Anne Kraemer Diaz | Wake Forest University School of Medicine (original) (raw)
Papers by Anne Kraemer Diaz
Community-based participatory research (CBPR) has become essential in health disparities and envi... more Community-based participatory research (CBPR) has become essential in health disparities and environmental justice research; however, the scientific integrity of CBPR projects has become a concern. Some concerns, such as appropriate research training, lack of access to resources and finances, have been
discussed as possibly limiting the scientific integrity of a project. Prior to understanding what threatens
scientific integrity in CBPR, it is vital to understand what scientific integrity means for the professional
and community investigators who are involved in CBPR.
This analysis explores the interpretation of scientific integrity in CBPR among 74 professional and
community research team members from of 25 CBPR projects in nine states in the southeastern United
States in 2012. It describes the basic definition for scientific integrity and then explores variations in the
interpretation of scientific integrity in CBPR. Variations in the interpretations were associated with team
member identity as professional or community investigators. Professional investigators understood scientific integrity in CBPR as either conceptually or logistically flexible, as challenging to balance with community needs, or no different than traditional scientific integrity. Community investigators interpret other factors as important in scientific integrity, such as trust, accountability, and overall benefit to the community. This research demonstrates that the variations in the interpretation of scientific integrity in CBPR call for a new definition of scientific integrity in CBPR that takes into account the understanding
and needs of all investigators.
Empowering Latino Youth Farmworkers as Youth Health Educators for Occupational Heat-Related Illness Safety Education in Eastern North Carolina, Jul 2013
Objectives: to examine the present-day knowledge formation and practice of indigenous Kaqchikel-s... more Objectives: to examine the present-day knowledge formation and practice of indigenous Kaqchikel-speaking midwives, with special attention to their interactions with the Guatemalan medical community, training models, and allopathic knowledge in general. Design/participants: a qualitative study consisting of participant-observation in lay midwife training programs; in-depth interviews with 44 practicing indigenous midwives; and three focus groups with midwives of a local non-governmental organization. Setting: Kaqchikel Maya-speaking communities in the Guatemalan highlands. Findings: the cumulative undermining effects of marginalization, cultural and linguistic barriers, and poorly designed training programs contribute to the failure of lay midwife-focused initiatives in Guatemala to improve maternal-child health outcomes. Furthermore, in contrast to prevailing assumptions, Kaqchikel Maya midwives integrate allopathic obstetrical knowledge into their practice at a high level. Conclusions and implications: as indigenous midwives in Guatemala will continue to provide a large fraction of the obstetrical services among rural populations for many years to come, maternal-child policy initiatives must take into account that: (1) Guatemalan midwife training programs can be significantly improved when instruction occurs in local languages, such as Kaqchikel, and (2) indigenous midwives' increasing allopathic repertoire may serve as a productive ground for synergistic collaborations between lay midwives and the allopathic medical community.
"In Guatemala over the last decade, the small Non-Governmental Organization (NGO) sector has grow... more "In Guatemala over the last decade, the small Non-Governmental Organization (NGO) sector has grown dramatically. However,
there is a critical lack of data examining the impact of this sector growth on target communities. We utilize ethnographic case
studies from the Guatemalan health care sector to examine the community-side effects of health care NGO proliferation. We
demonstrate how the constraints of “doing business” and serving as proxy agents for government have restricted the sector’s
flexibility and capacity for local engagement. We consider how these factors, together with competition for limited funds and
service duplication, create community burnout and fuels resource shopping. We conclude with a consideration of some recent
promising developments in community-based development and call for a return to greater reflexivity in the sector."
Community-based participatory research (CBPR) has become essential in health disparities and envi... more Community-based participatory research (CBPR) has become essential in health disparities and environmental justice research; however, the scientific integrity of CBPR projects has become a concern. Some concerns, such as appropriate research training, lack of access to resources and finances, have been
discussed as possibly limiting the scientific integrity of a project. Prior to understanding what threatens
scientific integrity in CBPR, it is vital to understand what scientific integrity means for the professional
and community investigators who are involved in CBPR.
This analysis explores the interpretation of scientific integrity in CBPR among 74 professional and
community research team members from of 25 CBPR projects in nine states in the southeastern United
States in 2012. It describes the basic definition for scientific integrity and then explores variations in the
interpretation of scientific integrity in CBPR. Variations in the interpretations were associated with team
member identity as professional or community investigators. Professional investigators understood scientific integrity in CBPR as either conceptually or logistically flexible, as challenging to balance with community needs, or no different than traditional scientific integrity. Community investigators interpret other factors as important in scientific integrity, such as trust, accountability, and overall benefit to the community. This research demonstrates that the variations in the interpretation of scientific integrity in CBPR call for a new definition of scientific integrity in CBPR that takes into account the understanding
and needs of all investigators.
Empowering Latino Youth Farmworkers as Youth Health Educators for Occupational Heat-Related Illness Safety Education in Eastern North Carolina, Jul 2013
Objectives: to examine the present-day knowledge formation and practice of indigenous Kaqchikel-s... more Objectives: to examine the present-day knowledge formation and practice of indigenous Kaqchikel-speaking midwives, with special attention to their interactions with the Guatemalan medical community, training models, and allopathic knowledge in general. Design/participants: a qualitative study consisting of participant-observation in lay midwife training programs; in-depth interviews with 44 practicing indigenous midwives; and three focus groups with midwives of a local non-governmental organization. Setting: Kaqchikel Maya-speaking communities in the Guatemalan highlands. Findings: the cumulative undermining effects of marginalization, cultural and linguistic barriers, and poorly designed training programs contribute to the failure of lay midwife-focused initiatives in Guatemala to improve maternal-child health outcomes. Furthermore, in contrast to prevailing assumptions, Kaqchikel Maya midwives integrate allopathic obstetrical knowledge into their practice at a high level. Conclusions and implications: as indigenous midwives in Guatemala will continue to provide a large fraction of the obstetrical services among rural populations for many years to come, maternal-child policy initiatives must take into account that: (1) Guatemalan midwife training programs can be significantly improved when instruction occurs in local languages, such as Kaqchikel, and (2) indigenous midwives' increasing allopathic repertoire may serve as a productive ground for synergistic collaborations between lay midwives and the allopathic medical community.
"In Guatemala over the last decade, the small Non-Governmental Organization (NGO) sector has grow... more "In Guatemala over the last decade, the small Non-Governmental Organization (NGO) sector has grown dramatically. However,
there is a critical lack of data examining the impact of this sector growth on target communities. We utilize ethnographic case
studies from the Guatemalan health care sector to examine the community-side effects of health care NGO proliferation. We
demonstrate how the constraints of “doing business” and serving as proxy agents for government have restricted the sector’s
flexibility and capacity for local engagement. We consider how these factors, together with competition for limited funds and
service duplication, create community burnout and fuels resource shopping. We conclude with a consideration of some recent
promising developments in community-based development and call for a return to greater reflexivity in the sector."