Session: The Power of Critical Consciousness to Battle Social and Health Inequities: Social Work-Based Interventions and Mechanisms of Change (Society for Social Work and Research 27th Annual Conference - Social Work Science and Complex Problems: Battling Inequities + Building Solutions)

Background and Purpose: Social Work promotes social justice through the application of the person-in-environment framework. Despite tremendous growth in research, more multi-level evidence-based interventions developed by social workers and informed by social work principles are needed. Critical consciousness (CC) theory is well aligned with social work principles as it explains how systems of oppression operate and how to dismantle these systems. CC has been found to be a promising approach to combat health inequities. In the field of substance use disorders (SUD), evidence-based interventions have focused on changing individual-level behaviors, assuming people struggling with addiction are broken. These interventions ignore how social determinants of health uniquely affect minoritized communities and overlook community members' experiential knowledge and their potential contributions to developing and testing interventions. To address this gap, our team has followed community-based-participatory-research principles (CBPR) in applying CC theory to social work research and practice in the field of SUD over the past 12 years. We have found that CC theory offers a strong framework to promote health equity and address racism, classism, and sexism at multiple levels. Through rigorous research, we have developed a methodology, informed by CC theory and grounded in social work principles, that can be used to address the impact of racism, classism, and sexism while empowering communities to improve health equity.

Methods: In order to exemplify the potential of CC as the main strategy to address health inequities, we will use this symposium to present findings from the development and testing of Community Wise, a new evidence-based social work intervention developed to reduce substance misuse (SM) and improve community health among formerly incarcerated people with SUD. More specifically, we will demonstrate how social work researchers and practitioners can use clinical tools to organize intervention participants and social work clients to promote equity, engage in community advocacy and service, while also adopting individual-level behavioral changes. We will show how intervention participants and social work clients can engage in dialogue to examine the impact of racism, classism, and sexism in maintaining a system that privileges some at the expense of others; and how to develop capacity building projects to improve health and equity in their community. The first two presentations will report main outcome findings from a large controlled trial funded by the National Institute on Minority Health and Health Disparities, including 602 formerly incarcerated men with a history of substance use disorder and incarceration. Presentations 3 and 4 will report results from qualitative analysis of session recordings from two intervention components focusing on examining the CC mechanisms of change and the intervention's application in social work practice. Following CBPR principles, presenters will include researchers, service providers, and research participants.

Conclusions and Implications: By using a concrete example, this symposium will provide clear guidance and demonstrate how social workers can develop optimized evidence-based interventions to address myriad health inequities using an innovative application of CC theory.-2022-->