Frerichs Leah, Lich Kristen Hassmiller, Funchess Melanie, Burrell Marcus, Cerulli Catherine, Bedell Precious, White Ann Marie
Prog Community Health Partnersh. 2016;10(3):443-459. doi: 10.1353/cpr.2016.0051.
Group model building (GMB) is an approach to building qualitative and quantitative models with stakeholders to learn about the interrelationships among multilevel factors causing complex public health problems over time. Scant literature exists on adapting this method to address public health issues that involve racial dynamics.
This study's objectives are to (1) introduce GMB methods, (2) present a framework for adapting GMB to enhance cultural responsiveness, and (3) describe outcomes of adapting GMB to incorporate differences in racial socialization during a community project seeking to understand key determinants of community violence transmission.
An academic-community partnership planned a 1-day session with diverse stakeholders to explore the issue of violence using GMB. We documented key questions inspired by critical race theory (CRT) and adaptations to established GMB "scripts" (i.e., published facilitation instructions). The theory's emphasis on experiential knowledge led to a narrative-based facilitation guide from which participants created causal loop diagrams. These early diagrams depict how violence is transmitted and how communities respond, based on participants' lived experiences and mental models of causation that grew to include factors associated with race.
Participants found these methods useful for advancing difficult discussion. The resulting diagrams can be tested and expanded in future research, and will form the foundation for collaborative identification of solutions to build community resilience. GMB is a promising strategy that community partnerships should consider when addressing complex health issues; our experience adapting methods based on CRT is promising in its acceptability and early system insights.
群体模型构建(GMB)是一种与利益相关者共同构建定性和定量模型的方法,旨在了解随着时间推移导致复杂公共卫生问题的多层次因素之间的相互关系。关于将这种方法应用于解决涉及种族动态的公共卫生问题的文献很少。
本研究的目的是:(1)介绍GMB方法;(2)提出一个调整GMB以增强文化响应能力的框架;(3)描述在一个旨在了解社区暴力传播关键决定因素的社区项目中,调整GMB以纳入种族社会化差异的结果。
一个学术-社区合作伙伴计划与不同的利益相关者举办为期一天的会议,使用GMB来探讨暴力问题。我们记录了受批判种族理论(CRT)启发的关键问题以及对既定GMB“脚本”(即已发表的促进指南)的调整。该理论对经验知识的强调导致了一个基于叙事的促进指南,参与者据此创建因果循环图。这些早期的图表描绘了暴力是如何传播的,以及社区如何根据参与者的生活经历和因果关系心理模型做出反应,这些模型后来逐渐纳入了与种族相关的因素。
参与者发现这些方法有助于推进艰难的讨论。由此产生的图表可在未来研究中进行测试和扩展,并将为合作确定增强社区恢复力的解决方案奠定基础。GMB是一种有前途的策略,社区合作伙伴在解决复杂的健康问题时应予以考虑;我们基于CRT调整方法的经验在可接受性和早期系统见解方面很有前景。