In this episode, Karma Chávez interviews Dr. Rubén Parra-Cardona about his recent co-authored study about the importance of faith-based organizations in taking leadership roles in implementing physical and mental health care initiatives.
Dr. Parra-Cardona discusses his recent work that advocates for the importance of faith-based organizations in taking leadership roles in implementing physical and mental health care initiatives. Dr. Parra-Cardona explains how the field of “implementation science,” or “the study of methods and strategies to promote the uptake of interventions that have proven effective into routine practice, with the aim of improving population health,” has been woefully ineffective in accounting for disparities and discrimination faced by marginalized groups such as Latinx immigrants. He also offers an example from his work with a parenting program to make a case for the need to consider faith-based groups as vital implementation partners, even as faith-based groups are still growing in their commitments to some progressive social issues.
Resources / Related Links:
Ruben Parra-Cardona, Ph.D. Profile
Implementing a church-based parenting intervention to promote NIDA prevention science among Latinxs (2023)
This episode of LatinXperts was mixed and mastered by Ean Herrera.
- Dr. Ruben Parra-CardonaAssociate Professor in the Steve Hicks School of Social Work
- Karma R. ChávezBobby and Sherri Patton Professor and Chair in the Department of Mexican American & Latina/o Studies | @queermigrations
Karma Chavez: [00:00:00] Episode 19. What role should faith based organizations play in serving Latinx? I’m your host Karma Chavez and this is Latinxperts. As part of our series, featuring researchers affiliated with the Latino Research Institute. Our guest today is Dr. Ruben Parra-Cardona, an associate professor in the Steve Hicks school of social work and the area director for research at the Latino research Institute.
His research crosses international borders and addresses issues of faith. Parenting and community partnerships in a recent short essay that Dr. Parra-Cardona published with colleagues in a supplement to the Stanford social innovation review. They argue for the importance of faith based organizations and taking leadership roles in implementing physical and mental health care.
Initially. The article contends that to date the field of implementation science or the study of methods and strategies to promote the uptake [00:01:00] of interventions that have proven effective into routine practice with the aim of improving population health has been woefully ineffective in accounting for disparities and discrimination faced by marginalized groups, such as Latin X.
The authors offer one example from their own work, with a parenting program to make a case for the need to consider faith-based groups as vital implementation partners. So Dr. Parra-Cardona, welcome to Latinxperts.
Dr. Ruben: Thank you so much. It’s wonderful to be here today and I appreciate it.
Karma Chavez: Absolutely. Well, we’re excited to have you here and I guess I’d like to just ask you if you’d start out talking a bit about what your role entails as area director for research in the LRI.
Dr. Ruben: Yeah. You know, it’s a, it’s a very fascinating role because basically my function. To support the director in the research objectives of the Institute. We have a wonderful team of researchers already affiliated with [00:02:00] the Institute as their primary appointment, but also very important to engage researchers in the university of Texas at Austin community and abroad into the mission of the LRI.
So it’s basically promoting the research agenda, but a research agenda that is strongly focused on integrated the best science, cultural relevance and social justice..
Karma Chavez: Well, and that ties in very much with your piece that I want to discuss with you today. And I’ll start out and say, I’ll be honest that as a humanity scholar, I had no idea that there was a science of implementation and I defined It briefly in my intro, but can you say more about the significance of implementation?
Dr. Ruben: It is really big. Those of us in intervention, it can be clinical intervention. When you have a clinical problem, let’s say depression, anxiety that you want eliminate that problem, that would be more clinical research, but you also have prevention research, right?
Which is the line that I [00:03:00] personally implement. That means that you really want to minimize the risk. For example, adolescents getting into substance use. And now we have tremendous wonderful signs about clinical interventions and prevention. Very rigorous randomized trials that have been conducted for years.
So we have the science of how to help people when they are facing these challenges in how to prevent these challenges from happening. However, we have two major challenges. One is that the most frequently diverse populations, low income populations. Yeah. Few resources have very few opportunities to access those interventions.
That’s one first step challenge that we have, right? If you don’t have private insurance, if you don’t have the capacity to pay out of pocket sessions, that puts you in a very, very critical disadvantage. The other one is when those interventions are delivered, you can take. Anywhere from seven to 12 years to [00:04:00] get to the people that need it because of the multiple barriers in systems.
Right? So we have these wonderful interventions, but how do you get it to the communities that need them the most? So implementation science is a science about how do we address these conundrums, these wonderful interventions, but that are not accessible by the people who need them the most. So there’s a whole science.
How to go about delivering these interventions to populations in short, in that gap that I was telling you about seven to 12.
Karma Chavez: And I’m going to guess, and you can correct me if I’m wrong, but. Historically that science hasn’t taken into account issues like culture and race, to the extent that might actually be beneficial to those communities. Is that fair to say? Okay.
Dr. Ruben: Absolutely. Absolutely. When I first got funded back in 2009 with my first grant, from the national Institute of health, there was actually bay that was called the cultural [00:05:00] adaptation. On one hand of the debate, there were the developers of interventions who said, you know, we have these wonderful interventions that work efficacious intervention.
We don’t need to change them. And we’re already implementing them in schools with kids from all cultural backgrounds. So there’s really a high risk to modify the interventions and make them move the way they work. On the other hand of the debate you had, ethnic minorities scholars saying, wait a minute, that can be scientific imperialism.
These interventions were originally developed mostly with your American population. Uh, us. Populations that are not experiencing the stressors that black African-American Latin X, immigrant communities face on a daily basis. So we truly run the risk of running into scientific Imperial. So there was a big debate at the time.
And since then we have had several colors, demonstrating importance of [00:06:00] culturally adapting, those interventions, according to the cultural values, cultural traditions of diverse populations and cultural adaptation is a whole field by itself. Just like implementation science. Cultural adaptation has to be rigorous in order to incorporate.
In a very thorough way. Cultural values and tradition is just not about translating materials or making sure that the visual image is represented. The focus population it’s really working with communities an ensuring that interventions are truly relevant to them.
Karma Chavez: It reminds me of something from my own research. Uh, when I, so I just finished a book that’s about HIV during the early years of the pandemic. And one of the things that I learned about in doing that research was that in the early, late eighties, early nineties was sort of the first time the federal government had said.
That they would be giving grants to these organizations who could help to do prevention around HIV. And it was very clear [00:07:00] early on that farm workers were one of the most struck group. And so they were looking to see, you know, some of these organizations, was there anything published in Spanish already?
And they found, of course, in San Francisco that there were, uh, some strategies to address the urban LA Latin X population in San Francisco. And so originally they took these directly to farm workers and, you know, the language was right, but it didn’t make any sense for them given their content.
Dr. Ruben: absolutely. Absolutely. According to the client, you know, if you’re working 12 hours in the field, if you’re exposed to pesticides, if you know, and then you’d come with these things about, okay, put your kids in timeout when you do. Your own place. So it’s, it’s a perfect and it, it happens. It happens. And so cultural adaptation needs to have there be a painstaking process is a multi-year process.
But we know, we know that culture, that interventions really make a difference in the lives of people. The problem again is even perfect culture that adaptive interventions don’t [00:08:00] get to the people that need them the most. And that’s where integrating cultural adaptation and implementation sciences.
Karma Chavez: So let’s talk a little bit about this case study from this piece you co-wrote. So. About the creation of a culturally adapted parenting intervention in partnership with San Jose Catholic church here in Travis county. And will you talk then about why you chose the church as your partner, and then a little bit about what the intervention itself.
Dr. Ruben: Yes, this goes back all the way years of the Obama administration. When we first got funded on our first call to adaptation study our focus populations out low income immigrant communities and the families we serve oftentimes have, um, mixed immigration documentation. So it’s very hard for them to go through formal systems of care because many of them don’t have social securities will have insurance.
Many of them, what they do is they save money and then they go back to Mexico. And take care of their [00:09:00] healthcare needs during the summer. And, you know, don’t get me wrong. These are populations that it’s one of the things about the us economy. If you remove undocumented immigrants from this economy, it would hurt so much because those vegetables that we’re getting in th e stores, um, the cables in our cars, the monitors being assembled, all those are, you know, uh, immigrant populations, many, many of them undocumented immigration.
So anyway, it’s a social justice species. How are, what are we doing for these populations that are offering so much to us in an unrecognized way? This a feature of the us economy has taken, uh, have been longstanding. So we started this work first in the industry. But along with that, we have an immigration system that needs to be redesigned reconsidered based on the realities of the us economy.
When we first tried to offer a parenting groups [00:10:00] in schools and community centers, it was very difficult because of this. There are other places like, uh, Arizona, Phoenix, where you have high concentration of Latin X populations in which, um, delivering interventions at the time was much easier because of the, of the social capital of immigrant population in those settings.
In the context where we started Detroit, Michigan, that was not the case. There was a lot of these drugs. However, it’s very important to recognize that church churches historically have been at the forefront of human rights of kind. In the church where we work Holly, the dealer in Detroit, uh, they had a full immigration court.
They were extraordinary in being advocates for immigrants. So anything coming from the church was a guarantee of safety for immigrants. So when we moved to offering the parenting programming churches, then our attendance went up the roof and we had a waiver. And not only that, but, [00:11:00] um, we had a case management approach.
So one of our interventionists would refer families to services. So it was not only doing a parenting intervention or parenting programs, but if the family didn’t have food or were working for an employer for west exploitative, um, we would offer case management services to elevate their quality of life.
And since then we have seen the powerful, powerful way in which faith based organizations protect immigrant family. And we have graduated year after year, that when you launch these initiatives from faith based organizations, it provides a layer of trust and safety to families. That’s critically important, particularly for the most vulnerable and families.
And. Our parenting groups, um, are attended by parents who have stable jobs, but also by many parents who are in a position of vulnerable.
Karma Chavez: And so is part of the implication of what you’re saying then that previous interventions that might’ve [00:12:00] been focused on parenting really just focused on the parenting piece of this and not the broader context in which parenting. Yeah.
Dr. Ruben: Yes. And we learn along the way. We, we didn’t conceptualize that right. In a way, because in the Obama administration, we know immigration policies, prioritize arrest of criminals, individuals breaking the law, et cetera. However, there were some, uh, arrests in the petitions of families who were undocumented without engaging in criminal behavior.
However, in our second. When we launched the second study funded by night, uh, we had a transition to the Trump administration and the immigration policies drastically. Drastic change. So for the first time we had a, in community, we have members of our parenting groups who were arrested for overstates of FISA.
I mean, stuff that we had never seen, we saw very, very aggressive [00:13:00] immigration stance and policy. But even with that, our retention rate in that study was amazing. It was like 86%. We had a couple of families that were deported. And, uh, but still families committed to the parenting program because they needed it for their family, but it was as we face more connections.
Challenges that we increase the case management approach. So we didn’t visualize it like that right in the beginning. But as the contextual adversity, as we learn more and more about the contextual adversity, our family serve, we increase that arm of the, of the study. So it’s not a standard in the parenting intervention world to, um, uh, include advocacy along parenting interventions.
But now we consider it easy.
Karma Chavez: And just to clarify, you used an acronym of a funding agency. NEDA, can you just tell us what.
Dr. Ruben: Yeah, nationally on drug abuse. Our first study was funded, uh, to, um, [00:14:00] examine the impact of an intervention with families with young children, four through 12, and our results were really sorry. And, uh, we presented our results to the national Institute of drug abuse. And so they got proposal to expand our program of research, to include families with adolescents.
So focus now ease the mental health of adolescents, but also the prevention of substance use.
Karma Chavez: So this is a case study and it sounds like a case study of part of a huge project. That’s in many locations with many, many different communities. And one of the things I was thinking though, as I was reading was potentially about some of the drawbacks of working with faith based communities, um, particularly for LGBTQ migrants, which is what my research is about.
And so I was wondering if You could talk at all about how questions related to sexuality or gender, uh, have come up in any of those.
Dr. Ruben: You know, I think, uh, working with. Sampler faith-based [00:15:00] community committed to social justice is important, and I really want to highlight our community partners here in, um, Austin, San Jose Catholic church. They have a ministry which is a social justice ministry, and it stands on its own. When I say stands on its own is that they have tackled one by one issues of social justice.
And yes, uh, are within the Catholic church. And they are part of the church itself, but I have been so impressed by them. Uh, like when we started focus groups to talk with parents about contextual challenges that they faced before we went into the room, they were running immigration petition workshops.
Can you imagine that? I mean, they would given pack. To families and saying, if you get arrested by ice, this is what you need to think. And they have friends there or, you know, relinquishing parental rights and stuff like that. Stuff that we have not [00:16:00] seen in other faith based organizations. So at least to say that your question is highly important, it has not been answered.
It has not been fully addressed, but I have a lot of hope in groups within the Catholic church. So these social justice ministry, but are aware of the issue and are working on the issue, but they are part of our, an organization and a Facebook organization in which they need to have these conversations. So I would say this is a long-term issue that needs to be addressed, but I have so much hopeful folks, you know, for the future, um, because of folks like the ones we are working with and the social justice ministry.
Questioning paradigms and, um, advocating for those mobile, most vulnerable groups, even within Europe.
Karma Chavez: That’s really exciting and encouraging to hear. Places. My question came from, was in, I think it was about 2002, the Audrey Lorde project. I’m not sure if you’re familiar with them. They’re an organization, uh, in New [00:17:00] York and they provide a lot of services to, uh, specifically LGBT immigrants. And they did this massive study in 2002 that was addressing the question.
Are immigrant communities more homophobic than your standard, us citizen, community, whatever that means, of course. And one of the things they found out. Interviews was, and this is primarily the study was related to refugee resettlement because the vast majority of volunteer agencies that support refugees in the United States are faith-based immigrants actually had adopted, or refugees had adopted.
The homophobic views of the churches that were helping them with resettlement. Uh, now this is 20 years ago. And, um, and so, uh, it sounds like what you’re saying is one that their churches have really grown in their progressive politics. Uh, but two, it seems the other implication to me is, uh, it’s really important to be very careful about the faith-based partner. [00:18:00]
Dr. Ruben: Yeah. Because, you know, in both collaborations have been wonderful. Um, uh, the human rights of every parent we have worked with have been, uh, truly respected in, in, in so many ways, in my own experience, openness, to a lot of conversations, you know, in the parenting world, we are just in the faces of integrating the science of parenting and advocacy.
So when you talk about the LGBTQ rights and all that, we definitely are not in that frontier yet. Uh, but, um, I think it’s very promising what I’m seeing in the fact that, you know, within the church, you have a, uh, a work of social justice, um, ministry committed to the mission of social justice is incredibly inspiring.
And there are so many examples I can share with you in terms of, uh, that they were very innovative. Uh, takers in terms of what they did within, you know, their scope [00:19:00] of intervention and work. So I feel very hopeful about it.
Karma Chavez: Well, and it seems another implication then of this research specifically thinking about advocacy is that churches are in a kind of unique situation. Perhaps vis-a-vis other nonprofit organization. To have advocacy built into their work, whereas they’re not bound to just provide services. For example, is that accurate or is this just something that’s actually quite
Dr. Ruben: Yeah, no. And see it. See, this is, this is what I share with folks. Um, so, uh, asked me why faith based organizations. And I tell them because of the commitment of people the head priest. Of San Jose has been extraordinary since they won providing full support for this initiative. We could have not done this without you support father like unequivocal, go for it.
And there are many barriers, institutional barriers there’s to get projects like this done, they were all address. [00:20:00] Then we have. Hopefully and other members of the social justice ministry that were completely on board since they won in there strong, very strong advocates. So you have that in the staff.
It’s something I tell people that they really need to get out of their preconceptions because, you know, we liberal old people getting our mind, you know, Too much and detached from reality many times. So the first time that I went to recruit for focus group parenting, But they invited me to give them the announcement of the eight o’clock mass on a Sunday.
Right. So I said, who’s going to have to be there at eight o’clock on Sunday. Right. So I get there and you’re like, ah, 10 minutes before nobody’s going to be there. I couldn’t park. I could not find a place to park. And then I walk into the church completely. At eight in the morning, we’ve fooled families, families with young [00:21:00] children, adolescents, everybody dressed up and it was like a smack on my face to say you liberal ruin.
You’re so full of yourself because look at the face of these people. These are the people who are working in the rooms at 105 degree weather in Austin. When we’re in our offices, these are the people doing the landscaping. These are the people who did not quit working during. Right. And the place they choose to go in the day that they rest is that church that is going to give them space for a better future.
None of us can offer that to them. Only that community of faith at that moment, whilst like I recognize my not being humble and I recognize I have to be humble and just to remain in silence and observe the face of people because. Who gives you energy to be in a hundred degree weather on the rooftop is when you think about your family, but also your face.
[00:22:00] And that’s when I was very humbled by that experience.
Karma Chavez: Yeah, well, I think that’s actually a beautiful place to leave our conference. Today, I’ve really enjoyed this conversation. Thank you so much for being with us today, Dr. Parra-Cardona.
Dr. Ruben: It’s my pleasure. And I really enjoyed the conversation and you are a great facilitator for that, to that.
Karma Chavez: Uh, thank you so much again, our guest today was Dr. Ruben , who is the area director for research at the Latino Research Institute. And I’ve been your host Karma Chavez, and this is LatinXperts.