Building Bonds, Healing Youth: Prioritizing Youth Critical Consciousness Development in CBPR

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Introduction
Community violence is a major public health issue that disproportionately impacts African American (AA) youth. AA youth are more likely to be exposed to ongoing community violence than White youth (Centers for Disease Control and Prevention, 2009;Morgan & Truman, 2019) and experience a myriad of related health and well-being issues (e.g., sleep disruption, sexual risks, depression, isolation, and academic failure) (Busby et al., 2013;Kliewer et al., 2019;Voisin et al., 2016). Few interventions specifically target community violence exposure (Voisin & Berringer, 2015), particularly among AA youth. New strategies are necessary to address the needs of AA youth burdened with the consequences of community violence.
Community-Based Participatory Research (CBPR) emphasizes community-developed research agendas, shared decision making, co-learning, and local capacity building to understand and intervene in problems from a socioecological perspective (Frerichs et al., 2016;Israel et al., 1998;Wallerstein & Duran, 2006). Increasingly, CBPR approaches are recommended to address youth violence (David-Ferdon & Simon, 2014) and provide an opportunity to partner with those most impacted to address public health gaps and build community capacity in the process (Collins et al., 2018). In this brief report, we describe capacity-building efforts in our CBPR project (Building Bonds, Healing Youth), which aims to develop and test a community-level intervention to promote resilience among AA youth exposed to community violence. Our Mobilize relevant community sectors to assist in providing support and enhancing youth resilience with youth-engaged programs capacity-building efforts centered around developing critical consciousness (CC), particularly among our youth partners, and were facilitated through our community advisory board (CAB). During our first two years, three specific CAB activities aimed to promote youth CC: 1) focus group data interpretation; 2) resilience needs assessment survey development; and 3) community forum planning and implementation. We describe each of these activities, how we focused on youth CC development, and share our lessons learned.

Emphasizing Youth Critical Consciousness Development in our CBPR Process
Critical consciousness (CC) has been defined in many ways, but generally includes critical reflection, political efficacy, and social action (Watts et al., 2011). It requires prioritizing participation, leadership, social networks, and power (Goodman et al., 1998) to build the foundation for sustainable work (Frerichs et al., 2016). The benefits of CC among youth are well-documented and include promoting mental health (Zimmerman et al., 1999), career development (Diemer et al., 2010), and occupational attainment in adulthood (Diemer, 2009). CBPR, with a foundation in critical theory, provides an opportunity for researchers and community partners to heighten critical consciousness (Branom, 2012). Engaging youth in participatory research through problem identification, analyzing and interpreting data, and providing feedback at every stage of research promotes critical consciousness (Foster-Fishman et al., 2010).

Youth Ambassadors Partnership
Youth Ambassadors (YA), established in 2010, serves over 250 underserved teenagers (ages 14-18) annually from the Kansas City, Missouri, metropolitan area. A substantial portion of YA teenagers are AA, have a history of multiple trauma exposure, and live in environments of concentrated poverty. YA uses Building Bonds, Healing Youth: Prioritizing Youth Critical Consciousness Development in CBPR Journal of Participatory Research Methods a strength-based curriculum that fosters resiliency by strengthening intrapersonal and interpersonal competence to mitigate the negative consequences of concentrated poverty and trauma exposure. Academic partners had previously collaborated with YA by volunteering at YA-sponsored career fairs and implementing a policy advocacy curriculum during the YA summer program. Through these experiences, a relationship was developed that led YA and academic partners to jointly pursue a funding opportunity to address youth violence and resilience. As a trusted youth development organization in the community, YA facilitated the engagement of youth partners in the Building Bonds, Healing Youth project. YA viewed promoting youth engagement in the CBPR project as an extension of their mission to increase opportunities for youth to thrive and advocate for change.

CBPR Activities to Promote Youth Critical Consciousness Building Bonds Community Action Board (CAB)
The Building Bonds CAB consisted of YA members, academic partners, and youth-serving adults from organizations representing multiple community sectors, who partnered to design and test a community-level resilience intervention. The Building Bonds CAB was guided by the recognition that to develop relevant and sustainable reliance-enhancing solutions in the face of community violence exposure, youth must be at the table. As one of our youth CAB leaders stated, "The only way to reach youth is to involve youth in the decision-making process." Building Bonds CAB meetings were structured to create a space for critical reflection and discussion regarding the research process and findings. Critical reflections often extended to youth's own lived experiences. As one youth CAB member described, "I always grew up around violence, so in order to survive I felt I needed to be violent. The first meeting with Building Bonds showed me that there was possibly a way to survive without having to succumb to violence." The critical reflection and discussion that occurred during CAB meetings provided mutual benefit in the CBPR process -enhancing the relevance of the research and honoring youths' lived experiences. One youth CAB member shared, "I always felt invisible in my family, because everyone assumed I was okay. I was fine in school, and I never caused problems, but I wasn't okay, because in my home I witnessed domestic violence every day. The CAB acknowledged me and provided me with a chance to be understood." The development of CC has been associated with healing processes for youth who have experienced violence (Ginwright, 2010), and it was critical to make space for this in our CBPR process. We learned that it was helpful to share information via a CAB newsletter and solicit feedback via email or phone between CAB meetings to allow more time for critical dialogue during each meeting.

Focus Group Data Interpretation
We conducted five focus groups with thirty-nine urban AA youth exposed to community violence to inform the development of our Building Bonds community-level resilience intervention. During two CAB meetings and one community forum planning meeting, youth CAB members participated in an extensive "member-checking" process that involved reviewing focus group data and ensuring appropriate data interpretations. During these meetings, researchers described preliminary focus group themes and passed out printed youth quotes that reflected each theme to facilitate ample discussion about the quotes. Through this process, youth leaders appeared to develop CC as they discussed social, economic, and political conditions that perpetuate community violence, refined data interpretations, and identified additional areas to further examine. As one youth leader stated, "We just really wanted each person to take each quote and be able to relate to it on a personal stance." Youth refined the data interpretation regarding the preliminary themes. For example, for the theme of inadequate responses from law enforcement, youth indicated that while current law enforcement responses were inadequate and led to feelings of mistrust, youth desired to have a closer relationship with law enforcement and saw them as critical in promoting community safety. Presenting this balanced interpretation of the data was important to youth. Youth also identified areas for further study, such as barriers to getting family support as critical to examine. This barrier was not an original an aim of the study, which was focused more on community-level factors. This feedback informed the resilience needs assessment and priorities for social action. We learned that it is critical that the member-checking process allows for ample time to conduct data interpretation and to engage in critical dialogue regarding what is missing from the data and needs to be further examined.

Resilience Needs Assessment (RNA) Survey Development
Needs assessments have traditionally been used to identify priority areas of focus to address a community-identified problem (Berkley-Patton et al., 2018;Fawcett et al., 1988). Guided by areas identified in our focus group memberchecking process, the research team prepared an initial draft of a community RNA survey. The RNA survey draft included items on demographics, health behaviors, psychosocial measures, and multi-sectoral strategies that had the potential to enhance resilience with urban AA youth exposed to community violence. Two CAB meetings were used to review draft survey items and refine the survey. During these meetings, several questions were removed that youth did not believe were relevant to their peers, some questions were added, and several questions were modified to improve readability. Youth expressed concerns that most of the behavioral and psychosocial items were being posed to youth and not adults, and felt it was important to know about the experiences of the adults who served them. They were also concerned that these important questions were at the end of the survey and that youth may not complete them due to the survey length. Based on this feedback, the adult version of the survey was expanded to include behavioral and psychosocial items, questions were reordered, and the youth survey was shortened to reduce survey fatigue. Building Bonds, Healing Youth: Prioritizing Youth Critical Consciousness Development in CBPR

Journal of Participatory Research Methods
The final surveys were administered with 189 urban youth and 97 adults who serve youth in key community sectors. Survey findings were discussed during CAB meetings. This process of survey development provided an opportunity for youth CAB members to build political efficacy. As one youth leader shared, "I didn't know how much community violence affects the larger community… It motivated me and inspired me to do better. I know what it's like to grow up in violence and have no one to talk to. It's a struggle and it can bring you down -mentally and physically. I want to make a place where they can share their experience and figure out a way to make the problem better." Our youth-engaged RNA survey development process highlights the value in incorporating specific feedback from youth and engaging in critical dialogue on why and how the survey can benefit the community.

Youth Community Forum
The Building Bonds community forum provided an opportunity for youth CAB members to extend their development of CC to the larger community through promoting community critical reflection and dialogue around the focus group and RNA findings to inform social action. A forum planning committee, comprised of youth CAB members and core research team members, met regularly via in-person meetings, GroupMe messages, and phone calls. Forum planning activities included: identifying forum goals; selecting data to share at the forum; determining the format for attendee participation; identifying community stakeholders to invite; and developing advocacy priorities to further develop CC among youth partners. The planning process further nurtured youths' political efficacy as their social networks expanded and supported their ability to carry out their vision as leaders. One youth CAB member shared: "Supporting each other is the only way we are going to affect change. Giving a platform where youth together can address an issue provides a first step in healing." Providing opportunities for leadership in the implementation of the community forum was also critical to nurturing youth CC. During the forum, youth introduced the mayor as the keynote speaker, shared their peers' writings on experiences of community violence, and co-facilitated table discussions which engaged forum attendees in critical reflection on study findings and priorities for social action. We learned the importance of involving youth and promoting youth leadership roles in every detail of the planning process.
Conclusion Building Bonds, Healing Youth aimed to develop and test a community-level intervention to promote resilience among African American youth exposed to community violence. Each phase centered on youth CC development as a priority. Lessons learned support the feasibility of prioritizing youth CC development in CBPR and reflections from our youth partners support its importance. One of our youth CAB leaders summarized her experience, stating, "It made me realize that everyone has their own challenges and how strong youth are. Despite what we have all been through they are still so strong. We have to make a change and the community needs to know what the youth go through." We hope others will prioritize CC when partnering with youth in CBPR to promote mutual benefit and capacity building.