Community-based Participatory Research Initiative Research Articles

'It doesn't happen any other way': relationship-building and reflexivity for equity-focused intersectoral practice (EquIP).

Intersectoral processes that bring together public institutions, civil society organizations and affected community members are essential to tackling complex health equity challenges. While conventional wisdom points to the importance of human relationships in fostering collaboration, there is a lack of practical guidance on how to do intersectoral work in ways that support authentic relationship-building and mitigate power differentials among people with diverse experiences and roles. This article presents the results of RentSafe EquIP, a community-based participatory research initiative conducted in Owen Sound, Canada, in the midst of a housing crisis. The research explored the potential utility of equity-focused intersectoral practice (EquIP), a novel approach that invests in human relationships and knowledge co-creation among professionals and affected members of the community. The three-phase EquIP methodology centred the grounded expertise of community members with lived/living experience of housing inadequacy to catalyze reflexive thinking by people in professional roles about the institutional gaps and barriers that prevent effective intersectoral response to housing-related inequities. The research demonstrated that EquIP can support agency professionals and community members to (i) engage in (re)problematization to redefine the problem statement to better include upstream drivers of inequity, (ii) support reflexivity among those in professional roles to identify institutional practices, policies and norms that perpetuate stigma and impede effective intersectoral response and (iii) spark individual and collective agency and commitment towards a more equity-focused intersectoral system. We conclude that the EquIP methodology is a promising approach for communities seeking to address persistent health equity and social justice challenges.

Translating community-based participatory research into broadscale sociopolitical change: insights from a coalition of women firefighters, scientists, and environmental health advocates

BackgroundWe report on community-based participatory research (CBPR) initiated by women firefighters in order to share successful elements that can be instructive for other community-engaged research. This CBPR initiative, known as the Women Worker Biomonitoring Collaborative (WWBC) is the first we are aware of to investigate links between occupational exposures and health outcomes, including breast cancer, for a cohort of exclusively women firefighters.MethodsIn order to be reflective of the experiences and knowledge of those most intimately involved, this article is co-authored by leaders of the research initiative. We collected leaders’ input via recorded meeting sessions, emails, and a shared online document. We also conducted interviews (N = 10) with key research participants and community leaders to include additional perspectives.ResultsFactors contributing to the initiative’s success in enacting broadscale social change and advancing scientific knowledge include (1) forming a diverse coalition of impacted community leaders, labor unions, scientists, and advocacy organizations, (2) focusing on impacts at multiple scales of action and nurturing different, yet mutually supportive, goals among partners, (3) adopting innovative communication strategies for study participants, research partners, and the broader community, (4) cultivating a prevention-based ethos in the scientific research, including taking early action to reduce community exposures based on existing evidence of harm, and (5) emphasizing co-learning through all the study stages. Furthermore, we discuss external factors that contribute to success, including funding programs that elevate scientist-community-advocacy partnerships and allow flexibility to respond to emerging science-policy opportunities, as well as institutional structures responsive to worker concerns.ConclusionsWhile WWBC shares characteristics with other successful CBPR partnerships, it also advances approaches that increase the ability for CBPR to translate into change at multiple levels. This includes incorporating partners with particular skills and resources beyond the traditional researcher-community partnerships that are the focus of much CBPR practice and scholarly attention, and designing studies so they support community action in the initial stages of research. Moreover, we emphasize external structural factors that can be critical for CBPR success. This demonstrates the importance of critically examining and advocating for institutional factors that better support this research.

"Give up your mic": Building capacity and sustainability within community-based participatory research initiatives.

Community-based participatory research (CBPR) partnerships strive to promote community capacity building and sustainability, yet initiatives often suffer when grants or relationships with academic partners end. To address these concerns, researchers hoping to develop truly sustainable CBPR partnerships should consider factors that promote the development of community capacity and, ultimately, independence. In this first-person account, using perspectives gathered from FAVOR, a Connecticut-based family-led advocacy organization and an academic researcher, we examine the practices and experiences of the members of a CBPR partnership focused on using community voice to inform changes in the state's children's behavioral health system of care. These practices ultimately led to FAVOR developing the necessary skills to assume full ownership of the community data-gathering initiative, ensuring that the initiative would be sustained. Through the perspectives of five FAVOR staff and an academic researcher, we describe the factors that contributed to the organization being able to develop the capacity to independently continue their community data-gathering initiative, including description of the training process and staff members' perspectives on training, autonomy, community value, and lessons learned. We use these stories and experiences to provide recommendations for other partnerships striving to promote capacity building and sustainability through community ownership of the research process.

165 Colorado Immersion Training: Ten years of lessons learned and accomplishments

OBJECTIVES/GOALS: The Colorado Immersion Training in Community Engagement (CIT) provides experiential training in community-based participatory research (CBPR). We summarized evaluations from the first ten years on program outcomes and lessons learned to inform future programming and the field of community research. METHODS/STUDY POPULATION: CIT is a six-month program that includes didactic sessions, group readings and reflections and a one week immersion experience in a Colorado community experiencing health disparities. The Evaluation Center - University of Colorado Denver provides external evaluation services to the Colorado Clinical and Translational Science Institute (CCTSI). Evaluators used three primary methods to collect data to evaluate the program; Document review, interviews, and surveys. Evaluation data were analyzed using the framework of CBPR Principles and the CBPR conceptual logic model to understand potential shifts in researchers’ thinking and actions, as well as to identify the potential for longer-term impact. RESULTS/ANTICIPATED RESULTS: As of 2020, CIT trained 122 researchers. 25 CIT alumni went on to receive 33 CCTSI Pilot Grants. Out of these 33 grants, an additional $8,723,000 of external grant funding was awarded to continue projects. Community Research Liaisons are a crucial component of the program through their efforts to bridge academic researchers and communities. Survey results indicated that community partners reported high levels of satisfactions with the program and shared stories about the impact they have seen in their community. Common challenges for researchers remain 1) protected time and institutional value and, 2) funding opportunities. DISCUSSION/SIGNIFICANCE: CIT has grown CBPR researchers. Similar programs should consider contributing factors: establishing institutional value and funding for CBPR initiatives with protected time for developing and maintaining community relationships. CIT offers a crucial connection between academia and community.

Community-based participatory research initiative to assess the scope of alcohol use within the community of refugees from Burma in the greater Denver area

Introduction For over fifty years, minorities in Burma have faced severe persecution and violence, forcing them to flee their homeland. In the past ten years there has been an influx in the number of refugees resettled in Denver, Colorado. Refugees often struggle to navigate the complexities of the American health care system and adapt to life in a foreign culture. The development of programs and partnerships to assist refugees in their pursuit of health and integration is essential to building stronger communities.Objectives This community based participatory research (CBPR) project was developed in collaboration with the refugee community from Burma living in the Denver area. After regular meetings with a group of motivated teenagers and young adults from this community to form our Youth Advisory Board (YAB), they identified alcohol use and misuse as a health concern within their community. With this identified issue, the project aimed to gather data from community members that could be leveraged to create, implement, and evaluate a culturally competent intervention to effectively address risky alcohol use in this community.MethodsData collection involved formal one-on-one, semi-structured, audio-recorded interviews with community members. Participants were recruited voluntarily at health information nights held by the student researchers at their local apartment complex. The interviews were conducted by one medical student researcher with one translator present and were transcribed afterward. The interview data was analyzed using Immersion Crystallization methodology.ResultsInitial results from the community meetings with the YAB, local organizations, formative community surveys, and key informant interviews highlighted the vulnerability of the refugee population, scarcity of culturally appropriate resources for alcohol abuse, and urgency of addressing problematic alcohol use. The analysis of the ten audio-recorded surveys showed several themes including negative consequences of alcohol use, specifically negative impacts on familial relationships, employment, and financial resources, and a perceived personal responsibility for managing one’s own alcohol consumption.ConclusionsThis project corroborates current literature regarding the scope and breadth of hazardous alcohol use within the community of refugees from Burma. Our data has expanded our understanding of the values of community members including the influence of religion and family on behaviors, and the negative impact on employment as the most impactful negative consequence. These findings need to be shared with the community to move forward in mapping the most effective and appropriate interventions.Disclosure of InterestNone Declared

Development of a Community Coalition to Influence Nutrition and Physical Activity in Early Childhood Education.

Recognizing insufficient support for healthy eating and physical activity in early childhood education centers in Greenville, South Carolina, a group of stakeholders formed a workgroup as an organizing structure. Members developed and implemented a 2-year community-based participatory research initiative aimed at nutrition and physical activity policy, systems and environment change in 10 early childhood education centers. This article 1) describes engagement efforts and partnerships leading to formation of the workgroup and initiative, 2) presents data on Workgroup members' knowledge and engagement, and 3) shares lessons learned. Workgroup member knowledge and engagement related to obesity prevention was measured at two time points during the ECE initiative using the "Stakeholder-driven Community Diffusion Survey." Knowledge and engagement scores increased over the measurement period. Scores for engagement were higher than scores for knowledge at both time points. There was a substantial increase in perceived leadership and stewardship, knowledge of intervention factors and how to intervene sustainably, and understanding of local resources and roles. An important strength was stakeholder buy-in and ownership of planning and implementation processes.

Project Lotus: A really cool community-based initiative assisting women post-homelessness

In Canada, recent conservative estimates report upwards of 235,000 individuals are homeless on a given night. Of those experiencing precarious housing situations, women make up approximately 30% and are among the most vulnerable. Their residential insecurity has been further exacerbated with the community and social restrictions of the COVID-19 pandemic. Existing resources that assist women experiencing homelessness or housing insecurity are often stretched to the limit dealing with emergency and crisis housing situations, with less focus on post-shelter supports.
 To address this issue, a community-based participatory research initiative ‘Project Lotus - Hope Together’ was established in Montreal. Grounded in the World Health Organization’s Commission on Social Determinants of Health Framework, the overarching goal of this research is to co-design a housing supports program for women leaving a shelter stay. We created a cross-sectorial Advisory Committee consisting of women with lived experiences of homelessness, service providers, community leaders, and researchers.
 To date, we have conducted preliminary research (literature review, interviews with women with lived experience of homelessness, stakeholder meetings) to identity what has assisted women through this transition, and what barriers exist. We have also held virtual community consultation meetings to discuss preliminary findings of recommendations of key components that should be in a post-shelter support program for women.
 This presentation outlines the current findings and highlights the importance of participatory research. Implementing whole person care in the area of women’s homelessness requires both a comprehensive and individualized approach to help women and children secure home, health, and a sustainable future.

Abstract PO-043: Perceived everyday discrimination, socioeconomic status, and mammography screening behavior

Abstract Black women (BW) experience age-adjusted breast cancer mortality rates that are 40-70% higher than White women. Although BW are more likely to report having had a mammogram compared to other racial/ethnic minority groups, differences in mammography utilization exist among women with lower socioeconomic status (SES). Moreover, perceived everyday discrimination (PED) has been shown to have an inverse relationship on health screening behavior among BW. However, mammography screening behaviors of BW with low SES, who also report higher levels of PED, is not well known. This study aims to explore the relationship between perceived discrimination, SES (income, education, health insurance), and mammography screening behavior. Methods: Participants completed a 40-item survey and were recruited between 2020-2021 through a community-based participatory research initiative—Bench to Community. Logistic regression was used to test the associations of mammography utilization with PED—short version of Everyday Discrimination Scale, SES, and race/ethnicity. Results: Most participants (n=159) identified as BW (55%)—African American, African, and Caribbean, followed by White (34%), and other groups (9.3%). Twenty-five percent had some high school (HS) or a HS diploma, 25% had some college education with 15% reporting an income below $25,000. Many respondents had health insurance (96%), and 74% reported having had a mammogram. Discrimination alone significantly impacted whether an individual had a mammogram, such that those who reported higher levels of PED were 38% less likely to have a mammogram, χ2(12) = 36.924, p<.001. Additionally, while education significantly contributed to the model, income demonstrated a trending influence overall, with less than $25,000 income reaching significance (B=-3.331, SE=1.210, Wald = 7.576, p=.006). As race and insurance did not significantly contribute to the overall model, subsequent model fitting excluded these variables. In a model that included only discrimination, education, and income, all three predictors significantly contributed to the model χ2(9)= 33.571, p<.001. Discrimination (B= -.536, SE=.178, Wald = 9.106, p=.003), education overall (B=-1.177, SE=.604, Wald = 3.797, p=.051), and income (B=-2.674, SE=.956, Wald = 7.815, p=.005) were significant predictors. More specifically, those with some college education or less were 3.245 times less likely to have a mammogram. In this final model, those who reported making less than $25,000 household income were .069 times less likely to have a mammogram. Lastly, race alone was significantly (p=.006) predictive of mammogram screening behavior. Discussion/Conclusion: PED, education, and income were associated with mammography screening behavior. The excess mortality faced by BW, is a probable reflection of their position within our hierarchal society. Addressing these social determinants of health factors may improve our understanding of ways discrimination leaves BW vulnerable to disparate health outcomes, including breast cancer. Citation Format: Jessica Vinegar, Marissa Ericson, Kommah McDowell, Tonya Fairley, Rick Kittles, Lindsey Treviño, Dede Teteh. Perceived everyday discrimination, socioeconomic status, and mammography screening behavior [abstract]. In: Proceedings of the AACR Virtual Conference: 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2021 Oct 6-8. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr PO-043.

Knowledge Transfer with Citizen Science: Luft-Leipzig Case Study

Community-based participatory research initiatives such as “hackAir”, “luftdaten.info”, “senseBox”, “CAPTOR”, “CurieuzeNeuzen Vlaanderen”, “communityAQ”, and “Healthy Air, Healthier Children” campaign among many others for mitigating short-lived climate pollutants (SLCPs) and improving air quality have reported progressive knowledge transfer results. These research initiatives provide the research community with the practical four-element state-of-the-art method for citizen science. For the preparation-, measurements-, data analysis-, and scientific support-elements that collectively present the novel knowledge transfer method, the Luft-Leipzig project results are presented. This research contributes to science by formulating a novel method for SLCP mitigation projects that employ citizen scientists. The Luft-Leipzig project results are presented to validate the four-element state-of-the-art method. The method is recommended for knowledge transfer purposes beyond the scope of mitigating short-lived climate pollutants (SLCPs) and improving air quality.

Early Learning from the Healthy End of Life Project (HELP) Ottawa in the Context of COVID-19

Healthy End of Life Project (HELP) Ottawa is a community-based participatory research initiative which is based in four community sites in Ottawa, Ontario (Canada) (2 community health centers, and 2 faith communities). Focused on the needs of people who are frail, living with advanced illness, and their caregivers, including the needs of people who are bereaved, HELP Ottawa strives to, 1)strengthen informal and community social networks, organizational cultures and linkages across local health and social care services; 2)create a community culture that supports people to build social care networks to be able to ask for and accept help, and, 3)mobilize and prepare community members to be confident and capable of offering and providing help to people in their communities. Unfolding within the context of COVID-19, each HELP Ottawa site has found ways to mobilize, adapt and respond to lockdowns, quarantines, increased isolation and altered needs and services. Drawing on 89 initial consultations, followed by 111 interviews and 16 focus group participants (n=164), qualitative findings speak to the heightened grief and fear experienced within each site during the COVID-19 pandemic, and the multiple costs of severed ‘essential’ links. Critically highlighted is the need to build and sustain social supports and connection through everyday and local means while also integrating technology and online communication. Further apparent are the critical questions that need to be asked about how compassionate communities, and communities at large, can prepare for and respond to current and future waves of COVID-19.

Assessing citizen science methods in IWRM for a new science shop: a bibliometric approach

ABSTRACT The main objective of this study is to detect scientific activities in the field of “water resources management” that include citizen science methods, using a bibliometric approach. The analysis aims at supporting the start of a new science shop based at the University of Brescia, Italy, in the framework of the European SciShops project. As the backdrop for science shops and community-based participatory research initiatives, citizen science is the focus of an increasing number of local, national and international activities, many of which are reported in the scientific literature available in the Web of Science. The results show that studies and publications on this topic, with a participatory perspective, are increasing. Australia, The Netherlands and Spain have a higher production than expected. The scarcity of Italian studies, especially on sustainable urban drainage, shows a promising field of work for future activities of the new science shop at Brescia.

Participating in a community-based participatory research module: A reflective inquiry

This commentary piece, using a narrative inquiry frame, explores the experiences of five individuals who came together to participate in a community-based participatory research (CBPR) module. Owing to the short time frame of this accredited module, when the module was live, a particular focus was directed towards dialogical techniques to build trust and respect within the group and subsequently generate potential research questions. The inaugural experience of collaborating on a CBPR module stimulated unique feelings, reflections and learnings for participants, many of which took time to surface. This article aims to make sense of those experiences to support those wishing to engage in CBPR initiatives.

Perspectives on Initiating Community-Based Participatory Research Partnerships

Community-based participatory research (CBPR) involves partnerships between academics and communities to address community priorities through collaborative research. Undergraduate student engagement in CBPR as part of an academic course is uncommon and there is limited evidence on the lessons learned about partnership initiation from course-based partnerships. This paper shares lessons from Medford and Tufts Community Health (MATCH), a course-based CBPR initiative. At the end of this course, three students, the instructor, and two community partners identified a list of four key lessons learned about partnership initiation. First, undergraduates should understand and explicitly attend to the privileges they bring to CBPR as students. Second, internal “champions,” who serve in a dual role in the community and university can provide students with important historical context to support partnership initiation. Third, students should assess and communicate what they can offer to community partners. Fourth, instructors should facilitate relationship building within student research teams. These lessons are critical for undergraduate instructors teaching CBPR courses and looking to initiate community partnerships with students

A Community-Partnered Approach to Developing Church-Based Interventions to Reduce Health Disparities Among African-Americans and Latinos.

Faith and public health partnerships offer promise to addressing health disparities, but examples that incorporate African-Americans and Latino congregations are lacking. Here we present results from developing a multi-ethnic, multi-denominational faith and public health partnership to address health disparities through community-based participatory research (CBPR), focusing on several key issues: (1) the multi-layered governance structure and activities to establish the partnership and identify initial health priority (obesity), (2) characteristics of the congregations recruited to partnership (n = 66), and (3) the lessons learned from participating congregations' past work on obesity that informed the development of a multi-level, multi-component, church-based intervention. Having diverse staff with deep ties in the faith community, both among researchers and the primary community partner agency, was key to recruiting African-American and Latino churches. Involvement by local health department and community health clinic personnel provided technical expertise and support regarding health data and clinical resources. Selecting a health issue-obesity-that affected all subgroups (e.g., African-Americans and Latinos, women and men, children and adults) garnered high enthusiasm among partners, as did including some innovative aspects such as a text/e-mail messaging component and a community mapping exercise to identify issues for advocacy. Funding that allowed for an extensive community engagement and planning process was key to successfully implementing a CBPR approach. Building partnerships through which multiple CBPR initiatives can be done offers efficiencies and sustainability in terms of programmatic activities, though long-term infrastructure grants, institutional support, and non-research funding from local foundations and health systems are likely needed.

Understanding community-based participatory research through a social movement framework: a case study of the Kahnawake Schools Diabetes Prevention Project

BackgroundA longstanding challenge of community-based participatory research (CBPR) has been to anchor evaluation and practice in a relevant theoretical framework of community change, which articulates specific and concrete evaluative benchmarks. Social movement theories provide a broad range of theoretical tools to understand and facilitate social change processes, such as those involved in CBPR. Social movement theories have the potential to provide a coherent representation of how mobilization and collective action is gradually developed and leads to systemic change in the context of CBPR. The current study builds on a social movement perspective to assess the processes and intermediate outcomes of a longstanding health promotion CBPR project with an Indigenous community, the Kahnawake Schools Diabetes Prevention Project (KDSPP).MethodsThis research uses a case study design layered on a movement-building evaluation framework, which allows progress to be tracked over time. Data collection strategies included document (scientific and organizational) review (n = 51) and talking circles with four important community stakeholder groups (n = 24).ResultsFindings provide an innovative and chronological perspective of the evolution of KSDPP as seen through a social movement lens, and identify intermediate outcomes associated with different dimensions of movement building achieved by the project over time (mobilization, leadership, vision and frames, alliance and partnerships, as well as advocacy and action strategies). It also points to areas of improvement for KSDPP in building its potential for action.ConclusionWhile this study’s results are directly relevant and applicable to the local context of KSDPP, they also highlight useful lessons and conclusions for the planning and evaluation of other long-standing and sustainable CBPR initiatives. The conceptual framework provides meaningful benchmarks to track evidence of progress in the context of CBPR. Findings from the study offer new ways of thinking about the evaluation of CBPR projects and their progress by drawing on frameworks that guide other forms of collective action.

Collaborative Transdisciplinary Research in a Small Institution: Challenges and Opportunities.

Aim/PurposeIn this paper, we discuss how a Transdisciplinary (TD) and a Community Based Participatory Research (CBPR) initiative was conceptualized, developed, implemented, and sustained at a small academic institution with limited research infrastructure, emphasizing die role of capacity building.BackgroundMost examples of die implementation of TD research come from large-scale initiatives in research-intensive institutions or centers widi multiple resources to establish collaborations among experts from different disciplines. However less is known about die implementation of TD and CBPR initiatives in small academic settings.MethodologyThis paper includes a discussion of the challenges and lessons learned of this process in a teaching-intensive Hispanic Serving Institution (HSI), which included a research component as part of the institutional priorities when it transitioned to a 4-year college in 2001.ContributionWe hope diat our experience helps odier researchers in similar institutions to engage in diis type of research.FindingsIn this case, a collaborative TD and CBPR initiative was successfully implemented despite limited resources for capacity building and research infrastructure, as well as diversity among researchers and community members.Recommendation for ResearchersTo sustain institutional collaborative capacity in this type of institution, authors recommend continuous capacity building efforts and the development of modules and/or courses to provide formal TD training for junior faculty while encouraging researchers to interact and collaborate. In addition, the importance of the role of the community liaison is highlighted.Impact on SocietySuccessful TD and CBPR initiatives may have a positive impact on the reduction or elimination of health disparities which involve complex phenomena that requires a broad view from different perspectives.Future ResearchEven though capacity building can facilitate the implementation of TD and CBPR, many challenges arise as an inherent result of community engagement and the integration of different disciplines. Thus, the need of continuous reflection to acknowledge them becomes critical for advancing TD and CBPR efforts.

Catalyzing Action on First Nations Respiratory Health Using Community-based Participatory Research: Integrated Knowledge Translation through Strategic Symposia

Assess, Redress, Re-assess: Addressing Disparities in Respiratory Health Among First Nations is an ongoing community-based participatory research initiative involving two First Nations communities in Saskatchewan. The initiative’s rationale is grounded in the ethos of transformative community-based participatory research and facilitated through integrated knowledge translation with the aim of building community capacity. The initiative’s goal was to engage community members to actively participate in all research phases, from the development of the research questions to dissemination of results and evaluation of community-chosen interventions that evolved from the results. After baseline assessment of predictors and indicators of respiratory health, a program of integrated knowledge translation was adopted. As part of this program, a community-researcher collaboration was put in place that produced two knowledge translation symposia. The two symposia have brought together First Nations community members, interdisciplinary researchers, federal and provincial policy makers, and multiple Aboriginal organizational stakeholders. The symposia provided a pathway for knowledge synthesis and sharing to ultimately integrate knowledge into practice and enable First Nations’ community capacity building in addressing and redressing critical respiratory health issues. This article delineates the processes involved in developing this model of integrated knowledge translation and highlights the continuing engagement with the participating communities supported by Knowledge Translation (KT) Symposia.

Intravaginal practices are associated with greater odds of high-risk HPV infection in Haitian women

ABSTRACTObjective: Haitian women have the highest incidence of cervical cancer within the Western hemisphere. Intravaginal hygiene practices have been linked with human papilloma virus (HPV) infection and cervical dysplasia. These practices, known as ‘twalet deba’ in Haitian Creole, are common among Haitian women and are performed with various natural and synthetic agents. As part of a community-based participatory research initiative aimed at reducing cervical cancer disparities in rural Haiti, we explored the use of intravaginal agents and their associations with high-risk HPV infection.Design: Community Health Workers recruited 416 women for cervical self-sampling from two neighborhoods within Thomonde, Haiti. Participants were interviewed regarding intravaginal hygiene practices and completed a cervical self-sampling procedure. Cervical samples were analyzed for the presence of high-risk HPV infection. Associations between each intravaginal agent and high-risk HPV infection were examined via univariate logistic regression analyses, as well as via multivariate analyses controlling for sociodemographic factors and concurrent agent use.Results: Nearly all women (97.1%) performed twalet deba, using a variety of herbal and commercially produced intravaginal agents. Approximately 11% of the participants tested positive for high-risk HPV. Pigeon pea and lime juice were the only agents found to be associated with high-risk HPV in the univariate analyses, with women who used these agents being approximately twice as likely to have high-risk HPV as those who did not. Only pigeon pea remained significantly associated with high-risk HPV after controlling for sociodemographic factors and concurrent agent use.Conclusion: Two agents, pigeon pea and lime juice, may contribute to risk for HPV infection in this population. Results suggest that in addition to cervical cancer screening interventions, future preventive initiatives should focus on minimizing risk by advocating for the use of less-toxic twalet deba alternatives.

NETWORK STRUCTURE, MULTIPLEXITY, AND EVOLUTION AS INFLUENCES ON COMMUNITY-BASED PARTICIPATORY INTERVENTIONS.

This study applies an ecological perspective to the context of community-based participatory research (CBPR). Specifically, it examines how endogenous and exogenous factors influence the dynamics of CBPR partnerships, including the tendency toward reciprocity and transitivity, the organizational type, the level of resource sufficiency, the level of organizational influence, and the perceived CBPR effect on organizations. The results demonstrate that network structure is related to the selection and retention of interorganizational networks over time, and organizations of the same type are more likely to form partnerships with each other. It shows that the dynamics of the CBPR initiative presented in this article were driven by the structure of the interorganizational networks rather than their individual organizational attributes. Implications for sustaining CBPR partnerships are drawn from the findings.

Get Vaccinated! and Get Tested! Developing Primary and Secondary Cervical Cancer Prevention Videos for a Haitian Kreyòl-Speaking Audience

Although routine screening reduces cervical cancer rates between 60% and 90%, thousands of women worldwide are diagnosed with the disease on an annual basis because of inadequate screening. Haitian women in South Florida experience a disproportionate burden of cervical cancer, with disease rates 4 times higher than the average for women in Miami. An ongoing community-based participatory research initiative to assess and reduce this burden has revealed that a complex interplay of factors contributes to a lack of access to screening in this community, including socioeconomics, language barriers, and traditional understandings of health and disease. In an effort to address some of these barriers and encourage uptake of primary and secondary cervical cancer prevention strategies, 2 videos on cervical cancer prevention were created using a community-based participatory research framework. The video screenplays were created by a Haitian screenwriter using evidence-based medical information provided by academic researchers. The films feature Haitian actors speaking a Haitian Kreyòl dialogue with a storyline portraying friends and family discussing human papillomavirus disease and vaccination, Papanicolaou testing, and cervical cancer. Focus groups held with Haitian women in South Florida suggested that the films are engaging; feature relatable characters; and impact knowledge about human papillomavirus, cervical cancer development, and current prevention recommendations.