The Boys and Girls Club of Hawaii (BGCH) utilizes evidence-based approaches in how it presents care and develops Initiatives for its youth. The BGCH refers to a concept at the core of Social Cognitive Theory (SCT) and community-based participatory action research (CBPR). On one of their main websites, the “What We Do” homepage, there is a section that highlights the use of positive role models within the BGCH structure as a means of facilitating and establishing positive behavior formation and modification in vital areas (e.g., character and leadership development). This section is followed with two statistics: (a) that 67% of BGCH club alumni said being part of the [BGCH] club kept them out of legal trouble and (b) 83% believe they can now make a difference in their communities [after being a part of [BGCH] (BGCH, n.d.); the information listed on the BGCH site shows statistics that were generated through the use of evidence-based approaches. The What’s Next Initiative uses a mix of the Socioecological Model (SEM) and Social Cognitive Theory (SCT) as its basis for theories of change. Both of these theoretical foundations to public health are evidence-based approaches and were used in the design and development of this brand-new initiative currently being implemented at the BGCH. Evidence-based practice must meet three requirements: (a) it must include at minimum, a sponsoring organization, initiative goals, implementation steps, and outcomes that demonstrate success in achieving the initiative goal(s) in multiple localities, (b) evaluation results must include quantitative measures showing improvement in the outcomes of interest after the implementation of the initiative and are compared at relevant time periods before and after the intervention or initiative implementation, or, there is use of a control group, and (c) the study is of peer-review quality and presents numbers in a scientific manner with precision and reliability measures on instruments included (Conduent, n.d.).
Boys and Girls Club of Hawaii also utilizes evidence-based approaches as it continues its evolution in adopting new tools and strategies into all of its Hawaii Clubhouses. For example, BGCH has adopted the BGCA’s “Formula for Impact”—a research-based theory of change that describes how the Movement and individual clubs can exponentially increase the impact on youth (BGCH, 2019). This occurs when youth attend BGCH Clubhouses physically, with the impact being made by the implementation of the five Key Elements for Youth Development into all Clubhouses, in addition to high-yield learning activities and targeted programs; the five Key Elements for Youth Development are: (1) Safe Positive Environments, (2) Fun, (3) Supportive Relationships, (4) Opportunities and Expectations, and (5) Recognition (BGCH, 2019). This research-based theory of change has been created and distributed by the larger BGCA organization and is now being implemented into BGCH Clubhouses. Another example of the evolution of evidence-based approaches to public health by the BGCH is how it is currently in the process of implementing trauma-informed care to all Clubhouses and in how the BGCH goes about approaching care for its Club youth. The trauma-informed supervision guide is available to all BGCA Clubhouses and is used to enforce positive club climates that target development of emotional intelligence using an evidence-based approach to social-emotional building skills through provision of tools and strategies to Clubhouses like the BGCH (BGCA, n.d.). That is why implementation of trauma-informed care into any community-based organization, such as those working with youth of all backgrounds, especially low-income youth, is vital in improving teen health and health outcomes, well-being, quality of life, and engagement (Menschner & Maul, 2016). In addition to the BGCH, the BGCA also utilizes evidence-based approaches to health in the initiatives they offer to their subsequent chapters. For example, Project Learn is a BGCA Initiative that promotes health, character building, social skill development, and leadership in youths, especially at-risk youths, through evidence-based practice (Conduent, n.d.).
Public health practice organizations and agencies can face numerous barriers to implementing evidence-based approaches and practices, such as limitations in funding or resources, lack of properly trained staff, or a lack of practical means to develop and investigate research due to having a foundation built on inadequate research (APHA, 2017). Regarding the implementation of trauma-informed care, this will require that all staff, both administrative and Clubhouse, are trained under this new policy operation and will require some time, money, and resources to be expended in its implementation. The addition of the evidence-based approach to help, trauma-informed care, is especially important in regard to the upbringing of youth from low-income families. This is because youth of low SES families are often more likely to experience events regarding trauma such as abuse, neglect, discrimination, and violence, in addition to other adverse experiences (Menschner & Maul, 2016). If trauma-informed care can help at least one BGCH member, its implementation is already a success. It would be of great recommendation that the BGCH continue in beginning its implementation of trauma-informed care into all active Clubhouses and that they consider adding some of the initiatives offered by the BGCA that use evidence-based approaches. However, for funds to be obtained to implement further evidence-based approaches to health in the BGCH, high-quality data collection must first be met. The BGCH is aware that non-profits tend to be lagging in their data department(s), mainly due to lack of resources or lack of knowledge; thus, BGCH submitted a federal grant application for $150,000 to purchase the MyClubHub Information Management System (iMIS) and to hire a contractor with data and management systems experience (BGCH, 2022). It is recommended that (a) the BGCH continue with gathering funds to hire a professional data analyst and oversee purchase of the iMIS, and (b) utilize the data analyst [and iMIS program, if applicable] for other organization programs, including the overall general BGCH program data statistics and analysis.
Many of the youth in our communities lack positive adult supervision, the ability to afford meals and resources for themselves outside of school, and may experience an inability to obtain much needed assistance for understanding the academia they cannot understand. Which`in turn, has an ability to lead to additional life challenges with nowhere for them to turn for help. This can lead to violence and crime, drug and alcohol use, lower literary levels, suicide, bullying, and low graduation rates (BGCH, n.d.b.). A study by Liang & Sun (2020) found that although middle schoolers are resilient regarding the ability to adapt after being left by their parents, they still experience long-term negative health impacts in three domains: their education, physical health, and mental health. By 6th grade, youth from middle-class families have likely spent 6,000 more hours learning than youth born into poverty, contributing to the continuously growing learning gap between social classes (BGCH, n.d.b.). Research has documented that factors like changes in socioeconomic status can impact health. Changes in the distribution of education implies changes in the complex, interwoven avenues between education and health in a way that demonstrates the relative index of inequality summarized by the magnitude of SES (Raghupathi & Raghupathi, 2020). Regarding health care and public health, lower literacy levels target an individual’s ability to understand health and public health information. This makes it less likely for youth and families with lower health literacy to obtain or adequately understand vital health information with the ability to critically affect or improve their health (CDC, 2022).
Integration of health care and public health by youth development organizations such as the BGCH provide programs that prevent and deter problematic behaviors, such as alcohol and drug use, violent crime, juvenile delinquency, school dropout and failure, and teenage pregnancy (Anderson-Butcher & Cash, 2010). Literature on key youth development recites the importance of reducing risks, enhancements of protection, and resultant resilience, with effective programs also enhancing protection through promotion of bonding between youths and adults; fostering social, emotional, behavioral, cognitive, and moral competence; providing recognition for positive behaviors; and increasing self-efficacy, among other factors (Anderson-Butcher & Cash, 2010). Participants in after school programs also show significantly improved attitudes towards school and education, self-perception, school performance, and behavioral adjustments, with strong support shown between out-of-school programs and their relationship with student achievement (Anderson-Butcher & Cash, 2010). Literature findings also suggest the importance of the role of Boys and Girls Clubs on reducing substance use, drug trafficking, property destruction within housing units, and criminal behaviors in youth; youth with higher Club attendance rates display higher academic achievement, less alcohol and cigarette use, and stronger positive attitudes towards school than their peers in lower Club attendance groups (Anderson-Butcher & Cash, 2010). This is especially important to note, as there is both notable difference in youth who (a) attend and do not attend a Boys and Girls Club or other afterschool program and (b) the frequency in which youth attend BGC programs and services. Frequency in youth Club attendance matters, as the benefits listed above can result in drastically different life impacts. For example, both youth with greater positive attitudes towards education and academics and youth with higher academic achievement(s) are more likely to pursue higher education and continue in higher education until they graduate (Social Capital Project [SCP], 2021).
The Boys and Girls Club (BGC) acknowledges that all youth do not come from equal standing in regard to the available resources, education, and opportunities available to them; this in turn causes different pathways to develop for each youth, based on the above factors available to them—meaning, the life paths that unfold for each youth are not equal and these disparities and inequities drastically alter youth future potential and the potential choices offered during their [future] life courses. Boys and Girls Club of America offers all of its Clubhouses the racial equity and inclusion strategic action and planning guide for Boys and Girls Clubs, “Our Journey to Racial Equity” (2021), which aims to present an opportunity to collectively create equality and equity for everyone at their Clubs, particularly those who identify as Black, Indigenous, and other people of color (BGCA, 2021). To further integrate health care and public health in addressing resource inequities among youth, especially those from lower income or disadvantaged backgrounds, it is recommended that the Boys and Girls Club of Hawaii do two things, the first is to incorporate more of the numerous diversity, inclusion, and equity (DEI) resources available through the BGCA (BGCA.net) into BGCH programming and curriculum or into the general program structure/framework, such as incorporating the strategic action and planning guide for BGCs (BGCA, 2019). The second recommendation is to create and develop measuring outcomes, specific to the BGCH, that measure racial equity outcomes at periodic intervals. Racial equity outcomes should be measured to assess the impact and success of the implementation of racial equity strategies on multiple levels, including individual/staff, organizational, youth, and families/communities levels by collecting data such as (a) how staff speak about or recognize race disparities and/or bias to internal and external audiences or (b) whether youth feel confident discussing racial inequity issues among youth of different racial or cultural backgrounds (BGCA, 2019). See Appendix G for a full list of sample racial equity outcomes.
The BGCH collaborated with partners and asked the community what could be done to help amidst the Covid-19 pandemic—this resulted in the BGCH’s support of Hawaii families during Covid-19 by the provision of food, clothes, supplies, and free memberships to BGCH youth [and their families] through the Clubs following the closure of all Hawaii Clubhouses (BGCH, 2020f). The closures of BGCH Clubhouses were a result of BGCH’s adherence to the CDC’s social distancing guidelines (BGCH, 2020f). The What’s Next Initiative by the BGCH is a cohort-based case management and mentoring program that focuses on having youth graduate on-time from high school, in addition to acquiring knowledge and practice in job readiness, workforce development, self-efficacy, post-secondary and college education, good citizenship, self-discovery, and life skill education and practice, among other program aspects (BGCH, 2021a). This program aims to address the potential gap experienced between youth of different socioeconomic statuses, income levels, and backgrounds regarding the availability of education and information, skills and tools, and opportunities and experience. One way the program is already adapting efforts is by the attainment of 25 roundtrip airline tickets on behalf of Southwest Airlines awarded to the WN Initiative. (BGCH, 2021a). Often, youth from lower SES and disadvantaged backgrounds lack parents or additional family members who have higher education experience, with prospective college students from low SES less likely to have access to informational resources about higher education and its corresponding details (e.g., searching for schools, the application process, financial aid, traveling for campus visitation) (APA, 2017). By providing all youth equal opportunities to learn about higher education information and details, visit campuses and other higher education learning environments, and gain knowledge and experience in alternative forms of post-secondary pathways that do not include higher education, the BGCH is already adapting efforts to the cultural values of Hawaii’s youth, especially those from low SES or disadvantaged backgrounds. Following the provision of food, supplies, and free memberships through BGCH Clubhouses during the Covid-19 closure, Clubs started incorporating virtual programming into its daily culture, with the goal of engaging youth to maintain those critical mentoring connections (through virtual programming) (BGCH, 2020f). This use of BGCH staff as positive role models to facilitate healthy lifestyles and behavior change is an application of evidence-based approaches to health through us of behavior theories and demonstrates taking action towards adapting efforts to promote cultural values and practices of Hawaii youth.
One way the What’s Next Initiative can go about evaluating its relationship with the cultural values, practices, and efforts put forth by the BGCH is by either creating a satisfaction survey for youth and their families, or by adding questions to youth and family satisfaction surveys, if these types of surveys already exist for the general BGCH Club population. Some examples of closed ended quantitative survey questions are: (a) Did the BGCH help by providing you with any materials, supplies, or resources this semester/year? or (b) Did the BGCH provide you with any materials, supplies, or resources this semester/year that you would not have obtained otherwise? An example of an open ended, qualitative survey question for the general BGCH Club population is: What resources did the BGCH help provide you with this semester/year? Another way evaluation of BGCH impact can be measured in the service population is through program satisfaction or post-surveys, such as the teen survey(s) specific to the What’s Next program—the What’s Next Teen Pre-/Post-Term Survey(s), which specifically evaluate the impact had by program aspects on the participating youth. An example of a Likert-type closed ended question could be: The What’s Next program provided me with information and resources I would not have accessed otherwise. An example of an open ended, qualitative question for the WN staff survey could be: What resources did the What’s Next Initiative administer to WN participants/youth during this session/term? Implementing these questions into feedback surveys then measuring, analyzing, and tracking the responses will provide data as to the impact had by the BGCH in adapting efforts to cultural values and practices of Hawaii youth, especially those from low-income families or disadvantaged backgrounds, which compose 81% of BGCH families (BGCH, 2019).
BGCH engages in numerous efforts to support policies that address resource inequity among Hawaii youth, especially low income and disadvantage youth and their families. All BGCH staff wear many hats, as they take on the role of coaches, educators, performers, community leaders, mentors, and youth advocates (BGCH, n.d.b.). The mission of the BGCH’s board of directors is to support and advocate for the youth and families BGCH serves and to build resources that advance and sustain the mission of BGCH and provide governance and oversight (BGCH, 2021b).To support families during Covid-19, the BGCH provided food, clothes, supplies, and free memberships to BGCH youth and their families through their Clubhouses following the closure of all Hawaii Clubs (BGCH, 2020f). Another way the BGCH takes action to address resource inequities besides offering programs that invest in Hawaii’s youth to help them succeed, is through the numerous ways it provides supplies, materials, and resources to all youth and their families. The BGCH does this through a collaboration with various organizations, such as the Motiv8 Foundation where it provides backpacks, school supplies, and meals to select youth (BGCH, 2020g). It also addresses resource inequities through its partnerships, such as a recent donation by Old Navy where 50,000 pieces of new clothing were distributed amongst the five O’ahu Clubhouses in addition to several non-profit organizations (BGCH 2020e). BGCH continually updates safety policies designed to promote child safety and protect young people from threats present in today’s society by implementing layers of safety policies and guidelines to keep kids safe, with comprehensive safety policies in place (BGCH, n.d.c.).
The BGCH already excels in its advocacy and policy-development efforts on a local level. However, there is room for improvement in its advocacy and policy-development efforts on a larger level (e.g., state, national, population). The BGCH can enhance advocacy by working with their partners or other organizations to bring about awareness of both low-income youth in Hawaii and the larger issue of youth raised in poverty or adverse circumstances and the resulting impacts/consequences on a national or global level. Consequences may include lesser access to education, resources, and opportunities; lower education, literacy levels, and academic achievement; lesser aspirations and feelings of motivation; and increased risk of experiencing poverty as an adult (APA, 2010; APA, 2017). Besides advocating for and educating others on this issue and population, the BGCH can go a step further in contacting an elected official to fight national and global resource inequities among youth and all affected populations. Some examples of elected officials the BGCH could write a letter or policy memo to are (a) Sharon Moriwaki, who is the current officeholder for the Hawaii State Senate District 12, which is where the Honolulu BGCH Spalding Clubhouse is located or (b) Karl Rhoads who is the current officeholder for the Hawaii State Senate District 13, which is where the main BGCH Administrative Office is located (Ballotpedia, 2020). One last way the BGCH could enhance its advocacy and policy development efforts is by teaming up with a grass roots organization to advocate for change on a local, national, global, and/or population level.
The Boys and Girls Club of Hawaii has an average daily attendance of nearly 800 youth with an outreach of over 14,000 and nearly 5,000 registered members—all youth between the ages of 7 and 17 years (BGCH, 2019). With such a vast reach across Hawaii’s youth, the BGCH is in a privileged and vital position in its ability to shape the lives of the youth it touches. The BGCH is one of the leading youth service organizations in the state of Hawaii and has been providing services to youth from disadvantages circumstances for decades (BGCH, 2019). Such as with most legal matters containing minors, when it comes to the nature of decision-making on behalf of Boys and Girls Club youth, decisions usually come down to the legal parent(s) or guardian(s). However, the Club still has a role in directing or influencing these decisions, especially if a decision is made that is not of benefit to the youth in question. According to a grant application filed by the BGCH (2019), “with over 40 years of experience working with Hawaii’s youth, the BGCH is uniquely positioned to deliver meaningful youth development services and activities.” This is done by the creation of an emotionally, intellectually, and physically safe environment for youth to grow and through the provision of mentoring services offered by staff and volunteers which nurture character development and life-enhancing skills, including leadership abilities and decision-making skills in youth (BGCA, 2019). Although at the end of the day, it is the youth’s parents that have final say over the decision-making on behalf of their child, the BGCH fosters a safe environment inclusive for all its members; 81% of which [members] report low to extremely low-income levels and an ethnically diverse population of over 51% self-identifying as Native Hawaiian/Part Native Hawaiian, 35% Asian, and the remainder broken down by Caucasian, Other Pacific Islander, African American, American Indian/Alaska Native , and Other (BGCH, 2019). Each decision that the BGCH makes, shapes the lives of its members—that is why it is vital that decisions are being made with the best interest of Club youth in mind, especially youth from disadvantaged backgrounds.
Regarding leadership style, the BGCH demonstrates a mixture of the type of leadership it uses in facilitating these efforts. The six leadership styles covered in the PUBH 5334: Foundations of Public Health course from the MPH@Baylor University program are (a) authoritarian “autocratic”, (b) participative “democratic”, (c) delegative “free rein”, (d) transactional, (e) transformational, and (f) Laissez-faire (Opusunju, n.d.). The BGCH demonstrates a mix of two leadership styles: transformational and delegative “free rein”, although it leans a bit more towards the former. Transformational leadership focuses on enhancing moral through mechanisms alternative to rewards, while at the same time viewing the leaders as agents or catalysts of change and strategic visionaries; ways that moral could be enhanced through methods beside compensation or reward include increased feelings of self-efficacy, satisfaction, or other means of intrinsic motivation amongst employees (Opusunju, n.d.). Delegative “free rein” leadership allows employees to make decisions, although the leader still maintains responsibility for all decisions made (Opusunju, n.d.). In this delegative leadership style, power resides with the group, not the individual leader (Opusunju, n.d.). The BGCH uses a mix of these methods, and as a result the organization’s leadership style uses mechanisms such as feelings of motivation, self-efficacy, and/or increased self-worth to enhance the moral of staff, while allowing staff the power to make decisions for the group. This keeps the responsibility for the decisions made with the leaders of the organization, who are viewed as a catalyst of change (i.e., strategic visionaries).
The BGCH also utilizes leadership theories in how it focuses on establishing change and implementing leadership into organization functions. Of the four leadership theories covered in the PUBH 5334: Foundations of Public Health course from the MPH@Baylor University program, (i) trait theories, (ii) behavioral theories, (iii) contingency theories, and (iv) transformational theories, the BGCH utilizes ____. Trait theories focus on the measurement of habitual patterns or traits of thought, emotion, and behavior seen with a leader, that differ from that seen with the followers/subordinates (Opusunju, n.d.). Behavioral theories focus on the behaviors among leaders, especially those transferred to subordinates/followers; there are four common styles of behavioral theories: (a) concern for task, (b) concern for people, (c) directive leadership, and (d) participative leadership (Opusunju, n.d.). Contingency theories focus on the context that leadership is being exercised, such that what’s needed changes by situation, which required leadership that can adapt to particular situations (Opusunju, n.d.). Lastly, transformational theories focus on the use of different mechanisms to enhance morale, motivation, and performance (Opusunju, n.d.). Since the BGCH focuses on ____ leadership theories, _____.
The BGCH recognizes its pivotal role in shaping the lives of hundreds, upon thousands of youths, which is why shaping the organizational decision-making framework and structure and positively influencing youth leadership and decision-making capabilities are of utmost significance. Recommendations to leadership and decision-making among the organization include training all BGCH staff within programs that specifically target development of youth’s self-concept, as enhancements in self-concept produce valuable outcomes in areas of positive self-beliefs and self-perceptions related to physical skill and appearance; academic achievement; and peer, family, and community relations, which is important to instigate into youth regarding their ability to make decisions for themselves (Anderson-Butcher & Cash, 2010). This may be done through positive modeling and reinforcement by staff as shown by example, or with targeted program activities and services. What’s Next, among other programs offered by the BGCH have a focus on leadership and decision-making capabilities among youth, especially in regard to decisions being made about oneself and the potential route of their own lives and futures. Similar to the racial equity outcomes in the Public Health and Health Care Systems section of the Integrative Analysis, it would also be of benefit to create measurable outcomes for leadership and decision-making aspects on behalf of the staff and on an organizational level. This would be to ensure there is still confidence and positive belief in the organization’s decisions regarding the safety and well-being of BGCH youth, especially those from disadvantage circumstances and that staff feel confident in their decision-making abilities, as well as in implementing decisions made by the organization on behalf of the BGCH youth.
The role of health communication in public health interventions comprises a significant portion of the program’s available impact. Health communication is defined as the use of communication strategies to enhance health by informing or influencing individual or community decisions (HHS, n.d.). Without effective communication strategies to convey program and organization materials, the likelihood of success within a program or initiative are very slim, as this is how program or organizational content is distributed and absorbed by its target audience; communication strategies include written and verbal mechanisms of communication with the goal of influencing individuals, communities, and populations in order to improve health outcomes. The BGCH utilizes communication strategies on an individual, group, and structural level, whereas the What’s Next Initiative by the BGCH only utilizes effective communication strategies on an individual and group level. Following the structure of communication strategies listed by Malikhao (2020), individual strategies include: (a) empowering the stakeholders with participatory media to let them have a role in designing, implementing, and evaluating public health programs; (b) empowering the staff to produce participatory media (i.e., What’s Next live sessions) to teach and distribute valuable health information; (c) empowering the youth, especially those from low SES and disadvantaged backgrounds with integrated media to advocate access and services for them; and (d) empowering youth, especially those from low SES and disadvantaged backgrounds with participatory media to provide knowledge, tools, and resources regarding a variety of health information and topics. Group level strategies include: (a) using new media to advocate for equal and equitable distribution of resources among Hawaii youth, especially those from low income or disadvantaged circumstances, (b) facilitating collaboration among families, members in a community, and age groups by producing participatory media and materials in healthy lifestyles for youth; the media can be used to engage stakeholders in developing ideas and implementing ideas for a public health program, (c) advocating for a community-based curriculum on healthy lifestyles, positive behavior change(s), and health literacy; (d) using participatory community media to air information on many topics such as feelings towards education and academics, feelings towards confidence and self-efficacy, healthy lifestyle choices, self-discovery and motivation, post-secondary option exploration, workforce development and job readiness, and life skills; and (e) contacting all partners, actors, and stakeholders to discuss indicators for success of such a public health program (Malikhao, 2020). Communication strategies that aim to promote health on a structural level include: (a) advocating for the rights of all youth, especially those from low income and disadvantage backgrounds; (b) advocating for improvement of resource and education distribution, equality, and equity among all youth, especially those from low income and disadvantage backgrounds; (c) advocating for intercultural communication sessions on community media programs; and (d) mobilizing social support on educational public health programs by use of participatory media (i.e., What’s Next live sessions) (Malikhao, 2020). Not only does the BGCH and What’s Next Initiative utilize numerous health communication strategies, all communication strategies are tangible strategies for reaching sustainability in health.
Health communicators need to consider the environment that influences the decision-making process, health behavior, and attitude of an individual, especially when it comes to a highly active and dynamic group of participants, such as youth and adolescents. To check whether communication strategies for program or organizational content are being successfully implemented, it is recommended that some form of formative and/or summative assessment be integrated into the program curriculum. This type of assessment(s) allows progress of curriculum content to be monitored and can track whether effective communication is being used in administering content, without having youth worry about the pressure of grading assignments or assessments. Examples of formative assessment include worksheets, discussions, and activities. Summative assessment may include a post-test or survey at the end of a term, a project, or a small-/large-group discussion for program feedback. It is also recommended that training be provided to BGCH and WN staff that include review of health communication strategies that are applicable to current projects; lessons on cultural competence; and diversity, equity, and inclusion (DEI) education.
The BGCH engages in many outlets to foster interprofessional practice, such as collaborations with other agencies and organizations, taking on interns from multiple areas of study and specialty fields, and providing myriads of networking opportunities for both BGCH youth and employees. For example, when the What’s Next Initiative was in the process of implementing its initial term with the first Pilot cohort (i.e., Cohort 1), the WN Team was composed of two interns from completely different settings (one was an incoming freshman at Yale University, the other was an MPH student with MPH@Baylor University), and the Initiative director was the BGCH’s SVP and CAO, Nadia Assaf; this offered professional advisement from numerous angles while in the initiative development phase of the program and required that all parties work together to foster a safe and cohesive working environment. Throughout the development phase other opportunities for interprofessional collaboration were introduced, such as working together with a program manager and data analyst, Elizabeth Makarra from Waikiki Health, who helped guide the creation of the program benchmarks/measurable objectives, or when a new intern joined the team during the second WN term who was a Master of Social Work (MSW) candidate and became responsible for the case management aspect of the What’s Next Initiative.
Without harmony and synchronization between all of these parties, friction within the organization and work environment may have evolved; luckily there was an underlying foundation of respect amongst all team members, whether old or new to the team, or whether a member of the team was 19 or 50 years of age. This basis of trust and respect resulted in care for all team members by each other, leading to healthy methods of conflict resolution when required. Caring for your teammates, looking out for another, asking for assistance, providing help when needed, and respectful means of conflict resolution/problem solving are concepts at the core of interprofessional practice. Without this interprofessional collaboration and practice, the What’s Next Initiative would not have been developed as quickly and thoroughly as it was; this potentially means that nine—or even 21 if it took a year longer—BGCH youth would have lost the opportunity to join this initiative, consequently losing the knowledge, tools, and resources that come along with it. As 81% of BGCH youth come from low to extremely low-income households, the loss due to inadequate interprofessional collaboration could have potentially been 21 low-income youth losing vital education and resources that could help them (a) graduate high school, (b) graduate high school on time, (c) have a plan for their future path after high school, and (d) leave feeling confident in their ability to succeed in life after high school (BGCH, 2019).
The Boys and Girls Club already has hundreds of partners and stakeholders, but recommended partners would include collaborations with social-emotional wellness coaches/mental health specialists, college/university advisors, nutritionists/dietitians, and various medical superlists to come in and educate both staff and youth on information from that area of specialty. Although these partners could be seen to be more beneficial to BGCH youth, each collaboration offers useful insights and additional knowledge to be retained on behalf of the BGCH staff. To enhance interprofessional approaches, it would benefit all staff/employees if the BGCH were to have services to introduce new members to all current staff. This would help introduce members from external teams and foster a more welcoming environment. It would also help to reduce anxiety or nervousness for external personnel and would help facilitate a feeling of belonging among new members, in addition to feelings of unity amongst the group. One other recommendation would be the creation and distribution of a satisfaction survey for staff regarding components of interprofessional collaboration and other aspects of the workforce environment, such as feelings of safety and belonging, teamwork, and feelings of respect. Improving the facets of interprofessional practices among the BGCH organization in turn impacts its abilities in the services and activities it is able to provide to Hawaii’s youth.
In public health, systems thinking includes the theories, methods, and tools used to illustrate the relationships and interactions amongst various working parts affecting an entire entity. Systems thinking refers to a critical interdisciplinary skill that describes the cognitive flexibility needed to collaboratively work on issues facing society using a holistic approach (Grohs et al., 2018). There are general BGCA resources in regard to systems thinking approaches but there are no specific theories or frameworks currently associated with the BGCH. A social, emotional, environmental, economic, and political framework is used by the WN Initiative to address resource inequity in Hawaii youth, especially low-income and disadvantaged youth. A systems thinking approach to the What’s Next Initiative includes a framework with the components leadership and governance; data collection and accountability; culture and cultural self-efficacy; youth, their families, and sense of community; organization funding and finances; social/political/economic context; social capital and social cohesion; and staff and organizational structure. See Appendix E to view WN Initiative systems thinking framework as a visual [figure]. Frameworks cannot implement themselves, and such a feat takes collaboration among stakeholders within communities with an understanding of the barrier and resource context (Ballard, Farrell, & Long, 2020). Implementation of the WN Initiative framework is done by members of the priority population (i.e., BGCH/WN youth), stakeholders, communities, and organization administration and staff.
A recommendation for the organization is to create a systems thinking assessment for BGCH staff that records the capability for systems thinking among organization personnel. BGCH staff have a pivotal role in the education and shape of Hawaii’s youth, so measuring the levels of systems thinking currently present in the agency is vital, as it requires an understanding of the BGCH or WN in an interdisciplinary framework, considering complex interactions with other societal components using a multifaceted perspective. Tools and models that facilitate independent assessment of skill development and application are needed to help the organization better align learning outcomes with specific governmental, institutional, and private sector needs and better understand program impacts (Grohs et al., 2018). One example of a systems thinking assessment that can be adapted for use among BGCH staff is the one created by Grohs et al. (2018) to be used among university students (see Appendix F). This framework employs three dimensions: (a) problem, (b) perspective, and (c) time, in addition to the measurable constructs associated with those dimensions (Grohs et al, 2018). This systems thinking framework is strongly informed by critical thinking literature in philosophy, problem solving literature in engineering education, and scholarship and theory related to public policy, leadership and community development, and organizational studies (Grohs et al, 2018). Only minor adaptions are required to make the provided prompts applicable to BGCH staff and personnel.