Knowledge-Based Practice


Power as Knowing Participation in Change Theory®

Power is the capacity to participate knowingly in change. Power is being aware of what one is choosing to do, feeling free to do it, and doing it intentionally. Power is not a thing to be acquired but a process that becomes a practice.

There are four indivisible dimensions of power: awareness, choices, freedom to act intentionally, and involvement in creating change. There are two types of power: power-as-control and power-as-freedom. The traditional power-as-control theories view power as the ability to prevent or cause change. Barrett’s theory proposes that in both types of power, change occurs in a dynamic process of these four dimensions. It is how one chooses to use power that determines whether it is power-as-control or power-as-freedom.

The objective is sex risk behavior change by changing sex scripts

Maximizing change in the desired direction requires all of the power dimensions: awareness, choices, freedom to act intentionally, and involvement in creating change. Unknowing participation in change differs from power since it is participation that lacks one or more of these dimensions.

This view of power as freedom is called power as knowing participation in change was developed by a nurse, Dr. Elizabeth Ann Barrett.

We appreciate the contribution of her thinking about power to assist us in interpreting women’s stories. The potential of these videos to promote change is important because the majority of women in the U.S. (90%) who are HIV infected were infected through unprotected sex with a male partner who had HIV.

Sex Script Theory (Simon & Gagnon, 1986) and Barrett’s Theory of Power as Knowing Participation in Change ® were integrated into a framework to explain young adult urban women’s unprotected sex, particularly with men they perceive to be engaging in an HIV risk behavior. Based on previous content analysis of focus groups with young urban women, sex scripts were conceptualized as either lower or higher power sex scripts.

It is important to note that both lower and higher power sex scripts were found to be germane and contemporary expressions among young urban women.

Lower Power Sex Scripts: Disappointment, Heartbreak, and Risk of HIV/AIDS

We listened and learned. We learned that having sex without using condoms is a usual practice to get a man, to hold on to a man, to show trust, and to get and stay close. Some women talked of “Having to Satisfy a Man” and accepting cheating because of “What He’s Doing for Me”, and to hold on to him, “As Long as He Comes Home to Me.” Some women said that they were “Blinded by Love”. We call these Lower Power Sex Scripts. Lower power means women have a lower awareness of themselves as women (using disrespectful names to describe themselves), seeing few choices (Need Him, As long as He Comes Home to Me), and were going about their lives to “Do Whatever it Takes” to satisfy and hold onto a man who was cheating on them.

The problem with the strategy of unprotected sex to hold onto a man is that it never seems to work!

The men leave anyway and the women end up unhappy and worse. Worse can mean feeling badly most of the time, it can mean financial problems, the baby’s father is gone, and it can also mean HIV infection.

Higher Power Sex Scripts: Don’t Allow Bad Relationships to Get in Your Way, You Don’t Own Me

We also heard Higher Power Sex Scripts from women who are aware of themselves as being worthy of respect and see themselves as having more choices in life and men. They tended to see their dreams (what we call choices) and then to go after their dreams, not allowing bad relationships to get in their way. We heard stories about Girl Power, Expecting Sex is NOT All Right, Take the Power, and You Don’t Own Me. Women had a lot to say about good relationships with men- men who really supported them to meet their own needs. First they clearly saw what their needs were, and they felt the freedom to act on their intentions. They participated knowingly in change and that’s what we call power.

Power is the freedom to act with intention to get the things we want. What many women want is to love and to enjoy sexual relations with their partner/s.

But many of us cave into power as control, that is, when someone acts to control and we let him control, so we lessen our power as freedom.

Why is this work important?

According to the Centers for Disease Control, for women, the most prevalent route of HIV transmission is unprotected sex with HIV infected men, accounting for 90% of transmission in 13 to 24 year old, and 87% in 25 to 34 year old women. Our research has led us to understand that most women are aware that their partners are engaging in behaviors that place them at risk if they engage in unprotected sex. But they have unprotected sex anyway…for many reasons…mostly to hold on. But to hold onto what?