Challenges Faced in the Design, Implementation, and Evaluation of Community-based Interventions

1. Challenges Faced in the Design, Implementation, and Evaluation of Community-based Interventions Robert Nash Parker and Roxie Alcaraz Southern California Academic Center of Excellence on Youth Violence Prevention, University of California, Riverside presentation for 2010 Summer Institute on Youth Violence Prevention August 4, 2010

2. The Tale of 3 Cities: Readiness to Change & Youth Violence Prevention ACE-UCR Communities Santa Ana, CA - zip code 92710 Riverside, CA - Arlanza neighborhood Perris, CA - entire city

3. Santa Ana, CA - zip code 92710 • 90% Latino immigrant population • Partner - Latino Health Access (LHA) • Interventions • FAST (Families and Schools Together) • CDPT (Child Development Parent Training)

4. Santa Ana, CA - zip code 92710 Challenges faced in Santa Ana • Recruitment of families • Scheduling • Attrition • Neighborhood violence • Immigration reform • Parent empowerment • Cost

5. Riverside, CA - Arlanza neighborhood • Highest concentration of Latinos in the City • Partners • City of Riverside, Mayor’s Office • Riverside Red Team • Youth Violence Prevention Policy Board • Interventions & Projects • Arlanza Youth & Family Resource Center • Neighborhood Indicators Project

6. Riverside, CA - Arlanza neighborhood Challenges faced in Riverside • Illiteracy • Changes in City government • Code Enforcement

7. Perris, CA • Ethnically diverse city - historically low income, • but with newly developed areas of upper-middle • to upper income populations • Partners • Perris Valley Arts & Activities Council • Riverside County 5th Supervisorial District • Perris Red Team • Interventions - None

8. Perris, CA Challenges faced in Perris • Divisive community • Lack of support from City • Government • Lack of support from powerful • business community

9. SUCCESS! FAILURE! Success vs. Failure Santa Ana, CA - zip code 92710 Riverside, CA - Arlanza neighborhood Perris, CA - entire city • 3 communities all with significant challenges for community-based intervention • 2 are successful, 1 is not... • WHY?

10. Readiness to Change

11. Transtheoretical Model (TTM) (Nidecker, et al., 2008). Behavior change model with 5 stages of “readiness to change”. 1. precontemplation 2. contemplation 3. preparation 4. action 5. maintenance

12. Community Readiness Model(Edwards et al., 2000) Community readiness model has 9 stages of “readiness to change”. 1. no awareness of problem 6. initiation 2. denial 7. stabilization 3. vague awareness 8. confirmation & expression 4. preplanning 9. professionalization 5. preparation

13. Community Readiness Model(Edwards et al., 2000) • Case study of Perris demonstrates how readiness to change may be a precursor for YVP community intervention • ACE-UCR lesson learned: Challenges and barriers faced in Perris might have been overcome had we more closely examined the community’s level of readiness to change • Work in Perris began in January 2004 with start up of the Perris Red Team • To date, no intervention or program to address youth violence has been developed or implemented

14. Community Readiness Model(Edwards et al., 2000) Overview of Perris Timeline (see Parker, Alcaraz, & Payne in readings) Year 1 - 2004 • Hints of denial and vague awareness of a problem: belief is that existing programs such as project SHIELD are address YV problems; no new efforts are needed • Evidence of preplanning and preparation: Red Team develops mission statement; conducts assessment of local service providers; 2 City Councilmen are convinced to attend Red Team meeting

15. Community Readiness Model(Edwards et al., 2000) Overview of Perris Timeline (see Parker, Alcaraz, & Payne in readings) Year 2 - 2005 • Edging toward initiation: Red Team plans to conduct teen focus groups; begins strategic plan • Relapse to preplanning and preparation: focus groups tabled; strategic plan became focus; City Councilmen don’t come back

16. Community Readiness Model(Edwards et al., 2000) Overview of Perris Timeline (see Parker, Alcaraz, & Payne in readings) Year 3 - 2006 • Moving closer to preparation: 3rd Councilmember joins Red Team, seems more committed to help; she gives guidance on development of strategic plan and how to present to City Council • Sliding back to preplanning: Red Team attendance is low; strategic planning slows; Red Team decides to model neighboring city organization - UNITY; all efforts go toward starting UNITY and strategic planning falls by the wayside • Again moving toward preparation: UNITY is established and Red Team begins again to focus on strategic planning and by end of 2006 strategic plan presented to City Council

17. Community Readiness Model(Edwards et al., 2000) Overview of Perris Timeline (see Parker, Alcaraz, & Payne in readings) Year 4 - 2007 • Moving again toward initiation: Workgroup meeting with City Council is productive; City Council will support a parent needs assessment survey in the 2 Perris school districts • Setback to preparation: Mistakes implementing survey in 1st school district cause delay in beginning second district survey; problems and issues must be resolved • Near relapse all the way back to preplanning: Difficulty getting cooperation from second school district; turnover in Red Team leadership; difficulties continue into 2008

18. Community Readiness Model(Edwards et al., 2000) Overview of Perris Timeline (see Parker, Alcaraz, & Payne in readings) Year 5 - 2008 • Initiation is close: Resumed survey project in Fall 2008; completed in spring 2009 Year 6 - 2009 • Moving still closer to initiation : Analysis of survey data revealed 4 key areas of concern; Red team takes report to City Council with a solid proposal for addressing one issue - the need for more arts and activities for children; summer program and provider ready to provide program in summer of 2009; City asked only to provide insurance rider • Possibility of moving to full-fledged initiation with stage 7, stabilization and stage 8, confirmation looming in the near future: Prospect quickly undermined by City leadership failing to act; summer program goes elsewhere

19. Community Readiness Model(Edwards et al., 2000) Overview of Perris Timeline (see Parker, Alcaraz, & Payne in readings) Year 6 - 2009 (continued) • Major slide and relapse to stage 4, preplanning: Red Team decides to publish a report of the survey findings; series of focused planning meetings to develop a publishable document were scheduled To date - 2010 • Document is complete and in the format and design phase; Perris Sheriff’s department is going to publish and distribute most likely in the late fall

20. Take Home Message Three factors explain lack of success in Perris 1. Unstable leadership • 4 different Red Team leaders • Political leaders in and out of Red Team 2. Shifting/unstable Red Team membership • Agency leaders dropped out, sending underlings to meetings • Members became tired and frustrated at lack of progress and quit coming 3. Shift in focus from reducing youth violence to creating another group, UNITY

21. Community Readiness Model: A Tool for Assessment Community Readiness: A Handbook for Successful Change ( Plested, Edwards, and Jumper-Thurman, 2006) • provides survey methodology • set of questionnaires for community leaders • determine if a community is ready for change • determine what approach might bring a community to a state of readiness to change