AMCHP 2006 ANNUAL CONFERENCE
EARLY CHILDHOOD: BUILDING THE FOUNDATION FOR LIFELONG HEALTH
March 4-8, 2006

C2 - Demonstrating, Replicating and Expanding Social Programs

TAMMI FLEMMING: All right, we’re going to go ahead and get started. And what we’ll do is --I’ve laid out already a couple of questions that we’re going to ask the Program Coordinator. And we’re going to jump around the issues and topics that we’ve already discussed, but then we’re going to open the room up for questions from you guys on--questions that they may be able to answer or myself can answer for you about implementation. So we’re going to start off first, by welcoming the panel, and we’re going to give them an opportunity to introduce themselves and talk a little about their community, staring with Carolina.

CAROLINA DARBISI: Hi. Good afternoon. My name is Carolina Darbisi, and I work for GCAPP, Georgia Campaign for Adolescent Pregnancy Prevention. And our site, it’s in Gainesville, Georgia. Gainesville is about 50 miles northeast from Atlanta. It’s a semi-rural area; 28,000 people is the population. It is the poultry capital of the world. If you didn’t know, so Gainesville is the poultry capital. And for that reason it has been in the last five years a huge Hispanic immigrant population. In the last five years 300 percent has increased in the Hispanic population. We thought we had the teen pregnancy rate is higher in the Hispanic population; it’s higher than the national and the state level rate.

Plain-Talk Site it’s about 246 apartments; those are in a project housing development. They are low-income family. They are 70 percent Hispanic, 28 percent African American, and 2 percent white. That’s the population. The adults, the Hispanic adults in the community, they don’t speak English. The children and the teenagers, they do. And the children they go to the same school system. That’s my site.

UNKNOWN SPEAKER: Leticia?

LETICIA IBARRA: Well, I’m Leticia Ibarra, and my site is in Brawley, California, which is about two hours east of San Diego along the border. So we’re very close to Mexico. So the community is largely Latino, Mexican-American, or Mexicans. We’re also a semi-rural area, about 28,000 population, and we have a big agricultural industry and a cattle industry as well. So a lot of our families are immigrant families, farm-working families, and migrant families, who do travel throughout California and other states, following crops.

In our community, our target area is about 500 housing units, apartments, government housing, and also private one-family dwellings. So it’s a little mix in the housing. We did our survey in about half of those housing units. In our population, the primary language is Spanish, even among half of our teens, because about half of our teens were also born in Mexico. So Spanish is our primary language for the project. Let me see, what else?

Oh, our teen pregnancy rate is--Brawley, California, is part of Imperial County, which is the county in California with the highest teen pregnancy rate, and Brawley is the town in this county with the highest teen pregnancy rate in the county. And so, it is a major issue there. I mean it is lower than the national average, but it is pretty high among California sites. Let’s see; I think that’s pretty much it.

UNKNOWN SPEAKER: Kara? Kara why don’t you tell us about your first site, and then you can also tell us about your new site.

KARA BECKMAN: My name is Kara Beckman. I work at Neighborhood House, which is a community based organization in St. Paul, Minnesota. Neighborhood House has been on; we call it the West Side of St. Paul, for a hundred, almost a hundred and ten years now. And we have traditionally worked with immigrant and refuge communities; so although you all think that I’m representing the white side, because of what Deborah said earlier, we are actually doing implementation with the Latino community as well in St. Paul.

On the West Side, it is an area of St. Paul that is very geographically distinct because it’s bordered by three sides by the Mississippi River. So it’s an area of St. Paul that’s always had a very real sense of community. And it’s also been the traditional, it’s actually, back in the late 1800s is actually where the boat stopped that was coming up the Mississippi River; so immigrants who were coming over sea or over water, I guess, really it’s not open sea, the boat stopped at Harriet Island which is a part of the West Side of St. Paul, and so the area has always been very diverse, and Neighborhood House has always been there to try and welcome new communities into St. Paul.

So, today, we’ve gone through several generations of different immigrant groups coming in, and the Latino’s population really took root on the West Side of St. Paul in the 1950s. So, new immigrants continue to come; so we have a good mix of third/fourth generation Latino’s as well as a lot of new immigrants. The West Side is one-third Hispanic, 30 to 40 percent and then diverse, we have a large Somali population. We also have some Southeast Asian immigrants, and then African American, and still about 50 percent Caucasian as well.

So we’ve been doing Plain-Talk with the Latino community on the West Side for almost three years now; we’re coming up our final community mapping phase. And then we are also in the very initial stages of beginning to replicate Plain-Talk with the Mnong community. And another neighborhood of St. Paul that’s called the East Side; we have a large Mnong population in St. Paul. It’s the largest I believe, it’s at least the largest per capita, and then we compete with Fresno, California around the actual numbers. But we have the largest per capita Mnong population in St. Paul. In the U.S., and have recently that population has been growing because of a new wave of Mnong refugees who are coming in from Laos. So, we are at the very beginning stages of planning a Plain-Talk replication with that. And that’s where the project demonstration, around, in Seattle comes in handy, because they certainly had some lessons learned with the Cambodia based program there that we are going to be trying to learn from as we start the Mnong replication in St. Paul.

UNKNOWN SPEAKER: Leticia, why don’t you tell us what phase you’re in as far as implementation.

UNKNOWN SPEAKER: Before she answers that, I don’t think we’ve told everyone that the program Plain-Talk combined with (inaudible) both in English and Spanish, all the training can be done in English or in Spanish, and all the material and the community surveys are in English and Spanish; so that, you know, if you hear about the Spanish-speaking communities, the program is (inaudible).

UNKNOWN SPEAKER: Leticia?

LETICIA IBARRA: We’re actually finishing Phase One of the project, which is finishing the community mapping. We did our physical mapping, which is just seeing the geographic layout of the community where different sites are for services and condoms or other contraceptives. Education materials, and the surveys, and we’ve just finished focus groups to kind of help us with our message in defining our key messages. And, we’ve done the Walkers and Talkers Training; so we’re about to head into that second phase now.

UNKNOWN SPEAKER: Carolina?

CAROLINA DARBISI: We are in the Second Phase, too, and according to your material in the page 15, we are in Stage Three. We have two weeks ago our Walkers and Talkers Training, and during the next eight to ten weeks, we are going to disseminate the message and create the message for that community, as well as provide more training to the Walkers and Talkers before they conduct a Home Health Party.

UNKNOWN SPEAKER: So for the Walkers and Talkers Training, just to clarify a little bit further, the Walkers and Talkers actually goes to forty hours in training. Twenty of those hours are conducted on with an on site-site visit from staff of PPB, where we go to all the materials, the template, and curriculum for Home Health Party, what information they need to learn and we give the coordinators an observer checklist so that when they start to do roll-plays of Home Health Parties inside, they know everything they have to look for. So they’re trained in the basics of education on basic, the communications skills, but they’re also trained to be facilitators so they know how to redirect, they know how to deal group dynamics when they go into the home. They know about recruiting, Home Health Party hosts; they know how to prepare those folks when they come into their homes. So that’s what that training consists of.

The other 20 hours are conducted by the coordinators themselves; so it’s follow-up, making sure that they’ve gotten all that information and internalized it, and are able really to communicate it in their own words in the community. So we’re presenting it, but they need to internalize that information, and digest it, and then regurgitate, probably not good terms to use. For some reason I’m thinking about food. So they have to be to do that; so that’s the training for them. Since all of you have finished the community mapping portion, and have been through a Walkers and Talkers Training, first off, I would like for you to share with the audience on how did you initially get community mapping volunteers, and was there any help from the partnership agencies. Maybe you can start Kara.

KARA BECKMAN: We ended up having kind of a ready pool of community mapping volunteers because of some of the relationships we had in the Latino community. The program that really took Plain Talk under its wing is called Comadres, and it’s been in the Latino community and the West Side for about twelve years now and that was initially started by and for Latino women to educate and then reduce HIV Aids within the community. So, it’s always used really a kind of community Health Worker model. So, fitting Plain-Talk into that model really helped us capitalize on the relationships we already had; so we went to people we already had relationships with, but then we also used this kind of as a really great opportunity to start developing new relationships with the community, because I think sometimes we have programs, or at least we do at Neighborhood House, we can get into  Rutzwith programming and continue to go back to those same people who you know are going to show up every time, and you can just count them every year as somebody new because it’s a new year or something. And so you’re impact really starts to lessen because you just kind of go back to those same core people all the time, and so we made a concerted effort to do some outreach around the community mapping, and went to some schools in the neighborhood as far as finding teen community mappers, and then just looking at other neighborhood partners who might be able to identify one or two people that are leaders within their organization who might have the skill-set to help us do the surveying.

LETICIA IBARRA: In our site we did develop a, like a community advisory group first, and the way we were able to recruit for that is that clincias does actually I never said what organization I’m working with. It’s a community clinic called Clincia Saluto Pueblo, which means, you know, “The Community’s Clinic”, “Community’s Health Clinic.” And this organization, this clinic, has been in the community for 35 years. And it already had on staff two community health promoters or promotoras, and so they’re very familiar with the target area and the community; they have been working for many years. And so to first recruit for our core group, so they went to several members in the community that they knew who were very active and who were always very interested in providing services and serving their community and their neighborhood. And, so that was one strategy.

They also, because they were conducting educational classes on other topics, like with the migrant education program and other parent meetings, we also went there to kind of give a feel, and talk about what this project would be, and how they would be helping develop the rest of the activities. And so that was another strategy. The two main strategies that were used for recruitment for our core group, for our advisory group. And then those adults actually brought their teenagers because the people who got most interested in this were the parents, were the adults who had teenagers at home, and so they brought in their teenagers, and so we ended up having a core group of about 15 adults and teens, and we were shooting for about half and half representation there. And then to recruit for our community mappers for those who were going to be conducting the surveys with our core group leaders together we decided that we going to do like a two-prong approach: use community contact, people they already knew, and then also do just like a mass recruitment, so we developed a flyer and took it door to door, to all the housing units in our target area. And that’s how we kind of came up with a group, well we ended up with a group of ten, but to be part of the survey team, we did do interviewing and everything like that to make sure that they knew what they were getting into and that they had the qualities that we were looking for.

UNKNOWN SPEAKER: Carolina, I want you to answer a somewhat different question, because I think the community mapping volunteers is pretty much the same. Were there any of your community mapping volunteers who you identified that actually became Walkers and Talkers?

CAROLINA DARBISI: Yes. The two of them, they were community mappers. One of them we identified checked through an after school program. With that partner, we asked the moms that were always waiting for, with the kids in that program, that way we identified  Tenisha, she’s our African-American Walker and Talker. Because when you do have in our community a bi-lingual Hispanic person to relate to the Hispanic, and we have the African-American. However, with this program what we want to do in Gainesville is to win the two neighbors together. My target is to have Home Health Parties, where the bi-lingual people, we have Home Health Parties with the African America.

UNKNOWN SPEAKER: I think two of the things that we really focus on here, and we haven’t laid everything out, and you can see it in your material, is that the reason you want to use the community residences is to really build on social networks, to really expand your area and the amount of folks you can really touch and impact with the program. The other thing I want to focus on is something that Carolina said is she did have two of her community mappers to become Walkers and Talkers, and one of the ways that we have been able to really assist the site is  Sara Beth who’s done all that data analysis and reading all that paperwork that the community mappers submit is able to send a list to the site of community mappers who have been really good at documentation, at following up the directions on completing the surveys because you really need those skills to be fine tuned as they go into the community and do the Home Health Parties. So you’re looking for certain folks; you’re not necessarily looking for college level students to volunteer, because a lot of the residents aren’t when we do the demographics, but you need someone who is functionally literate and who can follow directions and pick up and learn from the skills and the training. So that’s one of the things I did want to identify, and thanks for that.

We’re going to kind of jump around a little bit and talk a little bit about funding right now. I know you guys are excited about that. We’re going to start with Kara again, and tell us about your funding strategy on, to engage different stakeholders in this process.

KARA BECKMAN: I guess from our perspective, funding has been kind of, it’s been a challenge, but it’s also been a really great opportunity for us. We’ve been on board now for about three years, and what we’ve learned is that trying to piece funding together, which has really been how our organization has survived, is really difficult when you’re really looking replicating results that are, you know, replicating something that is going to get you good results, because having ten thousand here and five thousand there and twenty thousand there doesn’t allow you to have that kind of long term strategy that you want. And so we have struggled with this a little bit, because we got four months of funding through the community mapping, and then we had to, you know, get those results before we could leverage the next set of funding, and so we had a three or four month lag when we were trying to continue that community mobilization, but we weren’t able to promise that this is what this program is going to look like for three years, so you can trust what we’re telling you is going to happen. So that’s been one of our lessens learned around going forward is that you really do need to have one year of funding in place and you need to express from the very beginning with funders that this is a three year process. And even if you don’t, if you tell us we don’t do multi-year funding, that’s fine, but we want to know that you recognize that this is a three year process so that when we come back to the table next year at this time you’re going to recognize where we should be, and if we’re then give us credit for that.

So it’s been lessens learned around that, but on the other side of things, the Plain-Talk strategy really resonates with people, and funders like things that are new and evidence-based and all of those other things that we all know about. So, on the positive side of things, we have only been denied one, by one funder, and that was because teen pregnancy was becoming too controversial of a topic, so they just de-funded anyone who was dealing with that. But other than that everybody that we’ve approached has funded us, and we’ve actually engaged two new stakeholders, one at a 50 thousand dollar a year level and one at 15 thousand dollar a year level, as first grants, who had never been interest in our, or been compelled, I guess, by our services before. And one of those is a health provider, an insurance company. And that really has been one of the strategies that has been working well for us, because they understand the benefits, the cost benefit analysis, around young teen pregnancy prevention, and around the, you know, especially with new immigrant communities and really kind of the health education that comes along with that, around, you know, emergency room versus preventative care, and preventing pregnancy versus having child care and all those other long term benefits. So that’s been a strategy that’s been working well for us. We’ve gotten funding from at least three different health care plans, on very different levels, but the health plan does engage a fifty thousand dollars a year solid benefit of this and has been at the table.

UNKNOWN SPEAKER: I want to jump over to Carolina, because she has a different experience, because of those partnerships we stressed earlier, and I want to have her share some of their funding on strategy.

CAROLINA DARBISI: Okay. I feel a little bit privileged, because GCAPP made a commitment to support Plain-Talk for these three years. So it comes, my budget comes from the GCAPP (inaudible) satellite office. So it comes from the big fund raising activities that we do from the main office. But also, we apply for grants; we got a grant from the  NEKC Foundation, and right now we are writing a grant for the City of Gainesville, which is for low-income families. The partners that we have it’s, in kind donation partners for information for referrals but not for money. So when I approach them, they know not looking for money. I’m looking to maximize resources.

UNKNOWN SPEAKER: We’ll turn once more to Leticia.

LETICIA IBARRA: Oh, thanks. Well we had private funding for the first year from the California Endowment; and so that has been very helpful in terms of making sure that we complete the community mapping well. And I think especially the way the California Endowment, the way they structure their grand proposals really made the planning for the phase go really well. We have to, they like to give one year of funding; so we do have to reapply, and we’re about 50/50 whether we’ll be funding subsequent years or not, so we did have to make a commitment to look elsewhere for funding, which has been a little tough in California. One, a lot of foundations only accept proposals that they request from agencies that they are open to requesting. They have to ask for them, basically.

And also for the state government, the state office of family planning; they already have their money earmarked for certain programs, and our clinic actually received funding for two of those different programs that are teen focused. They’re not really focusing with parents, and so, but you kind of, you can’t really submit a proposal for something different from what they already have earmarked. So that’s been a little challenging for us on the public side. We are trying to maybe look for ways of doing the housing, because we are working in some government housing projects, maybe going that way, we’re still kind of looking into those other strategies.

This past year, also we did a lot of just local fund raising, because our community, our core group, our value street group was very interested in traveling to a national conference, and so they did get very involved with that, and so we submitted letters to a lot of private companies and businesses in the community, and we did homegrown fundraisers, car washes, raffles, a lot of things like that. So we did seek donations, like item donations from local Wal-Marts or other businesses, and we were able to raise about $5,500.00 through that. And so we’re trying to hopefully capitalize on some of that to continue with some, at least funding some of the activities for the next phase.

UNKNOWN SPEAKER: Carolina, did you want to say something?

CAROLINA DARBISI: Even though I’m not struggling for funding for next year, I keep looking for grants proposal, and Plain-Talk, I keep my eyes open, because it’s not just about teen-pregnancy prevention. You can tie Plain-Talk to education, to HIV Aids; so there are different and many ways where we can find funds for Plain-Talk.

UNKNOWN SPEAKER: What do you think of some of the barriers that are involved in, you know doing this national replication, being a part of a national replication on such as Plain-Talk. Anyone can go first; I know you’re prepared. Go ahead, Kara.

KARA BECKMAN: I think that the one thing that continually come up around replicating when you’re a community-based organization is making it appropriate to your community. And it’s really, and we of course talk about this all the time, because it’s really the struggle in a sense of the program coordinator. Because, as the intermediary really who is the person who understands the value of the national replication and why it’s important to buy into the universal data collection, and the core components as they are, and replication to get results and all of those pieces, and has to translate that in a way that’s going to convince the community that even though there are mandated pieces of this, it’s still going to work, and figure out the talking points around what we can do to make this work for our community that’s not going to undermine the results that we’re trying to achieve.

So, it’s certainly has challenges, and I would say that’s the biggest one, because there are certainly pros as well, but really trying to translate replication, first of all buy into it yourself, and then be able to figure out the ways in which you can talk to your community and get their buy-in and then figure out the great ways in which they, you know, ask them for their input on the things that they can give input on. You know, we don’t sit down with community members and say what do you think we should use as our core component and then say never mind we can’t do them because this is already mandated from the national office and make the national office look like the big evil outsider. So it’s about figuring out what are the things that community members can have input on, and then asking them for that input. And then kind of figuring out how to get the other pieces to happen the way they should happen. So it’s certainly, sometimes feels like a game, but it’s an important one because there really does have to be community buy-in, and this model really can work with a lot of different communities. But it’s kind of challenge of the site coordinator to figure out how to balance both of those things.

UNKNOWN SPEAKER: So, I think, just to sum it up, if you looked, if I wanted to kind of relay that, it’s on dealing with the structure of the core component, but being able to be flexible with other things, you think, has been a kind of challenge for you?

KARA BECKMAN: Uh-huh.

UNKNOWN SPEAKER: Leticia?

LETICIA IBARRA: You know, I really, I guess coming into the project at first I’ve always done community projects, and so I really love the idea that being, having the community planning process, you know where the community is part of developing the project, and the fact that you also work with local members of the community who get trained to be the pure educators and implement those pieces. And I guess for me it was also just finding how much, or how they’re going to help you really develop the project if these components are not, and one of the things that we found was, okay, so we need to have, we need to do community mapping, and we want to work with community members, but so the community the way they felt was in identifying the ways we were going to reach the community. Because we knew we had to do this, but how we had to do it was where our community group was able to kind of give input.

And then, in terms of the Home Health Parties as well, is the community members, the Walkers and Talkers that were recruited into program they’re also help being, find those strategies for finding those residents who are going to let us into their homes. And so, I think, it’s been a little, there were certain areas where I thought there was going to be more flexibility, but we have found areas where the community does definitely have an input into what is done.

I know like for us, in the Spanish-speaking community, because there’s a big difference in Spanish-speaking communities across the country, you know the surveys might have been, was an area where, okay, maybe the translation was not completely in sync with a Mexican community, just the Spanish, but you know there is a general Spanish that can be used, and you’ve just got to, and when you need to explain it to the community you can use other terms that don’t change the meaning of the question. So there are certain things that we did have to do to kind of tailor it to our community.

UNKNOWN SPEAKER: That has to be an interesting process to go into a different Spanish-speaking community and have to change certain words when as, I’m not sure which community but I think we were using (inaudible).

LETICIA IBARRA: (Spanish word).

UNKNOWN SPEAKER: (Spanish word). And it was apparently a bad word for one community--

LETICIA IBARRA: But it’s very popular in another.

UNKNOWN SPEAKER: --this is a better word to use. And then we went into, I think, (inaudible) city, and it was like, everybody was laughing when we read the survey out and giggling and we couldn’t figure out why, and she said “that’s not a good word to use.” So, you know, it’s been a struggle, because Sara Beth wants to make that, you know, the questions are the same in every site, but the language is appropriate, so that has really been a lot of work. Do you have any struggles or challenges?

CAROLINA DARBISI: Sometimes a timeline, because it’s a well-defined timeline; sometimes you can’t operate like losing a staff, for example, and having a gap because you need to find a new person to come on board.

UNKNOWN SPEAKER: And that has not just been with that site; some of the local realities that take into place given that time frame we gave for the four phases kind of pushed things back and working with the funders to make sure that they’re able to extend the deadline or they’re able to go over the funding on (inaudible) on issues with some of the sites but, we do, we try to give a window, I think, for each component to be implemented so, it’s not as the third month exactly that you have to implement community mapping, but we would hope by the end of the second quarter that that process is complete and your data has been submitted in.

Otherwise, you’re all the way off track on any, not just for us, but because it’s your community and the work has to happen, but as far as keeping folks engaged, once you start the community mapping process, I know Carolina and a couple of other sites that say, “well, we have to create stuff until it’s time to do the Home Health Parties, because you lose interest.” So that’s why I think the timeframe is more important around funding and around garnering support and interest in the community.

Let’s go to a different topic before we open the floor up and talk about media. Have any of you been able to garner any media support on local media and national media for your site?

CAROLINA DARBISI: Not national yet, but state media and local media. From the beginning from the planning a year ago we invited the reporters from the local newspaper. They Gainesville newspaper and the main Latino, Spanish newspaper. And they came two weeks ago, and here is a report from the Walkers and Talkers, training and results, and the way we do it, we always update them. We send an email with increase (inaudible); we send, you know meetings (inaudible), letting them know what is happening.

UNKNOWN SPEAKER: I think making sure that always have them engaged. You may not always want an ad to be on the front page, but if you keep them engaged when you need that publicity, you could use the media to your advantage, especially around those funding crunches and other issues that the sites may have. Anything you want to add?

KARA BECKMAN: We have been on the radio and had an article, we’ve been on the radio with a radio that really predominantly the Hispanic community; so that’s really, it’s different obviously with which media you’re talking about, because, we have a bi-weekly free Spanish language newspaper that is really about entertainment and letting people know where the best disco is. But it’s a free newspaper, and actually we even have managed to develop a relationship with them, because one of their lead people is interested in giving back to the community, and so he has let us, as long as we provide them with an article every two weeks, they’ll print it. So, just because he thinks it’s the right thing to do, and so even though it doesn’t necessarily have anything to do with what the best disco in town is, we can defiantly talk about how this related to teen pregnancy prevention. So we have an article in that paper every two weeks, as long as we remember to get it in by the deadline.

We’ve also had two or three articles in the biggest newspaper in the state, which is in Minneapolis and some of which has been good and some of which took an angle that we didn’t appreciate too much. So that can happen with media as well. And then, with our community partners, we have MOAPPP in town, which is Minnesota Organization on Adult’s and Pregnancy Prevention and Parenting. And they really help us garner some of that media support; so we just got together to do a strategy session around getting on one of the local radio stations in conjunction with the Minneapolis site that’s getting up and running to help even get more media attention, so, yeah.

UNKNOWN SPEAKER: I think I’ll let, I want to have Geri add something for one of the things from the national office I think we deal with is the way that those angles could taken off course for your own programs, and we’re developing materials to assist the sites with media packets giving them information that they can add in their own information, but having the basic stow the line.

But that is something that we are looking further at and making sure that folks are trained and have one or two folks on site who can do that media relations for them. And again I think that’s why those partnerships are important with the GCAPP office, the other offices, the state and local partnerships, because they may have relationships that you’re able to work, but also to get you prepared to do a newspaper article and have some feedback or input on with some of those media folks. Do you want to add about our media packets?

GERI SUMMERVILLE: All right. We’re having (inaudible) we’ve just contracted with a media specialist, whose putting together the packets for all the sites now. And he’ll be in training with all the sites (inaudible). And we’re also looking at national media for (inaudible) teen pregnancy prevention (inaudible) and Plain Talk (inaudible). (Inaudible) Time. Time Magazine (inaudible) one of our sites so we’re waiting to see, you know, you never know (inaudible).

UNKNOWN SPEAKER: Making sure folks are media savvy before they have those interviews, because everyone has their own agenda, and they can take a twist at this and make it into something totally different. I think the only other thing we, Geri talked a little bit about logos and copyright, and I wanted to kind of bring that up, because I know I’ve had this, not battle with the site coordinators but conversation around making sure the national logo is also on any publications and information that go out so that they can really capitalize on being a part of this process. Do you have any input on that?

KARA BECKMAN: That was actually one of the things again that I guess was one of the challenges. Because again you know I’d been doing a lot of community projects before, and I know that one of the key things for getting that ownership of a community for the project is coming up with your own identity for it. And so when we first started the project before we knew we were going to use a national logo we had already come up with local logo for our project, because other sites, the demonstration sites had done it previously, and so again this is something that came on later with the, when you get into this replication process.

And so for us, we feel that there should be some community identity involved again to make the community feel that this is their project. But I must say that one of the great things about working with the national project is that it does also create a lot of pride in the community group, because our core group is so proud of being part of this national project, and the fact that if this project works well with, you know, in our community, that we would be able to expand it into other communities, and that they would be contributing to that expansion.

So, you know there’s definitely a give and take. I mean we definitely see the value of creating again this, and I guess it’s that tension, that local identity, but seeing yourself as part of a bigger project or a bigger picture. And so, I don’t know if we have reached the compromise of using both identities, of being able to use both identities, I think has been--

UNKNOWN SPEAKER: I think, and Carolina has a great example, she said (inaudible) I was like she got it, yes. As we were talking about, they have really local logos. We used Brawley’s to send out to other sites and say “here’s something you can do,” but you can use both. You can use both, it’s not either/or and if I want to have an accreditation you want folks to know you’re United Way, and you want folks to know you’re accredited. You also want them to know you’re part of a national program. But I want to open it up and see if you guys have any specific questions.

UNKNOWN SPEAKER: Yes, I think this is very interesting, but I was wondering, in terms of replicating the smaller programs, doesn’t it have the advantage of a big national office behind it, what are the key elements that, I’m from the state (inaudible), are there some sort of key elements we should be thinking about in terms of trying to do something on a smaller scale?

KARA BECKMAN: One of the problems with taking the program, a small program like that and putting it in, and now having support, is that somehow you have to know some kind of (inaudible) in to it. What happens is it becomes it actually becomes (inaudible) sometimes more than if you were to, or (inaudible), because no matter what kind of program is you have to put some kind of data, (inaudible) it has to be free and clear. We also have to create some kind of

UNKNOWN SPEAKER: It seems to me what you are saying is that maybe while we’re developing it, do we put in the grant money for the staff to do all these different things (inaudible)...or is it more cost-effective for us to put into the grant a contract (inaudible)--.

UNKNOWN SPEAKER: Yes, depending on what your resources are, but I think your question is absolutely the right question. Not everybody has the resources to pursue this model, but what I want people to walk out of here with is the notion that it, we can cause more harm than good if we put the onus on a good program to do all the work that needs to be done in order to replicate (inaudible). You know, so that’s why we think about the partnership, and if you are writing grants, because they talk about this a lot within the private foundation world (inaudible)--for people who are seeking grants to lay out a framework that says your replication is important, but replication the right way is even more important, and that’s going to require technical assistance and training (inaudible), etc.

UNKNOWN SPEAKER: (Inaudible)

UNKNOWN SPEAKER: They can use this, because we’ve had (inaudible)--the youth and the PPB in-kind as a match on for, on leveraging all the money so that you have a shortage of half forty and services already and they’re using this money as a match to get more money from all the funders.

UNKNOWN SPEAKER: I have a question. We might not be at the point yet to get the (inaudible), but I was up in Chicago when (inaudible) went from 250 to 420 (inaudible). And one of the strategies that we developed, and back home in Indiana now, was to, instead of having a community strategy, you’d have a state right strategy, and to not try and do everything out of the Chicago office, but to build up state capacity to do all these different functions, and so I started out ninety-four with $24,999.00 (inaudible). But we only had about five sites; well now we have about 900 workers working in 56 sites, seeing about 30,000 families a year. So my contact is close to one and a half million a year to do all of that training and technical assistance and data management and research evaluation and all that; so it’s a heavy investment, but in Indiana we started even though we had six sites, I think, to begin with, we had a state-wide vision. We had a plan. And we (inaudible) toward that plan, but not without sufficient support. (Inaudible)

UNKNOWN SPEAKER: (Inaudible)

UNKNOWN SPEAKER: But what I’m thinking is when I’m in the national office, the goal was mainly just the states I was working with, because I was zipping around about twenty of them. But it was more appealing for the states that were funding to say “we will help you become self-sufficient, and build your in-state capacity with training teams an technical assistance and all that instead of having the national office do that, and have the states flow money out to somebody else. (inaudible)--had greater appeal to him.

UNKNOWN SPEAKER: (Inaudible)

UNKNOWN SPEAKER: Well, George is here. The southeast region was one of the most--was the most--was the highest priority for us to get into that area for a variety of reasons: Number one, that really (inaudible)--which is creating a new sense of urgency in those states to do something. Suddenly, politically, those three states aren’t considered very conservative, you know, so (inaudible)--and thirdly, they all had really strong state policy partners. And so we do have a state vision for each of these states within the southeast region that’s based upon strong community, high quality (inaudible) partners, because we’ve got to break those state public funding mechanisms (inaudible)--that we have to tap into more effectively. So we have the southeast regional strategy from a political perspective but also from a technical assistance and training perspective that we’re going to develop. Minnesota was, I mistakenly referred to as the White Site; it’s probably the most (inaudible)--after that we have in terms taking it to scale on a city level, and the vision really is though that it will create another attack to gain, on state attention. And it has gained state attention; so we really, we were hopeful last year that we would be able to tap into state office minority house dollars. That didn’t work out due to some staff transitions, but we’re still going to plug away at it; so when Leticia and Carolina and Kara were talking to you about their private funding development effort, I think what was not conveyed there is the really hard knocking on the doors of the title five, title ten (inaudible)--we’re really excited about this new venture we’re launching in New Mexico. It’s being (inaudible)--state department of (inaudible)--and we’re going to get (inaudible).

UNKNOWN SPEAKER: (Inaudible)

UNKNOWN SPEAKER: Any other questions? Any other thoughts that you want to share? They all have to get confirmation from each other.

UNKNOWN SPEAKER: I actually have a question. I mean (inaudible)--the strategy itself (inaudible)--do you see pregnancy as really, you know (inaudible)--I would just like to have you guys share whatever comments you might like to share about your experiences in community mapping that’s kind of like grounded in reality.

KARA BECKMAN: Yes, and would say that that’s one of the things that when you look at doing this on a big picture lever, it really is about going kind of place by place by place, because of the fact that that community mapping piece is so essential to creating this buy-in. We had a great experience with community mapping and it really is what gives you the momentum to keep going: asking people what they think is, you know, and doing surveys in low income communities of color is nothing new. Taking the information back to the community and asking their opinions is quite new and really helps you leverage support in the sense that you followed through on your word and you brought this back and you said “look at these results, what does this mean for your teenager?” That kind of interaction with community isn’t common. You know, the first thing that happens when you talk about doing surveys in the community is everybody says, “again? Great, we get to sit through another survey.” Because low income communities of color are surveyed and surveyed and surveyed and surveyed, but they aren’t very often engaged in a whole process that says, “We want you to help us use this date to inform an intervention that is going to give us good results around, you know, the number of teens that are pregnant in the community. And they might not believe you the first time you tell them that that’s what you’re going to do, but when you actually go back and knock on their door because they didn’t show up to the community meeting that, where you were going to give the results, and you say, you know, we still want to get opinion on this: what do you think about these three things? And then that engagement process is really a new experience for a lot of people, and it’s a respectful experience for people. And so that kind of, that component really does help garner support and create buy-in that really just doesn’t exist otherwise. I mean, you know, many of us have the kind of community advisory group for a whole lot of programs, but a lot of times they’re the same people or, you know, they’re a staff of color or whatever that, you know, works when you write a grant. But to actually engage 400 people in a community process and then take the information back to 150 or 200 of them and ask them for their input and say this is how this is going to inform the process. You know, engage those people in a way that is new and--you know.

LETICIA IBARRA: Yes, I want to add that we have been disseminating the results since February, and it’s been--and our community is pretty conservative, a very religious community as well, and I guess we were going in their thinking that maybe the project would be rejected even though it’s focusing on communication. You know, some people just because they’re talking about--you know that we going to talk about birth control, they think that that’s what we’re going to be advocating all the time. But what has been really surprising to me, I think, is that when you do talk about the results: this is your community; this is what’s happening here with these teens, that the community is less feeling that they have to do something. That has definitely been feedback that we’ve gotten; either, you know, whatever their religious views or beliefs might be or beliefs about contraceptive use, you know they do begin feeling that they do have to do something, and I think they do get the picture also about how important communication is and how much of a lack of communication that there is in the community--so. That’s something that’s very positive.

CAROLINA DARBISI: On another level, that data from the community mapping is very powerful, because I have my results released two weeks ago, and I have already received two invitations to present the results for the Commission of Family and Children in Gainesville and United Way to see how the agencies--how we can work together. So it becomes a powerful strategy to use that data (inaudible).

UNKNOWN SPEAKER: I think all the sites can contest that that partnership we talked about, when the (inaudible) comes back and goes over the results, they invite those partners. That’s an initial way to also keep them engaged, and that’s how you get those invites to do more formal presentations for agencies and partners and all...and the states. But also one of the questions on all the surveys asks the participants and residents, you know, would you like to be engaged on the next level and from that data they develop a list for the initial homes to go to the Home Health Parties, also I think.

CAROLINA DARBISI: And also the professional development. I like to call that (unclear – Spanish word), because that is even training in order to facilitate these (inaudible). And that’s the question of development for them; that’s an eye-opener. So that’s something else they can do.

UNKNOWN SPEAKER: And on that note. I love this whole process. And I’m wondering if you could talk about, would this process work on different issues, like infant mortality and the spirit (inaudible) in the outcome, to hear what people have to say, to share back with them, do the same kind of Walkers and Talkers and, you know, how (inaudible)--things like that, as a process to address other kinds of issues.

UNKNOWN SPEAKER: Actually, that comes up as a request very often if you talk about the (inaudible)--creative tension between running a national strategy and then implementing (inaudible)--at the community level. Where we stand on that is really important to get through (inaudible) and to generate (inaudible)--so that we can in fact be the first step toward achieving scale and (inaudible). And then once we have that under our belt then we can kind of say okay let’s go and try to take and adapt it. We know the results based upon the program demonstration, and we see that those results will be replicated, if you will, for each site. But based upon evidence, you know based upon what we actually know that works, and that’s what we’re selling. That’s what we’re marketing. This is what works. So--you know maybe fifteen years from now--.

UNKNOWN SPEAKER: (Inaudible)

UNKNOWN SPEAKER: Right. So we know right now what works in the communities. 28,000 is about as small as we go. We have a small community in Puerto Rico, but we’re not saying that it works in a rural area. We know that it works with white teens after (inaudible)--Latino teens, with some Asian immigrant population. You know, we’re not saying that it works for all immigrant groups; so there’s--what we’ve marketed, what we know actually works and that we have some good hunches about some other things, but we (inaudible) by working a rural area—we would call that “program demonstration” not “replication.”

UNKNOWN SPEAKER: It’s a wonderful example, I think of communication and participatory action. (Inaudible)

UNKNOWN SPEAKER: We agree. Yeah. You guys have actually been a wonderful audience. I think there’s been a tremendous amount of information that’s been conveyed one way, but if there are any questions, you do have our contact information. You know where our site is, and we’re available (inaudible) for more questions. Want to go one more round of questions--or?

UNKNOWN SPEAKER: Yeah. Any other final questions, final thoughts, or comments? No?

UNKNOWN SPEAKER: --to get funded. What would you say is a good technique that would work? (Inaudible)

UNKNOWN SPEAKER: To get funding?

UNKNOWN SPEAKER: Yeah.

UNKNOWN SPEAKER: Depending on, like what? The full program--

UNKNOWN SPEAKER: Are you a small agency or do you--? (Inaudible)

UNKNOWN SPEAKER: (Inaudible)--so it kind of depends on what type of agency you are (inaudible)--and where your funding mechanisms are right now for your agency. (Inaudible)

UNKNOWN SPEAKER: Right. I think the other thing is we did talk about like for this program there is an application process where we look at the implementation agency’s history of doing this work and also the funders who will be looking at the history of you know (inaudible)--what they are supposed to do and things like that; so it really would depend on the agency and their ability to garner more funding.

UNKNOWN SPEAKER: (Inaudible)

UNKNOWN SPEAKER: Another question?

UNKNOWN SPEAKER: (Inaudible)

UNKNOWN SPEAKER: (Inaudible)--Plain-Talk, and when they started coming together they formed another group called (inaudible) and they started addressing, like the grant issues and other issues; so we have seen (inaudible).

UNKNOWN SPEAKER: I think one of the other things that we talk about when we do the Walkers and Talkers training are not only the professional skills but they become resources; so we try to explain them: all right, you’re going to be expert in this area but you’re a resource for everything, because when you knock on the door who knows what you get? You know, folks say, “I would like to but I have four babies. You know you have to be able to direct them to resources for child care or rent assistance or other things. But we don’t want them to get all (inaudible) because that’s how folks get burned out. And we talk about using folks over and over for everything, but there are some--a lot of qualitative stuff and things in this process that really works not only for this specific area but for all kind of things that are happening in the community.

UNKNOWN SPEAKER: Right now there is a form that is actually--that the Walkers and Talkers have to fill out every six months--that assess certain skills.

UNKNOWN SPEAKER: They have to do a Walker Talker intake and a Walker Talker update every--uh, is it six months or quarterly? (Inaudible.) I think it’s quarterly.

UNKNOWN SPEAKER: (Inaudible)

UNKNOWN SPEAKER: It hasn’t come up yet, because, yeah--because we’re barely going to hit our first quarter. (Inaudible.)

UNKNOWN SPEAKER: (Inaudible)--and now we have a database where we can collect that data. (Inaudible)

UNKNOWN SPEAKER: (Inaudible)--when I got engaged in Plain-Talk I actually was a team parent in the St. Thomas Housing Development, and through this process I was able to, you know, kind of, with everything that was happening, I had stopped going to school--I went back to school. I actually went to job-school first. Actually, I went because my initiation in doing that I became the Plain-Talk secretary, but I actually went back to college and got Bachelor’s Degree, then went to Tulane and got my Master’s Degree in Public Health. And I’m one of many of those types of stories that you’ll see through Plain-Talk--on specifically do the Walkers and Talkers and community mappers, volunteers in the community--how that process works with them.

UNKNOWN SPEAKER: (Inaudible)

UNKNOWN SPEAKER: Yeah, and last week it was 29 degrees and at home it was 79.

UNKNOWN SPEAKER: (Inaudible)--for coming from all parts across the United States to join us. (Inaudible.) I’ll never again refer to Minnesota publicly as a White Site.

UNKNOWN SPEAKER: There’s some truth to that.