Presentation on theme: "Zha Blong Xiong University of Minnesota Yorn Yan"— Presentation transcript:
1Promising Models and Practices with Southeast Asian American Communities Zha Blong XiongUniversity of MinnesotaYorn YanUnited Cambodian Association of Minnesota
2Overview of Presentation Context of Southeast Asian (SEA) Americans in Minnesota.The Citizen Health Care Model to build collaboration between the University and Southeast Asian communities.The Statewide Tobacco Education and Education Project (STEEP) Model.Some evaluation data testing the model.Lessons learned.
3SEA Resettlement in the United States, 1975-1994 40,00035,00030,00025,00020,00015,00010,0005,0001975-19761977-19781979-19801981-19821983-19841985-19861987-19881989-19901991-19921993-1994
4U.S. Southeast Asian Population Asian IndiansFilipinoHmong = %; Asian Indian = %; Chinese = 23.36%; Vietnamese = 10.81%; Korean = 9.94%; Filipino = 17.84%;Laotian = 1.33%; Cambodian = %; Others = 13.53%
5Minnesota Southeast Asian Population Cambodian = 8,140; Hmong = 55,915; Lao = 10,070; and Vietnamese = 22,923 (Total MN Asian Pop = 214,234)
6HmongVietnameseOne county (Ramsey) near Minneapolis, MN, had concentrations of the Asian-alone-or-in-combination population between 10.0 percent and 24.9 percent of the total population. Counties with concentrations of 5.0 percent to 9.9 percent of the Asian alone-or-in-combination population were near all of the metropolitan statistical areas (Minneapolis-St. Paul, Bloomington (MN) mentioned above.
8Most Southeast Asians in Minnesota concentrated in urban and poor areas 53% of Minnesota’s Hmong population lives in Ramsey County and 45% within the City of St. Paul.The Hmong comprise 57% of all Asians in Ramsey County nd 65% of Asians in St. Paul ( American Community Survey 5-Year Estimates).
9Percentage of Household Income below the Poverty Line in St Percentage of Household Income below the Poverty Line in St. Paul, Ramsey and Hennepin Counties, MN by RaceCaucasianAfrican AmericanHispanicAmerican IndianAsian-non HmongHmongSt. Paul3.419.212.817.825.833.9Ramsey County2.618.712.314.112.631.9Hennepin County1.719.512.720.26.333.7
10Linguistically Isolated A recent study found that 81% of first generation respondents reported using a language other than Englishas their primary language, while 20% of second generation respondents also reported this (Robynn el al., 2010).Source: Census 2000 Data for Minnesota Population.
11Smoking ratesSmoking rates in the general population are declining since 2004 (stalled at 20%)Smoking rates in the SEA communities are still high.Some studies show that the prevalence rates for SEAs ages 18 and over ranged from 34% to 70% (Bautista, Ednacot, & Wong, 2005; Chen, 2001; McPhee et al., 1995).A 2009 study of 2,856 Hmong youth and adults in Wisconsin found that 15% of the youth ages reported daily use and 32% ever use.The American Legacy Foundation (2001) reported that the number of Asian American teens who smoke increased from 4.4% in middle school to 33.1% by 12th grade.Blue Cross and Blue Shield of Minnesota’s (2009) SEA study found that men are more likely to smoke (30%) than women (7%).
12Engaging the Southeast Asian Communities to Address the Tobacco Use Problem Community Engagement: Buy-in & PlanningCapacity BuildingCulturally Tailored, Multi-Approached EducationEmbedding and Systems Change
13Engaging the Southeast Asian Communities to Address the Tobacco Use Problem STEEPCollaborative Executive Team (CET)Lao Family Community of MinnesotaLao Advancement Organization of AmericaUnited Cambodian Association of Minnesota, Inc.Associationfor the Advancement of Hmong Women in MinnesotaDepartment of Family Social Science, University of MinnesotaAssociation for Nonsmokers-Minnesota
14Community Engagement Buy-in & Planning Model Citizen Health Care Model’s Principles:The greatest untapped resource for strengthening families and communities is the knowledge, wisdom, and lived experience of community members/citizens.Citizens must be included in the engagement process as producers and contributors, and not a clients or consumers of services.Researchers must come to the collaboration as citizen professionals to identify challenges, sources and nature of the problem, mobilize resources, and generate plans of action together.Source: Doherty & Carroll, 2002; Doherty & Mendenhall, 2006.
15Community Engagement Buy-in & Planning Process The Engagement Process for the Statewide TobaccoEducation and Engagement Project (STEEP) took 2Years (supported by ClearWay Minnesota: ):Action plans & program development: Retreat.Data collection: Focus groups.Data collection: Stakeholder interviews.Community leadership groups.The researcher and representatives of the four organizations met to establish roles and expectations, to review goals of the research project, and to draft and finalize the job descriptions for the community facilitators and the research assistantIdentified stakeholders for the community leadership groups.Capacity building for the collaborative & staff.Shared decision making and partnership building.
18Capacity Building Model: LAAMPP Approach: Train-the-trainers Community Engagement: Buy-in & PlanningCapacity BuildingCulturally Tailored, Multi-Approached EducationEmbedding and Systems ChangeModel: LAAMPPLeadership and Advocacy Institute to AdvanceMinnesota’s Priority Populations project (Lew, Honma,Portugal, & Baezconde-Garbanati, 2008).Build community and cross-cultural capacity for tobacco controlDeveloping a pool of CoachesApproach: Train-the-trainers(Corelli et al., 2007; Orfaly et. el., 2005).Capacity building of the collaborationStaff/Tobacco EducatorsVolunteers: Community fellowsAllies: Community leadersCommunity membersThis approach is based on the work of ClearWay Minnesota’s LAAMPP (Leadership and Advocacy Institute to Advance Minnesota’s Parity for Priority Populations) project (Lew, Honma, Portugal, & Baezconde-Garbanati, 2008) and the train-the-trainers model (Corelli et al., 2007; Orfaly, Frances, Campbell, Whittemore, Joly, & Koh, 2005).
19Culturally Tailored, Multi-Approached Education Community Engagement: Buy-in & PlanningCapacity BuildingCulturally Tailored, Multi-Approached EducationEmbedding and Systems ChangeSetting: Places of congregation (“if we build it, people will come” is not working )Community eventsTemplesMulti-housing unitsCommunity-based organizationsMaterials: Posters, objects, tools, etc. (see samples)Pedagogies: Story telling, demonstrations,and role playing.Evaluation: Pre- and post-tests; retrospective
20Chemical Poster What it is: A poster depicting the chemicals present in cigarettes.Why it is used:It is used to alert observers to the dangerouschemicals found in cigarettes.Its message:The chemicals pictured in this poster are chemicalsthat many observers will recognize. This posterencourages smokers to ask themselves,“If these chemicals are used in each cigarette,why am I still smoking?Retailer: Nimco Inc.,, Fax:Its message: The chemicals pictured in this poster are chemicals that many observers will recognize. This poster encourages smokers to ask themselves, “If these chemicals are used in each cigarette, why am I still smoking?
21Tar Jar What it is: This jar shows the amount of tar a smoker consumes in one year from smoking a pack(20 cigarettes) a day.Why it is used:It provides a visual picture of the tar that turnsthe lungs black.Its message:This educational tool teaches the effects of tobaccouse on health.Retailer: Nimco Inc.,, Fax:
22Community Engagement: Getting Communities & Institutions to Commit to Change Community Engagement: Buy-in & PlanningCapacity BuildingCulturally Tailored, Multi-Approached EducationEmbedding and Systems ChangeEmbedding practices and policiesHealthy living messages and practices become part of each agency’s programs.Co-presentations and team-focused programs.Systems change practices and policiesDevelop appropriate language for policiesAdopt policiesImplement and enforce adopted policiesEducate and inform existing state and local policies
23Commit to Embedding and Systems Change Community Engagement: Buy-in & PlanningCapacity BuildingCulturally Tailored, Multi-Approached EducationEmbedding and Systems ChangeAction taken:Date InitiatedDate CompletedCommentsInitial contact w/ member who knows someone in the entity.Talk with representative(s) of the entity about potential policy.Conversation with and/or present to group about potential policy.Have a conversation with the decision maker or the executive group.Present idea and language of policy and what the entity wants to cover.Help draft policy idea and language to the entity.Revise policy statement.Policy adopted.
24NUMBER OF POLICIES PASSED TYPE OF POLICYSYSTEMSTOBACCOCOMMUNITY BASED ORG.TEMPLEGROUPMULTI- UNIT HOUSINGOTHERSHmong Soccer Tournament (1)TobaccoXNo Tobacco Funding (5)Strengthening Comprehensive Policy (5)World Refugee Day (1)Multi-unit Housing (1)Cambodian Temple (1)Lao Temple (1)20% healthy options (5)Healthy Eating20% healthy options (1)20% healthy options (1)Bike racks (5)Active Living
25Lessons Learned Collaboration Staff Shared vision about the community well-being.Trust and respect one another as professional citizens.Commitment from the top of the organizations (i.e., executive directors).Shared leadership and sacrifice at the collaborative level (chair committees, rally, petition, cost to pay grant writer, etc.).The role of the University in the collaboration is key to our program success (i.e., model development, grant writing, and evaluation).The ongoing contributions of the TAs, consultants, and funders to guide, support, and strengthen the collaboration.StaffCapacity building is critical (i.e., demonstrate credibility, buy-in, and trust in the community, esp. with young, second-generation staff).Mentoring and coaching staff play an important role in our successes.Organizational flexibility (in office vs. in the field).
26Lessons Learned Evaluation Evaluation is a challenge when working with low literacy population.The need to balance between delivering the program vs. collecting dataAn hour training with pre- and post-testsThe challenge of using survey to collect data (i.e., response options; right and wrong answers).Reliable vs. practical measures.
27Lessons Learned Volunteers Program Challenge of retaining volunteers. Challenge of getting volunteers to commit to advanced training (tier three – two week training and a mentored project).ProgramBuild relationship with people is key to engagement, education, and systems change.If we move too quickly into systems change, the buy-in is not there in the community to pass policies.People need to personalize the problem before they can commit to change.
28Please don’t hesitate to contact us if you want to… Learn more about the Citizen Health Care Model to engage other immigrant and/or low SES communities;Learn more about our STEEP’s Dandelion and Systems Change Model;Have access to our evaluation data; orKnow more about our lessons learned and other success stories.
29CDC’s Program Evaluation Framework Framework for Program Evaluation in Public Health. MMWR 1999;48(No. RR-11)JH: this graphic summarizes the main points of the Steps in Program Evaluation and has the CDC stamp on it. It also references the AEA Evaluation Standards updated document which we can include in their electronic “packet.”
30American Evaluation Association Evaluation Standards Utility: credible, negotiated, timelyFeasibility: practical, context, efficientPropriety: formal agreements, conflict of interest, transparency, inclusiveAccuracy: valid, reliable, justifiedAccountability: documentation; internal & external metaevaluationYarbrough, D. B., Shulha, L. M., Hopson, R. K., and Caruthers, F. A. The program evaluation standards: A guide for evaluators and evaluation users (3rd ed.). Thousand Oaks, CA: Sage; 2011JH: This is a very brief summary of the AEA Evaluation Standards document and I don’t think we need to read every word. This is the skeleton of a 3-page document, which is on your thumb drives. The standards have been under revision for the past couple of years in committee and we are showing you this just to make the point that AEA evaluators continuously try to professionalize their evaluation practice, and hold practitioners to high standards of excellence. [One of the HELI participants asked about “standards.”]
31Evaluation Address four evaluative questions: How much have we been reaching out to the SEA communities?How much do the people in the community know about STEEP?How much have we made a difference in the SEA communities?How much have we made a difference to the people we educated?
32How much have we been penetrating the SEA communities? Conducted 65 events, delivered educational tools to 40,000 people in three target SEA locations: Twin Cities, Rochester, & St. Cloud.Recruited and trained over 120 volunteers; 20 of them delivered the education in their respective community.Networked/partnered with over 72 agencies and/or groups working on a variety of projects/activities in Minnesota.Recruited and trained 120 volunteers. Of the 120 trained volunteers, 20 had delivered the education using STEEP’s educational tools into their respective community.Networked and partnered with 72 agencies working on a variety of projects and activities in Minnesota.Engaged in several policy-related activities:
33How much do the people in the community know about STEEP? Nearly 97% of all survey respondents reportedhaving seen STEEP at community events in thepast year.More than 50% of the survey respondentsindicated hearing people talking “quiteoften” about STEEP’s work in their communitieswithin the past year ( ).
34How much have we made a difference in the SEA communities?
35How much have we made a difference to the people we educated How much have we made a difference to the people we educated? (Knowledge)Do you think smoking contributes to mouth cancers, poor vision, skin damage, ear ached. Now, think back to before you knew STEEP, would you say your answer to these questions (REPEAT) be (1) “the same now compared to before you knew STEEP,” ( 2) “a little different now compared to before you knew STEEP, or (3) “much different now compared to before you knew STEEP.”
36Graph 11. Rules about not smoking inside the home How much have we made a difference to the people we educated? (Smoking norms inside the home)Graph 11. Rules about not smoking inside the home. Changing smoking norms inside the home
37How much have we made a difference to the people we educated How much have we made a difference to the people we educated? (see smoking now vs. a year ago in the community)In your observation, do you see smoking in the following places NOW compared to A YEAR AGO in your community? Please answer Yes or No to each place
38How much have we made a difference to the people we educated How much have we made a difference to the people we educated? (see smoking now vs. a year ago in the community)
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