Not a duty but an opportunity: exploring the lived experiences of community health workers in Indiana through photovoice

  • Ryan I. Logan | ryanlogan@mail.usf.edu Department of Anthropology, University of South Florida, Tampa, Florida, United States.

Abstract

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.

Dimensions

Altmetric

PlumX Metrics

Downloads

Download data is not yet available.

References

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

Published
2018-12-17
Info
Issue
Section
Original Articles
Keywords:
Community health workers, Photovoice, Access to care, Health disparities, Lived experience, Indiana
Statistics
  • Abstract views: 1254

  • PDF: 332
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.