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Research with Local Impact
May 16, 2022

At the School of Social Work, the impact of research extends beyond academia. In many cases, faculty members partner with leaders in the local community to yield findings that have the potential to affect how people receive services, access programming, and ultimately, live their lives. This is the power of community-engaged research. “Community-engaged research aims to build authentic partnerships between researchers and the researched,” says N. Andrew Peterson, professor and associate dean for research, “as well as strengthen communities’ awareness of their own capabilities as researchers and change agents.”

Here are just some of the most current community-engaged research projects taking place right here in Rutgers’ home state of New Jersey.

PROMOTING SUCCESSFUL AGING IN THE COMMUNITY
Emily GreenfieldIt’s no secret that once they hit retirement, many residents leave New Jersey for another state. The agefriendly communities movement in New Jersey seeks to change this trend by working to make the state’s diverse communities better places to grow up and grow old, especially for older adults with fewer resources to navigate the challenges and opportunities of aging in their own homes and communities. As part of this movement, professor Emily Greenfield’s community-engaged research on agefriendly initiatives in New Jersey helped to spur the development of Age-Friendly North Jersey, a network of age-friendly leaders, allies, and stakeholders across Bergen, Essex, Morris, Passaic, Somerset, and Union counties. Her team’s most recent research with the network took place during the COVID-19 pandemic. “All of a sudden, communities had a far greater volume of older adults who needed help getting their needs met,” Greenfield explains. “This presented a unique and meaningful moment to understand how various initiatives responded.”

Greenfield and her team conducted interviews with agefriendly community leaders during the winter of 2020-2021. They found that the leaders tended to play a variety of roles within their communities. These roles included creator (launching new programs), advocate (encouraging other community actors to be mindful of older adults when planning their own programs, services, and events), communications broker (sharing and gathering information across diverse community networks), and good community partner (helping partner organizations in limited but meaningful ways, for example, by donating to help sponsor another organization’s event). The value of this research is that it gives current leaders the language with which to describe their work, make their work visible to others, measure success, and substantiate needs. “It helps other community leaders understand the nature of this work,” Greenfield says. “If they designate someone to lead an age-friendly community initiative in their municipality, this research shows what they can and should do to be effective.”

Following this research project, Greenfield was able to receive grants from private philanthropy to hire a staff member at the School of Social Work to help administer Age-Friendly North Jersey. “This speaks to the translational aspect of this research,” says Greenfield. “Before we were able to secure this staff position, our commitment at the School was what I could provide with my time and that of postdocs and students. Now, we have a professional to keep that superstructure going. This helps sustain it and stretches the reach of our collaborative learning and doing.”

ANALYZING SUBSTANCE MISUSE INDICATORS
About 15 years ago, the State of New Jersey adopted a public health model to guide changes within the substance misuse prevention system, with the aim to embrace data-driven processes, bring different community sectors together, and select smart strategies for local needs. “This is different from traditional curriculumbased prevention programs in that the focus is on environmental strategies, such as policy change, to make community impacts that might discourage substance misuse and promote health and wellness,” says Kristen Gilmore Powell, assistant research professor and associate director of the Center for Prevention Science.

In her work with prevention coalitions, Powell helped partners develop a mobile app called Be The One in 2017, which helps local leaders communicate through photos the positive and negative experiences of their community as they pertain to substance misuse. Now, Powell is analyzing three years’ worth of photos from across the state to find out what might support healthy choices in communities versus what might endorse substance misuse. One common theme that emerged from Powell’s research is the influence of product placement. “It’s very common to find drinking games merchandised right next to family board games in stores, which could promote a message around drinking to youth,” she says. “Being able to point this out has allowed coalitions to approach store management and work with them to think about product placement and marketing in a more responsible manner.”

Another area of improvement that the study revealed is the prevalence of litter. “It was common to see photos of a park that’s frequented by families littered with things like empty alcohol bottles or cigarette and vaping litter,” Powell says. “This is an important environmental consequence of substance misuse to consider.” On the positive side, coalition members have been able to utilize Be The One to showcase their prevention successes, including positive events that brought high school students together with community leaders such as doctors, pharmacists, and law enforcement. The manuscript for this paper is under development, but Powell’s hope is that her findings will help community leaders substantiate proposed policy changes. “Whether it’s regarding litter or product placement, the goal is to think about policy changes that foster a healthier environment,” she says. “It’s about examining our current practices, making changes where needed, and raising awareness.”

PREVENTING SEXUAL VIOLENCE
Victoria BanyardThrough an ongoing partnership with the New York City Alliance Against Sexual Assault, professor and associate dean for faculty development Victoria Banyard has been helping to evaluate the implementation and impact of Project Dream, Own, Tell (DOT), a 15 week sexual and relationship violence prevention program for adolescents centered around healthy relationships, bystander intervention, and youth leadership development. DOT also includes a community action component, in which participants create a project designed to make change locally. “The first evaluation we did with them was of an adult workshop they were doing,” Banyard says, which took place in the fall of 2019 and early winter of 2020. “The young people participating in DOT said it was great that they’re engaging in prevention, but that the adults in their lives needed similar education. So they worked with the staff at the Alliance to design a fourhour workshop for significant adults. We came in to do an evaluation that could examine the feasibility and acceptability of this adult workshop.” The findings indicated a high level of acceptability; the adults really enjoyed learning from the youth, and the youth leaders also benefited from teaching adults. Plus, the adults said the information was powerful and useful for them. “They didn’t have a lot of confidence about having these complicated conversations, but they ended up gaining a lot of information from that four-hour workshop,” Banyard says.

Most recently, Banyard helped the Alliance evaluate the online version of DOT, which became necessary during the COVID-19 pandemic. The program was conducted virtually via Zoom, and participants’ community change project involved the use of PhotoVoice, a participatory action research method designed to give voice to underrepresented groups. “Each of the final four sessions had a theme, and participants took pictures that corresponded to that theme and brought them back to the group for discussion,” Banyard explains. “After these discussions, they created a virtual presentation of the photos they took and invited adults in the community to attend.”

What Banyard found this time was that the students largely benefited from the online iteration of DOT, though they did also face challenges typical to remote learning such as access to private spaces and technology. “Right now we’re going back to the table with our partners at the Alliance to see if our evaluation has been useful and what else they might want to know,” Banyard says. “So much of community engaged work is about listening and coming back to the table. We’re excited to have those conversations and see what they want to find out next.”

OPTIMIZING RUTGERS FUTURE SCHOLARS
Adrian GaleThe Rutgers Future Scholars program (RFS) identifies first-generation, lowincome, academically promising middle school students from Rutgers’ home communities of New Brunswick, Piscataway, Newark, Camden, and Rahway, and offers them a unique pre college program that includes university programming, events, support, and mentoring that continues through their high school years. Students who successfully complete the fiveyear program and are accepted to Rutgers University receive full tuition funding. But the goals of the program extend beyond the impacts it has on individual students. Each year, RFS partners with the School of Social Work and the Edward J. Bloustein School of Planning and Public Policy to host interns interested in studying disparities in urban communities or gaining field experience working with middle or high school youth.

“The ultimate goal is that these young people will return to the community and enrich it,” says Adrian Gale, assistant professor in the child welfare and well-being research unit. “It’s not just a college access program. It’s a program that seeks to impact each of the larger communities where Rutgers resides by impacting its young people.” Gale is currently gathering data from current RFS participants to evaluate the different needs and outcomes that exist in each program. For example, how does being in an urban setting impact the implementation and outcomes of RFS in Newark? Which parts of the program are most impactful for scholars in Camden? Do suburban students in Rahway have the same needs as those in Piscataway? “We would like to learn, to the extent that it is possible, about which parts of the program—academic tutoring, mentoring, college socialization, or tuition scholarship—work best, and for whom it works best,” he says. “My assumption is that there are groups who may only need to know about the tuition scholarship in order to be successful, and that there are other groups who need all of the services to be successful.” In the future, Gale also wants to interview the parents and families of the scholars, to get their take on the program.

Gale anticipates that he’ll be able to analyze the data by the fall of 2022, and ultimately present it to leadership at RFS to help them determine best practices. “We want to find the students who have the greatest needs, and make sure they have the resources to be successful,” he says.

KEEPING FAMILIES TOGETHER
Nationwide, young children in the welfare system who have caregivers that misuse substances have between a 20 and 40 percent chance of staying in their home. What if there was a better way to approach these cases so that parents could get the help they need and children could continue to safely live at home with their families? That’s the goal of a new inhome recovery program, the result of a partnership between the New Jersey Department of Children and Families, the Yale Child Study Center, Preferred Behavioral Health Group, and assistant professor Emily Bosk at the School of Social Work. The program is currently operating in Ocean County, New Jersey (with plans to expand to Union County in April 2022), open to parents of children ages six and under, who misuse substances. Parents receive three visits per week from a care team that includes a substance use clinician, infant mental health clinician, and family support specialist. “The goal is to interrupt intergenerational transmission of trauma,” says Bosk.

“Three-quarters of our clients in the program report a history of family substance misuse, so it’s clear that intervention is needed from an intergenerational perspective.” Parents began participating in the program in January 2020 and, along the way, Bosk has been gathering data to examine outcomes in maternal and child mental health, child welfare, parent-child relationships, and substance use. “To date, out of the 46 families that have been receiving services, 90 percent of the children remain at home—this is incredibly significant when compared to the national average,” says Bosk. “We also see very few re-reports to child welfare when families are involved in the program.” Instead, children are identified for early intervention services quickly; 43 percent of kids in the program have been referred to and started early intervention. This is critical, says Bosk, as the earlier such intervention is started, the better the chances are of restoring positive developmental trajectories. This is a totally different way of approaching the treatment of caregivers with substance misuse and, for this reason, Bosk is providing client feedback every step of the way as families move through the program.

“Everything we research impacts practice on the ground and we’re contributing to quality improvement in real time,” she says. And though there is a risk in making changes to any system, especially where child welfare is concerned, Bosk points out that the benefits can be transformational for the state’s children and families. “Really strong community engagement research involves everyone willing to take some big risks,” she says.

ASSESSING MATERNAL HEALTH
A number of factors can influence a birthing person’s risk of severe maternal morbidity (SMM, a group of life-threatening labor and delivery outcomes—from heart attack to kidney failure—that result in significant short- and long-term health consequences). Could the community in which a person lives be one of them? Assistant professor Felix Muchomba says yes. In his recent study, Muchomba and his team gathered one million New Jersey birth records dated from 2008 to 2018, and linked each of these births with maternal hospital discharge records to determine rates of SMM across the state. Some of what Muchomba found was unsurprising, for example, that mothers with higher socioeconomic status had lower rates of SMM and those with advanced maternal age had higher rates. “But all of these factors only partly explain the variation we found across the state of New Jersey,” he says, which is that rates of SMM increased the more southern in the state the mother lived, with some exceptions. And, the municipality with the highest rate of SMM (Bridgeton, New Jersey, in Cumberland County) had over three times the rate of Westfield, New Jersey in Union County, which had the lowest rate in the state.

Additionally, Muchomba examined municipal spending data in the areas where the mothers lived, specifically, how these different municipalities invested per person in the areas of public health, housing and community development, transportation, libraries, fire protection and ambulance, and policing, and how this spending measured against the likelihood of SMM. Muchomba found that mothers living in municipalities that spend more per resident on these public services were less likely to have SMM, and an additional $1,000 per capita spent on these services reduced the odds of SMM by between 35 and 67 percent—with one exception. “More spending on police did not have the same association with better maternal outcomes,” he says. “Mothers living in places that spend more on police were actually more likely to have negative postchildbirth outcomes.”

Muchomba’s work, having recently been published, is currently being disseminated to media, community organizations, and municipal leaders. “This research helps us understand what kind of investments have the potential to improve the lives of birthing people in the state,” he says, “and could help municipalities create spending plans that better support the health of their residents.”

Support for Muchomba’s research was provided by the Robert Wood Johnson Foundation’s Policies for Action program. The views expressed here do not necessarily reflect the views of the Robert Wood Johnson Foundation. 

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