UNCG Research

Systemic change

Posted on Thursday, May 16th, 2013 by Sangeetha Shivaji.
ORED Featured

How do you keep teens away from drugs and gangs and prevent HIV/AIDS and chronic disease? You change the environment.

Dr. Vincent Francisco, associate professor of public health education, has spent 23 years working with communities to change and create programs, policies and practices that will positively affect behavior and health outcomes in those communities. His goal is systems improvement.

“You have to deal with what caused the problem in the first place,” he said. “You can give kids new behavior — that’s not the hard part. But when they are out in the community, the old behaviors come back. … If you try to change behavior without changing the context supporting the behavior, it won’t work.”

Francisco, trained as a developmental and child psychologist, understands prevention is key. And one single change isn’t going to work. It will take hundreds of changes across all the contexts faced by youth and adults in communities.

While working at the University of Kansas, he co-created the Community Tool Box, found online at http://ctb.ku.edu. Community organizations can go to the tool box and get a number of resources, including information on identifying issues and how to develop a framework or model of change. The more information and training people have, the better they are prepared to change their physical and social environments.

He notes the Americans with Disabilities Act is an example of a policy that changed all communities. Before 1991, businesses and communities could choose whether to make buildings accessible. People in the Independent Living movement empowered others to effect systems improvement that resulted in changes in the physical and social context in every community in the United States.

At UNCG, he — along with other faculty, staff and generations of students — has helped a number of groups identify needs and work toward change. They partnered with communities from as close by as Alamance County to far-flung Mexico, Russia and Canada.

Most recently, he is partnering with the Rev. Odell Cleveland and Dr. Bob Wineburg, UNCG professor of social work, to help Mt. Zion Baptist Church in Greensboro create lasting systems improvement so that people currently without insurance will get better access to health care.

They want more low-income people to have access to insurance and regular medical service. But that’s just the start.

“It’s all about long-term gain,” Francisco said. “Insurance alone won’t solve the problem.”

One woman from the congregation came to see him with a business idea. She has diabetes and wants to create a company to help others who deal with the disease.

“The doctors gave her insulin but did not tell her how to manage her disease,” he said. “She felt talked down to.” She wants to provide diabetes education, access to testing supplies and support groups.

Francisco, Wineburg and Cleveland teach a community grant writing course (HEA 702) to help people get support for ideas like these.

Francisco came to UNCG in 2004. He was particularly struck by the history of community collaboration at UNCG and the passion of alumni to give back to the community. Alumni — especially those of the Woman’s College era — have been a positive influence in North Carolina, he said. That passion is needed for lasting change to happen.

“We’ve got to work together or we’ll never change,” Francisco said. “We need to create a new future together. All of our futures are locked together.

“This is so the right thing to do.”

Reprint from UNCG Research Magazine 2013