Dec2017 1

Memoria~EngageforEquity(E2)Workshop~September18-19~Albuquerque

TheEngageforEquityprojectteamhostedthreetwo-dayworkshopsonPartnershipReflectionandEvaluationToolsinAlbuquerque,NewMexicoduringSeptemberandOctober2017,and25community-academichealthpartnerships(oftwotosixpeople)fromaroundthecountryattendedandparticipated.Thisisthesummary(or“memoria”)forSeptember18th–19th.

Seated(L-R):Logan,Lorenda,Shannon,Lucy,Rhonda,Victoria,Bonnie,AlStanding(L-R):Ellen,Thomas,Tabia,Jim,Louis,Lisa,LaShawn,Elizabeth,Marlana,Nina,Paige,Maureen,Miruna,Lena,Rachael,Justin,Lori,Rosey,Kelly,Darcy,ErikaNotpictured:AmericanSignLanguage(ASL)interpretersValeneandSally,Melissa(Seefulllistofpartnershipprojectsandattendeesonlastpage)OverviewTheworkshoppurposewastogivepartnershipsnewtoolsandtimetoreflectontheirengagementwithCommunityBasedParticipatoryResearch(CBPR).Theagendacoveredfourprimarytools:RiverofLife;CBPRModelasVisioningTool;PartnershipDataReportscustomizedforeachpartnership;andPromisingPracticesGuide.ParticipantsalsohadtheopportunitytogatherinseparateCommunityandAcademicpartnersessionstosharetheirexperiences.Dr.NinaWallersteinoftheUniversityofNewMexicoopenedtheworkshopbygatheringallparticipantsandfacilitatorsinacircleforintroductionsandsettingofintentions.Shestatedthatthemajorityofthetimewouldbespentworkinginsmallgroupstoapplythetoolsforeachindividualpartnership.Peoplewouldalsobesharingtheirthoughtsinthelargergroupfollowingeachexercise.EngageforEquityprojectteammembersservedasfacilitatorsforeachtable.Theintentionoftheworkshopoverallwastohonoreachkindandtypeofcollaborativeorpartnership,recognizingthatteamscamefromdifferentfundingsources,levelsofengagement,histories,andorganizationalstructures.Thehopewasforeachtoteamtobeabletousethe

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toolstoreflectonwheretheyareintheirengagementpracticesnowandwheretheywanttobeinthefutureintermsoftheirpracticesandoutcomes.

Theoverallphilosophyoftheworkshopwasthatreflectionmatters.Itwasbasedonthereflection/actionmethodologyofBrazilianeducatorPauloFreire,encouragingpartnershipstoengageinongoingcyclesoflistening,dialogue,andaction.Thetoolswereintendedtosupport:

1)deeplisteningamongpartnersandwithcommunitymembers;2)respectfuldialogueaboutpartneringpracticeswithintheircommunityandacademiccontexts;and3)integrationofcommunityandculture-basedknowledgeintoresearchandprogramspromotinghealthandhealthequityoutcomes.Thefourstatedworkshopgoalswere:

• ToenhanceReflectiononyourPartnershipsthroughApplyingTools• ToshareIdeasandPracticewithOthers• ToidentifyLearningsandToolstotakebacktoyourownPartnerships• TobuildaNationalCommunityofPractice

RatherthanstartwithaPowerPointpresentation,participantswereaskedtojumpintotheirownjourneyoftheirpartnershipforthefirstexercise,theRiverofLife.

1) RiverofLife

Dr.ShannonSanchez-YoungmanofUNMintroducedtheRiverofLifeexerciseandgaveinstructions.Posterpaper,coloredmarkersandcrayonshadbeenplacedonthetables,andpartnershipswereencouragedto‘diverightin.’ShedescribedtheRiverasareflectivetooltodocumentthelifejourneyorhistoricaltimelineforCBPRpartnerships(orcommunity-engagedresearchprojects).Throughguidedquestionsandusingthemetaphorofariver,theexerciseisdesignedtofacilitatecommunityandacademicpartnerstoactivelyreflectonwheretheyhavebeen,acknowledgingmajormilestonesandbarriersalongtheway,andthinkingaboutwheretheywanttogointhefuture.

Reflection/Action Praxis from Paulo Freire

Action Action ActionTobeagoodeducator(researcher)�meansabovealltohavefaithinpeople;to

believeinthepossibilitythattheycancreateandchangethings.�PauloFreire,1970

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Rhonda,LaShawn,andTabiausedtheRiverofLifetoreflectontheenvironmentaljusticerootsoftheirlongtimepartnershipwithcommunitymembersandtheMorehouseSchoolofMedicineinAtlanta.ThecurrentfocusofthisPreventionResearchCenter(PRC)isaprojecttoaddressSTIandHIV/AIDSPreventionamongUrbanMinorityYouth.

Erika,KellyandLorifromtheRochesterNationalCenterforDeafHealthpartnershipposewithUNMMPHgradstudent/facilitatorJustinafterfinishingtheirRiverofLife.

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Elizabeth,LucyandLouisposewiththeirRiverofLife.TheirpartnershiphadtheaddeddimensionoftheacademicpartnerbeinginArizona(ASU),whilethecommunitypartnersworkinHouston,TX.Theyrealizedtheirrelationshipwasorganic,andthatstoppingandreflectingwasveryimportantforthem.

Participantsdidagallerywalktolookateachother’sRiverofLifecreations,andNinaaskedfor‘aha’momentsabouttheexercise.

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Peoplesaidtheywerestruckbythecommonthreads:“ourorigins”amongallgroups.Onepersonnoted,“Ithinkgoingthroughtheexercisehelpedusseetheevolution…howourworkhashadtentaclesandspreadoutandgrown…”Othercommentsincluded:• RiverofLifeexercisewashelpfultovisualizethepartnership.• Historyisessentialtobuildingtheteam.• IpersonallylovetheRivermetaphor,therocks,churningwater…• ThevalueoftheRiverwasinseeingthehistoryanddevelopmentofourpartnership.• Theexercisehelpedustoreflectontheprogressourcenterhasmade.• Iwanttoreopenmymindandheartindealingwithchallenges(“boulders”)inourRiver.Withthatinteractiveexercisecompleted,Ninawentthroughtheten-yearhistoryoftheresearchwithaPowerPointslideshow.Tosegueintothesecondworkshoptool,sheshowedavideowiththeNicaraguastoryofusingtheCBPRmodeltoreducechilddeathsandillnessinruralareas.Forfuturereference,hereisthelink:

• https://vimeo.com/219716496

2) CBPRModelasVisioningTool

ThenextvisioningexerciseinvolvedpartnershipsusingtheCBPRModeltocreateavisionorplanofwheretheywanttobeandhowtheywillgetthere.Ninaexplainedthemodeltheparticipantswouldbeworkingfromastheyreviewedslidesandthehandoutintheirpackets.TheactivityfacilitatesuseoftheModel,notasastaticframework,butasadynamicguidetoadapt,brainstormideas,andco-createanewversionoftheModelthatworksbestforeachpartnership.

Themodelconsistsoffourdomains:Contexts,PartnershipProcesses,Intervention&Research,andOutcomes.

1. Contextsarethesocial,cultural,economic,political,andotherfactorsthatgroundpartnershipsinlocal,state,ornationalconditions.

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2. PartnershipProcessesarepracticesforsuccessfulpartnering.Theseinclude:individualcharacteristics(skills&attitudesacademic-communitypartnersbringtothepartnership);relationships(howpartnersmakedecisions,andinteractwitheachothertoachievegoals);andstructuralfeatures(whoarethestakeholdersandwhataretheirsharedagreements&values).

3. Intervention/ResearchDesignsarethenshapedbythenatureofpartneringandtheextentofequalcontributionofknowledgefromdifferentpartners,includingcommunitymembers,clinicians,healthprofessionals,government,andacademicmembers.

4. Outcomesincludearangeofintermediatesystemandcapacitychanges,i.e.,newpolicyenvironments,sustainabilityofprojectandpartnership,sharedpowerrelationsinresearch,andincreasedcapacities;aswellaslong-termoutcomesofcommunityandsocialtransformation,healthandhealthequity.

Participantsusedmarkersandbutcherpapertocreatetheirownpartnership’svisioninfourquadrantsforeachdomain,orinothershapesthatmadesensetothem.Teamswereaskedtostartwiththinkingabouttheiroutcomesfirst(whatthey’veachievedorareseekingtoachieveinthefuture).Thentheyfilledintherestofthedomainsintermsoftheircontext,practicesthattheywerealreadydoingorwantingtostrengthen,andhowpartneringprocessesimpactedtheirinterventionorresearchdesignandimplementation.TheteamshadthoughtfuldiscussionsandputinmucheffortincreatingCBPRvisionsfortheirpartnerships.Rachael,Lenaand

DarcywiththeCleveland-based

ImprovingNutritiousFoodAccessinLow

Income&AccessNeighborhoodsprogram.Theysaiddoingthe

modelvalidatedtheworktheyaredoingthattheyareontheright

path.

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Thomas,LisaandJimposewiththeirCBPRvisioningmodel.TheirPCORIprojectisCommunicationtoImproveSharedDecision-MakinginADHDinPhiladelphia.Thisgroupsaidtheyvaluedtheconversationonoutcomesbecauseitgotthembeyondjusttheirprojectandtowardssomethingbiggerandbroaderin5-10-15years.Theyhadnotengagedinthatconversationbefore.Theyalsosaiditwasusefulhavingthefacilitatortokeepthemmovingandnotgetcaughtupinbarriersandnegativespace.

Miruna,Maureen,Marlana,andPaige

representingtheUniv.ofWashingtonPT-

REFERproject:PhysicalTherapists

RecommendingEnhancedFitnesstoExpandReach.Their

long-termimpactistoimprovethehealthofolderadultsandthoseagingwithdisability.

Theyreflectedonhowtheycouldusethis

visiondocumentgoingforward.

Participantsdidagallerywalkoncemoretolookateachother’sCBPRModels,andNinaaskedfor‘aha’momentsabouttheexercise.Moresamplecommentsareonthenextpage.

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Atleft,LoridescribestheNationalCenterforDeafHealthResearch/RochesterNationalCenterforDeafHealthmodel,andsignlanguageinterpreterValenehelpsnon-signingparticipantsunderstand.DuringtheCBPRvisioninggroupreview,onepersonsaiditwashelpful“havingamomenttothinkbeyonddailyworklifeandidentifyingcoreissuesthatare

importantandthatyouneedtoworkoninthefuture.”Alongthesametheme,anotherpersoncommented,“Itvalidatedtheworkthatwearedoingthatweareontherightpath.Whenyou’rebusydoingthework,youdon’thavetimetoreflectandtomoveon,andtodaywewereabletothinkaboutlongtermandintermediateoutcomes.”Anotherpersonsaidtheirlongtimegroupwastryingtofocusonfuturegoals,andthefacilitatorwashelpfulguidingthemwiththeiropinionsandgettingitallwritten.“Doingthisexercise,atleastformyselfIthinkwe’reontherighttrack,anditletmevalidateandreviewwhatwe’redoing,”wrappedupthegroupcomments.

3) PartnershipDataReports(PDR)

ThethirdreflectiontoolintroducedwasthePartnershipDataReports(PDR).EachpartnershipwasgivenacustomizeddocumentcontainingthesummarydatafromtheEngageforEquitysurveysthatpartnershipmemberscompletedinlate2016andspringof2017.Insomecases,participantsattendingtheworkshopshadnotcompletedthesurvey,andthepeople(allunidentified)whohaddonethesurveywerenotpresent.ResponsesinthePDRwereorganizedaccordingtotheCBPRModelandthemajorpracticesthathavebeenshowntocontributetokeyresearchandhealthoutcomes.

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Forexample,theCommunityEngagementSurveymeasuredmanyoftheconstructswithinPartnershipProcesses(thoseinredwereonesthatweremeasured).Teamsweregiventimetoreflectontheirdata,andparticipantsengagedindiscussionsabouttheirpriorityareas.AworksheetattheendofthePDRreporthelpedparticipantsfocustheirindividualandgroupthoughtprocesses.Aglossaryoftermshelpedexplain

thelanguageusedinthePDR.KeyreflectionquestionsguidingthePDRgroupreflectionincluded:

• Whatstandsouttoyouaboutthepracticesthatmattermost?• HowmightthesecomparetowhatyoucreatedintheCBPRvisioningsession?

Samplecommentsasteamsreflectedontheirdata:“What’salwayspresentispowerandprivilege,whohasit,whousesit…howdowekeepfolksengaged…”“WeneedtoputReflexivityinaspartofourregularpractice,weneedtotellourstory,ourPRCis20yearsoldnextyear.”“WithPCORIwearebetterathealthimprovementthansocialtransformation…dobetteratBridgingSocialCapital,notjustcoreteambutengageeveryone…”“AttheuniversitylevelhowdowechangeenvironmenttobemoreopentoCBPR…”

4) PromisingPracticesGuide(PPG)

ThefourthtoolintroducedintheworkshopwasthePromisingPracticesGuide(PPG).NinaexplainedthattheinformationinthePPGisbasedupontwonationalstudiesofacademic-communitypartnershipsandengagedresearch.WhereasthePDRcontaineddataspecifictoeachpartnership,thePPGutilizeddataanalyzedfrom379federally-fundedpartnerships.Promisingpracticeswereidentifiedwhichserveasanopeningformorereflectionanddiscussion.Feedbackfromthisexerciserangedfrom“thequotesincludedmadeitpersonalandwererealistic,”to“itwouldbehelpfultogetthePPGfirstbeforethePDR.”SomeonenotedthatifthePPGandPDRwerecombined,itwouldbecomeacomparisonofhowindividualpartnershipsweredoingagainstthenationaldata.Somefeltthatwouldbehelpful,whileothersdisagreedbecauseeachpartnershipwassodifferent.

Partnership Processes

Partnership Structures

Relationships

Individual Charcteristics

Health Care

Agency

Government

Community

CBOs

Funders Academic

•Motivation to Participate •Cultural Identities / Humility •Personal Beliefs /Values•Spirituality•Reputation of P.I.

•Safety•Trust / Respect•Influence /Voice•Flexibility•Dialogue and Listening / Mutual Learning•Conflict Management•Leadership•Collective Reflection / Reflexivity•Resource Management•Participatory Decision-Making•Task Roles Recognized

•Formal Agreements•Partnership Values•Bridging Social Capital•Time in Partnership

•Diversity•Complexity•Control of Resources•% $ to Community•CBPR Principles

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CommunityandAcademicPartnersSeparateGatheringMostoftheworkoftheparticipantswasreflectingwiththeirteamsontheirownpartnerships.Theyreportedbackandsharedthoughtsinthelargegroup,buttherewaslessopportunityfor“cross-pollination”thanwasdesired.Recognizingthatpeoplecanlearnfromeachotherandsharemanysimilarsituations,theworkshopagendaincludedtimeforseparategatheringsofcommunityandacademicpartners.Participantssharedinatalkingcircleformatforaboutanhour.Thefirsttwoworkshopshadtheseparatemeetingthebeginningofthesecondday,andinthethirdworkshopthemeetingwastheafternoonofthefirstday.Itgavepeopletheopportunitytogettoknoweachotherbetter,andmanyrecognizedthattheyarenotaloneinthechallengesandconcernstheyhaveintheirwork.FortheSeptemberworkshop,AlandShannonledthecommunitygroup,andBonnieandLorendafacilitatedtheacademicgroup.Afterward,Alsaidthetakehomemessageforthecommunitygroupwastakingtimeandbeingintentionaltobuildpartnerships.EngageforEquityWebsite:www.EngageforEquity.orgTheworkshopconcludedwithabriefoverviewofthenewwebsitesettolaunchbeforetheendoftheyear.Eachofthesefourtools–RiverofLife,CBPRModelasVisioningTool,PartnershipDataReport,andPromisingPracticesGuide–willbeavailableonthewebsiteforpartnershipstoutilize,alongwithfacilitationguides,videos,andadditionalinformation.

Dr.Wallersteinsaidshewantedtoincludeworkcreatedintheworkshopsonthewebsite,butemphasizedthattheE2projectteamwillonlyshareitwitheachpartnership’spermission.Thewebsitebuildsonwhatwaspresentedintheworkshop.Partnerswhoattendedmaychoosetoshareandteachothersintheirpartnershiputilizingthewebtoolsandresources.Partnersalsomaylearnontheirownhowtousethetoolsthroughthevideosandmodelsonline.Inthe

future,thewebsitewillbehostedbyCCPH,Community-CampusPartnershipsforHealth.FutureofCommunityandAcademicPartnerships:CommunityofPracticeDr.Wallersteindiscussedtheideaofcreatingacommunityofpractice,andsheaskedthegroupforinputonhowtodoit.Peopleagreedontheneedtoworktogetheraswellastheprocessofworkingtogether.Ideasincludedhavingfollow-upwebinarsorphonecallswiththeirsame

FourToolsfromEngageforEquity

–RiverofLife/HistoricalTimeline–VisioningwiththeCBPRModel–PartnershipDataReport–PromisingPracticesGuide

ClaimingYour

Principles

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workshopparticipants,orwithallworkshopscombined.AnotherideawasconsultationforteamsbyE2projectstaff.ClosingThoughtsEachteamparticipatedinarecordedinterviewinwhichtheywereaskedaseriesofquestionsaboutthetoolsandhowtheymayutilizethem.Theywereaskedtoreflectontheirimpressionsoftheworkshopaswellastheiroverallprojectsandpartnerships.TheE2projectteamwilltranscribetheinterviews,sendthembacktoeachteam,andinterpretaggregatedinterviewsforfurtherlearning.Insixmonths,allparticipatingpartnershipswillreceiveafollow-upCommunityEngagementSurvey(CES),continuingtheE2projectanalysisoftheeffectivenessofthefourCBPRworkshoptoolsandresources.WorkshopparticipantsgavefeedbackontheworkshopeachdaywithPlus/Deltas–whatwentwellandwhatcouldbechanged.Hereissampleofwhatwascaptured.Plus(+) Delta(∆)Breakouts:Breakoutsweregreattospendtimewithcommunitypartners,academics,andallowedparticipantstoreallyfocus

Aroadmapfortheconceptualmodelwouldbehelpful

GoodFacilitators CEU’sTurntaking–easyforinterpreters SwitchtheorderofthePPG’sandthePDR’sInteractivewithRiverofLifePDR'swerehelpful

Spendtimeonthe4Domainsandexplainthemandthenmoveon

SurveyQuestionsonPDR(Shannon)Knewwheretogo–PDRTimetotalkthroughFacilitator–Usedexamplefromownexperienceinordertoreframequestion

RevisittheprioritieswithplanningforwardafterthethreeworkshopsCommunityinputtosharetheirviewsonthemodelSpendtimereviewingcpr.unm.eduwithworkshopparticipantsFlexibilityinapplyingthemodelStartoutwithexamples(ininitialslides)SharefirstdayevalsPacketorganization–lotsofloosepaperCouldnotseetheslideseasilyPrintoutslidedocument

Afinalgroupexercisewastheyarnweb,whereeachpersonstatedonewordonhowtheywere

feelingandthentossedtheyarntoanotherperson.Scissorswerepassedaroundsothatparticipantscouldcutapieceofthewebtotakehomeasaremembrance.

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ParticipatingPartnersandFacilitators–September18-19PreventingChildhoodObesitythroughEarlyFeedingandParentingGuidance

v ElizabethReifsnider,LouisReyna,LucyReynaImprovingNutritiousFoodAccessinLowIncomeandAccessNeighborhoods

v DarcyFreeman,LenaL.Grafton,RachaelSommerMulti-MethodApproachtoSTIandHIV/AIDSPreventionamongUrbanMinorityYouth

v LaShawnM.Hoffman,RhondaHolliday,TabiaHenryAkintobi

CommunicationtoImproveSharedDecision-MakinginADHDv JamesGuevara,LisaSnitzer,ThomasPower

PhysicalTherapistsRecommendingEnhanceFitnesstoExpandReachv MarlanaKohn,MaureenPike,MirunaPetrescuPrahova,PaigeDenison

NationalCenterforDeafHealthResearch/RochesterNationalCenterforDeafHealthv ErikaSutter,KellyMatthews,LoriA.DeWindt

ASLInterpretersv ValenePrzybylo-Souky,Univ.ofRochester;SallySchwartzUniv.ofNewMexico

EngageforEquity(E2)WorkshopFacilitatorsandStaff

v NinaWallerstein,ShannonSanchez-Youngman,AlanRichmond,BonnieDuran,LorendaBelone,VictoriaSanchez,EllenBurgess,JustinGaroutte,MelissaGallegos,LoganShea