Doing Health Anthropology: Research Methods for Community Assessment and Change Book

Acknowledgments     xiii
Preface     xv
Why Anthropology?     1
Guide to This Chapter     3
What is Cultural Anthropology? The Concept of Culture     3
How Do Cultural Anthropologists Collect Data?     6
How Do Cultural Anthropologists Analyze Data?     7
The Advantages of Anthropology for the Health Sciences     8
The Mighty Disease Model     9
The Social Perspective on Health     10
Why Isn't the Social Perspective More Widely Used?     11
The Advantages of the Social Perspective     13
Summary     19
Positivism: The Laboratory Theory of Knowledge     21
Guide to This Chapter     23
The Meanings of Knowledge     23
Positivism: The Laboratory Science Theory of Knowledge     25
Validity     26
Elegance and Parsimony     26
The Limits of Positivism     29
Summary     32
The Naturalistic Theory of Knowledge: Anthropology     33
Guide to This Chapter     35
Naturalistic Theory     35
The Idea of Usefulness     36
The Naturalistic Search for Knowledge     37
Intuition, or UsingWhat We Already Know     37
How Science Is Different from Everyday Problem Solving: The Issue of Persuasion     39
The Process of Naturalistic Research     39
Advantages of Naturalistic Knowledge     40
The Issue of Meaning     41
The Issue of Pattern Coherence     43
The Disadvantages of Naturalistic Theory     45
Verification     45
Objectivity     46
The Naturalistic Response     47
Time     48
Generalizability     49
What About Theory?     50
Summary     51
The Study of Real People in Natural Situations     53
Guide to This Chapter     55
Ethnography and the Anthropological Attitude     55
The Moral Relationship of Researcher and Community     56
Survey Research and the Positivist Attitude     60
The Importance of Contexts in Social Research     62
Summary     67
Designing a Research Project     69
Guide to This Chapter     71
The Process of Detailed Understanding     72
Identifying a Research Problem     75
Why Have We Chosen This Problem?     76
How Will We Recognize the Answer?     77
The Problem Statement     78
The Intuition Statement     80
Formulating Specific Research Questions     82
Characteristics of Good Questions     85
Research Design As a Continuous Process     86
Summary     86
The Researcher in and Beyond the Community     89
Guide to This Chapter     91
Participant Observation     91
Ethics and Values     93
Ethics for Other Styles of Research     94
Observing Unacceptable Behavior     95
Taking Roles, Fitting in     96
Clothing, Speech, Manners     97
Examples of Roles     98
The Role of Student or Scholar     98
The Role of Friend     100
The Roles of Leader, Teacher, and Expert     101
Culture Shock: Unavoidable, Highly Valuable     103
If Your Time in the Community is Limited     104
The Researcher Beyond the Community     106
Summary     108
Collecting Data     109
Guide to This Chapter     111
Planning for Research     112
The Research Problem     112
Background Research      113
Observing and Taking Notes     115
General Principles of Observation     116
What Situations and Behaviors to Observe     117
Minimizing Distortion     119
Rapport Building     120
Keeping Records     120
Audio and Video Recordings     120
Taking Notes     120
Adding Analytic Details     121
Interviewing     122
Minimizing Distortion     122
Closed-Ended Versus Open-Ended Interviews     123
Getting Truth Through Interviews     125
Maintaining Rapport     127
Keeping Interview Records 1     128
Unobtrusive Measures     130
Indirect Indicators     131
Summary     132
Analyzing Data     133
Guide to This Chapter     135
Data Analysis Uses Natural Human Skills     136
Analysis: Making Our Implicit Understandings Explicit     137
Data Management     138
Kinship Diagrams, or Genograms     139
Classification Trees, Organization Charts     140
Networks and Flow Charts     141
Face Sheets     142
How to Treat Data Management Tools      145
Analyzing Raw Data: Content Coding     146
Using Statistics     148
How to Read and Listen to Anthropology     149
Reading for Context     149
Reading and Listening for Technique     150
Writing the Results     151
Persuasion     151
Transparency     152
Language     152
Usefulness     152
Summary     153
The Theory of Needs     155
Guide to This Chapter     157
Existing Model of Community Health Practice (CHP)     158
The Concept of Health     158
The Concept of Community     159
The Goals and Limitations of the CHP Model     159
A More Effective Model: People Meeting Needs in Patterned Context     161
Meeting Needs     161
Patterned Context     162
Context, Meaning, and Change     163
The Basic Human Needs     167
Needs and Health     169
Synergy, Conflict, and Substitution Among Needs     170
Synergy     171
Conflict     171
Substitution     172
Needs and Community Health Research     173
Assessing Health in the Context of Needs     173
The Role of Social Change in Health     174
The Impact of Planned Changes on Health     174
A Method for Assessing Need Satisfaction Strategies     175
Summary     176
Community Change: The Theory of Hope     177
Guide to This Chapter     179
Anomie and Hopelessness     180
The Substitution of Satisfactions     182
Loss of Meaning     133
Self-Wounding Communities     135
Self-Healing Communities     187
The Process of Community Empowerment     188
Helping People Understand Themselves     189
An Alternative Theory of Community Change: Street Marxism     190
Using Theory to Help People Change     191
The Theory of Hope     191
The Theory of Street Marxism     192
Summary     194
Action Anthropology     195
Guide to This Chapter     197
Research as Community Practice     197
The Empowerment Process     198
Action Research Adds a Moral Dimension to Science     200
The Action Researcher and Community Empowerment     201
Developing Self-Awareness in the Community      201
Creating a Liaison Between the Community and Outsiders     202
The Limitations of the Action Researcher     203
Knowing the Community     203
Facilitating Change     205
Organizing Gatherings and Sharing Information     205
Organizing Work, Collecting Facts, Evaluating Actions     206
The Look, Think, Act Model     207
Sustaining the Process     209
Summary     211
Teaching Health Anthropology     213
Guide to This Chapter     215
Teaching and Research Should Go Together     215
Traditional Teaching Methods     216
A Better Way: Student-Centered Teaching     216
Benefits and Costs of the Student-Centered Method     218
The Method of Student-Centered Teaching     219
Class Size     219
Selection of Students     219
Location     219
Classroom Resources     220
Scheduling     220
Preparation     220
Role of the Teacher/Facilitator     221
Classroom Strategies for Creating Student Confidence     222
Classroom Strategies for Larger Classes     226
Group Teaching     227
Homework and Outside Assignments     228
Reading Assignments     228
Journals     228
Field Work     229
Problem-Based Learning     231
Summary     234
Professionalism in Naturalistic Social Science     235
Guide to This Chapter     237
The Quality of Naturalistic Research     237
Positivist-Friendly Naturalistic Method     233
Usefulness as Validity: A Better Solution     240
The Problem of Values     241
The Problem of Shared Tradition     241
Assessing Community Health Beliefs     243
Summary     244
Appendix     247
References     255
Index     261