Kevin J. Robinson believes in the power of stories.
He's apt to call them "qualitative data," but listening with a keen ear and an open mind to the personal narratives of his subjects is key to Robinson's approach to social research. He tells his students that it is critical to talk with members of the communities they propose to study before framing their research questions.
"Some researchers worry that if the personal narratives of research subjects drive the research agenda, they'll get the wrong story—a story that's unrepresentative, a story that contradicts the prevailing theory," Robinson says. "I'm less worried about getting the right story than about getting the story right."
Robinson, who joined the faculty of the Graduate School of Social Work and Social Research this year as an assistant professor, thoroughly explored an individual's experience of living with AIDS in his dissertation at Columbia University’s Mailman School of Public Health, from which he earned a Dr.PH in sociomedical sciences. Robinson also holds an M.S.W in community organization/community and social systems from the University of Michigan School of Social Work and an M.H.A in public health policy and administration from the Pennsylvania State University. His undergraduate degree, from Clemson University, is in biological sciences.
An individual case study is an unusual approach in the public-health field, and Robinson's work attracted quite a bit of favorable attention. He went from Columbia to a prestigious postdoctoral appointment as a W.K. Kellogg Community Health Scholar at the University of Michigan School of Public Health's Prevention Research Center. There he perfected his practice of community-based participatory research (CBPR) in a study of the efficacy of an intervention to teach adolescents about sexual health and reduce the incidence of HIV/AIDS and other sexually transmitted diseases among 11-to-19-year-old African Americans. The study was conducted in partnership with faith-based organizations in Flint, Mich. Robinson is now planning a similar study in the Philadelphia area.
Robinson describes CBPR as "an approach in which the community drives the research. They set the priorities and have an interest in the findings and the dissemination of the findings." Like the case study, it eschews the imposition of a research agenda from outside and relies on a lot of listening.
His dissertation research included many hours of interviews with his subject, a 51-year-old African-American gay man who was living with AIDS. Those conversations, Robinson says, were profoundly illuminating.
"Because I had the luxury of time, I was able to understand the background and context of his life in depth," Robinson explains. "That allowed me to explore the nuances and richness of his life. I was able to delve deeply into issues of racism in health care, differential diagnosis, delayed diagnosis, delayed treatment, stigma, spirituality/religiosity—I was able to dig into these things and speak in a way that could really move the research agenda forward."
A virtue of the case study, Robinson says, is that it can defy conventional wisdom or stereotypes that tend to stand in the way of access to health care and resources.
"Freddy" (not his real name), Robinson's subject, was on a complex regime of medications, an "AIDS cocktail," that had severe side effects. One of them was lipodystrophy, a redistribution of fat cells in his face and neck, that is sometimes regarded as the visible stigma of AIDS.
"He had the worst case of lipodystrophy that I've ever seen," Robinson says. "People stared at him on the subway. The medication also caused diarrhea, which was a real burden because he did a lot of traveling. But he adhered to his medications meticulously despite the side effects.
"There's a common understanding among physicians that people of color do not adhere to medication regimes," Robinson says. "Freddy's case can help combat that stereotype. Doctors need to know that they are not wasting time and medicine by prescribing it to African Americans."
Another revelation, Robinson says, related to Freddy's desire to find a spiritual home in a church from which he felt alienated because of his sexuality.
"At one time, when he was in the hospital, Freddy talked about this on a call-in show on the radio. The pastor of a church in Harlem heard his story and came to Freddy's hospital room with some members of the congregation to welcome him into their church.
"There are many churches that have done a lot of outreach and education on HIV and AIDS and have been welcoming to gay people," Robinson notes, "and I don't think that those churches have gotten enough attention."
Such churches would become a cornerstone of Robinson's research in Michigan. There, the Prevention Research Center where he was a Kellogg fellow worked with 11 churches and two housing communities to develop and evaluate a program that addressed the high incidence of HIV/AIDS and other STDs among African-American adolescents in Flint.
"Our community partners were involved at every step. A lot of my academic colleagues were skeptical when I told them that our community partners did the initial analysis of the data. But many of these community leaders were highly educated. A lot of them had master's degrees—some had two master's degrees—and a couple had Ph.Ds. And even those who didn't have that formal education had expertise in their areas that we didn't have."
An interesting finding of the Flint collaborative was a relatively low rate of sexually transmitted diseases among African-American women aged 18 to 24. Robinson and his partners are now analyzing the results of a study that investigated ways these women negotiate and navigate safer sex practices with their partners, given the financial considerations, attitudes, resistance, power/gender dynamics, and communication patterns in their relationships and everyday lives.
This is the issue Robinson hopes to explore with a community-based research collaborative in the Philadelphia area. He envisions roles for both graduate and undergraduate students in this work.
"I've talked to a couple of graduate students who are eager to get some experience in qualitative research," he says," and I've had quite a bit of contact with undergraduates, as well. [Professor of Social Work and Social Research] Toba Kerson and I co-taught a course on public health that was open to both GSSWSR students and Tri-College undergraduates, and I supervised a Haverford student in a Praxis course. I think there's a lot of interest in this kind of project in the Tri-Co community."
Posted 3/20/2008 by Claudia Ginanni