Community Engagement Toolkit: A Participatory Action Approach Towards Health Equity and Justice

COMMUNITY ENGAGEMENT TOOLKIT: A Participatory Action Approach Towards Health Equity and Justice Table of Contents Introduction................................................................................................................................................. Ready, Set, Go! ................................................................................................................................... STEP : Recruiting & Retaining Relationships............................................................... Recruiting Community Members.......................................................................................... Planning for Retention................................................................................................................... Making Group Agreements........................................................................................................ Establishing a Group Identity.................................................................................................... Reviewing Group Assets.............................................................................................................. STEP : Identifying Problems & Solutions......................................................................... Identify Community Problems................................................................................................. Select an Issue to Focus on....................................................................................................... Choose What to Research & How........................................................................................ STEP : Action Planning & Strategizing............................................................................... Action Planning................................................................................................................................... Stakeholders Power Mapping................................................................................................. Building a Communication Strategy................................................................................... Framing the Issue.............................................................................................................................. STEP : Evaluating & Documenting Progress................................................................ Evaluate the Outcomes................................................................................................................ Evaluate the Process...................................................................................................................... PAR Final Report................................................................................................................................ Appendices.................................................................................................................................................. Assessing Myself as a Community Connector Worksheet............................... Trusted 5 Worksheet...................................................................................................................... Organizational Readiness to Implement Change Worksheet......................... Setting Group Agreements Activity..................................................................................... Member Asset Identification Worksheet......................................................................... Member Asset Inventory Activity.......................................................................................... Ideal vs. Real Brainstorm Activity......................................................................................... Choosing an Issue Activity.......................................................................................................... Action Planning Worksheet....................................................................................................... Stakeholder Power Mapping Worksheet........................................................................ Developing an Overall Strategy Worksheet................................................................. Sample: Tobacco Free Youth Center’s Overall Strategy.................................... Developing a Strategic Message Worksheet.............................................................. Sample: Messaging for Healthy Food Access in Nixon Heights................... PAR Process Evaluation Worksheet................................................................................... PAR Report Worksheet Packet............................................................................................... 1 2 3 4 4 10 11 12 13 13 14 14 15 16 16 17 19 20 20 20 22 25 26 26 26 28 29 30 32 33 35 37 39 41 43 44 45 47 49 50 52 54 COMMUNITY ENGAGEMENT TOOLKIT 04 Community engagement was given a working definition by the Center for Disease Control and Prevention (CDC) when its first edition of Principles was published. The organization agreed that community engagement was: “...the process of working collaboratively with and through groups of people affiliated by geographic proximity, special interest, or similar situations to address issues affecting the well-being of those people. It is a powerful vehicle for bringing about environmental and behavioral changes that will improve the health of the community and its members. It often involves partnerships and coalitions that help mobilize resources and influence systems, change relationships among partners, and serve as catalysts for changing policies, programs, and practices (CDC, 1997, p 9 – published in CDC, Principles of Community Engagement Second Edition, 2011, p. 3)”. Community engagement is about ensuring that those most impacted by challenges and inequity have an equal voice in designing and implementing solutions. The active participation of residents and their families, partners and trusted leaders is an integral part of community engagement practices to achieve better results. A shift in power where community residents own the solutions will lead to a better impact, sustainability and ongoing civic engagement. This toolkit will guide local public health leaders, community liaisons, and coalitions through a step-by- step process of incorporating effective community engagement strategies into their local programs. This toolkit relies on local representatives acting as community connectors, a trusted partner with expertise in the topic being addressed, who supports community residents through a process to prioritize problems and solutions in their community. The community connector can link people to other resources and services in their community to improve their quality of life. Later in this toolkit, we’ll discuss the role of the community connector in more detail. Lastly, this toolkit encourages communities to celebrate “wins” of all sizes. Don’t feel obligated to delay celebrations until the end of the project. Several weeks or months of consistent, hard work deserves a reward. Small to large celebrations at various stages of the project keep participants engaged, excited and willing to continue the work. The celebrations should draw attention to the vision and direction of the project and encourage continued momentum. Some ideas on reason to celebrate include, meeting goals, finalizing plans, completing actions and bringing about a change. The participants will appreciate the break, as well as recognition of their hard work. Consequently, they will want to go back to work and achieve more wins. Introduction COMMUNITY ENGAGEMENT TOOLKIT 05 This toolkit is designed to provide a community connector or facilitator with basic easy-to-use action focused activities, tools, and resources to support community members in exploring and understanding issues affecting their communities. Included are tips for organizing, educating or advocating for change. The activities are designed to support a group that is comprised of diverse community members. The group should be open to members of all cultural backgrounds; all sexual orientations; working and non-working adults; single and married individuals; parents and grandparents; homeowners, renters, and the displaced; business owners and community activists. The list should be limitless. Typical of facilitating community-driven projects, each is different, so this toolkit is a guide for facilitation with a base set of activities, tools and resources. No project is required to use every element within this toolkit. Oftentimes, projects will incorporate other activities and tools to supplement and support the overall project. Before going through the step-by-step process, the toolkit will review some definitions and concepts that of the participatory action approach the toolkit is built around and discuss what organizations should do before starting their community engagement work. To frame and guide the way community members should be engaged let us begin by defining concepts used throughout this toolkit. Community engagement is driven by the residents. A community with unified residents is a powerful vehicle. It inspires changes that will improve the health of its residents. Residents who have similar interests or situations can address issues that affect their neighborhood’s well-being. Health and well-being are generated where people live, work, learn and play. Health inequities are the result of poverty, racism and widespread oppression. In community engagement, public health departments and other agencies work collaboratively on community-driven projects. These grass-root approaches are meant to let residents tackle community issues using their own united voice and actions. When an agency works with residents, it increases the likelihood of their buy-in and ongoing efforts. Drawing on local knowledge from a diverse group is smart. The group forms solutions that are practical, effective and rooted in the realities of the community. Being in control places community residents in a position to feel empowered as they build leadership, local capacity and trust. Inclusion

poverty, racism and widespread oppression. In community engagement, public health departments and other agencies work collaboratively on community-driven projects. These grass-root approaches are meant to let residents tackle community issues using their own united voice and actions. When an agency works with residents, it increases the likelihood of their buy-in and ongoing efforts. Drawing on local knowledge from a diverse group is smart. The group forms solutions that are practical, effective and rooted in the realities of the community. Being in control places community residents in a position to feel empowered as they build leadership, local capacity and trust. Inclusion and involvement in decision making supports empowering community members to improve the conditions of their community. Community Engagement Spectrum The Goal of this Toolkit HUNGER ENVIRONMENT AND SAFETY ISOLATION INCOME AND JOBS ACCESS TO CARE TRANSPORTATIONMENTAL HEALTH HOUSING EDUCATION SOCIAL DETEMINANTS OF HEALTH INFORMCONSULTINVOLVECOLLABORATEEMPOWER InformInvolveEmpower Low level of public engagement High level of public engagement Mid level of public engagement Provide community with info & assist in understanding, problems, alternatives and solutions. Obtain community feedback on analysis, alternatives and decisions. Work with community and consistently consider their concerns and aspirations. Partner with community in decision- making, including in identification of solutions. Community are making decisions and leading solution-based efforts. COMMUNITY ENGAGEMENT SPECTRUM *Based on the IAP@ Public Participation Spectrum, developed by the International Association for Public Participation, 2014 http://c.ymcdn.com/sites/www.iap2.org/resource/resmgr/foundations_course/IAP2_P2_Spectrum_FINAL.pdf Health equity means that everyone has a fair and just opportunity to be as healthy as possible. This principle requires removing obstacles to health such as, systemic poverty and racism, and their consequences. Those consequences include, powerlessness, lack of access to health care or good jobs with fair pay, poor education and housing and substandard environments. Opportunities to be healthy depend on the living and working conditions and other resources that enable people to live well. A population’s opportunities to be healthy are measured by assessing the social determinants of health (e.g., income, education, social inclusion, neighborhood characteristics, etc.) that people experience in their lives. Individual choices play a role in health; however, too many people lack access to options that provide healthy choices and are surrounded by targeted marketing for unhealthy behaviors. Health Equity COMMUNITY ENGAGEMENT TOOLKIT 6 A wide range of actions can be used to advance health equity for everyone. When residents band together to take actions against health inequity, the health and well-being of everyone improves. Therefore, community engagement is most effective when driven by the residents. COMMUNITY ENGAGEMENT TOOLKIT 07 Participatory Action Research (PAR) is research emphasized participation and action from communities that are most affected by the issue. It focuses on social change that promotes democracy and challenges inequity, information gathering, analysis and logical problem-solving. The goal is for the residents to reflect on the research and information to take action. As a model of community engagement, PAR allows organizations to work with these community members to actively participate in decision-making and problem- solving. The community members drive the lasting and effective community change. This framework nurtures community leaders who take responsibility for the well-being of their families, communities or the world. PAR builds network and strengthens an authentic community voice to address important issues. Elements of PAR are weaved throughout this toolkit. Participatory Action Research ParticipatoryAction Research Collaborating through participation Empowerment of participants Change - real life experience Evidence in terms of different outcomes New knowledge Documented lessons The Community Engagement Process Changing systems and social norms to address health disparities is a long-term process that requires many steps. This toolkit is broken down into the following steps: Recruiting & Retaining Relationships Identifying Problems & Solutions Action Planning & Strategizing Evaluating & Documenting Progress 1. 2. 3. 4. This toolkit contains background information, as well as activity instructions, worksheets and samples. Many of the steps and activities are included to support a participatory process and empower community members to take ownership of changes that affect them. This toolkit showcases a set of activities to guide a group through a participatory action-focused process. The group will explore health equity issues and solutions for healthier communities. Depending on the specific community issue(s) being addressed, and/or the demographics of the community being engaged, additional activities and resources are available with the Center for Wellness and Nutrition. Adapting to Engage Youth, Young Adults or Intergenerational Community Groups Engaging youth (ages 14-21) with this framework is a growing approach to addressing health equity issues. Youth-driven projects seek to strengthen their voice and empower young people to join in community change efforts. The desire to engage youth in this way is based on evidence from a wide variety of social learning, health promotion, popular education and youth development theories. Another growing approach in public health and community change is the engagement of intergenerational community groups that invite adults, seniors, and youth to talk about issues that affect the larger community. One of the primary benefits of working with many age groups is the power of connecting the strengths of older adults and youth in making a difference in each other's lives, as well as that of the community. COMMUNITY ENGAGEMENT TOOLKIT 08 The Role of the Community Connector is from the community or an existing and trusted partner to the community looks like, relates to, or speaks the language of the community has connections with community partners, government agencies, policy makers, media outlets, and/or other influential partners can commit to the duration of the project and a be a consistent supporter The role of the community connector is important to the success of this project. Most importantly, this person must have or build trusting relationships with community members. Whenever possible it is best to have a community connector who: The activities, worksheets and resources in this toolkit are designed for the community connector to draw on the expertise, knowledge, skills, and abilities of community members. The community connector will offer appropriate expertise and connections as it relates to the collective project. Throughout the toolkit there are tips for implementation to

the duration of the project and a be a consistent supporter The role of the community connector is important to the success of this project. Most importantly, this person must have or build trusting relationships with community members. Whenever possible it is best to have a community connector who: The activities, worksheets and resources in this toolkit are designed for the community connector to draw on the expertise, knowledge, skills, and abilities of community members. The community connector will offer appropriate expertise and connections as it relates to the collective project. Throughout the toolkit there are tips for implementation to accommodate specific situations. At the end of the toolkit, there is an appendix with examples of tools and resources . Communities are encouraged to make use of this toolkit and to contact the Center for Wellness and Nutrition for additional help. COMMUNITY ENGAGEMENT TOOLKIT 09 Making Sure that the Community Connector is the Right Messenger From the specific community or one similar From a similar cultural or ethnic background Speaks the same language, and/or Has experience with the specific issues The best messenger for this work is someone who has a deep understanding or respect for the specific community where work is being planned and implemented. This person should be an ally and trusted representative. The most effective community connector will be passionate about the efforts and committed to the long-term community engagement project. Ideally, a community connector that relates well to the population is someone: Beyond traits and experiences that make a community connector the right messenger, the person also needs to support empowerment and encourage the community’s unified voice. As a facilitator of this project, the community connector should challenge community members to take ownership of the project. The person should welcome and encourage everyone’s voice in all discussions and decision making. Lastly, the community connector supports community members as they move into leadership roles within this project and the larger community. Assessing Myself as a Community Connector is a worksheet that identifies default beliefs and practices. This tool will help the community connector reflect on how to become a stronger ally and/or advocate for communities. Recognizing personal unconscious biases is the first step of self-awareness for a community connector. This person should work on expanding social networks to include members of diverse groups. Engaging in more discussions with a diverse group of coworkers or volunteering in a different type of community can lead to a greater appreciation and perhaps, minimize the impact of unconscious biases of others. As a true ally to the community, this person should seek to bring community into places and conversations where it is not present. The community connector must be an unbiased, consistent, strong voice for authentic community involvement and perspective. A community connector should constantly look for opportunities to connect and empower the community with its people. COMMUNITY ENGAGEMENT TOOLKIT 10 Ready, Set, Go! Organizational Readiness Organizational readiness and support can influence whether community engagement is part of the planning process and if health interventions and system changes are implemented in, and ultimately integrated into, communities. It is important that your organization is ready to listen to the community and incorporate their feedback as well as be transparent about any limitation, deadlines, or funding restrictions you may have. The organization should also provide support and resources to the community connector who is directly engaging the community residents in the process. You can use a organization readiness tool, to assess where you are as an organization with supporting community engagement and change. You may consider using the Organizational Readiness to Implement Change Worksheet that can be found here: Immerse Yourself in the Community As an organization and an individual community connector, establish relationships and work with the formal and informal leadership throughout the community. Listen deeply and allow for rarely heard voices to be included in conversations that build understanding. Look for the community’s power and strength. Seek to understand the historical context of the community. What are the success stories, lessons learned, barriers and tensions related to previous attempts to engage this community? Above all else recognize, respect and appreciate the diversity of the community. COMMUNITY ENGAGEMENT TOOLKIT 11 First things first. Before beginning any work, community involvement is necessary. To accomplish this important step of full community participation, it is necessary to focus on Step 1. Timing for Step 1 will depend on previously established relationships with community members. Once a group is established, every interaction should be intentional. Developing a collaborative and trusting relationship should begin in the first few meetings. These activities will help to support the foundation. Recruiting Community Members Planning for Retention Making Group Agreements Establishing a Group Identity Reviewing Group Assets STEP Recruiting & Retaining Relationships 1: Recognize diversity and enforce inclusion at all times. Create a safe space where everyone is heard and encouraged to actively participate. Identify community and individual assets and strength that support the project. Let the members drive the decisions and remain flexible in meeting their changing needs. Community engagement with this framework relies heavily on the active and equitable role of local community members. Prioritize getting residents and informal leaders on board to contribute their knowledge, perspective and influence. Focus on local community leadership to create change and improve health. This approach serves to ensure that human resources and capacity in communities remain even after funding and projects end. Here are ways to maintain respect for members: As you plan to connect with community members, remember to listen and learn about the community's culture, perception, economic condition, social networks, power structures, norms, values, demographic trends, history and past experiences. Work with formal leaders and community influencers to help mobilize the community and engage other interested community members. Make sure you have a clear purpose or goal for these efforts. Is there a specific population, demographic, or subgroup of community members who are particularly affected by the issue needing to be addressed? Is there a group of community members that