News Centene Center

Bridging community knowledge into social policy

By Abaki Beck, research manager at the Social Policy Institute

I grew up picking root medicine with my family, knowledge passed down to my grandmother and aunts from their mother, and to my grandmother from her mother. I also grew up with a dedication to community activism from witnessing the health, economic and educational disparities facing my family on the Blackfeet Reservation of northern Montana.

Oral history is an important mode of knowledge production in many Native communities. I grew up learning about Blackfeet supernatural beings, plant medicine, and history through storytelling. My mother is also a researcher and has interviewed Blackfeet elders as part of her work, first at a Blackfeet language revitalization school, and later as an environmental historian. I thus grew up learning firsthand the importance of oral history and qualitative research, which became the foundation of my research skills. 

These values followed me in my early career. During graduate school, I had a practicum at a research organization based in a federally qualified health center that primarily served Native Americans in Seattle. In this role, I hosted focus groups and interviews and helped develop surveys. For surveys that would be sent to large groups of people, we would often table at events, like pow wows, to get community members’ feedback on the surveys. Later, I co-led the development of the Prison Education Project reentry program. Like program evaluation work, this involved interviewing currently and formerly incarcerated people to learn their needs and the best resources in the St Louis area. One of the key values I learned from working in Native communities and with incarcerated people is recognizing and uplifting community members as experts.

Shifting from empowerment to power sharing

At SPI, I’ve thought a lot about how to translate this value beyond program development or evaluation and into academic research. SPI’s work is focused on researching and advancing social policy that serves low to moderate income people – from examining the impacts of medical debt on access to care for people with Medicaid and Marketplace insurance to exploring how workplace financial counseling programs may improve credit outcomes among frontline workers. At SPI’s Equity, Diversity, Inclusion and Accessibility Committee’s working group meetings, we frequently discuss how to make our research more accessible – and what “accessible research” really means. Last year, the committee edited SPI’s values, and re-wrote the value “empowerment” as “power sharing,” to better reflect our goal of supporting and amplifying the voices of marginalized groups in our work. Power sharing implies an actual shift of power dynamics and relationship building. This subtle shift in wording can be an important reminder of our true values and how we want our research to be conducted and disseminated.

Equitable, impact-focused research is often fundamentally different than how most academics conduct research. Often, the only time we “engage” with people is when we distribute a survey and send them an incentive.

Leading research that transforms participants into experts

What would it mean if we saw those we surveyed as experts, not research subjects? SPI is beginning to have conversations through our Equity, Diversity, Inclusion and Accessibility Committee on how to integrate these principles throughout our operations and research work. How would our research questions look different if they were developed in concert with people with lived experiences with the issues we are trying to tackle? How would our research products have further impact if they were written with a different audience in mind, rather than fellow academics or our funders?

There are simple first steps. In my work at the Centene Center for Health Transformation, our surveys – which are sent to Medicaid and Marketplace recipients – are edited to a fifth-grade reading level to work towards accessibility. We also know it’s important to be intentional, or we may cause more harm than good by launching into more community-engaged, equity-forward research. At SPI, we are working on this accessibility and inclusion through both our Equity, Diversity, Inclusion and Accessibility Committee and by learning about the benefits and process of community-based participatory research at our all-staff meetings.  

If we were to infuse SPI’s values into social policy research, how we conduct research may fundamentally shift. We may have to learn new skills. We may have to look at different people as experts. Of course, working with people is complicated. When I worked with incarcerated people, I needed approval not just from the IRB, but from the Department of Corrections as well. I wasn’t allowed to bring in a recording device, so a colleague and I frantically hand-wrote notes during our focus groups. We had to adapt.

I think this shift is worth it. Too often, those most impacted by a social policy are excluded from its development.