`Seven habits' program assists inner-city minority women

What do executives of multi-million-dollar corporations have in common with low-income, inner-city minority women? As human beings, both groups are capable of motivation via the same basic psychological principles. At least that is what a group of health professionals, social scientists and community advocates is banking on as it begins a new experimental program designed to promote resiliency and prevent drug abuse and risky behaviors among low-income minority women.

The new multi-institutional, multidisciplinary project, led by nursing faculty, will take the principles of the Covey Leadership Center's Seven Habits of Highly Effective People, which are routinely used to train and motivate high-level corporate executives, and adapt it for use with young, high-risk, low-income, inner-city Hispanic and African-American women.

"Most health education programs for low-income minority populations focus on problems, and result in lots of referrals," said nursing professor Catherine Lindenberg, principal investigator for the program. "We were looking for something more fundamental, something that puts the control and the responsibility for a person's life in that person's own hands."

The Seven Habits program has been used effectively to improve individual performance, productivity and life satisfaction, and is founded on principles of human and organizational effectiveness. The habits include being proactive; taking control and responsibility for one's life; clarifying values and setting goals; developing winning strategies for improving relationships; developing organizational and time management skills; and promoting physical, mental and spiritual health through good daily habits.

Partially funded by the Hershey Foundation and under the auspices of the Covey Leadership Center, the project will be conducted collaboratively by six institutions in Atlanta and Southern California, including Emory, Mercy Health Care of Saint Joseph Hospital Corp.; the Grady Health Care System; the University of California/Irvine Medical Center and School of Medicine; and the Orange County (Calif.) Department of Health.

In early December, a Covey Leadership team came to Atlanta to conduct a training session for a team of 20 facilitators and trainees representing the six sites. The diverse group includes anthropologists, sociologists, health educators, nurses, physicians, clinicians and community advocates. The participants will bring a variety of visions about what the program should accomplish, said Lindenberg. Over the next two years, the group will hammer out differences and adapt the materials for a fifth-grade literacy level, for language appropriateness (both in English and Spanish), and for cultural and social appropriateness. The materials then will be pilot-tested through the Prenatal Education Clinic at Mercy Mobile Health Care.

Over the longer term, Lindenberg and nursing professor and co-investigator Ora Strickland plan a multi-site study to evaluate protective factors and triggers to substance use and risk behaviors among 1,000 minority women. This study also will evaluate the effectiveness of the Seven Habits program.

The idea for the Seven Habits program came from Lindenberg's earlier research on high-risk Hispanic women, which used the Social Stress Model for Substance Abuse Prevention. In this model, community resources, social support and personal competence are considered buffers to the kinds of stress that often lead to drug abuse and other high-risk behaviors.

"The social norms we derive from our families and peers and our ability to be personally competent and goal-directed are strong predictors of our behavior," Lindenberg noted.

"Statistics show that use of harmful substances among women of childbearing age, particularly low-income black American and Hispanic women living in large urban cities, is growing at an alarming rate," she said. "The National Pregnancy and Health Survey recently found that 5.5 percent of pregnant women use some illicit drug during pregnancy, and that inner-city women have rates three to four times higher.

"The cost to society is staggering, not just financially, but in terms of human suffering and social chaos. Drug use among pregnant women is linked to a multitude of problems in pregnancy outcome, infant health and development. Among this group of women, even small reductions in drug use may provide enormous cost savings for future generations."

The experimental program is unusual, said Lindenberg, because it is a prevention intervention, not a treatment, and it begins at the grass roots by listening to and engaging people within the community. It links the private with the public sector and involves people of many disciplines, institutions and ethnicities.

"We believe that if women implement the Seven Habits in their daily living they will be able to make good choices, manage and take control of their lives effectively," said Strickland. "We believe that young, low-income minority women need to know how to manage themselves, and this has to come from within."

-- Holly Korschun