Special Peer-Reviewed Issue
Fall 2005
YOUTH INVOLVEMENT
IN COMMUNITY VIOLENCE PREVENTION

Youth as Change Agents in Distressed Immigrant Communities

   

Lyndee Knox, Ph.D.
University of Southern California

America Bracho, MPH, CDE; Jazmin Sanchez; Moises Vasques; GingerHahn, MPH; Priscilla Monserrate Sanders, MPH; Cristina Jose Kampfner, Ph.D.
Latino Health Access

Our feature article explores how youth promotores (community health workers), in partnership with adults and Latino Health Access staff, have applied Paulo Freire's methods of reflective action to move from learned helplessness to hope in one low-income Latino community.

Background
Latino Health Access (LHA) is a community-based organization dedicated to improving the health and well-being of recent immigrant families in Santa Ana, California. LHA relies almost exclusively on promotores, or community health workers, to address a wide range of public health problems. Established in 1993, LHA conducts the majority of its work in the "92701" zip code, which has a population of 61,363 residents, 92 percent of whom are Latino, 60 percent of whom are foreign born, and 90 percent of whom are under age 45 (U.S. Census, 2000). The median household income is $33,728, with an average of 4.5 persons per family.

Overcrowding is a serious problem in the area with as many as three families sharing a one-bedroom apartment, and others resorting to renting garages and even closets to serve as sleeping spaces. A Rockefeller Institute study of urban hardship ranked Santa Ana as the hardest city in the nation to live in, when compared to the other 54 largest cities in the U.S. (Montiel et al., 2004). While the area comprises only 21.5 percent of the Santa Ana Police Department's south coast division, it generated more than 40 percent of all police reports in the city in 2003 and accounted for 56 percent of all juvenile crime reported in the city (Santa Ana Police Department, 2003). The area has few after-school opportunities for youth, and no childcare or community centers. Young children play unsupervised in the streets, older siblings are frequently the primary caregivers for their younger siblings, and school drop-out and teen pregnancy rates are high.

A Climate of Hope
Recently, LHA became aware of the challenges youth face in the community. In 1995, with start-up funding from the California Wellness Foundation, LHA established the Children and Youth Initiative. The goal of the program is to improve child and adolescent well-being and reduce risk factors for violence, school drop-out, and other health risk behaviors.

The youth-driven intervention is based on Brazilian educator Paulo Freire's methods of reflective action (Freire, 1970). These methods can help organizations join with groups that are socially and economically marginalized and without political voice, ultimately helping residents to create a climate of hope and overcome limits, rather than seeing their life situations as "dense, impenetrable, and enveloping" (Freire, 1970).

In Freire's model, assistants--in this case the youth promotores--go into the community with the intervening organization, collect data to describe life in that area, and report back to the larger group. These reports stimulate dialogue about the reality of living situations in the area. In this stage, called "decoding," each person presents and shares his or her findings and feelings about these observations. Through a series of discussions, they arrive at themes concerning situations that limit the residents. Themes for the youth program included alcoholism and related violence, poor pedestrian safety, lack of neighborhood beauty, problems with intergenerational family communication, and lack of positive activities for youth.


Themes for the youth program included alcoholism and related violence, poor pedestrian safety, lack of neighborhood beauty, problems with intergenerational family communication, and lack of positive activities for youth.


Questions are posed about why these situations and conditions exist. Through this process, people deepen their reflections and generate other questions.

Freire recommends the participation of a psychologist or sociologist in the process to help the group note the components of the themes as they emerge and develop skill-building and educational sessions around the themes. This process counters the view that nothing can be changed, and interjects hope. More discussion follows, during which the group identifies feasible actions, and then takes those actions, testing the residents' ability to successfully create change and giving the group the energy it needs to take yet another action.

The LHA Youth Promotor Program
From 1995 to 2000, LHA recruited, hired, and trained 12 high-risk youth, ages 13 to 19, to work as youth promotores within their communities. These youth promotores worked in-depth with approximately 120 additional youth, using youth councils as the organizing structure. Through their activities, youth promotores and the youth council members reached an additional 2,000 community members, 20 percent of whom were adults.

Recruiting and training promotores. Youth were recruited to the program through a three-phase process that began by the identification of "natural communities" within the 92701 area. Residents were asked to define their neighborhood or community--in general, the two- to three-block area around their home, or the building complex where they live. LHA selected four of these natural communities as intervention sites based on perceived need and residents' receptiveness.

Next, LHA staff and adult promotores conducted initial outreach in each of the four communities. They knocked on doors in the targeted neighborhoods, introduced the program, and extended invitations to social gatherings. During this process residents and agency staff became "co-investigators" in researching their community.

Once youth leaders are identified and enrolled as promotores, they receive comprehensive training in leadership, needs and resource assessment, data collection and analysis, problem solving, and communication skills. A critical part of this training is for youth to build skills in self-care and self-management (see sidebar).

Sidebar 1
Youth Promotores:
Challenges and Opportunities

Conducting community outreach and establishing youth councils. Once established, the youth promotor teams are assigned to work either in the communities where they live or in surrounding areas. The decision is based on three factors: their comfort level working in their own neighborhoods, their ages (older youth promotores are paired with younger ones), and their gender (boys are paired with girls).

Initially, the youth and adult programs were separate. However, it became clear that adults were needed to help the youth do outreach. Now all major outreach and events are conducted with an adult promotor present. In fact, the pairing of youth and adult promotores was so successful that adult promotores and the youth decided to jointly plan and implement a four-week, interactive alcohol campaign, which took place in the streets of the four neighborhoods (see the sidebar "Lorena's Story" for more about the campaign). Adult and youth promotor teams are supported during regular meetings by a social worker and psychologist.

Hope-energy-action. The cornerstone of the youth promotores' training, and of the intervention program itself, is the hope-energy-action project. Based on Freire's recommendations, youth promotores are taught to look and listen for "themes" in the communities they are assigned to. This occurs during casual conversations with youth and parents in the community, during home visits, at door-to-door surveys, and in community meetings.

Once the youth promotores identify a theme, they first bring the theme to the other promotores for discussion and confirmation. Next, the staff train youth promotores on the basic principles of data collection. Finally, youth collect data to confirm the accuracy and importance of the community-generated theme. After collecting data, youth report their findings back to their communities. The presentations help the youth develop leadership and problem solving skills, and promote involvement by youth and adults in the larger community. In turn, this helps to build the support the youth need to carry out their hope-energy-action projects, and to both build and strengthen ties between youth and adults.

Next, the youth promotores repeat the process of theme generation, data collection, and reporting back to their youth councils. Promotores and councils design and implement a "hope-energy-action" project that addresses the identified problems.

Sidebar 2
Lorena's Story

Reflection. After completing a hope-energy-action project, the youth promotores and their youth councils learn to evaluate the project impact by asking, "What happened as a result of the project?" In addition to collecting data to assess impact, the youth are guided through a series of questions designed to help them reflect on and gain a deeper understanding of the actions taken as well as the intended and unintended consequences of the actions. Using the energy generated by the (usually) successful actions, natural next steps are planned, or new themes are tackled. When Freire's process of reflection and action is successfully implemented, hope is generated, and energy to tackle new projects is high.

From a Freirian perspective, and for LHA, the objective of the action does not matter. Residents might work to reduce youth violence, increase park space, prevent the approval of more liquor licenses in their neighborhoods, or improve their community in other ways. What is most important is that participants understand the process of change and how action really does make a difference.


It does not matter whether residents are working to reduce youth violence, increase park space, or prevent the approval of more liquor licenses in their neighborhoods. It is important, however, that participants understand the process of change and how action really does make a difference.


Evaluation of the Youth Promotor Program
Imoyeshe, an evaluation team hired by The California Wellness Foundation, conducted a formal evaluation of the impact of the youth promotor program on social networks in the community. The results follow:

  • The number of people who participated in an activity to change something about their neighborhood more than doubled over baseline (42 percent, p<.01).
  • Youth reported receiving more parental assistance with homework (p<.05) and indicated that parents had visited their school more often than at baseline (p<.05).
  • Youth reported an increase in believing in the importance of serving as leaders at school or in the community (p<.01).
  • Seven times more adults and five times more youth participated in an activity to reduce alcohol consumption in their neighborhoods. Specifically, teens successfully mobilized peers and adults to block two conditional use permits in a neighborhood that is already saturated with alcohol outlets and that suffers from high rates of alcohol related problems.
  • All 12 of the youth promotores have completed some community college. All but two are expected to graduate in the next two years and transfer to state universities.

Challenges, Lessons Learned, and Implications for Practice
Agencies wishing to implement this model may want to consider the following ten principles of practice that LHA believes are critical to success.

  1. Offer a mechanism to enhance participation. People will participate, share assets, and work to improve the community, if a mechanism exists for them to do so. Hope- energy-action projects create this mechanism.
  2. Build on the skills of community members. Harnessing a community's skills and talents, LHA believes, is the secret to transforming that community. The promotores are trained to notice and ask about community members' assets, talents, and skills and to help create opportunities for those talents to be utilized so that community members can achieve their dreams and hopes. Much time is spent helping staff and community members see beyond the dominant culture's deficit view of immigrant communities, and to notice and build on what is right.
  3. Model agency management and intervention methods. The management of LHA models the program's methods and philosophy. Using the same principles taught to the youth, the agency director and staff use Freirian theories and empowerment approaches in all activities. Weekly training and support sessions with all staff are key to making this happen. The culture of empowerment created within the agency and staff is then communicated to the youth.
  4. Teach the benefits of reciprocity. LHA's partnerships with the community are based on a philosophy of mutual respect and mutual contribution. Underserved communities are very resourceful. People have something to give and feel better when they can give it. Contributions such as offering their living room for a meeting space, bringing food to a gathering, or making decorations for a fiesta allow people to maintain dignity and build ongoing relationships based on respect.
  5. Understand the value of compensation versus volunteerism. Youth and adults are hired and paid for the work they do. Children are compensated using a point system they can redeem for school supplies and other things they need and want. When professionals earning salaries ask residents in distressed communities to volunteer, it further underscores the daily inequities faced by these community members.
  6. View youth programs in the context of broader intervention efforts. The youth receive considerable support from a full team of professionals and lay community members. This is critical because community members view programs holistically, not categorically, as funders often do. Issues such as housing and violence, access to food and health, and family communication and academic success are all linked.
  7. Allow youth to be in charge. The hope-energy-action projects are conceptualized and developed by youth, who are perceived as the experts. LHA is seen as the support entity.
  8. Ensure long-term participation. Change takes time; building community trust takes time. "Hit and run" programs erode community trust. Staying long enough to see true change, which can take several years, requires both staying the course and being flexible as the community identifies other pressing issues. Learn to celebrate small successes and milestones along the way.
  9. Funding the program is a long-term commitment. In the past, foundations primarily funded new programs, which limits an organization's ability to stay with one project long enough to see change. However, some foundations are beginning to recognize the need to fund the operations of agencies or ongoing programs. Moreover, the hope-energy-action approach, in which content is less important than process, can allow an agency to view the community comprehensively and change content focus without losing the integrity of a program. This can help to sustain a program over the long term and reduce agency tendencies to change direction in response to funders' "hot topics" (e.g., youth engagement and violence prevention in the recent past, and obesity currently).
  10. Help low-income communities move from learned helplessness to hope and action. Learned helplessness is a major barrier to change for youth and adults in low-income communities, especially in immigrant communities. Many immigrants arrive in the United States after enduring much hardship and with great idealism and hope, only to endure exploitation by landlords, employers, and others after arrival. The effect can be particularly severe for the youth who are often alienated from parents because of long work schedules and varying rates of acculturation. Many service programs mistakenly reinforce helplessness and hopelessness by "doing for or to" rather than "with" the community and youth. Creating small opportunities for positive change, which youth and adults can drive, allows them to experience success in changing their lives and their communities, thereby building hope and paving the way to ongoing positive action in the community.

 

Authors
Lyndee Knox, Ph.D., works at the Department of Family Medicine, University of Southern California, Keck School of Medicine.

America Bracho, MPH, CDE; Jazmin Sanchez; Moises Vasques; Ginger Hahn, MPH; Priscilla Monserrate Sanders, MPH; and Cristina Jose Kampfner, Ph.D., are affiliated with Latino Health Access

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References

Freire, P. (1970). Pedagogy of the Oppressed. Continuum. New York.

Montiel, L.M., Nathan, R.P., and Wright, D.J. (2004). An Update on Urban Hardship.

Nelson A. Rockefeller Institute of Government. Available at: www.rockinst.org

Santa Ana Police Department (2003). Reports.

U.S. Census (2000).


Contact:

Ginger Hahn, MPH
Director of Communications
Latino Health Access
1717 N. Broadway
Santa Ana, CA 92706-2605
Phone: 714.542.7792
Fax: 714.542.4853
Email: ghahn@latinohealthaccess.org
Web: www.latinohealthaccess.org

 
 
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