Classmate 1: Jasmine: Hope your Thanksgiving Eve is peaceful, and all your famil

Classmate 1: Jasmine: Hope your Thanksgiving Eve is peaceful, and all your family and friends are safe and well! Six years ago, at this time of year, my best friend informed me she had cancer. She didn’t make it three months. I have missed her every day. Five years ago, also during this month, my husband’s life was altered forever in a simple car accident ‘sandwich’ in which he was in the middle car. We received more bad news about a close friend who may have cancer today. Being born on Thanksgiving, I have a thankful soul, but also knowing life isn’t always peachy, we are continually called upon to assist where there is a need, whether with our family, our friends, or our community. I am reminded to not only be thankful for the things I have, my health, ability to help others, being able to meet my family’s basic needs as well as a few wants. I am also grateful for things I don’t have, such as a cancer diagnosis, poor health, or a disability that limits my ability to work or play. There is so much work to be done in public health, and I am honored to learn alongside each of you as we prepare ourselves to fulfill some very difficult positions in the future.
This module forced me to think deeply about interactions with my students and staff, especially during the previous three school years, and why I have the approach that I do. I am brought back to a class in nursing school, called ‘Caring’, in which we spent an hour a week getting to know a single patient, not their diagnosis, or their vitals, or any health concerns (unless they came up in conversation) but instead, we sat with them, learning who they were, as a person. It was the most meaningful class I have ever taken, and it forced me to become comfortable sitting quietly with another human even when there was nothing left to say. It helped me see people as people, not just the numbers I could glean from them, or their ICD-10 codes, although these are important too! It helped me realize that everyone has a story, that they may want to share, in their own time, which may take a very long time, if ever, for them to fully trust enough to open their heart. Module 5 helped further validate my stance that numbers aren’t always everything. Before I left my previous job, a coworker asked what they would do without me, what things they might be missing in providing care to the students. I replied that getting to know the student’s baseline normal was the most important thing, and this needed to be done through listening to those spending the most time with the student’s day in and day out, the teacher associates. Listening to concerns associates brought regarding their students, who spent hours a day working closely with them and who knew them the best of anyone, was golden. This particular coworker of mine did not embody this mindset, and had a sign by their desk that helped describe their attitude about others’ concerns:
This attitude, which I attempted to embody over our time together since I thought my approach wasn’t good enough, tended to create much more tension than just being open and welcoming to those with concerns. I was much relieved when I found out the person replacing me likely had a more encompassing attitude for working with others, and I knew that concerns would be heard, and resolved before an injury or illness reached full exacerbation.
One of those ‘near misses’ occurred last spring when a student with limited communication who also historically cried ‘wolf’ several times in the past, was reporting pain in her stomach and shortness of breath. I could hear the concern in the staff’s voice as they summoned a nurse on the walkie. I ran to assist the student, and when I arrived, I was filled in on how the student passed out briefly and turned blue. We were not aware of any recent seizure history, but the student, whose vitals were within perfect normal limits, continued to report severe abdominal pain, chest pain, and shortness of breath. Knowing previous encounters with the student, I knew she didn’t look right. Although there was no concrete distress, not enough to initiate EMS response, I contacted the guardian and pleaded with them to go to urgent care for evaluation and to pick the student up vs. having the student ride the bus home. My coworker arrived after me to evaluate the student as well, and not seeing what I had seen, nor believing what I had seen, began to smooth it over, saying, well, the student looks ok, no apparent distress, they should be fine, likely it was due to the large BM eliminated several hours before. I held my ground, and after fighting my case with the guardians, I fought my own coworker to force evaluation of the student. Although nothing came of the urgent care visit that night, the student continued to have issues on and off over the following three days, and finally, a visit to the ER found the issue, a blood clot in her leg and lungs.
Building trust with a ‘community’ takes time, and maintaining that relationship requires hard work, but the rewards are immeasurable. Learning about the cultural norms, values, and struggles those in underserved ethnic communities face takes time for the CBPR researcher to uncover. The communities are not out seeking help, in many instances, they may hide their struggles, as they will be seen as a sign of weakness. Especially with someone ‘invading’ from the outside, bringing hopes of doing research, which we have discussed previously, carries negative connotations for many who have not been treated with dignity or respect when being ‘studied’. Knowing a community’s ‘baseline’ is also beneficial, so that seeing them in times of stress can be detected if they are not able to verbalize their pain or stress at any given moment. (Berry 2012) (Chamberlain 2021)
An emerging participatory perspective to me means to respect the research that has been collected, and continue to build upon that knowledge, but to encompass the knowledge ‘of the streets’, of those living and breathing and dying in those streets, as their stories have been left untold, continuing to be wiped from the record, if they are even approached at all. It is our duty to uncover these stories, to validate the concerns of those within our underserved target population, and not only add it to the current body of knowledge, but to give credit to those willing to give a true account of their life path, so that we may begin to find beneficial ways of helping those unable to advocate for themselves.
Have a safe and Happy Thanksgiving everyone!
Chamberlain University (2021). MPH509 Community Based Participatory Research. Week 5. Downers Grove, IL: Online Publication.
Berry, N., McQuiston, C., Parrado, E., & Olmos-Muñiz, J. (2012). CBPR and ethnography: The perfect union. In B. Israel, E. Eng, A. Schulz & E. Parker (Eds.), Methods for community-based participatory research for health (2nd ed.), pp. 305–334.
classmate 2: Andrea: Something I thought was key in this week’s evaluation of action research was the shift from peer-reviewed research findings to research that is accessible to the community of interest. When the authors speak toward having an emerging participatory perspective, they mean to say that community based participatory research moves away from studies that are only accessible for those with means of power, whether that be economic, educational, language driven, or the like and toward studies that benefit those whom are not benefitting from these privileges. This perspective shift makes participants of the study–the community members–active participants in their community’s development. By having an emerging participatory perspective, action researchers are able to remove the social hierarchy between researcher and observed.
An example from this week’s course readings of emerging participatory perspectives is the peer-mentoring CBPR pilot study. Formerly incarcerated men were put in focus groups to develop coping skills and intervention strategies for this population, who are at high risk for problems such as substance abuse disorders or future imprisonment, so that the group can make smooth transitions into their lives after prison (Marlow et al, 2015). While this research study included academics, the research team was also comprised of formerly incarcerated individuals who served as mentors. In this way, the researchers engaged in the participatory worldview, where they approached the study using experiential knowing. While this kind of participatory research would be ideal for positively engaging the target demographic, the reality of such studies is quite complex, as many marginalized communities experience distrust in research studies, leading to poor participation in some cases. I understand one hope for CBPR research is to alleviate some of this distrust by introducing respect and engagement into the make up of action research, where participants can clearly see their direct impact on a community, rather than studies aimed for academics in peer-reviewed journals.
Reference:
Marlow, E., Grajeda, W., Lee, Y., Young, E., Hill, K., & Williams, M. (2015). Peer Mentoring for Male Parolees: A CBPR Pilot Study. Progress in Community Health Partnerships: Research, Education, and Action, 9(1), 91–100.
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