Culture and community psychology: toward a renewed and reimagined vision

Evaluation of the psychometric properties of the UBACC questionnaire in a multi-country psychiatric study in Africa

BACKGROUND

The University of California, San Diego Brief Assessment of Capacity to Consent (UBACC) is a tool to assess the capacity of participants to consent in psychiatric research. However, little is known about the psychometric properties in low and middle-income countries. This study aimed to examine the psychometric properties of the UBACC.

METHODS

We examined the reliability, latent factor structure, and item response of the first attempt of the UBACC items in a sample of 32,208 adults (16,467 individuals with psychosis and 15,741 controls) in Ethiopia, Kenya, South Africa, and Uganda; exploring these properties in the full sample and stratified by country, diagnostic status, sex, and ethnolinguistic language groups.

RESULTS

Exploratory factor analysis (EFA) suggested a two-factor model for the overall sample. However, a three-factor model was more appropriate when examining the latent structure across country, language, and sex. Confirmatory factor analyses (CFA) revealed an adequately fitting three-factor model for the full sample and across country, sex, and language. A two-factor model, however, was more appropriate for English and Amharic languages. Across all groups, the internal consistency of the UBACC was low, indicating below-threshold reliability (Cronbach's α (95 % CI = 0.58 (0.57-0.59). Using a multidimensional item-response theory framework for the full sample revealed that UBACC item 8, measuring understanding of the benefits of study participation, was the most discriminating item. Many of the other items had below-threshold discriminating characteristics.

CONCLUSION

EFA and CFA converged towards a two and three-dimensional structure for the UBACC, in line with the developers of the original scale. The differences in properties between populations and language groups, low internal consistency, and below-threshold item functioning suggest that investigations into the cultural and linguistic nuances are still warranted. Understanding the utility of consent tools, such as the UBACC, in underrepresented populations will be a part of the larger process which ensures that research participants are adequately protected.

Threading a decolonial feminist response to COVID-19: One community psychologist's reflection on the assemblages of violence

To challenge and interrogate the assemblages of violence produced by racial capitalism, and exacerbated by the COVID-19 pandemic, community psychologists must engage in a transdisciplinary critical ethically reflexive practice. In this reflexive essay, or first-person account, I offer a decolonial feminist response to COVID-19 that draws strength from the writings of three women of Color decolonial and postcolonial feminist thinkers: Gloria E. Anzaldúa, Sylvia Wynter, and Arundhati Roy. Through their writings I share my reflections on the sociopolitical moment associated with COVID-19. Of importance, I argue in support of engaging a decolonial feminist standpoint to understand the inequitable and dehumanizing conditions under COVID-19, and the possibilities for transformative justice. I offer this reflexive essay with the intention of summoning community psychology and community psychologists to look toward transdisciplinarity, such as that which characterizes a decolonial standpoint and feminist epistemologies. Writings oriented toward imagination, relationality, and borderland ways of thinking that are outside, in-between or within, the self and the collective "we" can offer valuable guidance. The invitation toward a transdisciplinary critical ethically reflexive practice calls us to bear witness to movements for social justice; to leverage our personal, professional and institutional resources to support communities in struggle. A decolonial feminist standpoint guided by the words of Anzaldúa, Wynter, and Roy can cultivate liberatory conditions that can materialize as racial freedom, community wellbeing, and societal thriving.

Systematic Review of Cultural Aspects of Stigma and Mental Illness among Racial and Ethnic Minority Groups in the United States: Implications for Interventions

Stigma is integral to understanding mental health disparities among racial and ethnic minority groups in the United States. We conducted a systematic review to identify empirical studies on cultural aspects of mental illness stigma (public, structural, affiliative, self) among three racial and ethnic minority groups (Asian Americans, Black Americans, Latinx Americans) from 1990 to 2019, yielding 97 articles. In comparison studies (N = 25), racial and ethnic minority groups often expressed greater public and/or self-stigma than White American groups. In within-group studies (N = 65; Asian American, n = 21; Black American, n = 18; Latinx American; n = 26), which were primarily qualitative (73%), four major cultural themes emerged: 1) service barriers including access and quality (structural stigma); 2) family experiences including concealment for family's sake, fear of being a burden, and stigma extending to family (affiliative stigma); 3) lack of knowledge about mental illness and specific cultural beliefs (public stigma); and 4) negative emotional responses and coping (self-stigma). These findings confirmed stigma has both similar and unique cultural aspects across groups. Despite this, few studies tested stigma reduction interventions (N = 7). These cultural insights can inform contextual change at the health systems and community levels to reduce stigma, and empowerment at the interpersonal and individual levels to resist stigma.

Experiencing visions of Canadian church workers: Exploring the mentality fueling systems involved in poverty reduction

To better understand the preferred role of faith-based organizations in secular society, the Canadian Council of Churches partnered with researchers to explore current systems of poverty reduction. The nature of the systems involved in attending to the underlying collective subjectivities (i.e., group/communally-shaped psychological experiences such as shared motivations, values, and aspirations) often being overlooked was justification for the importance of the research. These collective subjectivities are the forces that often drive system functioning. We conducted exploratory qualitative work situated in a theoretical frame informed by bringing together systems theory along with cultural psychology (an approach that focuses on socio-communally shaped collective subjectivities). In turn, this theoretical frame-shaped how Interpretive Phenomenological Analysis was employed. A total of 33 participants' collective subjectivities undergirding systems surrounding poverty reduction reveals a missional faith foundation leading toward perceived essential processes of advocacy and congregational connections bridging communal divisions. They see themselves as distinctly striving to create opportunities that encourage poverty alleviation in a holistic and dignified manner reflected in a multidimensional understanding of poverty. Perceived procedural tension exists between giving (that has long-lasting change and resonates with colonial forms of charity) and forming relationships can help people more effectively.

Understanding community violence: A critical realist framework for community psychology

Critical realism can unsettle a number of orthodoxies that surround the study of community violence within community psychology. This is to say, because critical realism is embraced so rarely by community psychologists, it can institute a parallax shift within the discipline, whereby we are granted alternative ways of perceiving violence within community contexts. Drawing on transdisciplinary thought, we offer in this article a retroductive framework for studying community violence. This framework, we argue, can facilitate an understanding of structurally violent causal mechanisms through interrogating how direct-or observable-violence intersects with epistemic violence (i.e., harmful and inaccurate representation). Demonstrating the efficacy of this framework, we provide an example from our work, where participants from a low-income South African community produced and screened a documentary film on community violence and collective resistance. Reflecting on the ways by which this film engaged xenophobic violence in particular, we examine how community members used the film to trouble perceptions of community violence and advance a multifaceted antiviolence agenda. By way of conclusion, we consider how our framework can be used to inform a critical realist community psychology, wherein violent social structures are analyzed against the agentic community-driven initiatives which oppose these structures.

Suicide amongst the Inuit of Nunavut: An Exploration of Life Trajectories

This article reports results of the life trajectories from 92 Inuit who died by suicide, matched for age and gender with 92 living-controls. A proxy-based procedure and semi-structured interviews with informants were conducted to obtain trajectories of developmental events occurring over the life course for suicide and community-matched controls. Results from this research indicate two different trajectories that differentiate the control-group from the suicide-group throughout the life course. Even though the number of suicide attempts are similar between both groups, the suicide-group had a more important burden of adversity, which seemed to create a cascading effect, leading to suicide.

Community Self-Organisation from a Social-Ecological Perspective: ‘Burlang Yatra’ and Revival of Millets in Odisha (India)

In this paper, I focus on the revival of an Indigenous community seed festival known locally as Burlang Yatra (‘Indigenous Biodiversity Festival’) in the district of Kandhamal in Odisha (India). This annual event brings together millet farmers to share knowledge and practices, including exchange of Indigenous heirloom seeds. Such community seed festivals remain largely underappreciated (and underexplored). Investigating Burlang Yatra through a social-ecological lens allowed for a greater understanding of its capacity to build and strengthen relationships, adaptation, and responsibility, three key principles that together link the social and the ecological in a dynamic sense. These principles, driven by intergenerational participation and interaction as well as social learning, can be seen as fostering ‘social-ecological memory’ of millet-based biodiverse farming. The festival’s persistence and revival illustrate a form of grassroots self-organising that draws on values of an Indigenous knowledge system. Within a restorative context, it has the capacity to repair and restore cultural and ecological relationships that the community has with their own foods and practices. This paper offers a new understanding of community self-organising from a social-ecological perspective and particularly in a marginalised context as supporting the revitalisation of Indigenous food systems.

The Formal Systems Response to Violence Against Women in India: A Cultural Lens

Violence against women (VAW) has become an increasingly salient issue in India, with women at risk for different forms of gendered violence. While there may be universal elements in the international phenomenon of violence against women, it is a complex, multifaceted phenomenon that takes shape in a particular sociocultural context. The current study employs a narrative framework to systematically examine how culture is expressed in the formal systems response and women's help-seeking in two metropolitan cities in India. Specifically, we sought to understand, among formal system responders (a) what characterizes the dominant cultural narratives on violence against women in India; and (b) how these are reflected in community narratives of formal responders. Interviews were conducted with formal responders working in different types of local agencies (e.g., police, health centers, and non-governmental agencies). The paper illustrates the major themes that emerged from participants' narratives describing the multilevel influences that shape the formal system response to violence against women and women's help-seeking efforts. The implications of these findings for effective response and directions for future research are summarized.

Reflecting on Participatory, Action-Oriented Research Methods in Community Psychology: Progress, Problems, and Paths Forward

This paper provides a critical reflection on participatory action research (PAR) methods as they pertain to community psychology. Following a brief review of the fundamental aspects of PAR, key developments in the field are examined. These developments include the redefinition of the research enterprise among groups such as Indigenous and consumer/survivor communities, challenges that attend the "project" framing of PAR, academic and practice context challenges, and important domains in which PAR methods need to become more engaged (e.g., social media and disenfranchised youth). Three illustrative case studies of programs of work in the areas of youth homelessness, consumer/survivor engagement, and Indigenous research are provided to illustrate these contemporary challenges and opportunities in the field. The authors make the argument that without an effort to reconsider and redefine PAR, moving away from the stereotypical PAR "project" frame, these methods will continue to be poorly represented and underutilized in community psychology.

Culture, local capacity, and outside aid: a community perspective on disaster response after the 2009 tsunami in American Sāmoa

Research on diverse cultural contexts has indicated that aid organisations often fail to leverage local, culturally-grounded resources and capacities in disaster-affected communities. Case-study methodology was employed to explore the relationship between local and external disaster response efforts in American Sāmoa following the earthquake and tsunami on 29 September 2009 in the southern Pacific Ocean, with a specific focus on the role of culture in defining that relationship. Interview and focus group data from 37 participants, along with observational data, suggested that the local response to the event was swift and grounded in Samoan cultural systems and norms. External aid was viewed as helpful in some respects, although, on the whole, it was seen as a disruption to village hierarchies, social networks, and local response efforts. The study discusses the implications for the role of outside aid in diverse cultural contexts, and makes suggestions for improving the ecological fit of post-disaster interventions.

Prioritizing the Local in an Era of Globalization: A Proposal for Decentering Community Psychology

In this article, I outline a proposal for decentering the field of United States-based community psychology. Transnational migrations, border crossings, and proliferating neoliberal trade and global media characterize the contemporary moment we live in. These movements challenge any monolithic disciplinary narrative of community psychology. Drawing from liberation psychology and women of Color feminisms, I argue that decentering the field involves engendering more reciprocal, nonhierarchical relations between the core and peripheries of knowledge production. Specifically, I consider the decentering project in two related realms-content and agents of knowledge production. The first issue concerns the kind of research and theorizing we engage in, the issues or topics we investigate, and the subject populations we work with. The second issue pertains to the agents who engage in the aforementioned processes, exercising epistemic power, that is the authority to construct what is considered legitimate and valid knowledge. I conclude with the implications of the decentering project for a multistranded community psychology that is responsive to the cartographies of contemporary struggles.

The Acculturation of Community Psychology: Is There a Best Way?

In this paper I describe a community psychology perspective on acculturation and adjustment of immigrants and refugees and suggest that this field of acculturation research has in turn something to offer heuristically as we consider our identity and training for future generations of community psychologists over the next 50 years. I suggest that honoring our heritage, maintaining our disciplinary identity as community psychologists, and sustaining doctoral programs that offer training specific to community psychology are crucial for our survival as a field and is not antithetical to, and is indeed necessary for, interdisciplinary collaborations.

A volunteer alcohol consumption reduction campaign: participatory action research among Thai women in the Isaan region

Cancer is one of the leading causes of death in Thailand as well as other countries. Evidences from studies in Asia show that alcohol consumption has been linked to an increased risk for various types of cancer. In the qualitative participatory action research presented here, the possibilities of a volunteer women's movement to reduce harmful alcohol consumption by facilitating the creation of emancipatory knowledge in the Thai-Isaan community was explored. During in-depth interviews with 10 female volunteer participants, the following themes emerged: merit making, developing a sense of personal empowerment, and the experience of participating in an action plan that utilized various strategies. The project activities empowered participants to create and share knowledge which was then applied toward action for change. Adoption of this type of program by local health care providers to reduce health problems and risks related to alcohol misuse in similar contexts and cultures is recommended.

Ethnography in community psychology: promises and tensions

Community psychology recognizes the need for research methods that illuminate context, culture, diversity, and process. One such method, ethnography, has crossed into multiple disciplines from anthropology, and indeed, community psychologists are becoming community ethnographers. Ethnographic work stands at the intersection of bridging universal questions with the particularities of people and groups bounded in time, geographic location, and social location. Ethnography is thus historical and deeply contextual, enabling a rich, in-depth understanding of communities that is aligned with the values and goals of community psychology. The purpose of this paper is to elucidate the potential of ethnography for community psychology and to encourage its use within the field as a method to capture culture and context, to document process, and to reveal how social change and action occur within and through communities. We discuss the method of ethnography, draw connections to community psychology values and goals, and identify tensions from our experiences doing ethnography. Overall, we assert that ethnography is a method that resonates with community psychology and present this paper as a resource for those interested in using this method in their research or community activism.

Integrating cultural community psychology: activity settings and the shared meanings of intersubjectivity

Cultural and community psychology share a common emphasis on context, yet their leading journals rarely cite each other's articles. Greater integration of the concepts of culture and community within and across their disciplines would enrich and facilitate the viability of cultural community psychology. The contextual theory of activity settings is proposed as one means to integrate the concepts of culture and community in cultural community psychology. Through shared activities, participants develop common experiences that affect their psychological being, including their cognitions, emotions, and behavioral development. The psychological result of these experiences is intersubjectivity. Culture is defined as the shared meanings that people develop through their common historic, linguistic, social, economic, and political experiences. The shared meanings of culture arise through the intersubjectivity developed in activity settings. Cultural community psychology presents formidable epistemological challenges, but overcoming these challenges could contribute to the transformation and advancement of community psychology.

Diverse perceptions of the informed consent process: implications for the recruitment and participation of diverse communities in the National Children's Study

We examined the experiences, perceptions, and values that are brought to bear when individuals from different ethnic and cultural backgrounds consider participating in health research. Fifty-three women from Latino, Asian American, Middle Eastern, or Non-Latino, White backgrounds participated in seven English or Spanish focus groups facilitated by trained investigators using a standard protocol. Investigators described the National Children's Study (NCS) and then asked questions to elicit potential concerns, expectations, and informational needs. Group sessions were audio-recorded, transcribed verbatim, and analyzed using qualitative thematic methods. A major theme that emerged during focus groups was participant self-identification as a member of a cultural group or community when raising issues that would influence their decision to participate in research. A related theme was the belief by some that communities may differ in the ease of participation in the NCS. Identified themes related to the informed consent process included perceived risks, anticipated burden, perceived benefits, informational needs, and decision-making strategies. Although themes were shared across groups, there were cultural differences within themes. Findings indicated that individuals from diverse backgrounds may have different perspectives on and expectations for the research process. To effectively recruit representative samples, it will be important to address a range of issues relevant for informed consent and to consider the impact of participation on both individuals and communities.

Unikkaartuit: meanings of well-being, unhappiness, health, and community change among Inuit in Nunavut, Canada

Suicide among young Inuit in the Canadian Arctic is at an epidemic level. In order to understand the distress and well-being experienced in Inuit communities, a first step in understanding collective suicide, this qualitative study was designed. Fifty Inuit were interviewed in two Inuit communities in Nunavut, Canada, and questionnaires asking the same questions were given to 66 high school and college students. The areas of life investigated here were happiness and wellbeing, unhappiness, healing, and community and personal change. Three themes emerged as central to well-being: the family, talking/communication, and traditional Inuit cultural values and practices. The absence of these factors were most closely associated with unhappiness. Narratives about community and personal change were primarily about family, intergenerational segregation, an increasing population, more trouble in romantic relationships among youth, drug use, and poverty. Change over time was viewed primarily as negative. Discontinuity of kinship structure and function appears to be the most harmful effect of the internal colonialism imposed by the Canadian government in the 1950s and 1960s. Directions toward community control and action are encouraging, and are highlighted. Inuit community action toward suicide prevention and community wellness is part of a larger movement of Indigenous self-determination.