WORKABLE SOLUTIONS FOR COMMUNITY EMPOWERMENTA presentation at the 2012 National Refugee and Immigrant Conference
Sharon Morrison, Jigna Dharod, Stephen Sills, Maura Nsonwu, Andrew Young, Huaibo Xin
Chicago
Oct 18-19, 2012
SEE FULL SLIDESHOW
Origins
This presentation came about from our need for a methodology that explains how academic research conducted by Center for New North Carolinians (CNNC) research fellows through the Montagnard Health Disparities Research Network relates to and reinforces practical community-based action in Montagnard refugee neighborhoods.
Our Chicago presentation (see full slideshow) was outlined in a series of frames, starting from the largest, our CNNC association, to our highly focused work with the Montagnard community.
First, we walk viewers through CNNC partners, research fellows’ team, and stakeholders.
Next, we outline viewers’ take away from the presentation, its learning objectives.
The common conceptual frame for our understanding of the health disparities we see in the Montagnard community are explained through a game model that closely follows game theory.
A game model can help explain outcomes created by the interaction of two parties in the absence of complete information. It is also an effective way of demonstrating the psychology of players as they make decisions and see the results.
We have some hard data and many stories describing interactions between the Montagnard community and the region’s health establishment.
If conditions permitted we would gather more information, but this cuts to the heart of the Montagnard refugee experience. After some 25 years since their arrival, the American community at large seems to have concluded that sustained outreach is too hard and that costs exceed benefits.
Game models are one way out of this cul de sac because they can be constructed from existing information. Games are about choices, how conditions influence players’ choices, how players' choices modify conditions that in turn influence choices. Through the transformation of real-life scenarios into a game structure defined by rules, goals and players’ strategies, we can understand how certain choices and their results can generate the kind of real-life, deeply troubling stories we are told daily by community health workers and Montagnard families.
We invite participants to then share their experiences. Do they accord with the demonstration of the model?
We challenge those working with refugees, immigrants and newcomers to frame their experiences through a common conceptual frame because it contextualizes and explains many of the “horror stories” generated by avoidance, the frustrations and failures associated with competition, and the beautiful rare stories of collaboration and success.We next show a concept map from 2010 which shows the exasperating state of refugee affairs: many players, few rules and no discernible outcomes. This is a dysfunctional system that contextualizes the entire Montagnard experience.
We present short summaries of the research work of Stephen Sills, Sharon Morrison, Jigna Dharod and Huaibo Xin.We then define the relationship of research to community empowerment, reorienting ourselves to new information, community perspectives and needs, assessing and discussing options with community members, and then acting in concerted effort.
We review the presentations’ learning objectives.
In summary, we conclude with a new concept map which shows common goals for academic researchers and community members.
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Proposed goals of academics and refugee community with four parallel, mutually supportive tracks:
(1) CNNC/NCAT/UNCG/SIUE Academic Efforts
(2) CNNC Training for Montagnard MDs
(3) Community-Based Training for Montagnard MDs
(4) Community Health Worker Training.
Supportive Organizations not traditionally associated with health, medicine or research are also shown.
Waiting for “indispensable players”— health organizations and institutions that have direct stakes in refugee wellness — to come to the table has caused refugee community resources to be underestimated, has delayed community empowerment and the development of skills within the community that could improve its health, and has committed individuals and families to avoidable suffering and costly bills.
This map shows
(A) how a refugee community’s health can be improved despite the absence of indispensable players.
(B) how refugee expertise (former MDs, current CHWs) can be mobilized to educate and inform refugee families about wellness, preventive care, and health system navigation, while collecting data that builds the case for systemic changes that embrace culturally competent health care.
