Application Of Community-based Participatory Research Research Articles

A Model of Community Health Worker Integration into Schools: Community-based Participatory Research in Action

Abstract: Background: Schools are rich sites for collaborations between health and educational sectors. Objectives: To identify lessons learned from formation of a community–academic partnership and application of community-based participatory research (CBPR) to develop a model that integrates community health workers into schools. Methods: Individuals from an academic medical center, a large public school district, and a community-based research institute applied CBPR principles to reimagine schools as a place for improving the health of children. Lessons Learned: Three lessons emerged. Leveraging each team member's expertise centered the partnership on community strengths, co-learning, and stakeholder engagement. Adherence to CBPR's principles of power sharing and equity helped navigate the challenges of collaboration between large institutions. Early focus on sustainability helped address unexpected issues, build capacity, and boost advocacy. Conclusions: This partnership demonstrates how CBPR fosters conditions in which equitable partnerships between research institutions and public schools can thrive to promote childhood health.

A Framework for Equitable Partnerships to Promote Cancer Prevention and Control in Rural Settings.

Rural populations continue to experience persistent cancer disparities compared with urban populations particularly in cancers that can be prevented or detected early through screening and vaccination. Although the National Cancer Institute and the larger cancer research community have identified rural community partnerships as the foundation for reducing the disparities, we have identified limited application of community-based participatory research in cancer prevention and control research. Guided by the Community-Based Participatory Research Conceptual Model and our collective experience, we provide a framework for a community–cancer center partnership that focuses on promoting health equity. In this commentary, we articulate that the partnership process must foster capacity for communities and cancer centers, strive for rural representation in clinical trials and biobanking, build a pipeline for dissemination and implementation research, and create a bidirectional flow of knowledge between communities and academic institutions. Authentic partnerships with rural communities should be the ultimate goal of cancer centers, and the process described in this commentary can serve as an initial platform to build capacity and continue to strive toward that goal.

Community-Engaged Approaches to Cervical Cancer Prevention and Control in Sub-Saharan Africa: A Scoping Review.

Background: Cervical cancer remains one of the top causes of cancer mortality among African women. Cervical cancer screening and early detection and treatment of precancer is one of the evidence-based interventions to reduce incidence and mortality. The application of community-based participatory research (CBPR) has been used in the United States to improve participation in screening and reduce cervical cancer disparities. However, it is unclear whether these engaged approaches have been used in sub-Saharan African to address disparities related to cervical cancer mortality.Objectives: Highlight community engagement in cervical cancer prevention and control in Sub-Saharan Africa (SSA), describe the community engagement efforts that are currently being used, and to describe the best practices for community engagement toward the end-goal of cervical cancer prevention and control.Methods: We searched PubMed, Embase, CINHAL, African Journals Online (AJOL), and African Index Medicus-WHO from inception until June 8, 2020. After screening 620 titles and abstracts, and reviewing 56 full-text articles according to inclusion and exclusion criteria, 9 articles met the selection criteria and were included. Relevant data variables were extracted from the included articles and a narrative synthesis was performed.Results: Between 2005 and 2019, 9 articles describing research in Ghana, Kenya, Zambia, Senegal, South Africa, and Nigeria were included. These articles described work that largely took place in rural settings predominantly among women age 15–65 years. Leveraging community networks such as community health workers, religious organizations, traditional leaders, and educational institutions increased awareness of cervical cancer. Working within existing social structures and training community members through the research effort were promising methods for addressing the disparities in cervical cancer incidence and mortality among communities.Discussion: The findings of this scoping review have contributed to the understanding of which novel approaches to community-based practices can be used to address cervical cancer disparities among SSA communities that carry a disproportionate disease burden. Community engagement in the research process, while effortful, has shown to be beneficial to researchers and to the communities that they serve, and provides valuable next steps in the effort to address cervical cancer disparities in SSA.

Implementing Community-Based Participatory Research with Communities Affected by Humanitarian Crises: The Potential to Recalibrate Equity and Power in Vulnerable Contexts.

Worldwide, over 70.8 million people are forcibly displaced from their homes as a result of persecution, conflict, violence, or human rights violation. In humanitarian crises, protection and the provision of basic needs are often prioritized. Research may be seen as opportunistic. However, without documenting and researching humanitarian responses, knowledge is not shared and does not accumulate, limiting the application of evidence-based interventions where they are most needed. Research in humanitarian crises is complex, both ethically and methodologically. Community-engaged research, and specifically community-based participatory research (CBPR), can address some of the challenges of research in these settings. Using case studies of research we have conducted with communities affected by humanitarian crises, we highlight challenges and opportunities of the application of the ten core principles of CBPR in humanitarian settings. Despite some challenges and barriers, CBPR is a highly effective approach to use when engaging these populations in research. We argue that the application of CBPR in these settings has the potential to recalibrate the scales of equity and power among vulnerable populations.

Abstract A039: Utilizing community-based participatory research to facilitate the conduct of research in a safety-net hospital

Abstract Background: Safety-net hospitals, often in inner-city communities, provide a considerable level of care to low-income, uninsured, Medicare, Medicaid, and vulnerable populations. Establishing and performing research studies at safety-net hospitals may require additional planning due to the protections provided to ensure ethical research and the characteristics of the populations they serve. Community-based participatory research (CBPR) is a partnership approach to research that equitably involves community members, organizational representatives, and academic researchers in all aspects of the research process. The purpose of this study is to 1) report the application of community-based participatory research to develop the capacity to conduct a multilevel qualitative research study focused on minorities' participation in clinical trials in a safety-net hospital, and 2) discuss the lessons learned when planning research studies at safety-net hospital cancer centers. Methods: This qualitative study discusses the implementation of CBPR in the preintervention process of a multilevel qualitative research study within a safety-net hospital cancer center in Atlanta, GA. The seven principles of CBPR guided the structure of project meetings with hospital leadership and administration, process for development of research documents, and obtaining regulatory approval. Findings: Navigating the research approval process in a safety-net hospital and fostering relationships with key hospital leaders and administrators were critical to the initiation of the study. The study followed a university Institutional Review Board (IRB)-approved protocol; however, there were hospital procedures and policies specific to the safety-net hospital that required modifications to the timeline and protocol. In addition to the IRB approval, the study had to undergo a separate approval process by two hospital regulatory boards. The CBPR approach fostered processes that enabled hospital leadership and administrators to contribute their expertise with shared responsibility and ownership. Through CBPR, the academic research team was better able to understand effective strategies for conducting research in a safety-net hospital. Building trust and establishing rapport with hospital leadership and administrators involved a series of meetings, collaboration on community and hospital-based events, transparency by describing the study's purpose, and what knowledge was being generated and how it would be used. Through the CBPR approach, a process was established to feed back the data, jointly interpret the data, disseminate the data, and translate the data into interventions and/or policy. Conclusion: The information provided from this study is beneficial to future studies that partner with safety-net hospital cancer centers. When planning a study, researchers should follow CBPR principles to build trusting relationships with the hospital leadership and administrators. Citation Format: Dexter Cooper, Reagan Durant, Desiree Rivers, Natalie Hernandez, Jennifer Creighton, Brian Rivers, Monica Harris. Utilizing community-based participatory research to facilitate the conduct of research in a safety-net hospital [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr A039.

“Ask Me What I Want”: Community-based participatory research to explore transition-age foster Youth’s use of support services

Transition-age foster youth are a population deserving support, including possible psychological assessment and service provision. The majority of these youth do not receive adequate supports and face difficulties in the transition to adulthood. To understand the challenges and barriers to care, the majority of research relies on adult stakeholders rather than on the voices of youth themselves. This study used community-based participatory research to design and implement a survey of transition-age foster youth to learn about their experiences in foster care, use of professional services, barriers to initiating and continuing services, perspectives on treatment topics and therapist characteristics, and use of informal supports. This study details the methods and application of community-based participatory research with foster youth, and then presents a subset ofthe results of the survey completed by 84 youth transition-age youth in care. Findings indicate the importance of working towards equitable relationships with youth in care to inform research on youth’s experiences and perceptions. Survey results affirm transition-age foster youth’s desire for autonomy, their resourcefulness, and potential areas where services for these youth could offer more support, particularly during periods of transition.

Engaging Adolescents Through Participatory and Qualitative Research Methods to Develop a Digital Communication Intervention to Reduce Adolescent Obesity.

The complexity of the childhood obesity epidemic requires the application of community-based participatory research (CBPR) in a manner that can transcend multiple communities of stakeholders, including youth, the broader community, and the community of health care providers. To (a) describe participatory processes for engaging youth within context of CBPR and broader community, (b) share youth-engaged research findings related to the use of digital communication and implications for adolescent obesity intervention research, and (c) describe and discuss lessons learned from participatory approaches. CBPR principles and qualitative methods were synergistically applied in a predominantly African American part of the city that experiences major obesity-related issues. A Youth Research Advisory Board was developed to deeply engage youth in research that was integrated with other community-based efforts, including an academic-community partnership, a city-wide obesity coalition, and a primary care practice research network. Volunteers from the youth board were trained to apply qualitative methods, including facilitating focus group interviews and analyzing and interpreting data with the goal of informing a primary care provider-based obesity reduction intervention. The primary results of these efforts were the development of critical insights about adolescent use of digital communication and the potential importance of messaging, mobile and computer apps, gaming, wearable technology, and rapid changes in youth communication and use of digital technology in developing adolescent nutrition and physical activity health promotion. The youth led work helped identify key elements for a digital communication intervention that was sensitive and responsive to urban youth. Many valuable lessons were also learned from 3 years of partnerships and collaborations, providing important insights on applying CBPR with minority youth populations.

Harnessing the potential of community-based participatory research approaches in bipolar disorder.

BackgroundDespite the rapid growth in the sophistication of research on bipolar disorder (BD), the field faces challenges in improving quality of life (QoL) and symptom outcomes, adapting treatments for marginalized communities, and disseminating research insights into real-world practice. Community-based participatory research (CBPR)—research that is conducted as a partnership between researchers and community members—has helped address similar gaps in other health conditions. This paper aims to improve awareness of the potential benefits of CBPR in BD research.MethodsThis paper is a product of the International Society for Bipolar Disorders (ISBD) Taskforce on Community Engagement which includes academic researchers, healthcare providers, people with lived experience of BD, and stakeholders from BD community agencies. Illustrative examples of CBPR in action are provided from two established centres that specialize in community engagement in BD research: the Collaborative RESearch Team to study psychosocial issues in BD (CREST.BD) in Canada, and the Spectrum Centre for Mental Health Research in the United Kingdom.Results and discussionWe describe the philosophy of CBPR and then introduce four core research areas the BD community has prioritized for research: new treatment approaches, more comprehensive outcome assessments, tackling stigma, and enhanced understanding of positive outcomes. We then describe ways in which CBPR is ideal for advancing each of these research areas and provide specific examples of ways that CBPR has already been successfully applied in these areas. We end by noting potential challenges and mitigation strategies in the application of CBPR in BD research.ConclusionsWe believe that CBPR approaches have significant potential value for the BD research community. The observations and concerns of people with BD, their family members, and supports clearly represent a rich source of information. CBPR approaches provide a collaborative, equitable, empowering orientation to research that builds on the diversity of strengths amongst community stakeholders. Despite the potential merits of this approach, CBPR is as yet not widely used in the BD research field, representing a missed opportunity.

Using Community-Based Participatory Research in Parish Nursing

Parish nurses contribute to community health through the expertise and programming they provide to and through faith communities. Application of community-based participatory research (CBPR) principles helps develop, implement, and evaluate effective community interventions. University graduate students partnered with a Hospital Parish Nurse Program (HPNP) in an urban community to provide assessment data in a CBPR project that led the HPNP to focus resources and interventions on high obesity rates. The HPNP utilized data to write grant proposals to expand community services to impact obesity.

Cultural Effectiveness in Research: A Summary Report of a Panel Session Entitled “Engaging Populations at Risk”

ABSTRACT This paper summarizes two presentations and a panel discussion engaging health scientists, educators, and community outreach professionals who have drawn upon their experiences as researchers and agricultural workers to describe research challenges related to access, trust, language, culture, and participant benefit. These presentations and discussion took place at the New Paths: Health and Safety in Western Agriculture conference, November 11–13, 2008. An overview of changing demographics of the western agricultural workforce was provided followed by a presentation of the application of community-based participatory research (CBPR) principles including cultural considerations. Using an interview format, the panel participants discussed challenges related to involving members of vulnerable agricultural worker populations throughout the research process. Lessons learned and recommendations were explored and successes identified.

The practical application of community-based participatory research in Greenland: Initial experiences of the Greenland sexual health study

Increasingly, community-based participatory research (CBPR), with its emphasis on engagingcommunities as full and equal partners in all phases of the research process is being promotedto address the health needs of peoples living in the North American Arctic. However, the CBPRapproach is not without its challenges in Arctic countries such as Greenland, where researchcapacity, different languages, distance, time and cost become barriers to remaining true to thepurest form of CBPR. In this paper, we describe the practical application of CBPR principles andmethodologies to a sexual health project investigating sexually transmitted infections in Greenland.We present the initial challenges encountered in the early stages of the pilot CBPR sexualhealth study, and solutions to these challenges. We also provide recommendations for expandingthe capacity in Greenland to conduct CBPR projects.

Community-Based Participatory Research: Toward Eliminating Rural Health Disparities

Purpose/Aims: Rural communities throughout the US continue to sustain disparities in healthcare access and outcomes despite decades of health research and action. Community-based participatory research (CBPR) has been successful in empowering communities through research and tailored interventions toward the elimination of health disparities. The purpose of this study was to ascertain the community perspective on health issues within a CBPR project framework. Specific goals included identification of county-level key health issues, assessment of health related risk factors, and development of community capacity to deal with significant health challenges while working within a community-university partnership. Methods: A CBPR needs assessment was conducted using multi-method research through key informant interviews, a telephone survey of community residents and a survey of medical professionals to ascertain the community perspective on health issues. Results: Findings showed a wide range of health needs. Epidemiology assessment of county data revealed excess mortality due to cancer, diabetes, heart disease, chronic respiratory disease, accidents, infant mortality and suicide. Key informant interviews showed the top perceived health-related problems to be lack of insurance coverage, obesity, lack of education, and lack of consistency in primary care. Telephone survey findings revealed the top perceived health problems were poor quality or insufficient health services, lack of insurance, heart disease, cost of care/poverty, cancer, drug abuse, diabetes, lack of senior care, obesity, and pediatric/prenatal care. Implications: This study provides a specific application of CBPR to help reduce rural health disparities. Data was used to develop a Childhood Obesity Task Force Summit to combat the local obesity epidemic. A Healthy Week Initiative was also implemented. This research can serve as a model for future research and community engagement scholarship as it relates to CBPR as a paradigm to identify, address and eliminate health disparities. DOI : http://dx.doi.org/ 10.14574/ojrnhc.v15i2.353 Keywords: Rural health, Healthcare disparities, Community-based participatory research

Establishing an implementation network: lessons learned from community-based participatory research

BackgroundImplementation of evidence-based mental health assessment and intervention in community public health practice is a high priority for multiple stakeholders. Academic-community partnerships can assist in the implementation of efficacious treatments in community settings; yet, little is known about the processes by which these collaborations are developed. In this paper, we discuss our application of community-based participatory research (CBPR) approach to implementation, and we present six lessons we have learned from the establishment of an academic-community partnership.MethodsWith older adults with psychosis as a focus, we have developed a partnership between a university research center and a public mental health service system based on CBPR. The long-term goal of the partnership is to collaboratively establish an evidence-based implementation network that is sustainable within the public mental healthcare system.ResultsIn building a sustainable partnership, we found that the following lessons were instrumental: changing attitudes; sharing staff; expecting obstacles and formalizing solutions; monitoring and evaluating; adapting and adjusting; and taking advantage of emerging opportunities. Some of these lessons were previously known principles that were modified as the result of the CBPR process, while some lessons derived directly from the interactive process of forming the partnership.ConclusionThe process of forming of academic-public partnerships is challenging and time consuming, yet crucial for the development and implementation of state-of-the-art approaches to assessment and interventions to improve the functioning and quality of life for persons with serious mental illnesses. These partnerships provide necessary organizational support to facilitate the implementation of clinical research findings in community practice benefiting consumers, researchers, and providers.