Best practice? Not exactly. It’s even better.
Youth on a parade float in Clinton County, IN, educating the public about
how rates of teen pregnancy in the US compare with rates in other countries.
At Youth Catalytics, we’re often asked to make presentations about “best practices” of some sort or other. I’m a reluctant presenter, so this kind of gig doesn’t excite me much. But then I dig in, because while I don’t love presenting, I do love research. I’m irresistibly drawn to picking apart processes to see how and why they work to achieve some particular goal.
And it’s funny how often the variable that determines success isn’t really a “best practice” at all. It’s how a given activity is actually done in real time, in an actual community, over many days, weeks and months, by the particular cast of people doing it. It’s about the individual human beings, their personal ways of acting in the world, their levels of energy, and their own personal intent.
Unquestioning faith in best practice is surely at an all-time high in our field, so this paradox is worth pondering. There’s a whole industry devoted to churning out best practices (and their fraternal twin, written program models). Yet how well they work once you deploy them in your community depends not nearly as much on them as on you and your colleagues. Maybe that idea is depressing, or maybe it’s liberating. Either way, it’s true.
(A note here to acknowledge that there are many reasons why evidence-based practices might work in one place and not another. The mindset of project leaders isn’t the only one, but it’s a critical one, and it’s what I’m focusing on here.)
I was reminded of the importance of attitude again recently, when we were studying best practices in community mobilization around teen pregnancy prevention. Community mobilization is a clunky bit of jargon, but it just means finding partners and supporters of many different kinds, so your program – whatever it is – can flourish and perhaps live a long and useful life.
What does good community mobilization look like? Yes, it’s certainly about all the usual suspects: leadership, planning, partnership, youth engagement. That’s not surprising, because at a certain level, everything in this field is about those things. But what else is community mobilization about? What is it really about, in other words?
What does good community mobilization look like? Yes, it’s certainly about all the usual suspects: leadership, planning, partnership, youth engagement. That’s not surprising, because at a certain level, everything in this field is about those things. But what else is community mobilization about? What is it really about, in other words?
From Health Care Education and Training (HCET), in Indiana, comes this refreshing message. It’s about humility and reciprocity – not tenets of any best practice I know. Not even practices, in fact, but attitudes. This small intermediary went into a conservative rural county where they’d never worked, sat down with friends and officials and colleagues and regular people, and together agreed that teen pregnancy was a big problem. This wasn’t news to anyone in the county, of course—they’d been keeping an eye on pregnancy rates for years, watching them stay stubbornly high even as other adolescent health indicators, such as teen smoking, declined.
HCET positioned itself as the expert in reproductive health, but acknowledged that the community itself was the expert on what it would take to interrupt and reverse the high teen pregnancy rates in the county. Everyone had something worthwhile to say, and everyone working with teenagers in any way – even those who didn’t want to talk about sex or contraception – could be a part of the solution. It was a full-team effort aimed at a simple goal – healthy adolescence – that everyone could agree on.
HCET suggested a couple of evidence-based teen pregnancy prevention curricula, and let the schools where they would be delivered ultimately decide. Officials asked for adaptations, and HCET got them approved. HCET didn’t go in with deal-breakers, and didn’t tut-tut and gently insist that they knew best. Instead, they were willing to bend.
Project partners worked hard to involve teenagers from a range of places and settings, and then, with a little leadership training, turned them loose to do whatever they thought would be most effective. In the photo above, you can see some of them on a float in a parade, holding signs comparing US teen pregnancy rates to rates in other countries. A reminder: This is Indiana! [I grew up in the state, so I think I’m entitled to say, “Wow. Things have changed.”]
Genuine partnership, the kind where leaders actually share decision-making and happily let others take both responsibility and credit, isn’t as common as we’d all like to think. We all try, but then again, we’re all human, and turf and money and glory (if there’s any glory to be had) are always lurking under the surface.
What has HCET’s inclusive approach achieved? Well, as it nears the end of its five-year project period, teen pregnancy rates in the county have dropped by half. Short of a rigorous evaluation, we can’t know what percentage of that drop was due to HCET and its partners. But the drop is too precipitous to be coincidental.
As if the plummeting rates weren’t enough, as a result of all the new collaborative work between partners, a local group got funded to bring a first-ever Title X clinic to the county. (Title X clinics provide reproductive health care and prevention services to low-income people.) This long-term outcome goes beyond any ripple effect the project or its federal funder ever anticipated.
Success creates converts, of course. So now, some schools that had initially said “no” to teen pregnancy prevention are saying “maybe,” creating the potential for an entirely different set of benefits that go far beyond this project and the particular young people it reached.
And none of this happened because of a set of best practices in community mobilization, laudable though they are. They happened because a project lead, in this case HCET, approached their work with an attitude of deference and service to something larger. Let’s put that in a box and sell it.
~ Melanie Wilson, Research Director, Youth Catalytics