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Manuals and Guides: Health

Ethnic Minority Neighborhood Outreach

Copyright © 1995 by American Health Decisions

Contents

A Word from the Chairman of the Board
Foreword
A Word from the Project Director
Where This Guide Comes From

Know What You Are After
Know What It Takes
Build a Teamwork Plan
Carry Out the Team Plan
Maintain Effective Communication
Closure
Conclusion
Supplement

A Word from the Chairman of the Board

August 1995

Dear Friend of Ameriean Health Decisions:

I am pleased to learn of your interest in American Health Decisions' (AHD's) ethnic outreach project. As a national organization committed to helping people understand their health choices, we are continually challenged by the need for our programs and activities to reflect the diversity of our population.

Under the leadership of Ralph Crawshaw, M.D., founder of Oregon Health Decisions and creator of the health decisions movement, American Health Decisions undertook an ambitious project aimed at uncovering strategies for including diverse ethnic groups in a range of community- based initiatives. In this guide, you will find recommendations for reaching out to and communicating with diverse groups, engaging leaders within distinct populations, establishing credibility, and developing shared goals and objectives. As always, Dr. Crawshaw provides a candid, straight-from-theheart assessment about what works and what doesn't.

I hope this information will be useful to you as you engage people in discussions on their health choices in your neighborhoods, churches, community centers, and civic groups. Please let us hear about your experiences so our collective understanding can continue to grow.

Sincerely,

Ellen Severoni
American Health Decisions

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Foreword

American Health Decisions (AHD) is a group of 21 state citizen organizations. Each state organization is dedicated to activating public discussion and public action around health care.

Attendance by minority people at AHD meetings has been low. A fair question to ask, then, is why the members of AHD, responsible for initiating this guide, should know any more about outreach to minority people than anyone else. The answer is simple.

AHD went into ethnic minority neighborhoods and talked, back and forth, with all manner of local people, neighbors, about tough health care issues. We formed outreach teams in Georgia to reach African-Americans and Asians, in New Mexico to reach Native Americans, Asian-Americans, Hispanics, and African-Americans, and in California to reach Hispanics and Asian-American people. The W. K. Kellogg Foundation and the club of KOS generously funded much of the work.

We asked minority neighbors what it would take to get them to a neighborhood meeting about their health care. We asked, "What do you do for yourself and your family when you are sick? How do you get health care? Do you think your care could be better? Do you think you can make it better by getting together with your neighbors and talking out what you want?"

Neighbors' answers were direct and plentiful-enough to give AHD a clear idea of what it takes for successful outreach to minority people. We believe our findings can be valuable to others seeking to reach minority people.

Scientific measures of the AHD outreach effort showed that the health decisions process reinforces civic involvement for minority people. The purpose of this guide is to pass along our practical experience to help people working in minority neighborhoods. The guide is intended to support workers from start to finish, from what to do before knocking on a neighbor's door to how to say "Good-bye" so its echo is "Come by, again."

The guide is not about how-to-do a particular outreach. It is about organizing outreach efforts and how to get along with people who may not wish to cooperate or are openly hostile.


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A Word from the Project Director

This guide is the outcome of an ambitious American Health Decisions (AHD) project aimed at uncovering strategies for including diverse ethnic groups in a range of community-based initiatives. The AHD project team included Barry Anderson, Ph.D., James Beverly, Tracey Colbert, Donna Gambele, Ann Helm, Andrea Huff, and Gail Jorlemen.

Four health decisions organizations worked with the AHD project: California Health Decisions, Georgia Health Decisions, New Mexico Health Decisions, and Oregon Health Decisions.

And the project received the sustained help of an Advisory Committee: Tina Castanares, M.D., Ellen Pinney, Sharon Gary-Smith, Mary Strong, Louis J. Bernard, M.D., William Brooks, Darrell Millner, Ph.D., Howard Lichter, Ph.D., Michael Garland, Dr. Rel., Gloria Musquiz, Kaaren Johnson, Don Wilder, and Ben Rath.

It should be noted that if this guide reads as though written by a white, male, Anglo-Saxon, Protestant this is a reflection of reality. With those critics who may say that any guide for entering minority neighborhoods should be written by a member of an ethnic minority, the author agrees. However, despite a long and expensive search of all relevant literature, no comparable guide for neighborhood outreach written by anyone was discovered. It is hoped that this first attempt is swiftly replaced by a guide written by someone with sustained life experience in minority neighborhoods.

Ralph Crawshaw, M.D.

Golden Rule for Neighborhood Outreach

Neighborhood meetings involving local people should employ their leaders, on their territory, with their customs, speaking in their language about their problems.

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Where This Guide Comes From

This guide is intended to help front-line workers understand and overcome cultural boundaries in order to move across ethnic neighborhood barriers. Front-line workers are people who want to turn neighborhood barriers into gateways that allow neighbors to pass both ways.

Though it may be difficult to openly recognize, everyone comes with an ethnic background. Many people like to believe their way of thinking, speaking, dressing, and acting is the right way and that people who think and act differently are somehow foreign, wrong, and inferior. Too often differences between people become barriers when they might make for richness.

The guide sees a neighborhood as a place where people live who have characteristics distinguishing them from other people living in other neighborhoods. Distinguishing characteristics may be race, color, religion, language, education, geography, work situation, traditions, age, and/or political belief.

Often combinations of characteristics are lumped together and called "ethnic" Neighborhoods where many people have similar characteristics are called ethnic neighborhoods.

When the number of people in an ethnic group is smaller than all the other ethnic groups combined it is often called an ethnic minority, living in an ethnic minority neighborhood. All this means is that the people are in some way different from people living in other neighborhoods. One easy marker for an ethnic minority neighborhood is its grocery store selling particular foods neighbors like. Another is restaurants that cater to special ways of preparing food.

Too often names of neighborhoods carry different meanings than intended. Slum, ghetto, barrio can be more than a simple way of labeling an area. People who live in the neighborhood and call it "home" may hear these names as a put down and be offended. It is best to call the neighborhood by the name its inhabitants give it.

Neighborhood boundaries may not be clear but they are real. Once you enter a neighborhood the neighbors expect you to understand what they are doing in their words from their point of view. Without help, visitors may fail to meet this expectation, and find unexpected barriers. Barriers include failure to understand the special meaning of race, geography, lack of education, particular views, color, money, or lack of interest in the neighborhood.

Make no mistake, the gap between an outsider who is reaching into a neighborhood and the neighbors that live there can be vast. Outreachers from the white majority or workers of different ethnic backgrounds should not be surprised when their motives are suspected, greetings ignored, and expressed goals dismissed by the neighbors who live there.

Understandably neighbors may see "outreach" as "invasion." Just consider if African-Americans were to go door-to-door in white neighborhoods as outreachers. This turnabout may sound unlikely but it does uncover some of the "do-gooder" prejudices that make barriers where openness is wanted.

The guide focuses on how to help neighbors make their decisions for improving their neighborhood. The guide does not push any special program such as neighborhood sports, teenage pregnancy prevention, anti-crime action, or increased literacy.

As a diverse nation of many neighborhoods, we need coordinated action to govern ourselves. Seneca Indians in Brooklyn, New York, Samoans in Los Angeles, African-Americans in Anchorage, all live in neighborhoods bound together with countless other neighborhoods that make up the U.S. Even if every neighbor has a vote, voting is not worth much unless voters know why the election is important to their neighborhood and to neighborhoods of others.

Shared goals, an open attitude, and hard work can build effective civic ties between majority and minority neighborhoods. Helping each other means helping neighbors learn, if they do not already know, how to successfully change the government of their neighborhood and the greater government.

Only as neighbors cross over to other neighborhoods do we have a common government. Outreach, crossing back and forth between neighborhoods, is important for those who seek good government.

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Know What You Are After

"Outreach is about achieving change the neighbors value."

Developing neighborhood outreach demands person-to-person talk, not newspaper print, tabulated polls, or flashy publicity. It is not the talk of the leader of one neighborhood agreeing with the leader of another. Outreach talk is for neighbors to hear and think about their problems.

Outreach talk should be easy and fun but the goal is more than talk that makes people feel good. The talk should get the project idea across to a reluctant listener—that is what outreach is all about.

Example:

Project idea. This neighborhood will have better police service from the city (town, state) if every neighbor votes.

Change. Get the citizens of the neighborhood to register to vote in the next election.

Here is a goal clear and sharp enough for the out-reach worker to say it in one simple sentence.

Goal. "I am here to get neighborhood voters to register to vote "

The civil rights movement, complex and difficult as it was, could be summed up simply by every worker: "Get out the vote." A health decisions outreach worker can, when asked, say: "Tell me what you want in health care."

Dreams of a better neighborhood in a better nation require putting foundations under the dreams. Knowing what you are after and openly sharing it through person-to-person talk leads to constructive neighborhood change.

Reasonable Expectations

AHD experience teaches that:

1. Reaching minority neighborhoods is difficult. Frequently minority neighborhoods are walled off by fears and prejudices of people inside and people outside the neigh-borhoods. Crossing those barriers takes work that is best done through oxisting community organizations and net-works. Minority hosts should begin all neighborhood gather-ings. People want to see and hear people they know. People do not want to answer door-to-door pollsters and they do not want to fill out paper surveys.

2. Minorities can be activated. When properly approached, person-to-person, citizen-to-citizen, in our experience, Native Americans, Hispanics, and African-Americans become as fully committed to civic endeavors as majority people. For reasons that remain unclear, our work with Asian-American minorities while helpful in some ways did not reflect a significant level of commitment.

3. Minorities give time where it's hard to give money. Minority groups have economically deprived members and consequently lower dollars than majority people but they do have time, an important resource for change.

4. Health care values differ from minority to minority. Problems of immediate access and costs loom large in the thinking of many minority people. In addition, the ethnic culture of the neighborhood contributes to the traditions, circumstances, and expectations of how the people value health. For example, the respect and dignity a Native American expects in receiving health care may be far different from that of white, Anglo, middle class people: It is the custom of some tribes to leave the deceased in their death bed for twenty-four hours to allow the soul to depart.

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Know What It Takes

"Some people show different degrees of prejudice which makes sharing difficult."

Success in neighborhood outreach depends on three essentials: BRAINS, MONEY, and TIME. It takes all three to support an outreach team.

Nobody on the team is expected to contribute all three essentials but every team member contributes something.

It takes know-how to form an outreach team, the same know-how that it takes to form a baseball or basketball team. The team leader starts by asking interested people to try out for the team.

Those with something to contribute make the team. Those without a contribution are thanked for their interest but encouraged to look elsewhere. This way team members know that every member is expected to think and work as a player on a winning team.

Brains

The team leader is expected to carry the ball, pointing out the goal line and showing the team members how to score.

Here's an example:

Team leader to team members. "After meeting with the neighborhood ministers yesterday, I know we can count on them. We will check with each minister to figure out where and when they will help us bring their congregations to a neighborhood meeting. Starting tomorrow I want Charlene to join me in checking with the Northside ministers. Next week James would be a great help to me in lining up the Southside ministers"

To carry the ball the team leader must know the "community game," what is and is not allowed for scoring, including any special turf rules of a target neighborhood. Knowing includes more than walk-around experience though that is important.

The leader must work the territory for its tough problems, places neighbors avoid, the way different gangs size up and threaten passersby. The leader must have a strong working knowledge of the neighborhood's "flavor" in order to directly and quickly support team members in times of stress as well as to take full advantage of any unusual positive developments.

Visiting all the neighborhoods a project covers may not be possible for even the best of leaders. There are over 26 different Native American tribes in New Mexico; it is difficult for an outreach team leader to stay in touch with such varied ethnic territory. In this case at least one tribe should be visited repeatedly. The team leader's know-how, as someone who meets people, attends their community meetings, listens to their leaders, and understands how to test "the neighborhood temperature," should "rub off" on other members of the team.

Brains work best when supported by experience—and the team needs all the direct experience of the target neighborhood they can get.

Sensitivity to people is essential for effective team leadership. Sensitivity means knowing human limits, knowing how far workers can go without getting in over their heads. There is nothing but frustration all the way round if an unprepared worker is asked to go into a place that frightens them. That should be the job of another team member who feels comfortable enough to carry out the assignment.

Sharp sensitivity is needed to see hidden prejudices which may not be changed but certainly should never be aggravated. At the same time, many prejudices can be worked through by open, constructive response within the team, sharing the human problems of the team in taking on a tough goal.

A successful team needs a smart coach to help in the use of brains. In outreach, the coach is called a consultant for the team to bounce ideas and problems off. The coach works with problems the leader and team members run into in neighborhoods. The coach should be easy to get along with and able to take a question, any question, and come up with useful answers or know where to look for them.

Coaching discussions center on neighborhood problems, such as why some neighborhoods resist change. There is no limit on how to use the coach; there may be useful discussions about how the team is making out (personnel problems) and how to score (relating the work to the team goal).

Team members are expected to use their brains. No team member is expected to solve every problem that comes up but all are expected to be curious about answers. Smart team members learn to go where answers can be found.

For example, say a team member asks, "How come the folks on Delancy Street seem uptight? Everything looks pretty much the same as yesterday." A school teacher who knows and has helped the team might answer, "Since the fight on the high school grounds last week the two heavy gangs think they have to go to war over turf."

Finding answers can be both an individual and team effort. Team members can pass around tough questions, looking for answers from other members with neighborhood experience.

When it comes to questions without easy answers the team turns to people in the neighborhood, checking with school superintendents, church members, the officers doing community policing.

Money

Question: Is there enough money to get the job done?
Answer: Full budgets are rare, but there is generally enough to make do. Money is needed for salaries, office space, transportation, and communication.

The project's staff should be paid the going wage, not expected to be semi-volunteers, without health insurance or on-time paychecks. The quantity and quality of their work is directly proportional to the project's support.

Consultants should be paid the going wage. It is a false economy to either do without consultants or expect them to be volunteers. Coaches have bills the same as the rest of us. If they are taken away from their regular work to help, it is better for them to do a full job for full pay, rather than a half job, moonlighting at half price. Consultants can be priceless in anticipating hidden barriers others may not see, in keeping the team on track.

Neighborhood door openers, sometimes referred to as "two-culture" people, are an essential part of teach outreach. They are a special form of coach and should be treated the same way as any other project consultant. Frequently they are asked to do too much for nothing. They are absolutely necessary for an outreach project so the limited time they have available to help must be respected, treated as if it were gold, and reimbursed as is appropriate.

Most neighborhood projects rely on volunteers. Developing a cadre of volunteers takes care and thought. Volunteers respond to positive leadership, clear goals, and the way a project supports the volunteers' needs.

Volunteers will work hard making telephone calls, stuffing envelopes, distributing flyers. But phones, envelopes, and flyers take dollars. A basic dollar budget is necessary to support free work.

Common sense says that ethnic minority people living this close to poverty can not easily afford volunteering. Like other people they get hungry and have to pay baby sitters. The project's neighborhood meetings should provide free coffee, snacks, and baby sitters.

If there is a meeting for volunteers, make sure transportation, meals, sitters, and other out-of-pocket expenses of volunteers are provided for when needed.

Respect for volunteers is essential and comes with understanding the real situation. Volunteers' contributions should be clearly, openly, and repeatedly recognized as part of a significant neighborhood effort.

Time

Question: Is there enough time to reach the goal?
Answer: Like money, there is seldom enough time to do everything but generally there is enough to make do.

The project needs both an overall schedule and a daily one; both should be detailed enough to indicate assignments and allow reasonable time for team members to complete tasks. The schedule does not apply to neighbors, who may have different ideas about time.

The project should fashion its schedule to the needs and customs of the neighborhood people, not the other way round. Neighbors who lack ready transportation can have trouble keeping appointments. People who do not show up the first time around may wish to attend but be minimum-wage working people trying to keep their family going on less than it takes.

Few project schedules adequately consider the time staff need to keep records. Estimate how long it takes to hear out a staff member after a neighborhood meeting and for staff members to write a report on a contact in the neighborhood, then double time to make a practical schedule.

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Build a Teamwork Plan

Neighborhood outreach ideas mean little until turned into community action. Coordinated action needs a plan that lays out the steps to the out-reach goal.

The outreach teamwork plan will help:

  • Keep the project focused on results;

  • Keep the project on time; and

  • Promote teamwork that works.

Combining brains, money, and time into effective contacts with ethnic minority people needs preparation, street smart advice from available sources: neighborhood leaders and neighborhood door openers.

Door openers are people capable of understanding both team members and the neighbors the team is reaching out to. (See Neighborhood Door Openers in the Supplement.) Neighborhood door openers, seldom official leaders, are found by asking around among neighbors to identify and locate the person "who gets things done." They have a reputation for being able to talk with many different kinds of people who will listen to them.

Wise Advice from Neighbors

"Community organizers confuse us with advertisers' marketing agents. Don't think you can use us to sell your products! "

"One of the most valuable assets in civic organizing is a visible track record accompanied by interlocking community relationships."

Enlisting the ongoing advice and support of leaders of ethnic minority communities calls for more than "asking around." It becomes a matter of developing a project advisory board. (See Advisory Boards in the Supplement.)

Many ethnic neighborhoods have been pushed, planned, polled, and programmed to death by outsiders intent on doing something that has little or no importance to the neighbors.

Minority outreach demands that project planning include local people, for example church deacons, labor organizers, and community health nurses, from the start.

Local leaders are not difficult to find. Locate the neighborhood organization with a reputation for effective service. It may be there to find jobs for the unemployed, shelter for the homeless, health care for the neglected, day care for working families. Leaders of these working organizations can help as no others since they are on the neighborhood's front lines.

Let those leaders tell you how they went about making a difference for the neighborhood. Ask them for suggestions and reactions to your project. They can contribute immediate, practical insight for avoiding ethnic confusion, wasteful repetition, and political rivalry. Consider them for membership on an advisory board.

What an Advisory Board Does

A working advisory board offers the best check on how the project fits the neighborhood.

Though jumping into the water can be a swift way to learn how to swim it is not the best way. Nor is jumping into a neighborhood the best way to learn how to reach minorities.

The first trouble is "doing good." Avoid it. Learn where the deep water is—where trouble may come and what to do if it does. No one welcomes do-gooders who are out to improve our neighborhood, our family, or our behavior according to what they think is good. Bar none, do-gooders are not liked.

Outreach is not intended to "do good" but to find out what neighborhood people think is good. Outreach means finding out the proper fit of a project goal with what the neighborhood wants.

An advisory board can set practical limits on outreach action, determining what may and may not be possible when reaching out to the people of the neighborhood. These limits are a road map to service that works.

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Carry Out the Team Plan

Action starts with the first team meeting. Then the members, together, begin laying out what they can do as a team seeking a shared goal. Participation makes a team.

Example of carrying out a team plan: Goal—"It would be great to build playground equipment for the kids at the neighborhood elementary school."

Action—Set up who does what for the team to score: "Diane, can you get a list of the parents? Ed, would you look into finding out if any of the local businesses might donate materials? Marie, have we forgotten anything?"

Team Thinking for Action

Fielding negative remarks and questions calls for members willing to anticipate them and come up with answers.

Example:

Questions: "How come the school board never provided playground equipment?" "Who is responsible if a kid falls and breaks his arm?" "Didn't the church down the street do this three years ago and the equipment ended up trashed?"

Response: "Charlie, will you find out what the school board has done about play equipment and what happened to playground equipment in the neighborhood? We will find out what our legal responsibilities are from a lawyer. Let's follow up with a visit to the church down the street to find out their experience with people trashing the kids' equipment. Anyone have any other ideas?" Concerns left unresolved make for tag-along employees out of team members when they have trouble "owning" a project, believing in winning. Once the team has thought out what is possible, the conclusions should go down as the action plan.

Schedule for Action

Successful team action starts with a shared goal.

The agreed on plan serves as a handy reference point for checking out later misunderstandings and disagreements.

Successful action demands a schedule that the team has agreed on—and sticks to. Without a schedule, too many "good" ideas can scatter the team all over the neighborhood without accomplishing the agreed upon goal. If ideas are good they have to be better than any other use of the time and energy going into the action plan.

Also remember that the neighborhood and its way of telling time must be recognized in the schedule. Every outreach team member should remember that her or his schedule may not be the same as the neighbor's schedule.

The team must know the costs involved, the budget, to keep action from becoming too expensive and costs dragging the project down.

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Maintain Effective Communication

An outreach project is successful only after a neighborhood person acts on what the project suggests. Direct outreach focuses on establishing and maintaining effective communication. Productive outreach needs two-way communication between the team and the neighbors.

Communication is complex action. The outreach worker tries to communicate an idea to a neighbor. Then the neighbor responds. The response is generally in words but may be nothing more than the neighbor just standing there listening.

Whatever the response, it is accepted by the worker who continues to work from the neighbor's words or actions to state the idea closer to the neighbor's thinking. Eventually the outreach worker communicates to the neighbor that: "It seems like you need more time to think it over"; "So you think... might work"; or "So you think...won't work"

Successful communication goes back and forth between the team and the neighborhood. The message must be repeated until everyone has heard it with their own ears, thinks of it with their own thoughts.

A network of communication, from individual to individual, from project to neighborhood, from neighborhood to project, carries messages that lead to consensus and neighborhood action.

Communication carries both an idea and the team member's unspoken wish that the listener will act on the idea.

Example:

Communicated idea. "We can have a better neighborhood if everyone votes."

Unspoken wish. "I want you to go to the polls on election day and vote." The unspoken wish is communicated by how the outreacher speaks and acts.

Speaking to be Listened To

Outreachers' talk with neighborhood people is never more effective than what is listened to. The talk can be about many different things, such as being sick (health care), solving a neighborhood social problem (politics), getting jobs for unemployed people (economics), or getting gang kids to stop drive-by shooting in the neighborhood (security). What matters is what the neighbor listens to. Anything not listened to is waste.

For an idea to be heard it has to fit the words and experience of the listener. If the words do not fit the neighbor's thinking, the message becomes "fancy" talk, foreign and worthless. An idea that does not fit into a listener's mind will not lead to positive action.

Be honest, be honest, be honest! Speak sincerely about what you know and believe. Nobody wants to hear a memorized spiel: that is advertising.

Think while you speak. Continually match your message to whatever the neighbor shares with you. If the neighbor likes to argue, argue back in a friendly way. If the neighbor asks questions, answer them as directly as possible (no evasions). If the neighbor complains, show you are listening by repeating their complaint: "So, the city keeps saying they want to set up a clinic but nothing ever gets done."

Accept the neighbor's style of thinking as important. The neighbor's thinking as the source of successful neighborhood action.

Listen to the neighbor's words, "Yeah, my friend (the door opener) says you're O.K." Show you listen by repeating back what you heard, "Your friend says I am O.K." Then go on, "That man has it together, he wants to help me find out what the neighbors think about (health care, security on the streets)."

Support the neighbor's talk. Ask if he or she has more to say. For example, "You say the Indian Agency promised a clinic. How long have you been waiting?" If the neighbor does not offer any opening into the project idea, move the talk along from where the neighbor is, "Do you have ideas for about what kind of health care the neighborhood needs?"

Do not ignore negative feedback, deal with it. If a neighbor says, "Get out," make sure it is negative and if it is negative, how negative it is. Maybe you are hearing slang, "Get out, I don't believe you. You aren't for real. Are you?" This is not negative. It does not mean get out of my face.

Try to find out what is behind a genuine negative response. "How come you don't want folks around today?" If the answer is, "My husband just lost his job" move on with "That is not good. I hope he finds work right away." If the neighbor is turned off to the project idea, accept him or her as they are with, "I hear you. If you ever want to talk just let me know."

Talking with Neighbors

In one-on-one encounters, messages are telegraphed by tone of voice and attitude. How a team member breathes, speaks, facial expression, and body position sends messages as well.

The listener receives a fully loaded message, a message that is much more than words. For example, if you read (listen to) this guide and hear it is not talking with you, but talking down to you, the guide is not worth the paper it is printed on.

A comfortable speaker is easiest to listen to. Points to consider are how at ease the outreacher is when:

  • sending the message?

  • receiving a neighbor's message in slang, street rap, cool hip, business hype, soul talk?

  • receiving a neighbor's response—in Spanish, tribal tongue, Vietnamese?

  • recognizing how neighbors value talk—as sacrament, as put down?

Talk out with team members any confusion or uneasiness in communicating with neighbors.

To talk effectively with neighbors:

  • be close enough in attitude to be heard; and

  • keep the attention of the listener.

This means going to where the ears are and recognizing what the ears expect to hear. If you do not speak the neighborhood language you need an introduction from someone who does, a neighborhood door opener. The door opener needs to say, in neighborhood language, "This person (you) has something to say which is important for our neighborhood."

Once you have the neighbors' attention, do not talk the neighbor's ears off but do not leave the message as a one-time shot. Repetition need not be boring. It gives the listener time to think. With experience many ways of saying the same thing becomes easy.

Example: TV commercials repeat their message five or ten times in fifteen seconds, with the sound and lights revved up to force attention. This is not the way for one-on-one talk because it is too "strong" and turns off the listener. Repetition is best done through questions, like "Do you hear much talk going around about...?"

The tone and content of your message are best expressed from the heart. "I am here because I think this is important because ..."

Example: When a girlfriend says she likes her boyfriend's new sweater he is "all ears" even if she whispers.

Speak as close to the neighborhood language as you can. Never speak down but always speak with the idea that the listener wants to be seen as a good person with good ideas and good judgment about themselves and their neighborhood. Stick with your idea of the project.

Answering the Neighbors' Questions

Listeners may ask questions before moving to agreement and then to action. Treat questions as if they were free tickets of admission to another person's mind. Listen for the neighbor's thinking. Figure out what the listener has in mind.

Help the listener frame questions. For example: "At the last school meeting a lot of people were asking questions about taking care of kids. Do you have similar questions? Are you worried about your little girl's health?" If 'Yes,' that becomes a good opening to, "What can we do for children's health in this neighborhood?"

The questions you ask, while tickets of admission to another person's mind, come with a cost to the other person. A good response takes energy. "We have not seen many folks from your neighborhood turn up at our meetings and were wondering why." Pay close attention to the listener's reaction. To the listener it means a great deal, perhaps their cooperation, if they know they have been heard and are not wasting time and thought in answering you.

Only ask listeners questions that have reasonable answers. "In your words, what's the toughest problem in your neighborhood?" Let the answer to the question lead to answers concerning the project's idea, "Would talking about a tough problem like ... (the one the neighbor brought up) get you to come to a meeting?" Questions go two ways in good communication. The team member should expect to "walk the talk" that goes with an answer. "You wonder if it would be worth your time to come to a meeting. I sometimes ask myself that. It is not always easy to get to neighborhood meetings but how else can we change things?" If the listener comes back with a question that you can not answer, make that question yours. "That is a good question but I do not have an answer. Give me some time to find out and I will get back to you."

Good questions, neighbors' and team members', are valuable and should be remembered and shared with the team. Recognizing tough questions and learning how to answer them builds the team's strength and comfort in face-to-face talk with neighbors.

Teamwork

Sustained communication among fellow workers leads to project action. In any team activity, all the members should know something of how each member is functioning. Until processed and recorded by the team, a contact is little more than a social visit.

Letting teammates know what was talked about with neighborhood people means more than making a simple report. Members of the team need to fill in the details of front-line action through team feedback and discussion, sharing what happened in the neighborhood.

Timely recording makes a big difference, but do not take notes while in the neighborhood. Team members can get the information down once they are back in the office before the full memory fades.

Hesitate twice before asking neighborhood people to fill out questionnaires. Asking for written replies can be more than a chore. A questionnaire may be insulting proof that you are unaware that a neighbor might not feel comfortable reading or writing English or know how to read or write English at all.

A sure measure of successful teamwork is liking the people you work with, joking with them, and learning about their personal hopes and fears. This is the most human part of team work. It can be fun.

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Closure

Leave neighbors and the neighborhood feeling the way they want to feel about themselves, that they are the kind of people who want to do good things and are able to do good things for themselves and others.

Saying Thank You

Thanks is a powerful form of feedback: giving something back to those who participated in the effort. Two of the most powerful words in any language are "Thank you."

"Thank you" is more complicated than any simple declaration of thanks. The project must return its findings to the people for their review and validation. For example, this guide was sent back to the people who contributed their ideas, time, and spirit to get their feedback, two-way communication right to the end.

In the stress of outreach work thank you's should never be forgotten. The thank you list is long. Thank you for the face-to-face conversation on a street corner, for the volunteered hours spent on the telephone encouraging attendance at a neighborhood meeting, for making the coffee and cleaning up afterwards, for the evenings spent in committee meetings. Thanks to fellow workers for that extra push when it counted. Thanks to the newspapers and TV stations for helping educate the wider community. Thanks to local neighbors for allowing you to be part of their neighborhood. Thanks to charitable foundations for trusting enough to help pay the bill. Closure is a time for thanks giving.

Outreach efforts carry a responsibility for letting neighbors know how they made a difference. The team should never fail to recognize contributions. For genuine satisfaction neighborhood people need to know as precisely as possible what they have done. They can understand, if told, how important they were in discovering wise judgments (good policy).

The only way the neighborhood can know the project was not another in-and-out scheme to squeeze information out of them for someone else's needs is shared closure.

The neighbors have to understand the difference they made in order to pass it on to others, in their and others' neighborhoods.

Neighborhood people can accept the team as real persons when the team returns to share what has and has not been accomplished. Sharing means they can see that you are a good neighbor trying to make the neighborhood better by proudly representing what the neighbors see as good policy.

Going back to say thanks may not be easy. Differences making for mistrust may remain in many odd shapes, sizes, and colors. The outreach project team should say openly and repeatedly "Your trust made the project possible."

For closure to work all the teammembers and neighbors need to participate in coming to the project's conclusions. We went back to neighbors with this guide. In one case our outreach advisory board helped us to see how little help we gave the Asian-American population who expressed gratitude but did not respond with neighborhood change: Learning what we do not know helps us learn what we should know.

How communication becomes power for neighborhood change is reviewed in the third part of the Supplement.

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Conclusion

Our experience leads us to believe that with clear goals for making a difference in a neighborhood, a gutsy team prepared to listen to what other people say in a minority neighborhood and to honestly report what has been done in understandable language, has a good chance of bringing about constructive change. We believe that is what living in the USA is and should be all about.

Supplement

Neighborhood Door Openers

Neighborhood door openers serve the same function for their neighborhood as ambassadors do for their countries except that door openers seldom are paid for their civic contribution.

Frequently, door openers have grown up in an ethnic community, but moved away for an advanced education, a new job, obligatory military service, or just plain curiosity about the larger world outside their own community.

An example of caring door openers is found among the volunteer guides at the former leprosy colony on Molokai in Hawaii. For years our federal government, fearful of the spread of leprosy, forced islanders suffering from the disease to live in an isolated "treatment colony" on Molokai Island. Rather than let suffering by so many "minority" people be forgotten, a few patients volunteered to guide tourists through the "leprosy" neighborhood.

These door openers were dedicated to heart touching education for the wider community to a dreadful case of discrimination by the majority people.

Because neighborhood door openers simultaneously live, feel, and think effectively as members of the ethnic neighborhood and the larger community they are respected and accepted in both worlds. Their work is successful because they use their life experience in two cultures to cross, back and forth, between the cultures. They are bright, curious, and tolerant people with a caring way of helping others understand attitudes that might otherwise be disregarded.

With their unique, cultural self-education they are proficient at more than digesting two different diets or talking two languages. They know how to live, feel, and think in two cultures. They tread with care and understanding to avoid bruising where people of another culture may unknowingly tramp on toes. Consequently, door openers are sensitive to cultural ways that block communication between cultures and are indispensable to successful outreach efforts.

Advisory Boards

Functioning neighborhoods may lack clear boundaries but they generally have well-known leaders. A project advisory board is one of the most effective means of tapping into the neighborhood leadership. An advisory board brings together these informed neighbors, who are able to give in-depth consideration and feedback on what is possible in the neighborhood. They make a useful guide and checkpoint for the project.

A "quick-and-dirty" way of determining what neighbors wish for their neighborhood is talking with their leaders. Ministers, priests, government administrators, teachers, nurses, doctors, business men and women can provide a significant reading on where the neighborhood is headed. However, these contacts are informal and may be hard to tie down to what the project needs: neighborhood approval and access.

Neighborhood leaders come in many shapes, sizes, and titles. Some may not even have a title or may have given themselves the title of leader. These last have a neighborhood reputation of "all talk and no do." Check with effective front-line people when looking for people who "do." Find out their reliability as leaders. Avoid taking non-activists onto the advisory board as they may give it a bad name.

Some neighborhood leaders may appear dynamic but carry a private agenda that means they lack the flexible thinking necessary for effective board participation.

The point in having an advisory board is not bringing neighborhood leaders together to meet but to work. They need to know about the project and what is expected of them.

The board, like a team within a team, follows all the steps of organization that hold for the project team. If possible, have board members meet each other personally or hold an informal, introductory meeting to introduce the project and the project team. They can be expected to have experience crossing between neighborhoods, bridging the cultural gap between their neighborhood and the wider community. Board members are a sustained source of quick, practical advice since they know the organization and do not need to be filled in on every detail when thinking out solutions. From an insider's perspective, they can point out unexpected possibilities and hidden hazards. Their working membership goes a long way toward neighborhood acceptance of the project.

The three W's of successful board membership—Wealth, Wisdom, and Work—serve as a guide in selecting active board members. Every member should contribute at least one W. If a member offers two W's it is a bonus. Three W's and the board member is a civic saint.

The board should be kept well informed at every step of the project. This starts with their criticism, advice, counsel, and approval of the project's plan. They need to know through direct feedback how their contribution fits into the project's strategy and outcomes. With their help the outreach project develops in a number of directions, including gaining support from the wider community.

How Communication Becomes Power

Written notes have a showy name, data, which means they are bits of information to be saved and used in some way in the project.

How the notes are organized is important. Though the way people keep notes may vary it should be similar enough to permit comparing them. This allows the team to think out conclusions from them and allows other teams to compare their work with the project's work. This is called analysis. Analysis of any statistics needs to be owned by the people who gave the statistics. If no minority people are involved in the analysis at every stage it is another case of "They know what is best for us."

Patterns of neighborhood reactions show up as the team combines and compares notes. The patterns are knowledge, street smarts. Knowledge is information worked out from the bits and pieces of data. That is why the notes are important. Without the notes there can never be working knowledge for the team.

By uncovering patterns of response in the neighborhood the team becomes knowledgeable. The knowledge of practical patterns of response, getting to know the territory, should be used to improve the team's ways of talking with neighbors. Learning patterns of neighborhood response is a sure way of learning how neighbors think. By applying the knowledge of how neighbors think the team develops judgment which improves teamwork.

Using judgment in order to make the project idea work in the neighborhood is called wisdom. It shows the neighbors that you understand them and they in turn are more likely to pay attention to the project's idea. Following this pattern of communication sends out the word that the team is a thinking part of the neighborhood, is "one of us."

Wise judgment, the results of effective talking, has a name, policy. After the team has analyzed enough patterns to be sure the judgments are accurate the judgments are passed along as recommendations, policy recommendations, to community leaders, administrators, legislators, politicians, who make community decisions. This is the project's powerful and constructive way of improving life for neighbors.

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