Methods: Participants enrolled in the Community Wise Optimization Study were eligible to complete focus group interviews if their group sessions had been delivered and if they had attended at least one session. Participants were asked about overall impressions of the intervention, thoughts about critical consciousness, evaluations of specific components, and recommendations for improving the intervention. Focus groups were conducted in person by the local principal investigator, audio recorded, transcribed and entered into Atlas.ti. The principal investigator and two staff members used an iterative process to conduct a thematic analysis of the data. Each analyst independently read and coded three transcripts, then met as a group via Zoom to compare their initial codes, reconcile differences and group similar codes into categories. The process was then repeated with three additional transcripts. Using individual coding memos and reports generated by Atlas.ti, the team drafted a codebook, which they applied to the remaining transcripts, amending the codebook as new codes and categories emerged.
Results: A total of 37 from 97 eligible men attended focus group sessions. Most participants identified as Black and Hispanic with a mean age 45. Average annual household income was $8,300. Overall, the group structure of Community Wise enabled the dialogue necessary for raising critical consciousness and provided social support. Many participants found that recognizing and resisting internalized oppression motivated them to take critical action to improve relationships and to engage in self-care. Four thematic areas emerged as possible mechanisms of change from analysis of the data: Critical Thinking (the ability to assess and improve the thinking process); Personal Growth (participants recognizing their risk-related behavior as reinforcing responses to internalized oppression); Community Engagement (interacting with others to raise awareness and improve community conditions); and Social Support (sharing experiences with others).
Conclusions and Implications: Participation in Community Wise sessions seemed promising in developing critical consciousness through critical dialogue, engagement in community projects, and mutual support. Critical thinking contributed to personal growth and community engagement, but it is also a skill that participants recognize in its own right.