested assistance with a project.” Another stated, “I’m a [university] grad and while I was in both undergraduate and graduate school, I was very involved with a particular [instructor] who was a lot about community service.” Community partners also found instructors through the university-wide service-learning office: “Originally when the call was made to the Service Learning Center, it was to discuss the need that I had to have some help to teach a pre-natal education class…and as I talked to [the staff person], she told me about the college of art and she said, ‘Do you ever need any artwork done for anything?’ and I said, ‘Oh, yes. That would be amazing.’”

In other cases, organizations were contacted by instructors who were searching for service-learning projects for their courses: “When the first class started with us…they did contact the current volunteer coordinator at that time.” Also, “When [the instructor] actually contacted me, he heard about us and I had direct communication with them, and we just kind of set up what the parameters would be for the class.” In one case, the students contacted the community partner at the request of the instructor, “[The students] said that they were assigned by [the instructor] to do a community-involved project and they chose us.” Outcomes and enthusiasm for individual projects did not vary based on who initiated the relationship.

Stage 2 — establishing expectations. In most cases, the instructor and community partner met in advance of the semester to discuss needs, set expectations, and define the plan for the semester. Community partners frequently commented on the need for continued faculty oversight throughout the semester as a key to a success: “[We] started off in the spring, talking about expectations and what we were looking for in terms of needs of our marketing campaign. We identified some of those strengths, and [the faculty member] worked on passing those to the other [instructors], so that worked really well to have that advanced kind of planning session.”

Stage 3 — engaging students. In most cases, community partners met directly with the students who would be working with the organization to introduce the organization, explain how the organization works, and discuss the needs of the organization. In some cases this was done in the classroom: “We actually came in and did an orientation with the class, and there were probably about 30 or so students, and that really helps to educate them a little bit more about what [the organization] does.” In other cases, community partners met with smaller groups or one-on-one: “We began to meet [with the students] and form our ideas and we noticed that this was a need that we had at [the organization] and so we developed the mentoring program.”

Stage 4 — implementing the project. Community partners reported multiple levels of interaction across the project time frame. As previously stated, the three primary stakeholders in service learning are the instructor, the students, and the community partner. The interviews revealed interactions with a fourth stakeholder — the client of the community partner — which is discussed in more detail subsequently. Community partners described ongoing coordination between themselves and the instructors: “[The instructor] was very thoughtful of us, and he coordinated with us, and was very easy to work with. Good professors are key, I think.”

The community partners described contact throughout the semester between themselves and the students: “[A student] was always helping us rearrange the seating for our shows, and helping find cost effective ways of selling our tickets for our auditorium.” Interaction was also reported between the students and the clients served by the community partner’s organization. One community partner had this to say about a mentoring program set up by a group of MBA students: “These kids [the organization’s clients] see these college students coming and interacting with them…the more interaction with the kids, the better it is, even for us.”

In describing how the projects unfolded throughout the semester, the majority of the community partners commented on how eager, creative, smart students make all the difference. This statement sums it up well: “I could just see light bulbs going off in their heads as they were listening and whenever they went off to their teams and talked about things.”

Stage 5 — wrapping up. Depending on the nature of the project, some community partners were presented with final reports, while others did not see the students again after the projects were completed. One community partner listened to nine proposals and voted on which was best: “We had to attend all of their final presentations that culminated all of their knowledge, so it was kind of working hand-in-hand with classroom experience.” Another listened to three presentations: “I think it went really well, it was really fun, and the last three sessions they brought us in and they did their pitch to us as if we were a real client.” A few community partners discussed having a debriefing session to discuss what did and did not work: “At the end of the semester we did a wrap-up. I went to their class and spoke, and we talked about what the experience had been and how they helped us.” While a wrap-up was not reported by the majority of community partners, those who had this experience reported it to be a very valuable component of their service-learning experience.

Although many community partners said they did not receive a tangible outcome from the project, at least a few did: “They gave us a campaign book with their slogan, their strategy, a budget, and we also gave them a mock budget, so that is what they built their campaign around.” Of those who did not receive a tangible report, some expressed a desire for closure after the project. One community partner stated,

It would be kind of nice to get a little bit of feedback from them [the students], even if it is some type of generic survey that we come up with or something, really, about their time here, and see if it really benefited them, and to see what they got out of it.

Another said, “I would like to know where they end up and know if they are using some of the knowledge they gained while they were here and in their professional lives.”

The Value of Service Learning for Community Partners

Community partners were encouraged to report the value of service learning to their organizations as well as to themselves. In doing so, they readily talked about direct benefits to the organization and the organization’s clients. While there was no question to elicit their views on the benefits of service learning to students, they readily expressed their appreciation for the opportunity to contribute to student learning.

Direct benefits of service-learning projects. Community partners often described the immediate benefits of service-learning participation in terms of the extra hands of volunteers to carry out the daily work of their organizations in the face of resource constraints: “We’re a nonprofit organization, and so we have a small staff, and so the … relief that they’ve been able to provide in the normal daily tasks has been great for the organization.” Student volunteers were described as energetic and willing to do whatever needed doing, often going well beyond the community partner’s expectations by helping with fundraisers and awareness events.

In addition to volunteer hours, community partners recounted the benefit of access to expertise beyond the capabilities of their organizations: “Working in a college community has a lot of perks because any of those research questions you have, you don’t have to do it yourself; you can use a student or class.” One project specifically addressed the use of social media to raise brand awareness for the organization:

Our expectation was to really help us look at new social media strategies … and to, as far as brand recognition, to see if people knew about us or not. … We also were hoping to glean from them some new ideas of how to spin volunteering for [this agency] to the public.

Community partners expressed great appreciation for the opportunity to “engage young minds … and recruit some creative thinkers” to address issues facing their organizations. Even when projects did not produce the expected results, community partners reported that the process provided new perspectives and information to “chew on in our staff meetings.” As one community partner summed up: “Strategies some of us had never even thought of before are now going through our minds.”

Supporting the organization’s mission. The most powerful stories told by community partners described the value of service learning in helping their organizations to achieve their missions. The students themselves were described as invaluable resources that facilitate “life-changing experiences” for clients:

Because the children here … face extreme hurdles, and part of what assists them in overcoming those hurdles is having a positive role model, and so … we’re able to provide such a life-saving, or life-changing, experience for our kids here that it really has had positive impacts on the families.

Service learning provided the necessary support for one agency to launch a mentoring program with university students as mentors to children from dysfunctional homes:

One client, for example, did not have custody of her children … her child was coming to the mentoring room and therapy …. And [because of] the positive impact that the mentoring program was having on her son … she regained full custody of her son. They are still coming to mentoring, still coming to counseling, and their lives are rejoined. So that is one specific instance in which mentoring saved a relationship between a mom and her son.

One agency completely reorganized to incorporate the availability of students engaged in service learning into its business model in order to serve clients more efficiently and effectively: “We would have waiting lists that were just endless. … Now with the program revamped, … we usually don’t have a waiting list …. This has been wonderful for our clients because they have been able to get the services they needed quickly.”

Serving the students. An unexpected finding was the extent to which community partners readily talked about how much they valued the opportunity to be involved in students’ learning and development. As one alumna said, “I wanted to come back … and help students learn just like I did whenever I was a student.” Another reported that service learning was “an extremely valuable experience for me, so I like to be the promoter of continuing that sort of actual hands-on type of community learning experience for students.”

Non-alumni also valued the opportunity to provide “real-world” experience for students: “I did want to get those students that experience of actually doing a presentation in front of someone who was a businessperson … I wanted them to have that opportunity.” Community partners described the intrinsic satisfaction gained in guiding students as they discover their vocations:

I enjoy watching them grow, and start to think about, ‘Am I really about to do this?’ And really make some decisions here about what they are going to do once they finish. So that is really wonderful to watch that process.

Although the majority of community partners reported positive outcomes and evaluations, the service-learning experience was not without challenges. The most frequently mentioned frustration was students who waited until the last minute and did not follow deadlines: “It seems at the end of the semester, [the students] all show up at the same time to get their credit in.” Another contact person for a project said the students were “not very good at planning, so they would wait until the last minute to ask for assistance…they would contact us Friday night and want to know if we could answer the questions for them.” The community partners were careful to communicate that this was not the case for all students, “there were just some of those instances, but it wasn’t that many at all.” Another called it an “age-old problem.”

Discussion

The goal of this research was to understand the value of service learning to community partners. Community partners described five stages in their experiences of service-learning projects: (1) initial contact; (2) establishing expectations; (3) engaging students; (4) implementing the project, and; (5) wrapping up. In describing this process, community partners provide insight into factors that set the stage for a valuable service-learning experience from their perspective. First, they expressed the need for continuous faculty oversight of projects. Competent faculty members who conscientiously plan for and monitor the project are crucial to success. Faculty should, therefore, be prepared to commit the necessary time to coordinate activities with the community partner and to supervise student participation in the project. To prevent misunderstandings, instructors are advised to clearly outline the time commitment in advance for all parties including the community partner, the instructor, and the students. Second, community partners reported the value of participating in the initiation of the project by conducting an orientation for students. Engagement early in the course results in clear communication about expectations for the service-learning project.

Community partners described three dimensions of the value of service-learning projects: (1) direct benefits to the organization; (2) support of the mission, and; (3) serving the students. Direct benefits included volunteer hours and access to expertise. For community partners with limited resources, service-learning projects provide assistance that the organization otherwise could not financially afford. However, the benefit of additional volunteer hours and access to expertise is sometimes diluted by the cost of managing students’ propensity to procrastinate. Faculty can address this issue by structuring deadlines within the project. For example, volunteer hours could be distributed across the course with bi-weekly deadlines to avoid the end-of-semester rush. Similarly, problem-based projects with tangible outcomes can be staged to require students to submit portions of final reports as the semester progresses, instead of submitting everything at the end of the term.

The most important dimension of value for community partners was the extent to which service-learning projects support the organization’s mission. When community partners were in need of solutions, students brought fresh perspectives and new energy. Service learning delivers the highest level of value for community partners when there is synergy between the mission of the organization and the goals of the service-learning project. Thus, faculty are advised to design service-learning projects with careful attention to the relationship between the project and the community partner’s mission.

A significant finding is the value community partners place on their role as mentors and co-teachers in service-learning projects. Community partners expressed a sincere dedication to the students and their learning experiences. Similar to faculty, community partners value the opportunity to design and implement projects that deliver high-quality learning experiences for students. Hence, it is important for faculty to provide feedback on the knowledge and skills the students are gaining from the projects. Community partners value closure on the projects. Therefore, instructors are advised to design service-learning courses in a way that allows students to report their learning to community partners, such as formal presentations or final reflection papers. Moreover, it is desirable for instructors to schedule debriefings with their community partners to close the loop on the experience. Giving community partners closure increases their perception of value, which, in turn, facilitates an ongoing relationship with the community partner and ensures positive word-of-mouth to other potential community partners.

Limitations and Further Research

The limitations of this study point to directions for further research. Findings suggest multiple dimensions of value for community partners as well as a set of factors that contribute to creating value. A survey could be developed to measure the various dimensions of value and to test the relationship between value and contributing factors. Survey research could address the limitation of generalizability of findings that is inherent in the qualitative design employed in the present study. The present study was conducted in a southwestern U.S. university town. Findings could be different for similar studies conducted in other regions of the country, or other countries, with different underlying cultural norms and values. Such studies might discover additional dimensions of value or identify other factors that predict value creation for community partners.

Conclusion

Based on the preliminary findings of this study, courses involving service learning should include the following:

• Early involvement of the community partner; a meeting prior to the start of the project to establish expectations in recommended.

• Close attention to the alignment of service- learning project goals with the mission of the organization.

• Continuous faculty oversight of the project.

• Providing closure to the community partner; communicating how the project benefited students is warranted.

• Formal distribution of student volunteer hours and/or staggered deadlines across the semester to avoid the end of semester rush.

Service learning is pedagogy with the potential for powerful impact on students, faculty, and community partners. It is our hope that findings in this study will be useful in advancing our understanding of how to design service-learning projects that deliver value to all stakeholders.

References

Astin, A.W., & Sax, L.J. (1998). How undergraduates are affected by service participation. Journal of College Student Development, 39 (3), 251–263.

Astin, A.W., Sax, L.J., & Avalos, J. (1999). The long-term effects of volunteerism during the undergraduate years. The Review of Higher Education, 21(2), 187–202.

Berelson, B. (1952). Content Analysis in Communication Research. Free Press: New York.

Brower, H.H. (2011). Sustainable development through service learning: A pedagogical framework and case example in a third world context. Academy of Management Learning & Education, 10(1), 58–76.

Campus Compact. (2003). Introduction to service-learning toolkit: Readings and resources for faculty. Providence, RI: Campus Compact Brown University.

Carson, R.L. & Domangue, E.A. (2012). Youth-centered service-learning: Exploring the professional implications for college students. Journal of Community Engagement and Scholarship, 3(2), 27–39.

Clayton, P.H., Bringle, R.G., Senor, B., Huq, J., & Morrison, M. (2010). Differentiating and assessing relationships in service learning and civic engagement: Exploitative, transactional, or transformational. Michigan Journal of Community Service Learning, 16(2), 5–22.

Conville, R.L., & Kinnell, A.M. (2010). Relational dimensions of service-learning: Common ground for faculty, students and community partners. Journal of Community Engagement and Scholarship, 3(1), 27–39.

Creswell, J.W. (2007). Qualitative inquiry and research design: Choosing among five approaches. Sage Publications: Thousand Oaks, CA.

Furlow, N.E. (2010). Shoptorebuild.org—A service-learning project to boost commerce after Hurricane Katrina. Marketing Education Review, 20(1), 41–45.

Geringer, S.D., Stratemeyer, A.W., Canton, A., & Rice, W. (2009). Assessing service-learning outcomes in a principles of marketing course: A team-based vs. individual-based approach. Journal for the Advancement of Marketing Education, 14, 1–12.

Hagenbuch, D.J. (2006). Service Learning inputs and outcomes in a personal selling course. Journal of Marketing Education, 28, 26–34.

NVivo (2010). Qualitative data analysis software; QSR International Pty Ltd. Version 9.

Jacoby, B. (1996). Service‐learning in higher education: Concepts and practices. San Francisco: Jossey-Bass.

Kassarjian, H.H. (1977). Content analysis in consumer research. Journal of Consumer Research, 4(1), 8–18.

Kenworthy-U’Ren, A.L., & Peterson, T.O. (2005). Service-learning and management education: Introducing the “we care” approach. Academy of Management Learning & Education, 4(3), 272–277.

Klink, R.R., & Athaide, G.A. (2004). Implementing service learning in the principles of marketing course. Journal of Marketing Education, 26, 145–53.

Kurasaki, K.S. (2000). Intercoder reliability for validating conclusions drawn from open-ended interview data. Field Methods, 12(3), 179–194.

Lester, S.W., Tomkovick, C., Wells, T., Flunker, L., & Kickul, J. (2005). Does service-learning add value? Examining the perspectives of multiple stakeholders. Academy of Management Learning & Education, 4(3), 278–294.

Lincoln, Y.S. & Guba, E.G. (1985). Naturalistic Inquiry, Sage Publications: Newbury Park, CA.

Metcalf, L.E. (2010). Creating international community service-learning experiences in a capstone marketing-projects course. Journal of Marketing Education, 32, 155–71.

Miron, D. & Moely, E.M. (2006). Community agency voice and benefit in service-learning. Michigan Journal of Community Service Learning, 12(2), 27–37.

Petkus Jr, E. (2000). A theoretical and practical framework for service-learning in marketing: Kolb’s experiential learning cycle. Journal of Marketing Education, 22, 64–70.

Pless, N.M., Maak, T., & Stahl, G.K. (2011). Developing responsible global leaders through international service-learning programs: the Ulysses experience. Academy of Management Learning & Education, 10(2), 237260.

Post, D.M., Kundt, F.S., Mehl, E., Hudson, W.A., Stone, L.C., & Banks, F.R. (2009). Twenty years of experience in service-learning at The Ohio State University college of medicine. Journal of Community Engagement & Scholarship, 2(1), 18–30.

Sandy, M. & Holland, B.A. (2006). Different worlds and common ground: Community partner perspectives on campus-community partnerships. Michigan Journal of Community Service Learning, 13(1), 30–43.

Schwartz, J., & Fontenot, R.J. (2007). Recreating the principles of marketing group project: a case study in service-learning. Journal for Advancement of Marketing Education, 11, 11–18.

Shaw, D.M. (2007). Building sales competencies through service- earning. Marketing Education Review, 17(1), 35–41.

Stewart, T. & Alrutz, M. (2012). Meaningful relationships: Cruxes of university-community partnerships for sustainable and happy engagement. Journal of Community Engagement and Scholarship, 5(1), 44–56.

Strauss, A. & Corbin, J. (1998). Basics of Qualitative Research, 2nd Ed. Sage Publications: Thousand Oaks, CA.

Vernon, A. & Ward, K. (1999). Campus and community partnerships: Assessing impacts & strengthening connections. Michigan Journal of Community Service Learning, 6(1), 30–37.

Warnell, J.M. (2010). An undergraduate business ethics curriculum: learning and moral development outcomes. Journal of Business Ethics Education, 7, 63–84.

Wilson, J.C. (2011). Service-learning and the development of empathy in U.S. college students. Education & Training, 53(2/3), 207–217.

Zlotkowski, E. (1996). Opportunity for all: linking service-learning and business education. Journal of Business Ethics, 15, 5–19.

About the Authors

Shannon B. Rinaldo is an associate professor of marketing in the Rawls College of Business at Texas Tech University. Donna F. Davis is an associate professor in marketing in the College of Business at the University of South Florida. Josh Borunda is a research assistant in the Rawls

The Spoken Word Project: Using Poetry in Community Dialogue and Mobilization for HIV Prevention

By: Malika Roman Isler, Guarav Dave, Heather L. Jones, Doris Stith, Tiarney Richwood, Turquoise Griffith, Leslie Atley, and Giselle Corbie-Smith

Abstract

        Spoken word, a form of performance poetry, is a promising approach to HIV/AIDS awareness and prevention, as it has the potential to encourage dialogue among and within communities and address concerns regarding the social stigma present in rural communities. The purpose of this study is to describe the development and implementation of the Spoken Word Project (SWP), an HIV/AIDS pilot intervention in rural North Carolina designed to improve HIV-related attitudes and self-efficacy and decrease stigma through the use of performance poetry. Spoken word is a collaborative effort between residents of two rural counties in North Carolina and Project GRACE (Growing, Reaching, Advocating for Change and Empowerment), a community-based participatory research collaboration aimed at reducing health disparities in African American communities. The project included 15 adult and youth participants. Results indicated that spoken word has the ability to build upon local resources, generate community reflection, and engage a broad spectrum of performers and audiences. Our findings also showed that the effect of stigma and limited community conversations about HIV in rural communities can be abated through the use of spoken word.
        Of all U.S. regions, the South has the highest rates of HIV diagnoses — 23.8 per 100,000 (Reif, Whetten, Osterman, & Raper, 2006); and 64% of people living with AIDS in rural areas reside in Southern states (Reif & Whetten, 2012). As these rural areas continue to disparately experience the burden of HIV/AIDS, limited community conversations about HIV severely hamper prevention efforts (Hovey, Booker, & Seligman, 2007; Lichtenstein, 2005; McEwan, Bhopal, & Patton, 1991)). The social challenges of HIV stigma, fear, and denial impede the delivery of prevention messages and efforts to mobilize communities most in need of intervention (Darrow, Montanea, & Gladwin, 2009; Foster, 2007). Prevention efforts in rural communities are further challenged by prevalent poverty that is linked to less HIV-related knowledge and a tendency to stigmatize those affected by the condition (Des Jarlais, Galea, Tracy, Tross, & Vlahov, 2006; Foster, 2007; Hovey, Booker, & Seligman, 2007). In 2010, a report released by the White House Office of National AIDS Policy further described stigma as adversely impacting willingness to be tested for HIV, to disclose their serostatus to sex partners, and adherence to antiretroviral therapy among people with HIV/ AIDS. The report recommended strategies to reduce stigma, which included community engagement to support people with HIV/AIDS and developing new public health approaches to HIV prevention (White House Office of National AIDS Policy, 2010). One such innovative approach, performance poetry, holds promise to raise awareness about HIV/AIDS, foster dialogue among communities, and overcome the social stigma present in rural communities.
        Poetry, along with other artistic forms of expression, has a rich history as a tool for community mobilization and has the potential to provide an innovative approach to dismantling social challenges (Niba & Green, 2005). Performance poetry, a form of poetry often performed as a dramatized monologue in the presence of an audience, provides a platform to transcend stigma and marginalization associated with HIV/AIDS, both of which are significant challenges to rural HIV prevention (Pietrzyk, 2009). In addition, the use of performance poetry can have both individual and community level benefits. Performers often report a sense of individual empowerment and self-healing from the process of self-reflection and sharing of their life experiences (Chung, Corbett, Boulet, Cummings, Paxton, McDaniel, Mercier, Franklin, Mercier, Jones, Collins, Koegel, Duan, Wells, & Glik, 2006; Des Jarlais et al., 2006; Valente & Bharath, 1999). For the audience or broader community, performance poetry encourages dialogue around HIV; dispels stigma by encouraging community-wide empathy and social responsibility; and creates opportunities to discuss strategies for communities to engage in HIV prevention (Moyo, 2010). In addition to stimulating community interest in socially relevant issues, performance poetry also promotes peer-topeer camaraderie and social relationships through critical reflection and exchange of ideas. This in turn encourages greater community mobilization and cohesion around an issue of importance (Pietrzyk, 2009; Valente & Bharath, 1999). For both performers and communities, performance poetry serves as a vehicle to disseminate information, dispel misinformation and myths that may be common to a local setting, and provide educational messages about transmission and protective barriers (Hovey, Booker, & Seligman, 2006; Lichtenstein, 2005; Moyo, 2010; Pietrzyk, 2009).
        Performance poetry is well suited for communicating messages within African American communities (Banks-Wallace, 2002). Oral traditions in U.S. black communities have a long history as intergenerational vehicles of expression, from slavery through the Harlem Renaissance, to the Civil Rights movement and current popular culture (Ashe, 2002). Performance poetry, colloquially referred to as spoken word, combines elements of music and literary expression that can appeal to audiences of varying ages, literacy levels, and socioeconomic classes. Given the ability of spoken word to attract large crowds (Chung et al., 2006; Valente & Bharath, 1999) and reach broad audiences at once, this art form circumvents many of the resource challenges that may be present in rural communities. In addition, the process of developing and delivering performance poetry is closely aligned with participatory approaches to addressing health in underserved communities. Developing spoken word within communities builds upon the local expertise and experience, and supports communities in generating local solutions to improving health. Performers who are in and of the community increase the impact of performance poetry, as audiences are more likely to identify with the performer and their message. In addition, in studies with youth poets, students identified with the performers and their experiences based upon similarities in age (McEwan et al., 1991). By building upon local community assets, the development and delivery of poetry builds collective self-efficacy to address HIV/AIDS, and creates a sustainable network to reinforce de-stigmatization and ongoing positive local change. The local investment and enactment of performance poetry promotes long-term sustainability that is similarly seen with other creative and participatory media methods, such as photovoice (Yonas, Burke, Rak, Bennet, Kelly, & Gielen, 2009).
        While performance poetry effectively engages individuals and communities in social and health issues, few examples exist in the literature around methods to use it for HIV prevention in rural communities. Here, we describe the development, implementation and evaluation of SWP, an HIV/ AIDS pilot intervention in rural North Carolina that aimed to improve HIV-related attitudes and self-efficacy and decrease stigma through the use of performance poetry.

Methods
Study Background
        The SWP is a collaborative effort between residents of Edgecombe and Nash Counties of NC and Project GRACE (Growing, Reaching, Advocating for Change and Empowerment), a community based participatory research (CBPR) collaboration aimed at reducing disparities in health in African-American communities. Conversations with community partners in Project GRACE highlighted the need to raise social consciousness and awareness about HIV in the local community, increase individual and collective self-efficacy to prevent HIV/AIDS, facilitate dialogue about HIV, and decrease stigma towards HIV in the local community. Both Edgecombe and Nash counties have three-year HIV disease rates above the state average; Edgecombe at 31.4 and Nash at 17.4 cases per 100,000 (North Carolina Department of Health and Human Services, 2013). In response, Project GRACE and local community members engaged adolescents and adults, who had participated in an HIV prevention intervention, in the SWP. The institutional review board of the University of North Carolina at Chapel Hill approved this study.

Recruitment and Data Collection
        We recruited adolescents and adults who: 1) self-identified as African-American, 2) were living in Edgecombe or Nash counties, and 3) were youth ages 10–17 years or caregivers at least 18 years of age. Recruitment postcards were sent to all eligible participants who had previously participated in another HIV prevention project, and consent was obtained before the project began. The SWP consisted of two phases: spoken word training and spoken word performances.

Spoken Word Training
        The materials for the SWP drew from curricula previously developed for photovoice projects and in consultation with spoken word poets. Training sessions were led by trained facilitators and co-facilitators selected by Project GRACE’s community partners. All facilitators were trained poets with prior experience in performance poetry. Additionally, we recruited four guest poets from diverse geographic regions, representing a range of performance styles and genres. The guest poets also served as a motivational force for participants in the poetry-forming process. Adolescents and adults participated in six three-hour sessions held at a local community hospital, one of the partners in Project GRACE. Transportation to and from the program was provided along with a $10 cash incentive for each of the six training sessions. Each session was designed to prepare participants to deliver a spoken word piece during a local showcase and a regional showcase on World AIDS Day.
        The training sessions employed Freire’s (1973, 1993) theory of critical consciousness to support individual and community understanding of the root causes of HIV/AIDS and in turn build selfefficacious behavior. We supported participants in matriculating through three stages: 1) apathy, where participants begin to care about the problem through discussion with facilitators, peers and trained poets, 2) social responsibility, where participants engaged with others directly affected by the social issue to gain a sense of empathy, and 3) action, where participants were armed with skills to produce influential change in their communities (Wallerstein & Berstein, 1998).
        Six session topics were chosen: (1) Introduction to Spoken Word; (2) What HIV/AIDS Means to Me; (3) How HIV/AIDS Has Affected My Community; (4) What My Community Can Do to Prevent HIV/AIDS; (5) Spoken Word — Putting It All Together; and (6) Community, advocacy, and spoken word (see Table 1).
        The first training session introduced participants to the performance poetry art form and how it can work as an advocacy and awareness tool within their communities. The next three sessions focused on eliciting participants’ local experiences with HIV and guided participants in creating their own spoken word pieces. The fifth session gave participants the opportunity to plan a showcase to feature each participant’s piece, using a video recording of a previous spoken word showcase as an example. The sixth session focused on advocacy and creating solutions for community issues through the use of poetry, and rehearsal for the showcase performances.
        During the first session, participants received a journal to record their thoughts and assignments, and to facilitate the writing process for the poetry. Each spoken word training session was designed and facilitated using WORD (Write, Our, Relating, Do), which is an adapted form of the SHOWED method that is commonly used in photovoice (Gubrium & Torres, 2013; Kubicek, Beyer, Weiss, & Kipke, 2012; Wang & Burris, 1994, 1997). WORD guides participants through a process of posing problems and critical thinking by using group dialogue and writing exercises. WORD answers these questions: What can we write down about what is happening in this community related to HIV? How does HIV relate to our lives and how does the issue make us and others feel? How can I explain my feelings to others in a way that they can related to my emotions about the issues surrounding HIV? How can I use spoken word to demonstrate what others can DO to improve HIV awareness and attitudes, decrease stigma, and promote community mobilization? Before starting the WORD process, each group listened to and experienced a performance poetry piece, presented by a guest poet. Following the WORD process, participants received a homework assignment to create their own poetry around the topics discussed during each session. To assist participants in developing the poetry pieces, the group engaged in a brainstorming session to generate words and ideas that could be used in their poetry. However, due to limited literacy in the adult class, the facilitator guided the group in the development of one group poem instead of individual poems. After the fifth session, each participant selected one of the pieces they developed during training to deliver during the showcases.

Spoken Word Performances
        The SWP participated in one local and one regional showcase for the participants to deliver their performance poetry pieces. For the local showcase, participants created an invitation list of community members, elected officials, family and friends. Based upon discussion during the training sessions, participants also decided on the color scheme, attire, decorations, and program for the showcase. Publicity for the showcase included a press release and advertisements in a local newspaper. On the day of the local showcase, participants completed a practice performance of their poems before performing live. The facilitators served as Mistresses of Ceremony introducing each poet (participant) and the title of their poem. Each poem was intended to raise awareness about HIV, dispel stigma, and advocate for change in the community around the issue of HIV. For the regional showcase, the SWP participants opened the program with their poetry pieces, followed by performances by a nationally renowned

Table 1. Section Spoken Word Training Components
Table 1. Section Spoken Word Training Components

motivational speaker, a national recording artist, and a national spokesperson.

Data Collection and Management
        Outcome evaluation. Participants in the SWP completed self-administered pre- and post-test surveys at the beginning and end of the entire training program. The survey included three domains: selfefficacy, attitudes and beliefs, and stigma. The 9-item collective/individual self-efficacy domain, which was comprised of items adapted from Chung, Jones, Corbett, Booker, Wells, and Collins (2009) and the study team, measured one’s ability to address the burden of HIV/AIDS within one’s community, both individually and collectively. Example items include, “I feel comfortable talking about HIV/AIDS” and “I feel that I have the ability to make change in my community.” The 13-item attitudes and beliefs domain, comprised of items adapted from Chung et al. (2009), measured one’s beliefs and attitudes about issues related to HIV/ AIDS. Examples from this domain include “I think HIV/AIDS is an important issue in my community” and “I think poetry is a better way to teach people than lecturing them about HIV/AIDS.” The 13- item stigma domain, comprised of items adapted from Chung et al. (2009) and Van Rie, Sengupta, Pungrassami, Balthip, Choonuan, Kasetjaroen, Strauss, and Chongsuvivatwong (2008), measured negative thoughts associated with HIV/AIDS. Examples from the stigma domain include “People with HIV/AIDS should not play with other people’s children” and “I view people with HIV/AIDS as unclean.” All the domain-specific responses were structured using a 5-point Likert scale (5=strongly agree to 1=strongly disagree).
        For the showcases, we asked all attendees to complete self-administered pre- and post-test surveys that included 7 items from the self-efficacy domain, 8 items from the attitudes and beliefs domain, and all 13 items from the stigma domain. Showcase responses also used a 5-point Likert rating scale (1=strongly disagree and 5=strongly agree).

Process evaluation. In addition, SWP participants evaluated each training session. Participant responses were rated on a 5-point rating scale (1=very poor to 5=excellent). Following each training session, staff from the University of North Carolina at Chapel Hill, also members of Project GRACE, led a structured debriefing session with the facilitator and co-facilitator to discuss any process or emergent issues from the session. Debriefing sessions lasted no longer than 30 minutes. The sessions were recorded and transcribed verbatim. An independent reviewer crosschecked the transcripts to ensure accuracy. To ensure confidentiality, all identifying information was removed from the transcript. Immediately following the fifth youth session, we also conducted a focus group and gathered information about youth perceptions of the process and impact of the SWP experience. Focus group questions further explored the concepts included in the process evaluation (e.g. perception of the guest poets, likes and dislike about the program content and structure, and perceived benefits and barriers to SWP participation, etc.). The focus group session, which lasted approximately 45 minutes, was recorded and transcribed verbatim.

Data Analysis
        We used IBM SPSS Statistics 21© software for statistical analysis and reporting. The final sample excluded individuals if they had missing data. The participants’ demographic characteristics and self-reported information were described using frequencies, means and percentages. A paired-sample t-test was used to examine whether change in the self-efficacy, attitudes and beliefs, and stigma scores (pre to post) differs significantly from zero. All other data were summarized using descriptive statistics such as means, medians, proportions, and standard errors, with 95% confidence intervals. The statistical significance for all analyses was based on the conventional alpha level of significance of 0.05.
        For the debriefings and focus group, two team members reviewed the transcripts independently to familiarize themselves with the data, and identify conceptual patterns and groupings of the text, commonly referred to as themes (Braun & Clarke, 2006). The themes were shared with the research team, including the facilitators, for verification of the themes.

Results
Demographic Characteristics
        A total of 15 individuals (adult n = 7, 47%; youth n=8, 53%) participated in the spoken word training sessions. All participants were African Americans and more than half (n = 9) were males (see Table 2). The showcase attendees were primarily African American (77.8%) and most had at least some college-level education (64.4%).

Table 2: Demographic Characteristics of Participants* and Showcase Attendees
Table 2: Demographic Characteristics of Participants* and Showcase Attendees

Impact of SWP Training on Participants
        All 15 participants (100%) completed the overall pre-test survey and 14 participants (93.3%) completed the overall posttest survey. In general, participants in the SWP training demonstrated improvement in self-efficacy and reduced stigma towards HIV, while attitudes and beliefs remained relatively unchanged (see Table 3).

Table 3. Pre-Post Mean Differences in the Spoken Word Project, NC 2012 Participant Training Outcomes* (n=14)
Table 3. Pre-Post Mean Differences in the Spoken Word Project, NC 2012
Participant Training Outcomes* (n=14)

        The overall domain-specific mean for self-efficacy increased from 3.19 at pretest to 4.44 at posttest, though this difference was not statistically significant. However, two individual items in the self-efficacy domain showed statistically significant improvement — I know how to talk to my community about HIV/AIDS (p<0.05) and I think about how my surroundings are connected to HIV/AIDS in my community (p<0.05). For attitudes and beliefs towards HIV/AIDS, the overall domain-specific mean decreased from 4.21 at the pre-test level to 4.16 at the post-level, though the mean difference of -0.42 was not statistically significant. None of the mean ratings for individual attitude and belief items were different between pre and post-test surveys at a level of statistical significance. For stigma, the overall domain-specific mean decreased from 2.72 at the pre-test level to 2.46 at the post-test level, indicating an improvement in stigma scores. While the overall mean difference for stigma was not statistically significant, two individual items showed statistically significant resultsPeople with HIV/AIDS should not play with other people’s children and I would want to keep my distance from people with HIV/AIDS (p<0.05).

Table 4: Training Session Evaluation Outcomes — Mean Ratings* in the Spoken Word Project, NC 2012
Table 4: Training Session Evaluation Outcomes — Mean Ratings* in the Spoken Word Project, NC 2012

SWP Training Process Feedback
        On the training evaluation surveys, participants indicated that all sessions were either good or excellent (see Table 4). Specifically, sessions received a rating of 4 or higher, indicating that participants believed that sessions provided clear examples, facilitated a better understanding and application of spoken word in their performance poetry pieces, and facilitated better understanding of the journaling assignments. They also rated discussions during each session as helping them think through the issues [related to HIV/AIDS] (mean > 4.0) and felt that the facilitators/co-facilitators answered all their questions clearly, making the sessions enjoyable to attend (mean >4). After training session 6, participants reported that they were confident in carrying out their assigned tasks for the community during spoken word showcase exhibits (mean = 4.2).
        Participants offered positive feedback, as well as opportunities to improve the Spoken Word Program. Overall, youth participants appreciated the peer-to-peer learning environment. Youth participants noted, “I like being in an environment with people around my own age”, “My friends want to see me perform” and “It [spoken word training] builds your confidence”. Facilitators noted during debriefings that working in small groups gave both youth and adult participants an opportunity to receive constructive feedback on poetry efforts, to work together to brainstorm themes and ideas outlined during training sessions, and learn from each other’s poetry styles.
        Most of the participants had no previous experience performing spoken word. Facilitators noted the benefit of audio-video examples of previous showcases that “worked well and helped as a reference point.” For participants with limited exposure to spoken word, “asking them to come up with something they’ve never done is hard and asking them to decide how [to develop performance poetry} would have been an issue. The video was very helpful.” In addition, the diversity of guest poets enhanced the training experience as youth participants described the poets as “inspiring” and offering “different experiences to draw from”.
        Youth also described challenges to participation that included a desire for more incentive money, conflicts with the day of the week the sessions were held (six consecutive Saturdays), and the burden of completing evaluations. While engaging participants in the planning of the showcases was meant to foster ownership and empowerment for participants, some facilitators noted challenges with participant’s ability to plan a public event. Given the wide range of cognitive and literacy abilities of participants, facilitators observed opportunities to modify some of the language used in the training and the strategies used for delivering the information. Specifically, one facilitator noted difficulty among adult participants with lower functional literacy in developing spoken word and the need for more practical examples to support the adult’s creative process. Adults also needed more affirmation to be comfortable performing spoken word.
        Overall, facilitators noted that participation in the training and showcase experience helped youth participants with their performance poetry skills as “they recognized rhythm, rhyme, tone, sound, movement and discussed posture and how it can keep or lose your audience.” As a result of participating in the spoken word training, youth participants expressed that they “understand they have a voice in the community.”

Themes of Spoken Word Poetry
        The SWP participants developed a total of 36 poems during the spoken word training and chose 14 of those to perform for the showcase. Participants used poetry to cover a range of themes related to HIV. As part of the apathy stage of the SWP training, over half (8 out of 14) of the individuals described risk behaviors that contribute to risk for acquiring HIV; ranging from using “dirty needles” and having unprotected sex to not getting an HIV test and being unaware of one’s sero-status. Consistent with the “action” stage of the SWP training, most (6 out of 8) of these individuals also offered strategies to individuals to protect themselves from HIV infection by “being aware”, using clean needles, and practicing sexual abstinence. Half of the participants (7 out of 14) reflected the “apathy” stage of training through their focus on the personal experiences of people living with HIV/AIDS (PLWHA) and the impact of HIV on PLWHA’s significant others. Participants referred to the loss of friends who died from AIDS, the need for PLWHA to take pills every day, and even the pain of mothers seeing their children cope with living with HIV. One participant’s poem described the sexual risk behaviors that can lead to HIV infection, the personal awareness of becoming infected, and issued a warning to other members of the community to encourage others not to become infected:

I woke up this morning, happy as I could be,
not knowing that I had HIV.
It is something that I did not want to happen to me.
My mother warned me, “Son, be careful out there because of HIV,
it is easy to get,” but I did not listen.
I know the things that I didn’t do:
I know I got caught up with me using bad
needles that weren’t cleaned,
having sex with every woman that gave it
up free with no protection thinking that I
didn’t need it [protection].
Feeling bad and saying, “Man, it couldn’t have been me,
taking pills everyday though saying to myself, ‘What can I do?’”
I heard a voice say, “Pray, and I’ll pray for you.”
So remember, people, don’t do what I did!
Using needles that wasn’t cleaned.
Laying with every woman that give it up free.
If you do that, you won’t catch HIV.
Oh my God, it happened to me!

        Two participants spoke directly to the stigma associated with HIV/AIDS, and one described the subsequent need for communities to “respect those with HIV.” Several participants incorporated faith principles as part of the coping experience for PLWHA, and described “God watching over those with HIV” and “His love and strength” helping PLWHA to cope. Interestingly, a couple of participants also noted the critical role of PLWHA in generating apathy by sharing their personal experiences with others, and demonstrating their stories of perseverance and survival. As part of their social responsibility, some participants also used their poetry to describe action steps that individuals within the community can take to promote HIV prevention (i.e. be a community spokesperson, get the word out, make your voices heard, do your research, be unified, etc.)
Spoken Word Showcase Outcomes
        We reached approximately 200 adults and youth through the national showcase, which took place on World AIDS Day in Raleigh, NC through sponsorship from Black Entertainment Television’s Wrap It Up Campaign. Overall 33 individuals completed the pre and posttests assessments. The self-efficacy of the showcase attendees to address the burden of HIV/AIDS in their community remained relatively unchanged from pre (4.41) to post (4.39) and the difference was not statistically significant. The attendees had very positive attitudes and beliefs towards HIV/AIDS with a mean rating of 4.52 at pre-test, which remained unchanged at the end of the showcase. In assessing stigma associated with HIV/AIDS, we found that the mean ratings decreased from 1.72 at the pretest level compared to 1.67 at the posttest level. While this mean difference was not statistically significant, the decrease in mean ratings suggests an overall improvement in attendee’s stigma associated with HIV/AIDS. None of the mean differences for domain-specific individual items were statistically significant.

Discussion
        The purpose of the SWP was to facilitate community conversations about HIV/AIDS, to improve self-efficacy, attitudes, and beliefs about HIV, and to reduce stigma within a rural community. Participant representatives and other stakeholders guided the development of the SWP components thereby enhancing shared norms, common values and desire to address a mutual need — HIV prevention. This pilot relied on existing community resources and strengths by recruiting poets, facilitators and co-facilitators for the training sessions from within the community. We built upon the inherent social relationships and experiences within a rural community by involving community members, academic researchers, community organizations and local public officials in supporting community dialogue and decreasing stigma around a significant health concern identified by members of this community: HIV/ AIDS.
        Artistic forms of expression have often been used to identify issues of concern to a community and their use has the potential to lead performers, as well as their audiences, through a process that promotes social change (Fliegel 2005). The participants in the SWP appeared to move through the process of critical consciousness, which has been described as a process through which marginalized individuals interpret their social conditions and consider ways in which they could respond that might facilitate change (Freire, 1973, 1993). As demonstrated in other community interventions that utilized creative forms for expression, through poetry, performers in the SWP were able to engage with the issue of HIV in their communities and both performers and their audience were able to reflect on their role in addressing it (Gray, Oré de Boehm, Farnsworth, & Wolf, 2010).
        The demonstrated effect of the Spoken Word Project is similar to other applications of CBPR and the arts. For example, researchers using photovoice have successfully created “voice” among rural populations to tell their stories in their own words, and shifted participant roles from learners to teachers in their communities (Gubrium & Torres, 2013; Kubicek et al., 2012; Wang & Burris, 1994, 1997). The use of narratives and the transition of community members to leaders is necessary to bridge communication with local policymakers who develop governance for HIV prevention and treatment services. For both showcases, participants invited and shared their perspectives with influential people to whom they might not normally have access. Previous research has also suggested that poetry, in particular, can be a powerful means to allow groups that have been marginalized to express their perspectives and engender empathy for their concerns (Nyamathi, Slagle, Thomas, Hudson, Kahilifard, Avila, Orser, & Cuchilla, M. 2011).
        The SWP demonstrated benefits for both participants and the local community by improving some aspects of self-efficacy among participants and reducing HIV-related stigma among both participants and showcase attendees. These findings indicate that performance poetry may be an effective vehicle to raise awareness about HIV and support individuals to take action to address HIV associated stigma in their communities. The preliminary effectiveness of the SWP rested in its ability to effectively train local youth and adults to deliver messages using an innovative, culturally relevant, and sustainable approach. Consistent with this idea, others have shown that HIV interventions that are interactive by design, including those employing small groups and community-level engagement, have been shown to be the most effective in facilitating behavioral change and risk reduction (Albarracin et al. 2005).
        In addition to local performers, a contributing factor to the success of this intervention included the participation of the facilitators and co-facilitators, who were trained poets and selected by GRACE community partners. Other studies demonstrate that community-engaged interventions tend to be more successful when the facilitators share characteristics, such as age, ethnicity, and other demographic factors, with participants and target consumers, as was the case with the SWP (Crepaz et al., 2006). In addition, community-based interventions often face the challenge of sustainability (Minker, 2005); however, by building a cadre of local spoken word trainers and performers, SWP helped to create a local resource for continued community conversations to support HIV prevention and further reduce the local stigma surrounding HIV.
        Despite the overall success of SWP, there were some limitations. First, we experienced significant challenges with collecting data during the course of the showcases. In order not to disrupt the flow of the arrivals, only attendees who visited the project table during the pre-show exposition had the opportunity to complete the pre and post assessments. In addition, participants that arrived close to the start of the showcase or late were unable to participate in data collection. This logistical challenge limited our ability to determine effects of the SWP among attendees. Second, self-efficacy, attitudes and beliefs among showcase attendees completing the pre and posttest surveys were relatively high at pretest, which left little room for improvement (i.e., ceiling effect). It is also possible that attendees who self-selected into data collection may be more interested in and sensitive to the issues surrounding HIV within this rural community. Completion of the pre and posttest survey among a broader range of attendees may have presented a better understanding of community measures prior to and after participation in a spoken word showcase. In addition, we recruited the participants from a previous HIV prevention study — Teach One Reach One project. As a result, spoken word participants began the training with largely favorable attitudes and beliefs towards HIV/AIDS at the pre-test level, here again a possible ceiling effect. Future applications of spoken word in community settings will need to ensure participation by individuals that represent a broader cross-section of the community.
        While the SWP was designed as an intergenerational training, facilitators noted challenges to developing performance poetry that were specific to adult participants. The opportunity to stimulate dialogue around HIV/ AIDS prevention is clearly beneficial across all age groups; however, youth in this setting may feel more comfortable using the arts to facilitate community conversations. In addition, both counties have fewer residents with at least a high school education than is reported for the state overall (84.1% compared to 77.9% and 81.9%, respectively), which may explain some of the challenges with literacy that we encountered with adult participants. We felt it was important to make sure all voices were heard and made modifications to help individuals translate their ideas into individual written pieces. Given the strength of performance poetry as an oral art form, it may be particularly important that future programs employ activities and assignments that rely less on written formats (i.e., use of audio recording, videos, etc.) so that those most affected by health inequities can participate fully.
        Performance poetry builds upon local context and resources, generates community reflection and mental imagery regarding a health issue, and engages a broad spectrum of performers and audiences. Our findings show that the effect of stigma and limited community conversations about HIV in rural communities can be abated through the use of spoken word. As a form of performance poetry, spoken word provides channels of communication and benefits for those directly engaged in training and those who attend performances. As a strategy that leverages local experiences and capacity, performance poetry is a promising approach to raise HIV awareness, promote community conversations, and improve stigma in rural African American communities.

References

        Albarracín, D., Gillette, J.C., Earl, A.N.,
Glasman, L.R., Durantini, M.R., & Ho, M. (2005).
A test of major assumptions about behavior change:
A comprehensive look at the effects of passive and
active HIV Prevention interventions since the
beginning of the epidemic. Psychological Bulletin,
131(6), 856–897. doi:10.1037/0033–2909.131.6.856
        Ashe, B. (2002). From within the frame:
Storytelling within African-American Studies. London:
Routledge.
        Banks-Wallace, J. (2002). Talk that talk:
Storytelling and analysis in African American oral
tradition. Qualitative Health Research, 12(3), 410–
426.
        Boneh, G., & Jaganath, D. (2011). Performance
as a component of HIV/AIDS education: Process
and collaboration for empowerment and discussion.
American Journal of Public Health, 101(3), 455–464.
doi:10.2105/AJPH.2009.171991
        Braun, V., & Clarke, V. (2006). Using thematic
analysis in psychology. Qualitative Research in
Psychology, 3(2), 77–101.
        Chung B., Corbett, C.E., Boulet, B., Cummings,
J.R., Paxton, K., McDaniel, S., Mercier, S.O.,
Franklin, C., Mercier, E., Jones, L., Collins, B.E.,
Koegel, P., Duan, N., Wells, K.B., & Glik, D. (2006).
Taking wellness: A description of communityacademic
partnered project to engage an AfricanAmerican
community around depression through
the use of poetry, film, and photography. Ethnicity
& Disease, 16, S1–67–S1–78.
        Chung, B., Jones, L., Jones, A., Corbett, C.E.,
Booker, T., Wells, K.B., & Collins, B. (2009). Using
community arts events to enhance collective
efficacy and community engagement to address
depression in an African American community.
American Journal of Public Health, 99(2), 237–244.
doi:10.2105/AJPH.2008.141408
        Communicable Disease Surveillance Unit,
North Carolina Division of Public Health (2013).
2012 HIV/STD surveillance report, North Carolina
Department of Health and Human Services.
        Crepaz, N., Lyles, C.M., Wolitski, R.J., Passin,
W.F., Rama, S.M., Herbst, J.H., Purcell, D.W.,
Malow, R.M., & Stall, R. (2006). Do prevention
interventions reduce HIV risk behaviors among
people living with HIV? A meta-analytic review of
controlled trials. Aids, 20(2), 143–157.
        Darrow, W.W., Montanea, J.E., & Glasman,
L.R. (2009). AIDS-related stigma among Black and
Hispanic young adults. AIDS and Behavior, 13(6),
1,178–1,188.
        Des Jarlais, D.C., Galea, S., Tracy, M., Tross,
S., & Vlahov, D. (2006). Stigmatization of newly
emerging infectious diseases: AIDS and SARS.
American Journal of Public Health, 96(3), 561–567.
doi:10.2105/AJPH.2004.054742
        Fliegel, L.S. (2005). “I love ballet”: Arts
incentives for adolescent health and community
development. New Directions for Youth Development,
2005(106), 49–60.
        Foster, P.H. (2007). Use of stigma, fear
and denial in development of a framework for
prevention of HIV/AIDS in rural African American
communities. Family & Community Health, 30(4),
318–327.
        Freire, P. (1973). Education for critical
consciousness. New York: Continuum.
        Freire, P. (1993). Pedagogy of the oppressed. New
York: Continuum.
        Gray, N., Oré de Boehm, C., Farnworth, A., &
Wolf, D. (2010). Integration of creative expression
into community based participatory research and
health promotion with Native Americans. Family
& Community Health, 33(3), 186–192. doi:10.1097/
FCH.0b013e3181e4bbc6
        Gubrium, A.C., & Torres, M.I. (2013).
The message is in the bottle: Latino youth
communicating double standard ideologies
through photovoice. American Journal of Health
Education, 44(3), 146–155. doi:10.1080/19325037.
2013.767735
        Hovey, J.D., V.B., & Seligman, L.D. (2007).
Using theatrical presentations as a means of
disseminating knowledge of HIV/AIDS risk factors
to migrant farmworkers: An evaluation of the
effectiveness of the inf´ormate program. Journal
of Immigrant Health, 9(2), 147–156. doi:10.1007/
s10903–006–9023–9

        Kubicek, K., Beyer, W., Weiss, G., & Kipke,
M.D. (2012). Photovoice as a tool to adapt an
HIV prevention intervention for African American
young men who have sex with men. Health
Promotion Practice, 13(4), 535–543.
        Lichenstein, B. (2005). Caught in the clinic:
African American men, stigma, and STI treatment
in the Deep South. Gender and Society, 18(3), 369–
388. doi:10.1177/0891243204264809
        McEwan, R.T., Bhopal, R., & Patton, W. (1991).
Drama on HIV and aids: An evaluation of a theatrein-education
programme. Health Education Journal,
50(4), 155–160. doi:10.1177/001789699105000402
        Minker, M. (2005). Community-based research
partnerships: Challenges and opportunities. Journal
of Urban Health, 82(2), ii3-ii12.
        Moyo, C. (2010) Investigating performance
poetry as a medium for addressing HIV/AIDS
stigma. Retrieved from WIReDSpace Electronic
Theses and Dissertations (http://hdl.handle.
net/10539/8885).
        Niba, M.B., & Green, J.M. (2005).
Major factors influencing HIV/AIDS project
evaluation. Evaluation Review, 29(4), 313–330.
doi:10.1177/0193841X05276654
        Nyamathi A., Slagle, A., Thomas, A., Hudson,
A., Kahilifard, F., Avila, G., Orser, J., & Cuchilla,
M. (2011). Art messaging to engage homeless
young adults. Progress in Community Health
Partnerships: Research, Education, and Action, 5(1),
9–18. doi:10.1353/cpr.2011.0012
        Pietrzyk, S. (2009). Artistic activities and
cultural activism as responses to HIV/AIDS in
Harae, Zimbabwe. African Journal of AIDS Research,
8(4), 481–490.
        Reif, S., Whetten, K., Ostermann, J., & Raper,
J.L. (2006). Characteristics of HIV-infected adults
in the Deep South and their utilization of mental
health services: A rural vs. urban comparison.
AIDS Care, 18(S1), 10–17.
        Reif, S., & Whetten, L.K. (2012). SASI
update: The continuing HIV crisis in the US south,
southern HIV/AIDS strategy initiative. Retrieved,
2014, Retrieved from http://hivlawandpolicy.
org/sites/www.hivlawandpolicy.org/files/The%20
Continuing%20HIV%20Crisis%20in%20the%20
U.S.%20South%20%28Southern%20HIV%20
AIDS%20Strategy%20Initiative%29.pdf
        Valente, T., & Bharath, U. (1999). An evaluation
of the use of drama to communicate HIV/AIDS
information. AIDS Education and Prevention, 11(3),
203–211.
        Van Rie, A., Sengupta, S., Pungrassami, P.,
Balthip, Q., Choonuan, S., Kasetjaroen, Y., Strauss,
R.P., Chongsuvivatwong, V. (2008). Measuring
stigma associated with tuberculosis and HIV/AIDS
in southern Thailand: Exploratory and confirmatory
factor analyses of two new scales. Tropical Medicine
& International Health, 13(1), 21–30.
        Wallerstein, N., & Bernstein, E. (1988).
Empowerment education: Freire’s ideas adapted
to health education. Health Education and Behavior,
15(4), 379–394.
        Wang, C., & Burris, M. A. (1994). Empowerment
through photo novella: Portraits of participation.
Health Education and Behavior, 21(2), 171–186.
doi:10.1177/109019819402100204
        Wang, C., & Burris, M.A. (1997). Photovoice:
Concept, methodology, and use for particpatory
needs. Health Education and Behavior, 24(3), 369–
387. doi:10.1177/109019819702400309
        White House Office of National AIDS Policy.
(2010). National HIV/AIDS strategy for the United
States.
        Yonas, M.A., Burke, J.G., Rak, K., Bennett,
A., Kelly, V., & Gielen, A.C. (2009). A picture’s
worth a thousand words: Engaging youth in CBPR
using the creative arts. Progress in Community Health
Partnerships: Research, Education, and Action, 3(4),
349–358. doi:10.1353/cpr.0.0090

About the Authors

        Malika Roman Isler is an assistant professor in the Department of Social Medicine, School of Medicine at The University of North Carolina at Chapel Hill. Tiarney Ritchwood is a postdoctoral research associate at the Center for Health Equity Research at The University of North Carolina at Chapel Hill. Guarav Dave is the administrative director of the North Carolina Translational and Clinical Sciences Institute at the Center for Health Equity Research at The University of North Carolina at Chapel Hill and evaluation chair of the Southeast Genetics Regional Collaborative. Heather L. Jones is a medical student at the School of Medicine at The University of North Carolina at Chapel Hill. Doris Stith is the executive director of the Community Enrichment Organization in Rocky Mount, NC. Turquoise Griffith is a former master’s student at The University of North Carolina at Chapel Hill. Leslie Atley is the project coordinator at Project Grace and social clinical research specialist at the Cecil G. Sheps Center for Health Services Research at The University of North Carolina at Chapel Hill. Giselle CorbieSmith is a professor in the Department of Medicine and Center for Health Equity Research at The University of North Carolina at Chapel Hill.

Developing Conceptual and Methodological Foundations in Community Engagement

David P. Aday, Jr., Joanna K. Weeks, Christiana E. Sherman, Robert A. Marty, and Rebecca L. Silverstein

Abstract

        We describe the efforts of two related undergraduate projects to promote lasting social change in marginalized communities in the Dominican Republic and Nicaragua. The projects represent a test of the premise that undergraduate projects can engage academically based strategies and transcend good intentions to achieve effective community partnerships to improve health and health care. The projects proceed from a perspective and theory of marginalization and its consequences. Specifically, marginalization undermines individual and collective capacity to meet basic needs and efforts to thrive. Through strengthening social infrastructure, communities can overcome the effects of marginalization. Project work begins with annual medical clinics and, with the permission of community residents, team members conduct ethnographic descriptions of the communities and their health and health care concerns and resources. We use social network analysis (SNA) and geographic information system (GIS) techniques to describe social infrastructure. Working from those foundations, both projects have enabled increased social infrastructure. To date, we have observed increased communication among community residents, facilitated the development of community-endorsed five-year plans, and established partnerships with regional and international groups.

Community Engagement: Conceptual and Methodological Foundations
Introduction
        Writing from a student perspective, Bessaw, Gerke, Hamilton, and Pulsipher (2012) sketch issues that dog those committed to community engagement and scholarship in higher education: constraints on time, energy, and talent; compressed time frames; community apathy; and issues of trust. Over the course of the semester, these ambitious graduate students in bioregional planning hosted five community meetings. They reported that a core of about 10 residents attended meetings regularly and that they struggled to communicate effectively with residents throughout the community. Some residents expressed concerns about sustainability and some recalled earlier failed attempts at organizing. Still, Bessaw and her colleagues report that none of the locals stepped into active roles of leadership and that residents remained discouraged about prospects for the future.

        To be certain, community engaged scholarship in higher education faces challenges in addition to these, including institutional resources and academic values. Still, the issues identified by Bessaw et al. (2012) are sufficiently daunting and pervasive to warrant unpacking, closer examination, and some effort toward resolution.

        Often, students and scholars are drawn to community engagement by their concerns for inequities and injustices of various sorts, including those that involve health, the environment, employment, and human rights. For example, Bessaw et al. (2012) responded to issues of high unemployment in Priest River, Idaho. It is unlikely that these students expected to accomplish fundamental economic change. Instead, they articulated the following goals: (1) to establish a common vision; (2) to create a toolbox for the community to use in future projects; and (3) to identify leaders to ensure project sustainability. These students, and others who pursue community engagement research and action, share in common with contemporary students of international development certain philosophical predispositions (cf. Handler, 2013):

  • Intentional social change or development can be progress toward a better life,
  • Community-engaged work and development should entail cooperative, egalitarian social relationships.
  • Good communications are central to community-engaged social change and development

SAMOS and MANOS
        Undergraduate students at William & Mary combined these predispositions with concerns about health disparities in marginalized communities to form two independent but closely related projects: the Student Organization for Medical Outreach and Sustainability (SOMOS, working in a barrio near Santo Domingo, Dominican Republic) and Medical Aid Nicaragua: Outreach Scholarship (MANOS, working in communities in the microregion of Cuje, Nicaragua). With the guidance of a faculty mentor (co-author Aday), students in the two projects confronted the challenge of figuring out what undergraduates could offer to those who lack even the most basic health services. Working with the communities, SOMOS and MANOS sought to respond to the health problems that confront people in countries around the world: water, flooding, nutrition, and non-communicable diseases, among others.

        Over time, the projects have taken shape, emerging as variants of community-engaged scholarship. They are grounded in theories of marginalization, alienation and an evolving model of participatory development. The work proceeds through community-based research that is based in a developing partnership between the communities and the projects (Minkler & Wallerstein, 2011). Students at William & Mary compete for selection and remain with the project until they graduate. All team members take a required seminar each semester of their tenure, which has necessitated the creation of a pedagogy that takes into account the needs of both new and seasoned members. These arrangements answer some, but not all, of the issues raised by Bessaw and her co-authors. For example, the problem of constrained time is mitigated somewhat because team members work in the same communities (in each country) over years — now nearly a decade in both countries. Project teams travel each year for week-long trips (SOMOS during the semester break and MANOS during the spring break). Smaller teams do field research, project development and implementation during the summer and at one other time each year (i.e., semester break for MANOS and spring break for SOMOS). The summer work typically consists of several weeks to two months of continuous engagement. In total, project teams are in the communities in each country for seven to 10 weeks each year. In addition, we remain in phone or internet communication with our community partners throughout the year, in spite of the fact that both communities lack convenient access to even the most basic infrastructure (e.g., telephone lines or reliable electricity).

        Inadequate resources continue to nag but some partnering strategies are providing modest hope for progress. For example, both projects, in partnership with the communities, have submitted successful proposals for collaborating with Engineers Without Borders (EWB). Beginning with very limited engagement by residents and with widespread discouragement in both communities, our efforts have focused on nurturing collective capacity. The EWB proposals were advanced through community committees comprising elected or selected representatives from each of the block or focus groups in each community. The committees were selected by groups of residents, and these groups were identified through multiple rounds of social networks analysis, as described below. The committees are gaining status as standing arrangements to act on behalf of the communities on matters concerning access to water in Nicaragua)and flood mitigation in the Dominican Republic. EWB teams have visited the communities, collected data necessary to engineering proposals, and are working through community arrangements that have been nurtured through SOMOS and MANOS efforts in the communities.

        What follows is an account of the framing theory, evolving model of development, and basic methods of research of the SOMOS and MANOS projects. An overarching hope of this work is that students, professionals, and, most of all, community residents will see that intentional social change is possible through effective partnerships that combine systematic knowledge and local wisdom.

From Philosophy to Perspective
        SOMOS and MANOS began through the initiative of undergraduate students whose understandings of community engagement were enlightened by direct experience in service and humanitarian projects. In both cases, students returned from “health brigade/duffel bag medicine” (Roberts, 2006) trips with a strong sense of futility: “Like putting a Band Aid on cancer,” observed a founding member of SOMOS. However, none of the original student members had clear notions about what could be done to satisfy their sense that good intentions are not sufficient, or to tap the power of knowledge and research of their university setting.

        From the start, we agreed to some mantras:

  • Good intentions are dangerous things
  • Every helping act is a political decision
  • Change is not sustainable unless it creates new resources

        It was clear that improving health and health care would be the central focus of our work. We began by hosting annual free clinics in both communities. SOMOS established a relationship with an alumnus physician, and he became the medical director in the Dominican Republic. The team partnered with a health foundation (Fundación Sol Naciente), whose founding director also is the director of Physicians for Peace for Latin America and the Caribbean. Medical providers are recruited annually and oftentimes more than half-a-dozen medical professionals accompany the project. In Nicaragua, MANOS contracted with a physician from Managua. In exchange for salary and travel expenses, this medical professional has provided clinical services and leadership from the beginning. More recently, American-trained medical professionals have joined the clinical staff and provide expertise for the clinical aspect of the project work.

        The medical clinics do not yield the envisioned improvements in health and health care. Rather, they provide entrée to the communities: SOMOS and MANOS offer annual clinics and then ask residents if they may conduct research in order to find more continuous and sustainable strategies for improving health and health care. This practice of offering a concrete and needed resource provides initial credibility and encouragement about the prospects for change.

        In the first years, students approached the work with a variety of notions about the causes of observed problems of health, safety, and well-being, including the following:

  • Lack of information and education
  • Unemployment and limited job skills
  • Discrimination on the basis of national (e.g., Haitian) and ethnic (e.g., Chorotega indigenous) status
  • National and international economic exploitation
  • Poverty

        As the seminars continued, students expressed suspicions that these problems did not exist as separate entities but instead represented recognizable symptoms of a greater and more systemic issue. In the course of studying literature on service, voluntarism, community, and social change, and through descriptive field research (ethnographic and GPS-based observations of the community), a perspective emerged that focused attention on marginalization.2 To illustrate how the current theory and model developed from these initial hunches, early research findings are summarized below (2007–2009).

        SOMOS students made early and thoughtprovoking observations about Paraiso, a region consisting of multiple barrios, or communities. For example, although Paraiso sits within a twentyminute walk of a major metropolitan center with access to most parts of Santo Domingo, many parts of the area are rural. The transition from urban to rural occurs abruptly as the traveler leaves a major urban street (paved) and turns onto a rough and rutted dirt road that leads to the main sub-community of Altos de Paraiso. From these observations, SOMOS appropriated the term “paraurban” to describe the locality of the Paraiso region and to characterize aspects of Paraiso’s physical and socio-economic location.3

        Esfuerzo is one of the barrios that comprise the area known as Paraiso, and is the focus of our current research and development projects. It provides a micro example of social and geographic positioning of community.4 It is cut off from the rest of Paraiso by a flood control canal that either reduces or worsens the effects of flooding for members of the Paraiso community, depending on where they live. Those who benefit most from the canal live in the community of Altos, which means “high.” Altos is adjacent to Esfuerzo, but as its name suggests, it enjoys both higher elevation and better access to basic resources, including water, electricity, and our own annual medical clinics, which are hosted in the Altos public school. In a significant sense, the SOMOS team discovered Esfuerzo as residents of Altos attempted to guide field research away from the locality, expressing the opinion that the area is not part of the larger community (Paraiso). Over the next years, it was determined empirically that Esfuerzo actually was and is part of Paraiso. The municipal government identifies it as “Esfuerzo de Paraiso,” though early on, residents of the local barrio were uncertain of its official designation, even referring to it by various derogatory names.

        Most of the residents of Esfuerzo have lived in the community for about 10 years and were displaced from their earlier residences by the expansion of tourism (as part of larger, national economic shifts and changes in agricultural labor (especially increased employment of Haitian sugarcane workers; cf. Gregory, 2006). There are few extended family ties in the community and the residents are not able to find steady work with the low-level farm-labor skills that they have.

        The MANOS team works in a micro-region called Cuje, which comprises eight remote and widely dispersed communities. Our research and development projects are centered currently in Chaguite. Some of the communities are geographically identifiable by proximity to a school that bears the community name. Otherwise, there are few local features to signify collective identity.

        The historical, political, and economic sources of marginalization in Chaguite center on the clearcutting of the evergreen forests that characterized the region until the 1960s. At that time, residents of the micro-region mostly engaged in hunting and fishing for their livelihood. With accommodating national policies, foreign corporations purchased land resources rights5 and proceeded to cut trees. With few remaining trees, the ponds and lakes dried up and the small game stocks were exhausted quickly. Within a decade, the region began to experience alternating flooding and drought and residents turned to subsistence farming without the knowledge or skills needed and with little arable land beyond the rapidly eroding hillsides (Manachon & Gonda, 2010).

        The faculty advisor for both SOMOS and MANOS had the advantage of observing across the projects and noted important similarities in both clinical and research findings. For example, while the localities are disparate (para-urban vs. extremely remote, rural, and sparsely populated), the communities share core health issues: flooding; lack of access to clean water for drinking, cooking, and cleaning; poor nutrition; and high rates of diabetes and hypertension.

        Field research, consisting of house-to-house interviews and geo-coding in Esfuerzo and in Chaguite, yielded descriptions of housing, water resources, sanitation, flooding, and health resources and risks. The projects’ goals were to: (1) learn about residents’ health and health care concerns; (2) identify collectively shared priorities; and, (3) use the resulting understandings to encourage community engagement in collective efforts through a sense of commonality. Responding in part to conventional and common sense notions about social change and community organization, SOMOS and MANOS proceeded with efforts to identify leaders. More specifically we sought local residents who could help to communicate and to catalyze participation and engagement. Some of the early responses proved to be revealing. For example, in Esfuerzo, when we asked, “whom do you trust in the community,” the most common response was “no one,” followed by “God.” Next, we piloted interviews to determine the appropriate form and construction of questions that might help to identify local informal leaders and opinion-makers. Based on that study, researchers asked, “Who fights on behalf of the community?” Residents identified locals who had been part of the junta de vecino (a neighborhood association sanctioned by the mayor’s office, which is very far removed from the locality). However, probing further, interviewers learned that some of those same people had been discredited by allegations of graft. While these former junta members were identified as people “who fight for the community,” many residents did not trust them to do so. The interviews revealed widely shared sentiments of discouragement: “people are lazy and will not work”; “people are selfish and do not help others”; “little can be done without help from the government, and worse, the government never helps” (Aday, Owning change …, under review).

        Early work in Chaguite revealed similar patterns. In the first round of interviews, residents identified mayor representatives as local leaders, but many made clear as well that the representatives only worked with people of their own political party (the party of the incumbent mayor). They reported that these representatives were in touch with the mayor’s office only rarely and that the representatives would not likely be able to help much in any case. Residents identified brigadistas (health care volunteers) as leaders, but they were uncertain of the role and the responsibilities of those who were so designated — except in the case of acute medical emergencies (e.g., to help in summoning the ambulance from the municipal clinic). Many residents noted that they are not in communication with anyone and that they must rely on themselves and God.

Emerging Perspective and Theory
        Thoughtful reading of the literature of international politics and economics, development, and public health reveals that the poor and underprivileged around the world share health problems similar to those in Chaguite and Esfuerzo, in addition to other issues such as limited access to education and high rates of unemployment, drug and alcohol use, and domestic violence. This systematic understanding of the literature combined with direct observations in two distinct countries and cultures suggest an over-arching and framing perspective that highlights marginalization, both geographically and social structurally. Drawing from Vasas (2005), we define marginalization as “a process that pushes people, groups, communities, regions, and nations to the edges of spaces (physical and social), resources, and efficacy (ability to affect and to effect activities necessary to survive and thrive” (Aday, under review). The concept served to sensitize subsequent research, but observations suggested a need for finer articulation. We drew from Seeman’s (1959) analysis of alienation. He notes that alienation is a central theme in the classical works of Durkheim, Marx, and Weber and it continues to occupy the attention of contemporary sociologists. More importantly for current purposes, Seeman points to five distinguishable meanings that can be derived from work on the concept: powerlessness, meaninglessness, normlessness, isolation, and selfestrangement. Though we have not yet analyzed the data fully through this articulated framework, the concepts of marginalization and alienation form the basis of a general theory and an emerging model of participatory development (cf. Jennings, 2000; Chambers, 1995; Kapoor, 2002).6

        Our general view is that marginalization produces alienation and that, together, these social, structural, and geographical forces undermine individual and collective capacities for meeting basic individual and collective needs and hinder individual and collective efforts to thrive.7 As noted, some residents of Esfuerzo have experienced marginalization as they have been pushed from agricultural settings (including sugar cane plantations) and from other localities with the development of the tourism economy. Many residents report that they will remain in the community only until they are able to find some more viable residence. The residents of Chaguite have experienced the effects of extractive economies, beginning most clearly in contemporary time with the exploitation of land resources (including timber), and clear-cutting of their evergreen forests by foreign logging companies. Marginalization of the Chorotega indigenous people of the region began many centuries earlier with the arrival of the Aztecs and Spanish conquistadors (Manachon & Gonda, 2010).

From Theory to Model and Strategy
        Residents of Chaguite and Esfuerzo have experienced marginalization and live in communities that are marginalized. Geographically and social structurally, the communities are cut off from services enjoyed by other localities, including access to fresh water, sanitation, and electricity. They also do not enjoy effective representation in municipal decision-making and lack social infrastructure (social, political, and economic organization) that would enable collective and collaborative effort. From these observations, the projects moved towards embracing a role as partners with the communities with the goal of nurturing individual and collective capacities, defined initially as “the ability to achieve individually and collectively defined goals and objectives through sustainable infrastructure” (Aday, 2012, p. 1).

        The SOMOS and MANOS teams worked independently (but collaboratively) to articulate a community-based strategy to promote improved health and health care. We drew from the developing literature on participatory development (cf. Chambers, 1995; Kapoor, 2002; and Jennings, 2000) to conceptualize a role and a relationship to fit the theoretical view. Our goal was not to impose a paradigm based in American middle-class notions of success or achievement, but to foster a relationship that would allow the communities to articulate their own goals and develop their own methods for pursuing those goals.

        Working through annual medical clinics in both communities, we made clear our apprehensions about the limited efficacy of these episodic clinical efforts. Researchers engaged residents in discussions about their health and health care issues and concerns. Residents expressed appreciation for the clinics and agreed that there are certain fundamental issues that undermine health: access to clean water, nutritional deficiencies, and long-term effects of environmental degradation and flooding. They must have wondered — as we did initially — what student groups from an American college could offer by way of partnering to solve these crucial problems.

        Residents expressed appreciation for the careful efforts we made to get to know them. Early ethnographic studies communicated interest, concern, compassion, and attention to detail. Project students eagerly embraced basic training in field research methods and pursued fieldwork diligently. We incorporated Global Positioning System (GPS) and Geographic Information Systems (GIS) techniques because of the theoretical (geographic) perspective on marginalization and to facilitate systematic description. The field research provided opportunities for building interpersonal relationships. Residents of both communities have great capacity for hospitality, but they are not automatically welcoming to strangers. They have reasons for suspicion and even fear, but project team members express authentic interest in learning from residents and listening carefully to their issues and ideas for finding solutions.

        Summarizing, the SOMOS/MANOS model, as described to this point, includes the following elements:

  • A preconception of the possibility of positive social change through cooperative and egalitarian relationships and effective communication
  • A theory of marginalization and alienation and their consequences
  • A focus on community as the unit of analysis and the source for sustainable change
  • An unconditional contribution to the community that provides a service valued by the community (annual clinics)
  • Social science and geographic-spatial research methods (a) to describe the community and its resources and risks, (b) to identify and document shared concerns as part of a process for constructing social problems, and, (c) to map interpersonal relationships as part of a process for promoting organized collective action.

        Beginning in the summer of 2008 (in Esfuerzo, Dominican Republic) and in March 2009 (in Chaguite, Nicaragua,) project team members built from previous field-work and began to conduct interviews focused more specifically on identifying community leaders: residents who might help to organize collective efforts to achieve goals related to health and health care priorities. Drawing from sociological theory on how personal troubles become public issues and emerge as collectively defined social problems (cf. C. Wright Mills, 1959; Hilgartner & Bosk, 1988) team members sought to both identify household-level health concerns and, subsequently, to communicate information that revealed the extent to which these concerns were shared within the community. The projects adopted the analytical techniques of SNA (see Tichy & Fombrun, 1979; Marsden, 1990; Haythornthwaite, 1996; Hanneman & Riddle, 2005), interviewing residents within their homes and asking them to identify people who work on behalf of or for the good of their community.8

        The goal of the social networks studies was to identify organic interpersonal networks of communications, collaboration, and leadership. Interviews generated information about how residents relate to one another. Based in matrix algebra, SNA techniques allow researchers to see patterns of interpersonal ties among individuals, identified as nodes. Our ethnographic research had suggested that there was little communication or collaboration in either of the communities and that geography played a central role in interpersonal connections in both communities. Our first efforts focused on leadership relationships (“who works or ‘fights’ on behalf of the community?”). Our later efforts attended to the possibility that there are geographic locations where people communicate more regularly (intersecting footpaths or small markets, for example).

        In addition to describing patterns of association, communication, and leadership, we wanted to test our understandings about marginalization and alienation: To what extent do people help one another, collaborate for mutual aid, or support efforts to meet collective needs? Our emerging theory was that residents are able to engage collective efforts in part dependent on the extent to which they are connected through communications, collaboration, and leadership. We saw measures of network density as one promising empirical indicator of this possibility. Network density refers to the the proportion of interpersonal connections that respondents report as compared to the total of all possible dyadic relationships in a community (Hawe, Webster, & Shiell, 2004; Hanneman & Riddle, 2005; Scott, 2011; Wasserman & Faust, 1994). Logically, socio-centric density (the proportion of interpersonal ties for a community) has a maximum value of 1.00 — or, 100%; that is, all possible dyadic pairs are connected. There is not sufficient descriptive research in this field to allow characterization of variations in density, but conceptually and practically, density should be related to communication flow, collaboration, and prospects for organized efforts: the more interpersonal ties, the better the flow of information across a network, and the greater the prospects for collaboration and organization.. In both Esfuerzo and Chaguite, reported ties constituted less than three percent of the possible relationships. It is important to note that there are methodological problems with the data that ground this conclusion. To date, a population survey of the communities (for example, all households within each community or all adults within each community) has not been completed, but studies have included almost the entire population of households in both communities. Still, it seems almost certain that these low levels of density in communities that are relatively stable (low transience) and geographically bounded (about 90 occupied dwellings in Esfuerzo and fewer than 50 in Chaguite) support the projects’ conception of marginalization.

        Findings from early SNA explorative studies coupled with the evolving perspective, theory, and model suggested a focused strategy: nurture awareness of shared understandings of health concerns and promote increased communications to enhance individual and collective capacities. Drawing from SNA studies done subsequently (2008–2010), project teams identified subgroups within each community that involved central “nodes” (individuals within a network analysis) who are connected to others via reported interpersonal ties.

        Figure 1 is a representation of network ties in Chaguite in 2010. The seven blue squares in the upper left corner of the figure are respondents who named no one and were not named by anyone in interviews in which we attempted to identify patterns of communication and collaboration. In network terms, they are isolates. Recognizing that there were 53 respondents representing the same number of households, the analysis suggests that 13% of the population (of households) is not connected to others in the community. The larger red squares identify those residents named most frequently as people who work on behalf of the community and with whom they discuss matters of community concern, and the size of the squares reflects the relative number of ties, or interpersonal connections associated with each. Cleary, resident #38, was identified most frequently. Four other residents constitute network nodes with high reachability scores; that is, these individuals connect either directly or indirectly to a relatively large number of others within the community. Examining those subgroups and displaying the results spatially using GPS and GIS techniques helps identify clusters of households that optimize existing ties. In follow-up interviews, researchers asked residents if they thought it would be useful for them to meet in the identified groupings for the purpose of discussing common concerns about health and health care. In Chaguite, the residents not only endorsed the groupings,

Figure 1. Network Structure in Chaguite, 2010
Figure 1. Network Structure in Chaguite, 2010
Figure 2. Chaguite 2010 Paths, Households, and Groups
Figure 2. Chaguite 2010 Paths, Households, and Groups

they proceeded almost immediately to discussions about electing leaders for the groups. Figure 2 provides a geographic and social network characterization of the resulting organizing arrangement.

        It is clear that the networks and the pathways are related. This is not surprising, given the remoteness of the area, the absence of transportation, the reliance on footpaths, and the difficulty of traveling in any straight line between points within the region. Those who share a common path are more likely to know one another, to share a water source, and to communicate with one another.

        The SOMOS project followed similar methods to map Esfuerzo both geographically and using SNA. The resulting groups, based in organic ties, have become the organizing frameworks for community collaboration. Issues are discussed within these regional groups to increase opportunities for everyone to participate and to express individual opinions. Agreements reached in these groups are brought forward to community meetings. Through these arrangements, SOMOS and MANOS have built partnerships with the communities and collaborated to craft and gain community approval for five-year plans to improve health and health care. The plans include priorities, goals, objectives, and methods. They have formed the foundation for a community/MANOS partnership with Nicaraguan universities to improve access to clean water for some households. In both Chaguite and Esfuerzo, the project teams have facilitated the development of proposals for partnerships with Engineers Without Borders (EWB) and those proposals have been approved by EWB. The Chaguite project has been adopted by athe EWB chapter at California State Polytechnic University, Pomona, School of Engineering.

        Stated simply, the strategy is to understand community issues of marginalization as expressed in low-density scores (limited interpersonal ties across the community), to identify organic networks of interpersonal ties, and to nurture those as organizing elements. These organic networks have become the locus for discussing community health concerns. With some encouragement from the project team members, the groups engage practices of discussion and collaboration that result in increased capacity for collective action at the community level.

Conclusions
        Bessaw et al. (2012) raise significant questions about the impact of student-organized community engagement, questions about the sufficiency of time and other resources and about engaging community members in ways that yield sustainable solutions. Their brief article does not provide details about their approach, and we do not presume their orientation, perspective, or methods. Rather, we use the questions as a starting point for describing two projects in different countries, asking how we have fared, and more generically, whether it is possible for students to pursue community engagement beyond well-intentioned voluntarism. Are the challenges and roadblocks necessarily beyond the scope of students?

        We believe that the theory of marginalization and alienation help us to better understand the context in which we find the observed problems of health and health care. This theoretical understanding prepares us to ask better, more focused questions about our own role in the communities in which we work. Seeing manifestations of marginalization and alienation, we did not embrace common sense strategies such as collaboration and endorsement of formal leaders. If these leaders are not trusted or if they do not participate in effective communications arrangements, their role may contribute little to reducing marginalization or increasing capacity. The use of GPS and GIS techniques to develop descriptions of the community and the arrangement of interpersonal networks provided important clues about how to encourage inclusive communications and discussions at regional levels. SNA studies provided empirical indicators of community organization (and, by inference, marginalization) and helped us to identify meaningful organic interpersonal and communications networks.

        Our projects have faced challenging moments, including poorly attended meetings, failed communications, and momentum lost due to efforts that were poorly organized (by us and by various project partners). We continue to have too few material resources and fewer dollars than we need. We have worked self-consciously to articulate our theory, our methods, and our role in the community, and new students enter projects that are complicated. We face the significant challenge of ensuring that new students come up to speed and understand the foundations and history of the work — and that they feel empowered to question, challenge, and bring new ideas and perspectives.

        To date, we have measured project success in the following observed outcomes: (1) improved communications; (2) emerging regional organizations that promote inclusive conversations about health and health care issues; (3) the development and ratification of five-year development plans in each community; (4) the development of successful proposals for partnerships with Engineers Without Borders; and (5) the implementation of community committees to undertake specific projects, including health and health care planning and flood mitigation. In the near future, we will undertake, with our community partners, projects that are intended to improve directly the health and health care in the communities. If our theory is correct, our efforts to increase community capacity should produce strategies and tactics that reflect local wisdom and that benefit from the investments of those who are expected to benefit.

        Throughout, we have been determined to stay focused through the best of systematic research and theory. We hear residents’ expressions of hopelessness and dependency and we understand them through the structure and consequences of marginalization. These concerns challenge us to find strategies that will promote individual and collective capacities and to avoid those that will nurture dependence. We see signs of enhanced engagement in residents’ willingness to take on collective responsibilities, in attendance at community meetings, and in inclusive and reliable communications.

        SOMOS and MANOS are testing the proposition that students can pursue community engaged scholarship through academic and disciplinary foundations, exceed the limitations of good intentions, and participate authentically with community partners in fostering positive social change.

References

        Aday, D.P., Jr. (2012). SOMOS and MANOS:
Theory, definitions, and hypotheses (working paper).
Williamsburg, VA.
        Aday, D.P., Jr. (under review). Owning change:
Evidence-based participatory development, engaged
scholarship, and improving health in margiinalized
communities.
        Aday, D.P., Jr., Copeland, M.C., Weeks, J.K.,
& Wraith, S. (under review). Communities are real:
What it means to do “community-based projects.”
        Aday, D.P., Jr., Copeland, M.C., Weeks, J.K.,
& Wraith, S. (under review). The meanings of
community in community engagement: A structural
perspective and implications.
        Bessaw, M., Gerke, G., Hamilton, M.B., &
Pulsipher, L. (2012). Community engagement: A
University of Idaho student perspective. Journal of
Community Engagement and Scholarship 4(1), 70.
        Bolden, R., & Kirk P. (2009). African leadership:
Surfacing new understandings through leadership
development. International Journal of Cross Cultural
Management, 9(1), 69–86.
        Chambers, R. (1995). Paradigm shifts and the
practice of participatory research and development.
In N.A. Nelson, (Ed.), Power and participatory
development (pp. 1,437–1,454). London: Immediate
Technology Publications.
        Crevani, L., Lindgren, M., & Packendorff, J.
(2010). Leadership, not leaders: On the study of
leadership as practices and interactions. Scandinavian
Journal of Management, 26, 77–86.
        Gregory, S. (2006). The devil behind the mirror:
Globalization and politics in the Dominican Republic.
Oakland, CA: University of Califorinia Press.
        Handler, R. (2013). Disciplinary adaptation
and undergraduate desire: Anthropology and global
development studies in the liberal arts curriculum.
Cultural Anthropology 28(2), 181–203.
        Hanneman, R.A., & Riddle, M. (2005).
Introduction to social network methods. Riverside, CA:
University of California, Riverside (digital form at
http://faculty.ucr.edu/~hanneman/).
        Hawe, P., Webster, C., & Shiell, A. (2004).
A glossary of terms for navigating the field of
social network analysis. Journal of Epidemiology and
Community Health, 28(12), 971–975.
        Haythornthwaite, C. (1996). Social network
analysis: An approach and technique for the study
of information exchange. Library and Information
Science Research, 18, 323–342.
        Hilgartner, S.A., & Bosk, C.L. (1988). The rise
and fall of social problems: A public arenas model.
American Journal of Sociology, 94(1) 53–78.

        Jennings, R. (2000). Participatory development
as new paradigm: The transition of development
professionalism. Community based reintegration
and rehabilitation in post-conflict settings (pp.
1–10). Prepared for the Community Based
Reintegration and Rehabilitation in Post-Conflict
Settings Conference, Washington, DC.
        Kapoor, I. (2002). The devil’s in the theory: A
critical assessment of Robert Chambers’ work on
participatory development. Third World Quarterly,
23(1), 101–117.
        Kirk, P., & Shutte, A.M. (2004). Community
leadership development. Community Development
Journal, 39(3), 234–251.
        Manachon, D., & Gonda, N. (2010). Liberalización
de la propiedad versus territorios indígenas
en el norte de Nicaragua: el caso de los chorotegas
[Liberalization of ownership versus indigenous
territories in northern Nicaragua: The case of the
Chorotegas]. Rome / Managua: International Land
Coalition (ILC) / Centro de Investigaciones Sociológicas,
Económicas, Políticas y Antropológicas de
la Pontificia Universidad Católica del Perú [Center
for Sociological, Economic, Political, and Anthropological
Research at the Pontificia Catholic University
of Peru] (CISEPA-PUCP)/ Agrónomos y
Veterinarios sin Fronteras [Agronomists and Veterinarians
without Borders] (AVSF).
        Marsden, P.V. (1990). Network data and measurement.
Annual Review of Sociology (1990), 16,
435–463.
        Mills, C.W. (1959). The sociological imagination.
New York: Oxford University Press.
        Minkler, M., & Wallerstein, N. (eds.). 2011.
Community-based participatory research for health: From
process to outcomes. San Francisco: John Wiley &
Sons.
        O’Leary, V.E, & Ickovics, J.R.. (1995). Resilience
and thriving in response to challenge: an opportunity
for a paradigm shift in women’s health. Women’s
Health, Summer 1(2), 121–142.
        Roberts, M. (2006). Duffel bag medicine.
Journal of the American Medical Association 295(13),
1,491–1,492 .
        Scott, J.A. (2011). The SAGE handbook of social
network analysis. Thousand Oaks, CA: SAGE.
        Seeman, M. (1959). On the meaning of alienation.
American Sociological Review, 24(6), 783–791.
        Tichy, N., & Fombrun, C. (1979). Network
analysis in organizational settings. Human Relations,
32(11), 923–965.
        Vasas, E.B. (2005). Examining the margins: A
concept analysis of marginalization. Advances in
Nursing Science, 3, 194–202.
        Wasserman, S., & Faust, K. (1994). Social network
analysis: Methods and applications. Cambridge:
Cambridge University Press:

About the Authors

David P. Aday, Jr. is a professor of sociology and community studies and co-director of the public health minor at the College of William & Mary. Johanna K. Weeks is a graduate of William & Mary and a medical student at the College of Physicians and Surgeons at Columbia University. Christiana E.P. Sherman is a recent graduate of William & Mary. Robert A. Marty is a recent graduate of William & Mary and a graduate student in operations research and public policy at William & Mary. Rebecca L. Silverstein is a recent graduate of William & Mary.

University-Community Partnerships in Providing Relationship Education: A Longitudinal Qualitative Case Study

J. Mitchell Vaterlaus, Linda Skogrand, Kay Bradford, and Brian J. Higginbotham

Abstract

Relationship education (RE) has gained much public attention as classes have been implemented through state relationship initiatives. Developing university-community partnerships in implementing RE has been thought to increase access to underserved populations and increase awareness of healthy relationships in a community. Evaluation of these partnerships is just beginning. This three year longitudinal qualitative study represents five Cooperative Extension faculty members’ experiences with university-community partnerships in providing RE on a county level. Faculty members described their experiences identifying partners and outcomes from establishing partnerships and forming and sustaining partnerships. Results are discussed in terms of interdisciplinary university-community partnership literature and implications.

Healthy romantic relationships have been associated with positive outcomes for adults, their children, and for the larger community (Adler-Baeder, Shirer, & Bradford, 2007). Many couples who have had relationship problems do not seek professional assistance from marital therapists (Larson, 2004). However, Relationship education (RE) has been identified primarily as a preventive intervention that helps to improve relationships and reaches a broader audience (Larson, 2004).

RE represents a broad category of programs that vary in dosage including one-time events, skill-based programming, and series of classes (Hawkins, Carroll, Doherty, & Willoughby, 2004). RE has gained public attention due to the unprecedented amount of funds that have been allocated for the promotion of healthy relationships in the United States (Brotherson & Duncan, 2004). A primary focus of these funds has been to provide RE for underserved populations (Ooms & Wilson, 2004). Reaching diverse and low-income audiences requires educators to use more creative approaches for participant recruitment (Vaterlaus, Skogrand, Bradford, & Higginbotham, 2012). Developing meaningful university-community partnerships with organizations that already provide services for these populations create opportunities for collaborating agencies to refer clients to RE programs or provide relationship educators with an existing audience (Ooms & Wilson, 2004; Vaterlaus et al., 2012). The current study will add to existing literature by examining how Cooperative Extension faculty members have developed university-community collaborations in providing RE over time to low-income participants as part of a statewide healthy relationship initiative.

Hawkins and colleagues (2004) concluded that promoting healthy relationships should be a community-wide effort. When relationship educators build university-community partnerships with agencies and organizations within different sectors of the community, there is increased support for establishing and sustaining healthy relationships. Futris (2007) indicated that community collaboration is essential in providing high quality RE programs. His suggestions for identifying community partners included considering the skills and resources needed, recognizing organizations that have these skills and resources, and ensuring that there is a representation of the various services available for relationships in the community. Futris (2007) and The Lewin Group (2003) suggested that once they are formed, community partnerships are maintained through establishing structure (leadership), goals (including plans for these goals), and ongoing evaluation of the collaboration.

Few evaluative studies have been published specifically related to university-community partnerships (also known as collaborations) regarding the implementation of RE. Evaluation of collaborations can include identifying process, impacts, and outcomes (Futris, 2007). Evaluating the process of the collaboration involves recognizing the quality of the relationships, the roles and levels of involvement of the parties of the membership, and sustainability of the collaboration. Evaluating the outcome of the collaboration also requires identification of the results of the collaboration (e.g., the number of people served, the provision of the RE course itself), whereas the evaluation of impact focuses more on the influence of the collaboration on the larger environment (e.g., decreased rates of domestic violence; Futris, 2007).

One study used an ethnographic case study approach to identify how people (n = 9) from university-community partnerships managed challenges in collaboration within a regional healthy relationship initiative (Carlton, Whiting, Bradford, Dyk, & Vail, 2009). Semi-structured interviews were used to identify challenges and successes in the initiative’s collaborations. From these interviews, researchers identified four points that are key to collaboration — (a) people: participants commonly mentioned that it was the people in the university-community partnerships that made the program work; (b) relationships: the strength and duration of the relationships depend on the purpose of the relationship; (c) vision: common goals of the university-community partnership; and (d) structure: the operationalization of the goals and vision of the program. Carlton and colleagues (2009) also found that each of these factors were further influenced by elements in the collaboration’s process like communication, conflict resolution, and flexibility.

Purpose of the Current Study

Providing RE at a community level is a way to improve not only couple relationships, but the lives of children and the larger community (Adler-Baeder et al., 2007). University-community partnerships are thought to increase access to underserved populations (Ooms & Wilson, 2004; Vaterlaus et al., 2012) and community support of healthy relationships (Hawkins et al., 2004). The listed benefits have promoted the establishment of collaborations and now evaluative research on university-community collaborations is emerging (Carlton et al., 2009). The current study is a longitudinal qualitative process and outcome evaluation of collaborations between RE educators in a statewide healthy relationship initiative and organizations within their community. The longitudinal nature of the study allowed for understanding of the development, structure, and maintenance of these collaborations over time.

Method

Healthy Relationship Initiative
The current project is part of a statewide Healthy Relationship Initiative (HRI). County Cooperative Extension faculty members, also referred to as Extension agents in some states, applied for funding from the initiative by proposing RE activities designed to meet their individual county needs. To obtain funding, Extension faculty proposals were required to provide services for low-income couples and identify partnerships in the community to assist in program implementation and sustainability. In 2009-2010, 14 county Extension faculty members implemented RE activities throughout a western state. Between the years of 2010-2011 the number of faculty members implementing RE increased to 19, and in 2011-2012 the number grew to 21. The RE activities included one-time events (e.g., experiential date nights, lectures from relational experts) and more formal series of RE classes. Evaluations of the larger HRI have detailed the specific outcomes (Bradford, Higginbotham, & Skogrand, 2014), the successes and challenges of providing RE (Bradford, Huffaker, Stewart, Skogrand, & Higginbotham, 2014), risk of intimate partner violence in RE (Bradford, Skogrand, & Higginbotham, 2011), and providing RE for diverse and low-income populations (Vaterlaus et al., 2012). The current study focuses on evaluating the university-community partnerships in RE implementation.

Sample
At the conclusion of first year of the grant, five Extension faculty members who were actively forming university-community partnerships and reporting on their experiences in grant-related reports/ interviews were identified. The five faculty members were invited to participate in the optional longitudinal study through email, and there would be no penalty for declining. All five faculty members elected to participate. The faculty members in the final sample were all female, married, and had earned master’s degrees. The faculty members lived and worked in rural (n = 3) and urban (n = 2) counties.

        Pseudonyms were given to each of the participating county Extension faculty members to protect confidentiality. To provide some context for each of the faculty members’ counties, ethnicity and poverty levels are provided (U.S. Census Bureau, 2010, www. census.gov/2010census/). Laura lived and worked in a predominantly rural county with about 28% of the population living in poverty.

Table 1. Qualitative Data Sources by Grant Year
Table 1.Qualitative Data Sources by Grant Year
Laura’s county also included an American Indian reservation and American Indian residents represented nearly half of the population in her county. Cathy and Melinda also lived and worked in rural counties. Both counties were predominantly Caucasian and approximately 10 percent of their populations were living at or below the poverty level.

In contrast, Alisa and Natalie lived and worked in urban counties. Alisa’s county population included 10 percent of people who identified as Latino/ Hispanic descent and approximately 11% were identified as living in poverty. Natalie’s county similarly had 11% poverty rate in her county, and more the 16% of the residents identified as Latino/Hispanic.

Data Collection
The five Extension faculty members completed three proposals, 12 quarterly reports, one interview, and one emailed questionnaire during the three years of the HRI. IRB permission was granted for the study. Faculty members each completed a demographic form. Table 1 shows the different data sources used in this longitudinal study by grant year.

Grant proposals. Faculty members had the opportunity to apply for funding various RE activities through grant proposals each year of the grant. Grant proposals were used in this study to identify how faculty members changed/maintained their community partnerships over the three years of the grant. This was done because the proposals required faculty members to specifically identify the community partners that they would use and/or form to make their RE programs successful, in addition to other information such as proposed RE activities, budget, and number of people to be served.

Quarterly progress reports. As part of the grant requirements, faculty members completed quarterly activity reports that were submitted to grant administrators. These reports included specific information concerning progress, successes, and challenges experienced in implementing the RE activities, as well as university-community partnerships. These reports were submitted via email or fax to grant administrators.

Semi-structured interviews. At the conclusion of the first year of the grant in 2010 faculty members were invited to participate in interviews. One of the co-investigators and/or one research assistant conducted the interviews in person. Interviews were semi-structured in nature and asked about a variety of topics, but allowed faculty members flexibility to talk about topics that they identified as important. Faculty members were asked about their partnerships and also discussed them throughout the interview process. The interviews usually lasted 25–30 minutes for each faculty member. Interviews were recorded and professionally transcribed.

Emailed questionnaires. In 2012, the five selected Extension faculty members were invited to complete an online questionnaire. Questionnaires were personalized for each faculty member and included four of their own respective statements about university-community partnerships from their quarterly reports or transcribed interviews from the first year of the grant. Faculty members’ previous statements were highlighted in red and open space which asked faculty members to “Please re-read your past statement and under each statement write about how your ideas/thoughts about building and maintaining partnerships have stayed the same or evolved.”

Design and Data Analyses
A longitudinal qualitative case study approach was selected to “capture through long-term immersion” (Saldaña, 2003, p. 16) Extension faculty members’ experiences of working with community partners and to identify any changes of their perceptions of these collaborations over time. There is not a prescribed way for conducting a longitudinal qualitative case study; however, it is recommended that data be collected prior, during, and after the participant’s experience (Saldaña, 2003) and this recommendation was used in this study (see Table 1). Following data collection, all data were compiled into individual datasets for each participant. Information concerning university-community partnerships was identified and separated into a separate data set for each faculty member in time-order—organizing the experiences from beginning, middle, to end (Saldaña, 2003).

The time-ordered data sets were read and re-read several times for each faculty member individually. Each data set was used to construct an individual case study for each of the five Extension faculty members. Case studies were constructed in time order—listing experiences from beginning, middle, and to the present. This meant that information from all data sources was used throughout each case study.

Following the construction of individual case studies representing each Extension faculty member’s experience, themes were identified. Each of the case studies were read and re-read by one researcher, specifically focusing on how experiences evolved or remained similar over time. Four themes emerged and a second researcher validated the themes. When disagreements emerged, the two researchers consulted the data and case studies to ensure the themes were consistent with the faculty members’ shared experience. A new data file was created by taking information from each of the case studies and categorizing the information by themes. This data file was used to construct the results section.

Trustworthiness
To ensure the accuracy of the data in this evaluation of collaborations, triangulation and member checking were implemented (Vaterlaus & Higginbotham, 2011). Triangulation was implemented using multiple data sources and methods of data collection (e.g., emailed questionnaire, multiple interviewers, written reports). Also, to ensure the trustworthiness of the data, a variation of member checking was used (Cho & Trent, 2006). First, portions of the data from the first year of the grant were sent to each faculty member in the emailed questionnaire. Faculty members were asked to check their transcribed responses. Additionally, after case studies were complete they were sent to each faculty member who were then asked four structured questions to identify the accuracy of the presentation of their experiences. Minor suggestions and changes were implemented into the case studies.

Results
The results are derived from the five case studies. First, the themes identified across the case studies are presented. Following the presentation of the themes, two of the case studies were selected to provide the reader with a relatively richer, more in-depth understanding of benefits and challenges of partnerships for two of the five participants. After reading and re-reading the longitudinal case studies, four major themes emerged: (a) faculty members commonly described their process of identifying organizations in their community with whom they could partner— typically beginning with a broad perspective of potential partners and then narrowed partnership options based on faculty members’ specific RE goals; (b) forming community partnerships was discussed in terms of reciprocity of needs between the faculty members and the partnering organization, pre-existing relationships, experience, and challenges; (c) faculty members discussed their methods of sustaining their university-community partnerships as well as the challenges of sustaining these relationships; (d) finally, faculty members discussed the positive outcomes from forming community partnerships. All five faculty members’ experiences were represented in each of the themes.

Identifying Potential University-Community Partners
When the Extension faculty members submitted their first grant proposals, they used a shotgun approach in identifying university-community partnerships. Each faculty member listed several potential partnerships on their grant applications, but many of the listed partnerships were never mentioned again or developed over the three years of providing RE. As faculty members began to plan their specific RE activities, they began to identify the needs they had and started to look for partnerships that could meet these needs. Some were identified in the grant proposal, others were newly identified community partners. Faculty members were not just interested in general audiences, but had specific goals for reaching “target audiences.” Natalie and Melinda wanted to provide RE for adolescents, and both identified local school districts or high schools with which they could partner. Alisa and Laura intended on providing RE for minority populations and both considered organizations or agencies that could increase their access to these populations. Over time, faculty members were more specific in the grant proposals, even interweaving their community partners’ roles in their RE activity proposals for the following two grant years.

Common attributes faculty members looked for in partnerships included “existing audiences” and “already-existing” organizations. All five faculty members talked about the importance of having an existing audience and the faculty continued to recognize the value of this over time. Natalie explained, “Partnerships continue to be the ideal way to find participants for classes.” Forming university-community partnerships with existing organizations was valued because of existing structures and, in some instances, the existing relationship between the faculty member and organization. For example, Alisa identified a partnership to reach Latino residents she had made prior to providing RE in her county. She stated, “This group is an already-existing advisory council formed … in 2008 to assist and advise the Latino finance classes in [the county].” Many of these existing organizations identified by the faculty members were local churches, which had access to and rapport with the targeted audience.

After faculty members identified the community partnerships they sent letters, provided presentations, planned a dinner meeting, and met with these desired collaborators. Faculty members identified common goals that could be accomplished between the university-community partnerships. Cathy explained that she had an existing marriage coalition in her county with representation from many organizations (e.g., religious, mental health). Their original purpose was to strengthen marriage through a onetime event held in the county. Cathy’s leadership of the marriage coalition has increased the coalition’s efforts to strengthen marriage. The coalition has now grown to include planning, advertising, and teaching a variety of RE in the county. Cathy explained, “[The coalition] probably only meets about four times a year. They are very good to come and help with our marriage celebration and I’ve got four of them that teach [RE] classes for me now.”

Faculty members also used pre-existing experience working with target audiences as a way to form university-community partnerships. Laura decided that she wanted to provide RE for American Indian people in her community. Prior to providing RE for American Indians, Laura implemented a research study with American Indian participants. She explained:

It’s absolutely essential to have Native partners if you’re
doing a Native program. And it’s essential to have them
involved in the planning of the whole thing. And that’s why
I feel like the planning for this program was our research
study because we had their Native partners who helped us all
through the program.

Laura not only used existing partners to provide RE, but also implemented the skills she learned from her previous research experience with American Indians to form new university-community partnerships.

Faculty members also considered the people who would be the best contact to form their university-community partnerships. For example, Melinda wanted to increase healthy relationships for adolescents in her county. Melinda identified student body officers at a local high school and their advisor. In her first quarterly report she wrote:

[I] met with [high school] student body officers and their
advisor to provide incentive funds and brainstormed activity
ideas to promote and provide healthy dating and relationship
education with supplemental curriculum for the entire student
body of 617, plus administration, teachers, coaches, advisors,
counselors, and staff assistants.

Through the relationships with the student body officers and their advisor, Melinda was able to reach the students in the school. This university-community partnership met Melinda’s need to provide RE and the student body officers’ need to provide activities and leadership for their peers.

Faculty members did not ignore the challenges that arose in the process of forming community partnerships. Melinda reported that partnership formation was a time consuming process, “Networking and brainstorming sessions have taken a tremendous amount of time and effort, but will hopefully pay off in the long run. Local buy-in [for the RE activities] is extremely critical for successful programming at the community level.” Melinda specifically spoke about the challenges of “matching ideas of local agencies” and “maintaining the integrity and value of local support.”

Natalie also partnered with the schools to offer RE. There were some frustrations getting the RE curriculum approved by the school district. When Natalie reflected back on this experience, she said:

I have realized at the [local] school level that they get
rather frustrated with the district level because they get
the run around like I did and so often times teachers do
whatever they want. Since I did go to the district level and
ask permission initially, I have made an effort to respect
the district level wishes—but it can be challenging when I
have a teacher asking me to do the opposite.

Natalie was able to reach hundreds of adolescents through the university-community partnership with schools in her community.

Sustaining University-Community Partnerships
Over the course of three years, the Extension faculty members talked about the evolution, maintenance, and dissolution of community partnerships. All of the faculty members utilized the old saying, “If it’s not broke don’t fix it” with at least one of their university-community partners. Alisa continued to hold dinner meetings annually to maintain her relationship with the Latino Advisory Council (LAC) in her county. Melinda continued her relationship with the student body officers through their advisor at the school. Most talked about “making contact,” “sending emails,” and “attending meetings” as ways to maintain their community partnerships.

Cathy reported that the county marriage coalition, which included multiple partners, changed and evolved over time. Cathy indicated that the marriage coalition had become self-sustaining in membership recruitment because of the word-of-mouth referrals that came from the university-community partnership. Cathy reflected on her three years of partnering with the marriage coalition:

Our coalition has remained strong. Most of the members are
still on the coalition. Some changed. I have not had to
recruit new ones, because they come to me when they hear
about us. … We have a great community support from private
practice, schools, service organizations, church groups,
etc. Four of our marriage education classes are taught by
coalition members using the curriculum they helped design.

Not all of the partnerships originally established by faculty members were sustained over the three years of the grant. Challenges in sustaining university-community partnerships related to changes in the actual organization with which the faculty members partnered or challenges in the structure (e.g., leadership) of the partnership. Laura explained that needs and structures of some of her established partnerships changed, which made it difficult to maintain the relationship. Natalie talked about a partnership she formed with the Internal Revenue Service (IRS) to provide RE for their employees. The partnership was successful during the first year and because of the popularity of the RE classes Natalie was invited to additional sites. Following completion of the first year, Natalie’s original contact person was no longer working at the IRS and no courses were offered with this partnership in the second year. However, someone at the IRS had her name and contacted her a year later to provide RE.

Outcomes of Forming University-Community Partnerships
Throughout the three years of the project, county Extension faculty members continued to evaluate the benefits of forming community partnerships. They used words like “essential” and “helpful” to describe the role of university-community partnerships in providing RE. Faculty members specifically talked about outcomes in terms of participant recruitment, program implementation, and creation of new RE opportunities.

Participant recruitment. As stated previously, one of the major reasons faculty members sought to develop partnerships was to gain access to an existing audience. In some instances the partnership itself provided the audience and in others they became essential for advertising. Natalie acknowledged the importance of community partnerships in terms of recruitment for RE. She stated, “Partners often provide a set audience for presentations or at least can help to get the word out about classes and encourage participants to attend. It would be challenging to hold classes successfully without partnerships.”

Alisa explained the importance of her LAC in providing culturally appropriate advertising materials and existing trust between LAC members and the Latino residents in her county. Melinda worked closely with the student body officers at a high school to provide relationship education for adolescents and she also worked with the Local Interagency Council (LIC), which is similar to a marriage coalition, to provide RE for adult couples in her county. Melinda rallied her university-community partners to disseminate information about her programs. Melinda explained:

Flyers were prepared and shared with LIC participants to
distribute around the communities, and to their co-workers,
clientele, friends and neighbors. … Flyers were also
presented to and shared with [high school] student body
officers and their advisor to disseminate information to
entire student body, administration, counselors, teachers,
coaches, and staff assistants.

Program implementation. Over the three years, faculty members commonly talked about the importance of partnerships in implementing programs. They agreed that their partnerships provided culturally appropriate recommendations for curriculum and advertising, instructors, and locations for holding RE classes. Cathy specifically talked about the increased buy-in by the marriage coalition she partnered with over time. She explained that she collaboratively developed a marriage curriculum with people on the coalition and now members from the coalition are teaching the curriculum in the county.

Alisa described her partnership with the LAC as important for ensuring cultural sensitivity. Alisa presented her RE curriculum for the council’s review and their recommendations were implemented. Alisa also had members of the council serve as instructors at her RE events. This process was similar for Laura who worked closely with the American Indian population. Laura partnered with an organization that exclusively served American Indians in her county and through this partnership identified an American Indian who was qualified to provide her culturally sensitive RE curriculum. Laura said:

Our success I attribute 100 percent to the fact that this is,
first of all, sanctioned by [American Indian Partnership] so
they allow their employees to participate. And number two that
they authorized [their qualified employee] to be the one to
deliver the program.

Creation of new relationship education opportunities. One of the major benefits from forming community partnerships captured in a longitudinal perspective was that new RE opportunities emerged from established partnerships. Melinda talked about how her partnership with the LIC opened opportunities to provide RE for three additional organizations. Natalie explained that her partnerships with teachers provided new opportunities for providing RE every year. She said, “Because teachers generally have new students yearly, I have created some long lasting partnerships where they plan on including me each year as part of their coursework.”

All of the faculty members described how partnerships helped them increase their RE opportunities. They also, however, recognized how their established partners learned the value of RE and began to look for their own opportunities to increase RE in their counties. For example, Melinda said this about the student body officers with which she partnered:

The high school and the student body officers have come a long way,
and over time have became so invested in the value of healthy
relationships, they looked this year for ways to incorporate RE
programming and efforts throughout the entire school year, in addition
to the entire month of February.

Case Studies
Two case studies are presented to provide an indepth understanding of the identification, formation, maintenance, and outcomes of community partnerships over time. Laura’s experience included the dissolution of some of her most promising community partnerships, which provided a perspective of some of the specific challenges in maintaining community partnerships. In contrast, Alisa’s experience included working with the same community partnership over the three-year period. Together, the case studies highlight both positive and challenging aspects of the themes previously identified from the five Extension faculty members.

Case Study: Laura

In her first proposal, Laura said she would work with members of an American Indian Tribe, the tribal health care organization, the local Domestic Violence Coalition (DVC), the school district, the county’s council on aging, a fine arts organization, a women’s health resource team, the local university, and the Office of Rehabilitation. Laura received funding to provide marriage education for the American Indian population and RE for adolescents and young adults.

In Laura’s second quarterly report she stated, “I called the director of [a local health system serving the tribe] to propose a collaboration.” Her intention was to use their building and provide education for the employees. She also indicated that she attended the American Indian tribal meeting in her county. Laura also stated that she held a luncheon for the DVC to educate them on the progress of providing RE on the reservation and to solicit their recommendations on how to make this program successful.

It took more time than expected to build the university-community partnership with the health system. However, the wait was worth it and the chief executive officer agreed to collaborate and offer these classes to her employees. The health system even offered to have one of their employees who specializes in behavioral health and American Indian culture teach the RE classes. In her final quarterly report in 2010, Laura wrote, “Our greatest success was forming strong working partnerships with two significant organizations within two [tribal] communities. These collaborations provided not only cultural insights, but also opportunities to reach participants from the [American Indian community].” One frustration Laura explained was that the leaders of these organizations never attended the RE classes, so they really did not get to see the value of the program.

Laura’s second proposal again included RE activities for tribal members and young adults. Laura experienced some challenges with resuming collaborations formed during the first year of the grant. She explained:

Last year, we had an outstanding partnership with [the tribal health system]
to deliver marriage classes on the reservation. However, after meeting with
their representatives earlier this month, I learned that they are no longer
interested in having marriage classes offered through their clinics. So, I am
searching for a new partnership and a new venue for delivering our Strong
[American Indian] Marriages/Strong Relationships— Strong Lives curriculum.

Laura was disappointed, but also did not give up on the university-community partnership. She stated, “I have not given up on this partner, and will look for another possible format for presenting marriage activities so that we can salvage this partnership.” Despite the setback Laura formed a new collaboration with the director of student life at the local university to provide RE for young adults and she continued with the support of the DVC.

As the second grant year continued, success with the partnership increased and several young adults participated in RE activities. In her third quarterly report Laura wrote, “I regret not being able to identify [tribal] partners and venues on the reservation.” However, in the end she found a different organization within the American Indian community to partner with, and she was able to provide RE.

In Laura’s 2011–2012 proposal for providing RE, she proposed three activities that were not specific to the American Indian population in her county. She partnered with the DVC, the local university, and added the largest local high school in the county. In her first quarterly report of the grant year, Laura stated:

Coalition members feel dating violence prevention is badly needed in our high
schools. I explained that this year’s grant allows for healthy relationship
classes to be provided at the county’s largest high school. The coalition wants
to be involved and will help get healthy relationship classes into other high schools.

Laura and the DVC attempted to get the RE curriculum approved for implementation in the high school. The high school rejected the proposal because the curriculum included sensitive information. Laura felt support from the DVC during this time. She wrote, “I reported this barrier at our last DVC meeting and members expressed their surprise and support of the program.” A brainstorming session ensued and new ideas for getting the program into the high schools were devised collaboratively. Despite Laura and the DVC’s best efforts, the high school did not approve the RE offering. Laura indicated disappointment with this outcome, but she also stated that she felt support from the DVC and she continued to be committed to finding a partnership that would allow her to provide RE for adolescents in her county.

Case Study: Alisa

When considering providing RE for couples in her county, Alisa considered pre-existing university-community partnerships and several new ones. Alisa proposed including RE programming into the work of a pre-existing LAC in her county:

Members of this council are either leaders and well-known among the Latino community
or are actual Latino members of the community. Because of the diverse and, yet,
cohesive nature of this group and the work with low-income audiences, in addition
to being members of the Latino community, we believe that they will be perfect to
serve as the advisory council for the entire RE project in our [county].

The LAC included prominent local church leaders, educators or liaisons with schools, members from other community programs for Latinos, and people from government funded programs (e.g., Head Start). To begin to gain council support for RE in the community, Alisa planned a dinner meeting. She wrote in her first quarterly report, “We sent nearly 100 letters to current and potential LAC members notifying them of our dinner meeting in January, 2010. We also requested help in finding a location for the series.”

Alisa found some immediate successes from her partnership with finding a location for her event. She wrote, “[Four members of our advisory council] offered to let us use their buildings for the series. After touring these sites, we chose [the final site] because of its location and setup for the workshops, child care, and dinner.” However, Alisa was originally disappointed with her response rate for her dinner meeting. She stated, “Our response to attending the LAC meeting has not been as successful as we had hoped. Only about 20 members of this council have made reservations to attend this meeting.”

When Alisa did meet with the advisory council, she acknowledged in her quarterly report that they were supportive in identifying the cultural sensitivity of the curriculum and identifying respected people from the Latino community to provide the RE. Alisa also reported the usefulness of the advisory council for advertising her events with flyers, on the radio and through word of mouth. Alisa explained, “We are relying heavily on our advisory council to assist with helping us get the word out to members of the Latino community.” When the actual RE was implemented, the advisory council followed through. Alisa reported, “Workshops were held in April and May. They were taught by members of our LAC and our … Extension intern.”

As Alisa reflected on her first year providing RE in partnership with the LAC, she focused on the members/organizations on the council who were most helpful. She stated that the local church partners on the council were especially helpful in the advertising for RE to the Latino community. Alisa also indicated that through her council’s partnership she was invited to hold future RE in the local building that houses a variety services for Latinos families in the community. When asked if there were partnerships she would not use in the future, Alisa replied, “I don’t think so.”

During Alisa’s second year of providing RE in her county she, again, stated that she would partner with her LAC. In her proposal she stated that she wanted to increase her council membership utilizing more representation from organizations at the local university. Alisa also stated that members of her council contacted her about the classes this year. Representatives from the organization that invited them to hold the RE classes contacted her in July. Alisa said, “We were delighted to be invited to this beautiful facility!” Through this more specific partnership Alisa and her team had more access to Latino migrant farm workers.

Alisa held a dinner meeting in September, 2010 with her LAC. She took the opportunity to evaluate the program from the year before with the members and identify ways to improve the classes to be held in the Spring of 2011. She explained in a quarterly report:

… we met with our Latino Advisory Council to critique the Latino program from
last spring and to discuss changes we might want to make to the upcoming series.
They also helped us fine-tune our advertising. Many members of the Advisory
Council took copies of the flyer to share with the members of the Latino community
with whom they work.

Alisa reported strong turnouts to her Latino RE courses in the second year. She said, “The Latino relationship classes were very successful. To be able to reach an average of 80 adults and children who are members of the Latino community is a satisfying accomplishment.” The partnerships continued to prove positive for future RE opportunities. The two organizations that provided the facilities for RE in 2010 and 2011 both invited Alisa to hold classes in their facilities in 2012.

The LAC remained important to Alisa’s RE offerings in her county in her third year (2011-2012) providing RE as well. Alisa proposed similar RE activities and Alisa followed her previous pattern used for maintaining her relationship with the council. She wrote:

January 24, 2012—We were pleased to have 32 people attend the LAC meeting at a
restaurant. This group was able to assist us with fine-tuning our plans for the
Latino Relationships Series in April… . Several people volunteered to teach
and/or knew of others who would be willing to teach a workshop. The group also
helped us make our advertising more Latino-friendly. Everyone agreed to advertise
for us as soon as the updated flyer was available. I believe that this council is
the key to successful Latino programming.

In reflecting on her partnerships over three years, Alisa, again, focused on the benefits of individual members of her LAC. Alisa stated, “Local pastors and church leaders in the area … seem to be doing a great job of getting the information out to their members. On evaluations, many participants indicate that they heard about the program from their church.” Alisa also focused on the current status and value of her LAC in general:

Our LAC continues to actively help us make our Latino programming a success. We have
approximately 40 active members who meet annually to help us tweak our advertising,
identify speakers/workshop presenters, approve curriculum, and recommend topics for
the workshops. In addition, they provide locations such as schools, churches, etc. to
hold the Latino programming. Each member of the LAC takes a very active role in helping
us advertise the program.

Alisa concluded her thoughts on her experiences with partnerships in providing RE by saying, “Our collaboration with other agencies and organizations is essential to our success.”

Discussion
The results illustrate that university-community partnerships are vital in offering RE, and that these partnerships constitute an evolving process. The case studies provide contrasts in quality and maintenance of partnerships. Laura’s partnerships evolved due to changes in the community organization. In her interview, Laura mentioned that the size and remoteness of her county made for challenges in travel and even in communication; an aspect that would likely be different in an urban setting. Alisa capitalized on her partnership with the county’s Latino Advisory Council, a group with regular meetings and whose purposes included not only RE but other issues. Together the Extension faculty members articulated their experience with the identification, formation, sustainability, and outcomes of their university-community partnerships.

Identifying potential partners is obviously a key step in the process, but the data from this longitudinal study makes it clear that some proposed partnerships came to fruition and others did not. It is clear that these participants had to become comfortable with change and uncertainty when it came to collaborations. Moreover, partnerships changed over time as the vitality of the partnering organization itself evolved. Futris (2007) indicated that process of identifying community partners requires university faculty to identify their needed resources and skills and then to recognize community organizations that meet these needs.

The Extension faculty members in this study identified their needs primarily as audiences and organizations with existing structure. Schools, churches, and existing coalitions were identified as desired community partners. This is consistent with previous research on university-community partnerships (Jackson & Reddick, 1999; Prins, 2006). For example, Jackson and Reddick (1999) identified churches as community partners to develop early health detection and prevention networks for African Americans residents. Also, Prins (2006), in her case study of key members in a university-community partnership developed to plan a community park and provide youth development services in a rural California town, identified schools as effective partners. Schools have been identified to be ideal community partners for implementing university programs that are designed for eliminating social and economic problems in rural settings, because schools are both civic and social centers.

The themes from all five agents and the two case studies make it clear that partnerships help in terms of tapping into existing audiences, as well as gaining access to existing organizational structures and even physical facilities. The methods of initial contact were not surprising (e.g., letters or email, presentations), but the study results also highlight the importance of identifying the right contact person within a given organization. In their study of university-community partnerships, Carlton et al. (2009) similarly found that “having the right people to do the job is critical to anyone’s success” (p. 34).

Faculty members involved their community partners from the beginning of the program which allowed many of the community partners to catch the vision of RE in their community. They did this through holding meetings and seeking advice on cultural sensitivity of recruitment and program implementation. Jackson and Reddick (1999) indicated that successful university-community partnerships were formed when the community organization was involved early in the planning process. Community organizations may have limitations in resources, such as money, education, to provide large-scale projects. By involving partners early in the planning they can catch the vision about how reciprocal needs can be met through the university-community partnership.

Power differentials may arise in university-community partnerships because of the imbalance of resources, knowledge of the community, education, or skills (Prins, 2006). Sorenson and Lawson (2012) developed university-community partnerships to revitalize a city with services such as landscape architecture, community clean-up, and the establishment of computer labs throughout the city. One identified challenge was that community members in the partnership did not have the skills to allow them to collaborate on an equal level with students and faculty. Formal training sessions were implemented for community members and also knowledge was transferred through working/participating together. This may be similar to the process of faculty members in the current study, they involved their partners in identifying the purpose of RE and over time partners participated in the events, began to teach at events, and even found ways to provide RE independent of the university. This also sounds consistent with Hawkins and colleagues’ (2004) recommendation to make RE a community wide effort.

Laninga, Austin, and McClure (2012) implemented community design and development projects in three rural communities in Idaho through university-community partnerships. They explained that forming university-community partnerships was a time-intensive process. Faculty members in the current study validated this challenge in the formation process. Different than results in the current study, Laninga et al. (2012) described their formation process as contractual—a formal contract was developed outlining responsibilities, key roles, and financial contributions from the community and the university. Faculty members did not address the structure of their community partnerships beyond frequency of meeting and who served as members on coalitions. Additional research on the structuring of university-community partnerships and RE is necessary.

Futris (2007) suggested that the structure, leadership, goals, and evaluation are the qualities that sustain university-community partnerships. The faculty members illustrated that, once formed, partnerships benefited from ongoing maintenance. In some cases, this was accomplished via formal coalitions that held regular meetings, and in other cases, check-ins were less frequent and less formal. This is again consistent with the results from Carlton et al. (2009), specifically regarding not only the strength but also the duration of collaborative relationships (including interpersonal respect). Faculty members indicated that many of their partnerships were self-sustaining and that they continued to work with partnerships that seemed to be working well. It may be that the interpersonal relationships developed with these community partners helped sustain the university-community relationship. Jackson and Reddick (1999) concluded, “It appears that a core system of personal interactions sustains the relationship and serves as a foundation for building strong ties and effective collaborations” (p. 673).

None of the faculty formally talked about their leadership, structure, or evaluation of their partnerships. It was implied that many faculty members perceived that their community partners did value their own role in providing RE in their community. Israel and colleagues (2006) formed university-community relationship to address issues of public health in three urban communities. They identified that sustaining community partners required a clear evidence of community benefit and a public recognition of the contributions of the community partners. Faculty members acknowledged the value of partners in their reports, but there was no mention of formal recognition of their partnering organizations accomplishments.

Conclusions and Implications
The current study provided a rich understanding of the processes involved in identifying, forming, and sustaining university-community partnerships to provide RE over time. Through university-community collaboration unique audiences were reached, support was provided for program implementation, and increases in RE involvement were apparent at a community level. It appears that current practices within this sample are close to the best practices identified in the broader university-community literature (e.g., Jackson & Reddick, 1999; Sorenson and Lawson, 2012). A strength of the particular study was that both urban and rural counties were included in the analyses. Prins (2006) indicated that the majority of university-partnership studies have focused on only urban counties. There are limitations to this study because of the homogeneity of the sample, and only the university side of the partnership was evaluated. Future research should investigate the process of university-community partnerships from RE facilitators who represent different ethnicities, gender, and locations. Also, collecting data concerning the partnering community agency would be essential.

Practice and research implications can be derived from results from this study. It appears that facilitators of RE are identifying community agencies with which to partner that meet their needs. It is unclear whether formal structure or leadership is present in the university-community relationships. Models of effective university-community partnerships have suggested that structure and leadership is needed for sustainable partnerships (cf. Futris, 2007). Formal structure and leadership is apparent in university-community partnerships in different disciplines (Laninga et al. (2012) and perhaps additional training and research of how to formally structure these relationships in practice is needed in applied family science. Structure, leadership, goals, evaluation (Futris, 2007), interpersonal relationships, and community partners recognition of the benefits of the partnership (Israel et al., 2006) are the proposed qualities for partnership sustainability. The current study provided some evidence of common goals and strong interpersonal relationships. However, there was not a clear understanding of how faculty members evaluated their partnerships beyond continued contact and participation or how community partner’s accomplishments were publicly recognized.

This study adds to the current literature about university-community partnerships in that, although these partnerships were not very structured or formal, they did work. It might be useful to explore in more detail, with future research, why they worked. Is it the interpersonal relationships that sustained the relationships? Is it what could be described as somewhat of an intuitive approach to partnerships, rather than formal structure, leadership, and evaluation that held them together? If so, what is that process, and how can others be trained to use it?

References

Adler-Baeder, F., Shirer, K., & Bradford, A. (2007). What’s love got to do with it? The role of healthy couple relationships and marriages in promoting child, family, and community well-being. The Forum for Family and Consumer Issues, 12(1). Retrieved from http://ncsu.edu/ffci/publications/2007/v12-n1-2007-spring/indexv12-n1-may-2007.php.

Bogdan, R., & Biklen, S. K. (2003). Qualitative research for education: An introduction to theories and methods. Boston, MA: Allyn and Bacon.

Bradford, K., Higginbotham, B.J, & Skogrand, L. (2014). Healthy relationship education: A statewide initiative case study and outcome evaluation. Marriage & Family Review, 50(2), 93-106. doi:10.108
0/01494929.2013.851057

Bradford, K., Huffaker, S., Stewart, J.W., Skogrand, L., & Higginbotham, B.J. (2014). Successes and challenges in a statewide relationship education initiative. Family and Consumer Sciences Research Journal, 42(3), 252-266. doi:10.1111/fcsr.12059

Bradford, K., Skogrand, L., Higginbotham, B.J. (2011). Intimate partner violence in a statewide couple and relationship education initiative. Journal of Couple and Relationship Therapy, 10(2), 169–184. doi:10.1080/15332691.2011.562468

Brotherson, S., & Duncan, W. (2004). Rebinding the ties that bind: Government efforts to preserve and promote marriage. Family Relations, 53(5), 459–468.

Carlton, E.L., Whiting, J.B., Bradford, K., Dyk, P.H., Vail, A. (2009). Defining factors of successful university-community collaborations: An exploration of one healthy marriage project. Family Relations, 58(1), 28–40.

Cho, J., & Trent, A. (2006). Validity in qualitative research revisited. Qualitative Research, 6(3), 319– 340. doi:10.1177/1468794106065006.

Futris, T.G. (2007) Building community collaborations to support healthy and stable marriages. The Forum for Family and Consumer Issues, 12(1). Retrieved from http://ncsu.edu/ffci/publications/2007/v12-n1-2007-spring/futris-2/fa-6-futris-2.php.

Hawkins, A.J., Carroll, J.S., Doherty, W.J., & Willoughby, B. (2004). A comprehensive framework for marriage education. Family Relations, 53(5), 547–558. doi: 10.1111/j.0197-6664.2004.00064.x.

Israel, B.A, Krieger, J., Vlahov, D., Ciske, S., Foley, M., Fortin, P., Guzman, J.R., Lichtenstein, R., McGranaghan, R., Palermo, A.G., Tang, G. (2006). Challenges and facilitating factors in sustaining community-based participatory research partnerships: Lessons learned from the Detroit, New York City and Seattle Urban Research Centers. Journal of Urban Health, 83(6), 1,022–1,040.

Jackson, R.S., & Reddick, B. (1999). The African American church and university partnerships: Establishing lasting collaborations. Health Education & Behavior, 26(5), 663–674. doi:10.1177/109019819902600507.

Laninga, T., Austin, G., & McClure, W. (2012). University-community partnerships in smalltown Idaho: Addressing diverse community needs through interdisciplinary outreach and engagement. Journal of Community Engagement and Scholarship, 4(2), 5–17. Retrieved from http://jces.ua.edu/community-university-partnerships-in-small-town-idaho-addressing-diverse-community-needs-through-interdisciplinary-outreach-and-engagement/.

Larson, J.H. (2004). Innovations in marriage education: Introduction and challenges. Family Relations, 53(5), 421–424. doi:10.1111/j.0197-6664.2004.00049.x.

Ooms, T., & Wilson, P. (2004). The challenges of offering relationship and marriage education to low-income populations. Family Relations, 53(5), 440–447. doi: 10.1111/j.0197-6664.2004.00052.x.

Prins, E. (2006). Individual roles and approaches to public engagement in a community-university partnership in a rural California town. Journal of Research in Rural Education, 21(7), 1–15.

Saldaña, J. (2003). Longitudinal qualitative analysis: Analyzing change through time. Walnut Creek, CA: AltaMira Press.

Sorensen, J., & Lawson, L. (2012). Evolution in partnership: Lessons from the East St Louis Action Research Project. Action Research, 10(2), 150–169.

The Lewin Group (2003). Coalition building for a healthy marriage initative. Retrieved from http://www.lewin.com/spotlights/lewinhp/marriage.htm.

Vaterlaus, J.M., & Higginbotham, B.J. (2011). Qualitative evaluation methods. The Forum for Family and Consumer Issues,16(1). Retrieved from http://ncsu.edu/ffci/publications/2011/v16-n1-2011-spring/index-v16-n1-july-2010.php.

Vaterlaus, J.M., Bradford, K., Skogrand, L., & Higginbotham, B. J. (2012). Providing relationship education for low-income and diverse audiences: A phenomenological investigation. Family Science Review, 17(2), 40–61.

About the Authors
J. Mitchell Vaterlaus is an assistant professor in the Department of Health and Human Development at Montana State University. Linda Skogrand is a family life extension specialist and professor in the Department of Family, Consumer and Human Development at Utah State University. Brian J. Higginbotham and Kay Bradford are family life extension specialists and associate professors in the Department of Family, Consumer, and Human Development at Utah State University.

From The Editor: Diversity of Engagement Scholarship Demonstrated

Cassandra Simon, Ph.D. – Once again I welcome the opportunity to share with your some of the most impressive engagement scholarship research around. Whether a community partner, student, or university representative, there is something in this issue of JCES that will resonate with you. I guarantee it. Review of the manuscripts in this issue caused me to pause and reflect on the array of social issues with which we as a society are presented and their relationships to engagement scholarship. While I am still reflecting on this, and will for a while, I did conclude that one of the primary benefits for me of being involved in engagement scholarship is that the work fulfills so many aspects of my life. The connections that are easy to see are how engagement scholarship connects with me in my professional, academic, and scholarly roles. What might not be as apparent to some is how engagement scholarship helps me fulfill that humanitarian part of me that has a responsibility to contribute to society in a positive way. I find that most people would like to have their lives matter. Most people would like to know that their having lived somehow made a difference in the world. Engagement scholarship provides one mechanism through which that can be done. Engagement scholarship has the potential to change lives for the better, improve quality of life, have unheard voices heard, and yes, possibly change the world, no matter how small. Despite its relatively new position in the research arena, engagement scholarship is well positioned to do these things. The current issue of JCES is reflective of these possibilities. This issue has diversity in a variety of ways, including methodology, thought, purpose, participants, and geography to name a few. One longitudinal, qualitative study examines community-university relationships developed through, relationship education, while another addresses community-university partnerships within the context of a survey study and recognition of the inter-professional nature of such collaborations. From the Dominican Republic and Nicaragua to South Alaska and throughout the United States, this issue confirms that JCES recognizes the importance of community engagement within an international context. Also included in this issue are manuscripts that examine innovative ways for addressing community health through engagement scholarship.

The current issue of JCES is reflective of these possibilities. This issue has diversity in a variety of ways, including methodology, thought, purpose, participants, and geography to name a few. One longitudinal, qualitative study examines community-university relationships developed through, relationship education, while another addresses community-university partnerships within the context of a survey study and recognition of the inter-professional nature of such collaborations. From the Dominican Republic and Nicaragua to South Alaska and throughout the United States, this issue confirms that JCES recognizes the importance of community engagement within an international context. Also included in this issue are manuscripts that examine innovative ways for addressing community health through engagement scholarship.

One project reports on the use of spoken word, a form of performance poetry, to address HIV/AIDS and another discusses the use of “girl power” photovoice to address relevant health in communities. Several of the manuscripts focus on lessons learned, providing valuable insight on diverse aspects of engagement scholarship. Recognizing the importance of service learning to engagement scholarship, we include several manuscripts reporting on service learning efforts. I would also like to highlight that many of the manuscripts in this issue appropriately give particular attention to the cultural aspects of relevant communities and community partners. Given the importance of community partners to engagement scholarship, cultural (widely defined) nuances must be given attention to across all levels of the process, ideally from inception to dissemination, when possible. I was especially pleased to see this attention to culture highlighted in many of the manuscripts in this issue, along with the elevation of the role and levels of involvement of community partners.

As always, we look forward to receiving your feedback. What you have to say is important and will be valuable to JCES going forward. Please feel free to contact me at jces@ua.edu.