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PayGoal Evaluation

Kim Manturuk and Jessica Dorrance–Co-PIs … Continued

Assessing the Impacts of Pairing Coaching with Financial Products: Research on Effective Money Management/Manejo de Efectivo

Jessica Dorrance–PI. The four-city pilot … Continued

Durham Innovation Fund Professional Development

Mark McDaniel–PI. Bridges2Success (B2S) … Continued

Using Savings Incentives in a Progressive Banking Program

Jessica Dorrance and Kimberly Manturuk–C … Continued

School Rights: Law and the Dynamics of Everyday School Life

Karolyn Tyson–PI. This study brought tog … Continued

Research on Promising Practices in Asset Building to Reduce Racial Wealth Disparities in North Carolina

Roberto Quercia and Jessica Dorrance–Co- … Continued

Protest, Politics, and Economics in the Desegregation of the U.S. South

Kenneth Andrews–PI. Why do some social m … Continued

Model of Success

Mark McDaniel–PI. The two major objectiv … Continued

Grounding the State: An Institutional Ethnography of Agrarian Reform in Brazil
Wendy Wolford–PI. This project researched the creation of governance in post-authoritarian Brazil through an institutional ethnography of one of the most important government agencies in the country–the National Institute of Colonization and Agrarian Reform (INCRA). Over the past ten years, INCRA has become increasingly visible as new social actors mobilized landless farmers and rural workers to demand access to land. Between 1995 and 2001, the Brazilian government expropriated over 18 million hectares of land and settled approximately two million people. In overseeing the juridical, technical and administrative aspects of agrarian reform, INCRA employees are working with the poorest, most marginalized population in Brazil: the rural poor. As such, INCRA employees occupy an unusual position, working with both the needs of social movements and the state to re-distribute land and foster sustainable development on the new land reform settlements. In this study, the complicated process of governance is understood to be a dynamic relationship between institutional structure, everyday practice, and ideology. The research asked many questions in order to understand this dynamic: Who decides to work for INCRA and why? How does their work influence their political beliefs? How effective is INCRA in promoting viable land reform settlements? What is INCRA’s relationship with the different political mediators involved in agrarian reform–specifically, the Movement of Rural Landless Workers, the rural trade unions and the Catholic Church? How are these relationships produced and to what effect? How does INCRA’s mode of governance shape political practice among the land reform settlers and their political mediators? The research team answered these questions with a combination of methods–observation, semi-structured interviews, resource-allocation and community mapping, and media analysis–at multiple scales: national, state, community, and household. The research was carried out in Brasília, the capital of Brazil, and in the northeastern state of Pernambuco. Pernambuco, one of the poorest regions of Brazil, provided an excellent case study for the research because it has become a center of agrarian reform activity.

Promoting Prepaid Debit Cards for the Under-Banked
Janneke Ratcliffe–PI. This research is a test to gage the effectiveness of strategies to promote prepaid debit cards for the un- and under-banked consumers via bank branches. Funded by the Center for Financial Services Innovation, the CFSI has sought out the Center for Community Capital’s expertise in a consultative mode, for help in design of the experiment and analysis of results. CCC will provide back-end analytical support by performing statistical analysis of results, and summarize findings in a brief report.

Facilitating Savings for Low-Income Workers
Janneke Ratcliffe and Michal Grinstein-Weiss–Co-PIs. Sponsored by the Ford Foundation, $aveNYC tested the potential impact of short-term, non-goal-directed savings on family financial stability. Low-income tax filers made a commitment upon receiving notice of their refund to save by directing a portion of their refund to a twelve-month restricted account with the potential of earning a match if they continued saving for one year. This research followed participants for one year after receipt of their refund, along with two comparison groups of non-participants. The study furthered understanding of the experiences of low-income households with regard to savings, the impact of the simple matched savings offer on savings behavior, and the implications of the program for scale and replication. The research was based on telephone surveys, focus groups, key informant interviews, and tracking of data from third parties.

Marginalized Males Crisis Intervention Program
Mark McDaniel–PI. Over the last few years, public officials, practitioners and foundations have begun leveraging their resources in response to a national crisis made clear through a series of recent publications and nationally circulated articles—that health, economic, and social indicators for young males of color, and most significantly black males, have been precipitously declining compared to those of their peers or the rest of the nation. The Marginalized Males Crisis Intervention Project identified innovative and effective practices and advances understanding of how to serve vulnerable young males of color. The program’s goals include: delaying premature family formation, improving education; and promoting labor force attachment among young males.

Type 2 Diabetes: Ethnic Variation in Knowledge and Beliefs
PI-Anne Skelly, Funded by NIH. Type 2 diabetes is a highly prevalent and costly disease among the African-American, European-American, and Hispanic low income Populations of the rural and small town Southeast United States. No effective intervention has been developed which can delay or prevent the development of Type 2 diabetes in these populations. This study will provide the information needed to develop culturally appropriate, community-based prevention strategies for this disease. To develop prevention strategies, this study will use the PRECEDE-PROCEED conceptual framework incorporating Kleinman’s concept of Explanatory Models of Illness and Socio-Spatial Knowledge Networks to (1) describe and compare the knowledge and beliefs about diabetes causality, pathophysiology, treatment and sequelae of low income African American, European American and Hispanic males and females in a small, rural North Carolina community; (2) describe and compare the sources of information, including people, institutions and places, where mate and female adults in the three ethnic groups obtain and share information about diabetes, whom they trust regarding such information, and their perceptions of access to care; and (3) develop a method that can be used by nurses and other community based health workers to research the socio-spatial information networks of their communities that will allow them to implement culturally appropriate diabetes prevention programs in these communities. We propose an ethnographic design to integrate qualitative and structured data to identify individuals’ perceptions of diabetes’ causality, pathophysiology, treatment and sequelae, as well as where individuals obtain and share information about diabetes. These perceptions will be examined for inter-cultural and intra-cultural variation. We will use a site-based approach to identify and recruit a representative sample of 120 low income participants who have not been diagnosed with, but are at risk for Type 2 diabetes, and who include equally males and females, and African-American, European-American and Hispanic residents of Siler City, North Carolina. In-depth, semi-structured interviews will be conducted with each participant. These interviews will be taped recorded and transcribed. Systematic qualitative and geographic analyses of the ethnographic data will allow the investigators to compare beliefs, knowledge and information sources about diabetes among the community ethnically diverse populations for areas of convergence, difference and overlap. With these results the investigators will develop culturally relevant, community-based strategies to prevent or delay expression of diabetes and guide the restructuring of existing programs.

Geographic Accessibility of Health Care in Rural Areas
PI- Wilbert Gesler, Funded by NIH. Rural residence adversely affects health status and health care accessibility in comparison to urban residence. Research has not adequately explained how rurality and other geographic variables interfere with access to health services. Based oil the geographic concept of Central Place Theory, this research will showllow rurality (defined for a county in terms of adjacency to metropolitan area and size of urban population), various measures of distance, transportation availability, and consumer activity spaces differentially affect tile use of health services and how individual and household sociodemographic, cultural, and health status variables may reduce the effects of geographic variables. In an era of health care reform, understanding geographic accessibility and its interaction with other factors is needed to more effectively locate and improve the use of different types and levels of health services in rural areas. The specific aims of this study are to (1) measure tile effects of geographic factors on the use of health care facilities and practitioners by rural residents at the county level of analysis; (2) measure the extent to which sociodemographic, cultural, and health status characteristics reduce the effects of geographic factors on the use of health care facilities and practitioners by rural residents at the county level of analysis; and (3) measure the effect of geographic, sociodemographic, cultural. and health status characteristics on the use of health care facilities and practitioners by rural residents at the individual level of analysis. The study area is tile Mountain Area Health Education Center region, located in the Appalachian mountains of western North Carolina. A sample of 1,160 adults. and approximately 3,350 children, who reside in 12 counties in this region will be interviewed. The counties vary in rurality as defined by the Beale Codes. Active involvement of community leaders in the research will be solicited. Survey interviews will include items on (1) use of hospitals, public and private clinics, and primary care and specialist practitioners for regular, chronic and acute illness care, (2) distance traveled to car, transportation availability, and activity spaces: (3) individual and household sociodemographic characteristics, (4) health beliefs, health behavior, religiosity, and use of alternative practices, and (5) measured and perceived health status. Survey data collection will be conducted by the Research Triangle Institute. Analysis of confirmatory (county level) hypotheses will be based upon summary statistics, analysis of exploratory (individual level) hypotheses will be based Upon survey regression methods. Consumer and provider locations, roads, and places visited for various activities will be entered into a Geographic Information System in (GIS) to enhance measurement precision and create a coherent database to facilitate analyses.

A Political and Organizational Analysis of Maintenance Therapy for Opioid Dependence
PI-Daniel Gitterman & Elizabeth Fournier, Funded by SAMHSA. The substance abuse services research will investigate methadone maintenance therapy (MMT), using the methodological and theoretical lenses of political science and organization studies. The effectiveness of MMT as a treatment for opioid dependence has been repeatedly and consistently demonstrated. However, there is considerable variation in coverage, delivery, and utilization of MMT in treating substance abuse treatment clients who are opioid-dependent. This dissertation research will study the separate but interactive influences of policy and practice on methadone maintenance service delivery, by addressing several research questions. First, what are the political and economic forces driving state support for MMT? The focus is twofold: first, measuring the dimensions of Medicaid and other state policy regarding MMT services and second, probing the determinants of these state policy outcomes. Next, I will model the facility-level decision to deliver MMT services as a function of internal (organization-level) and environmental (state-level) variables. The final question is: how do organizational attributes and the delivery of MMT services independently and interactively affect treatment outcomes of clients with opioid dependence? The potential implications of this dissertation research speak to the gap in the understanding of MMT policy formation, to the knowledge gap regarding the determinants of access to MMT services, and also to the gap between knowledge and practice of evidence-based treatment for opioid dependence. Understanding the determinants of state-level MMT policy will improve the ability to understand the potential effect of efforts to expand the availability of MMT services. The dissertation findings will also improve the understanding of facility-level decisions that affect access to care. Finally, and of equal importance, this research examines the implications for substance abuse treatment of individuals with opioid dependence.

Farmworkers and Pesticides: Community-Based Research Conference
PI- Thomas Arcury, Funded by NIH. Community-based prevention research has been advocated to develop, deliver, and evaluate culturally appropriate interventions, in order to address growing health disparities in the United States. Such an approach is particularly appropriate for addressing the environmental and occupational health problem of pesticide exposure among seasonal and migrant farmworkers. However, common conceptual and theoretical development in this field of research is needed. The conference proposed here, “Farmworkers and Pesticides: Community-Based Environmental Health Research,” will bring together academic and community research partnerships to address three issues central to the success of these partnerships in reducing pesticide exposure among farmworkers and to developing common models and theories: (1) the value of a community-based approach for pesticide exposure reduction, (2) different models of academic and community partnerships, and (3) problems and solutions in achieving community and academic goals. The proposed conference will be held preceding the American Public Health Association annual meeting in November 1999, in Chicago. The one-day session will include a keynote address, three panel presentations by members of academic and community research partnerships currently funded by NIEHS, an interactive group discussion, and a concluding summation. The core group of participants will consist of representatives from three current research projects funded by NIEHS under the “Community-Based Prevention and Intervention Research Program” and two centers funded through the “Centers for Children’s Environmental Health and Disease Prevention Research” initiative. All five share a common focus on pesticides and farmworkers. The conference is expected to attract participation from public health researchers and practitioners interested in increasing their knowledge and skills in approaches to community-based research. Following the conference, the organizing committee will coordinate the rapid publication of an edited volume of papers based on presentations and discussion. This publication will be a resource to both researchers and practitioners in the field of environmental health.

Reducing Farmworker’s Exposure to Agricultural Chemicals
PI- Altha Cravey, Funded by Wake Forest University (Dr. Thomas Arcury). Seasonal and migrant farmworkers comprise a disadvantaged and medically underserved population exposed to significant environmental hazards that result in disease and disability. This project addresses the health effects of one type of these hazard, agricultural chemicals. The project will develop and test culturally appropriate interventions to reduce exposure to agricultural chemicals of seasonal and migrant farmworkers. This study focuses on an 8 county area of North Carolina in which sizable numbers of migrant and seasonal farmworkers are employed. The majority of these workers are Hispanic or African-American. Working collaboratively with seasonal and migrant farmworker communities and building on existing linkages with organizations that provide services to farmworkers and growers; this project will: (1) conduct formative research among farmworkers, growers, and service providers to identify knowledge, attitudes, and behaviors associated with exposure to agricultural chemicals; (2) use formative research to develop or adapt multiple culturally sensitive interventions designed to increase knowledge of, change behavior toward, and reduce exposure to agricultural chemicals; (3) test the effectiveness of such interventions using a controlled experimental trial with randomization at the level of both grower and worker; and (4) model the interactions of farmworker characteristics (including migrant status, ethnicity, and gender), the physical environment, and the social environment in producing changes in risk factor endpoints. The research will proceed in four steps, roughly corresponding to the four years of the project. Step I involves expanding collaborative networks and conducting formative research using qualitative methods (key informant and focus group interviews). Step II is development and testing of an intervention; testing is based on repeated measures interview with samples of farmworkers employed by 18 intervention and 18 control growers. Endpoints evaluated will be: knowledge of agricultural chemicals, exposure-related behaviors, and actual exposure assessed by biomonitoring. Step III is the revision and reevaluation of the intervention, followed by Step IV, final process and outcome evaluation and dissemination.

Gender Equity Values in Education Policy: Cross National Comparisons
PI-Catherine Marshall, Funded by Pacific Basin Research Center. The proposed project is a comparative study of the cultural values supporting gender equity policy in education in three Pacific Basin countries: the United States, Canada, and Australia. The overarching question is: by what processes do cultural values supporting gender equity converge and then how are they transformed into effective policies for education systems? Given that the underutilization of women (who represent 50% of the world’s population) is a serious problem worldwide, this project will contribute significantly to Pacific Basin Research Center current research focus concerning investment in social capital. Pacific Basin Research Center’s $15,000 investment in this project will support research on the values, philosophies and strategies of GEP leaders in teachers’ federations (TFs), supplemented with interviews of key policy maker/bureaucrats (PBs) and analysis of documents. Through cross national comparison, the research will reveal patterns of values and strategies that support GEP. The study will contribute new knowledge by: (1) exploring a method for cross-cultural policy analysis in an area where little policy research has been conducted, (2) identifying ways that national and international social movements for race, class, and gender equity intersect in policy directives for schools, (3) identifying and describing “mega-policies” (Montgomery), where international mass movements and policy groups pressure for gender equity; (4) documenting workable political and educational strategies, (S) uncovering how cultural values affect policy formulation, and (6) exploring the “fit”, cross-culturally, of a taxonomy of policy mechanisms. In the process, the project will identify and describe the motivators and supports for those who effectively articulate gender equity goals and move them onto the education policy agenda.

Community Wellness Project of the Siler City Immigrant Health Coalition (Project Nuestra Salud)
PI- Colin Austin, Funded by The Duke Endowment. Accessing health care is difficult for new immigrants. Barriers to care include language, cultural differences, transportation, inability to pay, and generally being unaware of available of available services. Immigrants often need help “navigating the system” or at least have some basic information about where to go for their health needs. In Vance and Granville counties there exists a variety of services and organizations that serve immigrants, but coordination of activities has proceeded on an informal basis. Immigrant residents and health providers themselves are often not aware of the full range of resources available. The Siler City Immigrant Health Coalition seeks to address this need by bringing together health care providers and members of the community to strengthen the health network. Working with tile community, the Immigrant Health Coalition will develop practical strategies and actions that will increase access to care. The goal of the Community Wellness project is to improve access to health care immigrants in the Siler City area. The objectives for meeting this goal are the following: Objective A: Maintain a forum (the Siler City Immigrant Health Coalition) where health providers can coordinate their efforts and where Community representatives can be heard and consulted. Objective B: Engage the local immigrant community in conducting data collection and strategizing about solutions to current problems. Objective C: Conduct an activity (like a Health Fair) to bring together members of the community and local providers, and distribute information about available services. The role of the Center for Urban and Regional Studies will be to coordinate Objective B, training community members and agency representatives to collect data.