Nia Project

Program Description

The Nia Project’s mission is to empower abused, suicidal African American women to access behavioral health services, find a new sense of purpose, lead more meaningful lives, and affirm their commitment to living a violence-free life. “Nia” is Kwanzaa principle that means “purpose”. In existence since 1992, this culturally competent program, which has served over 2000 women, includes 24-hour crisis management and resource attainment, 20 weekly therapy groups, individual and family therapy, and community programming free of charge. Offered by Grady Health System and Emory Department of Psychiatry and Behavioral Sciences, the program is effective in reducing the violence low-income African American women face in their intimate relationships, ameliorating behavioral health problems (suicidality, depression, hopelessness), bolstering self-confidence and self-efficacy, and helping women heal from interpersonal traumas. However, needs assessment information revealed that women desire assistance actively and positively engaging in their lives and communities. To this end, the Nia Project is in the process of launching the Reconnection and Community Reintegration Program (RCRP), which is based upon Acceptance and Commitment Therapy. RCRP strives to facilitate women’s efforts to (1) reconnect with and form healthy and supportive relationships and (2) identify and pursue life goals and valued roles in their communities.

Creativity

The Nia Project is the only program designed for this high-risk population with limited access to quality services. RCRP is the first effort to develop best practices for helping trauma survivors with a history of suicidal behavior engage actively and meaningfully in their social worlds and communities. The program’s cultural competence, collaboration with a Community Advisory Board of former participants and diverse community members, focus on biopsychosocial-cultural care and community engagement, and development and utilization of a suicide prevention app, makes it innovative. Community networking enables us to offer leisure and cultural experiences (e.g., attending concerts, visiting botanical gardens), volunteer opportunities (e.g., community gardening), health and wellness activities (e.g., exercise programs), and educational and vocational trainings (e.g., Peer Support Training). Another unique element is the provision of creative outlets for emotional expression and talent, such as the annual holiday talent show, blog, and published compilation of artwork and poetry (http://www.lulu.com/shop/the-grady-nia-project/the-purpose-of-life-is-a-life-of-purpose-a-compilation-of-artwork-created-by-grady-nia-project-patients/paperback/product-23148193.html).

Leadership

Dr. Nadine Kaslow, Past President of the American Psychological Association and a national expert in suicide and family violence, leads the team and is known as “Mother Nia.” The leadership team, comprised of diverse mental health professionals in partnership with a Community Advisory Board of stakeholders, serves as a gold standard for community-based participatory practice and research. This interprofessional team disseminates findings about outcomes, predictors and mechanisms of change in professional and lay publications; at trainings and conferences; and at local, regional, and national community-based talks. They consult to interested healthcare systems and community agencies about program implementation, provide manuals and training materials, and offer guidance to communities that have adopted the program. The leadership team offers extensive, specialized experiential on-site training in evidence-based and culturally-informed interventions for behavioral health, medical, and public health students, which prepares them to implement, disseminate, and evaluate the program in multiple sites.

Sustainability

This team has built an infrastructure that facilitates sustainability, as evidenced by the program’s 25-year duration. This infrastructure includes trainees, volunteers, and staff responsible for program development, implementation, and evaluation; large suite of offices furnished by Rooms to Go; comprehensive, up-to-date program evaluation database; and partnerships with community program’s that offer complementary resources. We have consistently secured community and research funding to sustain the program’s multiple components. The monies from our annual fundraiser and our donors’ contributions support the creation and sustenance of innovative elements of the program. There is considerable leadership and administrative support for the program through Emory University School of Medicine and Grady Health System, as it is considered a flagship program given the awards granted to Dr. Kaslow and the Nia Project and the impressive outcome data (https://www.youtube.com/watch?v=dHWIcR0j4Pc). However, significant resources are needed to build, evaluate, and disseminate our newly conceived Nia’s RCRP.

Replicability

The Nia Project team, at its weekly meetings, creates strategies to replicate our positive findings in other settings. The team provides expert advice, training, and community support to sites desiring to replicate the program. To support replication efforts, we have articulated the values that must undergird program implementation and developed a detailed yet flexible protocol that delineates processes for implementing and assessing all components of the Nia Project. We share this protocol and associated materials for free for any party who requests them. Many of the group interventions follow treatment manuals (e.g., Nia Project Culturally Competence Empowerment Group, Dialectical Behavior Therapy, Acceptance and Commitment Therapy). These manuals are available with appropriate training, which facilitates replication of these program components. An RCRP manual is being developed based on focus group data and will be modified following participant input from a pilot study. This revised manual will be available for replication.

Results/Outcomes

Based in a clinical-research and program evaluation tradition, the Nia Project assesses women’s psychological functioning and quality of life before the program, 10-weeks into the program, and every 6 months after that time to determine effectiveness. Assessments involve a comprehensive battery of reliable, valid, and culturally relevant measures and diagnostic interviews. Program outcomes are impressive. Compelling data demonstrate that the Nia Project is superior to standard services on virtually all outcomes; women who participate in the program lead more violence-free lives, are less suicidal, have fewer psychological symptoms, and are more resilient and able to cope adaptively in the face of trauma. Of note, they make remarkable progress in finding and pursuing meaning in their lives. Treatment outcome data are published in relevant, high-impact empirical journals. Key findings are highlighted on our website, blog, and twitter feed, and presented in a user-friendly fashion to participants, the lay public, and professionals.