Honoring, Training, and Building a Statewide Network of Elder Activists: The California Senior Leaders Program (2002-2012)

This case study explores the first decade (2002-2012) of the California Senior Leaders Program (CSLP), including participants' creation of a formal advocacy group, the California Senior Leaders Alliance. Grounded in concerns with ageism and invisibility, the CSLP provides recognition and support for diverse California elders engaged in community building and social justice work. This study employs qualitative analysis of data from participant interviews, event evaluations, program documents, video footage, and participant observation. Findings show emotional, learning, and networking benefits for participants, intergenerational influences, collective capacity and coalition building, and contributions to policy. Program challenges are described, and future directions discussed. © 2013 Copyright Taylor and Francis Group, LLC

Closing the Loophole: A Case Study of Organizing for More Equitable and Affordable Access to Health Care in San Francisco

This paper presents in-depth case study of a successful hybrid political and community organizing campaign to ensure equitable access to health care through the perspective of a grassroots San Francisco community-based organization, the Chinese Progressive Association (CPA), which has been organizing low-income Chinese immigrants for over four decades. First, it outlines the Health Care Security Ordinance (HCSO), which, since its passage in 2006, has established a near-universal health care access program, helping to make health care accessible and affordable to individuals living and working in San Francisco. Then it presents the campaign to save the HCSO, focusing on CPA’s participation in the HCSO coalition. Finally, it discusses health care as it relates to the San Francisco’s affordability crisis and the political economic context in which it is taking place. Despite the limitations inherent in small case studies like this one, it nevertheless provides a valuable opportunity to better understand how one politically progressive city attempted to address the problem of grossly inequitable health care access through the lens of community organizing, advocacy, and coalition building. San Francisco, like many major American cities today, is being confronted with rapid gentrification and growing economic inequality—the backdrop to the HCSO. Through innovative experiments in social responsibility like the HCSO, however, the city has made leaps in health care access. It concludes with lessons learned from local organizing and advocacy to save the HCSO as these may inform other local efforts to promote health care for all

Health in my community: Conducting and evaluating photovoice as a tool to promote environmental health and leadership among Latino/a youth

BackgroundThe PhotoVoice method has shown substantial promise for work with youth in metropolitan areas, yet its potential for use with Latino youth from agricultural areas has not been well documented.ObjectivesThis project was designed to teach environmental health to 15 high school youth while building their individual and community capacity for studying and addressing shared environmental concerns. The project also aimed to test the utility of PhotoVoice with Latino agricultural youth.MethodsFifteen members of the Youth Community Council (YCC), part of a 15-year project with farmworker families in Salinas, CA, took part in a 12-week PhotoVoice project. Their pictures captured the assets and strengths of their community related to environmental health, and were then analyzed by participants. A multi-pronged evaluation was conducted.ResultsYCC members identified concerns such as poor access to affordable, healthy foods and lack of safe physical spaces in which to play, as well as assets, including caring adults and organizations, and open spaces in surrounding areas. Participants presented their findings on radio, television, at local community events, and to key policy makers. The youth also developed two action plans, a successful 5K run/walk and a school recycling project, still in progress. Evaluation results included significant changes in such areas as perceived ability to make presentations, leadership, and self-confidence, as well as challenges including transportation, group dynamics, and gaining access to people in power.ConclusionThe PhotoVoice method shows promise for environmental health education and youth development in farmworker communities

Freire's Message for Social Workers

This paper re-examines key concepts in Paulo Freire's popular education approach and their compatibility with social work philosophy and practice on the group and community levels. Freire's vision of the field of social work is explored, and two case studies are utilized to illustrate the application of this approach and its promise for community practice at the dawn of a new century.måsjekke

Engaging with community researchers for exposure science: lessons learned from a pesticide biomonitoring study

A major challenge in biomonitoring studies with members of the general public is ensuring their continued involvement throughout the necessary length of the research. The paper presents evidence on the use of community researchers, recruited from local study areas, as a mechanism for ensuring effective recruitment and retention of farmer and resident participants for a pesticides biomonitoring study. The evidence presented suggests that community researchers' abilities to build and sustain trusting relationships with participants enhanced the rigour of the study as a result of their on-the-ground responsiveness and flexibility resulting in data collection beyond targets expected

V/STOL lift fan commercial short haul transports: Continuing conceptual design study

A design study of commercial V/STOL transport airplanes for a 1985 operational time period has been made. The baseline mission considered was 400 nmi at a cruise speed of M = 0.75 and a 100-passenger payload with VTOL. Variations from the baseline included mission distance, payload, cruise speed, and propulsion system failure philosophy. All designs used propulsion systems consisting of multiple gas generators driving remote tip turbine lift and lift/cruise fans. By considering the fan to be designed for operational reliability, significant simplication of the airplane systems and reduction in airplane size and cost can be achieved

Social Determinants of Late Stage HIV Diagnosis and its Distributions among African Americans and Latinos: A critical literature review

ABSTRACT This critical literature review was conducted to identify both individual- and environmental-level social determinants of health using an ecological framework as a way to contextualize risk for, and distributions of, late HIV diagnosis among African Americans and Latinos in the United States. Background: Late diagnosis, defined as a diagnosis of AIDS simultaneously with or within one year of an initial HIV diagnosis,1 disproportionately affects African American and Latino communities;2,3 disparities in this health problem thus represent a preventable inequity. Such disparities affect not only late diagnosed individuals but also population levels of HIV incidence, as transmission is unhindered before diagnosis.4,5 Methods: A total of 26 unduplicated studies in 26 peer-reviewed articles were analyzed within a social ecological conceptual framework. Both quantitative and qualitative studies of factors influencing HIV testing were reviewed. To be included, studies had to have been conducted in the United States, published in English within the past 11 years, and to have focused on Latino or African American populations and/or on racial disparities between these and other populations. Findings: The majority of studies on racial disparities in HIV testing and diagnosis have been either cross-sectional1,2,6–11 or focused on one racial or ethnic group, often in one geographic location.12–18 In all studies that compared racial and ethnic groups (n=17), Latinos and African Americans were more likely to receive a late diagnosis3,19 than non-Hispanic Whites or Asian Americans. 95.8% (n= 23) of the reviewed studies focused on individual level risk factors or investigated structural barriers via measurements at the individual level. Next Steps: Both more quantitative and qualitative studies are needed that will enhance understanding of the social determinants of HIV testing behavior among at-risk groups by measuring variables at the appropriate rung of the ecological model, and not solely on the individual level. Studies that investigate barriers to and facilitators of HIV testing in partnership with communities will help further interventions that can reduce racial/ethnic disparities in late diagnosed HIV/AIDS

Hearing the voices of older adult patients: processes and findings to inform health services research

Background Clinical academic research and service improvement is planned using Patient and Public Involvement and Engagement (PPIE) but older PPIE participants are consulted less often due to the perception that they are vulnerable or hard to engage. Objectives To consult frail older adults about a recently adopted service, discharge to assess (D2A), and to prioritise services improvements and research topics associated with the design and delivery of discharge from hospital. To use successive PPIE processes to enable a permanent PPIE panel to be established. Participants Following guidance from an established hospital PPI panel 27 older adult participants were recruited. Participants from Black, Asian and Minority Ethnic (BAME) communities, affluent and non-affluent areas and varied social circumstances were included. Methods Focus groups and individual interviews were conducted in participants own homes or nearby social venues. Results Priorities for discharge included remaining independent despite often feeling lonely at home; to remain in hospital if needed; and for services to ensure effective communication with families. The main research priority identified was facilitating independence, whilst establishing a permanent PPIE panel involving older adults was viewed favourably. Conclusions Taking a structured approach to PPIE enabled varied older peoples’ voices to express their priorities and concerns into early discharge from hospital, as well as enabling the development of health services research into hospital discharge planning and management. Older people as participants identified research priorities after reflecting on their experiences. Listening and reflection enabled researchers to develop a new “Community PPIE Elders Panel” to create an enduring PPIE infrastructure for frail older housebound people to engage in research design, development and dissemination