Often Difficult - But Worth It

Today's Extension professionals are encouraged to work in the broad university community and to conduct applied research. Collaboration with university colleagues in departments outside "the Extension family" presents that opportunity. Major philosophical issues and professional expectations, however, must be negotiated when two separate university units, motivated by different, sometimes conflicting agendas, collaborate.

A recent joint effort between the Minnesota Extension Service and University of Minnesota School of Medicine produced an important community-based research and educational program on stress, depression, and suicide prevention. The Teens in Distress program, which has involved nearly 10,000 people, represents a successful collaborative effort. It also illustrates the problems that can arise when Extension professionals work with academic researchers.

Prompted in 1985 by increasing teenage suicide attempts, Extension educators in rural counties began requesting information about adolescent stress and depression. Extension specialists recognized that additional expertise was required before they could present effective educational programs. Extension needed help in dealing with adolescent mental health issues. A child psychiatrist on the medical school faculty who had written extensively on youth suicide was asked to help Extension develop a program. A team, composed of a child psychiatrist, a psychologist, a 4-H youth development specialist, and an Extension program specialist was formed. This team designed and sponsored: six regional educational conferences for helping professionals, a statewide research study, a statewide video teleconference, a 30-minute video documentary, and a prevention curriculum for youth.

From the beginning, the relationship between Extension and the medical school was informal and open-ended. No funds were exchanged between units. Each system provided the resources necessary to get what it wanted out of the project. Cooperation grew out of mutual professional interest in the topic. The medical school was interested in research. Extension educators across the state were willing to collect data to have current local information on which to base programs.

The research study, "Stress, Depression, and Suicide: A Study of Adolescents in Minnesota," is the largest community-based study of depressed youth and adolescent suicide attempters ever reported in the literature. It was designed by Extension and the medical school team, conducted by Extension educators, analyzed by the joint team, and interpreted by the clinical faculty at the medical school. The medical school provided technicians and financed the computer data entry. Extension provided two faculty who worked 30% time on the project for 18 months. County-based faculty contributed hundreds of hours developing educational programs and community networks to support them. Both partners found themselves involved in a project that generated highly sensitive data with program implications for educators, parents, doctors, politicians, and professional youth workers.

Understanding the philosophical differences between Extension and academic units is essential for successful collaboration in a university setting. The Teens in Distress project highlights four significant issues that result from these differences.

Developmental vs Prescriptive Approach

Extension places high value on educational process while the medical model emphasizes research to produce prescriptions for cure or prevention. Extension educators value research findings that provide information to help individuals gain knowledge, understand alternatives, and make choices. The medical faculty sponsors research to add to the knowledge base for clinical study and provide prescriptive treatment methods and interventions. Who sets the research agenda on a joint project? Who determines what information is collected and how it will be used?

In the Teens in Distress project, it took time to recognize the different agendas, clarify them, and negotiate the differences. Medical staff didn't have the same priority as Extension staff for process, planning, and community participation. They knew what they wanted: to collect important data and report it. For example, at early planning meetings medical staff would stand up and excuse themselves after 55 minutes because scheduled patients were waiting. Initially, Extension staff felt their program concerns were being ignored. Over time, the team learned to plan jointly only those things critical to all parties. Extension staff stopped insisting on joint sessions to frame issues or set educational program goals since these weren't shared concerns. The team began to use time more effectively and go to meetings with clear, action-focused agendas. Meetings were held only when necessary to review progress, distribute tasks, and negotiate differences.

Consumer- vs Product-Driven System

The Extension System is consumer driven, responding to needs and issues identified by the public. Equipping people with the knowledge and skills necessary to solve problems and motivate change is an Extension priority. The medical research system responds first to other medical professionals. It's driven by an internal research agenda that's achieved when the research product is completed, scrutinized by colleagues, and determined to meet standards of quality for appropriate application.

This difference was underscored when Extension faced six conference audiences of 1,700 people who wanted to know about the teen suicide situation and what to do about it. Team expectations hadn't been synchronized. A day before the conference, the medical staff produced a preliminary report of findings for the conference consisting of two pages of uninterpreted frequency statistics on youth depression and suicide attempts. The Extension staff knew that conference participants would want comparisons and interpretations, so overnight the Extension team wrote a more comprehensive report in lay language to meet audience needs.

Producing Educational Materials vs Building the Research Base

Extension educators expect to use research to provide educational conferences, materials, and community programs. Medical professionals expect to publish research findings in scholarly journals and demonstrate new clinical approaches to healing. Educational materials aren't the same as research findings. The issue became whether research findings should be released when available or withheld until formal journal publication.

At the time of this project, suicide attempts were occurring in Minnesota communities. People knew the data had been collected and felt useful information was being withheld. The team had to find a way to meet the needs of both partners. The solution was for each system to take responsibility for its own client needs and system goals. Extension staff produced educational publications on understanding teen stress and recognizing youth at risk for suicide. It was agreed that no formal report would be officially released to the public until after publication of detailed findings in a scholarly journal. The medical staff authored the scholarly article with all team members given credit.

Research-Based Teaching vs Reporting Research Results

To stimulate public discussion and get research findings to people who can apply them are among Extension's priorities. Medical professionals integrate research findings into their clinical work to determine an effective treatment for troubled patients. Should university faculty tell people how to use research findings, or can people determine appropriate use based on their own situations?

This question was a source of conflict for medical and Extension team members. The Extension faculty goal for a video teleconference was a tightly structured day-long sequential learning experience to give front-line practitioners skills in recognition and intervention. The medical faculty understood their role to be reporting information. Extension balked at describing "the epidemiology of suicide" and "the psychopathology of depression." Medical staff were impatient with designing intervention role plays and group exercises for assessing community support networks. The project moved ahead when Extension staff assumed responsibility for designing the video teleconference goals, the agenda, the pre-produced video scripts, and the interactive group activities. Extension staff learned to say, "Please present this information this way," rather than, "How do you think we should present this?"

As a result of working through these issues with team members from the School of Medicine, Minnesota staff can offer eight practical ideas for Extension professionals who want to be involved in cooperative ventures.

1. Get the consent of Extension administration to work collaboratively and obtain authority to negotiate agreements. You gain credibility and support in joint ventures when they're clearly sanctioned by your own system.
2. Seek a change agent in another system who has a professional investment in the project and authority to act. You must begin with a great idea and a plan of action. Then invite others to join you - others who have as much to gain as you do by succeeding. Collaboration grows out of shared needs and commitment to accomplish broad mutual goals.
3. Have a clear understanding of your own agenda as well as that of your partner. Know what you want to learn from the research effort and how you intend to use the findings. Make sure the goals of all partners are articulated clearly to avoid mixed messages. Don't assume your goals are shared by others, and don't expect equal investment in all aspects of the project.
4. Be prepared to negotiate agenda and data use to maximize outcomes for both systems. The project agenda and the dissemination plan need not be dictated by one system. Negotiate a win/win plan that's clearly understood by all parties, agreed on in advance, and written down.
5. Come to agreement on how both systems intend to use the data collected. Use of the data includes such issues as who will author, who will publish, how findings will be released, timing on data release, and format/language for dissemination.
6. Allow plenty of time for negotiations. Be flexible. Don't let time pressures push aside resolution of important issues. It will save time and frustration later. Don't waste everyone's time on topics of interest to only one system. Be willing to compromise. If the product of your joint effort isn't greater than either system could achieve alone, don't bother collaborating!
7. Avoid responding to timelines imposed from the outside. Changing the agenda or timelines mid-project puts great pressure on your partner. Agree ahead of time on a schedule for collection, analysis, and release of findings that you can all live with - and stick to it!
8. Take responsibility for the pieces of the project that have a direct impact on your Extension work assignment. Think through the aspects of the project that have a direct impact on your job, the needs of your system, and the expectations of your supervisor and your constituents. Make sure that you control production of this part of the project. No one cares as much about your needs as you do.

In this case, the goal of cooperation was essential to success. Working to achieve it was worth the effort! Without the knowledge base, expertise, and prestige of the medical school faculty, the Teens in Distress research effort would have lacked credibility, clarity, and depth. Without the outreach, networking, and educational commitment of Extension faculty, the program would have lacked breadth, public ownership, and a mechanism for systematic follow-through in schools and communities across the state. Remember, major philosophical issues and professional expectations must be negotiated when two different university organizations motivated by two different, sometimes conflicting, agendas collaborate.

Talk with the Author

The Journal Partyline

January 20, 1989
10:30 a.m. CDT

Here's your chance to learn more about this collaboration effort in Minnesota. On Friday, January 20, 1988 at 10:30 a.m. CDT, you can call in to talk with this author. To reserve one of the special telephone lines, call Colleen Schuh at 608-262-3502 by January 13, 1989.