Is there a more touchy topic in American communities than the issue of sexuality, particularly adolescent sexuality? Recent research I’ve been doing for my dissertation suggests it remains one of the most difficult topics for any community to come together on to address. I’ve spent several years of my career working in the sub-field of teen pregnancy prevention. Though I started by developing and delivering teen pregnancy prevention curriculum directly to youth in schools and community based organization (CBO) settings, the success of my work gave me the opportunity to replicate the program at both organizational and community levels throughout the United States. As a result I often found myself in the middle of intense organization and community-wide conversations about adolescent sexuality.
I have to confess that much of the time I did it wrong. It’s not that I was trying to mess up. In fact, I was doing what I had been taught to do: identify and understand a problem, formulate a solution to the problem and apply the solution wherever I find the problem. There are many public health interventions where that approach works just fine. For example, immunization. Once the virus has been identified and understood, a vaccine can be formulated and widely applied with the expectation that a vast majority of the population will benefit from it. However, some public health issues are better informed by social science than medical science. Teen pregnancy is one of those. Viewing it through the lens of social science allows us to glimpse the context of complexity that surrounds teen pregnancy. A few years ago Teenwise Minnesota (formerly MOAPPP, the Minnesota Organization on Adolescent Pregnancy Prevention and Parenting) created a visual that attempted to capture the complicated nature of the challenge of teen pregnancy.
The Teenwise Minnesota Teen Pregnancy Puzzle illustrates that no less than 12 factors in every community contribute to solving the complicated puzzle of teen pregnancy. The issue is never addressed by simply addressing just one of the 12 factors but all twelve. When we consider that each of these 12 factors interact with one another in unpredictable ways and all of these 12 factors exist within larger community, state, national, and global contexts, we begin to realize it isn’t just a complicated problem but a complex problem in which no single intervention and no formula is going to be effective in all communities.
Add to this that teen pregnancy, as a sub-field of adolescent sexuality, is an emotionally charged topic for many Americans because we tend to view it not just through a public health lens but through values, morality, and religious lenses as well. Thus, engaging communities in order to move them toward effectively addressing the issue can be a very challenging process fraught with many perils. I have personally experienced many of those. They range from being shouted down in public meetings to being the subject of talk radio for several days on end to being stalked to being physically accosted. I’ve learned some good lessons through these less than stellar attempts at community engagement on the issue of teen pregnancy.
- First, the more sensitive the issue, the more important it is to deeply and broadly engage the community. I believe this is because community engagement that is deep and broad enough to include the whole community (Grasstops, Grassroots, and Residents with Lived Experience) creates deep ownership thereby reducing the likelihood of controversy and conflict. On a really touchy issue like teen pregnancy people in many communities will rally against proposed solutions, particularly those they view as morally dubious (e.g., condom distribution, morning after pill, etc.) or ethically questionable (e.g., abstinence-only until marriage), when they feel the solutions are being pushed upon them by others who don’t really “get” their community.
- Second, patience is more than a virtue, it is a survival strategy for community change on touchy issues. When communities are addressing issues like teen pregnancy that are very sensitive and emotionally charged, the change will not occur quickly or easily. It will most likely be incremental and the more it is pushed on people, the more likely resistance will grow – even if the resistance is not obvious. Here’s a quick story about unseen resistance: A few years ago I was contracted to provide six half-day training programs in a single week to 1,000 state employees who worked regularly with clients on public assistance. The topic was on how to make an effective client referral for family planning services. The employees were mandated to attend, the head of the agency was mandated to provide the training, and, because he disagreed with the order and feared backlash, another order quietly came from his office to all of the supervisors that basically instructed them to attend but disregard everything they learned and to tell their staffs to do the same. Of course I didn’t know this until AFTER all six training events were completed. However, at the time I was doing the training you’d have thought all was great. People were friendly, smiled, laughed at the right times, and attendance was actually quite strong. I left at the end of week feeling pretty confident all was good. To engage communities, even the “community” of welfare workers in that state, in a way that brings lasting change it is going to take deep and broad engagement over time that slowly builds authentic, lasting support.
- Third, community engagement is the group equivalent of the one-on-one strategy of “meeting people where they’re at.” One of the first lessons I learned in my first career (youth work) was that I would be more effective if I would meet young people “where they’re at” rather than pre-judge them and assume too much about them, including that they are all alike. Most people who go into social services as I did also learn this lesson. I’ve noticed though that we tend to forget it when we are working with communities. To meet communities where they are we need to know not just about the community but about what the community values, how the community sees the issue we have decided is a problem, and how, even whether, the community is willing to address it. There are more things we need to understand than these, but these are basic, especially when the issue we’ve identified is a touchy one like teen pregnancy.
There are some really scary things about patiently engaging the whole community and meeting it where it’s at on really touchy issues. What if people in the community have not progressed in their understanding of the issue as far as we have? What if they are wanting to take “the path of least resistance” in order to minimize the possibility of conflict even though that path may take them to less effective solutions? What if the community’s approach is more conservative, or more progressive, than ours? I’d like to suggest we shouldn’t be scared of these things but to expect them. All of these are likely because most people aren’t very fond of change and change is really very messy when the issue is touchiest. However, when it comes to community engagement on touchy issues, you have to start somewhere and the best place to start is “where they’re at.”
Once we meet them there, how do we move forward? Here’s five quick tips on moving forward to facilitate change that I’ve learned the hard way:
- Patiently invest in building trusting relationships with people and with the community.
- Patiently listen to their ideas.
- Patiently present our ideas as options, not as mandates or pre-packaged solutions.
- Patiently work together on a plan forward toward a stretch goal owned by the community that uses stretch strategies and tactics that are supported and implemented by the community. (By stretch I mean goals, strategies, and tactics that push everyone just a little bit out of their comfort zone and yet aren’t so extreme that most people can’t live with them.)
- Patiently practice faith in the desire, will, and capacity of communities to self-organize for good and to do good things when we simply support them and resist taking over or imposing our will.
One last thought…what makes an issue touchy for a community? Defining “touchy” is a lot like how I heard “major surgery” differentiated from “minor surgery” a while back. “Major surgery” is any surgery I have. “Minor surgery” is any surgery you have. So, the correct answer to the question is “It depends” on the how the community views the issue.
Copyright 2013 by Thomas W. Klaus