"The aim of the first therapeutic session,” child psychoanalyst Donald Winnicott has suggested, “must always be to get a second one.” It is a sentiment that anyone working in difficult neighbourhoods with reluctant clients, where the main problem is not so much arousing interest and commitment but maintaining it, will be all too familiar with.

Barbara Goldberg and her colleagues were faced with this very challenge when they were charged with implementing a teenage pregnancy prevention program in a tough district of Chicago. Cynics warned them that while most young people would probably listen, they would soon drift away.

The project was part of the wider FOCUS (Families in Our Community United for Success) program designed to build relationships between young people, parents, schools, community members and professionals to encourage healthy choices about sexual activity.

At the outset, the project staff realised that success would rely on building strong community partnerships and that these had to be established before services began to operate. They thus brought together all potential partners and those already running programs to assess their strengths and find ways of ensuring that all of them would benefit from the new program.

In short, they began to assemble a “community coalition”. Goldberg and her colleagues define this as “groups that unite individuals, leverage resources and focus on a problem of community concern to achieve better results than any single group or agency could have done alone. Diverse interest groups combine resources to effect a specific change that members are unable to bring about independently.’ Coalitions are ‘issue- oriented, structured, focused to act on specific goals external to the coalition, and committed to recruiting member organisations with diverse talents and resources”.

“Community coalitions” are not, however, the same as “community engagement”, which offers a much less structured framework and relies more on mutual respect and negotiation.

The Chicago program was successfully implemented with 219 young people participating and a retention rate of 88 per cent. Moreover, parents took part in just short of half – 49 per cent – of cases.

The success of the project clearly benefited from the intensive preliminary work to engage with, and build, community coalitions. These were based on the principles of helping to strengthen the existing assets of the participating groups; developing a shared vision while also respecting individual and organisational interests; being inclusive; valuing each participant’s contribution; and accepting some informality and flexibility. This was complemented by investment in staff, good marketing and rigorous evaluation.

For preventive action, the success of the Chicago program underlines the need to take time to build coalitions before offering services; the importance of being sensitive to the community and its characteristics, while also developing strategies to deal with those aspects, such as a high turn over of residents and the local sex industry, which might hamper the program; and efforts to gain the commitment of staff to both the aims and principles of the program.

Reference:
Barbara Goldberg, Victoria Frank, Susan Berkenstein, Patricia Garrity and Jesus Ruiz, “Successful community engagement: Laying the foundation for effective teen pregnancy prevention”, Journal of Children and Poverty, 17:1, March 2011, pp.65-86.