Introduction
Every two years or so I have the opportunity to teach Research with Diverse Populations. What great good fortune for me! This graduate-level course for nurses and others in the health sciences is unique—it’s an elective offering. Enough said about what that means for student interest and motivation. It also offers a forum for profound questions formulated by capable new researchers. Each week they formulated questions, like What is “vulnerability” in research? Who isn’t vulnerable when we do research? Can statistics liberate as well as inform? And each week we discussed those questions, referring to our readings and to our own experiences as researchers and the researched.
All told, I’m most grateful to teach this unique course because it’s purposefully uncomfortable. We steep ourselves in the strong brew of current dialogue about legacies of oppression and unconscious bias. Who we are, what language we speak (or don’t speak), and what we look like as researchers matters. If our appearance seems commonplace to us as academics and healthcare providers, it is anything but neutral when we consider who we are and what we represent. Taken a step further, what we appear to be matters when we approach a stranger and hope to enter a trusting research relationship fraught with issues of privacy, confidentiality, mandatory disclosure, and ethics review boards. None of those topics is benign.
For some students, this class is the first time their personal attributes came into consideration as part of their research education. In fact, we came to view personal relationships and attributes as part of the research equation. Positionality or one’s standpoint was one of the first things one considered as researcher preparation for fieldwork. Our class conversation about research with diverse populations began with positionality and an audio-recorded positionality statement. We considered our personal situations as either/both tangible impingements on research recruitment and retention, or conversely, enhancements to our rigor in the application of research methods.
This course promoted considerations of diversity and vulnerability in research in new ways. Through course assignments and experiences, each class member explored the interface of the researcher, the participant, and the specific research setting. You will see those personal explorations at the top of the ebook, with the contents arranged by student and their chosen research population of interest. Our class also discussed more general questions of vulnerability, recruitment, retention, and methods suited for research with diverse populations. Those became chapters, and are situated on the left of the ebook.
Throughout our class we appreciated the writings of Pranee Liamputtong, who wrote our major text, Researching the Vulnerable. I announced on our first day of class that our readings were incomplete, and that the reason we had to write an ebook was because the definitive text had not yet been written. This is not exactly true, as Liamputtong’s book was excellent, if dated. We hope she has another edition in the works. Similarly, Dickson-Swift and colleagues produced another helpful book we referenced, Undertaking Sensitive Research in the Health and Social Sciences: Managing Boundaries, Emotions and Risks. We are grateful for these and other authors who took the time to reflect on the processes and practices of research with diverse, vulnerable, marginalized, and stigmatized populations. We add to that discourse an ebook that we intend to be useful to others seeking, as we are, to continuously expand our thinking and our work with diverse populations research.
A final note about terminology is in order. The title for our course was Research with Diverse Populations. Because diverse can mean many kinds and degrees of difference, we acknowledge that the intended scope of our work was broad. We extend the diverse populations notion to populations globally (see Okang’s work on Ghanaian women and children). We also intend to stretch the label to include those who are marginalized at the lower rungs of a social ladder, in situations of poverty and homelessness (see Doughty’s work with people who are homeless in the northwestern US). Older people with chronic illness, children who are overweight, and adults with intellectual disabilities all qualify as vulnerable in research based on federal regulations that stipulate it is so and our clinical knowledge of their differential risk in research situations (see the work of Haynes-Lewis, Pittman, and Tacy on these populations). Finally, the inclusion of racial, ethnic, and language group diversity in research is central to answering questions about health promotion and risk reduction among populations with this sort of diversity. American Indians at risk for diabetes (Llanque) and Arab Americans who smoke tobacco (Ghadban) represent these diverse populations with health disparities.
Just prior to teaching this course, I published a paper that outlined my own experiences and ruminations about humanizing health disparities (Clark, 2014a). In this paper, I describe some personal and professional pushback I have experienced as a researcher pursuing topics related to diverse populations with documented health disparities. With challenges came more reflection and growth, so I considered different ways of fostering a humanistic gaze toward populations labelled “vulnerable” and “disparate” and all manner of other terms. I offer this paper and my podcast (Clark, 2014b) to the ebook, my personal contribution to the scholarly dialogue my students have so capably started. I look forward to contributions to our ebook from future students and colleagues. The wiki nature of publishing allows for continuous contributions, and we welcome response and participation.
Lauren Clark
Professor, College of Nursing
University of Utah
References
Clark, L. (2014a). A Humanizing Gaze for Transcultural Nursing Research Will Tell the Story of Health Disparities. Journal of Transcultural Nursing, 25(2), 122-128. DOI: 10.1177/1043659613515722.
Clark, L. (2014b). Podcast of Lauren Clark with Journal of Transcultural Nursing Editor, Norma Cuellar on the background for the recent article, A Humanizing Gaze for Transcultural Nursing Research Will Tell the Story of Health Disparities. http://tcn.sagepub.com/site/misc/index/podcasts.xhtml