What is community-centered evidence-based practice (EBP)?
This section explores a community-centered EBP (evidence based practice) approach that we adapted along with many test-tasters, including practitioners, community members and other researchers/evaluators. This EBP approach is meant to align with the work of community-based, culturally-specific organizations that work alongside community members. We hope that it increases understanding of how EBP can look from this perspective.
In October 2011, Esperanza United, formerly Casa de Esperanza, received an award from the Administration on Children, Youth and Families (ACF), Family and Youth Services Bureau, Family Violence Prevention and Services Program for us to serve as the national Latin@ domestic violence resource center. A priority of ACF has been to document and provide access to a continuum of trauma-informed and evidence-based practices (EBP). (Examples of that work can be found at www.dvevidenceproject.org and www.promisingfutureswithoutviolence.org.) Despite the long-standing history of culturally specific work being critical to meeting the needs of families, there has been a limited investment in documenting and developing the evidence base for culturally specific services. Given the challenges inherent in generalizing EBP approaches to a wide range of services, Esperanza United as well as other culturally specific resource centers were tasked by ACF to facilitate discussions on community-relevant approaches to EBP.
After consultation with the research literature, a national workgroup of researchers, community practitioners and ongoing feedback from national audiences we have adapted the Transdisciplanary model (Satterfield et al., 2009) in order to reflect our unique perspective. The result of this work has been captured in the following approach (see figure 1) and is intended to bridge culturally relevant, community based scholarship and EBP for the field of DV.
Of note, EBP is intended to be a process that guides the weighing of decisions for program implementation and adaptation. The following sources should be considered when making decisions about programming as well as documentation efforts (e.g., evaluation).
Just as the work of Esperanza United is informed first and foremost by community experiences, this adapted approach is grounded in community expertise as represented graphically by highlighting the “community expertise” circle. We’ve expanded this aspect to not merely consider community members needs and values but to actively engage community members in program decision making and documentation efforts. For example, Cardona et al. (2009) conducted focus groups with Latin@ immigrant families to understand the types of cultural adaptations the community found important before implementing an evidence-based parenting intervention. In this way, Cardona and colleagues collaborated with the community to inform the best possible implementation of an evidence-based treatment. In a similar manner, many culturally specific community-based domestic violence programs develop and adapt their programs based on the voices of the communities they serve. The process of engaging community experts is key to this adapted approach.
Expertise of community practitioners & other resources
Esperanza United views the expertise of community practitioners as a key component of EBP not only for the services they provide, but also in their role as consultants to other programs. The dissemination of knowledge among community programs has traditionally taken various forms including information sharing in conferences, roundtables, toolkits, and manuals. Publishing in academic journals has more recently increased for those agencies that have been able to establish academic partnerships. Here too, community practitioners have an important seat at the table, as they are often valuable consultants for academic researchers. Community practitioners can provide unique contributions in identifying meaningful program development and adaptation, culturally appropriate research and evaluation methodology (e.g., how to recruit participants), and interpreting results. Finally, community practitioners can also serve as allies to communities as they have earned the trust of community members. Esperanza United stresses the importance of building collaborations with community practitioners and other community stakeholders in order to increase funded community-based sources of evidence that offer higher rates of external validity or generalizability to communities, especially those that have historically been underrepresented.
Esperanza United’s approach of considering documented evidence is based on a flexible approach that values information from community and academia as equal sources of knowledge. We see community research as a different entity from other academic research, more closely aligned with community and broader in scope. As such we see “documented evidence” as including community-based research, organizational evaluations, as well as traditional academic research. In looking at various forms of evidence, some researchers have created hierarchies of evidence, prioritizing the use of RCTs; however, the CDC (Centers for Disease Control and Prevention), in their document “Expanding the Evidence Universe,” promotes the broader definition of evidence similar to what we have adopted, which sees program evaluation as a significant source of knowledge (Schorr & Farrow, 2011). In our approach, decision-making and documentation of evidence are carried out using an inclusive process and research methods appropriate for communities.
Environmental and organizational context
A central element in our work is the inclusion of contextual factors. We know that we cannot separate our work with community members and families from their larger context such as socio-cultural histories and policies (Perilla et al., 1994 & Perilla, 1999). Similarly, we cannot separate EBP from the larger contextual environment. They noted that decision making about programs and the ability to evaluate programs relies on organizational resources which in turn are influenced by the funding environment. These are all elements that need to be considered; thus, we expanded on Satterfield’s model to represent this very important point.
In our work with community organizations, we hope to utilize our adapted EBP three-circle approach as a guiding element in making decisions for implementation and documentation that considers all elements, including contextual factors, while prioritizing the voices of community members. This approach is consistent with Esperanza United’s long-standing belief about the central role of communities in ending domestic violence. Researchers and service providers across various disciplines have highlighted the importance of valuing the community’s expertise about their own realities. Thus, as with any one of our research initiatives, our EBP approach will value program staff and community stakeholders as key elements of our work. In this way, we will approach each opportunity with the flexibility to meet the needs of organizations, utilizing methods that align with Esperanza United’s commitment to human rights, community wellness, and social change.