CBPR in Action: Examining the Key Processes in Developing a Family-Based Intervention with Sex Workers

Background and Purpose: Mainstream society and media have superficially depicted and stigmatized sex worker mothers (SWM) as victims who lack agency, make poor parenting choices, and are inadequate mothers due to their profession. However, SWM continue to flip this narrative on its head through various acts of collective and individual resistance. This, in India, takes the form of 65,000 sex workers, mobilized by Durbar Mahila Samanwaya Committee (DMSC), that fight for sex worker rights. This resistance also takes the form of sex workers at DMSC collaborating with community-based researchers to carry out their own research, a process that is under-researched. Thus, the aim of this presentation is to describe the key processes by which a Family-based Sexual Health Communication Intervention (FSCHI) was developed in collaboration between SWM and a community-based researcher.

Methods: The study was a collaboration with DMSC, a sex worker collective, and took place in Kolkata, India. This study uses existing data, from the parent study, to document the key processes related to intervention development. Data includes the author’s participant observation and field notes from various phases of the study and thus is written from the sole perspective of the author’s experiences. Thematic analysis using the Community-based Participatory Research (CBPR) processes was employed.

Results: FSHCI, facilitated by SWM, is a four-session group-based intervention that aims to increase SWMs’ knowledge, comfort, self-efficacy, and skill set to engage in sexual health communication with their children. SWM were involved in all aspects of the study, showing community ownership and ensuring that the intervention was developed by and for the sex worker community. While the study was driven by all components of CBPR, a few processes were instrumental in centering SWM experiences: community need identification; knowledge sharing; openness and trust. The community need to better understand mother-child sexual health communication and develop the intervention was solely identified by SWM and was not the researcher’s preconceived research agenda.  Knowledge sharing was facilitated by transparency about roles, power, and who held what knowledge. This meant that the research process centered SWM voices and knowledge sharing, including SWM discussion strategies and tactics to address the needs. The researcher’s role, as a documenter of processes and organizer around CBT-oriented concepts, was discussed early in the development. This knowledge sharing was a dynamic process that included mapping theoretical constructs together and developing culturally appropriate skill-building activities. Finally, the collaboration was grounded in openness and trust, that was operationalized through the researcher engaging in three months of participant observation (and prior to any conversation about an intervention), meeting many stakeholders and sex workers, and the researcher not coming in with an established research agenda.

Conclusions and Implications: Understanding CBPR processes in developing interventions is essential in the global context because social work researchers have an ethical duty to resist and undo traditional systems of  “researching communities” to “researching with communities.” Examining key CBPR processes can further our knowledge around developing and implementing culturally appropriate, community-led interventions that ultimately leads to a more socially just research process.