Power between evaluator and community: research relationships within New Mexico's healthier communities

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Abstract

The relationship between evaluators and communities has been changing in the last two decades to a model of research `with' the community, instead of research `on' the community. This shift has paralleled increasing community demands for accountability and authority as community participation rhetoric has given way to words such as partnership, collaboration and community empowerment. Despite the rhetoric, there has been little reflection on the problematic and contradictory relationships between communities and researchers, specifically as related to their differing positions of power.

This article provides a reflective examination of the contested power dynamics of the research relationship within a participatory evaluation process of the Healthier Communities initiative in New Mexico. An in-depth literature review of the philosophical principles and the complex realities of evaluations based on participatory, community-driven and post-modern inquiry precedes the case study. Without ongoing consideration of power issues, the article argues that evaluation design, implementation and utilization of findings will be compromised.

Introduction

In the last two decades, the relationship between evaluators and community programs has been shifting from a model of research `on' the community to a model of research `with' the community. This shift towards community-based research has occurred in part because of community demands and in part because of government and private foundation mandates for coalitions, community advisory boards and community engagement (Goodman et al., 1993a, Goodman et al., 1993b, Kaftarian and Hansen, 1994, Connell et al., 1995, CDC, 1997). Academic research linkages to public health initiatives have also been increasing Bruce, 1995, Novotny and Nitzkin, 1996, Healton and Novotny, 1997, Seifer and Connors, 1997. The 1960s discourse of community participation has been supplanted with words such as partnership, collaboration, community empowerment and community capacity. In the evaluation field, many researchers have embraced the corollary rhetoric of empowerment evaluation or participatory action research Fals-Borda and Rahman, 1991, Fetterman et al., 1996.

Although there has been an upsurge of interest in community-based research and its methodologic problems, there has been little written about the problematic relationships between communities and evaluators/researchers. Recent case stories and philosophical writings have captured some of the dilemmas and tensions between health professionals and communities Labonte, 1994, Plough and Olafson, 1994, McKnight, 1995, Buchanan, 1996, Grills et al., 1996, Nyden et al., 1997, yet many of the challenges and contradictions of our role, especially related to our positions of power, as health researchers and evaluators, remain unexplored.

Issues of power are not typically addressed in the public health scientific literature, yet lack of power and control has been identified as an over-arching disease risk factor Syme, 1989, Wallerstein, 1992, Wilkinson, 1996, as a barrier to research findings being used for policy change (Waitzkin and Hubbell, 1991) and, from the position of research subjects who often have lower social status than that of researchers, as a barrier to collaborative community-based research.

Theories of power within the social and political sciences range from a pluralist view of equal competing agendas Dahl, 1961, Polsby, 1963, to a view of oppression based on political-economic and hegemonic power (Gramsci, 1971), or ideologic manipulation Lukes, 1974, Gaventa, 1980, Edelman, 1988. Ideology exerts power through exclusion of people from the agenda-setting process, through internalized oppression and victim-blaming Freire, 1970, Ryan, 1971, Gans, 1995, Lykes et al., 1996.

Foucault challenges the hierarchical view of oppressive power, arguing that power is a localized relationship of a multiplicity of forces, expressed through language and knowledge claims, particularly the knowledge-truth of scientific discourse (Foucault, 1977). Although knowledge/power attempts to produce a normalized truth, Foucault further argues that power relations are inherently unstable and therefore potentially reversible. Through `subjugated knowledges', people without power express their resistance in hidden and public discourse to reclaim their power (Scott, 1990).

The concept of empowerment builds on the productive nature of power as a progressive force: a social action process in which people in communities gain mastery and control over their lives (Rappaport, 1987).

In this paper, power dynamics will be discussed as a contested relationship between the illegimate abuses of power over others by the funding agency and the power/knowledge of the evaluator and the resistance to these oppressive forces by the community, through their legitimate claims to empowerment and self-determination and through their resistance to the evaluation findings.

My own role in community work has been as a long-time advocate for community power, empowerment and capacity-building to improve community life (Minkler and Wallerstein, 1997a). My work over the years has shifted from that of a community educator/organizer, to that of an academic evaluator of community-based initiatives. While I received guidance in my community organizing work from mentors and from case reports on how to successfully `enter' and work with communities, I have found the transition to evaluation difficult in using the principles of listening and respect for community opinions as I attempted to engage in participatory evaluation.

This case study of the New Mexico Healthier Communities initiative seeks to illustrate some of the tensions and contradictions in conducting a participatory community-based evaluation. As the lead evaluator of this initiative, I was an advocate for participatory processes and believed strongly that healthy communities, in particular, merited a participatory design. Yet, as I engaged in this process over a four-year period, I became painfully aware how difficult it is to walk the talk of participatory evaluation, especially when I did not recognize the positions of power which I represented in relation to the communities. Before illustrating these issues in the case study, I first present some of the strengths and weaknesses of the literature on community participation in community-based evaluation and research.

Section snippets

Participatory action research

Much of the writing related to community-based research has proposed a set of laudable principles and values in which the community jointly shares in the planning, implementation and dissemination of the research results. The oldest American tradition for this approach is that of Lewin's school of `action research' from the 1940s, which has spawned collaboration between researchers/evaluators and organizations to promote problem-solving, new knowledge production and transformational leadership

Case study from New Mexico healthier communities

The state legislature launched New Mexico's Healthier Communities with US$200,000 initial funding in 1992, as a result of efforts from child advocacy groups, the Department of Health and human service professionals. The driving force was to improve the quality of life for children and families in New Mexico who face some of the worst health statistics in the nation. The state ranks 50th in lack of adequate pre-natal care; first in fatalities from drunk driving crashes per capita; first in lack

Evaluation design

In 1992, after the money was allocated to the communities, I proposed to the Department of Health an evaluation of the process and outcomes of healthier communities in the first four sites, although there was no additional funding. I felt the state should not lose the opportunity to understand what facilitates or hinders success in community organizing and collaborative planning efforts to improve health. My first step was to issue an open invitation to Partnership members, the funded

Evaluation methods

The evaluation committee proposed a baseline community profile to become the initial community memory of the project. The committee chose an interview methodology with informal and formal leaders, with additional participant-observation of community processes. With last-minute additional funding from the Department of Health, I was able to hire four graduate students, one for each site, to conduct twenty to twenty-five interviews per site and to compile the first year profile. Interviewees came

Core learnings

While the baseline findings are found elsewhere1, this article centers on the learnings about the power relationships between myself as evaluator and the communities during the implementation of the evaluation itself.

Several baseline findings uncovered tensions at the community level and state level; the latter mirrored the conflicts that appeared between myself and the communities. At the community level, community leaders held

Acknowledgements

Much appreciation for comments on an earlier draft from Bonnie Duran, Meredith Minkler, Michel O'Neill, Michele Polascek, Allan Steckler, Howard Waitzkin and special thanks to two healthier communities' coalition coordinators, Patricia Erickson and Louisa Rogers.

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