Anti-Oppressive, Community-Engaged Praxis in the Study of Chronic Pelvic Pain and Interpersonal Violence

This dissertation critically examines the health inequities in the prevalence and experience of Chronic Pelvic Pain (CPP) among female survivors of interpersonal violence, advancing an innovative, multi-level approach to public health research and theory. Despite the established association between interpersonal violence and CPP, a comprehensive understanding of this phenomenon remains underexplored, particularly its embodiment in survivors. Intersectionality, critical theory, and anti-racist approaches are missing from the literature. The embodiment of strength-based phenomena using eco-social theory, life course, and ecological perspectives is non-existent. By integrating public health equity theory with anti-oppressive epistemologies and praxis, this study offers an alternative lens, moving away from individualistic approaches and instead emphasizing the systemic, structural drivers, and social determinants of health (SDOH), intersectionality, trauma, and ecological perspective of healing and resilience. This dissertation research critically engaged with literature on interpersonal violence, CPP, trauma, resilience, healing, public health theory, and research methodologies to develop a research organizing framework for Community Health Equity Trauma Research (CHET-Research). The CHET-Research framework, guided by ecosocial theory, social-ecological perspectives, and SDOH, underscores the importance of intersecting constructs in the study of health and trauma, including health equity, intersectionality, embodiment, and its conjoined constructs (i.e., pathways of embodiment, the cumulative interplay of exposure and resistance, and accountability and agency), and historical context. The CHET-Research framework connects and crosswalks common research steps and components, including (1) research problem identification; (2) knowledge production, (3) relational processes, (4) conceptualization and measurement, (5) analysis and interpretation, and (6) meta-theoretical systems thinking. This anti-oppressive praxis informs my approach to studying CPP and interpersonal violence while offering a launching point for health equity scholars investigating trauma and health. The holistic framework emphasizes critical reflexivity and collaborations with communities with lived experience knowledge in exploring, examining, framing, and interventions to disrupt the systemic, oppressive structures, policies, and practices that drive health inequities. Through this lens, this dissertation describes a study protocol to investigate healing and resilience among survivors of interpersonal violence with a history of CPP. Applying a transformative Phenomenological Mixed Methods Research (MMR) design, the study privileges the participants as 'co-researchers' in alignment with anti-oppressive research praxis. The approach engages with participants' lived experiences to understand healing and resilience in the context of their individual, interpersonal, and community-level realities. Finally, this dissertation co-developed evidence-based trauma-informed (TI) research guidelines with researchers using a participatory focus group methodology. The co-researchers' experiences and perspectives explored the experience of trauma in a variety of research settings, from traditional health science post-positivist methodologies to intersectional, participatory, and community-led ontologies and spaces. The focus groups generated themes revealing traumatic research experiences among participants and front-line and middle-management researchers, which is common in post-positivist research data collection. In contrast, anti-oppressive methodologies that privilege lived experience and collaboration with the study participants and team led to safe research spaces that made space to explore distress and trauma in participants' lives and illuminated collective and individual resilience and solution-oriented dialogue and action. The focus group dialogue was, in fact, praxis, offering a model for discussing trauma and trauma-informed approaches (TIA) with research teams. Their praxis emphasizes the need for community and academic co–leadership and using intersectional and ecological perspectives in developing TIA to research. The dissertation presents the co-researchers' praxis and offers pragmatic integration of TIA into research practices.