Community-engaged Research Project Research Articles

SWITCH-ing Quality Physical Education to Multicomponent Comprehensive School Physical Activity Programs

Comprehensive School Physical Activity Programs (CSPAP) coordinate physical activity opportunities for school-age children through physical education, programs offered before/after school and during the school day, and those facilitated through staff involvement and community engagement. An active school is considered to implement quality physical education and one additional CSPAP component. This paper aims to describe evidence-based school initiatives that have used a multicomponent approach to integrating CSPAP in schools. Common themes will be summarized to provide strategies and suggestions on creating, implementing, and sustaining a CSPAP in schools. The Let’s Get Fit to Learn partnered with local underserved elementary schools to increase physical activity at school designed to improve or increase health and on-task behaviors. The Whole Communities-Whole Health is an equity-centered, community-engaged research project one outcome is to deeply integrate physical activity into the school curriculum. SWITCH (School Wellness Integration Targeting Child Health) is an evidence-based CSPAP designed to build capacity through a partnership with 4-H Youth Development. In Ireland, Active School Flag is a national initiative focused on self-reflection, action planning and collaboration at the school level and provides options for schools to achieve the “Flag.” Multicomponent CSPAP purposefully links multiple points of intervention to maximize physical activity opportunities for children. Given the implementation of culturally relevant and contextually grounded learning opportunities in and around schools, the potential for impact and sustainability is high.

Standardizing, harmonizing, and protecting data collection to broaden the impact of COVID-19 research: the rapid acceleration of diagnostics-underserved populations (RADx-UP) initiative.

ObjectiveThe Rapid Acceleration of Diagnostics-Underserved Populations (RADx-UP) program is a consortium of community-engaged research projects with the goal of increasing access to Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) tests in underserved populations. To accelerate clinical research, common data elements (CDEs) were selected and refined to standardize data collection and enhance cross-consortium analysis.Materials and MethodsThe RADx-UP consortium began with more than 700 CDEs from the National Institutes of Health (NIH) CDE Repository, Disaster Research Response (DR2) guidelines, and the PHENotypes and eXposures (PhenX) Toolkit. Following a review of initial CDEs, we made selections and further refinements through an iterative process that included live forums, consultations, and surveys completed by the first 69 RADx-UP projects.ResultsFollowing a multistep CDE development process, we decreased the number of CDEs, modified the question types, and changed the CDE wording. Most research projects were willing to collect and share demographic NIH Tier 1 CDEs, with the top exception reason being a lack of CDE applicability to the project. The NIH RADx-UP Tier 1 CDE with the lowest frequency of collection and sharing was sexual orientation.DiscussionWe engaged a wide range of projects and solicited bidirectional input to create CDEs. These RADx-UP CDEs could serve as the foundation for a patient-centered informatics architecture allowing the integration of disease-specific databases to support hypothesis-driven clinical research in underserved populations.ConclusionA community-engaged approach using bidirectional feedback can lead to the better development and implementation of CDEs in underserved populations during public health emergencies.

Exploring theoretical mechanisms of community-engaged research: a multilevel cross-sectional national study of structural and relational practices in community-academic partnerships

BackgroundCommunity-Based Participatory Research (CBPR) is often used to address health inequities due to structural racism. However, much of the existing literature emphasizes relationships and synergy rather than structural components of CBPR. This study introduces and tests new theoretical mechanisms of the CBPR Conceptual Model to address this limitation.MethodsThree-stage online cross-sectional survey administered from 2016 to 2018 with 165 community-engaged research projects identified through federal databases or training grants. Participants (N = 453) were principal investigators and project team members (both academic and community partners) who provided project-level details and perceived contexts, processes, and outcomes. Data were analyzed through structural equation modeling and fuzzy-set qualitative comparison analysis.ResultsCommitment to Collective Empowerment was a key mediating variable between context and intervention activities. Synergy and Community Engagement in Research Actions were mediating variables between context/partnership process and outcomes. Collective Empowerment was most strongly aligned with Synergy, while higher levels of Structural Governance and lower levels of Relationships were most consistent with higher Community Engagement in Research Actions.ConclusionsThe CBPR Conceptual Model identifies key theoretical mechanisms for explaining health equity and health outcomes in community-academic partnerships. The scholarly literature’s preoccupation with synergy and relationships overlooks two promising practices—Structural Governance and Collective Empowerment—that interact from contexts through mechanisms to influence outcomes. These results also expand expectations beyond a “one size fits all” for reliably producing positive outcomes.

Walking to Build a Critical Community-Engaged Project: Collaborative Observations of Neighborhood Change in Long Beach, California

Academic and community research partnerships have gained traction as a potential bridge between the university and local area to address pressing social issues. A key question for developing justice-oriented research is how to integrate best practices for creating genuine, authentic research partnerships. In this paper, we discuss the process of building a critical community-engaged project that examines how urban redevelopment changes neighborhoods within immigrant and/or communities of color. Focusing on Long Beach, California, in this article, we detail the development of a mixed-methods study that involves undergraduate students and community members as co-collaborators. We discuss the use and outcomes of co-walking as method, emphasizing observational findings, as well as the process of building team collaboration. We find that neighborhoods in Long Beach are changing rapidly in terms of the use of greening, increased technology integration within neighborhoods, and modern aesthetics, revealing that new residents will likely be younger and single residents with disposable income and no children. From this process, we identified a more critical question for the research project: “Development for whom?”. We argue that co-walking as method is an observational and relational process that assists with the foundational steps of building a critical community-engaged research project.

Addressing Opioid Misuse Among Veterans: A Peer-Delivered Opioid Prevention Curriculum

Opioid use disorder (OUD) disproportionately affects military Veterans, who are more likely than the general population to experience chronic pain. A community–academic partnership launched a community-engaged research (CEnR) project designed to train Veteran peer mentor specialists to prevent and reduce opioid abuse among Veterans. A series of focus groups were conducted to obtain community input for the development of an opioid prevention curriculum to be utilized by peer mentor specialists. The focus group participants’ experiences contributed to nuanced perspectives that fostered appreciation of knowledge and service gaps by using a CEnR approach. The themes that emerged informed a curriculum with key concepts related to opioid abuse and recovery for peer mentor specialists providing peer support for Veterans. Integrating research with community input and partnerships optimizes the opportunity to address aspects of OUD experienced by Veterans and closes a significant gap in this area of study and practice.

Intergenerational Community Visions in Appalachian Ohio

Abstract In this research note, we present analysis of initial qualitative data collection from a larger community-engaged research project we are conducting about intergenerational community visions in Appalachian Ohio. Many people working in community action efforts in southeast Ohio today had their start during the War on Poverty programs in the 1960s. These community leaders are now at retirement age and, along with the context of an aging population in many small Appalachian Ohio communities, are confronting challenges to leadership succession. At the same time, younger generations across the region are becoming more active in their communities, but it is unclear the extent to which the two generations, younger and older, are working together. Through analysis of three focus groups with intergenerational community leaders in Appalachian Ohio, we find five common themes that participants discussed as important for community-building as well as some evidence of tension between generations. Based on these findings, we make two practical recommendations for community leaders and groups interested in developing intergenerational collaboration, and we contribute to the academic literature on intergenerational community-building in rural Appalachia.

Socioecological Factors Associated with an Urban Exercise Prescription Program for Under-Resourced Women: A Mixed Methods Community-Engaged Research Project.

One strategy to promote physical activity (PA) is for health care providers to give exercise prescriptions (ExRx) that refer to community-based facilities. However, facilitators and barriers specific to urban programs in the US for under-resourced women are unknown. Thus the purpose of this formative research was to explore ExRx barriers and facilitators specific to US under-resourced women to inform future intervention targets and strategies. This mixed-methods community-engaged research was conducted in partnership with an urban women’s only wellness center that exchanged ExRx for free access (1–3 months). Qualitative semi-structured interviews and validated quantitative questionnaires (SF-12, International Physical Activity Questionnaire, Physical Activity Self-Efficacy, Physical Activity Stage of Change, and Barriers to Physical Activity, Social Support for Exercise, and Confusion, Hubbub, and Order Scale) were administered by phone and guided by the socio-ecological model. ExRx utilization was defined as number visits/week divided by membership duration. Means and percentages were compared between ≥1 visit/week vs. <1 visit/week with t-tests and chi-square, respectively. Women (n = 30) were 74% Black, 21–78 years of age, 50% had ≤ high school diploma, and 69% had household incomes ≤45,000/year. Women with ≥1 visit/week (n = 10; 33%) reported more education and higher daily activity, motivation, number of family CVD risk factors and family history of dyslipidemia compared with <1 visit/week. Facilitators among women with ≥1 visit/week were “readiness” and “right timing” for ExRx utilization. Barriers among women with <1 visit/week (n = 20; 67%) were “mismatched expectations” and “competing priorities”. Common themes among all women were “sense of community” and “ease of location”. ExRx utilization at an US urban wellness center may be dependent on a combination of multi-level factors including motivation, confidence, peer support, location and ease of access in under-sourced women. Additional resources may be needed to address mental and/or physical health status in additional to physical activity specific programming.

Mental Health in the Time of COVID-19: Structural Violence, the Mindful Body, and Teen Advocacy

This essay describes a film that was produced for a community-engaged research project in a Spring 2020 Medical Anthropology course. The authors collaborated with the Society for the Prevention of Teen Suicide (SPTS) to make a video on how to practice mental well-being during the COVID-19 pandemic. The film can be viewed at https://commons.princeton.edu/ant240-s20/program-for-community-engaged-scholarship-proces-projects/educating-teens-to-prevent-suicide/.

Forests After Florence: an informal community-engaged STEM research project promotes STEM identity in disaster-impacted students

ABSTRACT Background Natural disasters, such as hurricanes, can have lasting impacts on a community Purpose This research evaluated how participation in an STEM education intervention after an ecological disaster affected students’ persistence, resilience, and STEM identity Sample Hurricane Florence impacted college students (N = 50) were recruited Design and Methods Participants completed pre-test, post-test and daily diary measures before, during and after they completed an intervention where they collected forestry data in their home hurricane-impacted communities Results Participants reported higher STEM identity following the intervention learning experience. Daily interest and enjoyment in science was higher on days when they reported more positive experiences. For resilience, for male students, but not female students, the learning opportunity fostered resilience. Male students reported higher STEM identity on days when they reported more positive learning experiences Conclusion These findings highlight the benefit of STEM education learning opportunities, particular for disaster-impacted students.

Community-engaged Research Approaches: Multiple Pathways To Health Equity.

Highlights Popular models and unifying frameworks fail to capture variance in community‐engaged research (CEnR) CEnR projects vary in how they approach process and partnership, knowledge generation, and power An expanded taxonomy of community‐engaged research could cultivate new approaches to social change

Community-Engaged Research to Address Health Disparities of Indigenous Women With Disabilities.

To address health disparities among underserved populations, occupational therapists can participate in community-engaged research and practice to improve access to preventive health services. This study used grounded theory and participant observation approaches to identify lessons learned from a community-engaged research project to improve cancer screening rates for Indigenous women with an intellectual and/or developmental disability (IDD). Audio recordings of meetings with a community advisory board (AB) were analyzed with an inductive coding approach, and results were member checked with AB members. The AB members (N = 8) were involved in statewide Indigenous health, cancer, and disability activities. Six of the eight AB members identified as Indigenous. Key themes highlighted within the Indigenous research framework included reflection, relationship building, project planning, and project execution. Results of this phase of the research project highlight the importance of codesigning research projects with Indigenous communities. The findings have limited transferability to other research contexts. However, this study highlights the need for future research on best practices for occupational therapists to participate in community-engaged research projects to address health disparities in underserved populations, such as Indigenous women with IDD.

Engaging Interdisciplinary Service Providers to Enhance Collaboration to Support Refugee Families whose Children have Special Health Care Needs

ABSTRACT This article reports on the early stages of a community-based participatory action research project aimed at understanding how medical, educational and social service providers in our community partner with refugee families whose children have special health care needs, what challenges they face, and how we might collaboratively address identified needs through forming a community of practice and collaboratively conducting action research. In this manuscript, we detail the methods used to gather interdisciplinary professionals from our community in focus groups centered on how participants collaborated and supported refugee families of children with special health care needs and how we could join together to engage in action research to benefit their work. Findings reveal strengths, barriers, and needs related to interdisciplinary collaboration and ideas for community-engaged action research projects on which the community of practice could focus moving forward. An implication of this study is the importance of participatory processes for initiating action research projects within the community. We also offer guidance around potential areas for improved practice across school, medical and community settings when serving refugee families whose children have special health care needs.

Scales of Practices and Outcomes for Community-Engaged Research.

Despite the growth of research on community-engaged research (CEnR), recent reviews suggest there has been limited development of validated scales to measure key contexts, mechanisms, and outcomes, impairing testing and refinement of theoretical models. The purpose of this study is to present the psychometric properties of scales from the Engage for Equity (E2) project, stemming from a long-term research partnership examining community-engaged research projects. This study used a three-stage, cross-sectional format: (a) a sampling frame of 413 CEnR projects was identified; (b) 210 principal investigators completed a project-level survey and nominated partners for another survey; (c) 457 investigators and partners completed a survey about project contexts, processes, interventions, and outcomes. Factorial validity was established through confirmatory factor analysis supporting seven scales: contextual capacity, commitment to collective empowerment, relationships, community engagement in research actions, synergy, partner and partnership transformation, and projected outcomes. Convergent validity was established through examining covariances among the scales. This study largely yielded results consistent with a previous psychometric study of related measures, while demonstrating improved ceiling effects of the items and refined conceptualization of core theoretical constructs.

Insider community-engaged research for Latinx healing in nature: Reflections on and extensions from Phase 1 of the Promoting Activity and Stress Reduction in the Outdoors (PASITO) project

In Spanish, pasito means “small step,” and in Phase 1 of the PASITO (Promoting Activity and Stress Reduction in the Outdoors) project we took small steps towards reclaiming nature for Latinx communities. The Latinx reclamation of green spaces for healing is a necessary step alleviating the observed unequal burden of chronic and infectious disease. Paradoxically, the Latinx community who could greatly benefit from green spaces has reduced access, as is the case for many poor communities of color. This perspective seeks to reflect on and utilize the lessons learned from PASITO in order to expand the positive impacts of nature for communities of color. Through self-reflection by members of the academic research team and a community leader, as well as preliminary analysis of qualitative data gathered from PASITO participants, we share insights from a community-engaged research project. Our approach validated culturally competent research practices with insider researchers, as well as culturally sensitive biospecimen collection, and revealed steps towards recruitment, retention, and healing for Latinx participants in research projects. These findings come at a pivotal time for park stewards and green space researchers as the need for spaces for healing accelerates for all communities of color, including Latinx, as we face a society plagued by biological and social reckonings. To find true and sustained healing within these communities calls for communities to progress from small steps towards giant strides in the reclamation of natural landscapes for well-being.

Advancing the Concept of Resilience for Older People Who Are Experiencing Homelessness

Current conceptualizations of resilience have overlooked the lived expertise of older people experiencing homelessness (OPEH) – individuals who have much insight to offer in terms of progressing notions on how people ‘stand up’ to adversity and ‘bounce back’ to a state of physical and psychological homeostasis across the life course. Drawing from extant literature and data from a community-engaged research project, which interviewed 40 participants and examined the health supports needed for individuals experiencing homelessness upon hospital discharge, we provide a comparison of resilience among homeless individuals generally and resilience among OPEH. Based on narratives of significant adversity experienced by OPEH in Vancouver, Canada, we offer a critical analysis of ‘resilience in ecological context’ that identifies unique characteristics of resilience at micro, meso, exo, and macro system levels. We discuss how our conceptual model of resilience pertinent to OPEH can be used to shape research, policy, and practice. Part of a symposium sponsored by the Environmental Gerontology Interest Group.

Evictions &amp; Inequality in North Minneapolis: Centering Community in the Creation of Public Policy

Single Black mothers face the highest risk of eviction in the United States. In North Minneapolis, a community manufactured to contain undesirable populations through housing discrimination, decades of urban disinvestment, and unfair lending practices, the situation has become further exacerbated by the rise in distressed-property investment and disproportionate rates of eviction. This community-engaged action research project engages with tenants and landlords to illuminate how and why evictions occur in North Minneapolis, MN. The approach disrupts the power imbalance that exists between researchers, local power brokers, and community-based organizations to produce research findings that both value people’s lived experiences and utilize those experiences to produce community-centered public policy solutions. Community-centered policy solutions include lengthening the formal eviction process, creating a more human-centered process for financial support, and disrupting a cycle of dependency that is often reinforced by the state.

4449 Building Capacity in the Flint Community in the Midst of the Ongoing Water Crisis

OBJECTIVES/GOALS: Examining the impact of the Building Capacity for Research and Action (BCRA) Award created by the Community Engagement (CE) Program at the Michigan Institute for Clinical &amp; Health Research (MICHR)--a Clinical &amp; Translational Science Award (CTSA) site at the University of Michigan--in partnership with Community Based Organization Partners (CBOP). METHODS/STUDY POPULATION: The BCRA is a funding mechanism that supports new community-engaged research (CEnR) partnerships and projects that address community-identified health needs in Flint, Michigan. BCRA projects are required to be Flint-based and inclusive of both community and academic partners. A study section consisting of 10 MICHR-affiliated faculty and community partners reviewed proposals and made funding decisions. Funded teams were trained on Institutional Review Board (IRB) and reporting requirements by CE staff. MICHR provides support to BCRA-funded teams through monthly email correspondence with the CE Flint connector, budget review, mediation, regulatory assurance of IRB and the National Center for Advancing Translational Science (NCATS) requirements, coordinating six-month and final reporting, and hosting an annual stakeholder meet and greet. RESULTS/ANTICIPATED RESULTS: In 2017, the BCRA Award submitted its first request for proposals. It received 20 applications in 2018, and selected eight awardees, providing them with a total of $60,000 in funding. Four received $5,000 for partnership development and another four received $10,000 for their research projects. The BCRA Award received 16 applications in 2019, expanding its academic pool to include the University of Chicago, U-M Flint, Michigan State University, and Michigan State University-Flint in addition to the University of Michigan. Five recipients were selected and received a total of $45,000 in funding. One was awarded $5,000 for partnership development and another four were awarded $10,000 for their research projects. MICHR has invested over $100,000 in Flint through this mechanism, which was renewed in 2019. DISCUSSION/SIGNIFICANCE OF IMPACT: Each awardee presented at the annual stakeholder meet and greet. They showcased their projects with a brief overview and spoke about their expectations, lessons learned, partnership strengths and challenges, translational issues, and proposed next steps for subsequent grants, publications.

Measuring Community-Engaged Research Contexts, Processes, and Outcomes: A Mapping Review.

Policy Points Community‐engaged research (CEnR) engenders meaningful academic‐community partnerships to improve research quality and health outcomes. CEnR has increasingly been adopted by health care systems, funders, and communities looking for solutions to intractable problems.It has been difficult to systematically measure CEnR's impact, as most evaluations focus on project‐specific outcomes. Similarly, partners have struggled with identifying appropriate measures to assess outcomes of interest.To make a case for CEnR's value, we must demonstrate the impacts of CEnR over time. We compiled recent measures and developed an interactive data visualization to facilitate more consistent measurement of CEnR's theoretical domains. ContextCommunity‐engaged research (CEnR) aims to engender meaningful academic‐community partnerships to increase research quality and impact, improve individual and community health, and build capacity for uptake of evidence‐based practices. Given the urgency to solve society's pressing public health problems and increasing competition for funding, it is important to demonstrate CEnR's value. Most evaluations focus on project‐specific outcomes, making it difficult to demonstrate CEnR's broader impact. Moreover, it is challenging for partnerships to identify assessments of interest beyond process measures. We conducted a mapping review to help partnerships find and select measures to evaluate CEnR projects and to characterize areas where further development of measures is needed.MethodsWe searched electronic bibliographic databases using relevant search terms from 2009 to 2018 and scanned CEnR projects to identify unpublished measures. Through review and reduction, we found 69 measures of CEnR's context, process, or outcomes that are potentially generalizable beyond a specific health condition or population. We abstracted data from descriptions of each measure to catalog purpose, aim (context, process, or outcome), and specific domains being measured.FindingsWe identified 28 measures of the conditions under which CEnR is conducted and factors to support effective academic‐community collaboration (context); 43 measures evaluating constructs such as group dynamics and trust (process); and 43 measures of impacts such as benefits and challenges of CEnR participation and system and capacity changes (outcomes).ConclusionsWe found substantial variation in how academic‐community partnerships conceptualize and define even similar domains. Achieving more consistency in how partnerships evaluate key constructs could reduce measurement confusion apparent in the literature. A hybrid approach whereby partnerships discuss common metrics and develop locally important measures can address CEnR's multiple goals. Our accessible data visualization serves as a convenient resource to support partnerships’ evaluation goals and may help to build the evidence base for CEnR through the use of common measures across studies.

Aligning Community-Engaged Research to Context.

Community-engaged research is understood as existing on a continuum from less to more community engagement, defined by participation and decision-making authority. It has been widely assumed that more is better than less engagement. However, we argue that what makes for good community engagement is not simply the extent but the fit or alignment between the intended approach and the various contexts shaping the research projects. This article draws on case studies from three Community Engagement Cores (CECs) of NIEHS-funded Environmental Health Science Core Centers (Harvard University, UC Davis and University of Arizona,) to illustrate the ways in which community engagement approaches have been fit to different contexts and the successes and challenges experienced in each case. We analyze the processes through which the CECs work with researchers and community leaders to develop place-based community engagement approaches and find that different strategies are called for to fit distinct contexts. We find that alignment of the scale and scope of the environmental health issue and related research project, the capacities and resources of the researchers and community leaders, and the influences of the sociopolitical environment are critical for understanding and designing effective and equitable engagement approaches. These cases demonstrate that the types and degrees of alignment in community-engaged research projects are dynamic and evolve over time. Based on this analysis, we recommend that CBPR scholars and practitioners select a range of project planning and management techniques for designing and implementing their collaborative research approaches and both expect and allow for the dynamic and changing nature of alignment.

Community-Engaged Air Monitoring to Build Resilience Near the US-Mexico Border.

Initiated in response to community concerns about high levels of air pollution and asthma, the Imperial County Community Air Monitoring Project was conducted as a collaboration between a community-based organization, a non-governmental environmental health program, and academic researchers. This community-engaged research project aimed to produce real-time, community-level air quality information through the establishment of a community air monitoring network (CAMN) of 40 low-cost particulate matter (PM) monitors in Imperial County, California. Methods used to involve the community partner organization and residents in the development, operation, and use of the CAMN included the following: (1) establishing equitable partnerships among the project collaborators; (2) forming a community steering committee to guide project activities; (3) engaging residents in data collection to determine monitor sites; (4) providing hands-on training to assemble and operate the air monitors; (5) conducting focus groups to guide display and dissemination of monitoring data; and (6) conducting trainings on community action planning. This robust community engagement in the project resulted in increased awareness, knowledge, capacity, infrastructure, and influence for the community partner organization and among community participants. Even after the conclusion of the original research grant funding for this project, the CAMN continues to be operated and sustained by the community partner, serving as a community resource used by residents, schools, researchers, and others to better understand and address air pollution and its impacts on community health, while strengthening the ability of the community to prepare for, respond to, and recover from harmful air pollution.