Adapting to Context in Community-Based Participatory Research: “Participatory Starting Points” in a Chinese Immigrant Worker Community

Community-based participatory research (CBPR) is increasingly being used to better understand and improve the health of diverse communities. A key strength of this research orientation is its adaptability to community contexts and characteristics. To date, however, few studies explicitly discuss adaptations made to CBPR principles and processes in response to community context and partners’ needs. Using data from our CBPR study, the San Francisco Chinatown Restaurant Worker Health and Safety Project, and drawing from literature on immigrant political incorporation, we examine the links between the contexts of the Chinese immigrant worker community, adaptations made by our collaborative, and study outcomes. In particular, we explore the concepts of contexts of reception and participatory starting points, which may be especially relevant for partnerships with immigrant communities whose members have historically had lower rates of civic and political participation in the US. We discuss contextual findings such as worker partner accounts of language barriers, economic and social marginalization, and civic skills and participation, as well as subsequent adaptations made by the partnership. We also describe the relative effectiveness of these adaptations in yielding equitable participation and building partners’ capacity. We conclude by sharing lessons learned and their implications for CBPR and partnerships with immigrant communities more broadly.     

“Ought Implies Can,” Framing Effects,and “Empirical Refutations”

This paper aims to contribute to the current debate about the status of the “Ought Implies Can” (OIC) principle and the growing body of empirical evidence that undermines it. We report the results of an experimental study which show that people judge that agents ought to perform an action even when they also judge that those agents cannot do it and that such “ought” judgments exhibit an actor-observer effect. Because of this actor-observer effect on “ought” judgments and the Duhem-Quine thesis, talk of an “empirical refutation” of OIC is empirically and methodologically unwarranted. What the empirical fact that people attribute moral obligations to unable agents shows is that OIC is not intuitive, not that OIC has been refuted.     

Family and Partner Facing a Chronic Disease: Chronic Fatigue Syndrome

The purpose of this article is to analyze the growing interest in the influence of the family, particularly the patient's partner, on chronic fatigue syndrome (CFS). Social support is a vital element in many medical conditions. There is growing interest in the influence of the family, particularly the patient's partner, on chronic fatigue syndrome (CFS), but more work is needed in this line. Helping family members to optimize the support they provide may be the key to improving the efficacy of therapeutic interventions in CFS, and have a positive impact on the patient's symptoms.     

Infants and Young Children in Military Families: A Conceptual Model for Intervention

Infants and young children of parents in the military deserve special attention because the first years of life are pivotal in establishing trusting attachment relationships, which are based on the developmental expectation that parents will be reliably available and protective both physically and emotionally. For young children in military families, the stresses of extended absences of mothers and/or fathers as the result of deployment abroad, recurrent separations and reunions resulting from repeated deployments, or parents struggling with the emotional sequelae of their war experiences, and the traumatic impact of parental injury and death can strain and derail the normative expectation of parental availability and protectiveness. This article describes the key features of mental health in infancy and early childhood, the developmentally expectable early anxieties that all children experience in the first years of life across cultures and circumstances, and the ways in which these normative anxieties are exacerbated by the specific circumstances of military families. The article also describes interventions that may be helpful in supporting military families and their children with the specific challenges they face.     

Race and Women's Identity Development: Distinguishing Between Feminism and Womanism Among Black and White Women

Black and White women may experience feminist identity development differently, and the womanist (Ossana, Helms, & Leonard, 1992) and feminist (Downing & Roush, 1985) identity development models may differ in their ability to capture those experiences. Black (n = 29) and White (n = 94) female college students completed a questionnaire that included feminist identity, womanist identity, and self-esteem scales. Results provided partial support for the hypothesis that Black women would agree more strongly with the womanist model, whereas White women would agree more strongly with the feminist model. In addition, the womanist model better differentiated between stages of identity development than did the feminist model for Black women. Results also partially supported the hypothesis that race would moderate the relationships between the womanist and feminist identity models and self-esteem.     

Conceptualizing Genetic Counseling as Psychotherapy in the Era of Genomic Medicine

Discussions about genetic contributions to medical illness have become increasingly commonplace. Physicians and other health-care providers in all quarters of medicine, from oncology to psychiatry, routinely field questions about the genetic basis of the medical conditions they treat. Communication about genetic testing and risk also enter into these conversations, as knowledge about genetics is increasingly expected of all medical specialists. Attendant to this evolving medical landscape is some uncertainty regarding the future of the genetic counseling profession, with the potential for both increases and decreases in demand for genetic counselors being possible outcomes. This emerging uncertainty provides the opportunity to explicitly conceptualize the potentially distinct value and contributions of the genetic counselor over and above education about genetics and risk that may be provided by other health professionals. In this paper we suggest conceptualizing genetic counseling as a highly circumscribed form of psychotherapy in which effective communication of genetic information is a central therapeutic goal. While such an approach is by no means new—in 1979 Seymour Kessler explicitly described genetic counseling as a “kind of psychotherapeutic encounter,” an “interaction with a psychotherapeutic potential”—we expand on his view, and provide research evidence in support of our position. We review available evidence from process and outcome studies showing that genetic counseling is a therapeutic encounter that cannot be reduced to one where the counselor performs a simple “conduit for information” function, without losing effectiveness. We then discuss potential barriers that may have impeded greater uptake of a psychotherapeutic model of practice, and close by discussing implications for practice.