While you are expected to review all of the readings, here are some hints to help you cover the material in an effective and quality way.
- Review the lectures before you read. Embedded in the lectures are questions to help you think about what you are reading and prepare for the class discussions.
- Review the threaded discussion questions before you read. They will help guide the focus of your reading.
- Review any case studies or extra material before you do the readings.
- Once you have completed the readings, review case studies and extra material again with the discussion questions in mind.
Core Concepts and New Theories
There are three core concepts that provide the underpinnings for how we will be thinking and talking about CBPR work during this course: participation; theories and use of knowledge; and power relations. Let’s discuss each of these concepts.
Since the 1970s participation has been a hot topic in public, global, and environmental health spheres. Community participation is seen as critical to sustainable change and health enhancement. However, academic professionals have questioned the authenticity of participation and community members often doubt its value in improving their situations. Community members are often ensnared in modern society’s “systems” with their life worlds and concerns commoditized and homogenized. As a result, community members often feel like they don’t matter and their participation won’t make a difference. The Academy often reinforces this idea.
How do we get to meaningful participation? To begin, we must think of participation as a complex developmental, emergent and iterative process that changes over time based on the level of nurturing the partnership/relationship receives and the shifting power relations and social and historical contexts of the research project. So, as the public health professional, you must begin by recognizing: 1) the historical research relationships and historical traumas within a community; 2) power differentials between you and the community; and 3) the differing needs and agendas of the academic researcher and the community. You must be willing to engage in hard discussions about these issues and develop a capacity for self-reflection to see your own role in current relations and past histories.
You must also ensure that constituents from every level of the community are represented. Often, community agency leaders are asked to participate rather than the people on the ground, who are living the experience every day. It’s important to make sure that people who are closest to the experience are included at the table and given a voice.
Theories and Use of Knowledge
The positivist approach to science is that all knowledge creation is bias-free and value-free. In public health positivism is considered to be “a powerful ideology that thwarts the field’s interests in alleviating suffering and promoting social justice” (p. 33). Ouch! CBPR’s approach to the creation of knowledge and its use is hermeneutic, emancipatory, and values people’s experiential reality and their local knowledge. CBPR views knowledge and its creation as historically and social constructed, and therefore, knowledge can never be value or bias free. CBPR seeks to understand the power differentials and systemic inequities and with that new understanding (i.e. knowledge) challenges and changes the power structures under which people are suffering. In CBPR knowledge is emancipatory, that is it seeks to improve and/or enhance the health of the people in collaboration with the people. CBPR differs from positivistic approaches because it is always engaged in the situation and never takes a distanced or ahistorical stance. The social and historical contexts in which knowledge is developed are an inherent part of the CBPR process. In CBPR, knowledge is co-created via dialogue between people (that is, researchers and community members) and the social contexts in which they exist (e.g. the community and the university).
In CBPR work, people think critically about the worlds in which they live and question together how they can make different choices to improve their circumstances. Knowledge generated by CBPR is valued for its practical application as well as for its capacity to provide information more generally. These qualities of CBPR grounds it in hermeneutic versus positivistic approaches to knowledge creation. For more information about these two approaches, see Positivism & Hermeneutics A Brief Primer and the hand-out, Positivistic and Hermeneutic Table.
CBPR practitioners must be acutely aware of the power dynamics at play in their work and always strive to equalize inequitable power structures. In relation to working with marginalized or underserved communities, it is important to think critically about power’s repressive role in these community members’ lives. Repressive power is often hidden behind the dominant narrative of one powerful group. People are not able to participate in deliberations about their access to improved education, employment, and living conditions because the hegemony or dominant power structure directly and indirectly controls (e.g. through policies and language) peoples’ access to power and control over the systems and structures that affect them. CBPR seeks to break open these hidden and dominant power sources as a way to enhance health and promote social justice.
Repressive power is diffused throughout society via discourse, practice, and relationships. While repressive power is very controlling it is also unstable and always open to being challenged (which is the work of CBPR practitioners). In challenging power, e.g. community members gaining experience and skills in research, the power transforms from repressive to productive. Productive power has the capacity to resist and overturn repressive power structures, therein giving the community power, control, and self-determination over itself.
As the CBPR practitioner, it is important to be aware of the repressive power structures (the university, the public health department) you represent coming into a community. Your race and gender may also represent repressive power. Therefore, you must be willing to examine your positions of power and let the community examine those positions with you. This is how trust, over time, is developed with communities. It is also how the power differentials between the Academy and the Community begin to be equalized.
To continue the lecture readings, click the following links.
Linda Tuhiwai-Smith | Michel Foucault | Paolo Friere