Design and Implementation of the Diabetes Impact Project: A Multisector Partnership to Reduce Diabetes Burden in Indianapolis Communities.

CONTEXT: Community-level health disparities have not arisen suddenly but are the result of long-term systemic inequities. This article describes the design and implementation of a community-engaged multisector partnership to address health disparities by reducing the diabetes burden in 3 Indianapolis communities through the implementation of evidence-based strategies across the prevention continuum. PROGRAM: The project has 5 foundational design principles: engage partners from multiple sectors to address community health, focus on geographic communities most affected by the health disparity, practice authentic community engagement, commit for the long term, and utilize a holistic approach spanning the prevention continuum. IMPLEMENTATION: The design principles are incorporated into the following project components in each community: (1) health system community health workers (hCHWs), (2) neighborhood CHWs (nCHWs), (3) community health promotion initiatives, and (4) resident steering committees, as well as a backbone organization responsible for overall coordination, project communication, evaluation, and partnership coordination. EVALUATION: This complex multilevel intervention is being evaluated using data sources and methodologies suited to each project component and its purpose overall. Each component is being evaluated independently and included holistically to measure the impact of the project on the health and culture of health in the communities. Key Performance Indicators were established upon project initiation as our common metrics for the partnership. Because complex interventions aiming at population-level change take time, we evaluate Diabetes Impact Project-Indianapolis Neighborhoods (DIP-IN), assuming its impact will take many years to achieve. DISCUSSION: Health disparities such as the diabetes prevalence in project communities have not arisen suddenly but are the result of long-term systemic inequities. This complex issue requires a complex holistic solution with long-term commitment, trusted partnerships, and investment from diverse sectors as seen in this project. Implications for policy and practice include the need to identify stable funding mechanisms to support these types of holistic approaches.

Empowering Change Agents: Youth Organizing Groups as Sites for Sociopolitical Development.

In addition to social action campaigns, some youth organizing groups provide formative learning experiences which engage youth in relevant sociopolitical issues through critical approaches. These groups support sociopolitical development (SPD), a self and socially-oriented process which influences youth personally, politically, and professionally into adulthood. This study explored how youth organizing experiences influenced SPD in the professional domain, applying an empowerment lens. Phenomenologically-based interviews were conducted with former sexual health education youth organizers and adult program staff. Former youth participants chose socially-oriented career paths influenced by the group's empowering approach to sexual health education and advocacy. They related meaningful sociopolitical learning experiences (e.g., interpersonal, educational, and civic engagement) to empowerment outcomes (e.g., political efficacy, critical awareness, and participatory behaviors) which informed career decisions. Professionally, participants sought to empower others as the group empowered them, drawing upon youth organizing social and human capital as they worked toward this aim. Combining sociopolitical and empowerment theorizing, the study adds to what is known about how purposefully designed youth organizing experiences support long-term development outcomes for individuals. Viewed as socially-oriented career development sites, youth organizing groups build capacity for social change beyond the groups themselves. Implications for youth organizing scholars and practitioners are provided.