Reviewed by: Society for Medical Anthropology
Of interest to: Practicing and Applied Anthropologists, Students, Those Involved in Mentoring Activities
Primary Theme: Health
Secondary Theme: Inequality
Many anthropologists write convincingly about substance use culture, use rationales, and structural factors contributing to use. The anthropological imagination takes a critical stance toward the historical and structural manipulation of addictive substances and resonates with users’ rationales and dilemmas. Anthropological advocacy for policies promoting substance control are common but action to address resilience in the face of relentless marketing and social influence to use is rare. Few anthropologists have been directly involved in the complex process of translating research on substance use to practical interventions using critical approaches and rigorous evaluations. In this roundtable, five anthropologists “bend the curve” with 10 minute presentations by a) offering examples of their collaborative applied approaches in substance use research, training, intervention and policy promotion and b) raising critical questions about implementation for discussion with the audience.
Roland Moore addresses ways of sustaining collaborations with American Indian tribes. He discusses building initial alcohol prevention partnerships, joint involvement in creating and implementing prevention programs, and challenges in sustainability of associations between the research team and Native youth, adult and provider stakeholders. His questions focus on how to approach, build and sustain these or any partnerships.
Juliet Lee describes a Participatory Action Research (PAR) project based on Freirean principles with under-reached youth in California who develop their own tobacco prevention initiative and implement it in California schools. She argues that youth-led Participatory Action Research is an underutilized approach in bringing about behavior change by involving young people in research, critical analysis and tobacco action. She questions PAR’s legitimacy, empowerment capacity, potential for real change, funding, and sustainability. 71
Kathleen Lynch introduces participatory methodology for co-designing a social mobile app and teletherapy platform for addiction recovery support. She describes collaborations with local clinic service providers and recovering patients to identify integration of new technology with local settings, and acceptable app and teletherapy components. She questions the process of co-design of interventions with stakeholders, and approaches to evaluating pilot studies for scaleup.
Jean Schensul describes a complex international partnership to develop and implement an HIV adherence intervention using multi-level approaches with different provider and advocacy partners to reduce alcohol risk in men living with HIV attending ART clinics. The study had positive predicted alcohol and adherence results as well as unpredicted positive effects on smoked and smokeless tobacco reduction. She raises question about partnership maintenance, intervention synergy versus intervention siloing, what to do with important unanticipated results and scaling up.
Mimi Nichter discusses her work in Indonesia and India where she and colleagues developed a smoke free homes initiative as a social movement focused on the health and well being of women and children. Her paper details how formative research was conducted to assess community interest in participation in the initiative and how an intervention was developed, refined and implemented. It raises questions about the role of social movements, and the importance of addressing cultural practices in tobacco control.
The audience will be engaged in critiquing and building better partnerships, intervention methods, approaches to evaluation, and policy generation.