All parties in community–academic partnerships have a vested interest prevention program success. Markers of success that reflect community’s experiences of programmatic prevention success are not always measurable, but critically speak to community-defined needs.
The purpose of this manuscript was to (1) describe our systematic process for linking locally relevant community views (community-defined indicators) to measurable outcomes in the context of a youth violence prevention program and (2) discuss lessons learned, next steps, and recommendations for others trying to replicate a similar process.
A research team composed of both academic and community researchers conducted a systematic process of matching community-defined indicators of youth violence prevention programmatic success to standardized youth survey items being administered in the course of a program evaluation. The research team of three community partners and Five academic partners considered 43 community-defined indicators and 208 items from the youth surveys being utilized within the context of a community-based aggression prevention program. At the end of the matching process, 92 youth survey items were identified and agreed upon as potential matches to 11 of the community-defined indicators.
We applied rigorous action steps to match community-defined indicators to survey data collected in the youth violence prevention intervention. We learned important lessons that inform recommendations for others interested in such endeavors. The process used to derive and assess community-defined indicators of success emphasized the principles of community-based participatory research (CBPR) and use of existing and available data to reduce participant burden.
Community involvement in all stages of program development, implementation, and evaluation is now a standard of public health practice. Essential to sustainable collaboration is the ability to demonstrate the “return on investment” to a wide variety of stakeholders.
Francisco and Butterfoss
The PCVPC is a Centers for Disease Control and Prevention funded Urban Partnership Academic Center of Excellence established in 2006 that is a collaboration of four academic institutions and a community research collaborative, the Philadelphia Area Research Community Coalition (PARCC).
The first phase of the process of creating measures of community-defined indicators of program success involved three steps of matching indicator constructs to available measures and existing data.
As identified in
Reported more fully in Hausman and colleagues,
Step 3 of matching community-defined indicators to available data focused on data being collected for the preliminary evaluation of the PARTNERS intervention project.
An eight-member team composed of five academic and three community researchers from the PCVPC was formed to conduct a systematic item-by-item review of the evaluative standardized instruments administered in the youth violence prevention intervention. For clarity here, we will call these team members “raters.” Academic partners included four faculty members and one doctoral student training with the PCVPC. The three community members were members of PARCC and PCVPC, and lived and/or worked in West/Southwest Philadelphia. They had backgrounds in business, grassroots community organizations, and community and economic development. The community members were nominated by PARCC to participate in this research because of their ability to represent the intervention community and they demonstrated a clear interest in promoting the health of the communities in West/Southwest Philadelphia. These community members had been involved with the development and implementation of PCVPC’s research endeavors from the outset.
The process of matching the indicators to the evaluation tools started with having one rater (an academic partner) review all of the items in the youth surveys used in the evaluation (
During the initial step with the first rater, 98 youth survey items were matched to 11 (of the 43) community-defined indicators. In keeping with a process that aimed to be inclusive of different interpretations for matching, individual survey items could be matched to more than one community-defined indicator. The 11 community-defined indicators initially matched by the first rater were academic performance, future orientation, helping others, increased civility, decreased truancy, more participation in community organizations, less cursing, more parental involvement, showing kids love, more adults intervening for youth, and kids helping around the house.
Once items were grouped under their matched community-defined indicators by the initial rater, the seven other raters reviewed the initial matching and scored their agreement (yes/no) with the match. The matching by the initial and subsequent raters was recorded and examined for patterns of agreement. Results of the matching process for each item were discussed among the team and this provided opportunity for any needed clarification or questions answered. We then reviewed the patterns of agreement across the team for each set of items matched for each indicator. After discussion and review of the empirical data from all raters, the research team decided that five of the remaining seven raters needed to agree on a match in order for an item to be retained for future analyses. This allowed for a clear majority of the group to agree on a matching. Additionally, this solidified that no item would be retained that had the three community team partners disagreeing with a match. At the end of the process, 92 youth survey items were identified and agreed upon as potential matches to 11 community-defined indicators. For example, 14 items from the Alabama Parenting Questionnaire,
In our matching results, it is important to note that disagreement with matching of items to an indicator did not fall along academic/community lines. There was only one match of an item to an indicator that was retained where two out of the three community raters disagreed with the academic remainder raters. For the rest of the items retained in the matching process, two or more community partners agreed with the academic partners. No items had all three community members disagreeing with the rest of the raters. We saw this as strength in the process for communication and common views. We had one example of where an agreed upon definition of an indicator construct might have likely yielded different results was observed in the matching process for “increased civility.” For this indicator, two academic team members consistently disagreed with the rest of the raters on 43 items. The decision rule of five out of seven agreement maintained that the 43 items could not be rejected, but two important points emerged. First, no other indicator had 51 items to be reviewed for matching. Second, through discussion, we assessed that the two dissenters were clearly defining the construct in a different way than the rest of the team. Keeping true to the established process required keeping the results as is, but it became clear that this was one construct where further work was needed.
The first phase described here in the process of creating measures of community-defined indicators of success places emphasis on community participation and existing available data. A strength is that this process emphasized how academic researchers and community leaders can collaboratively work together to create measures of locally meaningful outcomes that meet established standards of evidence without adding to the research burden of participants. Both community and academic researchers participated in all stages of planning and reviewing, and community researchers had decision making power equal to the academic researchers.
The process described demonstrates several key areas where evaluation research can further the goals of CBPR. First, the process demonstrated that academic and community researchers can be well-aligned in interpretation and decision making within the research process. The process by which community views were “matched” to available data can have implications beyond violence prevention intervention, with potential for application to health outcomes of individuals and communities across the lifespan. This observation encourages additional similar processes as we described here, where community partners function fully within the research process. Second, there was good congruence in the agreement patterns even without definitions of the community-defined indicators. The consistent pattern of agreement between academic and community raters suggests that the raters may have had the same interpretation of each community-defined indicator. Defining the indicators and creating formal measures is an iterative process, and we feel that the results presented here are merely one of those iterations. Last, not all indicators were matched with items, and not all items were matched with an indicator. Thus, we acknowledge that some new measurement tools might need to be developed to fully capture community-defined constructs.
Another important lesson in our study was that the process provided a way to put CBPR into action in a proscribed manner. Following the procedures for the matching, academic partners in the research team further learned the importance of evaluating items reflecting community voice. In turn, community leaders were exposed to the systematic research process, which will help them in the future be more active consumers and advocates of research. The community partners in the PCVPC from PARCC came to the “research table” with a structure, support, and experience that not all community partners may have. Involvement with community partners who are not as familiar with the research process requires more time for establishing trust, communication, research goals, and a commitment to the process. We recognize that many of the community and academic partners had experience in CBPR and this added strength to the process.
We recognize the limitations to our process. First, the reliance on existing instruments used by the PARTNERS evaluation limited the number of available pool of items. Second, all eight raters did not review each item from all of the standardized instruments. Although the first rater purposefully erred on the side of inclusion rather than exclusion, there may be items that the first reviewer did not include for further review by the group that others may have included. Additionally, because it was an academic team member who did the first pass, it might introduce an academic bias to the process. There might also have been even more uniformity in agreement with proposed matches if standardized definitions of the community-defined indicators were provided at the beginning, rather than leaving interpretation to the raters. However, there were patterns of high agreement among raters and results indicating acceptable internal consistency, even without standard definitions.
We proposed important next steps in this process (steps 4 and 5 in
Because we used tools that are being used to collect data in the context of the PARTNERS evaluation, we will have access to data with which to conduct these analyses. We are careful not to interpret the results of our matching as a reflection on the valid, standardized instruments and the constructs they were originally designed to measure. The instruments were originally developed to measure specific constructs in youth development and are in fact of interest to the PARTNERS intervention. We will have the opportunity to analyze the new item configurations and evaluate consistencies and differences in the data between the original scales in PARTNERS and the items that comprise the new indices of the community-identified indicators.
Results of the entire matching process (to public data [step 2] and to PARTNERS evaluation data [step 3]) yielded six community-defined indicators that were matched to both public and PARTNERS data (increased civility, future orientation, academic performance, helping others, decreased truancy, and more residents participating in community organizations). This presents an additional area of evaluation in future phases, where we can compare and contrast the community-defined indicators based on data from these different sources.
Although the community-defined indicators of violence prevention programmatic success may not yet be considered universal and the availability of data will certainly vary by context, the process of reviewing and comparing community-defined indicators to academically defined outcomes and measures is informative and provides an opportunity to engage community members in the evaluation research process. The lessons learned from our experience encourage replication of the process in other communities and intervention program contexts and demonstrate how community voice can be woven into evaluation science in meaningful and important ways.
The process described here capitalizes on collected data to meet the voiced needs of the community to have locally relevant indicators of program success available. The matching process linking community identified indicators with survey items from established standardized measures used in a violence prevention intervention integrated continuous community and academic feedback. Community members were involved in every step of the research process. This method not only avoided additional participant burden and conserved limited financial resources, but also sought to increase return on investment for the community by using available and accessible data. As such, we worked toward a mutual goal of meeting both academic and community needs for evaluative information. Emphasizing the use of existing and accessible data also increases community capacity to evaluate programs and address local information needs. This process should be broadened beyond youth violence prevention to other forms of interventions relevant to local communities. This innovation will improve the capacity of program evaluations to address community interests and help build support for sustainability.
This manuscript was supported by the cooperative agreement number 5 U49 CE001093 (PI; Fein) from The Centers for Disease Control and Prevention. Its contents are the sole responsibility of the authors and do not represent the official position of the Centers for Disease Control and Prevention. This research was also supported by Award Number F31NR011107 (PI McDonald) from the National Institute of Nursing Research, and Award Number T32NR007100 (PI Sommers) from the National Institute of Nursing Research.
Our collaborator Dr. Thomas TenHave passed away May 2011 and will be greatly missed for his wisdom, kind patience, and mentorship. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute of Nursing Research or the National Institutes of Health. We would also like to thank Saburah Abdul-Kabir, Melanie Freedman, Kevin Giangrasso, Wanda Moore, Kate Radetich, Chris Reiger, Brenda Rochester, Maurice Stewart, Kim Wilson, and Crystal Wyatt for their contributions to the study.
* The results of Steps 1 and 2 are described more fully in Hausman and colleagues.
Recommendations for Indicator Matching
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The research team should have academic and community partners with experience working together in program planning, implementation, or research projects Identify definitions of indicators though methods that engage the community members (e.g. focus groups) and verify through community feedback Attempt to use existing data (public or primary data collection already in place) that does not add to participant burden; verify any matches with community members Develop a team of academic and community partners willing to engage in an exercise of communication and room for agreement and disagreement for matching data to indicators |
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Provide definitions for community-identified indicators to the matching team; engage in a discussion about the definitions prior to matching process Have a subsample of academic and community partners rate initial agreement Have the remainder of the academic-community partner team rate their matching agreement Develop a matching threshold (e.g., 5 out of 7 agree) that will not allow a data item to match to an indicator if all community partners disagree with the matching |
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Close the feedback loop and bring data from the matching-process back to the larger community Consider assessing the reliability of any new survey item configuration, or otherwise acknowledge the deviation from any standardized scale. Consider that new measurement tools might need to be developed to fully capture community-defined constructs. |