Community Action Program For Children (CAPC)

Learning To Listen: What Program Participants Can Teach Us About Empowerment

5th International Qualitative Health Research Conference
University of Newcastle, Australia
Session 11.3 - Issues of Empowerment and Change
Friday, April 9, 1999 (13:35pm - 13:55pm)

PDF Format (22 KB)

Please note that this document was published by Health Canada prior to the announcement of the establishment of the Public Health Agency of Canada on September 24, 2004. Any reference to Health Canada should be assumed to be to the Public Health Agency of Canada.

Authors:		Nicole Bernard, Pauline Raven, Michelle Rivard, Yolande Samson, Madine VanderPlaat, Lynn Vivian Book
Presenter:		Yolande Samson Evaluation Consultant, Health Canada 1557 Hollis Street, Suite 709 Halifax, Nova Scotia, Canada B3J 3V4 Yolande_Samson@hc-sc.gc.ca

This paper presents the insights about empowerment and change that government managers, community workers and the principal researcher have gained from the evaluation of the Community Action Program for Children (CAPC), a community-based health promotion program. In particular, this paper looks at what participants involved in the evaluation have taught us about empowerment evaluation and about what is required to effect meaningful social change.

I would first like to briefly describe the program being evaluated. The Community Action Program for Children or CAPC as we often refer to it, is a national program that seeks to improve the health and well-being of Canadian children (from birth to age 6) and their families, particularly those families who require additional support because of difficult life circumstances such as low income or social isolation, or who traditionally have been referred to as “at-risk” families. CAPC adheres to an empowerment-oriented health promotion strategy and is participant-driven -- participants are the ones who decide how individual projects will be run, what programs they will access and how resources will be allocated. CAPC projects can take numerous forms, but in Atlantic Canada, the region where this evaluation took place, a typical CAPC project usually involves a family resource centre within a central community with outreach sites in rural or remote areas. CAPC projects offer a variety of parent-, child- and family- (parent and child) focused programs and activities such as drop-in play, parenting programs, toy lending libraries, community kitchens and so on.

CAPC is funded by Health Canada, a federal government department, and therefore is required to undergo periodic formal evaluations. The national evaluation used standardized quantitative tools to collect comparable data which measured the progress and impact of all CAPC projects in Canada. The Atlantic CAPC Regional Evaluation was largely a qualitative study adding richness and depth to the quantitative information being collected at the national level. This regional, two-year, million-dollar study involved five governments working at different levels and over 40 community-based CAPC projects. It is one of the largest empowerment-oriented evaluations ever conducted in Canada.

In Atlantic Canada, it was agreed that the CAPC community and the government representatives involved in the evaluation would pool their resources and expertise and work together to design and manage the regional evaluation. Given the scope and complexity of this regional evaluation, there were several factors which we feel contributed to making this possible:

• there was already a history of federal and provincial government collaboration on community-based health promotion programs;
• the Program across all four geographically and politically different jurisdictions was based on the same model of family resource centres; and
• Program principles and mandates were similar and shared among all 40 CAPC-funded projects.

Because participant involvement in both project management and program planning was recognized as a central component to success, evaluation activities also needed to be designed in a way that would ensure participant ownership. Evaluation-related activities needed to intersect comfortably with the family-positive mandate of CAPC where family-, child- and parent-focused programs were being designed and implemented in close consultation and collaboration with local families. Designing an appropriate framework and format for evaluation that acknowledged the involvement of participants at the local level presented unique opportunities and challenges. These are outlined below.

From the onset of evaluation discussions, a clear focus on the need for the regional evaluation to mirror the principles of the CAPC program was recognized. Therefore, community acceptance, involvement, support and active participation in the evaluation process needed to be assured. The management team representing all stakeholder groups was mandated to build a rigorous evaluation that would identify actions and/or changes needed at the community level, while ensuring a comfortable environment and meaningful role for all involved, especially the parents/caregivers. A Participatory Action Research (PAR) model was identified as the most suitable framework for research activities.

Broad-based consultation and collaboration was key to this evaluation, beginning with the management structure which included representatives from the community as well as the federal and provincial levels of government. Furthermore, it was agreed that the community development principles adopted by local CAPC projects had to be mirrored in the evaluation. That is, evaluation activities were to be participant-driven and were to ensure that participant needs and interests were incorporated in both the design and implementation of the evaluation. To facilitate this, a bottom-up approach was developed with an active partnership among community-based organizations, program participants and government officials. Involvement of parents in decision-making was essential. For example, parents, staff and volunteers helped define the overall research by identifying:

• the questions that were most relevant;
• the methods that were acceptable and feasible; and
• the results that were meaningful to them.

The evaluation process also needed to be a positive, shared learning experience wherein all participants could readily exercise and enhance their own experience and expertise. In this way, they could build a capacity to participate meaningfully in the evaluation regardless of their personal or professional background or level of education. To accomplish this, the evaluation process focused on two activities in addition to data gathering. These were:

• training in evaluation activities to enhance individual understanding of, and skills in, evaluation;
• establishing appropriate communication mechanisms to keep stakeholders informed of progress to date and enable them to participate at critical points of the evaluation process (for example, a communication committee created concise, easy-to-read and attractive fact sheets for projects at critical stages of the evaluation).

Attention to these activities seems to have helped build enthusiasm and respect for research and its potential within the projects.

I have spent a great deal of time describing the empowerment evaluation model. The model itself has provided valuable insight into how an empowerment evaluation needs to be constructed to maximize the potential for long-term change. We learned that participation in evaluation activities that empower individuals and communities does increase community competencies, acceptance and action which can then lead to change. How does this happen?

The empowerment evaluation model enabled CAPC projects to:

• step back and see what they were accomplishing and to feel pride and ownership, to celebrate and promote their successes, learn from their challenges and focus on what really needs to change. Because of the “ownership” and “buy-in” from those directly involved, evaluation became a pro-active rather than an ominous activity or something to fear, as is often the case with programs which must carry out evaluations for funding purposes. Projects came to place a high value on evaluation as a way to showcase activities and outcomes. They also recognized that evaluation offers a way to ensure that programming remains responsive to their participants’ and community’s needs.
  
  
• increase their credibility within the community because community partners are directly involved in evaluating the project work. Engaging community members in the evaluation process results in the community becoming aware of the project’s needs and its desire for accountability. It makes the community a partner for change. For example, at one local project, a community representative was selected to participate in a focus group with other community partners and volunteers. Some of these volunteers were also CAPC participants. Here, the community representative observed the commitment of CAPC participants to the program and the overall responsibility they demonstrated to the project. She herself became “sold” on CAPC and is now one of CAPC’s greatest ambassadors.

Putting communities at the center of the evaluation, through the evaluation process itself, also means that information and ideas that are generated by the evaluation remain in communities for their immediate use and action. This results in linking what is often referred to as a “marginalized” group to decision-makers within organizational and government systems. This, in turn, can lead to program and policy change at all levels. For example, government health officials directly involved in the CAPC evaluation understood from participants and evaluation results why “hard-to-reach” parents were not accessing their public health programs but were being reached by CAPC. Participants spoke about CAPC as friendly, warm, supportive and non-judgmental. Instead of mandating this “hard- to-reach” population to attend their public health programs, government health officials referred them to CAPC. In addition, they provided resources and support to the CAPC projects to accomplish their work. Participation in evaluation becomes very empowering when participants can see the direct link between their input and real change. Everyone, project and community included, can see that putting time and resources into evaluation has had direct results and benefits. The whole community then becomes the centerpiece of the project’s work. Because the community is at the centre, the knowledge gained does not collect dust but is translated into action and change. This was certainly the case with this evaluation.

The evaluation process also made us increasingly aware that as the research team, we had a powerful role in defining the change that was occurring. The evaluation forced us to reassess our understanding of empowerment and the way in which this understanding played out in everyday interactions. It was through our close contact with the CAPC community that we all became increasingly aware of the way in which we spoke and wrote about project participants, the underlying values the language of our respective disciplines reflected, and how offensive and disempowering this often was.

As a result, we became increasingly sensitive to language at all levels. In particular, we had to make a very conscious effort not to objectify participants or talk about them as people who had things done to them. We learned to avoid conventional evaluation language -- such as what impacts CAPC had on parents -- and instead talked about what parents did within CAPC. Parents and their motivations, rather than the Program, were treated as the independent variable. We also used empowering language in our report and wrote about parents in a pro-active way. For example, instead of saying, “CAPC gives parents ...,” we would use language which reflected the parent’s proactive role, “Parents use CAPC to ...”. Other examples of this language shift include:

• instead of, “Parents get help with ...” we would say, “Parents access resources related to ...”;
• instead of, “Parents learn skills ...” we would say, “Parents build on existing skills ...”.

The importance of this more positive language is that it much more accurately reflects reality -- parents use CAPC to enhance their own and their children’s lives. It also moves us away from constructing these parents as needy, passive, incapable of action and deficit-driven. It allows us to define projects in terms of people having something to offer, wanting to build on their existing knowledge and skills and wanting to make a contribution within their communities to issues that affect themselves and their families. Language, thus, becomes an important tool for empowerment and social change.

Our individual differences in location and politics were most obvious in these debates over language. While these discussions were sometimes painful, they did give each of us a better understanding of where others were coming from and what strengths each position brought to the table. In particular, we came to recognize and appreciate the different levels of activism in which we were each engaged. Activists within the CAPC community came to understand that despite the academics’ and bureaucrats’ positions of privilege -- or more accurately because of their position of privilege -- all were able and willing to use the evaluation to challenge existing systemic practices and policies within both government and the evaluation community. As a result, “new” community relationships emerged that could achieve social change in the longer term.

Consequently, one of the more critical insights at this time was the understanding that meaningful social change requires interaction between human agency and social structures. By focusing solely on the empowerment of the CAPC community, we had reduced the notion of social change to individual or at best group change. We ignored the fact that as academics and government bureaucrats we were part of the structures in question and as such were in a position to use the evaluation of the CAPC experience to make changes within our own disciplines, organizations and systems.

One of the interesting effects of this was that it led to a redistribution of power, with the community moving into a more central position while those in more traditional settings were moved into more marginalized positions. For example, projects found themselves around a table where they could safely exercise their power. Those of us working in government and academia found ourselves in the unusual situation of being marginalized within our respective working communities by our colleagues who were trying to understand our approach. We were constantly on the defensive in terms of the approach we were using and the principles that underscored our relationship with program participants.

The idea that parents -- primarily women, often without partners and living in poverty -- could accurately create knowledge about their own life experiences is not necessarily welcomed in the upper echelons of academia or government. For example, the developmental psychologists whose discipline has dominated the evaluation of parent/child programs in Canada, are hard pressed to give legitimacy to an approach that does not involve observing parenting behaviour or documenting that behaviour in carefully constructed indices and scales. Likewise, we were often at loggerheads with more traditional evaluators and researchers who seriously questioned the validity of a political approach to evaluation, particularly one that relied on narrative as a means of demonstrating effectiveness.

The CAPC evaluation made those of us in government and academia very aware of our role as social activists. We were not apolitical evaluators or bureaucrats. We had to acknowledge our commitment to an emancipatory ethic and ensure that our every action was consistent with that ethic.

This situation forces academics/bureaucrats/social activists to recognize themselves as part of the discursive community that gives meaning to social relations. It fundamentally challenges the notion that those with privilege are already empowered by virtue of that privilege. It also demands that we use this privilege to actively change the policies and practices within our own disciplines and organizations that contribute to the disempowerment of others. To do this meaningfully and effectively, we must in turn be empowered by the communities we serve. We must recognize that we are as much the focus of social change as we are its advocates.

To be effective and result in social change, the empowerment model must recognize its own political nature. It must go beyond the participant as “researcher” and evaluation as “a tool for action.” It must also go beyond the evaluator as “methodologist and facilitator”. Rather than seeing “change” as being project-specific, it must take into account that social change happens at all levels.

In this more emancipatory model of empowerment evaluation, there is recognition that social change requires individuals, social structures and systems to change -- not just participants. Multiple systems are impacted and each needs to change. Success is then judged by what happens in the overall environment as well as what happens to individuals and organizations in the collective. By using this empowerment model, the participant becomes an agent for change, the evaluators and bureaucrats become their advocates, and communities challenge and change systems. The result -- sustainable and long term change.