Using empowerment theory in collaborative partnerships for community health and development

Models of community empowerment help us understand the process of gaining influence over conditions that matter to people who share neighborhoods, workplaces, experiences, or concerns. Such frameworks can help improve collaborative partnerships for community health and development. First, we outline an interactive model of community empowerment that describes reciprocal influences between personal or group factors and environmental factors in an empowerment process. Second, we describe an iterative framework for the process of empowerment in community partnerships that includes collaborative planning, community action, community change, capacity building, and outcomes, and adaptation, renewal, and institutionalization. Third, we outline activities that are used by community leadership and support organizations to facilitate the process of community empowerment. Fourth, we present case stories of collaborative partnerships for prevention of substance abuse among adolescents to illustrate selected enabling activities. We conclude with a discussion of the challenges and opportunities of facilitating empowerment with collaborative partnerships for community health and development. This work was supported by Kansas Health Foundation Grants 9206032B and 9206032A to support and evaluate community partnerships to prevent adolescent substance abuse. Thanks to Tom Wolff for sharing his wisdom about community coalitions so generously, and to Bill Berkowitz and anonymous reviewers for thoughtful comments on an earlier version of this manuscrpt. We also thank our colleagues from the Kansas Health Foundation, Mary K. Campuzano, Steve Coen, and Marni Vliet, and those from collaborating communities, who continue to teach us about ways to enhance community capacities to address local concerns.     

Protective Factors and the Development of Resilience in the Context of Neighborhood Disadvantage

The purpose of the present study was to examine relations among multiple child and family protective factors, neighborhood disadvantage, and positive social adjustment in a sample of 226 urban, low SES boys followed from infancy to early adolescence. The results indicated that child IQ, nurturant parenting, and parent-child relationship quality, measured in early childhood, were all significantly associated with a composite measure tapping low levels of antisocial behavior and high levels of social skills at ages 11 and 12. Parental romantic partner relationship quality (RPRQ) was only significantly related to positive social adjustment in the context of low levels of neighborhood disadvantage. Results suggest that with the exception of RPRQ, these protective factors operate in a comparable manner with respect to positive social adjustment for this predominantly low-income urban sample of boys.     

The association between life events and suicide intent in self-poisoners with and without a history of deliberate self-harm: a preliminary study

The associations between life events in the 12 months preceding an episode of self-poisoning resulting in hospital attendance (the index episode), and the suicide intent of this episode were compared in individuals for whom the index episode was their first, episode and in individuals in whom it was a recurrence of DSH. Results indicated a significant interaction between independent life events, repetition status, and gender in the prediction of suicide intent, the association between life events and intent being moderated by repetition status in women only. The results provide preliminary evidence to suggest the presence of a suicidal process in women, in which the impact of negative life events on suicide intent diminishes across episodes.     

Motives and suicide intent underlying hospital treated deliberate self-harm and their association with repetition

The association between motives for deliberate self-harm (DSH), level of suicide intent, and history of DSH is poorly understood. As part of the WHO/EURO Multicentre Study on Suicidal Behavior, the Suicide Intent Scale, and the Motives for Parasuicide Questionnaire were administered to 146 patients presenting with DSH in the Cork region in Ireland. DSH patients reporting high suicide intent were more motivated to escape from their problem (M = 3.15, p < .001) compared to those with low suicide intent, who were more motivated to appeal to others (M = 1.61, p < .001) and to get a temporary break from their problem (M = 2.47, p < .001). Repeaters more often reported motives aimed at escape (M = 2.98, p < .01), revenge (M = .60, p < .005), and appeal (M = 1.43, p = <.05). Selfharming patients are characterized by ambivalence and struggle with aversive thoughts and situations. Therapeutic approaches should include distress management and coping strategies.     

Queering Bem: Theoretical Intersections Between Sandra Bem’s Scholarship and Queer Theory

Sandra Bem revolutionized psychology with her research on gender, androgyny, and gender schematicity, which culminated in her book, The Lenses of Gender. Her work also provides a model for how to cross inter-disciplinary lines to enhance scholarship and reach political goals. We analyze similarities and differences between Bem’s scholarship and scholarship in queer theory, a theoretical movement in the humanities that analyzes discourses that construct man/woman and straight/gay binaries. There are important overlaps between Bem’s lenses of gender (biological essentialism, gender polarization, and androcentrism) and the ideas of many queer theorists. There are also several interesting differences between Bem’s ideas and queer theory: attention to the intrapsychic processes that make up gender, the extent to which individuals can be liberated from gender, proliferating versus contesting gender, intersectionality, and epistemology and methodology. By assessing the similarities and differences between Bem and queer theorists, we show that the two complement each other, affording a better understanding of gender and sexuality. Additionally, both Bem and queer theory lend insight into feminist and queer activism. The theoretical and political advances that can be made by integrating Bem’s ideas and those of queer theorists serve as examples for why it is worthwhile to cross disciplinary lines.     

Religiosity and well-being among older Jewish Israelis: Findings from SHARE

ABSTRACT

This study examined the correlates of religiosity among Jewish Israelis aged 50 and older. Based on the second wave of the Survey of Health, Ageing, and Retirement in Europe, the findings show that almost half the Jewish respondents never pray and that, on average, prayer frequency is lower among Jewish Israelis than it is among most of their European counterparts. Multivariate logistic analyses revealed that those who pray more often have more health conditions, are less able to make ends meet financially, and have fewer years of education. However, when facing ill health those who pray more often display a relatively lesser decline in their sense of well-being.     

Social Identification and Well-Being Following a Terrorist Attack: A Longitudinal Study of Israeli Adolescents

The authors examined the role of familial and national social identification in shaping the well-being (positive self-esteem [PSE] and satisfaction with life [SL]) among Israeli adolescents following a terrorist attack. Adolescents living in an attacked town (n = 259; M age = 16.19 years, SD = 0.74 years) and adolescents living in a not attacked town (n = 281; M age = 16.14 years, SD = 0.69 years) were studied longitudinally at 3 weeks and 1 year after the attack. Family identification promoted SL concurrently and PSE concurrently and longitudinally in both groups. Israeli identification hindered subsequent PSE and SL among trauma exposure group adolescents. The authors apply the findings to explain the protective and detrimental potential of social identification following traumatic experiences.     

Withdrawal Aversion and the Equivalence Test

If a doctor is trying to decide whether or not to provide a medical treatment, does it matter ethically whether that treatment has already been started? Health professionals sometimes find it harder to stop a treatment (withdraw) than to refrain from starting the treatment (withhold). But does that feeling correspond to an ethical difference? In this article, we defend equivalence—the view that withholding and withdrawal of treatment are ethically equivalent when all other factors are equal. We argue that preference for withholding over withdrawal could represent a form of cognitive bias—withdrawal aversion. Nevertheless, we consider whether there could be circumstances in which there is a moral difference. We identify four examples of conditional nonequivalence. Finally, we reflect on the moral significance of diverging intuitions and the implications for policy. We propose a set of practical strategies for helping to reduce bias in end-of-life decision making, including the equivalence test.