"without Critical Consciousness, How Could You Move on?" Critical Consciousness and Recovery Among Formerly Incarcerated Men in Newark, NJ

Background: Critical consciousness posits that most social problems and many health conditions are rooted in structural and internalized oppression and marginalized people have the ability to recognize forms of oppression (e.g., racism, class and gender discrimination) that lead to health inequities and take action to resist oppression. While research supports a significant and positive relationship between critical consciousness and health, little is known about the specific mechanisms of change that explain this relationship. This presentation discusses findings from qualitative exit interviews with 37 men who participated in research optimizing Community Wise, an evidence-based, multi-level intervention grounded in critical consciousness theory developed under CBPR principles. The goal of the analysis was to identify concepts to develop hypotheses of the intervention’s mechanisms of change, based on participants’ perspectives.

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.