Running head: SOCIAL JUSTICE INTERVENTION Development of a Social Justice Intervention Emily D. Loe University of Florida
SOCIAL JUSTICE INTERVENTION 2 Abstract In a small rural county, Latino immigrants are facing social stressors and social isolation whic h have the potential to lead to decreased mental health. Faith based organizations may be able to reach out to this isolated group. The purpose of this p roject is to develop and implement a social justice awareness intervention in faith based organizations that will educate community members about the isolated Latino community with the hope that they will reach ou t to the Latino population. An integrativ e review of literature was performed that looked at the use of spirituality and religion in developing interventions for faith based organizations It was found that spirituality and religion can be integrated into the content and delivery of an intervention in a faith based organization. The results of the literature review were then incorporated into the development and implementation of the int ervention that was validated with the community advisory board, church leaders, and was IRB approved. A pamphlet, video and survey were presented to one faith base d organizations. Church member s perceptions of Latinos and the intervention were gathered through the survey. Church members identified social and religious ways to reach out to Latinos in the community
SOCIAL JUSTICE INTERVENTION 3 Introduction There are currently 2,775 Latinos that are known to be living in a small rural county in Florida (US Census, 2010). Recent research with this population has found that they are experiencing mental health disparities and that they feel isolated in the community (Staccarini, 2008). Isolation has been found to affect the mental health and physical heal th of Latinos (Hara r i, Davis, & Heisler, 2008 ). Many religious texts support outreach to the underserved, and may be helpful in improving the health of the underserved population ( Bopp, Fallon & Marquez, 2011 ) Faith based organizations (FBOs) have been found to be a culturally acceptable place to provide a community health or wellness interventions (Asomugha, Derose, Lurie, 2011) L ittle work has been done to examine interventions that motivate these organizations to change their community It is believed that FBOs may be more receptive to a social justice intervention and may be more likely to embrace and enact social justice. The purpose of this project is to develop and implem ent an awareness intervention. The goal of this intervention is t o educate community members about the isolated Latino community with the hope that they will reach out to the Latino population. The intervention will be delivered to c ommunity members through faith based organizations This project has three components: the methods of delivering an awareness intervention, the content of the intervention, and the use of spirituality and religion in an intervention. This paper focuses on the third component and integrates religious a nd spiritual concepts into the educatio nal intervention. Specific aims for this project are to : 1.) d escribe the literature on faith b ased public health interventions, and 2.) develop a social justice intervention that incorporates spirituality and religion
SOCIAL JUSTICE INTERVENTION 4 Methods This was a pilot developmental descriptive study that follows the Community Engaged Research (CEnR) p rinciple s (Principles of Community Engagement, 2011). To accomplish the first aim of describing the literature on faith based public health interventions, an integrative r eview of research articles was completed. CINAHL, PubMed, and PsychINFO were searched using the keywords intervention, community, Latin Hispan*, church, faith based, social, and social action To accomplish the second aim of developing a social justice intervention, three honors students collaborated on developing an evidence b ased intervention. One student focused on the metho d of the intervention the second student focused on the content of the intervention and the third incorporated religious and spiritual themes This was accomplished through the development of a pamphlet and video that included scripture references, religious principles, and religious themes and by utilizing the chur ch hierarchy to deliver the intervention The intervention was then reviewed and validated by the community advisory board the student research team and w a s approved by IRB. Several churches were contacted and the intervention was then reviewed by the church leadership. The intervention was delivered at the church, with pastoral support for the congregation to consider attending. A post intervention survey was given to the c ongregations. N=1 churches have received the intervention at this time. Results Literature Review Evidence suggests that the integration of spirituality and religion is an important component of the content of an intervention, and the use of religion is important in how the intervention is delivered in the FBO. The two central t h emes identified were: 1) use of spiritual ity and religion in the content of an intervention and 2 ) use of spirituality and religion in
SOCIAL JUSTICE INTERVENTION 5 the delivery of the intervention. The theme of using spirituality and religion in the content of an intervention had two sub themes of 1) the use of spiritual concepts, and 2) the use of religious quotes. The theme of using spirituality and religion in the delivery of an intervention had two sub themes of 1) utilizing the church hierarchy, and 2) delivering a multi method intervention. Integra ting religious themes into the content of the intervention was accomplished by quoting religious texts, encouragement of religious practices, and a focus o n a personal spiritual calling. Using spirituality in implementing an intervention was done by tailo ring the intervention e intervention, and the use of more than one media to implement the intervention Evidence is summarized below. Table 1 Use of Spirituality in the Cont ent of an Intervention Content of an Intervention Spiritual Concepts in Content Religious Quotes in Content Link of spirituality and health Religious Call to Action Christian Hospitality Texts that direct Christians to R each O ut to U nderserved P ersons Christian Social Ministry Biblical Sto F oreigners Table 2. Use of Religion in the Delivery of an Intervention Delivering an Intervention Church Hierarchy in Implementation Multi Modal Intervention Church clergy and l eadership can Help Meet Needs Spread Information Increase awareness Group discussion Interactive literature Clergy lead education Mixed method
SOCIAL JUSTICE INTERVENTION 6 One of the most prevalent themes in the literature was the importance of including spirituality in an educational intervention delivered in an FBO. Spirituality and health can be linked and incorporated into intervention materials (Bopp, Fallon & Marquez 2011). This can be done by including religious themes that align with the intervention. For example, t here is a religious call to action to serve other people (McKinnon, 2009) This call has been emphasized ntral tenant of many churches. The spiritual theme of hristian H ospitality or being welcoming to all persons, was also identified (Sackreiter & Armstrong, 2010). This goes beyond the Christian call to serve others and includes helping to meet social needs such as friendship in addition to physical needs such as hunger (Sackreiter & Armstrong, 2010). not the end product, and acts of Christian charity are not the same as enduring changes that lead to justice (Turner, 20 10 ). McKinnon (2009) emphasizes the use of the Christian theme of helping others, when encouraging church members to reach out to recent Latino refugees in the border towns of New Mexico. Another spiritual theme that align s with the concept of social justice is the imago Dei (Turner, 2010). Imago Dei is the idea that all persons were created in the image of God, and as such, each person has an inherent worth (T urner). The use of these religious themes is to provide audience specific encouragement for enacting social justice not to evangelize to the congregation Literature did not only support the use of spiritual themes, but also quotes from religious texts ( Bopp et al. 2011) Christian social ministry is often based on scripture and t here are many Christian religious texts that direct Christians to reach out to underserved populations (Roberts Lewis & Armstrong, 2010 Sackreiter & Armstrong, 2010 Turner, 2010 ). Scripture references in the New Testament of the Christian Bible include the themes of outreach, serving
SOCIAL JUSTICE INTERVENTION 7 others, and feeding the sick and hungry. The Old Testament of the Bible describes times when the Hebrew people were foreigners and encourage s the Hebrews to remember this and to treat foreigners well (Sackreiter & Armstrong, 2010). Interventions in Catholic churches have included information on the patron saints of health conditions; for example, the patron saint of cancer, St. Bernard Clairv aux, was included on a physical health intervention (Bopp et al. 2011). Including spiritual concepts and religious quotes in the content of the intervention was encouraged by the existing literature, but no study has studied the effectiveness of including spiritual themes and religious quotes in an intervention in an FBO. Church clergy and leadership have been identified as valuable resources within the church to help meet mental health needs (Aten, Topping, D enney & Hosey, 2010). Clergy can help dissem inate information to the congregation which can then be disseminated to the community (Aten, et al. ). Priest and church leader involvement has also been found to increase congregation recognition o f intervention materials (Bopp et al., 2011). A g roup discussion guided by researchers and church leaders or an educational intervention lead by church leaders or priests has been supported by several studies (Sackreiter & Armstrong, 2010 Hartwig, Kissioki & Hartwig, 2006 ). As the leader of the church, th e priest is the person who will set the tone for the congregation and can encourage them to enact the principles of social justice in the long term. Various methods have been implemented in interventions in faith based organizations A t this time, none o f these methods has been evaluated for effectiveness, only anecdotal support exists. One method is the use of i nteractive literature that places the participants in the Having the congrega tion think through the decision making processes that an underserved population faces, allowed
SOCIAL JUSTICE INTERVENTION 8 identification and support for social justice (Turner). In addition, multi method information provided through flyers, posters, bulletins, inter church contests group activities, and informational sessions has been found to increase congregation awareness of the intervention topic (Bopp et al. 2011). Other methods include educating the church leaders, discussion with several church leaders, and then dissemination to the church, as well as a discussion of church members lead by researchers, followed by a discussion lead by the pastor to identify realistic things the church could do (Hartwig, Kissio ki, & Hartwig, 2006, Sackreiter & Armstrong, 2010). The use of more than one method was best supported by the literature review. Development and Implementation of Intervention The development of a faith based intervention was based on the results from th e lit erature review. The four sub themes identified in the literature review: use of spiritual concepts, use of religious quotes, use of church hierarchy, and multi modal approach were all incorporated into the intervention that was developed and presented. To begin, a pamphlet was designed that included information of social isolation, the problems Latinos were facing and scripture verses (See Appendix A) Scripture verses were chosen that included the concepts of social justice, ministry and outreach, and the title given was To include a multi modal approach, it was then decided that a short, three minute video would be developed. The video was created using Prezi Powerpoint Software, and the audio and visual were recorded using Camtasia Recorder 8. This video included the reasons Latinos come to the United States, the social stressors that they face, spiritual themes and religious quotes that support social justice, the def inition of social justice, and ideas for ways to practically enact social justice. The spiritual themes that were included were social ministry, the call to serve
SOCIAL JUSTICE INTERVENTION 9 As Christi anity. Religious quotes in the video intervention included quotes on treating foreigners like non p e r s o n s are equal, and the call to act justly towards others. These quotes and themes were integrated throughout the video and s erved as support for the other information. For example, there was a religious quote about acting justly, then the definition of social justice was stated and examples of ways to enact social justice were stated (See Appendix B for s creen shots of the v ideo ). A short three question survey was also developed to assess congregation perceptions following the intervention (See Appendix C) The What are your feelings about this issue? Have your feelings about Lat inos in the community changed? Do you have any ideas of ways to do this in your church? The survey was designed to encourage the church members to express to us their perceptions of Latinos and Latino isolation and to identify realistic ways that they a s a church could reach out to the Latino population. The entire intervention was validated with the Community Advisory Board The Community Advisory Board is a group of leaders in rural Northwest Florida who are committed to the research of Dr .Jeanne St accarini ( preceptor ) They are involved in the community independently of this research, but they also provide support, feedb ack, and community connections. After their feedback was received, the pamphlet and video were revised and then presented to the church leader at one of the churches who was interested in the intervention. In this the church hierarchy w a s i n t e g r a t e d into the development of the intervention. T h e c h u r c h l e a d e r w a s c o n t a c t e d and a m e e t i n g w a s s c h e d u l e d t o pre sent the intervention materials to him. He allow ed intervention t o b e p r e s e n t e d after two of the church services. T h e researchers a t t e n d e d t h e c h u r c h s e r v i c e were introduced by the church leader and a short explanation o f t h e
SOCIAL JUSTICE INTERVENTION 10 p r e s e n t a t i o n was given. Following each of the two services, t h e v i d e o and pamphlet w e r e p r e s e n t e d to congregation members who chose to participate and they answered the survey question s. N=20 surveys were completed. Results on the p erceptions of Latino isolation and their recommendations for outreach services to this population are listed below in Figure s 1 and 2. The discussion of the results will be focusing on the spiritual and religious aspects of the recommendations Congregat ion members mainly identified that they always treat Latinos well and that all d the need for prejudiced against Latinos. Figure 1 Perceptions of 0 2 4 6 8 10 12 Perceptions of Latinos' Isolation Times Mentioned
SOCIAL JUSTICE INTERVENTION 11 Figure 2. Outreach Recommendations Congregation members identified social, educational and cultural ways to reach out to Latinos in their communities. Social ideas that were identified included religious ministry, social ministry, and the existing activities at their church. Religious ministry would include t he pastor or church leaders reaching out to Latinos. Social ministry included more church social events that included Latinos and Non Latinos, and a church visiting committee that would visit isolated Latinos. At this church there is a Latino population that attends a weekly Spanish mass and is involved in the church. Some congregation members identified the existing church service, annual Festival of Our Lady of Guadalupe, potlucks, and Christian education classes as ways to reach out to Latinos. The c ongregation members also identified educational and cultural outreach ideas, however, they did not relate to spirituality or religion. Discussion Social justice interventions based on Faith Based Organizations may be helpful in promoting social interaction and reducing social isolation of Latinos. As this study is ongoing, there is not currently any evidence of how this intervention will impact the community. The use of spiritual themes in the development and implementation of a social justice intervention may 0 2 4 6 8 10 12 14 16 Social Outreach Educational Outreach Cultural Outreach Outreach Recommendations Times Mentioned
SOCIAL JUSTICE INTERVENTION 12 be helpful in increasing audience receptiveness to the topic, and encouraging the audience to enact the principles of social justice within their community. Clergy support was very helpful in presenting the intervention. One of the bigg est limitations in this study is that t here is no t currently existing research on social justice interventions in faith based organi zations. There is a need for research in this area to examine how the use of spirituality and religion in an intervention a decision to embrace and enact the concepts of social justice. In addition, out of the two io was intermittently unclear. These technical problems were fixed before the second presentation. the needs of Latinos in their community. Role and Function i n the Study In this study, t h e r o l e o f t h e s t u d e n t r e s e a r c h e r was to examine the use of spirituality and religion in developing a faith based social justice intervention. T h i s w a s d o n e b y e x a m i n i n g the existing literature on social justice interventions, as well as interventions in FBOs. T h e n s p i r i t u a l i t y a n d r e l i g i o n were incorporated into the interventi on t h a t w a s d e v e l o p e d B y identified the religious quotes to be included in the presentation, i t w a s p o s s i b l e t o incorporate spiritual themes into the design of the video T h e s t u d e n t r e s e a r c h e r s r o l e a l s o i n c l u d e d f a c i l i t a t i n g the communication between the churches and t h e r e s e a r c h groups. O n sev eral occasions t h e s t u d e n t r e s e a r c h e r m e t with the Community Advisory Board to present research and t o validate t h e intervention. In addition, t h i s research w a s p r e s e n t e d a t the Florida Undergraduate Research Conference in a poster presentation, and a t t h e College of Nursing Research Day in a poster presentation.
SOCIAL JUSTICE INTERVENTION 13 Issues E ncountered and Learning Acquired There were difficulties receiving feedback from the Community Advisory Board as well as church leaders due to geographic limitations and time constraints. Despite the geographic distance, there were also issues with communication, as each p e r s o n involved in this study has full time employment and is involved on a volunteer basis. Other issues faced included problems organizing scheduling with the three student r e s e a r c h e r s each w i t h different s c h o o l schedules. The learning acquired b y t h e s t u d e n t r e s e a r c h e r has been inval uable. T his type of research project w a s u n i q u e a n d a l l o w e d f o r a b r o a d e r e d u c a t i o n t h a n simply h o w t o c o l l e c t a n d i n t e r p r e t d a t a Specifically, since there are not any existing social justice interventions in FBOs that have been formally studied this project became an incredibl e opportunity to learn about an undiscovered topic and do something original. From trying to find literature that closely aligns with the concept, to developing an intervention from scratch, to delivering it, this was uncharted territory. The s t u d e n t r e s e a r c h team was in valuable, and this project would not have been developed w ere it not for a l l o f t h e individual team members. Each m e m b e r brought a unique perspec tive, knowledge base, and skill s e t to the group. Recommendations Recommendations for future researchers include follow up evaluation at the churches to determine the impact of the intervention One recommendation from a survey included having a discussion to help talk about the t opic with other church members. This was supported by the literature, but it was decided to not have a discussion initially fo r logistical, and team reasons. I n t h e f u t u r e t rying to encourage a discussion specifically with the Latino and non Latino church members would b e h e l p f u l t o i m p r o v e u n d e r s t a n d i n g o f o t h e r c h u r c h m e m b e r s and the issue. I t w o u l d a l s o b e h e l p f u l t o e x p a n d the intervention to a larger number of churches, and eventually,
SOCIAL JUSTICE INTERVENTION 14 t o r e a c h out to the Latino community that does not attend church through community outreach, rather than religious outreach. There is still a large amount of research to be done with the rural Latino population to determine how to best promote mental health wellness.
SOCIAL JUSTICE INTERVENTION 15 References Asomugha, C. N., Derose, K. P., & Lurie, N (2011). Faith based organizations, science and the pursuit of health. Journal of Health Care for the Poor and Underserved 22 (1), 50 55. Aten, J. D., Topping, S., Denney, R. M., & Hosey, J. M. (2011). Helping African American clergy and churches address minority disaster mental health disparities: Training needs, model, and example. Psychology of Religion and Spirituality, 3 (1), 15 23. Bopp, M., Fallon, E. A., & Marquez, D. X. (2011). A faith based physical activity intervention for Latinos: Outcomes and lessons. American Journal of Health Promotion, 25 (3), 168 171 DeKraai, M. B., Bulling, D. J, Shank, N. C., Tomkins, A. J. (2011). Faith based organizations in a system of behavioral health care. Journal of Psychology and Theology, 3 9 (3), 255 267. Hagan, J. (2006). Making theological sense of migration journey from Latin America: Catholic, Protestant, and interfaith perspectives. American Behavioral Scientist, 49 (11), 1554 1573. Harari, N. Davis, M. Heisler, M. (2008). Strangers in a strange land: Health care experiences for recent Latino immigrants in Midwest Communities. Journal of Health Care for the Poor and Underserved 19 1350 1367 Hartwig, K. A., Kissioki, S., & Hartwig C. D. (2006). Church leaders confront HIV/AIDS and stigma: A case study from Tanzania. Journal of Community & Applied Social Psychology, 16 492 497. McKinnon, S. L. (2009). Bringing new hope and new life: The rhetoric of faith based refugee resettlement agencies. The Howa rd Journal of Communications, 20 313 332. Northern, V. M. (2010). Social workers in congressional contexts. Social Work &
SOCIAL JUSTICE INTERVENTION 16 Christianity, 37 (2), 265 285. Principles of Community Engagement. (2011) Clinical and Translational Science Awards Consortium, Community Engagement Key Function Committee Task Force on the Principles of Community Engagement (2nd ed., p 1 193). Washington, D.C.: NIH. Roberts Lewis, A., & Armstrong, T. D. (2010). Moving the church to social action. Social Work & Christianity, 37 (2), 115 127. Sackreiter, A., & Armstrong, T.D. (2010). Radical hospitality: Welcoming the homeless s tranger. Social Work & Christianity, 37 (2), 204 228. Stacciarini, J. M. R. (2008). Focus Group: Examining a community based group intervention for depressed Puerto Rican women Issues in Mental Heath Nursing 29 679 700. Turner, J. (2010). Seeing the poor and moving toward justice: An interactive activity. Social Work & Christianity, 37 (2), 142 160.
SOCIAL JUSTICE INTERVENTION 17 Appendix A Pamphlet
SOCIAL JUSTICE INTERVENTION 18 Appendix B Video Screenshots
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SOCIAL JUSTICE INTERVENTION 21 Appendix C Survey Appendix C: After Video Survey 1) What are your perceptions about this intervention? 2) After seen this video, have your feelings about Latinos in the community changed? 3) Do you have any ideas of ways your church could support the Latino community?