COPE in Action: Community-Based Participatory Research As a Community Organizing Tool

Background and Purpose:

Louisiana rates of mental health conditions are higher than the national population. As of February 2021, about 715,000 adults reported a mental health condition, and nearly half (47.5%) reported symptoms of anxiety or depression – yet approximately 3.4 million people live in a community without sufficient mental health providers. Compounding this, the state contends with frequent natural disasters on top of high levels of socioeconomic disadvantage. In 2020, 5 named storms hit the southern part of the state, several aimed directly at East Baton Rouge Parish (EBRP) before changing course. A few years prior, EBRP experienced “catastrophic” flooding of its neighborhoods. In August 2021, Hurricane Ida flooded more than 40,000 homes and businesses, leaving over 1 million people, including much of EBRP, without power. Parish households were already stressed – household poverty is higher than the national average, and 10.5% of the population is uninsured. The compounded effects of economic and environmental precarity have taken a toll on residents’ mental health.

Methods:

We are conducting a Community-Based Participatory Research (CBPR) study to better understand mental health in EBRP and community-based solutions. The study follows a multiphase mixed-methods design to adapt, deliver, and assess the efficacy of a brief group mental health intervention. Through an academic and broad-based organization (BBO) partnership, the adaptation included the development of a delivery model aligned with a community organizing strategy that is guiding intervention implementation. This paper focuses on how community organizing is used in the Dynamic Adaptation Process to adapt an intervention model targeting healthcare and social service providers and the development of an organizing implementation delivery model.

Results:

Two teams of community leaders, recruited from diverse organizations in the BBO Together Baton Rouge (TBR) and EBRP, guided curriculum adaptation and implementation planning. The intervention–Communities Organizing for Power through Empathy (COPE)–aims to (1) reduce psychological distress and amplify protective factors, and (2) build individual and community psychological support response capacity. Specific curricular adaptations accounted for delivery within faith-based institutions and varying literacy levels. Incorporating community organizing into the implementation process afforded innovative strategies for recruiting and retaining participants, particularly those in the attention control groups, while maintaining fidelity with the stepped wedge randomized control design. Training community facilitators associated with the institutions where the COPE intervention is being delivered offers unique opportunities for building long term mental health supports.

Conclusions and Implications:

The COPE curriculum and implementation model presents an innovative approach to improving community mental health with the potential for replicability among BBOs across Louisiana and throughout the United States. By utilizing a CBPR approach that involves community organizing strategies, we can further democratize the research process to best develop and implement community-based interventions to address mental health and economic inequities, thus recentering voices of the most vulnerable.