https://doi.org/10.4081/qrmh.2018.7816
Not a duty but an opportunity: exploring the lived experiences of community health workers in Indiana through photovoice
Submitted: 10 September 2018
Accepted: 19 November 2018
Published: 17 December 2018
Accepted: 19 November 2018
Abstract Views: 2201
PDF: 640
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All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
Few studies have conducted photovoice projects to explore themes related to the lived experiences of community health workers (CHWs). As a relatively unknown segment of the health care workforce in the United States, CHWs are typically members of the communities they work within and fulfill unique and complementary roles through health education, health prevention, community outreach, and advocacy. This article documents a photovoice project that assessed the strengths, challenges, impacts, and what it means to be a CHW in Indiana. In this project, CHWs participated in the method of photovoice in two formal meetings – one to introduce the method and another to analyze the photographs. Participants displayed photographs, interpreted these images, and co-constructed their lived experiences. Several key themes emerged from discussion of the photographs including: participant descriptions of building individual and character traits, conceptualizations of this position, and how participants connect disparate resources for their clients. Themes and findings from this research can be utilized to reach out to potential employers and policy makers regarding the integration of CHWs into the workforce. Overall, this project documents the lived experiences of CHWs and highlights their voices as they become an accepted member within the broader workforce.
Bureau of Labor Statistics. Occupational employment and wages, May 2017. 21-1094 Community health workers. 2017. Available from https://www.bls.gov/oes/current/oes211094.htm
Ingram M, Reinschmidt KM, Schachter KA, et al. Establishing a professional profile of community health workers: Results from a national study of roles, activities and training. J Community Health 2012;37:529-37.
DOI: https://doi.org/10.1007/s10900-011-9475-2
Rosenthal EL, Brownstein JL, Rush CH, et al. Community health workers: part of the solution. Health Aff 2010;29:1338-42.
DOI: https://doi.org/10.1377/hlthaff.2010.0081
Najafizada AM, Bourgeault IL, Labonte R, et al. Community health workers in Canada and other high-income countries: A scoping review and research gaps. Can J Public Health 2015;106:e157-64.
DOI: https://doi.org/10.17269/CJPH.106.4747
Balcazar HG, Rosenthal EL, Brownstein JN, et al. Community health workers can be a public health force for change in the United States: Three actions for a new paradigm. Am J Public Health 2011;101:2199-203.
DOI: https://doi.org/10.2105/AJPH.2011.300386
London K, Damio G, Ferrazo M, et al. Addressing social determinants of health through community health workers: A call to action. Policy brief. Hispanic Health Council. 2018. Available from http://hispanichealthcouncil.org/images/Brief2018.pdf
Kangovi S, Grande D, Trinh-Shevrin C. From rhetoric to reality – community health workers in post-reform U.S. health care. New Engl J Med 2015;372:2277-9.
DOI: https://doi.org/10.1056/NEJMp1502569
Wang C. Photovoice: A participatory action research strategy applied to women’s health. J Women’s Health 1999;8:185-92.
DOI: https://doi.org/10.1089/jwh.1999.8.185
Wang C, Burris MA. Photovoice: Concept, methodology, and use for participatory needs assessment. Health Educ Behav 1997;24:369-87.
DOI: https://doi.org/10.1177/109019819702400309
Johnson CM, Sharkey JR, Dean WR, et al. Promotoras as research partners to engage health disparity communities. J Acad Nutr Diet 2013;113:638-42.
DOI: https://doi.org/10.1016/j.jand.2012.11.014
Nebeker C, Kalichman M, Talavera A, Elder J. Training in research ethics and standards for community health workers and promotores engaged in Latino health research. Hastings Center Report 2015;45:20-7.
DOI: https://doi.org/10.1002/hast.471
Pérez LM, Martinez J. Community health workers: Social justice and policy advocates for community health and well-being. Am J Public Health 2008;98:11-4.
DOI: https://doi.org/10.2105/AJPH.2006.100842
Baquero B, Goldman SN, Simán F, et al. Mi cuerpo, nuestro responsabilidad: Using photovoice to describe the assets and barriers to sexual and reproductive health among Latinos. J Health Dispar Res Pract 2014;7:65-83.
Mayfield-Johnson S, Rachal JR, Butler J. When we learn better, we do better: Describing changes in empowerment through PhotoVoice among community health advisors in a breast and cervical cancer health promotion program in Mississippi and Alabama. Adult Educ Q 2014;64:91-109.
DOI: https://doi.org/10.1177/0741713614521862
Mitchell C, DeLange N, Moletsane R, et al. Giving a face to HIV and AIDS: on the uses of photo-voice by teachers and community health care workers working with youth in rural South Africa. Qual Res Psychol 2005;2:257-70.
DOI: https://doi.org/10.1191/1478088705qp042oa
Allen JK, Himmelfarb CR, Szanton SL, Frick KD. Cost-effectiveness of nurse practitioner/community health worker care to reduce cardiovascular health disparities. J Cardiovasc Nur 2014;29:308-14.
DOI: https://doi.org/10.1097/JCN.0b013e3182945243
Arvey SR, Fernandez ME, LaRue DM, Bartholomew LK. When promotoras and technology meet: A qualitative analysis of promotoras’ use of small media to increase cancer screening among South Texas Latinos. Health Educ Behav 2012;39:352-63.
DOI: https://doi.org/10.1177/1090198111418110
Cross-Barnet C, Ruiz S, Skillman M, et al. Higher quality at lower cost: Community health worker interventions in the health care innovation awards. J Health Dispar Res Pract 2018;11:150-64.
Carlson ED, Engebretson J, Chamberlain RM. Photovoice as a social process of critical consciousness. Qual Health Res 2006;16:836-52.
DOI: https://doi.org/10.1177/1049732306287525
Langhout RD. Photovoice as methodology In: Schenker MB, Castañeda X, Rodriguez-Lainz A, eds. Migration and health: a research methods handbook. Oakland: University of California Press; 2014. pp 327-342.
Bade B, Martinez K. Full circle: The method of collaborative anthropology for regional and transnational research. In: Schenker MB, Castañeda X, Rodriguez-Lainz A, eds. Migration and health: a research methods handbook. Oakland: University of California Press; 2014. pp 306-326.
Schaaf M, Warthin C, Manning A, Topp S. Report on the ‘think-in’ on community health worker voice, power, and citizens’ right to health. 2018. Available from http://accountabilityresearch.org/web/wp-content/uploads/2018/01/Learning_Exchange_Report3_January-18-1.19.18.pdf
Nichter M. Global health: why cultural perceptions, social representations, and biopolitics matter. Tucson: University of Arizona Press; 2008.
Nading A. Love isn’t there in your stomach: a moral economy of medical citizenship among Nicaraguan community health workers. Med Anthropol Q 2013;27:84-102.
DOI: https://doi.org/10.1111/maq.12017
Goldade K. Health is hard here or health for all? The politics of blame, gender, and health care for undocumented Nicaraguan immigrants in Costa Rica. Med Anthropol Q 2009;23:483-503.
DOI: https://doi.org/10.1111/j.1548-1387.2009.01074.x
Horton S. Different subjects: The health care system’s participation in the differential construction of the cultural citizenship of Cuban refugees and Mexican immigrants. Med Anthropol Q 2004;18:472-89.
DOI: https://doi.org/10.1525/maq.2004.18.4.472
Closser S. Pakistan’s lady health worker labor movement and the moral economy of heroism. Ann Anthropol Prac 2015;39:16-28.
DOI: https://doi.org/10.1111/napa.12061
Sabo S, Wennerstrom A, Phillips D, et al. Community health worker professional advocacy. J Ambul Care Manage 2015;38:225-35.
DOI: https://doi.org/10.1097/JAC.0000000000000089
Colvin CJ, Swartz A. Extension agents or agents of change? Community health workers and the politics of care work in Postapartheid South Africa. Ann Anthropol Prac 2015;39:29-41.
Castañeda H, Holmes SM, Madrigal DS, et al. Immigration as a social determinant of health. Annu Rev Public Health 2015;36:375-92.
DOI: https://doi.org/10.1146/annurev-publhealth-032013-182419
How to Cite
Logan, Ryan I. 2018. “Not a Duty But an Opportunity: Exploring the Lived Experiences of Community Health Workers in Indiana through Photovoice”. Qualitative Research in Medicine and Healthcare 2 (3). https://doi.org/10.4081/qrmh.2018.7816.
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