Latino Community Development Agency

IPV/SV Project – CDC Site Visit

January 17, 2002 @ LCDA

 

 

Present:  Angela Banks, Project Officer from CDC; Joanne Klevens, Epidemiologist from CDC; Ruth Barajas-Mazaheri, Project Director from LCDA; Cynthia Tobar, Project Coordinator, IPV/SV Project; Dr. David Barney, OU-Centro de Evaluación; Timothy Brittingham, OU-Centro de Evaluación; Saleem Ahmad, OU-Centro de Evaluación; Betty Duran, OU-Centro de Evaluación

 

Ruth request clarification on the direction of current proposal as perceived as research based versus intervention development.

 

Joan responded by stating original application included development of Linkage Council and IPV/SV case management, she was uncertain on proposed evaluation plan.  David advised plan-included evaluation of services and impact on social systems.  She described process of proposal review within CDC.  Joanne expressed concerns regarding the following: 1) demonstration project to provide culturally competent services – felt that no prior research had been implemented to support this endeavor.  The case management proposed was not supported with empirical research.  2) what was proposed was not scientific enough to support scientific merits/finding.  When Joanne arrived at CDC, she looked at how the proposal could be restructured to meet CDC expectations.  Rewrote proposal leaving in Linkage Council and developing a process that would support development of an intervention based on information collected from Council, focus groups and surveillance.

 

Pat stated agency did not apply for a research grant and have never partnered with any other agency to do research.  The RFP that LCDA responded to was for development of an intervention and evaluation of intervention.  It appears that what they have proposed has been changed into a more scientific research grant.  The agency has a mission to provide services that address community issues.  As a result of the grant award, LCDA has set an expectation within the community that IVP/SV services were to be established within the community by the end of the first year.  LCDA responded to the RFP based on the guidance and need clarification as to changes proposed by CDC.

 

Joan stated change focus is on program design and evaluation of the intervention and not research based. 

 

Pat expressed concerned with CDC expectation that information may be sought from other agencies to support required surveillance data which LCDA does not have capacity to mandate or collect.  Also past experience indicates that Latinos as a population are under reported or often misclassified.  Cannot rely on state wide data to accurately represent Latino issues.  Additionally in Oklahoma, Latino are classified as “White” in surveillance data collected by the State and County.

 

 

Joan stated that the plan is to use information that exists to develop an intervention.  Look at medical and police records to determine what IPV rates were before intervention was implemented. 

 

Betty explained that surveillance data in Oklahoma is quite limited, especially in the area of IPV/SV.  Although LCDA and OU recognize the value of surveillance data, LCDA does not have the capacity to work with community, city, county or state agencies on development of needed IPV/SV surveillance data.  To attempt such an effort will be costly and time consuming without guaranty that information collected would adequately reflect IPV/SV within the Latino community.  A potential benefit of the Linkage Council would be to make recommendations to various IPV/SV lead agencies on the benefits of developing a coordinated effort to implement surveillance data collection in OKC, as well as statewide.   

 

Saleem stated Tulsa and OKC have some surveillance reporting for IPV.  Another source is hospitals which have reported based on race.  The police depart in OKC only keeps some information on IPV but not true for others. 

 

David advised that the LCDA project will serve Latinos in Canadian County, OK, as well as Cleveland County.  Data available would not be equal in all locations.

 

Angela asked if LCDA tracks clients by ZIP codes or counties.  Ruth advised agency does track some services but not for all programs.  She stated the Linkage Council would identify the needs in the community and reach out to the larger community to respond to some of the identified needs.  The needs assessment information obtained by the Linkage Council would be used to develop an intervention.  Joanne said that this is essentially what CDC is proposing.  Cynthia stated the Linkage Council is volunteering their time and efforts, she is concerned with being able to demonstrate to the Council that LCDA is able to address the issues the Council identifies.  Joan stated that CDC would like to see the overall impact on mortality and morbidity in OKC as result of intervention.

 

Pat stated that LCDA has looked at the State’s response to Latino needs in community.  The agency goal is to aide existing community agencies to enhance the services provided to Latinos.  This is done through advocacy and by providing interpretation services by LCDA.  An outcome is to work with existing services to become more culturally competent in providing services to Latinos which hopefully could be expanded to the larger community. 

 

Ruth stated the original proposal did state that the agency would work with existing providers to enhance their capacity to provide services to Latinos.  An example is shelters, where bi-lingual workers are needed and little is known by staff of the cultural issues that affect victims when seeking services.  Pat advised that LCDA wants to reach an agreement with CDC to implement something that is achievable and beneficial to the community and that LCDA can deliver.  David advised that Oklahoma history is of being Indian Territory, with a large number of American Indians in this state which brings in large revenues to Oklahoma.  The State’s consciousness of Hispanics is low, racial misclassification is evident in many databases, and therefore the quality of any surveillance data that could potentially be identified would have questionable value.  David’s role is to look at what works for the agency and community. 

 

CDC staff asked if LCDA has close ties with state agency that addresses domestic violence.  Pat stated LCDA has long standing relationships with many state agencies.  These connections can be used to create an environment of cultural competence in OKC. 

 

Cynthia identified the extended members of the linkage council.  CDC asked is they could provide a question to the Linkage Council as to what services are provided by community agencies to address domestic violence.  Cynthia stated that the extended Linkage Council will meet in about two weeks and Pat suggested the question could be posed at that time.  Resource inventory would also provide this information.  David asked if evaluation is re-written each year as project plan is revised.  Joanne said that if evaluation does not support research, then it does not require IRB review.  Joanne said CDC can publish finding even though data collected is not from research.  Pat asked if LCDA would like to publish would they need CDC’s permission.  She wanted to know who owns the data.  CDC staff stated that LCDA owns data, but they need to acknowledge funding source, as well as make available to data CDC staff for publication.  Joanne said if CDC staff participate in a publication, then it must go through CDC clearance.  Joanne will seek clarification on publication from CDC and advise LCDA.

 

Joanne offered the following summary:

  1. LCDA’s concern with impact evaluation because surveillance data is not reliable and concerned with effect – CDC will look for alternatives.
  2. Agency will evaluate impact of intervention on client outcomes
  3. This is not a research based grant
  4. Inventory of services - # of Latinos served and gaps in services

 

David asked about the relationship to The University of Oklahoma IRB to CDC.  CDC staff said both are separate IRBs. Betty then asked “who does LCDA answer to” in regards to compliance of human subjects protocols as approved by the IRB.  Joanne stated that CDC does not regard this proposal as research, therefore IRB approval is not required.  She suggested David submit their IRB proposal to The University of Oklahoma.  David asked if CDC IRB states surveillance data will be collected whereas OU states we will look at evaluation outcomes, does that obligate LCDA to collect surveillance data.  Joanne said this decision has not been made, but if that was ultimately submitted to CDC, then LCDA would be expected to comply.  Betty reiterated LCDA should not be expected to do surveillance due to limited capacity and lack of uniform reporting statewide.  Ruth expressed concern as to why proposal is being re-written and would like to discuss why the change over time.  Joanne discussed CDC staff change, stated most are very new, there has been a change in policy and focus on what was funded.  Unfortunately LCDA went a whole year without accomplishing something due to these changes at CDC.  Pat said community responded to guidelines, received the grant, followed contract guidelines and are concerned with changes proposed by CD C.  Her experience has not included any case in which a funding source would come back and change the proposal plan for the grantee.  As a reviewer, there is an expectation that the government agency and grantee will fulfill the expectation of the guidance and the grant contract.  Joanne stated that in Cooperative Agreements, grants are awarded then a negotiation occurs in which CDC works with the grantee to modify their proposed project to meet CDC guidelines.  Ruth said LCDA is not opposed to what is proposed but are concerned with surveillance issues.  Joanne said she felt bad about the time lapse, therefore took initiative to write the proposal in order to allow CDC-IRB review to occur within a shorter time frame.  CDC staff advised that only one of ten grants under this initiative have received IRB approval.  All are going through a similar process as LCDA.  David asked what criteria was used to determined what is research and what is evaluation.  Joanne said it had to deal with human subjects and research that produces generalizeable information.  Betty asked is we could develop a proposal outline of what LCDA would like to do.  All agreed.

 

Proposal Plan:     

  1. Linkage Council – Latino based Linkage Council

Cynthia said that Latinos to whom she has spoken with have stated that the most critical issue they have identified is the lack of bi-lingual services, but felt a need for support services such as case management.  Joanne said that interviews with survivors would be important to support this concern.  Additionally interviews with providers would also be beneficial.  Betty stated that the case management model would be developed based on information obtained from focus groups, resource inventory, cultural factors, specific service needs, and other matters that may affect victims and perpetrators.  Focus group information would aide in answering many of these issues.  Ruth advised that the first meeting of the Linkage Council is to introduce Latino members to each others, share with them the IPV/SV project plan, discuss future activities, then inform them of meeting with other linkage council members of the extended Linkage Council.  Believe this is important to ensure community buy in. 

 

2.  Community Survey – Joanne was not sure who would be represented in survey.  Felt that some questions should be more broad based.  Referred to page 20 in CDC proposal to be used as a qualitative interviews in focus groups.  Betty asked is issue of IPV/SV would impede individual’s desire to share their experiences in a focus group?  Pat said she should like to see interviews with victims in groups.  Joan said what she has proposed is to be administered to larger community and not necessarily with victims and perpetrators.  Discussed possibility of Town Hall meetings which would be recorded and transcribed.  David addressed issue that OU could not undertake the number of interviews proposed as our original work plan did not include quantitative data.  Discussed whether LCDA would be able to request a budget increase to pay for additional evaluation costs.  Angela is uncertain if LCDA can support request for increase in project related to evaluation activities, it will need to be reviewed by CDC.  Budget increase would also include incentives which can include cash incentives. 

 

Summary of activities to be completed by LCDA include development of Latino Linkage Council (core group); incorporate extended community in Linkage council: conduct resource inventory; and oversight of focus groups. 

 

Angela will review the following issues and advise LCDA:

 

Qualitative Study:  2-focus groups; 10 Key Informant interviews; resource inventory; and incentives for participants.  Betty estimated $25-30,000 to conduct these activities.  Angela advised that LCDA can request to use carry-over funds from YR-01.

 

Meeting adjourned at 3:20 pm.

 

 

IPV/SV Project – Follow-up Meeting

January 18, 2002 @ 8:30 am – Westin Hotel

 

 

Present:  Dr. David Barney, Tim Brittingham, Saleem Ahmad, Ruth Barajas-Mazaheri, Cynthia Tobal, Angela Banks, Joanne Klevens, Pat Fennell

 

Ruth opened discussion on yesterday’s meeting.

 

Angela also interested that topics like alcohol consumption weren’t mentioned

 

Cynthia feels these issues were mentioned in Goal 2.

 

Joanne surprised that community did identify IPV as a problem.

 

Discussion of vocal physician at Linkage Council meeting.

 

Angela felt there was a good representation of those attending yesterdays Linkage Council Meeting.  Joanne wondering if the people felt there were others missing that should be represented at the meeting.

 

Discussion of SE Community Health Center

 

Joanne felt that if the meeting was in Spanish, people could better express themselves.

 

February 8th will be the date for the larger meeting. (with the extended community)

 

Cynthia believes churches can provide location for focus groups and can possibly refer people to the program for these groups.  CDC reminded project to work on budget reallocations

 

Joanne expressed concern that we didn’t ask the group if we know enough information, should we gather information?  Pat expressed the importance of introductions in the first meetings.  Angela said that it might be appropriate to have more guidance ( objectives) for the Linkage Council meetings.

 

Ruth said the meeting allowed people to say what the issues were and the larger meeting would allow for more exploration.  Joanne said that in participatory research, the CDC scientist can help with this.

 

What if council said we don’t need focus groups, let’s just get the work done.  Joanne said that is very likely and the scientist can direct the people to the importance of the focus groups. 

 

Joanne said that we should not be giving the community the option to do focus groups.  Expressed concern about letting the community decide scientific methods.  David said that it is important to let the community know that this was an administrative decision.  In the community model, it is important to let the community make the research decisions.  David stated that we need to be careful on our decision making process.

 

Joanne would like to ask the community what do they need to know about the community and IPV and what will help them make better decisions about IPV, and what would help us get that information.

 

Cynthia concerned that as soon as they see us dictating to them, Linkage Council members will be a turn-off.  Joanne expressed that we are merely offering information. 

 

Next steps:

 

Next conference call

            Thursday, January 24th at 10am.

 

Key informants in service providers.

            Use snowballing to identify agencies

            25 service provider key informants

            get directory information at the same time

            located in page 19th of the revision

            open-ended questions

            open to non-Latino community providers

           

Victim/Perp

            5 of each

 

Youth

 


Community Focus Groups

 

Should have at least 2 focus groups in each category

 

Possible use of DJ’s fraternity as a focus group

 

Recruit at least 10-12 for each focus group and hope that 8 appear

 

Offering a cash incentive is important

 

David stressed importance of sampling plan.

 

Joanne asked about coverage of faith based organization

 

Joanne concerned about who we would be missing in the recruitment process

 

3 groups, 2 subgroups in each group

 

Men, women, elderly

 

Joanne questioned instruments that have been developed

Key Informant Interviews

·        at least 5 of each (victims and perps)

·        Interviewers don’t necessarily need a Master’s level interviewer, as long as they interact with the people very well and are competent

 

CDC going to check if IRB is needed for focus groups.  OU has to have it.

 

Incentive tracking

 

Joanne is going to check at CDC to see if it OK to start collecting information, will respond on Tuesday.  Information on community/facts & figures are to be forward to Joanne and Angela.

 

Dr. Barney said that we must have OU-IRB approval before we can do focus groups.

Getting information from professionals in the community OK, but not individuals.

 

Joanne would like to have a copy of the literature review.  Copy already given to previous science officer.  Should be in file.

 

Conference call will focus on outcome measures, details associated with long-interviews, additional funding.

 

National Sexual Violence Conference is in May 2002 in Chicago.

 

Dr. Barney asked if Sexual Violence includes stranger rape.  Joanne said that it would not include stranger rape.

 

Meeting adjourned at 10:00am