Circle of Life Framework in Breast Health Education Article Critique Analysis: Use of the Talking Circle for Comanche Women's Breast Health Education, by E. Haozous, V. Eschiti, and J. Lauderdale

The journal article, "Use of the Talking Circle for Comanche Women's Breast Health Education" by E. Haozous et. al. (2010), promotion of education on breast health was explored using a specific and unique tradition as the framework of the study. This tradition, called the Circle of Life (COL), is an "intertribal cancer prevention program focused on breast health education" and is specifically implemented among American Indian (AI) women (378). Using the COL as framework, the authors aimed to achieve "cultural congruency" in exploring, discovering, and identifying the different dimensions concerning breast health education and promotion effectiveness in the context of AI women's culture -- specifically, Comanche women (378). Harmonized understanding of the Comanche community, female and health cultures led to an understanding of factors that could significantly determine the effectiveness of initiatives related to breast health education (e.g., information dissemination through printed and audio-visual materials).

As rationale and support to the authors' decision to use the COL framework in the study, the situational analysis and review of literature centered on the criticality of understanding breast health as understood and perceived by Comanche women. Focus on this specific group was supported by an empirical study demonstrating that AI women -- specifically Comanche women -- is a high risk group in the U.S. when it comes to the health problem of breast cancer (378). Apart from being a high risk group in the health issue and problem of breast cancer, Comanche women also have a unique set of values and beliefs when it comes to health and health-seeking behavior. Given these unique characteristics of Comanche female culture, it was then necessary to undergo the study using a framework that is also known as uniquely derived from AI culture.

Thus, the central focus of the review of related literature was the development and utilization of the COL framework. The review revealed that COL was a framework that brings about "community-researcher partnership," a characteristic that is necessary for community-based participatory...

As COL literature is limited, the authors managed to cover its history and development comprehensively, at least within the scope by which the framework was used in the study. The fact that COL literature is limited was pointed out as a limitation to the review; however, rather than a limitation, this made the literature review an intensive and extensive study of COL studies throughout its 20 years of existence. In the article, the authors strengthened the literature review through empirical data supporting the claim that Comanche women is a high risk group for breast cancer, in addition to a historical review of the creation and development of COL. Combining this information from the article, the authors developed an effective synthesis that set the ground for the study's methodology (the Talking Circle) and analysis framework (emergent themes from the Talking Circle).
The framework of the study itself, the COL, is hinged on AI cultural tradition, making the study qualitative in nature utilizing the focus group discussion technique in data collection. This FGD technique is aptly called the Talking Circle, where participants/discussants are given a specific "talisman" to signal that it is the participant's turn to talk freely about an issue being discussed. Although the talisman was not used during data collection, the principle behind the Talking Circle was nevertheless implemented by the authors. The authors detailed that exploration of dimensions and themes related to the issue of breast health education and promotion were thoroughly exhausted. In addition to discussion transcripts, the authors also took note of their observations of the participants and the participants' facial expressions during the group discussion. To establish rigor in bringing out all the emergent themes from the group discussion, the authors used content analysis to "reach a consensus" in terms of identifying the 'codes, categories, and themes' that will be used during data analysis (380).

The decision to use the Talking Circle as a group discussion technique demonstrated that the authors wanted to reflect the 'community-based' and 'participatory' nature of their study. As a tradition, COL was fully integrated as the anchor that steered the direction of the study, as what qualitative studies must exhibit at the…