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Grants to organizations in the Wellness Village Program provided resources for projects to transform the physical, chemical and social environments to improve community health. These projects were planned and led by residents, of which a majority were youth. Using techniques of youth development, community organizing and asset-based community development, residents learned how to address environmental concerns and how to evaluate progress in achieving goals.

The program had three components: 1) Community Health Projects, which engaged community residents in activities aimed at transforming their environments; 2) Community Mentoring, which connected middle-school-age youth with adults in the community to increase social capital in the wellness villages; and 3) Academic Support, which promoted partnerships between local colleges and universities and wellness villages to maximize and share resources in their communities.

Goal:

To improve the health of several communities in California by engaging children and youth in the transformation of their social, physical and chemical environments.

Objectives:

Planning Phase

• Support the development of local planning efforts that enable communities to invest resources in making environmental improvements that influence the health and wellness of children and youth.
• Encourage new models of collaboration that build on community assets.
• Conduct health education, peer support, and other programs necessary to engage youth in designing a wellness village.

Implementation Phase

• Implement a community-level advisory group consisting of residents, 50 percent of whom are youth, including civic and business leaders as well as public-sector representatives.
• Follow an approved logic model to implement a minimum of three community health projects that engage representative numbers of residents, especially children and youth, in activities that lead to measurable improvements in environmental conditions that influence health.
• Link support services of a local college or university to complement the community health projects through specific activities that are observable and measurable.
• Conduct a mentoring program for middle-school-age youth.

Accomplishments:

• Sixteen groups completed the planning phase of the Initiative. All 16 sites developed, through active community participation, action plans to improve community health.
• Wellness villages created substantive advisory groups. Each wellness village maintained an active advisory group that consisted of youth and adult residents who were involved throughout the course of the five years in all phases of the planning, implementation and evaluation of projects and activities.
• The Initiative encouraged a paradigm shift in the planning and implementation of community health programs. With an emphasis on enhancing the contributions or assets of youth in communities, the wellness villages provided youth development opportunities for their youth by engaging them in policy issues and ongoing dialogues about common concerns. In a number of wellness villages, city councils and other decisionmaking bodies created youth advisory boards and committees to help guide decisions affecting communities and young people.
• Wellness villages encouraged communities to view youth as positive assets capable of planning, implementing and evaluating projects that addressed community health needs. Youth developed into leaders as a result of opportunities to participate in training workshops and public speaking, and with responsibility as mentors, role models and staff within lead agencies. Youth from wellness villages were trained as evaluators and “village techies.” “Techies” became computer proficient and had responsibility for maintaining electronic contact with peers in other villages.
• Diversity and cultural competence were embodied by TCWF staff, CYCHI advisory committee, CYCHI support grantees, wellness villages, and wellness village advisory groups. Participants at all levels of the Initiative addressed issues and tensions associated with diversity and modeled respectful and just approaches to incorporating and reflecting different perspectives.
• High levels of resident involvement were achieved. There were deep and significant levels of involvement and participation of youth, families and kinship groups at the community level. Parents and other adults were involved alongside children and youth.

Challenges:

• Fostering adult and youth partnerships is a challenging task. Adult and youth partnerships require time, energy, technical assistance, and deliberate and facilitated discussions. In many of the communities, equitable roles for adult and youth in collective decisionmaking, planning, and implementation of activities were new concepts that challenged convention, tradition, cultural and community norms, and capacity among youth and adults.
• Involving residents in planning and programs required significant changes on the part of the lead agencies. Not only did the lead agencies have to relinquish control, they also had to mentor and teach new skills to the youth and adult residents. These notions of reciprocity and equity among traditionally unequal partners highlighted the tensions that members of each wellness village had to identify and work through. Along with power and control issues, time commitment, outreach efforts, data collection and language were barriers to consistent resident involvement.
• The rate of staff and volunteer turnover at all levels of the wellness villages was high. The turnover affected organizational memory and capacity to deliver outcomes according to established timelines. Mid-course corrections, organizational and leadership flexibility, and a quest to understand this phenomenon as inherent in community and organizational transformation were pivotal.
• The importance of community-organizing interventions to promote community health was recognized but the potential development of these skills was not realized. Community organizing as a tool that helps communities identify problems, resources and strategies to solve problems cannot be taught in short periods of time.
• Change in the social health environment precedes change in the overall community health environment. It was challenging for lead agencies to undertake the social engineering required for cooperative, sustained implementation of projects. Tensions among adults, youth, ethnic groups, community organizations and other stakeholders required time and energy to resolve before real work could begin.
• The process of selecting 10 wellness villages from an initial group of 16 planning sites was widely perceived as unfair. The level and intensity of competition between grantees gave way to mutual support and appreciation toward the end of the planning period. The encouragement of democratic processes at the wellness village level led to organized efforts to challenge the Foundation’s authority in selecting grantees.

Lessons Learned:

• Youth can be key stakeholders in determining effective approaches to the promotion of community health. Engaging youth to address community conditions that profoundly affect their health may influence how they will live as adults. Over the five years of the Initiative, many young participants completed school, obtained employment, began families and became active participants in the life of their community.
• The same opportunities for training, coaching and encouragement given to youth are also necessary for adults. It was anticipated that youth would need certain supports to effectively participate. It was a mistake to believe that adults did not need similar supports.
• Many youth, given the opportunity, will choose positive involvement in their communities. The focus on youth in this process ensured their involvement and engagement in the community and decreased their sense of social isolation. Youth became credible and valued leaders in their neighborhoods.
• The Foundation’s five-year commitment to 10 communities was valuable to the residents of these communities. During that time frame, the wellness villages had the time to plan, implement, evaluate and learn from their efforts. Participation in, and acknowledgment of, the accomplishments of the wellness villages cultivated community pride among the residents and transformed communities. Perceptions of the wellness villages, by those external to the communities, also improved.
• Grants of $1,050,000 over five years provided significant support to accomplish objectives. Wellness village grants were larger than community action grants in other initiatives. Increased resources allowed more work to be accomplished in a shorter time frame.
• The lead agency model made the grantmaking more efficient. Lead agencies, rather than collaboratives, were funded to implement all aspects of the program in the local community. Contracts for academic support and mentoring programs with the lead agency, rather than grants from the Foundation for those programs, led to greater accountability to the community.
• The local neighborhood was an effective center for organizing efforts to promote health and behavior change. Communities must be challenged to continually adopt resident driven community health improvements. Community organizing is necessary in community building because it stresses the identification, development and celebration of community assets.
• Neighborhoods have many assets that contribute to community health. Existing structures and facilities, such as churches, housing projects, schools and recreational centers, are all potential health resource centers. Such structures provide safe spaces for residents to meet, plan and host events that will contribute to improvement of health outcomes.
• Recognizing communities’ assets is an important step to improve the health of communities. The Initiative acknowledged the communities’ ability to define and solve broadly defined health problems at their place of origin, building on shared values and social relationships that inspired trust and strengthened social capital.
• Increasing the capacity for health promotion of individuals and organizations at the neighborhood level can result in community actions aimed at health improvement. Investing in and valuing individuals created a deep level of involvement in community health projects and a sense of community ownership of the work.
• A healthy respect for multicultural and cross cultural understanding is essential in community building efforts. It is critical to forge alliances among communities, learn to speak in common terms, and reach consensus around values and goals rather than foster competition at the community level. The shared understanding that developed among residents greatly contributed to the success of the Initiative.