Abstract
Objectives: Racial disparities in health present a challenge to public health because of the complexity of interacting social forces. The Harlem Birth Right Project sought to improve understanding of these forces by using qualitative and community participatory methods. In this paper we 1) describe the process of qualitative inquiry and community involvement, 2) evaluate the impact of community participation, and 3) present a brief summary of the findings on social context as it relates to pregnancy outcomes of women in Harlem. Methods: We operationalized the qualitative method by combining participant observation, longitudinal case studies, and focus groups. An ethnographic survey was used to verify and triangulate findings across methods of data collection. We involved the community in the design, implementation, and analysis by collaborating with community-based organizations, setting up a community advisory board, and the use of dialogue groups and community meetings. Results: The use of qualitative methods and community partnership uncovered important aspects of the social context of women's lives that may not have emerged through traditional epidemiologic research. We found that pregnancy may serve as a catalyst to increase perception of the magnitude of preexisting social stressors. Several stressors and chronic strains associated with structural forces were identified. For example, the high percentage of households headed by women is seen as one consequence of larger structural forces. While social support networks serve as an important coping mechanism to buffer against the stress caused by these structural forces, the types of support women seek differs by social strata, and some strategies were identified as being substantially more effective than others. Conclusions: Qualitative and community participatory research can be successfully conducted to support public health goals and can derive important new information on the social context of women's lives.
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REFERENCES
Schoendorf KC, Hogue CJR, Klienman JC, Rowley DL. Mortality among infants of blacks as compared to white collegeeducated parents. N Engl J Med 1992;326:1522–6.
Baum F. Researching public health: Behind the qualitative-quantitative methodological debate. Soc Sci Med 1995;40: 459–68.
Rothman KJ, Greenland S, editors. Modern Epidemiology, 2nd ed. Philadelphia: Lippincott-Raven, 1998.
Wise PH. Confronting racial disparities in infant mortality: Reconciling science and politics.AmJ Prev Med 1993;9(Suppl. 6):7–16.
Mullings L, Wali A. Stress and resilience: The social context of reproduction in Harlem. NewYork: Kluwer Academic/Plenum Publishers, in press.
Fullilove MT. Psychiatric implications of displacement: Contributions from the psychology of place. Am J Psychiatry 1996;153:1516–22.
New York City Department of City Planning. Community District 10. New York: Department of City Planning, 1990.
Health and Hospitals Corporation. A summary examination of excess mortality in Central Harlem and New York City. New York: Office of Strategic Planning, Health and Hospitals Corporation, 1991.
Chesler MA. Participatory action research with self-help groups: An alternative paradigm for inquiry and action. Am J Community Psychol 1991;19:757–69.
Fals Borda O. Participatory action research. Development 1984;2:18–20.
Freire P. Pedagogy of the oppressed. New York: Continuum Press, 1970.
Park P. What is participatory research? A theoretical and methodological perspective. In: Park P, editor Voices of change: participatory research in the U.S. and Canada. Westport, CT: Bergen and Garvey; 1993.
Schensul M, Stull JD. Collaborative research and social change: Applied anthropology in action. Boulder, CO: Westview Press, 1987.
Schensul S, Borrero M. Resource-based training for organizational change. Urban Anthropol 1982;11:129–53.
Schensul S. Skills needed in action anthropology: Lessons from El Centro de la Causa. Human Organization 1974;33:203–209.
Whyte WF, editor. Participatory action research. Newbury Park, CA: Sage, 1991.
Gamble VN.A legacy of distrust: African Americans and medical research. Am J Prev Med 1993;9(Suppl. 6):35–8.
Rowley D, Hogue CJR, Blackmore C, Ferre C, Hatfield-Timajchy K, Branch P, Atrash H. Preterm delivery among African American women: A research strategy. Am J Prev Med 1993;9(Suppl. 6):1–6
Patillo-McCoy M. Black picket fences: Privilege and peril among the Black middle class. Chicago: University of Chicago Press, 1999.
Williams B. Poverty among African Americans in the United States. Human Organization 1993;51:164–6.
Dohrenwend BS, Krasnoff L, Askenasy AR, Dohrenwend BP. Life events: The PERI life events scale. J Health Soc Behav 1978;19:205–29.
McLean D, Hatfield-Timajchy K, Wingo PA, Floyd RL. Psychosocial measurement: Implications for the study of preterm delivery in black women. Am J Prev Med 1993;9(Suppl. 6):39–81.
Brown GW. Social origins of depression. NewYork: Free Press, 1978.
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Mullings, L., Wali, A., McLean, D. et al. Qualitative Methodologies and Community Participation in Examining Reproductive Experiences: The Harlem Birth Right Project. Matern Child Health J 5, 85–93 (2001). https://doi.org/10.1023/A:1011397031640
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DOI: https://doi.org/10.1023/A:1011397031640