Eliciting behavior change in a US sexual violence and intimate partner violence prevention program through utilization of Freire and discussion facilitation

Abstract

Designed by Migrant Clinicians Network, the Hombres Unidos Contra La Violencia Familiar (Men United Against Family Violence) Project used facilitated discussion groups as the method to encourage self-reflection and behavior change. Male participants were not taught to rectify any past sexual or intimate partner violence (SV/IPV) ‘tendencies’, rather the discussion facilitation allowed them to reflect on the SV/IPV that was present in their lives and in the Hispanic community. Subsequently, the sessions and self-reflection, coupled with the discussions with other participating males, empowered several participants to have further interactions about SV/IPV with individuals in their community. The discussions led participants to realize that SV/IPV existed in their community, but that there were males within their community that wanted to change. The Hombres Unidos Contra La Violencia Familiar project demonstrated that behavior change does not need to be actively persuaded, but that self-reflection, which elicits behavior change, can be achieved through facilitated discussion and by permitting the facilitators to become participants. By creating sessions that allow participants to construct their own understanding of the perceived problem while reflecting on their past behavior, true behavior change that is initiated by the participant can be achieved. Through discussion facilitation, a targeted and structured behavior change intervention can assist participants in realizing that their past actions were damaging to themselves and their community, while aiding the participant in employing self-initiated responses, learned within the discussions, to alter their behaviors.

INTRODUCTION

In ‘Pedagogy of the Oppressed,’ Paulo Freire asserts that an individual's knowledge, actions and view of the world are based on his or her experiences (Freire, 1992). Although Freire's work is often mentioned in discussions concerning oppression and liberation (Jackson, 2007), his writings provide insight into an individual's engagement in certain behaviors. In accordance with Freire, an individual that engages in a behavior deemed inappropriate by a certain segment of society might be engaged in that behavior because the action was reinforced through their experiences.

In health behavior change research, which is primarily concerned with the alteration of harmful behaviors, interventionists attempt to change adverse behaviors by changing individual attitudes and providing self-management strategies (Norman, 2008). Several health behavior change approaches engage in changing unhealthy behaviors, armed with the notion that individuals possess a ‘self-system’ that aides them in relating a measure of control over their feelings, thoughts and actions (Bandura, 1989)—despite their experiences. Pajares (Pajares, 1996) amended the theory of the ‘self-system’ by suggesting that an individual's ‘self-system’ also allows them to engage in self-reflection and allows for the planning of an alternative strategy (Becker et al., 2004).

An intervention, which conjoins the work of Freire, Bandura and Pajares, results in a theoretical framework that considers an individual's motivation toward a certain action and a method in which the individual could be spurred to change the respective action via self-reflection. This kind of intervention then only needs to be tailored to overcome various cultural differences between individuals and delineate what constituted a ‘harmful behavior’ in need of alteration.

Many health behavior change programs dictate what behaviors are correct and incorrect, yet fail to address the idea that culture may interact with the intervention conceptualization in complex ways, helping or hindering the program (Arroyo and Miller, 2003). To combat this problem, the Migrant Clinicians Network (MCN) decided to use a fusion of the concepts of Freire, Bandura and Pajares to create a program where male participants received education about sexual and intimate partner violence (SV/IPV), but were not taught that the behaviors were ‘inappropriate.’ The aim of the MCN program was to encourage men to reflect on their experiences with sexual and intimate partner violence in their lives through discussion facilitation and come to their own understanding of their behaviors. This paper presents the concept of discussion facilitation as an agent of self-reflection and the unique use of male discussion facilitators to foster male participants' growth via the Freirean concept of empowerment.

BACKGROUND

The Hombres Unidos Contra La Violencia Familiar (Men United Against Family Violence) project

Intimate partner violence programs have focused on a variety of populations. MCN, funded by a grant from the United States Center for Disease Control and Prevention (CDC), designed a prevention project intended for migrant Hispanic males, an underserved community. The main goal of this primary prevention project was to decrease the prevalence of sexual and intimate partner violence in three Hispanic migrant farmworking communities by conducting courses where males participated in discussions with their peers and two male facilitators.

This program fits into other prevention work that has focused on men's ability to influence their peers with regard to attitudes and beliefs surrounding sexual and intimate partner violence (Berkowitz, 1992; Katz, 1995; Flood, 2001; Berkowitz, 2002; Schwartz and DeKeseredy, 2002; Fabiano et al., 2003). Most of the work in this area has focused on college students (Hong, 2000; Breitenbecher, 2001; Yeater and O'Donohue, 1999), but it is important to note, because it attempts to reconstruct violence as a problem affecting both women and men. Recent literature has also shown that attitudes towards SV/IPV are mediated by multiple key factors including gender roles and relations and other forms of social differences associated with ethnicity and class. These attitudes are further affected at the community level by participation in informal peer groups and networks (Flood and Pease, 2009). The Hombres Unidos Contra La Violencia Familiar (Men United Against Family Violence) project fills an important gap within the literature and available intervention programs targeting SV/IPV, as it addresses Hispanic farmworker men's attitudes and beliefs within a culturally appropriate framework.

The Hombres Unidos Contra La Violencia Familiar project incorporated two phases. Phase 1 began in 2005 and consisted of collecting data on Hispanic farmworking males and their knowledge, attitudes, beliefs and behaviors (KABB) related to SV/IPV. The KABB survey was conducted at five migrant farmworker sites throughout the USA and the KABB data were analyzed to aid MCN in subsequent course development. In phase 2 (2006), a culturally sensitive program curriculum was developed from the KABB data and three sites were selected to conduct courses to educate male Hispanic farmworkers regarding SV/IPV.

Based on the findings and conclusions of the KABB survey, MCN decided that discussion facilitation would be the primary method in which to achieve the program's aim. The program centered on five themes that were revealed from the phase 1 KABB survey:

1. Men are naturally loving, sensitive and nurturing human beings

2. Violence and the acceptance of violence are learned and can be unlearned

3. Men can and want to help stop violence against women

4. Men must provide support for each other in order to change the social acceptance of violence

5. We can only change ourselves; we cannot change anyone else.

The Hombres Unidos Contra La Violencia Familiar curriculum consists of a course, which is composed of 5 weekly 2-h sessions. The course addresses a variety of topics related to sexual violence and intimate partner violence. The weekly sessions feature non-formal educational games and activities as part of the self-reflection approach. Sessions accommodated the schedules of the male farmworkers at each site, and were conducted in Spanish by two male Hispanic facilitators. Upon completion of the five sessions, participants received a certificate indicating program completion.

CONCEPTUAL MODEL AND PROGRAM BASIS

Freire

Traditionally, gender roles have been researched and presented as an explanation for SV/IPV, regardless of culture (Yllo and Bograd, 1988; Zimmerman, 1994; Lee and Dodson, 1998; Sciortino, 1998; Ashford, 2001). As such, projects that aim to reduce the incidence of sexual violence typically attempt to aid males in redefining their gender roles within their environment (Hertz et al., 2008). MCN focused on aiding participants in understanding the mechanisms behind men's participation in sexual and intimate partner violence. Building a positive intervention strategy that was Hispanic-male-sensitive, the curriculum used approaches which avoided stereotyping or demonizing males (Lee, 2004). Freirean theories were chosen as the underpinning of phase 2 of the intervention, the male-only sessions, since they addressed many of the themes important to MCN, while avoiding several limitations other interventions had experienced, such as dictating correct and incorrect behaviors to participants.

Problem-posing

Paulo Freire (1921–1997) was a Brazilian educator and theorist who is best known for his work in the philosophy of education (pedagogy). Freire rejected the traditional model of student–teacher interaction, which he labeled the ‘banking’ model of education. When participating in the ‘banking’ model, teachers ‘deposit’ knowledge into the student. The knowledge ‘banked’ would only be that of the teacher's reality, leaving the student powerless as to whether or not to reject the ‘teacher-owned’ knowledge. In reference to the project, MCN decided that by avoiding the ‘banking’ method of education, the course sessions would circumvent dictating to the participants the ‘correctness’ of SV/IPV. Instead, MCN used Freire's ‘problem-posing’ approach to education, which relies on dialogue between the student and teacher. Freire believed that ‘problem-posing’ education alters the student–teacher relationship, making the interaction between the two entities level. Freire concluded that the discussions that ensued between teacher and student would allow both parties to actively learn and build knowledge through each other's experiences and realities. Facilitators ‘… would be taught in dialogue with the student, in turn while being taught also teach’ (Freire, 1978). Via ‘problem-posing’, MCN facilitators did not define reality for the men, but instead explored the issues with them.

The ‘problem-posing’ model of education allowed MCN and facilitators to avoid the limitations of many behavior change interventions and gave the facilitators the opportunity to observe the course participants' attitudinal changes and evaluate the course sessions. The ‘problem-posing’ model also enabled participants to construct their own realities, engage in self-reflection and build on their experiences.

Freirean characteristics of an effective educator

According to Freire, educators needed to possess ‘indispensable qualities’ in order to be effective. Freire believed that prospective teachers should demonstrate humility, use common sense, manifest lovingness, develop courage, exhibit tolerance, express impatient patience and pursue the joy of living (Simpson et al., 2006). These qualities would allow teachers to foster an environment that engages students in dialogue and subsequently self-reflection.

MCN also believed that facilitators should possess Freire's ‘indispensable qualities’ if effective discussion facilitation were to occur. MCN also conceived that male discussion facilitators would possess additional characteristics that would enable the groups to engage in discussions regarding such a sensitive topic. MCN theorized that in the end, these men would experience growth and gain new perspectives as a result of being a facilitator in the discussion of SV/IPV.

Bandura and Pajares

Albert Bandura's ‘Social Learning Theory’ is used to explain sexual and intimate partner within this project. Social learning theory posits that people learn behaviors through experience and observation, model the behavior of others with whom they identify, and the consequences of those behaviors either reinforce or deter the future repetition of behavior. Social learning theory can explain SV/IPV as something that is learned through social interactions, observations, vicarious learning and modeling. If this is indeed true, then sexual and intimate partner violence is not inevitable, but rather is a behavior that is learned, shaped by consequences and will continue if reinforced. The only reason that it continues to be present is because it is modeled at individual and societal levels, deemed to have positive results (for the perpetrator) and is rarely associated with serious punishment (Bandura, 1977). Therefore, a curriculum aimed at reducing SV/IPV must include social interaction, observation, vicarious learning and modeling. This was done through dialogue (social interaction) and role-playing activities (observation, modeling and vicarious learning).

Adding to Bandura's learning theory, Pajares' theory does not assume that what one experiences and observes wholly dictates behavior. Social learning theory also includes the concept of the ‘self-system’, which is the internal, cognitive process of self-reflection and regulation (Pajares, 1996). The Hombres Unidos curriculum is based on these concepts.

HOMBRES UNIDOS CONTRA LA VIOLENCIA FAMILIA

Recruitment: facilitators

In 2007, MCN recruited facilitators from three migrant health/education center partners in Pennsylvania, Florida and Illinois. Two facilitators were chosen from each site to work on the project (6 in total). Facilitators were Latino males, former or current migrants, bilingual in English and Spanish, literate and had some experience leading groups. Every effort was made to ensure that facilitators possessed Freire's ‘indispensible qualities’.

Facilitators were trained via an intensive training workshop held at the MCN offices in Austin, Texas. The training workshop was held over a 3-day period and each facilitator was required to attend. During the workshops, the project director and an experienced trainer taught the group facilitation techniques and how to interact with the discussion group and foster discussion. To reinforce the training, facilitators were asked to present a course topic from the curriculum to the larger group. Additionally, during the project, the male discussion facilitators engaged in conference calls with MCN staff to troubleshoot curriculum issues and discuss the facilitation process.

Facilitators were asked to engage in discussions with participants, rather than ‘teach’ in a top-down model, about SV/IPV. Facilitators used the developed course activities as the springboard for discussion, since each activity was designed to encourage participants to talk about their experiences with SV/IPV. The discussions operated as a method in which each participant could engage in learning about SV/IPV within the larger community and learn from other participants' experiences. To encourage an active discussion among participants, facilitators were instructed to actively listen, foster social interaction between group members and to only speak when sharing their related experiences or to keep the group on task.

Recruitment: participants

Participants were recruited by word of mouth through the migrant health/education centers (n = 157) in 2007 and 2008. Participants had to be Latino, male, migrant workers and available for five continuous weeks. Participation was entirely voluntary. Participants were given meals at each session, program t-shirts and a certificate of completion at the end of the course.

Curriculum

The Hombres Unidos Contra La Violencia Familiar curriculum is a Spanish-language course made up of five 2-h sessions. The weekly sessions include discussion, games, role-plays and activities, all designed to illicit self and group reflection on the topics of SV/IPV. Table 1 provides a summary of the learning objectives and goals for each session.

Table 1:

Hombres Unidos Contra La Violencia Familiar objectives and goals

Session	Learning objectives	Goals
1	Identify goals of program	Participants get to know one another and begin to feel comfortable with the group
	Understand how men are socialized and how this socialization can contribute to violence	Participants understand the role of the facilitator, the goal of the course and the way the sessions will be run
		Establish rules that will allow for open and honest conversation
		Gain understanding of current knowledge and attitudes of participants regarding sexual and intimate partner violence
		Discuss male socialization and how it impacts our behavior
		Participants ask questions or provide comments on the session
2	Strengthen participant understanding of sexual and intimate partner violence/abuse	Participants share their reflections on the last session
		Identify what is abuse and the three types of abuse
		Discuss different types of violence
		Provide information about what men really think with respect to gender stereotyping and healthy relationships
		Answer participant questions
3	Identify the causes and consequences of violence	Participants share their reflections on the last session
	Understand the cycle of violence	Brainstorm who has power in society and how this affects the use of violence
		Provide participants with information on resources
		Answer participant questions
4	Identify skills needed to prevent and respond to sexual and intimate partner violence	Participants share their reflections on the last session
	Practice advocating for the prevention of violence	Participants share their ideas about how they would respond to witnessing violence
	Discuss strategies for action	Participants practice responding to witnessing violence
		Establish concrete strategies to prevent ourselves from acting violently
		Participants state what they will do to prevent violence in their community
		Assess changes in participant knowledge, attitudes, beliefs and behaviors since the first session
		Participants give their feedback on the course
		Participants ask questions or provide comments on the session
5	Conclude the program	Participants share information on what they learned from the course
	Reinforce participants' commitment	Participants make a public promise not to use violence
	Participants share with the community	Honor and thank the participants for their dedication and hard work
		Participants and guests talk informally about the program

RESULTS

Pre- and post-test

All participants were given pre-tests prior to the start of the course and post-tests immediately following the course. The tests were designed to measure key concepts related through Hombres Unidos curriculum. They consisted of 12 questions related to the program goals. There were three responses to the questions: yes, no or a question mark. The question mark indicated that the participant was undecided or did not know the answer. Each response was located inside circles colored green (yes), red (no) and yellow (don't know). The tests were purposely designed this way to accommodate participants with low literacy levels. (The test questions themselves were read aloud by the facilitator.)

The questions were developed in English, translated to Spanish and then back into English to check for fidelity. The English version of the questions were as follows:

• Q1. Do you think men should make the decisions in a relationship?

• Q2. Do you think that women have the right to say ‘no’ if they don't want to have sex with their partner?

• Q3. Do you think that being drunk causes men to hit their partners?

• Q4. Do you think that when a man hits his partner, it can be her fault for provoking it?

• Q5. If your friend was hitting his partner, would you tell him that this was unacceptable behavior?

• Q6. If your friend was insulting his partner, would you tell him that this was unacceptable behavior?

• Q7. Do you think that when a man rapes a woman, it can be her fault?

• Q8. Do you think that rape is caused by uncontrollable sexual desire?

• Q9. Do you think most women who report they have been raped are telling the truth?

• Q10. Do you think that it is abuse if a person insults his partner?

• Q11. DWould you know what to say if you saw someone being violent towards another person?

• Q12. Do you believe you can help prevent rape and partner abuse in your community?

Questions 1, 3, 4, 7 and 8 had a desired response of ‘no.’ Questions 2, 5, 6, and 9–12 had a desired response of ‘yes.’ The question responses were designated a score of 1 for the desired response and a 0 for the undesired response, no response or for a question mark. Question response scores were added to get an overall score for each of the tests (pre and post). The highest possible and most desirable score was 12. The lowest possible and least desirable score was zero. Two (IL, FL) out of the three groups showed statistically significant results, while the third group (PA) did not reach significance at the 0.01 level. This may have been due in part to the smaller sample size of the PA group. The results of statistical analysis are shown in Table 2.

Table 2:

Paired t-test on pre- and post-test scores by state

		Mean	n	Mean difference	t	df	Sig. (two-tailed)
PA	Pre-test Score	7.92	36
	Post-test Score	8.58	36	−0.667	−2.256	35	0.030
IL	Pre-test Score	8.06	63
	Post-test Score	9.08	63	−1.016	−3.279	62	0.002
FL	Pre-test Score	5.19	58
	Post-test Score	8.90	58	−3.707	−7.631	57	0.000

Qualitative evaluation

Follow-up interviews

One year after project completion, interviews were conducted with course facilitators. According to Freire, both facilitators and participants were involved in the creation of new realities through their interactive dialogue. Thus, in the absence of participants, MCN felt that follow up interviews with the facilitators would provide valuable information about the effects of the program. Four facilitators from two of the three intervention sites were interviewed by telephone, in their language of preference. MCN staff tape-recorded these interviews and then transcribed and translated selected quotations. Concurrent with the facilitator interviews, both project directors and the facilitator trainer were interviewed by telephone using a separate questionnaire.

Interviews were conducted, (1) to capture the observations of the facilitators in regards to the participants, (2) to capture the observations of the project director and the facilitator trainer with regards to the facilitators and (3) to evaluate the effectiveness of utilizing Freirean concepts as the theoretical underpinning of a behavior change intervention. Interview questions were open-ended and interview participants were asked to respond honestly about their opinions and experiences. Interviews were conducted from June 2008 to August 2008. The participants were interviewed in their preferred language by one of the authors. Each interview lasted approximately 40 minutes.

‘Problem-posing’

The facilitator trainer believed that having facilitators utilize Freire's ‘problem-posing’ approach shifted the focus from health education to participant empowerment. Instead of providing one-on-one interventions, which provide health information to participants, the facilitator's task was to foster discussion. A consequence of the discussion facilitation was that the participants were not learning from one source, for example the facilitator, but drawing on the experiences of all the participants and learning from each other.

Whereas promotores are concerned with teaching a skill or relaying health information, the facilitator had to participate and moderate participant discussion, while talking about their own experiences and struggles with sexual violence.—Facilitator Trainer

Course format

The facilitation–discussion format of the course allowed the participants to self-reflect, on their own terms and timelines.

… the majority of the participants reflected in their closing comments [at the program's conclusion] that they felt like they were more open and able to discuss the issue after having learned so much.—Facilitator

With each participant experiencing behavior and attitudinal change at their own pace, MCN believed that each participant involved in the intervention would begin at different levels of knowledge, experience and attitudes regarding sexual violence and intimate partner violence.

The norms about intimate partner violence and sexual violence against others, such as homosexuals, is very real in the Hispanic community. The facilitators had to come into the workshops knowing that each participant's journey would be different in the process of dismantling their [preconceptions].—Project Director

After the sessions were completed, the men were able to verbalize to other men the lessons learned through the discussions. Facilitators provided illustrations of participants using the lessons he learned within the discussions to intervene in a potential domestic dispute:

Last year, while we were still in the middle of a series of sessions, we had an experience that was really wonderful. One of the participants told us the story of how a man he knew got mad one day. This man had wanted to kill his wife - he was really angry and was getting ready to go find her. The participant intervened, and talked to the guy, calming him down. Then helping him to see things differently, he changed the guy's mind. The guy who gave us his testimony said that he felt that he could help the other guy with what he had learned in the course, basically, that he could stand up and talk to the other male and calm him down.—Facilitator

At one of the group meetings, one man shared with the group. He volunteered to give us his own personal experience. He has a friend of his back in Mexico, a man going through problems with his wife. And by phone to Mexico, this participant was giving advice to his friend. It was a great feeling to hear this. He shared that with us one day, and you know, everything got better. One of the experiences we had- just little things that happen that got to me.—Facilitator

Removing barriers

Through participating in discussions about SV/IPV, and sharing their own struggles with the topic, the facilitators began to break down the facilitator–participant barriers. The MCN project trainer observed this interaction and realized that the facilitator was ‘… just like them, and struggled with the topic as they did.’ Furthermore, the participants thought that they could facilitate discussions about sexual violence within their communities.

Towards the end, the participants started to look at the facilitators as peers, and started to think that they too could have these tough discussions with people where they lived, in the campo, at church, wherever. [The participants] started to believe that the facilitators weren't endowed with some special knowledge or education, and any man willing to engage another person could do their work.—Facilitator Trainer

Facilitator characteristics and growth

According to Freire, those who are given the privilege of leading discussion with a group require certain indispensible qualities to aid them in their task. Although MCN did not inform the facilitators of these indispensible qualities, the facilitators themselves believed that discussion leaders had to possess certain innate qualities that could not be taught.

A facilitator should be passionate, conscious of the work that has to be done. And [have] a sense of dedication.—Facilitator

To do this you have to be able to express yourself, not to be shy and want to help others. Also you need to be knowledgeable about what you're talking about – the material.—Facilitator

Freire theorized that both participants and facilitators would experience growth by engaging in dialogue.

Without the ability to interview participants, the data from the facilitators' interviews become an important proxy for understanding the growth of both groups. The facilitators learned lessons while participating in the discussion, which is a reflection of the interaction between both parties. Both facilitators and participants were learning and contributing, thus growing and building new perspectives on SV/IPV.

In my case, there was an exchange. I found that some of the men, with what they presented in the sessions - what they asked, or when they gave a testimony or shared new ideas, [that] I learned as the facilitator, just like everyone else learned as well.—Facilitator

For this topic of domestic violence, we would begin to break the ice by sharing our own experience and some of the facts. We are just sharing with them. So at first it was very slow… we would give experiences from our own lives. DV, in a group of men, could be an intimidating topic to discuss. I think that what we did- we tried to introduce the idea very slow and divide them into different groups. The role plays were really good- it was incredible. The activity, I think in the fourth section, when their friends are at a place and had to talk, well we did it- my father and I [co-facilitators], as kind of an example and they then went into their groups. I didn't think that they would be willing to do it. But they did it and it was really good.—Facilitator

Participants

The facilitators described their experiences with the participants and shared particularly interesting stories about the project.

One thing that excited them a lot was the certificate. At one of the meetings- my dad [co-facilitator] brought up the idea of a certificate when we were all beginning this project. Some men had never graduated from school- and never received a certificate. They felt accomplished. I think that it was neat- it said that they graduated from a class on DV –that is a big thing. Can you imagine they bring this back home and hang it in their homes?—Facilitator

We know that there is definitely a problem of domestic and sexual violence in the Hispanic community, but with this project the many men are making changes. This indicates that things are getting better and this is improving their families and community. Things are getting better. Each of the men that participated last year have made personal improvements and have shared it with others.—Facilitator

Another thing is that we see that even a year later, the men have left up the paper that we have given them, or the posters. They feel fine with them there even if they are not taking the courses again. They are remembering the rules, the approach. The people really have changed, they want to make a difference and change themselves away from a violent approach. Their knowledge has really grown from what they knew before to what they know now about domestic and sexual violence.—Facilitator

An important thing in this project is that the information is timeless. It is for use now and in the future. This was most rewarding for the young people who might not yet have a family but it helps them now and it helps to prepare themselves to be better men, for themselves, their families. So many of them experienced violence in their youth - but in the future—well this is a type of prevention. So at the end they came to us and said that they will be better as fathers and husbands. That they felt more prepared. They were so thankful for this experience—a positive reinforcement of a different way of doing things. It is always better to prevent things.—Facilitator

DISCUSSION

The results of the Hombres Unidos Contra La Violencia Familiar program indicate that a behavior change intervention that is based on sparking self-reflection through discussion can be successful within the male Hispanic migrant community. Although the project focused on Hispanic males, the results suggest that Freire's use of discussion facilitation, as a method to induce self-reflection, is effective and can be the underpinning of a behavior change intervention.

Through facilitator-aided discussions, the male participants were not taught to rectify their past domestic violence impulses, rather the discussion facilitation allowed them to reflect on SV/IPV that is present in their lives and in the Hispanic community. Subsequently, the sessions and self-reflection, coupled with the group discussions with other participating males, empowered several male participants to have further interactions about SV/IPV with individuals in their community. The discussions led participants to realize that SV/IPV existed in their community, but they also led the participants to realize that there were males within their community that wanted to change.

Usually, behavior change programs actively attempt to persuade their targeted population to undergo the given change. MCN and the Hombres Unidos Contra La Violencia Familiar project revealed that behavior change does not need to be actively persuaded, that self-reflection which elicits behavior change can be achieved through discussion facilitation and permitting the facilitators to become participants. Programs can shed the ‘teacher’ role. By creating sessions that allow participants to construct their own understanding of the perceived problem while reflecting on their past behavior, true behavior change that is initiated by the participant can be achieved. Through discussion facilitation, a targeted and structured behavior change intervention can help participants to realize that their past actions were damaging to themselves and their community, while helping the participant to employ self-initiated responses to alter their behaviors.

LIMITATIONS

Migrant farmworkers are constantly on the move following the planting and harvesting seasons, making it very difficult to do any longitudinal work with this population. Due to the migratory nature of farmworkers, MCN used the pre-test/post-test method of evaluation immediately before and after the intervention. The positive effect of the intervention reflected in the results could have been at least partially due to test–re-test bias. The participants may have also answered the questions according to what they believed the facilitator wanted, a problem common with self-report. This problem was partially mitigated by the use of a Freirean curriculum, as the participants were not told the ‘correct’ answers at any point during the program by the facilitator. MCN was unable to measure the prevalence of sexual and intimate partner violence in the community at any time during the project and therefore it is impossible to definitively show if the intervention truly changed behavior or the incidence of SV/IPV among the participants or their communities.

NEXT STEPS

The interviews reported on here were conducted at the conclusion of the third year of the Hombres Unidos contra la Violencia Familiar program. In year 4, the program expanded to an additional site, in Arizona. The facilitators continue to develop as leaders and receive annual training updates from MCN. They have taken on additional responsibilities including assisting with the training of new facilitators and conference presentations about the program. The curriculum has undergone revisions and will be available for distribution in 2010.

FUNDING

This project was supported by Grant Agreement Number (US4/CCU624949-01) from the Centers for Disease Control and Prevention.