FFT: Don’t Dream Of Becoming A Doctor, Dream Bigger

If your dreams don’t scare you, they aren’t big enough.  -Muhammad Ali

Food For Thought: Don’t Dream Of Becoming A Doctor, Dream Bigger

Don’t dream of becoming a doctor! That is not big dream enough! Dream bigger! Dream of curing cancer and in the process become a doctor.

Since age 5 or 6, I dreamt of becoming a doctor. Why? I don’t know; perhaps, I desired to help people since that was my nature. Deciding my future at that early age paved a path that I was prepared to navigate. It made choices easy and the sacrifices expected.

When I became a doctor, dreaming stopped. I worked hard and got into the routine of living life: A working single mom raising two active, athletic boys. Also, after 20+ years in clinical medicine, I felt unchallenged. Patient care required minimal brain power and more clerical skills as the years passed.

I wasn’t prepared to leave medicine, wasn’t ready to be a patient and hadn’t thought about a future without medicine. The first few years of leaving medicine, I felt useless; my education had no value. I knew nothing but medicine. Here I was starting over at my age. It took years for me to figure out what I wanted. It wasn’t easy and took time. The earlier you start planning your future, the better your chances of success, happiness, and inner peace.

If your children are older like mine, remind them to dream big then dream bigger. When you remind them, it doesn’t matter if it seems impossible and they ignore you, continue to tell them anyway. They listen if you repeat it often enough. If your child comes up with something that seems impossible, don’t knock reality into them. Encourage them to dream even bigger. Have confidence they will figure it out.

For those lucky enough to have babies that’s the best time to start preparing your child to dream big by giving them the confidence to dream big and then bigger.  #DreamBig

Dream Big then Bigger
Dream Big then Bigger

 

Source of Images:  Pinterest

Evidence-based Programs: Answers But Not Proof or Solution

Evidence-Based Programs are Not proofs
Evidence-Based Programs are Not proofs

Evidence-based Programs:  Answers But Not Proof or Solutions

 

What are evidence-based programs?

Simply put, a program is judged to be evidence-based if it meets the following criteria:

  • Evaluation research shows that the program produces the expected positive results;
  • The results can be attributed to the program itself, rather than to other extraneous factors or events;
  • The evaluation is peer-reviewed by experts in the field; and
  • The program is “endorsed” by a federal agency or respected research organization and included in their list of effective programs.

 

Start with what we have! A glance at the National Registry of Evidence-Based Programs and other similar registries and best practices is enough to demonstrate that increasing disparities between disadvantaged and non-disadvantaged groups does not stem from a lack of evidence-based programs. Absent are contextual  measures pivotal to accurately assess effectiveness and appropriateness of evidence-based programs operating within diverse communities. We may have the answers to the wrong questions. Evidence-based is not proof of   effectiveness, safety or application of programs in diverse communities.

“Why are gaps or rather disparities increasing?” I propose the answer lies in the belief that using evidence-based programs guarantees effectiveness and desired outcomes, particularly if fidelity, reliability, and validity have been demonstrated. Some in public health still believe-evidence based programs replace the need for metrics. This is wrong!

Research  studies showed positive nurturing environments d from birth to 5 years old is critical to  formation of healthy foundations.  Healthy foundations increased the likelihood of successful, productive, and healthy behavioral and academic outcomes in adulthood.

Currently, educational outcomes are measured by indicators such as academic performance, standardized tests, graduation rates and college entrance rates. These metrics provide useful information, but not about healthy foundations or  how to improve future potential of children, particularly children from impoverished backgrounds. The tests show that disadvantaged groups (poor children) lag behind and have not benefitted from the science of our advanced technologies, thereby decreasing future potential and  increasing disparities in education, health, and social class.

 

Why Evidence-Based Doesn’t Work?

This is partly due to:

  • Lack of evaluative tools to  guide effective and appropriate strategic interventions that are scalable,  replicable  as well as form strong, agile customizable  infrastructures;

  • Academia’s insistence on fidelity when implementing evidence-based programs defies factual observations that one size does not fit all. Fidelity–loyal to protocol –ignores  nuanced cultural contexts of communities and members of each stakeholder.

    1. Fidelity in implementation unintentionally devalues a community’s culture by replacing with Anglo-Saxon culture;

    2. Acting against one’s beliefs and values without creating a rational narrative stresses the psyche and the body, triggering profound inner turmoil known as cognitive dissonance;

  • Evidence-based studies are based on evidence within a particular context, community  or environment.    Also, keep in mind most studies are short term.  The wide application of evidence-based studies to diverse communities does not assure desired outcomes.   For example, Headstart, one of the government’s longest running”successful”  programs for in-need pre-school children,  fades within one to two  years of starting school. Why? That research has not been done yet HeadStart expanded.

  • Finally, without appropriate metrics and allowances for context, health is not measured nor is the long-term impact or harm of many well-intended social programs.  As well-intentioned as the missions of social programs, most are ineffective at best.

Causing harm, oppression and creating new issues  for those without safety nets were not issues anticipated by researchers.  Many brilliant minds still  reside in a tunnel.    Evidence-based studies  and best practices do harm simply by not  understanding or appreciating the impact or POWER of  diverse cultures.

 

This slideshow requires JavaScript.

With the above in mind, imagine living in a community struggling to survive without basic needs—a food-insecure community lacking shelter where safety is of huge concern, not because of crime but because of local police departments.  In 2012, about 50 million Americans fit the description of food- insecure with 8.8 million children living in food-insecure households.    Mistrust and fear are high in communities struggling to survive.

 Maslow Hierarchy450px-Maslow's_Hierarchy_of_Needs.svg

Maslow’s hierarchy is a good starting pointing in understanding the stages of fulfillment of human needs. The bottom needs are essential to move up the hierarchy. Basic physiological needs—sleep, food, water, sex—are essential for survival. The next level includes security, safety and employment.

Keep the above in mind as you imagine the following scenario. A new program distributing information about obesity comes to your community. You unknowingly fall into a high-risk group. Considering Maslow’s hierarchy, would obesity be high on your priority list if food and safety are also concerns?

Unfortunately, most programs operate on the presumption that a community’s priorities are similar to those of researchers. When programs do not work, this apparently flawed assumption ignores the tendency of social workers to double down  and  request  more funding.

Suggestions:

Please, Please, Please No more spending and no more programs hatched in petri dishes, please! Social problems are complex adaptive problems that require all parties at the table, feeling discomfort while totally invested in the outcomes. Integrating appropriate metrics with social programs not only guides strategy but can be educational and a tool to build trusting relationships within communities for future collaborations.

A system-of-care approach determines the needs of children and their families within communities, based on a number of factors including a community’s own resources.  Community members form  core infrastructures germane to a programs’ success and longevity; as well as facilitate development of  culturally appropriate metrics (which improve  compliance)  to guide evaluation, implementation and outcomes. Engaged communities collaborate with researchers to  facilitate adoption of    cultural-contextually appropriate solutions. Interestingly, if one looks and listens, successful solutions with desired outcomes already exist within communities.

 Evidence-based studies are tools to help communities carve their own solutions.  They are not THE solutions.

References:

1.  SAMHSA National Registry of Evidence-Based Programs and Practices

http://nrepp.samhsa.gov/

2.   Cognitive dissonance

http://en.wikipedia.org/wiki/Cognitive_dissonance

3.   What Is Cognitive Dissonance?

http://psychology.about.com/od/cognitivepsychology/f/dissonance.htm

4.   Definitions of Food Security

http://www.ers.usda.gov/topics/food-nutrition-assistance/food-security-in-the-us/definitions-of-food-security.aspx#.U-DWLvldV8E

5.   Food Security in the U.S.

http://www.ers.usda.gov/topics/food-nutrition-assistance/food-security-in-the-us.aspx#.U-DV4vldV8E

6.   Food Security

http://www.who.int/trade/glossary/story028/en/

7.  Research Review Evidence-Based Programs and Practices: What Does It All Mean?

http://www.evidencebasedassociates.com/reports/research_review.pdf

8.  Evidence-based medicine

http://en.wikipedia.org/wiki/Evidence-based_medicine

9.  About Evidence Based Programs

http://www.projectenhance.org/aboutevidencebasedprograms.aspx

the 10 things you’ll learn by the time you’re a teen

I learned a few things I had forgotten and cannot think of anything to add to the list. Great Article!

The Success of The War On Drugs on Education

The Success of The War On Drugs  on Education

Part 2 of Prison Reform Benefits Education Reform

 

Was the war on drugs successful? At one time, many believed that blacks were criminals, and I started to fear my own people. The power of the media in creating illusions should never be dismissed.

The war on drugs (WOD) neither reduced drug overdoses nor drug ingestion. WOD harmed innocent children and their families by depriving children of education and placing them in toxic environments (prisons) where they were physically abused and sexually molested (by the United States government).

Over sustained periods, violent environments lacking support produce toxic stress. Toxic stress is a well-established risk factor for both physical and mental illnesses; stress is a major factor underlying the pathology of chronic medical conditions.

Toxic stress compounds pre-existing risk factors in children, as much as four to six times over children with similar risk factors who are exposed to stress, but have supportive adult networks and are not exposed to prison.

Table 1 List of High Risk Behaviors

Risky behaviors include and are not limited to:

1.  Increased risk of drug and alcohol abuse;

2.  Increased risk of suicide;

3.  Increased risk of violence;

4.  Increased risk of sexual infections, pregnancy and molestation;

5.  Increased risk of homelessness;

6.  Increased risk of poverty;

7.  Increased risk of Mental Illness; and

8.  Increased risk of re-incarceration.

Again, I repeat: public schools are the main pipelines to prisons. School-to-prison pipelines are massive problems in communities of color. Zero tolerance, racial profiling, and school-to-prison policies relegate school discipline to prisons. Children who act out are considered difficult to teach, consuming scarce and valued time. What else can overworked teachers and educators working in understaffed schools do with children considered as “trouble-makers?”

Public schools and private prisons expose inner-city children with risk factors to distasteful mixtures of human depravity, bondage, and isolation, as well as unnecessary cruelty, violence, torture, sexual molestation, humiliation, physical abuse, and death. In the United States of America, children with behavioral issues are treated in prisons regardless of their age, diagnosis of mental illness, and lack of appropriate comprehensive evaluation. How effective has that been?

A study of 35,000 former Chicago public school students (4), completed by Anna Aizer of Brown University and Joseph Doyle Jr. of the Massachusetts Institute of Technology, showed:

Unsurprisingly, going to jail as a kid has “strong negative effects” on a child’s chance to get an education. Youth that went to prison were 39 percentage points less likely to finish high school than other kids who were from the same neighborhood. Even young offenders who weren’t imprisoned were better off; they were thirteen percent more likely to finish high school than their incarcerated peers.

 

More surprisingly, given that prison is supposed to deter crime, going to jail also made kids more likely to offend again. Young offenders who were incarcerated were a staggering 67 percent more likely to be in jail (again) by the age of 25 than similar young offenders who didn’t go to prison. Moreover, a similar pattern held true for serious crimes. Aizer and Doyle found that incarcerated youths were more likely to commit “homicide, violent crime, property crime and drug crimes” than those that didn’t serve time.

These findings are particularly troubling given that kids are often sent to the criminal justice system for relatively minor offenses.

The prefrontal cortex of a child does not fully develop until around 25-30 years old. Incarcerating children for mistakes – such as drug possession or bullying – teaches the wrong lessons, stunts personal growth, and exponentially increases baseline risk factors for children. Prisons create more risk factors and ensure children fail by limiting their paths to one of darkness, without opportunities for light, often ever again.

Children cannot communicate their feelings as well as adults, so they do what children do best: act out.

Public schools, soon to be charter schools, are similar to private prisons, cataloguing children by name, rank, and future potential inmate ID. Public school pipelines to prison are well-funded, lucrative, and powerful alliances that exploit children, families, and communities by turning the lights off on brighter futures while damning innocent children to lives of deep psychological pain.

Are teachers and educators listening to their customers? What are children telling teachers and educators? Few teachers take time to listen or inquire, and we have few indicators to measure student satisfaction with education.

Are teachers better educators with children in prisons instead of classrooms? How can teachers and educators create positive school climates?

How much does the average inner city class size shrink due to imprisonment of students by the end of the year? What is the impact of these policies on other students?

A system of care approach that applies Big Data is a scalable and fully customizable model for making education relevant and appropriate, leading to healthy, productive children.

Our culturally diverse country makes one-sized education to fit all communities unpalatable and irrelevant for many cultures. A system of care approach empowers communities to set priorities around needs of children and their families while employing resources within the community.

A system of care approach is one of many collaborative approaches to education and metrics that empower communities through community participation and engagement.

Armed with Big Data, education and law enforcement will be more responsive to communities, which will be more informed… I hope.


 ***

References

  1.  What Is IDEA?

http://www.ncld.org/disability-advocacy/learn-ld-laws/idea/what-is-idea

  1.  What is a System of Care?

http://www.thefamilygateway.net/supports-services/system-of-care/what-is-a-system-of-care/

  1.  United States Citizens Justice Database 

https://failuretolisten.com/2014/07/01/united-states-affluenza-and-genocide-online-database/

  1.  STUDY: Throwing Kids In Jail Makes Crime Worse, Ruins Lives

http://thinkprogress.org/justice/2013/06/17/2166481/study-throwing-kids-in-jail-makes-crime-worse-ruins-lives

  1. Prison Reform Benefits Education Reform  Part 1

 https://failuretolisten.com/2014/07/18/prison-reform-benefits-education-reform/