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Extension's philosophy of systematic program evaluation to improve supports for families and communities furnished the framework for the project. Elements felt to be essential for a well-designed, 1-day grandparent education program have been extracted from past evaluation cycles and offered here as recommendations. Dory M. Diana J. American family life is reconfiguring in ways more dependent on extended family support.

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The combination of a changing family dynamic and deep state-level budget cuts to kinship care has significant implication for Extension initiatives to support grandparents raising grandchildren. Grassroots' assessment of need among the 63, Kentucky kin caregivers is an essential step in Extension's strategic plan to help Kentucky individuals, families, and communities create more abundant lives and healthier environments.

Reported here are the results of a comprehensive evaluation of an annual, 1-day education program for grandparents sponsored by the University of Kentucky Cooperative Extension Service. The purpose of this article is to report what we do, what we learned, and the impact of education on grandfamily health. Family and Consumer Sciences Extension focuses on individual and family development by promoting effective communication, understanding developmental ages and stages, appreciating individual and cultural differences, developing a strong value system, making wise decisions, and encouraging a supportive environment.

An output of the Grandparents and Relatives as Parents GAP program is building community capacity to nurture families through appropriate collaborations and programs that exist locally and statewide.

Program development was based on the Nurturing Families initiative that was identified as a statewide high priority need in the University of Kentucky's Family and Consumer Sciences Extension's Strategic Plan. Over a decade ago, a representative from city government attended a grandparent support group at a local elementary school. At that time community efforts to support grandparents raising grandchildren were sparse and decentralized.

Those grandparents shared their desire for education with the city's Coordinator for Aging Services, and the idea for a grandparent conference-style education program was born. Under Extension guidance, concerned service providers and volunteers took the idea to scale by planning a citywide grandparent education program. What began as a small group meeting in the Fayette County Cooperative Extension Office has since grown into a multi-county, regional event with over people from 55 counties participating in the most recent program.

While the program has expanded and adapted to changing needs, the primary goal to educate and support kinship families in taking action to improve their lives has remained consistent. West endorses use of an Internet survey to simplify program evaluation and underscores the need for Extension professionals to also apply the results in a meaningful way. The GAP Board has representation from a diverse group of people with backgrounds in education, financial, legal, health, and social service venues, so program evaluation results are interpreted from multiple perspectives.

Formal and often extensive discussion of assessed need leads to an informed plan of action to revise next year's offering. Partnering agencies require impact data, so evaluation procedures were developed to discover whether conference attendance actually influences grandparents' ability to raise grandchildren. What actions do grandparents take on behalf of their grandchildren? Analysis of grandparent interviews in a recent evaluation cycle revealed a complex set of environmental and social stressors that undermine action toward more positive parenting.

Educar Para el Manana. Life on a Small Planet. New York: Philosophical Library, October-November, Volume Six, Number One, Los Angeles: Kalimat Press, Book Review of Charles David Kleymeyer ed. Comment on Interpreting Education by Abraham Edel. Journal of Social Philosophy 19, no. Journal of Social Philosophy 14, no. With Maria Alcantara. During this stage, the vision promoted by KSDPP a healthy community, free of diabetes and the norm underlying this vision diabetes is a preventable disease appeared as successfully disseminated in the community.

For instance, a Masters student research project led to the development and implementation of a physical activity policy in the elementary schools — and a PhD student project conducted in collaboration with a multi-sectorial committee contributed to the development of an active school transportation project — These projects involved representatives of partner organizations, who are now assuming the leadership of these initiatives [ 71 , 72 ].

For instance, the physical activity policy — was developed in close collaboration with the community elementary schools [ 73 ]. However, participants group 1 recognize that there is still resistance from some sectors of the community and some participants group 2 highlighted the need to build stronger collaborations with some health organizations in the community to get funding instead of competing with each other. Using the same rationale, additional benchmarks are proposed for stage 3 Alliances, partnerships, networks; Advocacy agenda and action strategy and stage 4 Base building and mobilization; Alliances, partnerships, networks.

By comparing the actions and processes of KSDPP to the chosen theoretical framework, this analysis has exposed potential areas of improvement for the initiative. Even if some evidence shows a renewing of the research and intervention leadership in KSDPP, there is still some room to plan and foresee the future of the partnership leadership, which is essential in avoiding stagnation or dissipation in a movement.

Because if we look at the people that are selling food, are providing food services, we know that they are supplying demand; the community is demanding salt, fat, sugar, carbs, etcetera. We want them to shift to something else but we always backed off from them. The first author was invited to participate in the design of these conversations and integrated the results of this study, including potential area of improvement and action paths, in this reflection.

Based on the framework benchmarks, we conclude that KSDPP has reached the last stage of movement-building, which is the maintenance and integration stage into the Kahnawake community. Framing KSDPP as a social movement, this study points to other significant processes and outcomes, such as creating awareness; shifting norms and beliefs about diabetes in the community; fostering community mobilization, collaboration and leadership around this issue; building community capacity, skills and expertise in diabetes prevention; creating culture of collaboration and resource sharing among community organizations and permeating the diabetes prevention agenda into other organizations.

Our study highlights important community-level processes and outcomes in Kahnawake, which can be considered as transitional steps towards health improvement. A movement-building framework such as that by Masters and Osborn [ 31 ] is an applicable and innovative tool with which to understand and assess CBPR projects. Although the movement-building framework has been applied retrospectively in the current study, it can be used prospectively to encourage ongoing reflection and assessment in the context of CBPR [ 31 ]. Using the framework retrospectively can help coalitions situate and assess themselves with respect to the collective action they led and the progress made over the years.

Using the framework prospectively can assist coalitions plan ahead by providing general guidance about aspects of the action that are important at a specific moment. While the phases of the framework are modeled on social movement development stages, they nonetheless provide useful markers to assess the development and progress of CBPR projects and other collective action strategies over time, Furthermore, the core concepts of movement-building i.

Moreover, the benchmarks associated with each phase help identify key accomplishments at each stage as well as areas where additional efforts need to be focused. For instance, it suggests that in the second stage coalescence of development, CBPR teams should not expect to pervade the agendas of collaborating organizations, but should rather focus on refining collective action goals; in addition, CBPR leaders should not expect to be recognized from the base, but rather should work at building and expanding core collaboration.

However, while the framework offers a number of distinct intermediate goals on which to focus, it does not provide strategies with which to achieve these goals, which might be a limitation to translating findings into implementation. We believe that social movement frameworks, such as the one used in this study, apply particularly well to long-standing, sustainable community-based projects. However, it is important to acknowledge that these frameworks may not be useful or relevant to all CBPR projects.

In the case of KSDPP, the specificities of Kahnawake and the Mohawk culture favored the emergence of this form of large, sustainable community-based projects — one that is similar to social movements. The current study assessed the processes and intermediate outcomes of the Kahnawake Schools Diabetes Prevention Project using a social movement building framework.

This study proposes some innovative insights regarding the evaluation of CBPR projects and the assessment of their progress by building on their similarities with other forms of collective action. Review of community-based research: assessing partnership approaches to improve public health. Annu Rev Public Health.

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Glossary: participatory action research. J Epidemiol Community Health.

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Cargo M, Mercer SL. The value and challenges of participatory research: strengthening its practice. Uncovering the benefits of participatory research: implications of a realist review for health research and practice.

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Milbank Q. Reconsidering community-based health promotion: promise, performance, and potential. Am J Public Health. What predicts outcomes in CBPR? In: Minkler M, Wallerstein N, editors. Community-based participatory research for health: from processes to outcomes. San Franscico: Jossey-Bass; Building multisectoral partnerships for population health and health equity. Prev Chronic Dis. What counts as evidence: issues and debates.

Nutbeam D. Evaluating health promotion-progress, problems and solutions. Health Promot Int. Instrument for evaluating dimensions of group dynamics within community-based participatory research partnerships. Eval Program Plann. Institute of Medicine. Evaluating community efforts to prevent cardiovascular diseases. Horn J. Gender and social movements overview report. In: Cutting edge. Brighton: Institute of Development Studies; Jenkins JC.

Mobilization theory and the study of social movements. Annu Rev Sociol. Critical issues in developing and following community based participatory research principles. Community-based participatory research for health. San Francisco: Jossey-Bass; Mano a Mano: improving health in impoverished Bolivian communities through community-based participatory research. Fam Syst Health. Wilkinson P. Social movements. London: Pall Mall; Tilly C. From mobilization to revolution. Reading: Addison Wesley; Comparative perspectives on social movements.

Boston: Cambridge University Press; Mueller CM. Frontiers in social movement theory. Building social movement theory. New Haven: Yale University Press; Maton KI. Making a difference: the social ecology of social transformation. Am J Community Psychol. Minkler M, Wallerstein N.

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Improving health through community organization and community building. In: Minkler M, editor. Community organizing and community building for health. Can we build on social movement theories to develop and improve community-based participatory research? A framework synthesis review. Jenkins JC, Perrow C. Insurgency of the powerless: farm worker movement Am Sociol Rev. Oberschall A. Social conflict and social movements. Englewood Cliffs: Prentice-Hall; Goodwin J, Jasper JM. Caught in a winding, snarling vine: the structural Bias of political process theory.

Sociol Forum. Framing processes and social movements: an overview and assessment. Gamson WA. The social psychology of collective action. De la Porta D, Diani M. Social movements: an introduction. Malden: Blackwell Publishing; Masters B, Osborn T. Social movements and philanthropy: how foundations can support movement building.

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  8. Asian Communities for Reproductive Justice. Movement building indicators. Oakland: ACRJ; A guide to measuring policy and advocacy. Organizational Research Services: Seattle; Activity implementation as a reflection of living in balance. Social-relational understandings of health and well-being from an indigenous perspective. Int J Indigenous Health. High prevalence rates of diabetes mellitus and hypertension on a north American Indian reservation.