Accomplishing structural change: identifying intermediate indicators of success

Toward a community psychology transformative praxis: A descriptive review

In this paper, we present a descriptive review of the foundational components of transformation-the starting places and gaps-in a move toward synthesizing current works into a Community Psychology Transformative Praxis. This review focuses on published work identified in North American Community Psychology journals (namely two United States based journals)-a review from the belly of the neoliberal and imperial beast. We reviewed and categorized seven foundational dimensions for beginning and sustaining transformative praxis and which represent how Community Psychology (CP), in the United States publishing context, is engaging in transformative efforts. In Part 1, we present three dimensions of transformative process, focused on early and iterative practices that develop and enact shared (1) values, (2) visions of a just world, and (3) critical problem frames. In part 2 we present four additional dimensions of transformative action; the considerations that inform action in a given transformative process or intervention including (4) planning for the long-term nature of transformation, (5) targeting multiple levels of analysis, (6) engaging in solidarity with those most impacted by injustice, and (7) identifying and resisting power holders and/or power structures that prevent transformation and maintain the status quo. In Part 3, we review the relationship between process and action, where processes can be understood as driving, directing, and bounding the types of actions or interventions taken or imagined in a particular transformative intervention. We close the paper with critical reflections and calls to action to further develop the transformative potential of CP praxis and name the tendency of settling for ameliorative solutions to problems needing transformative solutions.

Pride in our community: Reflecting on LGBTQ publications in the American Journal of Community Psychology

In this Virtual Special Issue (VSI), we curate and discuss a set of 28 articles previously published in the American Journal of Community Psychology (AJCP) focused on lesbian, gay, bisexual, transgender, and queer (LGBTQ) communities. The purpose of this VSI is to bring visibility to this body of scholarship in AJCP and to reflect on how the strengths of our field have been used throughout this work in pursuit of supporting LGBTQ wellbeing. In this VSI, we first discuss articles that help to set the historical background for publications in AJCP. We then discuss papers under the broad themes of HIV/AIDS, identities within ecological context, and social activism among LGBTQ communities. We then reflect on opportunities for our field to further leverage our strengths in contributing to LGBTQ scholarship. Overall, this VSI celebrates the contributions to LGBTQ research already present in AJCP, and we hope inspires future contributions to the pages of AJCP and beyond.

Association between community characteristics and implementation of community programmes and policies addressing childhood obesity: the Healthy Communities Study

BACKGROUND

Little is known about whether characteristics of communities are associated with differential implementation of community programmes and policies to promote physical activity and healthy eating. This study examines associations between community characteristics (e.g. region and race/ethnicity) and the intensity of community programmes and policies implemented to prevent childhood obesity. It explores whether community characteristics moderate the intensity of community efforts to prevent childhood obesity.

OBJECTIVE

The objective of this study is to investigate associations between community characteristics and the intensity of community policies and programmes to prevent childhood obesity documented in the Healthy Communities Study that engaged a diverse sample of US communities.

METHOD

Programmes and policies were documented in 130 communities across the USA, reporting over 9000 different community programmes and policies to prevent obesity among children ages 4-15. We examined associations between community characteristics and the intensity of community programmes and policies implemented (i.e. their amount and reach, duration and strength of change strategy).

CONCLUSION

Community characteristics explain 25% of the variability in the intensity of community programmes and policies implemented in communities. Particular characteristics - urbanicity, region, being a large county and the per cent of African-Americans in a community - contributed to more (over 18% of the 25%) of the observed variability.

Structural and Community Change Outcomes of the Connect-to-Protect Coalitions: Trials and Triumphs Securing Adolescent Access to HIV Prevention, Testing, and Medical Care

Connect to Protect (C2P), a 10-year community mobilization effort, pursued the dual aims of creating communities competent to address youth's HIV-related risks and removing structural barriers to youth health. We used Community Coalition Action Theory (CCAT) to examine the perceived contributions and accomplishments of 14 C2P coalitions. We interviewed 318 key informants, including youth and community leaders, to identify the features of coalitions' context and operation that facilitated and undermined their ability to achieve structural change and build communities' capability to manage their local adolescent HIV epidemic effectively. We coded the interviews using an a priori coding scheme informed by CCAT and scholarship on AIDS-competent communities. We found community mobilization efforts like C2P can contribute to addressing the structural factors that promote HIV-risk among youth and to community development. We describe how coalition leadership, collaborative synergy, capacity building, and local community context influence coalitions' ability to successfully implement HIV-related structural change, demonstrating empirical support for many of CCAT's propositions. We discuss implications for how community mobilization efforts might succeed in laying the foundation for an AIDS-competent community.

How to Identify Success Among Networks That Promote Active Living

OBJECTIVES

We evaluated organization- and network-level factors that influence organizations' perceived success. This is important for managing interorganizational networks, which can mobilize communities to address complex health issues such as physical activity, and for achieving change.

METHODS

In 2011, we used structured interview and network survey data from 22 states in the United States to estimate multilevel random-intercept models to understand organization- and network-level factors that explain perceived network success.

RESULTS

A total of 53 of 59 "whole networks" met the criteria for inclusion in the analysis (89.8%). Coordinators identified 559 organizations, with 3 to 12 organizations from each network taking the online survey (response rate = 69.7%; range = 33%-100%). Occupying a leadership position (P < .01), the amount of time with the network (P < .05), and support from community leaders (P < .05) emerged as correlates of perceived success.

CONCLUSIONS

Organizations' perceptions of success can influence decisions about continuing involvement and investment in networks designed to promote environment and policy change for active living. Understanding these factors can help leaders manage complex networks that involve diverse memberships, varied interests, and competing community-level priorities.

Community health coalitions in context: associations between geographic context, member type and length of membership with coalition functions

The coalition literature recognizes context (geography, demographics and history) as a variable of interest, yet few coalition evaluation studies have focused on it. This study explores the association between geographic context and structures (e.g. member type) with functional characteristics (e.g. decision making or levels of conflict) in a statewide system of community health councils (coalitions). The study was part of a multiyear, statewide evaluation of New Mexico's health councils' contributions to systems-level changes. We adapted the Coalition Self-Assessment Survey (CSAS) for all county health council members and paid council coordinators. Both multilevel univariate and multivariate procedures were used to compare index scores, summaries of CSAS questions used to characterize council functions, with selected demographic variables and region. Member type was associated with decision making and policy capacity; paid staff expressed higher levels of agreement than voting members for both items. Length of membership was associated with decision making, positive leadership and shared vision. Results indicated that geographic context was significantly associated with many functional characteristics. The study highlights the idea that geographic context may influence coalition functioning. Understanding how geographic context influences coalition planning and actions may help explain differences among coalitions that on the surface share common organizational characteristics and external goals.

The Benefits of Youth Engagement in HIV-Preventive Structural Change Interventions

Youth are infrequently included in planning the health promotion projects designed to benefit them as many of the factors infringing upon youth's health and well-being also limit their engagement in community-based public health promotion projects. This article explores youth engagement in 13 coalitions implementing structural changes meant to reduce HIV transmission among adolescents. There was wide variation of youth membership and involvement across coalitions. Using analytic induction, the authors show that youth engagement was associated with the successful completion of structural change efforts. The authors also describe how youth engagement indirectly facilitated coalitions' success. The authors suggest that youth engagement in planning and conducting structural interventions is itself a valuable structural change.

The influence of community context on how coalitions achieve HIV-preventive structural change

Community coalition action theory (CCAT) depicts the processes and factors that affect coalition formation, maintenance, institutionalization, actions, and outcomes. CCAT proposes that community context affects coalitions at every phase of development and operation. We analyzed data from 12 Connect to Protect coalitions using inductive content analysis to examine how contextual factors (e.g., economics, collaboration, history, norms, and politics) enhance or impede coalitions' success in achieving outcomes. Consistent with CCAT, context affected the objectives that coalitions developed and those they completed. Results suggest that local prevention history and political support have particular impact on coalitions' success in creating structural changes. These data underscore the heuristic value of CCAT, yet also imply that the contextual constructs that affect outcomes are issue specific.

Conflict transformation, stigma, and HIV-preventive structural change

Over the prior decade, structural change efforts have become an important component of community-based HIV prevention initiatives. However, these efforts may not succeed when structural change initiatives encounter political resistance or invoke conflicting values, which may be likely when changes are intended to benefit a stigmatized population. The current study sought to examine the impact of target population stigma on the ability of 13 community coalitions to achieve structural change objectives. Results indicated that coalitions working on behalf of highly stigmatized populations had to abandon objectives more often than did coalitions working for less stigmatized populations because of external opposition to coalition objectives and resultant internal conflict over goals. Those coalitions that were most successful in meeting external challenges used opposition and conflict as transformative occasions by targeting conflicts directly and attempting to neutralize oppositional groups or turn them into strategic allies; less successful coalitions working on behalf of stigmatized groups struggled to determine an appropriate response to opposition. The role of conflict transformation as a success strategy for working on behalf of stigmatized groups is discussed.