Community Perspectives | Our Journey into a CBPR Project: Health and Nutrition Solutions in the Alabama Black Belt
Yawah Awolowo, Debra Clark, and Darlene Robinson
Project UNITED is a federally funded grant that addresses obesity issues in the Alabama Black Belt. The Black Belt represents some of the poorest counties in the United States and is plagued with chronic health conditions—obesity, diabetes, high blood pressure, cancer—which are predominantly found in African Americans. Community leaders from the Black Belt Community Foundation, a 501(c)3 nonprofit corporation whose purpose is to help improve the quality of life of residents in the Alabama Black Belt, participated in the project as community health scholars. Project UNITED partnered community health scholars and academic scholars to develop proposals that addressed obesity issues in rural communities. A team of three community health scholars and three academic scholars collaborated and formed, Home Sweet Home, a two-year, $50,000, multigenerational obesity intervention in Greene and Sumter counties. This paper provides reflections from the three community health scholars regarding their experience in a community based participatory research (CBPR) project.
The paper is presented as first person testimonials describing the experiences of each participant.
Darlene Robinson, Greene County
Being one who is always looking for ways to improve myself and my community, I took a step of faith in response to the invitation I received to become a community health scholar with Project UNITED. I also believed I would acquire knowledge that would help my community. In the community my mission is to improve everyday life of parents and their children. Even though my plate was already full, I felt it would be an opportunity to find ways to improve myself and my community.
The Project UNITED journey introduced us to individuals from around the state who also wanted to improve themselves and their communities. I could tell the training was well thought out, as we visited a small garden at a rural school where the youth were being introduced to growing their own foods. This was the Project UNITED pilot project. Educating our community about healthy lifestyle changes is very important and we learned ways to take it home. Project UNITED brought professors from the University of Alabama and community people together as a learning tool that showed that we all share the same passion of making Alabama a healthier place to live.
The circle was complete when our team formed. We had three members from the community and three members from academia, with a mission of curtailing obesity by educating ourselves. As a group we merged our thoughts, hashed out our ideas, made a plan, found an audience—the preschoolers and their parents—and formed a roadmap to get us where we wanted to go. We named our program “Home Sweet Home.” Our mission was to introduce and teach a new way of thinking about eating. We sought to change current statistics that says we are an obese society.
If you’re busy, think you have that all you can handle, feel you know all you need to know, then CBPR is probably for you, because it takes all you’re doing and all you can handle and turns it into a mission that you’ve been on all the time but gives you directions to get to a better place. Then it will not just be your idea of what the community needs, but the community will be able to tell you what they want.
Debra Clark, Sumter County
In 2013, I was chosen by the Black Belt Community Foundation to be a community health scholar. This was because of my health-related awareness work at the Health and Wellness Education Center (HWEC) Disease Management Program. At the first meeting my first thought was “Why am I here?” realizing that I did’t have time to take on an additional project. But my second thought was “how can I not participate?” considering the impact this project could have on my community. Certainty, it is through strong community partnerships with local agencies that has made HWEC successful. The agency has made great strides to implement initiatives to address obesity, diabetes, cardiovascular disease, and other chronic illnesses to improve the health of local residents.
As a result of this project, I
1. Was invited to present a paper entitled “Fighting Obesity for the Health of It” at the Rural Health Conference in Tuscaloosa in 2013.
2. Received the Rural Heroes Award from the UA College of Community Health Sciences.
3. Was able to expand the Jump To It (what is it?) program for additional communities.
4. Produced a simple handout on the traffic light diet to promote healthy eating for distribution at health fairs and community events.
5. Have witnessed the greatest impact within my own family. My 5-year old grandson was never introduced to yogurt, but now eats yogurt and encourages his mom to “add stuff” to make it good.
Although this fight has been tedious and time consuming, I must admit that rewards have been greater than the struggle. The program has helped build capacity and strengthen my agency by connecting me with a team of experts with genuine concern and interest, which correlates with the agency’s mission of promoting healthier lifestyles through education and prevention.
Yawah Awolowo, Sumter County
As a community health scholar participating in Project UNITED, I have enjoyed adding to what I already knew about health-related issues and unhealthy eating. I nurtured my family in an organic, self-sufficient, natural homebirth/home schooled permaculture environment and have sustained five seriously committed years of organic farming on a 66-acre, family-owned farm. My journey with CBPR and the development of a partnership with academic researchers not only expands my baseline knowledge, but the collaborative process has also allowed me to continue to put into practice my knowledge in a way to benefit my community. I have learned that while academic researchers are very knowledgeable about health and treatment, I also bring a great deal of knowledge about nutrition and health. Additionally, I have expertise about the rural community where I live, which I know is valuable for eliminating obesity in this community.
My participation in Project UNITED enlightened my interest in heart disease and obesity, major health concerns in my family. My mother, who was 90 years young developed heart disease. She had no hypertension, diabetes, no medicines for her entire life. The doctors informed the family that there was a blockage in one of her heart valves; surgery was necessary to remove the blockage. One of the major reasons I chose to be involved as a community health scholar in Project UNITED was because I watched my 90-year-old mother go through heart surgery and witnessed her spectacular recovery as she completely changed her eating habits. The other reason for my interest is because there are so many people in my family who have serious health conditions. My sister had surgery two weeks prior to my mother and my daughter has also had medical issues. For these reasons, my desire has been fueled to establish alternative eating habits as a means to prevent disease, especially with kids at an early age. I believe this can be done by letting them be involved with the purchase, preparation, cooking, and serving of good healthy foods.
Project United was the right program for my personal and community needs to learn more about prevention of this disease in our community. I realized that the cultural normality of food intake always consists of some type of animal products on a daily basis that cause blockages and slow down the process of the heart pumping blood and oxygen.
Involvement in Home Sweet Home Project
As a community health scholar I have been able to work with a team of people who share my interest of eliminating diseases through education and awareness. We met as a group utilizing a tool called speed dating to develop a professional relationship/marriage that has grown into a big happy family. Consider the three-legged stool; one cannot stand without the other. Each of us brings so much to table that I wonder how we could have been so close without ever crossing paths. Nevertheless, we have bonded and now look for ways to improve our efforts by enhancing our writing skills and seeking additional resources to promote sustainability to enhance our community for a better future. Community health scholars: What better name can you give to such individuals who are a community’s first choice when it comes to health care. We are the movers and shakers in our community.
Home Sweet Home is our project. We named it, we designed the program, we listened to the community, we respected the community, we educated ourselves, and we educated the community. The program was not handed to us; it was made by us for us with the mission in mind of changing lifestyles by teaching our families how to spend time together, talk to each other, share with others, cook with love, train our children how to prepare a dish and making home truly Home Sweet Home. The mission of introducing new ways of cooking to our parents was well received. The preschoolers enjoyed the experience and the parents appreciated the information because our eating habits have led to many health improvements. The traffic light playing cards (red light = foods to avoid; eat; yellow = sometimes foods; green = go foods) were designed as a way for families to learn what foods to stop eating, for example cautiously eating the yellow foods and eating lots of all the green foods. Each family received a deck of Home Sweet Home cards designed by the team.
The program was introduced in the communities represented by the community health scholars. The team was glued together by a passion to make a difference, and we believe it is the start of great things to come. Our coming together was not by accident; it was time for academia and the community to unite on a mission of bringing the idea of healthy eating to the community.
Project United has been a perfect learning catalyst. One of the major goals of the project was to partner community leaders with academic researchers to develop and pilot test an obesity intervention program. We spent the year getting to know each other’s interests and personalities with an emphasis on building trust and working toward sustaining a lasting relationship. This was important to me because I have had several business encounters where I have shared ideas and people have either ignored or taken my ideas. These experiences have made me wary to trust experts sometimes. Therefore, any emphasis on building trust and sustainability are going to be important for me and my community.
I eventually ended up working with a team of six. We talked about potential projects based on our interests where we would be competitive for funding internally. We also evaluated the best approaches to write the grant using all our strengths. As a member of the team, I also earned my IRB certificate, which builds on the training I received in medical ethics and research. We titled our submission: Home Sweet Home, with a focus on home food environment. This project addresses obesity in the age group 2 to 5 years (pre-k). Our primary goal was to get 2-5-year-old children, along with their parents, to learn how to choose good, healthy produce, prepare food in a clean area, practice safety measures, make it a child friendly environment, create their own recipes using the things they like to eat, and spark their interest in healthy eating habits from an early age.
Thankfully, our collaborative proposal received funding for one year through a competitive internal grant process.
As I reflect on the past year of my role as a Community health scholar and the value that CBPR has added to my life, I believe that the time invested in the program will save lives in my community. And that is time well spent. As the program began its journey into the community, the best began to happen with children and the parents. We prepared familiar food with new twist, collards greens with no meat; to make home-cooked foods with fresh herbs and olive oil; the children preparing salads, constructing parfaits and serving their parents and grandparents; providing chef hats and aprons and gifts for families to continue their healthy journeys.
About the Authors
Yawah Awolowo is an organic farmer and chef at Mahalah Farms in Cuba (Sumter County), Alabama.
Debra Clark is founder and executive director of the Health and Wellness Education Center in Livingston (Sumter County), Alabama.
Darlene Robinson is founder of Imagine Me Youth Development Program in Greene County, Alabama.