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Still Invisible: One Size Does NOT Fit All

Posted By Darnell Bell, Tuesday, March 09, 2010
It is amazing that in 2010, many of those in positions of authority and responsibility in the prevention field (city, county, state and federal) have forgotten the invaluable lessons learned in the 80's and 90's that stirred us to develop programs, models and curricula that matched and responded to the needs of our specific communities. In developing programs, models and curricula, "one size did not fit all".  Though this is nostalgic and to many, ancient history, the beauty of the Elaine Johnson years in CSAP was an acknowledgement that the best and most effective programs, models and curricula targeting children and communities of color should come from experts representative of those communities. For those who remember the days, she convened "expert committees" of "heavyweights" like Dr. Wade Nobles, Dr. Sharon Shaw, Dr. Leonard Long, etc., to help the department develop appropriate and relevant programs, models, curricula and guidelines for ethnic-specific, culturally-focused prevention programming in the black community.
 
As we strive to maintain funds to continue our prevention efforts in our communities of color, we are now being told that to continue receiving funds, we must select an "evidence-based model" from a SAMHSA, CIMH, Department of Juvenile Justice, Department of Education, etc., listing that "best" matches our communities.
 
Not to be insensitive to the need for research based programming that shows impact and justify dollars spent, the reality is, unfortunately, none of these "evidence-based" programs or models are developed by folks of color; address the culture needs of our community and community youth; view culture has a significant risk or protective factor; nor acknowledge the impact of racism, oppression, poverty on our current mental health and self-destructive behavior, etc.
 
Yes, it is important that research drives programming. But, something is very wrong when certain research, or research done by experts outside of the inner circle, is completely ignored and is not allowed to play a role in program development, particularly program development in the black community.
 
It is amazing that our decision makers are not aware of the work and research of prominent African-American psychologist, educators and researchers, especially the work of Drs. Wade Nobles and Lawford Goddard of Oakland’s Institute for the Advanced Study of Black Family Life & Culture. From THEIR research, we learn that interventions designed to be effective in the black community must "overtly and intentionally develop competent, confident and conscious African-American boys and girls” to reduce the incidence of trauma-related, self-destructive behavior among African-American youth and that they must  be "based on the philosophy, culture, and values of African and African-American people. These interventions must "educate and inoculate” Black youth and re-align them to a value and belief system which was consistent with the positive nature of African people. It  is equally amazing that these same people have not read some of the evaluations of our local prevention efforts. While many of us function on small budgets, lack the funds to hire "expert evaluators",  lack university connections or lack the resources/sophistication to complete the NREPP application, some of us have research-driven programs that produce outcomes of merit.  
 
While CSAP will acknowledge the limited relevancy of many of the "evidence-based models" to the inner city black community, this caveat has been ignored by many others in authority inour local and state goverment who insist that "all kids are kids", "all kids use drugs for the same basis reasons", "race (or culture) has nothing to do with substance abuse and has little to do with preventing it".
 
It is sad that many fellow prevention practitioners will be forced to sacrifice the needs of OUR children and of OUR community by selecting an arbitrary, and totally inappropriate and irrelevant "evidence-based intervention" to maintain our funding.  As it pertains to substance abuse prevention, I guess the observations of Ralph Ellison still hold true today........"we are still invisible"!
 
 

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Greg Pliler says...
Posted Wednesday, March 10, 2010
Well written. I have always been told though, if you come with a problem, you had better also come with 2 possible solutions. So i challenge you, what are your solutions to this issue?
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Greg Pliler says...
Posted Wednesday, March 10, 2010
After checking the NREPP database, I found 29 interventions specifically for african americans. Granted, when you start talking specific age groups and types (substance abuse, violence, etc), it starts to narrow. The point is, that there are interventions out there (evidence based and on the NREPP list), that can be effective in the African-American Community. Not every grant or money source requires you to have your intervention straight off of the NREPP list.

You made the statement: "While CSAP will acknowledge the limited relevancy of many of the "evidence-based models" to the inner city black community, this caveat has been ignored by many others in authority inour local and state goverment who insist that "all kids are kids", "all kids use drugs for the same basis reasons", "race (or culture) has nothing to do with substance abuse and has little to do with preventing it". ----- I have not found he same issue in my state (Iowa), and that most prevention agencies take care to be very culturally competent. I am curious as to what state you are from.

Also, you have pointed to the fact that you or those you know have shown effective results in your communities with programs not on the list. Would you mind sharing these, the results, and how you came about these results?

I know it probably sounds like i am arguing with your statement, which i am not. I also do not necessarily agree with a "one size fits all" notion. I just don't know if i feel this "inner circle" exists, or if there is a "kids are kids" attitude in the prevention world.

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Darnell Bell says...
Posted Tuesday, March 16, 2010
Thanks for the feedback. I am in the state of California, more specifically in Los Angeles County. I deeply believe that our new leadership in substance abuse prevention in the county acknowledges that "one size does not fit all" and is willing to entertain models and interventions that have "real data" to support their effectiveness. However, those in higher authority in our county government, though experts in their own areas of expertise, are not as open-minded and do not share this same understanding. While they have a good understanding of youth and adolescent substance use/abuse, from a culturally narrow or singular perspective, they don't appear to acknowledge the nuances of youth substance abuse across the county's many diverse communities; nuances that can't be ignored in the development of appropriate prevention interventions/models.

Much of the research done by organizations like the Association of Black Psychologist and the research of its Latino counterpart, demonstrate the importance of culture, a "shared worldview", and the need for models and interventions that "spring (are developed) from our unique experiences. Unfortunately, others (though well intentioned) are developing programs/interventions for our community that are not base on our "shared experiences and worldview"...our understanding of the world around us and how it interacts with us.

The various list of programs on the NREPP, Department of Education, Department of Juvenile Justice, etc., are convenient. They are interventions that have been researched, tested and work in the communities where they have been developed and implemented. Of course, I don't doubt the overall effectiveness of the interventions, even in communities of color. But, like my grandmother always told me, "to a barefoot person, rubber shoes feel good!"

Having been in this field for almost 40 years, I am tired of "rubber shoes". Its time to "step up to leather!" I am one of several providers who has a long-standing program with "real data" showing its impact on African American youth. My intervention/program has been on the same elementary school campus for 25 years, uses a culturally specific curriculum, employs a control group, and uses t-tests, f-tests, ANOVA, etc. to analyze our results. Unfortunately, we don't have the budget or university connections to "get our information out there".

Yes, like you, I've reviewed the listing to see if the interventions COULD address the needs of black youth, and yes, many of them have shown, like "rubber shoes" that they CAN BE effective. Unfortunately, in my opinion, they are not grounded in our experiences and do not reflect our perspective of the substance abuse problem, its root issues and remedies. Until we get interventions/models that have the "feel and comfort" of homemade leather shoes, their effectiveness will be short-term in the black community.

I really hope that I haven't rambled on too long and that I haven't appeared to be argumentative. I would be happy to share information with you about my intervention and my outcomes. Should I post them under "Discussion", send it to your email address or post the information someplace else on this site? Let me know and thanks for the feedback and input.
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