Community perspectives: mixed-methods investigation of culture, stress, resilience, and health.

Despite well-documented ethnic and socioeconomic disparities, our understanding of child, maternal and family health is based disproportionately on White middle-class populations in the United States. The National Institute of Child Health and Human Development funded the Community Child Health Network (CCHN) in 2004, a partnership of five academic institutions and community organizations, to collaborate in the design and conduct of a study to foster new understandings of these disparities. Reported here are findings from a pilot study conducted at one site to inform CCHN regarding community views of stress, coping resources, family and health. Mixed-methods (qualitative and quantitative) interviews were conducted with 54 adult participants recruited from public healthcare clinics to obtain both their self-reports and their reports of their communities' perspectives. Findings include the pervasiveness of experiences of racism and gender differences in support seeking and coping behavior. There was little recognition of some common health conditions, such as low birth weight and preterm birth, which disproportionately affect poor and minority communities. Many indicators of strength and resilience in individuals, families, and the communities at large emerged in these interviews. Communities were described as valuing achievement and upward mobility. Participants also indicated an intuitive understanding of effective parenting and of the roles of nature (genetics) and nurture (environment and behavior) in determining child health. The results inform intervention and stress research in underrepresented communities.