The CAPC/CPNP Think Tank: Maximizing Parental Involvement

On March 23 and 24, 2000, the Community Action Program for Children (CAPC) and the Canada Prenatal Nutrition Program (CPNP) sponsored their first "CAPC/CPNP Think Tank" in Ottawa. CAPC and CPNP support a range of community action programs and services for pregnant women and children living in conditions of risk across Canada. The Think Tank was funded by Health Canada under the CAPC/CPNP National Projects Fund, which funds projects that support the objectives of the programs and directly benefit CAPC and CPNP projects across Canada. The model for this unique event was conceived by program consultants at Health Canada, and was then further developed by a team from the Centre for Health Promotion, University of Toronto. (Additional information on CAPC, CPNP and the National Projects Fund is also available on the Division of Childhood and Adolescence website.

The CAPC/CPNP Think Tank brought representatives from 38 CAPC/CPNP projects together with community-based participatory researchers to discuss four important issues of common interest to CAPC/CPNP projects being implemented across Canada. The four issues that were addressed were:

• Maximizing parental involvement
• Reaching and maintaining the focus population
• Factors that contribute to an increased breastfeeding rate in the CAPC/CPNP population
• Partnership and intervention in dealing with child abuse prevention

In order to ensure that the outcomes of the Think Tank were meaningful to CAPC/CPNP projects, an Advisory Committee with representation from projects, as well as regional and national Health Canada staff, designed and shaped the event. This included identifying the priority issues that were addressed during the Think Tank, nominating the researchers who participated in the process, and nominating/selecting projects which had demonstrated innovation and expertise in one of the four issue areas.

The Think Tank resulted in the production of four papers (one on each issue), which integrate the experience and expertise of the project representatives and the community-based participatory researchers. A fifth paper provides an overview of this unique, experimental model and the process that was used to produce the results.

This topic addressed moving from relating to parents and pregnant women as participants to seeing them as partners. What are the strategies, challenges, innovations and outcomes for involving parents in program development, delivery, management and evaluation?

What the community said

. Learnings

The group which dealt with Maximizing Parental Involvement identified three key "learnings" that, together, constitute a recipe for success for involving parents as partners in CAPC/CPNP programs. These three learnings are:

1. Parent-centered Philosophy and Belief System
2. Resources
3. Flexibility

First Learning: Parent-centred Philosophy and Belief System

Establish a belief system or philosophy with written guidelines and policies that establish ways of working and create a culture where parents are valued as partners and are considered to be the key players in program development, management, delivery and evaluation.

A CAPC/CPNP Centre offers a place where people can learn how to be nurturing parents.^{1In this context, "parent" can also be interpreted as meaning "primary caregiver".} There is a sense of "community" in successful programs.

"Nothing for the people, without the people."

"This is a program by families, for families, and with families."

To successfully involve and relate to parents as partners, first and foremost, the organization must work from the basis of a core philosophy which is incorporated in the belief and value system, mandated in policy, demonstrated in action, and reflected in the environment.

Some of the most successful programs are often started by parents themselves.

In many cases, fifty percent of the members of the Board must be parents from the community. Board meetings are conducted in a comfortable manner and everyone is encouraged to have their say.

Life experience is highly valued during the hiring process. Some centres only hire people from the community. This reflects the belief that, when it comes to parenting, parents are the experts, although other professionals also play an important role. The staff have to be able to work within a family-centred model and respect parents as the leaders and decision-makers when it comes to programs and services for their child. For example, a nutritionist has to understand that good nutrition on a parent's income maybe challenging.

Staff have to "fit in ". Those who do not are either not hired or tend to stay on for only a short period of time. In some cases, the parents themselves do the hiring.

"The one who lives the situation is the expert."

In some centres, staff are not permitted to hang their diplomas on the wall.

Sensitization training is sometimes offered to staff from outside agencies. One centre developed a "Reality Game" as a teaching tool for partnering agencies. Players have the opportunity to "walk in someone else's shoes" and experience the life of one of the participants. (This means trying to manage scenarios with the same level of resources that a participant would have.)

Parents must be valued both as experts and as human beings. We must recognize that each one has unique qualities and talents, and something of value to contribute.

"Rather than labelling parents as 'at-risk' and 'needing help', we assure them 'contrary to what others may have told you or what you believe to be true about yourself, you are valuable and in fact we need you. And you can consider this to be your place'."

"Right from the very first introduction to the centre, we build self-esteem by doing a personal skills assessment. We ask questions like, do you knit? Can you make bannock? Would you be interested in teaching others how to make bannock?"

For, example, in some programs, participants are required to contribute a minimum of ten hours a year. This stems from the belief that everyone has something of value to contribute, which in turn enhances self-esteem and ownership.

In one project, the mission and philosophy stem from the belief that we are investing in Canada's future. It is recognized that parents are doing the best they can with what they have at that time, based on their life experience. If you want to help someone, you have to start where they are and respect their "map of the world".

This is about creating an environment where people can empower themselves.

Successful organizations that have parents as partners seem to work differently from those that do not see parents as partners. Their organizing priorities are different. The process and programs are inclusive. In many groups, the decision process and the action process are the same. Everyone has the opportunity to participate at every level, with the goal of encouraging and facilitating both representation of and leadership by the parents. All contributions are welcome, and appreciated. The attitude is one of collective ownership. Ways of being, thinking, doing and working are different from the more traditional service model.

The language is different. Some centres eliminate "client like" terminology. One centre uses the term "Working Group" rather than Committee. (Working Group is seen as more action related and participatory, allowing parents to participate in meaningful ways.)

Open communication is critically important. The emphasis is on relationships. Building rapport and creating trust are essential to the success of the program.

An "open door policy" is practiced. Face-to-face outreach and "word-of-mouth" recruitment are considered very effective. For example, a coordinator may go door-to-door inviting people to come to the centre. Parents play an important role in outreach activities by bringing other parents to the programs.

Partners are not only parents. Sometimes, a partner is someone giving back their expertise and time to the community. Some centres recognize the participation and involvement of these partners by holding annual volunteer appreciation events.

The process of involving parents as partners is continuously evolving, but the benefits of running a community-based program like this are enormous.

Second Learning - Resources

Organizations working in partnership with parents must have resources and supports that adequately allow for time, human resources and other supports.

"We have 10 people sitting around the table who are doing it within budget. But, in fact, that isn't true, because many are doing their paperwork at home on their own time. That work isn't being compensated so it can't be considered within budget. And this doesn't even include the work parents are doing as partners."

Resources (both time and money) are necessary to run a Parents as Partners program in a fair and equitable way. Currently, some centres struggle to maintain the required knowledge and supports. From a staffing perspective, flat budgets over the past seven years have meant no room for cost-of-living increases, benefits, pensions, etc. From a volunteer perspective, resources are tight or unavailable. In order to adequately support volunteers, ideally some provision should be made for reimbursing their out-of-pocket expenses.

One program reported that it provides services to approximately 300 to 400 families per year, with approximately 15 employees paid for 200 hours a year. However, in reality, these employees probably work between 500 and 600 hours a year. This translates into several hundred hours of staff work that is actually contributed on a voluntary basis. This is an illustration of the level of staff dedication and commitment that exists.

"Health Canada gets a great return on their investment."

Program management is highly dependent on the skills and training of the project coordinator. To attract and keep qualified people, projects need appropriate funding levels to provide adequate salaries that reflect job descriptions, education, experience, abilities and levels of responsibility. However, in the field, coordinators are often paid much less than others in similar positions in their community.

Even if there were an increase in budget, there are competing priorities and there is always a trade-off between covering administrative costs, increasing program activities and reducing waiting lists.

In addition, resources are required to support a number of important activities and services:

• Childcare and transportation costs to allow parents to come to the programs. Many parents cannot afford to pay for such services out of their current budgets.
• Honoraria. The defining line between "staff and "parents" becomes unclear when parents are considered to be truly partners. They should receive some monetary compensation.
• Social events. These are important opportunities to attract and retain parents. These event programs break down the social isolation felt by parents with young children.
• Progressive training opportunities for partners, such as Orientation, Leadership, Facilitator, Board roles and responsibilities, and skills development (e.g., speaking and presentation skills; writing and document preparation; computer skills).

Skills development and training increases self-esteem and equips participants to take on meaningful work opportunities as full partners in the organization. Participants can represent the centre and make presentations; prepare documentation using desktop publishing skills; and write pamphlets and brochures to inform others about the program. Moreover, skills development and training helps to prepare participants for the labour market.

The staff's role is to develop the opportunities, do the paperwork, to help build the confidence level of the parent-partners and to act as coaches and mentors.

Third Learning - Flexibility

Flexibility is a guiding principle of CAPC/CPNP. Sites are responsive to the communities they serve and are able and willing to try different strategies to meeting particular circumstances and changing needs of children and families. As a result, projects build flexibility into all aspects of their work and are discovering innovative ways to meet challenging objectives. In order to continue to be effective, the flexibility of projects cannot be compromised by external needs and requirements, such as evaluation.

"In order to respond to the diversity of communities across Canada and the particular circumstances and changing needs of children and families, CAPC/CPNP programs must be flexible."

Current CAPC/CPNP guidelines do in fact mandate flexibility. It is important that this element be maintained rather than imposing rigid models.

CAPC/CPNP programs are community-driven. Allowing people to empower themselves is the critical success factor.

The flexibility principle applies to the way the programs are run. For example, to encourage families to participate at meetings and other functions, some projects provide meals, on-site childcare, and transportation. If this is not feasible due to space confinements, the centre might hold their Board meetings during lunchtime when it is less hectic for families or provide childcare reimbursement.

Flexibility also applies to programs and outreach activities. In the Yukon, there are many First Nations' projects making cultural sensitivity an important aspect of program delivery. For example, they have a "Mother Moose" program instead of a "Mother Goose" program.

To build rapport with parents, the centres do some things that might be considered unconventional, such as helping to fold the laundry during site visits, or accompanying the family on fishing excursions in order to learn about their cultures and traditions.

"If you don't have rapport, them you don't have thier trust and they won't come to our center"

Last but not least, flexibility must be reflected in the evaluation process.

In the CAPC/CPNP way of working, priority is placed on human relationships. In keeping with the flexibility principle, the government may need to alter the evaluation criteria to meet the needs of partners/parents in the community. The evaluation process needs to be more flexible. Flexibility is also the key to program objectives and structures, for the same reason.

"You can't promote flexibility within programs and then expect rigidity in measurement of outcomes."

The programs have developed a culture where making mistakes is seen as a learning opportunity. Rigid evaluation criteria may fly in the face of this type of culture.

An evaluation "tool kit" could be developed, containing a variety of measuring methods that would allow for "a mosaic of evaluation versus one picture". For staff, the assessments are not usually culturally sensitive. Staff struggle to write "plain language reports", with varying degrees of success.

Challenges to Maximizing the Involvement of Parents as Partners

Think Tank participants identified three main challenges to achieving the objective of including parents-as-partners:

First Challenge: Professional's mind set²

2-Although "professional" was never clearly defined, it can include the following groups: (bureaucrats, researchers, social workers, program practitioners, nurses, dieticians, recent graduates, staff from other agencies, other child care experts etc.)

"There is a lot of resistance by professionals to change their ways; which is interesting when you think that part of their job involves trying to get others to change their ways."

Practitioners frequently seem to be caught up in the process and the agenda, and in counting the number of participants to meet evaluation criteria. It may prove difficult to change this mind set when, only too often, practitioners are spending so much of their time "putting out fires".

It would probably be easier to initiate the right philosophy and thinking from the outset, rather than to try to change in mid-stream. A mentoring program could be initiated where projects that have been more successful at relating to and involving Parents as Partners could mentor other programs.

The main challenge facing staff is how to involve families in crisis as partners? A family in crisis does not usually have the extra energy or resources to give back.

Finally, the process used to bring participants on board may be a barrier to parental participation. For example, in projects where registration cards/forms are used, there appears to be some resistance to completing these forms.

Second Challenge: Resources

The time required for involvement may become a barrier to participation for parents. Resources, both human and financial, often limits the project/program activites.

Third Challenge: Evaluation and Tracking

"Sometimes there is confusion between accountability and success. Accountability is important in the process, but it does not in reality measure success."

"You can't count these families like chickens."

There can be a perceived level of intrusiveness in the role of evaluation. The challenge may be to clarify the objectives. If the program funders/sponsors are not clear about their goals, it is very difficult to track or measure success. Moreover, it is important to define what is meant by "appropriate" involvement of parents as partners. How do you define partnership and success? And, according to whose values?

"You can measure empowerment in different ways, yet a variety of tools can ascertain the same things"

"Context can never be avoided."

Research Questions

The working group members identified a number of important areas of research that are required to support the learnings, keeping in mind that there may be different motivations between and among funders, staff and the parents themselves for wanting to involve parents as partners. The bottom-line question then becomes, how do we negotiate the differences?

• What are the optimal indicators to reflect participant involvement as a "partner"?
• What kind of staff characteristics (skills, attitudes, beliefs, behaviours, experience, etc.) improve participant involvement as a partner?
• What are the optimal ways to actualize parental involvement?
• What are the best practical supports and material resources needed to maximize parental involvement?
• What milestones can be identified to help project participants mark where they are in terms of achieving parental involvement outcomes?
• How best can the necessary flexibility in all levels of the CAPC/CPNP program, including the evaluation process, be ensured to allow for and foster parental participation?
• How does each individual project effectively document the success of parental participation?

Production of this document has been made possible by a financial contribution from the CAPC/CPNP National Projects Fund, Health Canada.

The views expressed herein do not necessarily represent the official policy of Health Canada.

Working Group Members

Sterling Carruthers

Kids West,

Prince Edward Island

Joy Comeau

Family Resource Centre (SJ) Inc.

New Brunswick

Leona Corniere

Child Development Centre

Yukon Territory

Dilly Knol

Andrew Street Family Resource Centre

Manitoba

Sue Lebrun

Our Children/Our Future

Ontario

Angela Mann

Al Ritchie Family Wellness Project

Saskatchewan

Edna Olsen

The Children's Centre/Food for Two

Alberta

Debbie Smith

Bridgewater Family Support Centre

Nova Scotia

Gae'le Trebaol

APEP - Association des Parents d'Enfants

Prematures du Quebec

Quebec

Researcher: Yann Lebosse Universite Laval Quebec

Advisory Committee Member: Anita Ducharme Abinotci Mino-Ayawin Manitoba

Advisory Committee Member:

Dominique Parisien Health Canada (Quebec Region)

Literature Review, What the research says..

Summary

Maximizing Parental Involvement in Community Initiatives: Towards a Necessary Negotiation for Mutual Perspectives

Prepared by: Yann Le Bossé

The literature review examined the link between the learnings that CAPC/CPNP project staff have gained from their experience and the knowledge available on community involvement in the recent literature.

First, the issues associated with maximizing parental involvement are clarified. Three types of factors have been identified:

• Factors related to sponsors and service planners
  Project staff and other stakeholders view the development of an effective partnership with parents as one of the keys to the success of their initiatives.
• Factors from the parental point of view
  Several studies stressed that community involvement is particularly beneficial for participants directly involved in activities and decisions (Rutten and al, 2000; Speer, 2000).
• Democratic factors
  The reinforcement of the potential of all community players directly contributes to the revitalization of local democratic processes and to a fairer distribution of available resources.

The three main success criteria for success identified by the Think Tank participants are analysed in light of the recent literature.

Note: This is a translation of the Literature Review, which was originally produced in French.

First Success Criterion

To adopt a practice framework that is based on the improvement of parents' skills and on their role with children.

Think Tank participants asked three questions and the author tried to answer these questions based on information currently available in the literature.

• What are the professional qualities (skills, attitudes, beliefs, behaviours, experience, etc.) that are likely to encourage the involvement of parents as partners?
• The project staff who have been most successful in maximizing parental involvement:
• Believe that their expertise in and of itself is insufficient for successful intervention and that parental knowledge and skills are essential;
• Accept parents "as they are," i.e., do not require them to follow a rhythm, a format or rigid collaborative methods;
• Put as much effort into stimulating individual and collective parental action as into achieving results;
• Feel a sense of competence in their ability to understand, translate and validate parental and community needs.

The optimal methods for maximizing parental involvement rely on:

• Explicitly taking parental needs into account;
• True negotiation with parents to develop a strategy for action that takes their daily concerns into account;
• A thorough understanding of the potential costs and benefits associated with parental involvement;
• The constant development of new opportunities for involvement which are adapted to parents' lives.

Some of the most appropriate indicators of parental involvement are:

• The use of reinforcement methods for parental involvement that assess potential involvement within the milieu (behavioural perspective);
• The use of a communications strategy specifically aimed at reaching parents (social marketing perspective);
• A strong partnership between the various community stakeholders (ecological perspective);
• The organization's ability to develop opportunities for involvement compatible with parental needs (pragmatic perspective);
• The increase of parental involvement in five specific areas of organizations:
  1. contribution to needs identification,
  2. exercise of leadership,
  3. contribution to organization,
  4. mobilization of resources, and
  5. management of the organization. A further indicator is the priority of orienting organizations towards the less fortunate members of society (citizenship development perspective)

Second Success Criterion

Availability of resources

The analysis of this criterion led the Think Tank participants to the following question:

What are the practice conditions and material resources required to maximize parental involvement?

An examination of the literature on community involvement reveals that the question of inherent costs in this type of social practice has not been systematically investigated. And while the striking lack of resources is constantly being pointed out, exactly what resources are required for the success of these initiatives has yet to be established. Since there is a lack of information in this area, programs tend to be systematically under-funded, thereby reducing their potential impact.

Third Success Criterion

Flexibility

While the Think Tank participants appreciated that flexibility had been built into the CAPC/CPNP program, they also emphasized the inappropriateness of the evaluation procedure that accompanied these programs. Unanimously, the use of a single procedure that focuses on very general indicators and that uses tools too broad to be sensitive to different contexts was deemed inadequate. The participants believed that this evaluation procedure reveals rigidity in the design and application of success criteria that seems incompatible with the required flexibility of all aspects of these initiatives. The analysis of this question first illustrates the necessity to distinguish three specific functions of evaluation:

• Accountability
  This relates to ensuring that the funds are spent appropriately and that they have an impact on the targeted objective.
• Support for action
  This relates to informing the stakeholders about the strengths and weaknesses of their activities with respect to the targeted objective.
• Increasing knowledge
  This relates to gathering lessons from a given initiative in order to apply its conclusions to a group of similar procedures and to increase the understanding of the observed change.

Without such a clarification and a direct but explicit negotiation of these different factors between all stakeholders (participants, professionals, program planners and managers, designers and scientists), there is significant risk of introducing an evaluation procedure that is less likely to fulfill its function. Contrary to what one might think, the rigidity of the evaluation tools and documentation put forward by the Think Tank participants is not inherent to the need to rigorously document the activity. Instead, it is the result of a dysfunctional opposition between the different factors involved.

Four questions were asked by the participants on two distinct themes:

How can the principle of flexibility inherent to CAPC/CPNP programs be reconciled with the evaluation process?

and

What methods would ensure the flexibility necessary to all levels of efforts to increase parental involvement, including evaluation procedures?

After a survey of the various philosophies of program evaluation, and following an analysis of CAPC/CPNP initiative goals, it was proposed that:

• A consultative evaluation procedure be adopted in order to optimize the involvement of all stakeholders;
• A relativist (as opposed to objectivist) approach to evaluation be adopted (Stufflebeam, 1994);
• A procedure be chosen that is likely to foster the development of people's and communities' power to act (empowerment evaluation) (Fetterman et al., 1996). This is composed of four major steps: 1) assess the situation, 2) identify objectives, 3) determine strategies and help participants develop their own strategies for reaching their objectives, 4) determine the nature of the information needed (indicators) to credibly document the progress made in attaining previously identified objectives.

Are there tools that would help program managers assess their progress with respect to parental involvement?

and

How can programs efficiently document the success of their efforts to involve parents?

An analysis of the literature shows that there are few tools that can directly illustrate the progress of parental involvement. On the other hand, certain parameters can be identified to help professionals create a "control panel" of parental involvement in their organizations.

• It is essential that the instruments used not be intrusive (i.e., that they do not force parents to divulge information they wish to keep private).
• It is important to select indicators according to defined objectives related to parental involvement. A general measurement of involvement is not useful if it does not accurately reflect the expected impacts of the initiative.
• The assessment of involvement indicators is relevant only when it is systematic and carried out over a long enough period of time.
• Among the potentially applicable indicators are:
  1. an increase in opportunities for involvement,
  2. the levels of decision making accessible to participants,
  3. the number and length of the activities in which parents are involved, the representativeness of groups and leaders,
  4. the sense of belonging felt by community members,
  5. the parents' sense of satisfaction with their involvement, and
  6. the level of achievement of long-term objectives.
• The analysis shows that the most practically available tool for assessing the improvement of parental involvement within an organization is probably the method developed by Rifkin et al. (1988) and expanded upon by Bichmann et al. (1989).

Finally, several recommendations are made for deepening the understanding of increasing parental involvement.

Main Recommendation

That all conditions for success of CAPC/CPNP programs (preferred practice methods, optimal funding mechanisms, expected results, appropriate evaluation methods, etc.) be listed and organized in order to define a reference framework that will maximize the effectiveness of these programs.

Consequently, it is necessary to:

• Expand the knowledge and practices relative to practice methods that are most likely to contribute to program effectiveness while recognizing the need to adopt an approach centred on the respect of different forms of expertise.
• Expand the knowledge and practices relative to optimal financing mechanisms for this type of program by taking into account all costs inherent to program implementation within the community.
• Expand the knowledge and practices relative to outlining the types of effects that can legitimately be expected once a community initiative has been implemented.
• Expand the knowledge and practices relative to evaluation procedures that explicitly take various contexts into account, that use tools adapted to the specific characteristics of the community and, above all, that prioritize effectiveness over the increase of knowledge.

Maximizing Parental Involvement in Community Initiatives: Toward a Necessary Negotiation of Mutual Stakes^{3.This study received financial support from the Centre for Health Promotion, University of Toronto.,4.The author would like to thank Ms. Annie Lefebvre for her contribution to the preparation of this text.}

Yann Le Bosse^{5.Assistant Professor in the Department of Education Foundations and Practices, Laval University.}

"The obstacles to parental involvement are not the result of incompetence, but rather of the partners' inability to let this involvement emerge. "

Debbie Smith, Director of the Family Support Centre in Bridgewater, Nova Scotia

In March 2000, at a meeting organized by the Centre for Health Promotion, University of Toronto on behalf of Health Canada, four groups of project staff involved in implementing the Community Action Program for Children (CAPC) and the Canadian Prenatal Nutrition Program (CPNP), discussed the lessons they had learned. Each group was accompanied by a researcher assigned to contribute to the proceedings on the basis of the available scientific knowledge. One of these working groups had the theme of "maximizing parental involvement." This group included representatives from nine CAPC/CPNP projects, recommended on the basis of their success in this area by the Advisory Committee responsible for planning the Think Tank. These individuals participated in two four-hour sessions to share information on the main lessons learned from their experiences in the field. An interpreter and a note taker also took part.

The first task of the participants was to determine the most important lessons learned from their daily experiences with parents using the following question: "From your point of view, what worked and what did not work in your efforts to integrate parents as partners?" Thereafter, they were asked to formulate these lessons as essential criteria for success in their work. Finally, they had to select the three most important criteria among all those mentioned, based on three specific indicators:

1. that the lesson was deemed important by all participants,
2. that it dealt specifically with conditions for successful parental involvement in programs, and
3. that it could be the subject of a systematic survey within the context of a study.

Thereafter, the participants were asked to debate these criteria further and raise questions for research upon which a process for deepening the knowledge might be based through an analysis of the literature available on the topic. The purpose of this literature review is to document these research questions further and to identify other potential lines of research. The three criteria for success selected by the participants are identified and described. Thereafter, the research questions formulated by the Think Tank participants are studied in light of the available literature.

Toward a Necessary Clarification of the Stakes Related to Parental Involvement in Programs such as CAPC/CPNP

As mentioned by Anderson (1998), the motives of sponsors and program staff for community member involvement are sometimes based on very different objectives. Thus, in the context of educational institutions, it is not uncommon for the involvement of parents and other community members to be seen as a way of legitimizing decisions made by institutions that have been questioned by the public. The author uses the example of budget cuts made by central authorities while the management of these funds is left to local parent committees. In the context of health promotion initiatives, the importance of community involvement stems from a widening of the notion of "health" by the World Health Organization to include all social and environmental factors (Kar et al., 1999); Minkler & Pies, 1997; Rifkin, 1990). This widening has led program planners to integrate community involvement as one component of their local and decentralized initiatives (Rifkin et al., 1988). However, this involvement is often symbolic and limited to what Anderson (1998) calls a consumer philosophy of community involvement, in which community members only serve to legitimize the organization and ratify its decisions as "clients." However, experience has clearly shown that community support alone does not lead to better program performance and generates many adverse effects such as reinforcing the control by professionals and sponsors over the identification of problems and their solutions. This problem has been clearly identified and documented (Abrahams, 1996; Breton, 1994; Church, 1996; Fortin et al., 1992; Hildebrant, 1996; Lord & Dufort, 1996; Mason & Boutilier, 1996, O'Neill, 1992; Rousseau, 1993; Robertson & Minkler, 1994).

In fact, it is becoming clear that attaining the health promotion objectives of sponsors and professionals can only be achieved by forming close partnerships with community members. For programs like CAPC/CPNP, the issue of parental collaboration is crucial. Indeed, if program designers are concerned with the involvement of parents as partners, it is mainly because the development of child welfare in a community—whether it be of a preventive or palliative nature—cannot be limited to the professional intervention sector (Peters & Russell, 1994; Mundale, 1991). In other words, the improvement of child welfare cannot seriously be considered without the involvement of all community members. Therefore, parental collaboration is central, both to reaching children in need and to prolonging the effects of intervention in the family environment (Hahn & Rado, 1996; Hoover-Dempsey, & Sandier, 1997; Phillips Smith, Connrell, Wright, Sizer & Norman, 1997; Raffaele & Knoff, 1999; Wendy, Grolnick, Benjet, Kurowski, Apostoleris, 1997). This active and essential parental role immediately excludes the consumer-based approach since a simple after-the-fact validation of professional decisions is not sufficient to allow the intervention to achieve its potential impact in the medium and long terms (Robertson & Minkler, 1994; Rifkin et al., 1988). It then becomes imperative to lay the foundations for close partnerships with the parents, which implies an integration of parental concerns into programs since this is necessary to achieve true partnership (Arcury, Austin, Quandt, & Saavedra, 1999; O'Donnel et al., 1998).

Parallel to these strictly strategic factors, several studies emphasize the particularly beneficial character of community involvement for participants concretely engaged in the development of actions and decisions (Rutten et al., 2000; Speer, 2000). People who contribute personally to group actions and decisions develop a sense of competence and self-esteem and widen their notions of empowerment in the face of adverse living conditions (Bernstein et al., 1994; Kieffer, 1984; Le Bosse, Lavallee and Herrera, 1996; Le Bosse et al, 1999; Servian, 1996; Wallerstein, 1992; Lee, 1994; Cox, 1991; Friedmann, 1992; Moreau, 1990; Mullender & Ward, 1994; Serrano-Garcia, 1984; Simon, 1990). Active parental involvement in the design and development of community programs like CAPC/CPNP is therefore vital to the feasibility of these programs and beneficial for the general health of these people.

Finally, community involvement is also an issue from the standpoint of the development of democracy. For many authors, it is even the natural goal of any effort to involve community members (Anderson, 1998; Carroll, 1994; Prilleltensky, 1994; Rifkin et al., 1988). Reinforcing the potential for contribution of all community members plays a direct role in revitalizing local democratic processes and ensuring a fairer distribution of available resources. Often illustrated using the concept of "collective empowerment" (Andranovich & Lovrich, 1996; Bernstein et al., 1994; Labonte, 1989; Plough & Olafson, 1994), this concern with involving all interested parties in the identification of problems and possible solutions is today omnipresent in the broad sphere of social services and more specifically in the health promotion field (Bernstein et al., 1994; Minkler & Pies, 1997; Wallerstein & Bernstein, 1994).

The circumstantial convergence of these three categories of factors has forced many players to pay more attention to the mobilization and involvement of community members in community initiatives. However, the common interest in this issue has not necessarily resulted in similar points of view. As emphasized by many authors (Annie Casey Foundation, 1991; Fawcett et al., 1996; Grolnick et al., 1997; O'Donnel et al., 1998; Woelk, 1992), the greatest challenge in the area of community involvement is the harmonization of expectations and objectives among the various stakeholders (sponsors, program planners, professionals and community members) in order to foster a collective will that is strong enough to overcome the many obstacles that arise when trying to "mobilize a community" (Howell, Devany, McCormick, Raykovich, 1998).

It is within this context of pragmatism that this Think Tank session—and more particularly the debate on maximizing parental involvement—should be considered. The presence of different types of stakeholders (sponsors, professionals and researchers) concerned about developing solutions that are viable and that will satisfy the various stated objectives already constitutes a constructive starting point in the development of a coherent and effective collective strategy. As will be shown, the criteria for success identified by the participants will contribute actively to clarifying a basis for practice that will foster real partnerships between the different stakeholders.

First Success Criterion

Adopt a practice framework based on the promotion of parental skills and on their role with the children.

Like many authors (Bracht & Gleason, 1991; Brollier, Shephers, Richmond & Markley, 1994; Kar et al., 1999; O'Donnel et al., 1998), the Think Tank participants felt that increasing parental partnership requires a serious change in current professional practices in order to encourage parents to use their skills and to develop new ones. One participant pointed out that when a mother comes to her organization, the first thing she is asked is what her skills are so that she has an immediate opportunity to contribute to the collective effort. This example illustrates clearly one of the important issues in the development of real partnerships between professionals and parents. This emphasis on people's strengths is the cornerstone of any strategy aimed at involving parents in community initiatives (Arcury et al., 1999; Fiedler, 1991; Hahn & Rado, 1996; MacDonald, 1998; Middlestadt et al., 1997; Raffaele & Knoff, 1999; Waler, 1998). As will be seen later, this objective goes beyond the simple acquisition of new techniques and includes the entire definition of the professional's function within a community. For example, such an orientation requires a radical rethinking of the professional's notion of expertise. The participants' understanding of this issue was clear when they stressed that they consider the role of the professional to be more that of guide and teacher than of care giver. It remains that transforming the relationship between professionals and the people they try to help is not an easy task. Therefore, it is necessary to clarify the community practice conditions that will foster the optimal development of true partnerships with parents. Three main questions came out of the discussion:

• What is the professional profile (skills, attitudes, beliefs, behaviour, experience, etc.) that is most likely to encourage parents' involvement as partners?
• What are the optimal methods for maximizing parental involvement?
• What are the most appropriate indicators of parental involvement?

What is the professional profile (skills, attitudes, beliefs, behaviour, experience, etc.) most likely to encourage parents' involvement as partners?

Redefine and widen the notion of expertise

By definition, professional training leads to the development of a certain type of expertise that tends to be employed in situations requiring intervention. This is the cause of what Breton (1994) calls the "professional monopoly," i.e., the tendency of professionals to define problems in such a way that solutions depend on their expertise (Sarason, 1981). All studies dealing with ways to maximize parental involvement refer more or less directly to this problem (Anderson, 1998; Checkoway & Zimmerman, 1992; Fiedler, 1991; Raffaele & Knoff, 1999; Sviridoff & Ryan, 1997; Woelk, 1992).

However, this attitude can only be understood within the context of the value system with which these professionals identify. More specifically, the development of real empowerment and decision sharing between professionals and community members must be based on the principle that the involvement of community members in community initiatives is essential to the accomplishment of their mission (Berkowitz, 1990; Waler, 1998). However, this philosophy is in direct conflict with the professional values predominantly instilled in professionals during their training. These values stem essentially from a medical view of aid, with its tendency to place the entire responsibility of defining problems (diagnostic skills) and finding solutions (therapeutic skills) in the hands of professionals (Labonte, 1994; Weick, 1983). The people being helped are approached exclusively from the point of view of their deficiencies, which the professionals try to alleviate (Kretzmann & McKnight, 1993; Lee, 1994; Levy-Simon, 1990). Professionals are judged according to their ability to solve problems for and on behalf of those they help using techniques that they are supposed to have mastered (Brown, 1994). In this model of social practices, to give up some of the responsibility (and therefore power) for defining the problem and its solutions is to question the foundation of professional expertise. Today, this is one of the main obstacles to the development of true partnerships with the parents or other community players (Abrahams, 1996; Breton, 1994; McWhirter, 1994; Newton, 1996).

Similarly, sharing the power of expertise with non-professionals implies that the latter are able play their part. Thus, many authors recognize that this condition is not easy to fulfill. It is a process to which takes time and which depends a great deal on the professionals' ability to develop relationships of trust with participants (Arcury et al., 1999; Fiedler, 1991; MacDonald, 1998; Waler, 1998). Any previous negative experiences that participants may have had in their contacts with professionals, as well as the large cultural gap that can sometimes exist between professionals and participants, are also important obstacles to the establishment of the trust necessary to developing close partnerships (Raffaele & Knoff, 1999). To attain such an objective, professionals must undertake to change the values upon which their practices are based in order to create the conditions that will allow participants to truly take part in healthy and beneficial partnerships (Labonte, 1994; McWhirter, 1994).

Professionals as mediators of mutual support

Inescapably, professionals determined to modify their practices and broaden their circle of collaborators to include all potential stakeholders, must necessarily redefine their notion of expertise. Most of the problems mentioned by the authors relative to the development of close cooperation between professionals and parents stem from overvaluing professional knowledge and undervaluing parental knowledge (Anderson, 1998; O'Neil, 1992; Minkler & Pies, 1997; Waler, 1998). The reversal of this outdated hierarchy rests on widening the notion of expertise to include any type of human experience, regardless of the personal characteristics of the people who have acquired it (LeBosse, 2000). By definition, no one has a monopoly on such "experiential expertise," because it belongs to everyone.

Secondly, professionals must redefine the specific functions of their expertise (education, professional experience, etc.) within the context of the pool of expertise available through all stakeholders. As such, the work of Breton (1994a, 1994b, 1989), Mullender & Ward (1994) and Riessman (1990, 1985) meaningfully illustrates specific ways social practice professionals can contribute to the collective action while maximizing participants' opportunities to use their expertise. The main idea of the author's who took this view of

intervention is that professionals concerned about maximizing the use of people's knowledge should base their skills and performance on their success in stimulating the processes that lead participants to individual or collective action, rather than exclusively on the results of this action (Cox, 1991; Delgado-Gaitan, 1991; Wallerstein, 1993; Wilson, 1996; Yeich and Levine, 1992). Without losing sight of participants' accomplishments, professionals should concentrate their efforts on promoting actions that bear useful and constructive lessons.

Most of the authors who studied the difficulties of partnership between professionals and parents or other players in the community emphasized the importance of professionals' ability to use and reinforce community members' skills while respecting their availability and culture (Bracht & Gleason, 1991; Hahn & Rado, 1996; Phillip Smith et al, 1997; Shoo, 1991; Waler, 1998). This ability to play a mediating role between participants' latent skills, their realization and their development in the context of a progressive approach is certainly one of the most central skills in any process of maximizing parental involvement. However, it also requires a good deal of objectivity with respect to the rhythm and methods that go along with the development of these actions. These processes take time and patience, and their success is clearly incompatible with an overly aggressive approach (Annie Casey Foundation, 1991; Millet, 1996; O'Donnel et al., 1998; Howell et al., 1998).

In respecting differences and striving to highlight all participants' skills, mediating professionals gain a feeling of professional accomplishment from their ability to contribute to both the development of empowerment within the community and to the reinforcement of participants' desire to contribute to the collective action (Bernstein et al., 1994; Hahn & Rado, 1996; Philips Smith et al., 1997). They also see their skills in the light of their ability to understand, translate and validate the needs of the community (Abatena, 1997; Bracht & Gleason, 1991; Raffaele & Knoff, 1999). They see indicators of their performance in the overall increase of parental involvement in their organizations. As with Rifkin et al., (1988), they judge this involvement by recognizing the extent of community involvement in the organization, in terms of its actions, its overall orientation and its daily management. This sense of professional accomplishment is also experienced when their support is no longer required for the daily management of the initiative and when it becomes more and more possible to widen their scope of action. (Delgado-Gaitan, 1991; Lee, 1994; Millet, 1996).

What are the optimal methods for maximizing parental involvement?

As seen above, involving parents begins by taking their concerns into account when actually defining the goal of the initiative. (Howell et al., 1998). In other words, consulting parents on how they can contribute is essential to their involvement. (Delgado-Gaitan, 1991; Millet, 1996; Mullender, 1994). However, it must be noted that the application of this principle implies excellent awareness of the needs of the parents invited to participate. Waler (1998) illustrates this very well by emphasizing the importance of knowing parents' interests before determining the nature of actions in which they may be involved. A few examples of this author's recommendations are to:

• Associate opportunities for involvement and education with activities that stimulate parental interests.
• Concentrate on parental and community needs rather than those of the school or its personnel when creating opportunities for involvement.
• Create a database of the jobs, interests and affiliations of parents and community members.
• Identify participants according to the tasks and themes for which they show the most interest.
• Respect the cultural identities and life experiences of those who wish to involve themselves in the school.

In addition, numerous studies have examined the factors that contribute to community involvement from the standpoint of social exchange, based on rigorous cost-benefit analyses. First, these studies emphasized that, above all, parents have their own needs, which are sometimes independent from those of their children. The study by Prestby et al. (Prestby, Wandersman, Florin, Rich & Chavis, 1990) showed that the benefits associated with participants' involvement can be classified into three categories:

Material benefits: These are all tangible rewards that can be translated into monetary value (e.g., wages, increases in property value and information).

Solidarity benefits: These are primarily the products of social interaction such as socialization, the granting of new status, the opportunity to identify with a reference group, and what authors call "recognition," i.e., changes in perspective or ways of reasoning in the face of certain realities.

Purposive benefits (related to the goal of involvement): These are benefits that arise from a sense of achievement of supra-personal goals within the organization and inclusion in the community, a sense of doing one's civic duty, and the development of a sense of responsibility.

According to these authors, the benefits most often associated with involvement are those related to solidarity and mission. It would seem that such benefits are determining factors in the decision to participate. In an article analyzing the potential of cost-benefit management methods for stimulating community involvement, Mattaini (1993) confirmed the relevance of these methods with respect to the reinforcement of benefits. The conclusions of Prestby et al., (1990), support the idea that an approach that increases the tangible advantages of participating would have a good chance of success with parents. On the other hand, active involvement in an initiative also entails certain costs that should be minimized to make the most of all potential advantages. Furthermore, Prestby et al. (1990) proposes that these costs be determined according to the three previously defined categories:

Material or personal costs: These include time, effort and the loss of time for certain personal or family objectives. They also include investment in the skills and knowledge necessary for involvement as well any financial sacrifices this may entail.

Costs of solidarity: These are interpersonal conflicts, the lack of social support, and the weakness of other community members' interest or involvement.

Mission related costs: These are the disappointments and disagreements related to an organization's goals and activities as well as failures in communication or planning.

Interest in the involvement of parents facing difficult life conditions necessitates a consideration of the costs involved. For example, significant parental involvement will not occur if it entails material costs (Lauder, 1998; MacDonald, 1998; Woelk, 1992). Many authors have shown how the elimination of logistical barriers to participation is a determining factor in successful parental involvement (Arcury et al, 1999; Butterfoss et al, 1996; Fiedler, 1991; Hahn & Rado, 1996; Mattaini, 1993; O'Donnel et al., 1998). The main logistical obstacles mentioned by the authors were: difficulties in finding babysitting and adequate transportation, availability during the activities, participation in a language that is not well-mastered, and fear of going out at night. Other types of costs identified by Prestby et al., (1990), such as those related to commitment to a collective approach, can also be important obstacles for parents who want to get involved. These difficulties are both unavoidable and potentially very stimulating if they can be resolved using available or easily accessible skills and in a positive and secure climate (Butterfoss et al., 1996; Checkoway & Zimmerman, 1992; Fortin et al., 1992; Riessman, 1990, 1985). Another important consideration is that the targeted parents often have a poor view of their own skills to begin with and they may prefer to have a professional manage the change if they strongly perceive a risk of personal failure (Bracht & Gleason, 1991; Brown, 1994; Kar et al., 1999; O'Donnel et al., 1998).

This last factor highlights the importance of "taking parents where they are." This observation applies to both geographical and symbolic levels. On a geographical level, it is essential to develop strategies that encourage contact in places where parents normally meet rather than expecting them to travel to the program (Altpeter et al., 1998; Lauder, 1998; Linden & MacFarland, 1993; Mattaini, 1993; Mayer et al., 1998; Lauder, 1998; Linden & MacFarland, 1993; Mattaini, 1993; Mayer et al., 1998). On a more symbolic level, opportunities for involvement should be compatible with the profile and life experience of the parents in the community. Once again, the success or failure of a program can depend on the abilities of the people in charge to negotiate methods of involvement with parents and program designers that are mutually satisfactory (O'Donnel et al., 1998).

Finally, it should be stressed that the idea of "creating opportunities for involvement," which is omnipresent in the authors' recommendations, is based on the premise that such recommendations are by no means restrictive. In other words, it would appear that the success of parental involvement is more related to an increase in the number of opportunities to contribute to the collective effort than to the meticulous planning of a fixed program that requires regular attendance (Delgado-Gaitan, 1991; Plough & Olafson, 1994). Generally speaking, parental involvement is by nature changeable and dynamic. The fact that participant turnover rate is high does not mean that parents are dissatisfied (Riessman, 1990. 1985).

What are the most appropriate indicators of parental involvement?

Responding to this question requires a summing up of the theoretical models currently available in order to define the community involvement process. Mattaini (1993) suggests that knowledge of current behavioural theory be applied to the entire community involvement process. This approach is well-founded insofar as the search for positive reinforcement and the avoidance of negative reinforcement are important elements in the continuation or decline of community involvement (Raffaele & Knoff, 1999; Phillips Smith, 1997). Nevertheless, and consistent with a behavioural perspective, this contextual framework has little to offer in terms of the process of increasing parental involvement. The techniques proposed by Mattaini (1993) and other authors interested in community involvement from a cost-benefit standpoint are thus essentially useful for evaluating the status of parental involvement within an organization by using questions such as:

• Does the strengthening associated with parental involvement relate to their values? (Daley et al, 1989; Fiedler, 1991; Kaye, 1997; Mattaini, 1993; Olsen et al, 1989; Waler, 1998).
• Does the organization have opportunities or events (e.g., ceremonies) to highlight participants' contributions? (Bracht & Gleason, 1991; Carpenter, 1990; Landerholm & Lowenthal, 1993; Mattaini, 1993).
• Are the needs expressed by parents responded to in a manner that will maintain their motivation? (Carpenter, 1990; Hahn & Rado, 1996; Landerholm & Lowenthal, 1993; Olsen et al., 1989; Waler, 1998).

Similarly, the "social marketing" approach (Middlestadt et al., 1997) is an understanding of the promotion of both community involvement and healthcare in general from a commercial marketing perspective. This maybe very useful in the initial phase of canvassing since it develops tools appropriate for contacting parents through messages designed specifically for them. Several studies have shown that certain media (e.g., door hangers, brochures, articles about the program and its goals, church bulletins, etc.) can be excellent methods of recruiting parents (Altpeter et al., 1998; Arcury et al., 1999; Lauder, 1998; Linden & MacFarland, 1993; Mattaini, 1993; Mayer et al., 1998; Plough & Olafson, 1994). The same can be said about choice of location and opportunities to draw attention to the initiative or program (Butterfoss et al., 1996; Kaye, 1997; MacDonald, 1998; Mattaini, 1993; O'Donnell et al., 1998; Philips Smith et al., 1997). Undoubtedly, a detailed communication plan will only improve the canvassing effort and help maintain an active presence in the community. However, this approach does not assess the progress of an approach for increasing community involvement. To reach this objective, it is necessary to rely on studies more specifically dedicated to the study of increasing involvement.

Wandersman & Glamartino (1980) have developed an "ecological" model in which a community's environmental and social features form the context that determines the optimal conditions for involvement. In light of this comprehensive understanding of the factors that influence involvement, Chavis and Wandersman (1990) regrouped these determinants around the notion of "sense of community." After a number of studies on members of a neighbourhood association, the authors showed that the "sense of community"—measured using a questionnaire—proved to be the best indicator of the probability of respondents' involvement in their association. Although specific to the context of neighbourhood associations in a big American city, the results of these studies confirm the importance of working within a community to encourage the involvement of its members. Thus, developing partnerships with other organizations in the area or working toward the improvement of living conditions (health, transportation, etc.) contributes significantly to the social cohesion of a community and consequently encourages the involvement of community members (Checkoway & Zimmerman, 1992; Collora Flynn et al., 1994; Kaye, 1997).

Hoover-Dempsey and Sandier (1997) have developed a model of the parental involvement process in the context of partnerships with schools. This model attempts to illustrate how parental participation evolves toward greater involvement and increases the positive effects on their children's scholastic performance. For the most part, it is important to remember that the authors view the progression of involvement as a form of continuous negotiation between parental preference and availability and the true opportunities for involvement provided by the school. Therefore, this model confirms the importance of adjusting the opportunities for action to fit parental needs and expectations. This implies that when asking for the involvement of parents who face difficult living conditions, it may be necessary to respond to their urgent needs before considering any type of partnership with them. In other words, in order to achieve active involvement from underprivileged parents, it maybe necessary to concretely address the changes necessary to their life situations (O'Donnel et al., 1998).

From an even more dynamic standpoint, Rifkin et al., (1998) developed an observation grid for community participation levels based on progressive involvement toward a maximal level. The main concern of the authors was to develop a model for involvement that would allow for a comparison of different surroundings or different stages of the initiative. The authors defined involvement as

"A social process by which specific groups sharing needs in a geographical common region actively pursue the identification of their needs, make decisions and develop mechanisms to fulfill these needs." (our translation, p. 933)

Clearly, the authors considered that the goal of involvement was to contribute to the redistribution of resources to reach a greater equity. The authors used six factors to evaluate community involvement:

1. Contribution to defining needs
2. Leadership
3. Contribution to the organization
4. Mobilization of resources
5. Management of the organization
6. Prioritization towards the most underprivileged

The first five factors form an axis, the extremes of which correspond to total control by stakeholders and total control by professionals. The sixth factor cannot be evaluated. The major advantage of this model is that it allows the increase of community involvement to be assessed as the initiative is being implemented. On the other hand, it is clear that the adoption of such a model assumes agreement with the very strict notion of involvement held by the authors. However, independent of the authors' premises, an assessment of the community members' progress in taking control of the initiative is consistent with maximizing the psychological benefits associated with community involvement. (Checkoway & Zimmerman, 1992; Le Bosse et al., 1998; Rutten et al., 2000). Overall, the model proposed by Rifkin et al., (1998) is the most efficient tool currently available for deepening the understanding of the development of community involvement and its associated conditions.

Second Success Criterion

Availability of resources

Frequently during the Think Tank, problems related to the lack of available resources were raised in the discussions. All participants stressed the importance of volunteers in their practice because of the inadequacy of available funds. Several mentioned the inappropriateness—even the inconsistency—of soliciting parents as partners and in often being unable to remunerate them for their contribution. According to the Think Tank participants, the problem of under-funding is first and foremost a direct limit to the potential effectiveness of the process of maximizing parental involvement. Developing partnerships with parents requires time as well as personnel and other necessary resources. The lack of resources occasionally means making a choice between fairly remunerating professionals and offering services to a larger number of families (extending opening hours, number of daycare spaces available, etc.). This situation leads to underpaying the staff of these organisations even though they are often required to have a skill set equivalent, at the very least, to that of a middle manager in the civil service. Indeed, Think Tank participants mentioned that in certain areas of practice, the professionals were sometimes as poor as the parents they try to help. The participants also stressed the negative impact that this situation has on the viability of local initiatives. They also agreed that the overall investment necessary to foster true parental partnership is largely underestimated by the government representatives responsible for funding CAPC/CPNP programs. Only one central question emerged from this part of the discussion:

What are the practice conditions and material resources necessary for maximizing parental involvement?

The question of funding the program activities related to maximizing parental involvement is a concern that is clearly documented in the literature (Chilman, 1994; Hardina, 1994; Fortin et al., 1992; Rifkin et al., 1988;^x Segal & Kotler, 1993; Ozawa, 1994). On this subject, Rifkin et al. write:

In spite of the adherence (...) to the Alma Ata regarding the importance of primary health conditions, traditional notions of judging the success or failure of a health program in terms of the number of services provided and of overall health are still very meaningful. In a certain way, one of the reasons for this is because there are few factors on which an evaluation of involvement and equity can be based. (Our translation, p. 931)

This problem of determining the changes in community involvement explains in large part the reluctance of planners to invest in the processes of canvassing and coordination that are necessary for the development of sustained community involvement. The work of the Annie Casey Foundation (Annie Casey Foundation, 1991) on this topic is helpful in identifying the obstacles encountered by sponsors who fund community initiatives. The authors reviewed the seven-year financing of a huge multi-site program intended to improve the lives and development of young people. Many of the lessons they learned apply directly to the process of improving community involvement:

• Such initiatives require a great deal of time. Much more time must be given to the sites to build the partnerships that are needed to develop such an important initiative. It is necessary to ensure that all potential stakeholders are included, even if this complicates the collaborative process. The absence of important players can lead to difficulties when their particular involvement is required. Time is essential in this implementation phase, and cannot be replaced by grants, techniques, or recommendations, no matter how pertinent they are.
• It is not easy to foster local leadership. Care must be taken not to suppress this leadership because it is not viable in the long term. Everything (finances, evaluation, etc.) must be thought of as a function of strengthening this leadership.
• Carrying out an initiative of this type requires a constant effort to rethink and improve it. Such a project cannot be done without changes.

To the best of our knowledge, the real costs of a process for maximizing community involvement have not yet been thoroughly analyzed and documented. The extremely dynamic nature of this process as well as its great sensitivity to variations in context would make such an analysis extremely difficult. A detailed study of requests by professionals as well as a systematic comparison of projects of a similar nature (taking into account contextual specificities) could determine more precisely the baseline costs of implementing a process to increase parental involvement. In this sense, recommendations of researchers for the elimination of logistical barriers to parental involvement (child care services, transportation, tangible benefits to maintain motivation, etc.) already illustrate the costs inherent to increasing and maintaining such involvement. (Arcury et al, 1999; Lauder, 1998; O'Donnell et al, 1998).

Finally, the question of assessing the costs inherent to increasing parental involvement in community initiatives has yet to be extensively documented. In addition to necessary changes in attitude by planners and sponsors with respect to certain indicators, a more in-depth study is of the minimal material conditions for increasing and maintaining parental involvement initiatives such as CAPC/CPNP is needed. Without such steps, and given the costs of many of the conditions for success identified by researchers, the effects of this type of program may well be considerably mitigated over the medium and long terms.

Third Success Criterion

Flexibility

The Think Tank participants felt that it was essential that practice methods and performance standards be flexible if they are to meet the needs of program participants and adapt to the various cultural and regional contexts in which the programs are carried out. They also felt that one of the great strengths of this type of program—and perhaps the cornerstone—was the explicit recognition of the need to adopt a flexible approach in defining CAPC/CPNP programs. Nevertheless, the participants believed that it is necessary to adopt the same philosophy with respect to the evaluation of local initiatives. Think Tank participants would have liked to place the emphasis on relationships with parents rather than on standardizing their intervention procedures. They believed that recent evaluation procedures have taken an approach that is overly formal and insensitive to differences in context. The Think Tank participants hoped for the development of procedures measuring change that are simple and compatible with the current intervention methods. One participant highlighted the contradiction between promoting program flexibility and imposing a rigid approach to program results. Another participant mentioned their job was not simply to "count families like chickens." Four distinct questions emerged from this part of the discussion:

• How can the principle of flexibility inherent to CAPC/CPNP programs be reconciled with various evaluation procedures?
• What are the methods that would ensure the flexibility necessary to all levels of the effort to increase parental involvement, including evaluation procedures?
• How can programs efficiently document the success of their efforts to involve parents?
• Are there tools that would help program managers assess their progress with respect to parental involvement?

In fact, these four questions represent the overall challenge of assessing the strict but flexible nature of the activities funded by the programs. Therefore, it is necessary to ask these questions in the more general context of the debate concerning community initiatives.

"To improve not to prove" (Millet, 1996): from the necessary distinction between attribution, support for action and the increase of knowledge.

Although program evaluation is an increasingly widespread practice, its exact purpose is not always agreed upon (Stufflebeam, 1994). Should it simply render a systematic report of program results (Scriven, 1994), try to explain the mechanisms used to achieve the results, express an opinion of the program's intrinsic value (Stufflebeam, 1994) or promote the self-determination of the people being assessed (Fetterman, 1996)? These options, which are the ones generally put forth, are not equivalent and the debate on their respective value remains intense (Allard, 1993; Guba & Lincoln, 1990; Sechrest, 1994). Far from being purely academic, this debate illustrates the significant ambiguities upon which evaluation procedures are based. By serving as measures for management control, decision-making and scientific research, the role of evaluation procedures constantly fluctuates between verifying fund use, improving the program actions and the need to demonstrate the programs' intrinsic and extrinsic values (Legare & Demers, 1993; Millet, 1996; Stufflebeam, 1994). Any progress in considering the goal of a particular evaluative approach requires, above all, that the relative importance of each of these objectives be clarified.

Accountability

Since CAPC/CPNP projects are entirely funded by the Government of Canada (Health Canada), it is logical and consistent for the sponsor to ensure that allocated funds are used properly and efficiently. The goal of verifying fund management is, in general, simply to ensure the adequate use of allocated sums, an objective that is easily achievable through administrative audits. As the financial structures of local programs are relatively simple, this type of audit is relatively straightforward at the local level. The other aspect of attribution is more concerned with the issue of how efficiently funds are used. This aspect is even simpler because it deals with indicators that are easily observed and quantified. For example, the cost-benefit ratio of governmental investment in "back to work" programs can be studied by observing the corresponding reduction in the number of people who require last-resort assistance (Dechene, 1994; Gueron & Pauly, 1991). In the context of CAPC/CPNP projects, the use of such evaluation procedures will lead to the pursuit of indicators that allow this type of comparative format (e.g., increase/decrease of costs related to child health care). As indicated by Rifkin et al. (1998) in the above-mentioned excerpt such an approach quickly leads to an impasse in the context of programs based on community involvement. Therefore, it becomes necessary to develop indicators more in line with the reality of these programs, i.e., more directly related to the concrete measures taken in the context of these initiatives. Of course, the task then becomes much more difficult, but, as noted by Smith (1994), "programs are first designed to be efficient, not to make their evaluation easier." (our translation) In fact, this type of evaluation is feasible insofar as sponsor representatives agree to negotiate the evaluative methods with all stakeholders (Guba & Lincoln, 1989; Legare and Demers, 1993; Millet, 1996). When "macro" criteria are used unilaterally in evaluating costs and benefits, the results are often simple and simplistic, thus the conclusions produced by this type of analysis are likely to be broadly challenged.

Support for action

Another essential function of evaluation is to inform stakeholders of the efficiency of their activities and the methods used. Chen (1994) notes that this type of evaluation is essential to assessing the performance of social programs. Indeed, unlike programs aimed at producing specific material effects, the improvement of social program operation is a very important objective. In the context of social programs, understanding how programs work is essential to identifying improvements and, especially, sources of harmful side effects. Thus, steps toward a process of clarification cannot be taken as if the end product were the only goal. By definition, a "support for action" approach is aimed less at deciding on the "merit and value of programs" (Stufflebeam, 1994) than on the means to continuously improve them. In this case, evaluation is used more like a "control panel"—to give precise and regular feedback to those people dedicated to improving a program's day-to-day efficiency. Without such an evaluative approach, the conclusions drawn from other types of documentation are generally of little use to local players and are sometimes rejected out of hand (Guba & Lincoln, 1990). Furthermore, this type of evaluation at best partially responds to sponsors' legitimate concerns about costs and benefits. Once again, a common approach based on cooperation and true consideration of the various concerns is found through negotiation (Allard, 1993; Hembroff et al., 1999; Sviridoff & Ryan, 1997).

Increasing knowledge

Scriven (1994) states that it is essential to accurately distinguish the role of evaluator, who is specifically dedicated to assessing program value, from that of scientific researcher, whose primary objective is to develop general and theoretical knowledge that can be applied to observable phenomena within the context of these programs. This distinction is effectively important because, while not completely incompatible, the two roles have goals that are often contradictory. Guba & Lincoln (1990) have shown very clearly the risks associated with assimilating evaluation into the strict scientific process.

First of all, there is a fundamental debate within the scientific community on the concept of neutrality associated with any process of strict observation. Above and beyond the implications of adopting such a concept of research, Guba & Lincoln (1990) showed that any claims to neutrality are more or less heretical in the area of program evaluation. Even though many evaluators defend the relevance of this neutrality in evaluation (Stufflebeam, 1994), the authors did not see how it could be seriously practical since the function of evaluation is to assess (and therefore judge) the results or a lack thereof. The argument that these neutral examinations are directed only toward observable facts ignores the reality that these facts are themselves chosen on the basis of judgments and strategies that serve certain notions of efficiency.

Furthermore, the classic scientific approach leads to a dogged search for results that can be generalized and, consequently, it does not take into account the contexts of the programs under study. The necessity for standardization (i.e., identical regardless of context) greatly reduces the range of indicators that can be considered in the evaluative approach. Thus, what is "real" becomes limited to what can be "measured," and any aspect of a program that cannot be measured using the criteria established by the scientific process is excluded from the overall assessment of the program.

Finally, such a unilateral approach to defining "reality" leaves no room for negotiation, nor does it allow for dissent since the evaluator is simply responsible for the accurate application of the methodology, which supposedly reflects the true "reality" being studied. Evaluation thus becomes a divisive factor among those being evaluated, who have no means of modifying or adjusting its contents, there being no "valid" interpretations outside the given "scientific" approach. Moreover, as mentioned by Masse (1993), a quasi obsessive view of the merits of standardization often means that researchers can only draw upon a single group of variables (the pool of available tools being limited), which reduces that much more the analytical viewpoint provided by such an approach.

While the search for knowledge is commendable in itself, if this is the only goal of an evaluation approach, it runs the risk of restricting the vision of the reality being surveyed to the sole intellectual interests of the researchers or the general ambitions of the sponsors (Hembroff et al., 1999 Maloff et al, 2000; Masse, 1993; Smith, 1994). However, this does not mean that such a purpose is not relevant in an evaluative process. Indeed, it can be advantageous and sometimes necessary to be able to increase the understanding of how programs influence the reality. But first, it is quite possible to develop scientific processes that are reliable and thorough, while adapting them to the contexts in which they are used (Fawcett et al., 1996; Yin, 1993). Secondly, an evaluation methodology that is accurate and that has great scientific potential can be developed within a framework of partnership and still take into account the different needs of various stakeholders involved (professionals, planners, sponsors, etc.) (Allard, 1993; Guba & Lincoln, 1990; Fetterman, 1996; Smith, 1994).

As shown, the rigidity of the evaluation or documentation tools put forward by the Think Tank participants is not inherent to the need for thoroughly documenting the process. Instead, it is the result of a dysfunctional opposition between the different factors involved. In the context of CAPC/CPNP programs, whose effectiveness is based primarily on the vitality of community mobilization, it is essential to root evaluation in a framework of close partnership between all players (parents, professionals, program managers, planners, sponsors, etc). Millet (1996), the former Director of Evaluation for the K. W. Kellogs Foundation, clearly explains the reasons for choosing this type of cooperation:

(The challenges) are largely to reconcile methodological rigour with the desire to maximize program results. In other words, to solve the potential tension between program implementation and its effects. One must constantly strive to adjust the approach in such a way that it allows for a better alignment between the need to improve program effects and the need to demonstrate their effectiveness. (Our translation)

Clearly, authors agree that this approach is more difficult and requires more time and resources (Allard, 1993; Guba & Lincoln, 1990). However, it does provide the real possibility of developing a methodology that fulfills the requirements for both rigour and flexibility pursued by the various stakeholders involved in evaluating community initiatives. This standpoint also furnishes possible answers to questions asked by the Think Tank participants during this part of the discussion. Given the thematic overlap of the four questions, and to avoid redundancy, they will be dealt with in pairs.

How can the principle of flexibility inherent to CAPC/CPNP programs be reconciled with various evaluation procedures?

and

What are the methods that would ensure the flexibility necessary to all levels of the effort to increase parental involvement, including evaluative procedures?

As shown above, the theoretical notions of program evaluation are extremely varied and sometimes completely contradictory. The classification suggested by Stufflebeam (1994) clarifies the opposing points of view. The author classifies the different theoretical trends into two broad categories. The first is deemed the "objectivist" movement, based on the theory that "moral good" (state of mind) is "a referent objective and independent from the personal and merely human feelings and perceptions" (p.326, our translation). The author calls the second category the "relativist" movement because "the criteria used to evaluate a program depend on the beliefs, objects and particular preferences of the customer or other sponsors" (p. 325, our translation).

Whereas the objectivist approach aims to determine absolute or fundamental principles of truth (i.e., independent from individual contexts and points of view), the relativist approach prefers to define principles of truth relative to the reality being studied (i.e., taking the context and agreed-upon definition of the plan into account). In addition to fundamental differences between the two movements, the studies they produce are also very different.

In concrete terms, "objectivist" evaluations produce data on a limited number of predetermined variables to answer one or more specific research questions. These questions generally deal with highlighting impacts and identifying cause-effect relationships. The essential decisions regarding the nature of the indicators and the types of data recorded are made by the evaluator after consulting with the client-partners. Because of the selective and abstract nature of such surveys, the data produced by this type of evaluation is useful primarily to decision makers and scientists involved in research.

"Relativist" evaluations produce data on variables that are the consensus of all partners. The questions of the evaluation can deal as much with program improvement as with the measurement of impacts and the analysis of relationships between various aspects of the program. The essential decisions regarding the nature of the indicators and the types of data recorded are made in partnership (based on the sharing of expertise) with the evaluator and all stakeholders. Because of the consensual nature of the approach, the data produced by this type of is useful for all stakeholders (decision makers, professionals, etc.) concerned with improving the program, and for making decisions about the overall value of the program.

The flexibility so ardently wished for by the Think Tank participants excludes a priori strictly objectivist evaluative approaches for the simple reason that they are unilaterally applied regardless of context. On the other hand, relativist approaches (Stufflebeam, 1994, identifies 5 different ones) all take into account the influences of context on the evaluation methods. The main distinctions between the two approaches are to be found in the factors prioritized in the evaluation. Therefore, the approach proposed by Fetterman (1996) would appear closest to the Think Tank participants' concerns since it prioritizes the autonomy of the program's stakeholders.

Evaluation based on the principle of increasing the empowerment of people and groups.

Fetterman (1996) calls his approach "empowerment evaluation." Developed from a synthesis of his evaluation experiences and those of numerous other colleagues (many of whom are researchers involved in the development of evaluation in partnership with communities), this approach is defined as:

"The use of concepts, techniques and recommendations appropriate to evaluation to foster improvement (of programs) and self determination (of participants)" (Fetterman, 1996, p. 4, our translation).

This approach is particularly suitable for programs based on community involvement (Millet, 1996) and has four major steps:

Assess the situation

This step consists of determining the program baseline by asking the participants to evaluate, on a scale of 1 to 10, the quality of the different program components. In cases of program implementation, this step maybe used to identify partners' expectations of the program.

Identify objectives

During this stage, participants identify their goals for the program. Fetterman (1996) recommends that these objectives be formulated in terms that are clear and action-based. Similarly, identifying medium-term positions is more important than setting long-term deadlines.

Determine strategies and help participants develop their own strategies for reaching their objectives.

Strategies must be planned according to principles of teamwork and collective implementation. Program participants are generally in the best position to determine the applicable strategies. Adopting these strategies must be achieved through a dialogue with program designers and sponsors.

Determine the nature of the information needed (indicators) to credibly document the progress made in attaining the previously identified objectives.

A critical phase of the process, this step identifies the types of documentation associated with each specific objective. This is a long and arduous process but it helps to avoid disappointment and disillusionment when attempting to assess the effects of the program.

Obviously, such an approach is practical insofar as all stakeholders agree to collaborate in formulating a process of evaluation that reflects all concerns at issue. And while the initial development phase can often seem difficult and laborious, the subsequent implementation of proper regulatory and technical support mechanisms deals with most problems that arise (Fawcett et al., 1996). The advantage of this approach lies in how it develops a group of applicable indicators relevant to all stakeholders and generates a common basis for assessing the evolution of programs and their impacts. Its primary disadvantage is the slow and often cumbersome nature of the initial phases (i.e., before the development of the protocol for evaluation) compared to relativist approaches (Allard, 1993).

Are there tools that would help program managers assess their progress with respect to parental involvement?

and

How can programs efficiently document the success of their efforts to involve parents?

Several authors have studied practical methods of evaluating involvement, including Lauder (1998) who recommends carrying out interviews and collecting personal histories to describe the participants' views of involvement. This author also suggests using quantitative measures to determine the extent of involvement over a given period. Collecting demographic data may also be useful in determining the representativeness of program participants with respect to their community; however, this data should be treated in a sensitive manner when dealing with people wary of all forms of bureaucratic formalization (Lee, 1994). Generally, it is important to use only indicators directly related to stated involvement objectives (Maloff et al., 2000). For example, there is no point worrying about the length of activities if this indicator has no practical interest with respect to the purpose of the initiative. It should also be noted that taking such indicators into account is only beneficial if achieved systematically and for a sufficiently long period of time. The inconsistent or intermittent use of these tools will only result in extra work without providing any real benefits from an evaluative standpoint. Once these factors have been established, any number of indicators can be named, such as the number of opportunities for involvement, the level of decision making accessible to the participants, the number and length of activities dedicated to achieving established objectives, the representativeness of groups and leaders, the sense of belonging among community members, the sense of satisfaction with involvement, the degree of achievement of long-term objectives (Bracht & Gleason, 1991). Furthermore, it should be stressed that currently available studies on the influence of various involvement indicators on a set of psychological factors associated with empowerment show that these factors in particular foster action and responsibility, which contribute directly to the improvement of scores given by respondents (Israel, Checkoway, Schultz & Zimmerman, 1994); Le Bossé et al., 1998; McMillan, Florin, Stevenson, Kerman & Mitchell, 1995; Schulz, Israel, Zimmerman & Chechowayy, 1995; Zimmerman, 1995).

From the standpoint of the degree of parental involvement, and judging by the number of studies that it has inspired (Bichmann et al., 1989; Nakamura & Siregar, 1996; Taal, 1993), the method developed by Rifkin et al. (1998) is once again the most complete and practical tool for evaluating involvement. The fact that this method is specifically designed to assess how the process of involvement evolves rather than its direct impacts means that it is both extremely flexible and very accurate. The points raised by Bichmann et al., (1989) concerning classification criteria complement Rifkin's initial proposal and provide professionals wishing to use this tool with all the necessary information.

Conclusions

Obviously, the Think Tank participants' acknowledgements are reinforced by the work of scientists who have studied the community involvement question over the last fifteen years. This general point of convergence is a clear demonstration of the relevance of the knowledge acquired in the different surroundings of practice and ability to suggest a fruitful synthesis. Beyond this first point of convergence, the choice of three selected criteria constitutes a very pertinent contribution to the evolution of the research in this area. The insistence on the necessity to develop an approach centered on competencies, allows us to clearly further the debate on the different intervention models by orienting the efforts towards the development of practices that respect all the opposing expertises. Otherwise, the importance paid to the alignment of resource allocations with the real costs (in time, money, infrastructures, etc.) of these programs, emphasizes the necessity to open a debate on the optimal methods of funding community initiatives. The simple transfer of current rules for the other types of programs cannot be maintained without the difficulties mentioned by the participants enduring and directly threatening the efficiency of the effort made by all the partners. Finally, the necessity to maintain a minimal level of flexibility at all the stages of the program, including the evaluation, is also an important involvement contribution to the different actual opposing points of view in the literature. Identifying flexibility as one of the fundamental conditions of success of these initiatives clearly suggests on a redefinition of standards for the planning and applied to the community programs. The only way to go beyond the actual separation between the designer and evaluator prescriptions and the program efficiency requirements consists in promoting the development of a specific reference framework for all the initiatives that require taking root in the communities and the collaboration of community members. By stating the minimal feasibility conditions of a community program in all the areas of its implementation (intervention methods, optimal methods of funding, type of foreseeable impacts, compatible methods, etc.), such a framework would allow all participants to appreciate more precisely the feasibility of their project and their ability to satisfy the requirements for its success. Then, one may be able to see an irreversible change in our ability to successfully lead a global community development strategy.

Recommendations

In the light of the information obtained in this literature review, several recommendations can be formulated. However, as they all originate from the same recommendation, it is more relevant to present only one main recommendation and to consider the others as its convenient consequences.

Main Recommendation

That all the success conditions of CAPC/CPNP programs (intervention methods, optimal funding methods, type of expected impacts, compatible methods, etc.) be listed and articulated so that a reference framework be defined in order to maximize the efficiency potential of these programs.

Consequently, it is necessary:

• To develop the knowledge and practices relative to these intervention methods susceptible to contribute the most to the program efficiency while respecting the necessity to adopt an approach centred on the respect of the different expertise formats.
• To develop the knowledge and practices relative to the optimal funding methods of this type of program by taking into account all the costs inherent to the implementation period of the program in the community.
• To develop the knowledge and practices relative to the formulation of the types of impacts to be legitimately expected after the implementation of a community initiative.
• To develop the knowledge and practices relative to evaluation methods that can explicitly take into account the contexts, the use of tools adapted to the specific characteristics of the environment and mainly the priorization of the efficiency over the knowledge development.

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CAPC/CPNP Think Tank 2000 Common Themes and Observations

Common Themes and Observations: CAPC/CPNP Think Tank 2000

Each Think Tank Working Group addressed a specific issue, and identified "learnings" relevant to that issue. These learnings are reported, in the language of the participants themselves, in the individual Working Group reports. The hope is that these will provide insights, ideas and guidance to other CAPC/CPNP projects that are dealing with similar issues and challenges.

In addition to project representatives, each Working Group included an academic researcher with a particular knowledge of and expertise in community-based research. The role of the researchers was to link the experience-based learnings identified by the project representatives with broader, research-based findings drawn from well-known and well-respected national and international sources. Thus, each Working Group report is supplemented by a "literature review" conducted by the researcher following the Think Tank.

Over the course of the two-day Think Tank, project representatives emphasized that each project had its own dynamic and unique flavour. The culture of the local community, the demographics of the target population, the specific needs and life experiences of the participants (and of the staff) - factors such as these affect the way each project is designed, how it works, and what it achieves. In the context of a community-based project, the representatives cautioned, the critical success factors are flexibility and adaptability. A cookie-cutter, rigid methodology just does not work.

At the same time, however, a number of common themes and elements are evident throughout the four Working Group reports, regardless of the specific issue under discussion. These same themes and elements are identified in the literature reviews conducted by the individual researchers. Clearly, there is validity and consistency to the approaches and strategies of CAPC/CPNP projects across the country.

Some of these shared observations and themes, with representative supporting literature references, are summarized below. Please note that the themes are not "ranked" to reflect any order of significance.

The references identified here are representative only of the sources identified by the academic researchers who worked with each Working Group on the four issues discussed. It must be emphasized that each researcher provided extensive bibliographies of source material. These bibliographies are included with the Literature Reviews appended to each Working Group report.