Category: Uncategorized

A Note to Human Service Programs: Four More Practices for Building Social Capital During COVID-19

Co-Authors: Maureen Berner, UNC SOG; Phillip Graham, RTI; Justin Landwehr, RTI; Brooklyn Mills, ncIMPACT

 

In the first installment of this blog series, A Note to Human Service Programs: You Can Still Build Social Connections in a Time of Social Isolation, we shared the definition of social capital, insights on different types of social capital, and general principles that human service programs seeking to build social capital should consider. In the second, A Note to Human Service Agencies: Think About What Type of Social Capital You Most Need to Build Online, we shared insights on different types of social capital and general principles that human service programs seeking to build social capital should consider.

In the third installment, A Note to Human Service Programs: Three Practices for Building Social Capital During COVID-19, we focused on three questions and corresponding practices:

  1. How and Where Will We Connect? – Use Peer Groups with a Facilitator to Engage Participants;
  2. How Will This Make a Difference? – Help Participants Build Quality and Meaningful Relationships
  3. Is What’s Yours Mine? – Tapping into Social Capital in Organizations to Increase Participant Social Capital

As you read through the following additional social capital practices, remember there is no one-size-fits-all approach to helping participants build social capital in a human services program.  Every program has a different context with different values and goals. You, the program managers and directors, know best the population you are trying to serve. That said, here are some questions and practices that might help you.

What Matters Here? – Use Data and Logic Models for Social Capital Decision-Making and Evaluation

This may be the perfect opportunity to focus on data that are key to answering questions about the importance of social capital to your program outcomes. For example, you might use a simple email or text-based survey with applications such as Survey Monkey or PollEverywhere to gather data on participants’ relationships with potential employers. This might help organizations be prepared to aid individuals to better leverage those connections for advice, training, and information about job openings during and when the pandemic is over. In another example, you might ask program participants to list their sources of bonding capital to reveal whether the connections are likely to hinder, rather than help, program outcomes, such as cases of criminal activity.

Of course, this national emergency is not the time to overly burden program participants. Many may be feeling stressed and struggling to manage all the new restrictions on everyday life. Whatever data collection you do should be easy to complete and the value must be clear to program participants.

Finally, this may be a good time for a virtual team meeting among staff to stress test the organization’s logic model.  Logic models are a type of map that outline, in step-by-step fashion, how programs progress from resources and activities to short- and long-term outcomes. Does yours stand up to your aspirations for building and leveraging participants’ social capital in times such as this? This may be a time to engage your staff and a few participants in a virtual conversation supported by tools such as Zoom and Google Docs.

What About My Interests?  – Create Space and Opportunity for Organic Connections to Happen

Many successful programs balance freedom and structure in creating space and opportunities for connections to develop into trusting relationships. The right physical, social, and emotional environment can help people develop relationships by creating a welcoming atmosphere, or providing spaces suitable for conversations. In-person meetings often benefit from tactics such as offering food for participants. In a virtual environment, the tactics should be more geared to interaction. Games, visual images, and a welcoming facilitator can be important to building and maintaining relationships with program participants that allow them to move from formal engagement to organic connections. Video-based platforms could be key tools in creating spaces for participants to engage remotely.

Who Came Before Me? – Include Qualified Individuals or Alumni in Programming and Staffing

The intentional hiring of former participants, or individuals with similar experiences, may add to your program’s credibility in the eyes of current participants. This can help them establish trusting relationships with staff who have a familiar background (bonding capital) and reduce the reluctance to use relationships with those who are different (bridging and linking capital) for their own personal growth. In effectively reaching out virtually to current participants, these alumni can quickly become role models because they can relate to participants and are concrete models of success.

Not all alumni will be qualified to work in a program, but when qualified, alumni may add significant value.  If you don’t have alumni involved right now, you might engage some as volunteers or interns if you are able to do phone or online training. Then, they gain valuable skills and training while you are determining whether they would be a good fit as a staff member. In a note of caution, however, directors and managers may want to balance the value of these individuals with other staff who may have more diverse experiences and expertise needed by the organization during the pandemic.

How Do We Hold Each Other Responsible? – Emphasize Accountability

Accountability is one key aspect of social capital relationships. Social capital grows more efficiently when people hold each other “to their word,” and you may be worried that you are losing that spirit of accountability while so many program participants are isolated. If you don’t have a formal accountability instrument, you may want to think about the potential benefits of agreements or commitments in which participants, peers, staff, and/or supporters are explicit about what is expected of each other during the pandemic, and there is a mechanism to check back in or show fulfillment of promises online.  If you already have an instrument in place, this is the time to remind participants of it. These instruments can help bring transparency, consistency, and predictability, and add longevity to the relationships with/among participants.

There are different ways to structure accountability agreements. One way is through accountability agreements among the entire group. Another is through informal agreements that hold two peers accountable to each other.

Individual social capital may also be built through accountability structures between people in a bridging social capital relationship.  One of the easiest examples to understand is the relationship between a mentor and mentee.  Mentorship relationships imply responsibility to communicate, connect, and respect alternative views.  There is an expectation that advice is sought and provided.

Join Our Free Webinar!

For more information about social capital measurement and outcomes, please join our free webinar on April 1, 2020, 1:00 – 2:00 pm Central/2:00 – 3:00 pm Eastern: Measuring How Social Relationships Contribute to the Outcomes of Program Participants.

This webinar will:

  • Provide an overview of social capital—or the value that arises from relationships—and describe why human services programs should try to measure and evaluate their success in helping participants build social capital;
  • Offer concrete examples of ways to measure social capital in human services programs, and key considerations in doing so;
  • Explore the value of logic models and approaches for documenting social capital inputs, activities, outputs, and outcomes in a program logic model; and
  • Demonstrate how one program is tracking social capital to measure program outcomes, support programming, and build evidence of success.

The material for this blog series has been adapted from content based on: information gathered by engaging a panel of national experts for interviews and focus groups; conducting a national program scan of notable human services programs using social capital; visiting agencies in person, and writing in-depth case studies with selected programs, and augmented by research on virtual communities conducted by Anita Brown-Graham. The team responsible for that original content includes The Office of the Assistant Secretary to Planning and Evaluation at the United States Department of Health and Human Services, RTI International, and the ncIMPACT Initiative at the School of Government at UNC-Chapel Hill. All images are stock photos. This does not necessarily represent the views of the Department of Health and Human Services. Nothing in this blog series should be construed as endorsing any company or platform.

[1] Woolcock, M., & Narayan, D. (2000). Social Capital: Implications for Development Theory, Research, and Policy. The World Bank Research Observer 15(2) 225–249. https://doi.org/10.1093/wbro/15.2.225

[1] U.S. Department of Health and Human Services, https://www.hhs.gov/ash/oah/resources-and-training/tpp-and-paf-resources/cultural-competence/index.htm

[1] Mayer, J. D., Roberts, R. D., & Barsade, S. G. (2008). Human abilities: Emotional intelligence. Annual. Rev. Psychol.59, 507-536.

Mitigating the Risk for Falling through the Cracks: Strengthening the Census Response Rate

The Census.

In capturing data on everyone once every decade, the Census is a handy tool on which many of us base our research, programming, and communication. The Census has been around for 117 years, and every decade we see the stark differences in our composition from the decade before. Across many dimensions, the Census measures the pace of change for the country as a whole, each state as a whole, and any local community. In order for us to react to our changing surroundings, we must first know in what ways it is changing—this is the value of the Census.

Aside from the value of the Census for our research, programming and communications, it is also a powerful tool for determining where many federal, state, and local resources are allocated. As the most reliable composition of the population, Census data provides the foundation for distributing more than $675 billion in federal funds each year to communities across the United States to support important programs—including housing, education, transportation, healthcare, and employment. Census data is also used to re-establish the boundaries of congressional and state legislative districts, in addition to other local and state political boundaries, all structural means of increasing representation.

As of today, April 1, here is where we are as a state:

Self Response Rate for North Carolina: 33%

Rank of NC in the U.S.: 39th

As of March 29th, here are some numbers on hard-to-count populations:

% of Young Children in Census Tracts Average Self Response Rate
Less than 4.1% (542 Tracts) 29%
4.1% to 5.5% (541 Tracts) 30.8%
5.5% to 7.2% (541 Tracts) 31.2%
7.2% and above (541 Tracts) 29.4%

Young Children – 5.9% of NC population ages 0-4

% of Foreign-born Residents in Census Tracts Average Self Response Rate
Less than 2.9% (542 Tracts) 28%
2.9% to 5.7% (541 Tracts) 30.4%
5.7% to 9.8% (541 Tracts) 31.1%
9.8% or higher (541 Tracts) 30.8%

Immigrant Population – 7.9% of NC population is foreign-born

% of Minority Residents in Census Tracts Average Self Response Rate
Less than 14% (542 Tracts) 30.2%
14% to 28% (541 Tracts) 32.6%
28% to 50% (541 Tracts) 30.7%
50% or higher (541 Tracts) 26.9%

Minority Population – 34% of NC population is American Indian, Asian/Pacific Islander, Black, or Hispanic/Latinx

% of Residents in Census Tracts with No Internet Average Self Response Rate
Less than 12% (541 Tracts) 35%
12% to 21% (541 Tracts) 30.4%
21% to 31% (541 Tracts) 28.2%
31% or higher (541 Tracts) 26.9%

No Internet – 21% of NC households do not have Internet at home

For more data like this, please check out NC Demography’s Census Tracker: https://www.ncdemography.org/2020-census-tracker/

 

As an organization that works in public policy alongside communities and community partners, the ncIMPACT Initiative uses Census data all the time. A question we’ve been asking ourselves is: how can we all do our part to make sure this year’s North Carolina count is as accurate and complete as possible?

Here are some ways that might help you amplify the importance of the Census within your reach:

  1.  Use your social capital. One example of using your social capital, or your networks and connections, is by tweeting, sharing, or blogging about the Census on your social media platforms. Share the related content of others and make sure to follow any trending topics by using a hashtag on Twitter (#Census2020 is a popular one on Twitter).
  2.  Talk about your own experience filling out the Census. One thing you can do to spread awareness about the Census is to personalize it. Talk about your experience with the Census, whether that is through social media, newsletters, and everyday conversation (most likely through phone calls or Zoom calls, in our current world of social distancing).
  3.  Intentionally reach out to hard-to-count-communities. Leverage your relationships with organizations and communities that work directly with hard to count communities. For those who run these organizations, be intentional about encouraging the Census completion to your program participants and communities. Hard to reach communities include:
    • Young children under age 5
    • Hispanic or Latino individuals
    • American Indian/Alaska Native individuals
    • Black or African American individuals
    • Frequent movers
    • Renters
  1. Know the numbers. While it’s important to tell personal stories and make an individual case for filling out the Census, it is also incredibly important to emphasize what is at stake, including the number of dollars. More than $1.5 trillion in federal funding to state and local governments is distributed based on Census data – that’s a lot of dollars, and the number may help you make a compelling case for completing the Census.

We challenge you to spread the word about the Census and its great importance today. The link to respond to the Census can be found here: https://my2020census.gov/  

A Note to Human Service Programs: Three Practices for Building Social Capital During COVID-19

Co-Authors: Maureen Berner, UNC SOG; Phillip Graham, RTI; Justin Landwehr, RTI; Brooklyn Mills, ncIMPACT

 

In the first installment of this blog series, A Note to Human Service Programs: You Can Still Build Social Connections in a Time of Social Isolation, we shared the definition of social capital. In the second, A Note to Human Service Agencies: Think About What Type of Social Capital You Most Need to Build Online, we shared insights on different types of social capital and general principles that human service programs seeking to build social capital should consider.

As you read through the following social capital practices, remember there is no one-size-fits-all approach to helping participants build social capital in a human services program.  Every program has a different context and different values and goals. You, the program managers and directors, know best the population you are trying to serve. That said, here are some questions and practices that might help you.

Following are the first three practices. [NOTE: Blog Four in this series, A Note to Human Service Programs: Three Practices for Building Social Connections in a Time of Social Isolation, covers four more practices.]

How and Where Will We Connect? Use Peer Groups to Engage Participants

When peers work together, each person’s individual network becomes part of the joint network, ideally forming a peer-based safety net and resource web. In this time of stress and uncertainty, networks can be especially valuable, but you may not have time to build your own virtual platform. Moreover, virtual peer groups work better when using platforms that program participants already use. Facebook groups, WhatsApp, Next Door, and text message-based groups may be particularly helpful in leveraging the bonding social capital that exists among program participants. You can use “live events” on some of the platforms to replace in-person meetings that had to be canceled due to COVID-19 related restrictions on the size of gatherings. Whether “live” or not, expect in these challenging times that, in addition to your program content, participants will use the opportunity to seek needed information about resources from others. This may also be a time to see whether someone close to them is willing to barter some toilet paper in exchange for some other resource.

The long term social and economic effects of this pandemic will be significant. Now is the time to connect participants to the people and institutions that will be able to help them. Email, Twitter, and LinkedIn are useful tools for making connections to people who are needed for bridging and linking capital.

Some virtual groups include millions of people. However, virtual peer groups that are focused on building bonding capital for human services may often benefit from being small enough to allow participants to get to know each other meaningfully. A manageable size can provide opportunities to notice when someone is missing or just lurking rather than participating.  Also, virtual groups may in some cases do better when they have active facilitators who encourage participation and keep the group on task.  They generally require a strategy for capturing program participants’ attention, especially in a time such as this.

Before you launch a virtual peer group, ask yourself, “Do we have someone to get the group started? Have we determined when there will be live activities that require everyone to be online at the same time and when the activities will allow people to check in at their own convenience? If the group is closed (predetermined membership), have we decided when or whether to allow new members into the group?”

How Will This Make a Difference? – Help Participants Build Quality and Meaningful Relationships

Social capital involves building trusting connections, but trusting relationships take time and energy, whether they are in person, by phone or online. Some research suggests that trust may be hardest to build online, but it can be brokered. Your program may be well positioned to help participants know who they can trust online.

While there is no standard number of times a group might need to connect online, the interactions will generally benefit from being frequent enough for social bonds to develop. Interactions need to be meaningful to increase trust and connections. As such, this may be a good time to ask about challenges participants are facing. It can help to have participants who already have strong relationships with each other model this type of meaningful online dialogue for others.

For programs that seek to stay connected to alumni, this pandemic may provide an important opportunity to check in with them virtually or by phone.   

Is What’s Yours Mine? – Tapping into Social Capital in Organizations to Increase Participant Social Capital

Organizations have their own social capital, which may be embodied in their positive reputation in the community or referral networks. Building and accessing organizational social capital can improve a program’s ability to focus on participants’ individual-level social capital. This is a good time for you to explore how your organization can build connections that help individual participants be a part of networks to achieve their goals, such as partnering with the local workforce board, or a childcare agency.

In the midst of this COVID-19 pandemic, human services programs have the opportunity to get on the phone or online and tap into the networks of their stakeholders, including staff, volunteers, board members, congregations, and others to identify resources. By working remotely to reach out, you will be able to identify resources, open doors, and create connections for participants. This could be a good opportunity for some targeted matchmaking.

Join Our Free Webinar!

For more information about social capital measurement and outcomes, please join our free webinar on April 1, 2020, 1:00 – 2:00 pm Central/2:00 – 3:00 pm Eastern: Measuring How Social Relationships Contribute to the Outcomes of Program Participants.

This webinar will:

  • Provide an overview of social capital—or the value that arises from relationships—and describe why human services programs should try to measure and evaluate their success in helping participants build social capital;
  • Offer concrete examples of ways to measure social capital in human services programs, and key considerations in doing so;
  • Explore the value of logic models and approaches for documenting social capital inputs, activities, outputs, and outcomes in a program logic model; and
  • Demonstrate how one program is tracking social capital to measure program outcomes, support programming, and build evidence of success.

The material for this blog series has been adapted from content based on: information gathered by engaging a panel of national experts for interviews and focus groups; conducting a national program scan of notable human services programs using social capital; visiting agencies in person, and writing in-depth case studies with selected programs, and augmented by research on virtual communities conducted by Anita Brown-Graham. The team responsible for that original content includes The Office of the Assistant Secretary to Planning and Evaluation at the United States Department of Health and Human Services, RTI International, and the ncIMPACT Initiative at the School of Government at UNC-Chapel Hill. All images are stock photos. This does not necessarily represent the views of the Department of Health and Human Services. Nothing in this blog series should be construed as endorsing any company or platform.

A Note to Human Service Agencies: Think About What Type of Social Capital You Most Need to Build Online

Co-Authors: Maureen Berner, UNC SOG; Phillip Graham, RTI; Justin Landwehr, RTI; Brooklyn Mills, ncIMPACT

 

In the first installment of this blog series, A Note to Human Service Programs: You Can Still Build Social Connections in a Time of Social Isolation, we noted that social connections can be critical to program outcomes for many human service program participants. Even in a time of physical isolation, those connections may need to be maintained, built and leveraged.

As human service agencies help program participants take social capital activities online, it is important to be clear about the purpose for the social capital – what program-related purpose does it seek to serve? Researchers and policymakers commonly discuss the following three types of social capital:[i]

Bonding social capital refers to the relationships built among individuals with characteristics, experiences, or group membership in common (“people like me”).  Do your program participants need to stay connected to those who are similarly situated to help each other to “get by?”

Bridging social capital refers to relationships built among individuals, communities, or groups with differing background characteristics or group membership (“people different from me”). Do your program participants need connections between social groups, social class, race, religion or other important sociodemographic or socioeconomic characteristics to help get ahead?

Linking social capital is an extension of bridging capital and it focuses on networks and organizations that provide connections across power dynamics, giving access to more resources (“individuals or institutions in positions of power”).  Do your program participants need relationships with people or institutions in positions of power?

Online platforms, such as Facebook, allow for the production and maintenance of both strong ties and weak ties and, by extension, can influence positively users’ life satisfaction, trust and public participation. Several research studies suggest that a person’s bridging and linking ties may increase more easily because the technology is suited to maintaining these links cheaply and without high barriers. Bonding ties, however, will likely be limited to maintaining or solidifying existing offline relationships as opposed to meeting new people who serve to help participants “get by” unless human service agencies are able to meet participants’ need for identifying with others and gaining a sense of belonging; finding a basis for conversation and social interaction; connecting with family, friends, and society; and gaining insight into the circumstances of others—all these reasons can foster norms of reciprocity and trust and result in bonding capital

Once you have determined what type of social capital you have been building for participants and why, you may be ready to implement the strategies identified in the next two installments of this blog series, A Note to Human Service Programs: Three Practices for Building Social Capital During COVID-19, and A Note to Human Service Programs: Three Practices for Building Social Connections in a Time of Social Isolation, to serve those clients who have access to the phone and virtual tools.

However, it is important to note that social capital works best when in a supportive environment.  If you want to implement these practices, we recommend you do so within the context of the following underlying principles.

People at the Center

Person-centered programs view participants as experts, inviting them to drive the goals and services, and use staff as facilitators and supporters instead of directors. When participants are listened to and their interests and experiences drive the process, they may be more likely to feel cared for and respected. Trusting, reciprocal relationships may be more likely to develop among them and with program staff and volunteers.

Relationships as Assets

Programs that are successful in helping their participants leverage social capital often think of social capital as a critical asset. It has value, as important as the organization’s building or bank account. As such, program leaders seek to build, nurture, leverage, and monitor social capital that results in high levels of trust.

Staff and Participants as Partners

Programs that view participants as partners offer their participants agency to help shape and scope the program in ways that work for the participants. One way of doing this is to work to minimize any sense of an uneven power dynamic so that participants feel empowered to set their own goals and take the lead in developing a plan to achieve them.

Cultural Competence

Programs that reflect cultural competence promote “positive and effective interactions with diverse cultures” through “a set of attitudes, perspectives, behaviors, and policies.”[ii] This is often very challenging work for human services agencies, as staff and volunteers often have very different lived experiences and represent different cultures than program participants.

Emotional Intelligence

Emotional intelligence involves the capacity to effectively navigate emotions and use emotions to improve, rather than hinder, decision-making.[iii] It can lead to stronger bonds and trust (for example, by naming emotions or accurately recognizing others’ feelings) and may be a particularly important quality in the staff and volunteers of social capital-building programs by helping them navigate sensitive interactions.

Read the following blogs here, A Note to Human Service Programs: Three Practices for Building Social Capital During COVID-19, and A Note to Human Service Programs: Four More Practices for Building Social Capital During COVID-19, for particular practices you can implement during the COVID-19 pandemic with program participants who have internet access.

Join Our Free Webinar!

For more information about social capital measurement and outcomes, please join our free webinar on April 1, 2020, 1:00 – 2:00 pm Central/2:00 – 3:00 pm Eastern: Measuring How Social Relationships Contribute to the Outcomes of Program Participants.

This webinar will:

  • Provide an overview of social capital—or the value that arises from relationships—and describe why human services programs should try to measure and evaluate their success in helping participants build social capital;
  • Offer concrete examples of ways to measure social capital in human services programs, and key considerations in doing so;
  • Explore the value of logic models and approaches for documenting social capital inputs, activities, outputs, and outcomes in a program logic model; and
  • Demonstrate how one program is tracking social capital to measure program outcomes, support programming, and build evidence of success.

The material for this blog series has been adapted from content based on: information gathered by engaging a panel of national experts for interviews and focus groups; conducting a national program scan of notable human services programs using social capital; visiting agencies in person, and writing in-depth case studies with selected programs, and augmented by research on virtual communities conducted by Anita Brown-Graham. The team responsible for that original content includes The Office of the Assistant Secretary to Planning and Evaluation at the United States Department of Health and Human Services, RTI International, and the ncIMPACT Initiative at the School of Government at UNC-Chapel Hill. All images are stock photos. This does not necessarily represent the views of the Department of Health and Human Services. Nothing in this blog series should be construed as endorsing any company or platform.

[i] Woolcock, M., & Narayan, D. (2000). Social Capital: Implications for Development Theory, Research, and Policy. The World Bank Research Observer 15(2) 225–249. https://doi.org/10.1093/wbro/15.2.225

[ii] U.S. Department of Health and Human Services, https://www.hhs.gov/ash/oah/resources-and-training/tpp-and-paf-resources/cultural-competence/index.htm

[iii] Mayer, J. D., Roberts, R. D., & Barsade, S. G. (2008). Human abilities: Emotional intelligence. Annual. Rev. Psychol.59, 507-536.

A Note to Human Service Programs: You Can Still Build Social Connections in a Time of Social Isolation

Co-Authors: Maureen Berner, UNC SOG; Phillip Graham, RTI; Justin Landwehr, RTI; Brooklyn Mills, ncIMPACT

 

Let’s face it. Most of us crave human connections. They make our lives better in so many ways.

During this period of the COVID -19 pandemic, then, when we are doing our best to practice social distancing, many of us feel socially isolated. We miss our normal in-person connections. Students miss experiencing the interactions of in-person instruction, employees miss the water cooler conversations with their colleagues, and families and friends miss the dinners out on the town, the meet ups at the gym, and the hugs.

There is a cost to social isolation, and many of us have spent our first weeks of social distancing fighting against loneliness by using virtual platforms, such as Zoom, Google Hangouts, Webex, Talky.io, Facebook groups, and Instagram as our means of being together. We are working hard to minimize our sense of loss by trading in our usual face-to-face connections for virtual ones. We are finding ways to continue building and leveraging our social capital online.

We are not alone. Alcoholics Anonymous recently announced that it is moving its regular peer group meetings online. This causes us to wonder how other human service programs are using platforms and telephones to help their clients continue to build and leverage the social connections that may be critical to program success. The question is, “how do agencies help others build and leverage social connections at a time when physical interactions are so restricted?”  

Social connections can be critical for many human service program participants. The value that is derived from these connections is sometimes called “social capital,” and is an important resource in life – creating moments of positivity, supporting us through good times and bad, and exposing us to new ideas and people. When you cultivate healthy connections, research suggests you will enjoy a longer, happier, and more prosperous life as a result of the social capital created. This social capital can be accessed or mobilized to help you succeed in life by producing resources like information and emotional or financial support.

Remember the old adage, “it’s not just what you know, but who you know?” Well, there is research to prove this is true. The research on social capital suggests the key to building it is helping people to develop an increased sense of trust as they connect with other people, making it easier for them to work together. The more we connect with other people, then, the more we trust them and, the more we trust, the more we are able to effectively work together to reach shared goals. It turns out that this is true across different countries and across different states in the United States, as well as across individuals of intersecting group memberships. It is true irrespective of differences in education, age, income, race, and gender. People who are connected are people who trust. Even without the facial expressions, verbal cues, and nonverbal cues afforded in face-to-face connections, people can build trust through telephone and online interactions.

There is significant research on online activity, phone calls, and the creation of social capital. While some have argued that online actors have traded that medium for fewer face-to-face interactions and lower social capital, subsequent research has found that online and telephonic communications may actually have a positive effect on individuals’ social trust. The general assumption today is that patterns of online use is positively associated with individual-level production of social capital. This is an opportunity for human service agencies during the social distancing phase of COVID-19.

More Blogs in This Series

In the second installment in this series, A Note to Human Service Agencies: Think About What Type of Social Capital You Most Need to Build Online, we shared insights on different types of social capital and general principles that human service programs seeking to build social capital should consider.

In the third installment, A Note to Human Service Programs: Three Practices for Building Social Capital During COVID-19, we focused on three questions and corresponding practices:

  1. How and Where Will We Connect? – Use Peer Groups with a Facilitator to Engage Participants;
  2. How Will This Make a Difference? – Help Participants Build Quality and Meaningful Relationships
  3. Is What’s Yours Mine? – Tapping into Social Capital in Organizations to Increase Participant Social Capital

Finally, the fourth installment, A Note to Human Service Programs: Three Practices for Building Social Connections in a Time of Social Isolation, offers additional practical tools and frameworks for consideration.

Join Our Free Webinar!

For more information about social capital measurement and outcomes, please join our free webinar on April 1, 2020, 1:00 – 2:00 pm Central/2:00 – 3:00 pm Eastern: Measuring How Social Relationships Contribute to the Outcomes of Program Participants.

This webinar will:

  • Provide an overview of social capital—or the value that arises from relationships—and describe why human services programs should try to measure and evaluate their success in helping participants build social capital;
  • Offer concrete examples of ways to measure social capital in human services programs, and key considerations in doing so;
  • Explore the value of logic models and approaches for documenting social capital inputs, activities, outputs, and outcomes in a program logic model; and
  • Demonstrate how one program is tracking social capital to measure program outcomes, support programming, and build evidence of success.

 

The material for this blog series has been adapted from content based on: information gathered by engaging a panel of national experts for interviews and focus groups; conducting a national program scan of notable human services programs using social capital; visiting agencies in person, and writing in-depth case studies with selected programs, and augmented by research on virtual communities conducted by Anita Brown-Graham. The team responsible for that original content includes The Office of the Assistant Secretary to Planning and Evaluation at the United States Department of Health and Human Services, RTI International, and the ncIMPACT Initiative at the School of Government at UNC-Chapel Hill. All images are stock photos. This does not necessarily represent the views of the Department of Health and Human Services. Nothing in this blog series should be construed as endorsing any company or platform.

 

Opioid Response Project Team Spotlight: Transylvania County

Co-Author: Mary Parry

Naloxone is now regularly carried in first responders’ vehicles in Transylvania County, thanks to the collaborative work of their local Opioid Response Team. Naloxone is an opioid antagonist drug, used to reverse overdoses and save the lives of those struggling with opioid addiction. The team also seeks to make the drug available in public buildings like schools, libraries and city hall. But keeping Naloxone within arm’s reach is just the first step, according to Jim Hardy, who serves as a board member with the CARE Coalition of Transylvania County. “The issue has been training people to use Naloxone,” said Hardy. “There is a hesitancy around liability issues.”

Hardy is one of 12 members of the Transylvania Opioid Response Team, made up of key community leaders including the county sheriff, a county commissioner, director of the county health department, head of emergency services for the county, and medical professionals experienced in addiction. Aside from their work increasing access to Naloxone, the team collaborated with another agency to offer an information fair in Transylvania County. “Our goal is to provide public outreach, finding opportunities to help the public learn what resources we have available to help us curb this epidemic,” said Hardy.

Looking ahead, the Transylvania team would like to provide a clean needle program in the community. There are two such programs in the nearby Asheville-Buncombe area experiencing overwhelming demand. “One of the Asheville programs saw 700,000 needles distributed in one year,” said Hardy. “Those numbers show that not only is there a need for clean needles in our area, but that people are coming from other counties and other states to participate.”

The team has work to do before they feel the county will be receptive to a clean needle program of its own. “There are political issues. We live in a conservative county,” said Hardy. “We need to keep working to get people on board with tackling the opioid crisis from this angle.”

Members of the Transylvania team are starting to lay the groundwork by talking to community leaders about the benefits of offering a clean needle program. The most obvious benefit is cutting down on bloodborne diseases like Hepatitis C. As clients approach clean needle programs, workers are able to assess needs, offering help with health conditions. Sometimes those conversations lead to treatment.

Clean needle programs also help track the spread of Fentanyl, which is a potent substance showing up in a variety of drugs, and often a cause of overdose. Program workers offer Fentanyl test strips to clients, which can help them test drugs for the deadly substance before they use them. “One big problem with launching a clean needle program is location. Where do you do it?” Hardy asks. “In our population, we have a sizable number of people located in the Brevard area, but we also have quite a few people dispersed in rural areas. How can we make these easily accessible for the people who need clean needles?”

Community spaces like the health department, normally used for public health offerings, often don’t work well for clean needle programs. Residents aren’t as likely to access government facilities for information or resources related to habits they know are illegal. Another issue is funding for the purchase of clean needles. As for the Asheville-Buncombe clean needle program experiencing such high demand, those costs are covered by the church offering the program. “In addition to the needles, the church offers meals and a safe space,” said Hardy.

The Transylvania team’s work throughout the Opioid Response Project faced challenges, but the benefits have been many. Hardy points to their growing network as the most change-inducing outcome from this experience. “Being part of this team has created an opportunity for local leaders to sit down at the table together in an organized way to hear from each other and collaborate on working toward solutions to the opioid epidemic,” said Hardy.

“It’s projects like this, learning from others and sharing what we know, that empower new projects to happen.”

To learn more about the Opioid Response Project coordinated by the ncIMPACT Initiative, please visit: https://www.sog.unc.edu/opioidresponseproject

Emerging Healthcare Technologies in the Time of COVID-19

The pandemic we are currently facing is challenging traditional means of healthcare and highlighting the need for greater capacity for telehealth. In this current and unprecedented moment, the ncIMPACT Initiative aims to keep our partners and stakeholders informed by starting data-driven conversations and connecting you with resources that can boost your work – now more important than ever as COVID-19 continues to spread.

When ncIMPACT sought out new opportunities for improving health outcomes in the state of North Carolina for a recent project, we explored the potential of emerging technologies and methods of data collection in the health arena. Our work included interviewing 25 statewide and national health experts, and our findings continue to surface as relevant. Our experts pointed out several advantages to telehealth that have surfaced as critical during COVID-19.

Telehealth’s Advantages

  1. Screening patients remotely prevents the need for an in-person Doctor’s visit in which a symptomatic person exposes medical professionals and the public. With a virtual screening, physicians are able to instruct on next steps, including an in person visit with protective procedures if necessary.
  2. Routine care and check-ins can be provided to those living with chronic illnesses to prevent risking exposure. Many follow-ups and regular appointments can be done via telehealth, aiding in keeping those most vulnerable to complications in their homes.
  3. Telehealth models protect healthcare workers from coming into contact with as many potentially infected patients. Not only is it a preventative measure, but expands the capacity of providers. As there are less providers able to care for patients due to being infected, telehealth allows the physician to continue working if they choose to do so while quarantined.
  4. Telehealth will be vital to responding to mental healthcare needs during this time. Our capacity was already strained before COVID-19, and it undoubtedly will face new demands during and after the pandemic. Many people are increasingly facing health challenges and economic challenges, and are often facing these challenges as they are isolating themselves to flatten the curve.

 

 

Making Telehealth Work

As more telehealth methods are developed, the community will need to be integrated into the new language and setups of technological systems and data collection methods used by providers. One health expert from our qualitative interviews noted the importance of transparency in order to know what “goal we’re shooting for.” Transparency entails having “conversations with clients, providers, [and] payers,” and making information available to them. To make the technology work for the community, the respondent said, we need to “set up accessible models with a clear sense of what we intend to get out of them.” As many people are shifting to this new model, transparency and communication about telehealth models and the anticipated outcomes is vital to create trust between the patient and the provider.

Barriers to Accessing Telehealth

Telehealth offers many life-saving solutions during a time when person-to-person contact can be potentially deadly. However, we must recognize that these models of healthcare often require access to resources—financial resources to pay for the services if uninsured or uncovered and insurance models that give parity to telehealth services, physical resources (such as a computer) to access telehealth, and connectivity resources to have internet access. For example, North Carolina has a broadband access rate of 68%. This is just one requirement for accessing services, and around 32% of households do not have full broadband access. As we continue to talk about the vitality of telehealth, we must remember that there isn’t equitable access and then work to achieve it.

 

The Dos and Don’ts of Working in Rural Communities

North Carolina’s demography represents a high concentration of rural areas. In fact, there are 80 counties with an average population density of 250 people per square mile or less (NC Rural Center, 2016)

Those working in rural communities often come across situations in which it may be unclear what the next step is or how to go about that next step. The following categories represent different aspects of working in rural communities from a presentation given on January 24, 2020 by Calvin Allen, Maureen Berner, Anita Brown-Graham, and Brooklyn Mills.

 

YOUR INTERACTIONS

DON’T:

  • Avoid personal interactions for convenience
  • Assume norms around communication
  • Assume choice, power, ability, or resources: Either that folks don’t have them or that they do

DO:

  • Develop maximum opportunities for personal interactions. Physically immerse yourself locally as much as possible. Face to face interactions matter for trust building and learning the people and organizations in the community.

 

YOUR PARTNERSHIPS

DON’T:

  • Create a perception that your expertise is greater than community expertise
  • Devalue input from the community—they are the experts of their own community
  • Come in with a set plan without the expectation to adapt

DO:

  • Treat the community as a true partner

Involve local community members as experts, thought leaders, and partners, not research subjects. Their input will be invaluable to ensuring your project’s success. Take their feedback and suggestions to heart. Compensate them for their time, if possible.

 

YOUR INTENTIONS

DON’T:

  • Focus solely on scholarly research outcomes
  • Use community members as research subjects
  • Let parameters of funding be SOLELY in control

DO:

  • Intentionally address local needs and values obtained from research findings

Be serious about addressing community needs and improving local quality of life. Your work may well lead to important publications in scientific journals, but it is not the responsibility of community residents to help researchers achieve that. They are motivated to participate to make things better in their community.

 

YOUR RESPONSIBILITY

DON’T:

  • Assume norms and systems of rural communities
  • Assume that you have the knowledge required
  • Assume that just because models worked in other similar settings, they will work here.

DO:

  • Be prepared always to learn and shift

Recognize the limited knowledge of the researcher about place-based economic and social factors influencing program and service use in rural areas. Don’t assume you can always import models that have worked in urban settings.

 

YOUR END GOALS

DON’T:

  • Forget to fully wrap up a project with a future sustainable plan for the community.
  • Have an end goal of using information purely for academic purposes. Consider developing products that can also be used by the community

DO:

  • Leave a legacy of enhanced capacity and sustainability

Enhance skills, competencies, and social capital among community residents. It is the researcher’s responsibility to develop local capacity to sustain interventions and intervention evaluation after the initial research is completed and there is no more funding.

 

YOUR DATA

DON’T:

  • Assume that your data speaks for itself
  • Use data-oriented language that is not accessible
  • Expect that things will always go smooth sailing

DO:

  • Tell a story with the data
  • Be open about the fallibility of data
  • Be ready for questions
  • Be honest when you don’t know the answer

Find a way to connect with communities around authentic stories of what’s going on. Make sure to go beyond the numbers.

 

 

Drawing provided by: Hope Tyson

Impacts of Safety Nets for Families on Health Outcomes

As we continue to explore our findings from our Health Outcomes qualitative research interviews that we conducted in the summer of 2019,  we wanted to highlight the importance of children’s health in moving the needle towards health improvement. When we look at moving the needle toward  health outcomes, a natural place to address future outcomes is by addressing the need for investment in children’s health. Poor childhood health leads directly to poor adult health, which eventually contributes to a generational cycle of poor health within families. The 25 experts that we interviewed advised that one of the biggest impacts on childhood health is the ability to support families through health and human services safety nets.

 

Image result for health children

 

The experts that we interviewed reiterated that the key to improving population-health indicators in the near future AND in the distant future lies in improving our children’s social, economic and physical conditions. Childhood health outcomes will trickle into the adult-health outcomes as generational changes occur. Safety nets, such as nutritional aid, income supports, access to healthcare, and housing assistance, provide parents the opportunity to focus on their child’s well being instead of economic hardship. Without an increase in safety nets, the outcomes can be expected to be exacerbated and the chances of climbing the economic ladder are slim. This then creates a cycle of generational poverty, creating family hardships that we know is impacting children’s health.

 

“There is a large and growing population of people who have played by the rules, but cannot afford above a poverty-level existence,” said one expert. “This is affecting their kids. They have no health safety net and are often living in multi-generational households.”

 

Social safety nets must be well developed for families with children. One of the biggest influences on health outcomes for children are ACEs (adverse childhood experiences), which can affect health outcomes well into  adulthood. These experiences include physical abuse, sexual abuse, living with a parent who abuses drugs, and similar instances of household dysfunction. According the data, (American Health Rankings, 2019), one out of four children in North Carolina experience ACEs which have been found to be major risk factors for alcoholism, drug abuse, depression, and suicide attempts.8 Experts explained that children experiencing three or more ACEs have a greatly increased risk of health issues. The chart below displays  the frequency of ACEs experienced by North Carolinians under the age of 18 by severity of ACE frequency.

 

 

Adverse childhood experiences, such as abuse, drug use in the house, and household dysfunction, are likely to occur in households with economic hardship. While the aim is to help people transition out of hardship and climb the economic ladder, in the meantime, health experts suggest that safety nets must be in place. Not only can these safety nets in the form of services increase the chances for economic mobility, but they also have a direct impact on possibly preventing adverse childhood experiences.

 

“Bottom line: there are fewer opportunities for children in cycles of poverty to grow and realize full potential,” offered one expert.

 

 

 

 

Sources:

https://www.americashealthrankings.org/explore/health-of-women-and-children/measure/ACEs/state/NC

Ann E. Austin and Harry W.B. Herrick, The Effect of Adverse Childhood Experiences on Adult Health: 2012 North Carolina Behavioral Risk Factor Surveillance System Survey (2014), 6.

 

Accountable Care Communities Offer An Opportunity to Address Healthcare Disparities at the Systems Level

In a previous blog post, which you can find here, ncIMPACT shared information around NCCARE 360, an interdisciplinary referral tool being implemented in the state of North Carolina’s medical care systems. As we continue to research impacts of the health of a community, we find it increasingly important to look at the way data around how changes become integrated with existing cultural norms and daily lives of community members in North Carolina. NCCARE 360 is part of an effort to implement a model of Accountable Care Communities (ACCs).

ACCs

ACCs aim to address health at the community level through addressing the social drivers of health and looks at health on a systems level to better coordinate healthcare with a wide variety of stakeholders within a community. This coordination includes involving non-traditional partners in health initiatives, such as faith communities and academic researchers. ACCs have an underlying value of authentic community engagement. In the context of the ACC model, it is not enough to go into communities and give out information. Stakeholders must work alongside communities to create a power dynamic that gives community members agency and self-determination. Under the ACC model, the goal is to elevate the voices of community members who are most impacted by health disparities. For example, specific race groups are more likely to experience disparities within population health–those voices need to be amplified within this model.

 

 

Health Inequities by Race

In fact, the data suggests that many health initiatives have historically neglected or taken advantage of specific race populations, such as the Native American and African American communities (see Black-White Disparities in Health Care Report, released by the American Medical Association[1]). Racial disparities in health begin even at the stage of conception. African American babies are more than twice as likely to die during childbirth than white or Hispanic babies in North Carolina. While white babies die at a rate of 5.4% in North Carolina (comparable to the Hispanic rate of 5.5%), Black babies die at a rate of 12.4% (see figure below from NCDHHS).

 

 

Maternal mortality rates are alarming in general, but when analyzed by race, it is evident that Black mothers have a totally different experience during pregnancy and childbirth than their racial counterparts. In 2013, in the state of North Carolina, the maternal mortality rates for Black and white women was almost the same, with the white racial category making a large jump up in rates and the Black racial category briefly falling. However, since then, the numbers have since diverged once more. Today, a Black woman in North Carolina is 3x as likely to die from giving birth than a white woman. From 1999-2013, Black women accounted for 49% of the deaths due to childbirth in the state of North Carolina, while African Americans make up 22% of the state’s population (https://schs.dph.ncdhhs.gov/data/maternal/).

While working with the Kate B. Reynolds Charitable Trust on their targeted health strategies, our interviews with experts repeatedly brought up the importance of cultural competency at the systems level to address disparity. For example, one anonymous interviewee we spoke with mentions struggles with healthcare perceptions for older African American men:

“He grew up in a time where he knew studies were being done on Black people. Telling him he needs to go to the doctor brings up distrust for him. Entering into those large facilities, he’s not inclined to do that. He needs a provider that looks like him and be able to come to a place that feels safe.”

 

These disparities are alarming and to begin addressing these health inequalities, research and reports indicate that strategically culturally appropriate care, community capacity building, and homegrown community leader involvement will all need to be present as a start to making the state’s health system more culturally appropriate. These non-traditional partnerships implemented in Accountable Care Communities will require a breaking down of walls for everyone involved–silos will need to be removed for an integrated community care system.

For more guidance on implementing the ACC model, please see the following guide, provided by Kate B. Reynolds Charitable Trust and Duke Endowment, visit http://nciom.org/nc-health-data/guide-to-accountable-care-communities/

 

 

[1] https://www.ama-assn.org/about/ama-history/history-african-americans-and-organized-medicine

 

 

 

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