Making Change Personal – Deb Dole

Engaging communities really begins with engaging individuals. I have written recently about voice, building capacity, representing communities, and engaging communities. My own dissertation work with adolescent mothers opened my eyes to a new way of engaging people in discussion through photography. I am not an artist. I am not a professional photographer. I AM visually stimulated. I AM a visual learner – figuratively and literally. I think in terms of analogy – usually a visual analogy. When I "see" it in my mind, it then becomes a reality. The possibilities are endless. What does this have to do with making change personal? The process of self-reflection forces one to "see" in context.

 This photograph meant one thing to the teen mom who took it – it captured her sense of being trapped in a corner. It came to symbolize something different for me – there is always a way out. The differing perspectives seemed to reflect where we each were in our experience. I was "out", she was still trapped.
As I reflected on the differing perspectives I began to recognize the importance of seeing. A group of teen mothers were given cameras and answered their own group generated questions through photography, group discussion, journaling and collage building. During that process my role as researcher quickly evolved into facilitator, and learner. It was through their eyes that I began to see myself differently. It was a change that altered the way I practice, the way I communicate, the way I engage.  For that I am grateful.

Alphabet Soup, Community Health and Capacity Building – Deb Dole

AR, PAR, PR, CBPR, CBR - The letters and words we use to describe the process and practice of participation and action sometimes appear as a secret language code created by and for the select and privileged. The parrallel threads of action and participation cross at multiple points along the contimuum of engaged scholarship that implies both social action and participation. As a fledgling action researcher who identifies strongly with community-based participatory research, I find myself contemplating my own identity.  Can I lay claim to any one research family?  Along with family membership comes responsibility and accountability.


Stoecker (2009) discusses the historical division and divergent nature of action and participation. Differentiating community-based organizations from the term community. How is community participation defined in terms of setting the agenda, identifying the issues, strenghts and potential strategies? What does the “action” consist of?  Does one begin the process of engaging participation of a community through a community-based organization who may or may not represent community member interests.

What is the end game? Is it through participation that social action is possible? How does capacity impact the ability to participate in order to even envision social change? Nelson, Poland, Murray and Maticka-Tyndale (2004) propose a framework for capacity-building within community health graduate programs. In the context of developing a framework for educating future community health researchers, the approach supports the idea that those engaging in research for social change must first have their own capacity envisioned and developed. This process is accomplished through clear identification of values, assumptions, power, partnership, systems and action.  Build your own capacity first before you attempt to build others.  Seems like a pretty obvious concept.

The questions are many and the answers remain elusive.  I do believe standing at the intersection of participation and action requires one to have capacity.  The alphabet soup seems to matter less than the ability of the researcher to reflect on their own motives and expectations.  Only then can we truly facilitate capacity building in the community. 


Referenced:
Nelson, G., Poland, B., Muray, M. & Maticka-Tyndale, E. (2004). Building capacity in community health action research. Action Research, 2(4), 389-408.
Stoecker, R. (2009). Are we talking the walk of community-based research? Action Research, 7(4), 385-404.

Does the “community” really have voice? – Deb Dole

The business of health care has effectively muffled, if not silenced the voice of communities. The real needs of communities are often overlooked as health care dollars, programs and initiatives are rolled out in an effort to "fix" what is believed to be broken. The result is a labeling of individuals and communities as "non-compliant" or "resistant" when the pre-determined initiatives do not have the desired effect. I was perusing http://www.Grants.gov/ to see what the latest topics in maternal/child health were being funded. All of the buzz words such as "health disparities", "infant mortality", and "teen pregnancy" were prominently displayed in many titles. After reading further, a majority of funding opportunities were directed at implementation of programs previously "proven effective". Where is the voice of the community in determining what their own needs are or what programs might be useful? Issues of power and control continue to rule the day.

Action research and community-based participatory research hold the promise of changing the dynamics of the discussion…redistributing the power. The midwife in me tends to want to mother those around me. While well-intentioned, sometimes this is not the most helpful approach. Let me help you often turns into let me do it for you. Engaging communities, not just health professionals who work in communities in the discussion is critical to turning up the volume of community voice. Teaming those who have access and voice (academic community, medical professionals) with those who have been muffled or silenced can fundamentally change the ways in which public policy directed at the health of communities can be shaped to actually benefit those communities. Change from the inside out…lasting and meaningful…How do we start?

Maybe we start by listening.