Cassandra's blog has moved!

Dear followers,

I have moved my blog to my new organizations website, which has other goodies as well. You can find and follow it at http://policypeople.org/blog/ Your following should have been automatically moved over. If you got the post about tuskegee today then we were successful.

Look forward to seeing you at the People's Policy Institute. Also check out the Connect feature, where you can get into conversation with other policy-oriented community-driven folks.

Regards,

Cassandra

The Art of Participatory Leadership

I went to a workshop with the Art of Hosting folks last week. www.artofhosting.org

entitled the Art of Participatory Leadership. Upon reflection I think it is interesting that some of the practitioners are moving from the nuetral language of calling, hosting, and conversing to the L word.

Leadership. It is a concept I struggle with in my work. To lead suggests a direction, a goal, a set of values. Yet many of us involved in collaboration shy away from leadership, worrying that to lead is antithetical to the concept of collaboration. Some of us attempt to offer our skills and resources to communities, because we believe that community-driven solutions work better. "We have tools to help you with your goals," we say. At least that is often where I am coming from. Of course all of our tools and processes are laden with values. To assert no values is a value in itself.

The Art of Hosting folks practice a wide range of participatory tools that are very much in line with the principles of CBPR and other participatory methodologies. The do this in the service of changing the world for the better. Moving toward transformative rather than incremental change.

I think their move from hosting to leadership, might stem from the insight that there are specific ideas that they value and they want to promote those values through the processes they share. I have had that insight recently. When in Omaha this winter I was challenged by a workshop participant that the policy analysis methods I was teaching could be used for anything - good or bad. That is a really important criticism.

So in my work I am thinking about two questions:

1) How to design a collaborative process for policy design and advocacy that is a true synthesis of traditional policy design processes and participatory action strategies?

2) How to bring a discussion of inequality, and race and gender in particular, into this work?

These are the questions that I want to lead others to think about. The processes introduced by the Art of Hosting folks gave me a chance to put these questions to others. That is the genius of it. Getting people to think on your hard questions, while you help them think on theirs. Inspiring each other to work together in things we, collectively, care about. You should check them out.

Community-Campus Partnership for Health Conference!

CCPH is having their annual conference in Portland in two weeks. I have found their conference is the best place to meet other people doing CBPR. Their conferences are action oriented. I am going with some questions of my own. 1)Thinking about how to integrate a rather academic approach to policy analysis to an Alinsky-style approach to policy change. 2)How to keep inequality generally, and race specifically, at the center of what we do - or at the very least on the table.

I will be running a pre-conference session on May 12th in the afternoon focusing on policy analysis. I will also facilitate a session on cost-benefit analysis on Friday morning. Otherwise fine me at the thrasher sessions on Thursday and Saturday, as well as the breakfast roundtable on Saturday.

Hope I get a chance to connect face-to-face with you at the conference. For details go to

http://www.ccph.info/

See you in Portland!

Systems Failure

I recently had the pleasure of meeting the women and girls of the Young Women's Empowerment Project. YWEP is made up of women and girls ages 12-23 who are involved in the Chicago sex trade and street economies, either willingly or unwillingly. They have been around six or seven years and have clearly spent a lot of time and energy thinking about how to build an organization that can be an asset to women and girls in their community.

Their Motto: Girls do what they have to do to survive.

Website: www.youarepriceless.org

Values: Self-care, empowerment, harm reduction, social justice, and popular education.

Not coincidentally, these well -chosen values would work well to guide a community academic partnership.

YWEP’s research was conducted over the course of a couple of years with design help from adult allies. (Scientists). They were able to reach 205 women and girls with a combination of street surveys, interviews, and focus groups. About half of the women and girls in the YWEP study were mothers or pregnant at the time of the research.

One of their research findings was that individual violence was magnified by individual violence. The individual violence was from family, pimps, johns, other community members. The institutional violence came from systems designed to help and protect their community. The criminal justice, child welfare, the hospital/public health systems, and other social services. They gathered many stories. Stories of girls being abused in foster care, then having their babies taken away from them and put back into that same abusive system. Stories of police demanding sex in order to let girls go and then arresting them anyway. Stories of hospital workers turning away girls because they admitted to being in the sex trade or because they were transgender or queer.

After conducting this research, YWEP concluded that they should continue to work on resistance to oppression and resiliance in their community without engaging the systems that were failing them. I have a lot of respect for these strong, intellegent, resiliant girls, and when they tell me that their resources are better spent working in their own community than on the systems surrounding it, I respect that decision. Although I did offer to help them work on system-level change any time they feel ready to do that.

The total rejection of systems seems a bit extreme, but the reality is that right now in America there are so many systems that are failing the communities they serve, and many individuals who are turning their backs on those systems - some practicing resilience and resistance like the YWEP girls and some simply hopeless. These system failures are expensive, tragic, and unjust. So let’s think about how community-academic partnerships can combine evidence-based policy with organized constituencies to effect changes in those systems.

Insights from the ICU

Permit me a somewhat off topic post for my blog after a difficult ending to 2009. I spent the last couple of weeks sitting by my father's bedside in the intensive care unit of a Florida hospital. My parents were run down on the sidewalk a couple days after Christmas by a drunk driver. My mother took less of the impact and was released from the local hospital after a few days. My father was helicoptered to a trauma unit at a hospital about an hour away. His is out of ICU and well on his way to what will be a long, but probably full recovery.

All that is the backstory of why I was spending so much time observing an intensive care unit. I noticed something very interesting there. This unit had a nursing to patient ratio of 1 to 2; 1 to 3 very rarely during rush times. The nurses are highly trained, and mostly very experienced. They were extremely attentive. The first few days I felt weird asking people with years of education, training, and experience to get more ice. But one day it suddenly hit me. In the intensive care unit, everything is important. From family involvement to fluid intake, everything contributes to marginal improvement or marginal decline.

And because people in intensive care are, almost by definition, not out of the woods, each of these pieces of information contribute to the whole picture that can literally mean life or death to the patient.

So, in this hospital there are no nurses aides in intensive care. I didn't ask about this, but here is my theory. I don't think it is that there aren't lots of things that nurses aides are perfectly qualified to help with in the ICU. I think that the hospital has determined that it is too risky to rely on information exchange with these critical patients. That having one person watching, recording, and ministering to each patient improves their changes of survival.

Now on to my insight about what this means for the work we do in partnership to design and promote more effective policies. For the most part, we operate in an environment in which the stakes are high - because we seek to improve health in our communities and sometimes that need is high - but the activities are longterm - so burn out is a serious risk if we don't pace ourselves. And almost all of us are working on other things. So here are a few things to think about.

1) Sometimes a few individuals (ideally 2 or 3) will have to take on the roles of the ICU nurse, meaning they will have to be the ones carefully watching, recording, communicating, and making decisions. These times usually are short-term and revolve around change activities like public actions, negotiations, and political campaigns. In partnership, careful attention needs to be paid to who those people are, and how they are chosen.

If the intense period drags on, or is expected to be sustained (as during ballot initiative campaigns), then a mechanism must be put in place to replenish the members of this group with reinforcements. This is part of the reason why good recording is so important. It allows new people to understand what is happening. If possible rotate out one individual at a time.

If face-to-face negotiation is the method, it is pretty important to keep the negotiating team consistent. This helps both with rapport, and with continuity of understanding. So much of face-to-face negotiating is non-verbal, picked up as feelings. Those intangibles can be difficult to express adequately to people who were not present.

2) Our work is long-term. The analogy to the ICU patient continues here as well. Once out of ICU recovery continues. Once a victory, whether negotiated or electoral, is secured, the partnership moves on to an examination of the implementation. For both the patient and the partnership this can be a surprisingly frustrating time. Not always, but often, recovery and policy implementation share the traits of being slower and less complete than we would like. It helps to be emotionally prepared for this.

Wishing all a personally and politically healthy new year.