Community Health Worker Training Made Me a Better Anthropologist

By Renee Cadzow, PhD

I landed my first tenure-track faculty position in 2012 at a small private college after working for about eight years at a Research I university as a grant-funded health disparities researcher. During that time I simultaneously completed my PhD in biological anthropology (2008). The decision to jump from a research 1 facility to a small private college was inspired by my fourth baby. A 10-month appointment with flexible hours would better lend itself to care for my soon-to-be four children compared to a 9–5, five-day per week, 12 month per year job. What I did not anticipate was the resultant rapid expansion of opportunities to better engage in the community. I was able to commit myself to issues and activities about which I felt both personally and professionally passionate.

In early 2012, I rediscovered my identity as an anthropologist after participating in a community health worker (CHW) two-day workshop. CHWs are people who are of and from the communities that they serve and work to bridge systems and communities.  In observing a role play activity of a stressed mother with numerous household hazards and behaviors, I fell into the (intended) trap of only identifying the negative aspects of the scene and completely missing the positive ones. I was disappointed in the bias I showed and recommitted myself to implementing stronger observation skills. This ultimately led to me joining the board of the Community Health Worker Network of Buffalo. I became a trainer and now lead community-driven research and evaluation efforts supporting the work of CHWs. I have discovered in the last few years that CHWs share many qualities of applied anthropologists. They develop skills in effective communication, learn to see situations from multiple perspectives, rapidly assess the nature of situations and circumstances and work to convey this information to others to resolve problems and link people to resources.

Renee Cadzow and Denise, a Community Health Worker. Renee Cadzow

I also joined the board of the Buffalo Prenatal Perinatal Network, an agency that employs CHWs to address maternal/child health through home visits and system navigation support. Then I served the board of Erie Niagara Area Health Education Center (AHEC), which is an organization that aims to increase the representativeness of the healthcare workforce through immersing underrepresented/minority youth in health careers development programs and supporting healthcare disparities professional education opportunities.

These and other similar linkages supported increased involvement in advocating for health and wellness policy adoption and implementation in the Buffalo Public Schools to improve child and adolescent health and wellbeing. Immersion in school wellness work led to writing opinion pieces in the Buffalo News (Another Voice: Academic Achievement depends on wellness, Another Voice: Replace academic time with physical and health education, Another Voice: Buffalo schools can help students learn by providing physical education), participation in wellness committees, assistance with assessment and evaluation, and advocacy at press conferences and board of education meetings.

This work was synthesized in a grant award (2015-2017) from a local foundation wherein the project team linked the school wellness work to CHW training, college student service learning, and opportunities for faculty and graduate students to engage in community based research. Students and parents received CHW training and ongoing support in order to facilitate their involvement with their school wellness teams at a subsample of the 60 schools in the district. Parent and student CHWs have helped with training school wellness team chairpersons in strategies to better engage them on the teams. My mixed-methods, anthropological research training has facilitated data collection at parent meetings, development of evaluation methods that are responsive to the needs of the target population, and translation of ideas and findings across social classes within the bureaucracy of a large public school system. As a participant observer and equipped with CHW skills, I now can effectively navigate the dynamics of parent meetings as well as meetings of teachers, and meetings of high level school administrators. Through the collaborative work funded by this 2-year grant, we have succeeded in training over 40 parents, students and community members, evaluating 2 years of school wellness team activities, and leading the revision of a comprehensive school wellness policy based on the Whole School, Whole Community, Whole Child model (which is essentially another form of the anthropological biocultural or socioecological model).

Renee Cadzow, with her 4 children. Renee Cadzow

Most recently, I have also been involved with providing cultural competency/health literacy training sessions to healthcare providers, medical students and residents, and health-related community based organizations. These interactive trainings, wherein we are essentially providing some baseline training in applied anthropology (though participants don’t know that), have been well received. They report a great need to address bias and communication issues in healthcare settings. Colleagues at the local medical school are planning to use evaluation results to advocate for it as a permanent component of the curriculum.

I also consult on special populations recruitment for that same R1 university’s Center for Translational Research Institute. The Institute’s aim is to increase the involvement of populations who are underrepresented in research (e.g., children, minorities, and the elderly). Rather than focus on efforts to get these populations to engage in research, though, my efforts have been spent on helping researchers understand the population (i.e., cultural competency/health literacy training) and helping the community understand what research is and how it can be important to them. As a common saying goes “nothing about us, without us, is for us.” The greatest success of this effort to date is the publication of a children’s activity book that explains the research process from the perspective of a little girl named Sofia.

One could never have drawn me a road map of where I would be and what I would be doing. The core skills of anthropology have afforded me a holistic perspective of community health and wellbeing, adaptability, and research methodology to support multi-sectoral efforts driving towards population wellness. A small private teaching college afforded the flexibility in time as well as more broad definition of scholarship that encourages my time engaged in rapid assessment and community driven research. And a tireless and passionate group of community leaders served as the inspiration to use my anthropological skills in the messy world of community engaged research.

Renee Cadzow is assistant professor in health services administration and director of the Center for Research on Physical Activity, Sport & Health at D’Youville College.

Gemmae Fix and Megan McCullough are contributing editors for Anthropology in the Public Sector. The views expressed in this article are those of the authors and do not necessarily represent the views of the Department of Veterans Affairs or the United States Government.

Cite as: Cadzow, Renee. 2017. “Community Health Worker Training Made Me a Better Anthropologist.” Anthropology News website, September 15, 2017. doi: 10.1111/AN.622

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