iCare: Research Replication and the Binghamton Standard

It is no secret that we are doing great research at Binghamton University and within the College of Community and Public Affairs. We are looking at local impacts on hydraulic fracturing, race based educational disparities, and, of course, all of the amazing work that we are doing with the Broome County Promise Zone. One of the issues to consider when conducting research is its replicability: can another research team employ your protocols and yield similar results?

I conducted a social work study in partnership with UHS Wilson Hospital (that is currently in press) with my interdisciplinary colleagues from UHS and BU: Shawn Berkowitz, MD, Kris Marks, MSW, Paul Gould, PhD and Gary James, PhD regarding the prevention of re-hospitalization within thirty days. As the Affordable Care Act focuses on the quality of care patients receive, there are some cases in which hospital readmissions within thirty days are seen as a failure of the institution and therefore hospitals will not receive payment for these subsequent hospital stays. This puts hospitals under enormous pressure to limit the thirty day readmission rate. Through a randomized control trial, we were able to provide a social work student to patients at discharge who were at moderate to high risk for re-hospitalization and fifty years of age or older and asked them if they wanted to participate in a social work intervention. Our eighty nine participants divided almost equally between the experimental and control group. The experimental group received the social work intervention, including support to the patient in understanding their treatment plans and providing them with help negotiating after care, for thirty days prior to discharge. The results were that there were only eight readmissions within the thirty day window, all of whom came from the control group (http://usat.ly/1wezd5w).

I was approached by University of South Carolina, who secured a $20,000. planning grant and asked me to be a consultant in the development of a larger grant proposal related to our work in Binghamton. This planning grant is being used in the attempt to secure a 1.5 million dollar grant to develop and implement an interdisciplinary team of professionals to replicate and expand the intervention we implemented in Binghamton on a larger scale, over a longer period of time and with a larger range of interprofessional colleagues. In March, I traveled to Columbia, SC to meet with the research team, led by Teri Browne, MSW, PhD regarding the structure of their intervention and considerations. The University of South Carolina team is developing an interprofessional intervention that consists of social workers, nurses, public health administrators, physical therapists, pharmacists, and communication disorder specialists under their initiative of iCare, which stands for Interprofessional Collaborative for Avoiding Readmissions through Education. Represented in their list of participants are professors, program directors, doctoral students, deans, and community partners who are all working toward a common goal: the reduction of hospital readmissions within thirty days of discharge. Though certainly there is an economic value to this research, as this has the potential to save hospitals a lot of money, as well as creating employment and educational opportunities, there is also an increase in agency and quality of life of the patient.

As the Dean of the College of Community and Public Affairs, it was refreshing and fun to put on my researcher hat for 1 ½ days as I collaborated with this interdisciplinary team of professionals from USC. I was also able to use my administrator hat and assist the team with developing a plan that speaks to the needs and goals of the institution. How is this project that they are undertaking going to showcase their university and the work that they are doing there? In what ways are they able to measure impact in their instruction in addition to their community engaged efforts including workforce development? It is exciting to have your work replicated on a larger, more dimensional scale and to be a part of it. The 22-person collaborative research team at iCare, of which I am proudly a part, has the capacity to improve health outcomes for people in Columbia, South Carolina, and to test a model that began in Binghamton and which can be replicated nationwide. From Johnson City, NY to Columbia, South Carolina, and beyond!

Dean Laura Bronstein

College of Community and Public Affairs at Binghamton University

Debating Effective Philanthropy

This spring, for the sixth straight year, Binghamton students will grapple with how to give money away. It’s a great problem to have, but as students tell me every year, it’s not as easy as it looks. In the undergraduate class, I teach, Philanthropy and Civil Society, students have $10,000 to donate to local organizations, provided to them by the Learning by Giving Foundation. Public administration graduate students, too, will be doing philanthropy, using money they raise through the annual “Party with a Purpose.” It’s all part of the University’s Philanthropy Incubator, which emphasizes the central role that giving time and money plays in community life, and preparing students for lives of active citizenship.

In deciding how to give the money away the students’ debates center around one primary question “what is effective philanthropy?” It is a great time to be engaged in this work, because so many people have been debating what it means to do philanthropy well. Stanford Social Innovation Review provides a regular source of articles, blog posts and podcasts; charity rating services, such as Charity Navigator and the Better Business Bureau/Wise Giving Alliance provide criteria for evaluating giving opportunities (and blog about these issues as well); and the Center for Effective Philanthropy raises questions about what it takes for donors (foundations, in most cases) to do their job well.

In addition, the ethicist Peter Singer and the charity rating organization Give Well have developed a philosophy they call “effective altruism,” which encourages giving based on rigorous evaluation and other quantifiable measures of effectiveness.   Lastly, the New York Times columnist Nicholas Kristof, who has regularly used his column to get us to think about philanthropy, has published a new book (with Sheryl WuDunn) on this topic, A Path Appears, (PBS debuted a new series this week based on the book). I like the book and am using it in my class this semester. It provides a valuable overview of many big themes in contemporary philanthropy. I credit Kristof, too, for introducing me to one last source of information about philanthropy, another book I use in my class The Power of Half, which tells the story of a family’s decision to sell their home and use half the proceeds for international philanthropy.

So, what is effective philanthropy? Is there a single answer? I like the sources I listed above because they ask good questions about our philanthropic choices, and they have led me to think about philanthropy differently. All good. Here’s what I worry about, though: The debates about effective philanthropy rarely lead to Binghamton or to Upstate New York, for that matter.

The effective altruism movement recommends that we limit our giving to organizations with rigorously demonstrated results in which the impact of individual donations is quantifiable and assessed as making a difference. For Give Well, at present, that means four organizations…in the world. Kristof & WuDunn take a broader view, and also embrace the importance of giving to organizations that can show meaningful results (which I agree are VERY important). They highlight the work of social entrepreneurs many of whom do great work; in many cases, high-profile organizations led by people with high social capital, extensive social networks and schooled at Ivy League institutions. My concern is that these profiles are not representative of those who are making a difference in our community.

While Give Well’s rigorous standards and Kristof and WuDunn’s book provide valuable ways for us to reflect on our giving choices they rarely include the kind of small, workmanlike organizations that build the Binghamton community (and other small communities around the country). These organizations are led by dedicated, professional staff, and too often in Kristof & WuDunn’s book they are dismissed as well-intended but lacking in professional skills. That critique is over-stated, and MPA programs like ours are helping to add skilled professionals to the local nonprofit sector.

Our local nonprofit organizations are essential elements in building civil society, creating bonds of social capital. They reflect what the economist Lester Salamon calls “individual initiative in the public good.” Without them our community would be considerably poorer. Further, my research (with Professor Kristina Lambright) looks at the challenges small nonprofit organizations face in quantifying the results of their work (see examples here and here). Nearly all human service organizations in the six counties in South Central New York we studied embrace some forms of performance measurement, which means they can tell us something about the results of their work. Performance measurement is imperfect but improving.

The lesson for me is that there is no one perfect donation, no one way to make the right giving decision. For me, effective philanthropy must start with the valuable role nonprofit organizations play in places like Broome County, and be followed by information—information about performance, the experience of the people the organization is trying to help, what we know about community needs and the best ways to address particular social problems.

So, as we start another semester of philanthropy at Binghamton University, I say to our students, have at it. Show us all how you make good giving decisions. And after you graduate, do more and change the world.

David Campbell, Ph.D.
Associate Professor and Chair
Department of Public Administration
College of Community and Public Affairs
Binghamton University

Grandparents raising grandchildren in Broome County

Grandparents raising grandchildren is a population that is growing fast. They are important in sustaining healthy family systems, but the caregiving is demanding and requires that the older adults make significant shifts in the roles that they hold in their families. Grandparents struggle with high stress and they tend to be depressed than non-caregiving older adults. Furthermore, the upheaval from unexpectedly taking on parenting responsibilities may hinder positive aging. Unfortunately, however, grandparent-headed families’ access to and utilization of professional services are limited, and current social services do not meet their needs. For example, grandparents need information on grandparent rights, programs for their grandchildren, legal advocacy, and respite care. These services are often unavailable or, when they exist, the custodial grandparent may be unaware of their eligibility for these services.

To explore needs and experiences of grandparent-headed families, I talked to twenty two grandmothers and one grandfather in Broome County from 2012 to 2013. Of the 23 grandparents, twelve were White, ten were African American, and one was Hispanic. The mean age of the sample was 60 years old (range: 44-76), and the mean age of their grandchildren was 11 years old (range: 5-17). The median annual income of the grandparent-headed families was $40,560, but varied greatly, ranging from $12,500 to $150,000. Economic hardship was prevalent. Of the 23 grandparents, 15 reported family incomes below 150% of the poverty line.

While the stressors impacting grandparent headed families were wide ranging and often unique to a particular family situation, they tended to cluster into four areas: (a) grandparents’ health problems, (b) financial stress of the grandparent-headed families, (c) social isolation, and (d) fragmented support systems. In addition, in all but two cases, the grandparent gained custody of the grandchildren following highly stressful, and frequently, traumatic crises in the family. Circumstances under which the grandparents gained custody included the brutal murder of a grandchild’s mother (the daughter of the grandmother), profound abuse and neglect of the grandchildren by their biological parents, and severe domestic violence that was witnessed by the grandchildren. There were also indications that some families had endured years of highly stressful situations that culminated in the biological parents either losing custody through court order, or voluntarily surrendering the children when they realized they were not capable of parenting. Others stated that they took custody when the adult children’s mental illness interfered with their ability to adequately parent their children. In many cases, the children showed signs of emotional problems that the grandparents attributed to trauma related to the circumstances with the biological parents.

Despite the traumatic events the intergenerational families have experienced, the grandparents show signs of family resiliency that can promote health and growth. Grandparenting gave them the ability to learn from past child-rearing mistakes and improve parenting skills. The grandparents also enjoy loving, rewarding relationships with the grandchildren. For example, one stated, “You learn with your children what not to do with your grandchildren. You become more educated and have more wisdom about what you did as parents.” Another grandmother said, “I’m learning more now and I am finding out the mistakes I made with my daughter and I’m not making those mistakes again. The grandparents shared that raising their grandchildren positive influence their life. One said, “I’m healthier because of him, I have to get up and do stuff because of him, and I walk to school to pick him up so it’s a positive impact.” Another stated, “At my age I am healthier than I was before, I run up and down the stairs, I’m taking them to the movies, putting up the pool, doing things that keep me fit.”

From the interviews, I learned that the multigenerational impact of the trauma is clear and impacts each generation differently. Understanding the physiological nature of trauma and toxic stress reactions and focusing on strengths and resiliency factors are important in working with the grandparent-headed families. Moreover, in spite of the family trauma, the grandparents whom I talked worked hard to protect their grandchildren, nurture them, and provide the stable home life they need. Interventions for the older adults should include efforts to access resources and help custodial grandparents build a coherent support network. While the children may need care to ensure their stability and social emotional development, attention to the older adult’s development is important as well. Linking the normal development process of all generations to the process of healing from trauma can help reinforce positive growth and the development of healthy family systems.

Youjung Lee, Ph.D, LMSW
Assistant Professor, Department of Social Work
Director, Center for Family, School, and Community Partnerships
College of Community and Public Affairs
Binghamton University

The Broome County Promise Zone model: A Community and University Strategy

What do you get when you combine limited funding for full-time staff, college students searching for meaningful learning opportunities, and public schools facing increasing demands and budget constraints? A recipe for success to build a foundation on which to build a county-wide, university-assisted community school model! That is exactly the ingredients we used to build our model of service through Broome County Promise Zone where we take the privilege of connecting Binghamton University students to the important work we are doing with public schools in Broome County to meet the needs of children and their families.

I recently heard a speaker say that education is “like climbing a hill”. A quality education pushes students to achieve their academic and personal goals even when it feels like an uphill climb. Unfortunately, for many of students this hill can feel more like a mountain that seems impossible to climb. Although the aspiration may be the same, the mountain seems daunting and the hope of success a far off dream. Motivation soon dwindles and academic achievement seems like something for everyone else.

A community school brings the necessary tools for all students and their families together in the school to provide support and access that help to balance the challenges poverty and life barriers can bring. Optimizing access allows children to plan their life “around choice rather than circumstance” and gives families the support needed to help them become engaged and active in making choices rather than succumbing to defeat allowing circumstances to take the lead. Rather than perpetuating the intergenerational cycle of poverty, community schools help to align resources in the community and make the school a hub where educational, physical, emotional, and social needs are met. This shift can provide more options for success in work, school, and life. As the saying goes, “it take a village to raise a child”, we know it takes a community school to bring true equity and access to all students.

At Broome County Promise Zone we feel that the use of enthusiastic college students to infuse resources into schools and our agency makes perfect sense. Not only do our college interns bring new ideas and needed support to our public schools, they also provide a view on the work that helps a hard job stay fresh and new. The college students report a learning experience that could not happen in the classroom and a new appreciation for understanding cultural competency, intergenerational trauma, and systems change that has a lasting effect to be carried into their future life and careers. College interns not only serve to meet needed adult support for professional staff, they also serve as role models and mentors to our young participants as well as educators and advisers to their families.

What started as a logical placement for master level social work students as part of a required field placement has expanded to include undergraduate students across disciplines using passion and expertise in the prescribed field to further the work under Broome County Promise Zone. In addition to providing academic support and serving as mentors and role models, you might find a computer engineer helping us to build and implement a website design or one nursing student educating urban young people about asthma and ways to control symptoms while another educates parents about diabetes in a rural setting. Perhaps you might witness a student studying business and management working on a plan for marketing and branding our name so that our community knows and understands the work we are doing. Regardless of the area of interest, we work to fit future life goals to the assigned internship. With 40 – 60 interns a semester, there is plenty of opportunity to serve and even more opportunities to learn and grow together as we work to expand limited resources to maximum capacity while embedding the aspiration of educational experiences with the exciting opportunity to make a difference.

Luann Kida MA, LMSW, Community Schools Director

Broome County Promise Zone, Binghamton University, College of Community & Public Affairs

 

Binghamton in 5: BU + community = success

The Binghamton University College of Community and Public Affairs (CCPA) at the University Downtown Center is committed to the growth and vitality of downtown Binghamton, including being partners in making that a reality. With an investment in social entrepreneurship, CCPA faculty, staff and students are contributing to the public and nonprofit sector through applied research and best practices.

In five years, we hope that the efforts of CCPA’s growing students, faculty and staff contribute to making Binghamton a place where increasing numbers of people choose to live and work.

CCPA makes significant investments in our local community through hundreds of thousands of internship and volunteer hours a year. This, combined with faculty’s applied research, contributes to our local schools, health care, government organizations, nonprofits, and colleges and universities.

For example, faculty and students are involved in the Broome County Promise Zone initiative in collaboration with Broome-Tioga BOCES and the Broome County Department of Mental Health, geared to supporting all public schools in the county in becoming community schools. Binghamton city schools have been actively involved with this effort to make schools the hubs of their communities, where children, families and communities gather beyond school hours to take advantage of needed health and social services, enrichment, recreation and arts programs. In five years, we expect schools will be seen in this light.

In addition to providing programming and services for existing community members, this initiative has the potential to draw professionals and families and to keep Binghamton University alumni in our community. With cutting-edge educational systems, professionals will want to work here, and families will want to send their children to our schools.

The same can be said about our local health care settings. Many students and faculty in CCPA and across the university are involved in developing, implementing and evaluating innovative practices and programs at local hospitals, nursing homes and outpatient settings.

If an alumnus can graduate from Binghamton University and work here implementing state-of-the-art, evidence-based practices, then why would they move to a major metropolitan city for similar opportunities but with twice the pricetag? And if our services are among the best in the country, then as these young professionals age, they have fewer reasons to leave our community — and more reasons to stay.

So, a vision for “Binghamton in 5” consists of our community as a magnet for professionals of all ages and as a place where increasing numbers of the university’s graduates choose to stay and make their home. It’s a place that is known for increasing innovations in business, social entrepreneurship, programs, practices and services. This effort drives up home values (although still keeping them vastly lower than larger cities), and promotes more successful retail endeavors downtown. In summary, “Binghamton in 5” is a go-to place for people to live, raise families, age and engage in innovative career opportunities. Let’s make this so, together.

Dr. Laura Bronstein

Dean of the Binghamton University College of Community and Public Affairs

Note: this post appeared originally September 17, 2014 in the Press and Sun Bulletin

Learning about Social Media and Helping Local Nonprofits

fb twitSocial media is changing the way organizations operate. Public and nonprofit organizations are no exception. The use of social media presents both opportunities and challenges for public and nonprofit organizations. Students in my PAFF 526 course this fall have a chance to apply the lessons that they are learning in the classroom about how public and nonprofit organizations use social media to a real-life context by working with three nonprofit organizations and making suggestions about how these organizations can improve their Facebook pages.

In PAFF 526: Managing Information and Technology, students gain an understanding of the complexities of managing information in the public and nonprofit sectors and how technology can facilitate this process. They also discuss the challenges of using technology when accountability is paramount. The overall goal of the course is to increase student interest in the role of technology in public and nonprofit administration.

As part of their work for PAFF 526, students will be assigned to work with one of the three following nonprofit agencies: Family & Children’s Society, Action for Older Persons and Broome County Habitat for Humanity. All of these organizations are located in the Southern Tier and provide essential services to the community. Family & Children’s Society delivers a wide array of human services to individuals at all different stages of their lives, such as counseling, home care and afterschool programming. Action for Older Persons focuses on serving older adults and offers education, counseling and advocacy programming. Finally, Broome County Habitat for Humanity builds and renovates housing for low-income individuals and families. Each of these organizations is interesting in improving the way that their organizations use social media, especially Facebook, to better meet their respective missions. This where the PAFF 526 students come in!

Representatives from the nonprofits came to our class on September 30th. They provided background information on their organization, information about their organization’s current use of Facebook, and information about their organization’s goals for social media.  They also discussed what their goals for this project were.  Following the presentations by the agencies, students had an opportunity to ask the representatives questions.

Students are now working on critiquing the Facebook page of the organization to which they are assigned. As part of their critiques, students are assessing whether the primary audiences for their organization’s Facebook page and the primary reasons for using Facebook identified by their organization’s representative correspond with how the organization is actually using Facebook. They also are identifying strengths and weaknesses of how their organization is using Facebook and will be making specific recommendations about how their organization could better use Facebook in the future. Key things students will be considering when making their recommendations include: (1) the strategies their organization could use to increase the number of visitors their Facebook page; (2) the additional constituencies their organization could target and the specific information the organization could share with these constituents on their Facebook page, and (3) the additional goals their organization could try to achieve by using Facebook and the specific information they could add to their Facebook page to achieve these goals. Finally, students are identifying the next steps their organization should take to implement their recommendations. Each student needs to write a two page memo summarizing their critique and recommendations. I will then select the best written memo for each organization and forward it to the organization.

I am hoping that the project will be a win-win situation for everybody involved. It’s one thing to read about social media in a book or talk about it in class. It’s another to be able to assess the opportunities social media offers for public and nonprofit organizations in real life! By completing this project, students will hopefully have an opportunity to apply some of the key concepts we are discussing in class when they are critiquing their assigned organization’s Facebook page. This will help deepen their understanding of the course material. I am also hoping that the project will benefit the nonprofit organizations by giving them concrete ideas to consider in order to get gain more leverage from their use of social media in the future. I am looking forward to watching the project evolve and the students grow from their experiences.

Kristina Lambright
Associate Professor

Department of Public Administration
College of Community and Public Affairs
Binghamton University