Capacity Of Community-based Organizations Research Articles

Abstract C007: Building capacity in health clinics and community organizations serving LGBTQ+ communities on tobacco prevention

Abstract Background. Tobacco use remains a significant public health issue, particularly among the LGBTQ+ community. Los Angeles County, which is home to the second-largest LGBTQ+ population in the US, has notably higher prevalence of tobacco use compared to the general population, partly due to targeted marketing by the tobacco industry, social stressors, and discrimination. These factors contribute to higher rates of smoking and tobacco-related health disparities; however, little is known about the capacity of community-based organizations, clinical providers, support staff, and other personnel that work closely with the LGBTQ+ community to provide smoking cessation services. Methods. Cedars Sinai Cancer Center Community Outreach and Engagement (COE) assisted in the facilitation of conducting a needs assessment, Clinical Provider and Staff Survey, to assess the opinions of clinical providers and community leaders about tobacco cessation-related topics related to 1) Building culturally competent tobacco cessation services; 2) Reducing health disparities in tobacco cessation services; 3) Improving access to care (Medicaid/Medi-Cal access and uptake) for diverse populations that are affected by tobacco-related disparities; 4) Improving the utilization of tobacco cessation services. The survey was administered online from December 2022 to April 2023 with providers throughout Los Angeles County. Results. A total of 261 surveys were collected which revealed several key issues at the organization level: they do not prioritize tobacco screening, treatment, or referrals; there is no standardized process for client management; staff have limited knowledge on tobacco prevention and patient navigation; and there is limited staff capacity and funding. To address organizational-focused barriers, COE trained 147 clinical providers and staff from 4 local health clinics and organizations and on capacity building, including the basics of tobacco, evidence-based interventions like "Ask, Advice, Refer," and lung cancer screening. Additionally, to address Client/Patient-Focused Barriers for Organizations, such as: lack of motivation to quit, low perception of the severity of smoking, and a lack of culturally competent or targeted cessation resources, COE staff assisted in navigating resources, ensuring both providers and clients were aware of and could access relevant support services. This involved sharing LGBTQ+ affirming resources, including medical care, behavioral health, and housing, and referred smokers to gender-affirming cessation support groups. Conclusion. The survey highlighted the need to enhance service delivery and support for the LGBTQ+ community. With these findings, our COE staff were able to increase organizational capacity through training and education for clinical providers and staff to enhance their knowledge and skills in tobacco cessation and share gender-affirming resources and navigation, which are crucial towards improving the overall effectiveness of tobacco cessation services for LGBTQ+ populations. Citation Format: Victor Cristanto, Alexandra Caro, Reener Balingit, Zul Surani. Building capacity in health clinics and community organizations serving LGBTQ+ communities on tobacco prevention [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr C007.

Abstract A041: University of California Moores Cancer Center CancerDAT: Development of an online tool to reduce cancer disparities by engaging and linking local organizations and researchers

Abstract The purpose of Moores Cancer Center (MCC) CancerDAT is to reduce cancer disparities through the development of an online tool that will facilitate research partnerships, build the capacity of community-based organizations, and encourage community engagement. CancerDAT is a part of the MCC Community Outreach and Engagement Initiative (COE), which aims to decrease the burden of cancer in San Diego County, the MCC catchment area. San Diego is geographically and demographically unique, bordering the Pacific Ocean and Mexico. Across and within neighborhoods, the population varies greatly in socioeconomic status, acculturation, and languages spoken. In order to effectively recruit from, collaborate with, and intervene in communities, cancer researchers and practitioners must understand these unique sociodemographic characteristics and community needs. To achieve this kind of understanding, researchers need access to local data and local organizations and leaders, as well as information about existing efforts to address cancer disparities in a given community. Many organizations in San Diego are devoted to reducing cancer disparities; their efforts, however, are hampered by an inability to fully engage in research and implement evidence-based practices. Local community needs assessments have identified barriers to organizational participation in these activities, including an inability to access relevant and current local data, a lack of knowledge about adopting and adapting interventions for their communities, and a lack of connection to local academics open to collaborative research. The MCC COE, in partnership with their Community Advisory Board, will address these needs by: 1) assessing the catchment area cancer burden across neighborhoods; 2) facilitating transdisciplinary basic, translational, and clinical research; and 3) disseminating evidence-based practices and resources for cancer prevention, screening, and treatment. To facilitate this, the MCC COE collaborated with the UC San Diego Altman Clinical and Translational Research Institute and consortium partner San Diego State University to develop CancerDAT (moores.healthdat.org). This tool will be used by academics and community partners to identify and address cancer disparities across communities. For example, breast cancer mortality rates vary greatly in different San Diego communities: the age-adjusted death rate in the Del Mar region is 6.06/100,000 compared with 49.67/100,000 in the Jamul region. These disparities can be easily visualized and identified by CancerDAT users. CancerDAT is a free, user-friendly, online platform that provides: 1) mapping of neighborhood-level cancer outcomes, demographics, behaviors, and social determinants of health; 2) descriptions of best practices to address cancer disparities; 3) neighborhood programs and resources that address disparities; 4) links to community-engaged academics interested in collaborating; and 5) links to existing relevant local collaboratives. Citation Format: Corinne R. McDaniels-Davidson, Jesse Nodora, Samir Gupta, Sandip P. Patel, Tanya Penn, Maria E. Martinez. University of California Moores Cancer Center CancerDAT: Development of an online tool to reduce cancer disparities by engaging and linking local organizations and researchers [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 A041.

Assessing Research Activity and Capacity of Community-Based Organizations: Refinement of the CREAT Instrument Using the Delphi Method.

Community-based organizations (CBOs) are essential partners in community-engaged research, yet little is known about their research capacity. Community experts and organizations bring unique knowledge of the community to research partnerships, but standard validated measures of CBO research capacity do not yet exist. We report here on the refinement through a structured Delphi panel of a previously developed and piloted framework of CBO research capacity and an accompanying instrument, the Community REsearch Activity Assessment Tool (CREAT). A Delphi panel composed of twenty-three experts recruited from community (52%) and academic researchers (48%) from around the USA participated in five rounds of review to establish consensus regarding framework domains, operational definitions, and tool items. Panelists rated the importance of items on a 5-point Likert scale and assessed for the inclusion and language of items. Initial rounds of review began with reviewing the framework and definitions, with subsequent rounds including review of the full instrument. Concluding rounds brought back items that had not yet reached consensus for additional review. Median response values (MRV) and intra-quartile ranges (IQR) were calculated for each Likert item. Items with an MRV > 3.5 were deemed as having reached consensus and were retained. Language changes were made for items with MRV > 2.0 and < 3.5 and an IQR > 1.5. Items with MRV < 2.0 were excluded from the final tool. Panelist response rate was high (>75%). Consensus was achieved for the inclusion of all domains, subdomains and operational definitions except "evidence-based practices." Extensive changes to the CREAT instrument were made for clarification, to provide additional detail and to ensure applicability for CBOs. The CREAT framework and tool was refined through input from community and academic researchers. Availability of a validated tool to assess research capacity of CBOs will support targeted research capacity building for community organizations and partners, thus strengthening collaborations.

Surviving suburban redevelopment: Resisting the displacement of immigrant-owned small businesses in Wheaton, Maryland

ABSTRACT In the past several decades, the suburbs of many U.S. metropolitan regions have seen rising levels of poverty, immigration, and racial and ethnic diversity. At the same time, suburban redevelopment has led to more “urban-like” development patterns and struggles over gentrification and displacement. In a case study of Wheaton, Maryland, this article explores how redevelopment impacted suburban immigrants and small businesses and how they fought back. Using interviews with key stakeholders and secondary documents about Wheaton’s redevelopment, it shows several challenges to advancing equitable development in suburbs, including the capacity of community-based organizations, political representation, and limited government policies and programs. However, grassroots activists and grasstops policymakers have slowly built the capacity of communities to balance the scales of development. As suburbs redevelop, the article offers lessons about the consequences for socially and economically vulnerable groups and the political and community-based structures and support needed to advance equitable outcomes.

Developing the Asian Pacific Islander Caregiver Train-the-Trainer Program in the United States

ABSTRACT This article describes our project to design the Asian Pacific Islander Caregiver Train-the-Trainer (APICTT) Program in the United States. The project relied on a sequential approach to gathering and building upon (1) evidence mapping to identify existing caregiver training programs in the United States available in API languages; (2) assessment of API caregiver training needs among community-based organizations using survey and focus group; and (3) Chinese and Korean caregiver focus groups. The findings highlight language, culture, and access gaps in current caregiver training programs and reinforce the importance of developing a culturally and linguistically appropriate caregiver training program for API caregivers in the United States. The findings also shed light into using the train-the-trainer model to enhance the service delivery capacity of community-based organizations.

A qualitative exploration of suspended youth social connectedness in a community-based intervention program

ABSTRACTOut-of-school suspension continues to disconnect an overwhelming number of economically disadvantaged ethnic minority (EDEM) youth from school—leading to out-of-school placement. Youth communities and localities may provide alternative spaces for suspended youth and create opportunities for prosocial engagement and support. The present study employed participant observation and interviews to explore suspended youth sense of social connectedness in a community-based intervention program in the United States. Findings illustrate psychosocial assets and youth sense of social connectedness emerged from relational bonds and a structural culture enforcing a nurturing and inclusive environment. A discussion on improving the capacity of community-based organizations to address the needs of suspended youth follows.

Assessing Research Activity and Capacity of Community-Based Organizations: Development and Pilot Testing of an Instrument

Assessing Research Activity and Capacity of Community-Based Organizations:Development and Pilot Testing of an Instrument Debbie L. Humphries, PhD, MPH, Amy Carroll-Scott, PhD, MPH, Leif Mitchell, BA, Terry Tian, MPH, Shonali Choudhury, PhD, MMH, and David A. Fiellin, MD What Is the Purpose of This Study? • To develop a framework of research activity and capacity within community-based organization (CBOs) and to develop and pilot an instrument (the Community REsearch Activity assessment Tool [CREAT]) for assessing research activity and capacity of CBOs. • The CREAT tool was broad in scope to capture the different research and reporting experiences and priorities of CBOs. What Is the Problem? • Recent emphasis on CBO participation in academic–community research partnerships, community needs assessments, program monitoring and evaluation, and evidence-based practice has depended on CBOs’ capacity for research. • Little is known about CBO capacity and little attention has been paid to this issue in the literature. • Both a framework and measures are needed that can assess CBOs’ existing research infrastructure, skills, activities and needs; and capture changes that occur as a result of research capacity-building efforts. What Are the Findings? • The four primary domains of the CREAT framework include 1) Organizational support for research, 2) generalizable experiences, 3) research specific experiences, and 4) funding. • Thirty CBOs participated in the CREAT pilot survey. • These organizations reported a high prevalence of activities in the research specific experiences domain, including conducting literature reviews (70%), using research terminology (83%), and collecting primary data (100%). • Almost two thirds reported collecting primary data at least weekly. • Disseminating research findings was important to respondents, and funders, board members, and policymakers were the most commonly reported dissemination audiences. • The scientific community was identified as an audience for dissemination by only one third of the organizations overall, and by only 18% of respondents from smaller budget organizations. • Respondents reported a number of barriers to conducting research, with the most commonly identified issues focused on staff time and skills. [End Page 413] Who Should Care Most? • Individuals and organizations working to enhance research capacity and activity of CBOs in a way that aligns with their mission. • Community organizations interested in strengthening their research capacity. • Institutional review boards with responsibility for overseeing ethical approval of community-based research and for overseeing research affiliates. • Academic and other researchers who work in research partnerships with CBOs. Recommendations for Action • Disseminate CREAT framework and measures among a wide range of CBOs to further refine the tool. • Encourage CBOs to use CREAT tool to understand and enhance their research infrastructure needs. • CBOs interested in developing research capacity could complete the CREAT to identify areas of higher and lower research capacity. • CBOs could also complete the tool as a way to think more about the role of research in their organizations. • Encourage CBOs and researchers to use CREAT before starting a new community research partnership or project to identify and enhance the research capacity needed for their joint endeavor. • Develop a complementary framework and tool for assessing researcher capacity to conduct community-engaged research to inform new partnerships and projects. [End Page 414] Debbie L. Humphries School of Public Health Center for Interdisciplinary Research on AIDS (CIRA) Amy Carroll-Scott School of Public Health Center for Interdisciplinary Research on AIDS (CIRA) Leif Mitchell Center for Interdisciplinary Research on AIDS (CIRA) Terry Tian Center for Interdisciplinary Research on AIDS (CIRA) Community Health Center, Inc. Shonali Choudhury Center for Interdisciplinary Research on AIDS (CIRA) Institute for Community Research University of Miami, School of Nursing and Health Studies David A. Fiellin School of Public Health Center for Interdisciplinary Research on AIDS (CIRA) School of Medicine, Yale University Copyright © 2014 The Johns Hopkins University Press

Assessing research activity and capacity of community-based organizations: development and pilot testing of an instrument.

Although awareness of the importance of the research capacity of community-based organizations (CBOs) is growing, a uniform framework of the research capacity domains within CBOs has not yet been developed. To develop a framework and instrument (the Community REsearch Activity assessment Tool [CREAT]) for assessing the research activity and capacity of CBOs that incorporates awareness of the different data collection and analysis priorities of CBOs. We conducted a review of existing tools for assessing research capacity to identify key capacity domains. Instrument items were developed through an iterative process with CBO representatives and community researchers. The CREAT was then pilot tested with 30 CBOs. The four primary domains of the CREAT framework include 1) organizational support for research, 2) generalizable experiences, 3) research specific experiences, and 4) funding. Organizations reported a high prevalence of activities in the research-specific experiences domain, including conducting literature reviews (70%), use of research terminology (83%), and primary data collection (100%). Respondents see research findings as important to improve program and service delivery, and to seek funds for new programs and services. Funders, board members, and policymakers are the most important dissemination audiences. The work reported herein advances the field of CBO research capacity by developing a systematic framework for assessing research activity and capacity relevant to the work of CBOs, and by developing and piloting an instrument to assess activity in these domains.

Getting Off: Development of a Model Program for Gay and Bisexual Male Methamphetamine Users

An evidence-based gay-specific cognitive behavioral therapy (GCBT) intervention for methamphetamine-using gay and bisexual men was adapted for use in a community-based setting, thereby moving research into practice. The 48-session, 16-week GCBT intervention was revised to 24 sessions requiring 8 weeks and renamed Getting Off: A Behavioral Treatment Intervention for Gay and Bisexual Male Methamphetamine Users. GCBT was modified for implementation within the limited resources and capacity of community-based organizations while also retaining drug use and HIV risk reduction outcomes. Since 2007, Getting Off has been sustained with public health funding at the community site and has been adopted by multiple community-based sites.

Making Governance More Participatory at the Local Level in Nigeria

Yearning for good governance in Africa and Nigeria, in particular, has remained a pressing and topical issue. Indeed, governance and development issues are on the front burner in democratizing societies like Nigeria. The crisis of development has been described as a ‘crisis of governance’ by the World Bank (2003). This crisis of governance has adversely affected the quality and quantity of public utilities provided at the local level. Development strategies of government at the federal, state and local levels have not actively enlisted the participation of Community-Based Organizations (CBOs) in local governance despite their obvious activities and contributions to development in their communities. The bureaucratic institutions of State Administration have become so centralized with the CBOs largely relegated and made irrelevant. It is believed that if the self-governing capacity of CBOs is harnessed, supported and reinforced by governance structures, socio-economic development will be positively affected and possibly lead to its sustainability. It is against this backdrop that this paper examined the essence of CBOs participation in governance for facilitating and fast-tracking socio-economic development and ensuring accountability and responsiveness among government functionaries. The paper also presented the necessary conditions that must be met for CBOs involvement in governance as well as the expected gains of participatory governance. The paper concluded that participation of CBOs in governance could lead to effective representation and empowerment which would, in turn, enhance democratic dividends at the grassrootsl, especially in the local communities.

Lessons Learned: Building the Capacity of Community-Based Organizations and Health Departments Implementing HIV Interventions in African American Communities

ABSTRACT Even with the medicalization of HIV/AIDS, bringing programs and services into communities requires effective programs and service delivery systems. Developing and maintaining the capacities of these programs are critical. Because capacity building has become such an important part of HIV prevention work, greater attention must be given to the best practices in this area. In this article, the best practices and lessons learned from one national capacity building initiative are presented. Using a nonexperimental approach, the authors present 4 years of capacity building assistance service provision in the field of HIV prevention.

Assessing and Developing the Evidence Base of Macro Practice Interventions with a Community and Neighborhood Focus

ABSTRACT Assessing and developing the evidence base of macro practice with a community and neighborhood focus is challenging because of the lack of rigorous studies, difficulties posed by conducting research at the community level, and lack of evaluation capacity at multiple levels of practice. Current evidence on community interventions is summarized. Resources for assessing community interventions are presented, along with strategies for searching, appraising, and synthesizing the evidence. Challenges and potential solutions to developing the evidence base of community interventions are discussed, including defining and analyzing complex community interventions, developing rigorous research designs, and building the evaluation capacity of community-based organizations.

A model for capacity-building in AIDS prevention programs.

This article discusses a collaboratively organizational capacity-building model for agencies engaged in HIV/AIDS prevention. The cooperative training approach (CTA) utilized by the Training and Technical Assistance Program trained participants to incorporate learned skills into their daily work practices, and to become trainers to help disseminate their newly acquired skills, first to others in their own organization and later to other organizations. The CTA was successfully implemented among 285 community-based organizations (CBOs) serving predominantly Hispanics in the U.S.-Mexico border region. The program evaluation demonstrated that it has significantly upgraded the program implementation capability and the organizational infrastructure of the participating organizations resulting in improved delivery of services to their clients. Furthermore, it fostered networking and collaboration for the development of sustainable training and technical assistance networks of agency staff skilled in organizational capacity building. It is suggested that funding agencies examine the feasibility of using this approach to increase the organizational capacity of CBOs involved in HIV/AIDS prevention.