Development of a Scale for Measuring African American Neighborhood Social Cohesion

1. Jennifer Rienks PhD (c) 1Geraldine Oliva, MD, MPH1Virginia Smyly, MPH, CHES 2Linda Mack Burch, MPH 1Judith Hager Belfiori, MPH, MA1 Development of a Scale for Measuring African American Neighborhood Social Cohesion and Personal and Environmental Factors Associated with Perceptions of Low Cohesion 1) University of California, San Francisco, Family Health Outcomes Project, 3333 California Street, Suite 365, San Francisco, CA 94118 2) San Francisco Department of Public Health Community Health Education Section, 30 Van Ness Avenue, Suite 2300, San Francisco, CA 94102

2. Background • San Francisco Health Depart., with funding from the Centers for Disease Control REACH 2010 initiative, created the SevenPrinciples Project to address personal and social environment factors thought to be related to the much higher rate of infant mortality experienced by African American babies compare to white babies. The Family Health Outcomes Project at the UCSF is working to evaluate project efforts. This study was conducted at part of the evaluation.

3. Objectives • To measure African American perceptions of factors in the social environment that may be related to infant health outcomes • To create a reliable scale to measure African American neighborhood social cohesion

4. Methods • 15-minute telephone survey conducted with African Americans in four multi-ethnic neighborhood • Survey items address feeling of sense of belonging or community, frequency of participation in social and community activities, barriers to participation, volunteer activities and social cohesion • Social cohesion items taken from Saguaro Seminar’s Social Capital Community Benchmark Survey and modified to be specific to about cohesion among African Americans

5. Results • 993 people identified as eligible to participate • 163 refused to participate and 26 terminated interview before completed • Overall refusal rate – 19% • N = 804 • 71% of respondents self-define as African Americans, 22% as Black, and 6.7% as African American and other

6. Demographics

7. Social Cohesion Scale • Summing together responses in Table 1. creates a scale of African American Neighborhood Social Cohesion • Cronbach’s alpha = .79, indicating good reliability • Dichotomous variable made to distinguish between those reporting high and moderate levels of social cohesion (61.5%) vs. low levels of cohesion

8. Logistic Regression Results • Logistic regression modeling was done using low cohesion as an outcome variable and the variables listed in Table 2. as predictor variables • Hosmer and Lemeshow Goodness-of-fit Test indicated good fit between expected and predicted values (X2 = 2.27, df = 8, p>.97) • Variables in model account for 13% of unstandardized variance and 18% of standardized variance

9. Logistic Regression Results (cont.) • Respondents reporting lower levels of social cohesion also more likely to be under 40, less socially active, less knowledgeable about the importance of getting good prenatal care to avoid SIDS, less likely to believe they have something of value to give to the community, less likely to say that concerns for safety NOT a barrier to being involved in the community, less likely to volunteer for art/cultural organizations, and less likely to reside in the Excelsior/Ingleside neighborhood compare to the other 3 study neighborhoods.

10. Conclusion and Implications • A tailored African American neighborhood social cohesion tool can provide important information for better understanding the impact of social environment factors on negative perinatal outcomes in African Americans. • Such a measure can also be useful as a control variable when evaluating the impact of community interventions, as prior levels of cohesiveness may play a role in the success or failure of an intervention.