Community-based Research Principles Research Articles

Health Care Engagement of Limited English Proficient Latino Families: Lessons Learned from Advisory Board Development.

Specific information on the development and evaluation of patient/family engagement in health care improvement for populations with limited English proficiency (LEP) is lacking. We sought to provide information for use by other health care organizations aiming to engage LEP populations through advisory groups. Informed by community-based research principles, we formed a family advisory board of LEP Latino families and conducted a multimodal evaluation of initial implementation and partnership development. The board met process measures goals for sustained engagement of LEP families and for establishing a group structure and process. Board outcomes included contributions to clinic educational materials and initiation of a project to increase the child friendliness of the physical space. Mothers on the board reported satisfaction with their participation. We successfully sustained engagement of LEP Latino families in health care improvement using an advisory board. To promote patient-centered care and address health care disparities, LEP populations should be included in patient engagement programs.

Using Community-Based Research Principles to Guide the Collaborative Process in Health Sciences Undergraduate Education

Group work is frequently used in undergraduate health sciences education to help students become accustomed to working with others because the healthcare industry increasingly values and requires interprofessional collaboration to accomplish its aims. However, many students have reservations about group work, which inhibits a positive educational experience before the group members meet for the first time. In order to achieve academic excellence, most students would agree that group work detracts from having complete control over one’s grades. Thus, group work becomes a significant source of anxiety because one must rely on the work of others and relinquish total control over the process used to complete assignments.

Shifting the evaluative gaze: Community-based program evaluation in the homeless sector

Homelessness is a growing social issue that is a consequence of structural inequities and contributor to the development of health inequities. Community-based research (CBR) has been proposed as an effective research strategy for addressing health equities and promoting social justice through participatory processes. The purpose of this article is to examine the application of CBR principles and practices in the homeless sector and the implications for the production of knowledge and social change to address homelessness. Drawing on our experiences as researchers and service providers, we reflect on the significant successes and challenges associated with using CBR in the homelessness sector. In our discussion we emphasise insights, challenges and lessons learned from a community-university partnership that focused on an evaluation of a transitional shelter program in a large urban centre where housing is expensive and often unavailable.Keywords: Homelessness, housing, transitional housing, transitional shelter, program evaluation, community-based research

The Dynamics of Show and Tell: Arts-Based Methods and Language Ideologies in Community-Based Research

In this article, we examine the use of the arts as a means of conducting research based on community-based research (CBR) principles. Drawing from our experience of conducting the Canadian Experience research project, which examined the employment barriers faced by skilled immigrants to Canada and used arts-based methods informed by CBR principles, we explore how the concept of language ideology may be used to understand the utility of the arts as a CBR method. We highlight the importance of understanding language not only as a means of referring to the social world but also as a means of social action.

Addressing Asian American mental health disparities: Putting community-based research principles to work.

Addressing Asian American mental health disparities: Putting community-based research principles to work.

Community-Based Research in Generating Usable Knowledge for Public Policy and Administration

Community-based research (CBR) is an approach used by researchers in partnership with practitioners and community members to tackle complex social problems for the betterment of society. Its application to the field of public policy and management is fairly new, and as a result, frameworks for its application are underdeveloped. This article discusses the rationale for applying this tool to the public policy and management field, and outlines major challenges that exist in its application. This article also highlights key principles of CBR and applies them to a study funded by a federal agency in the United States.

Community-based research for food system policy development in the City of Guelph, Ontario

Community-based research (CBR) has grown in popularity as a research approach, which aims to foster collaboration between academic researchers and community members or organisations. CBR is often initiated with the intention of creating constructive social change at the same time as generating knowledge or understanding of specific concerns raised by community members. The June 2011 Ontario Provincial Planners Institute Call to Action, entitled Planning for food systems in Ontario, identified the need for participatory planning for sustainable food systems in municipal policy planning. This article provides an example of one such planning process in Guelph, Ontario. Using principles of CBR, researchers from the University of Guelph partnered with a grassroots food security organisation in order to collaborate on food policy planning and make a contribution to the review process for the City's Official Plan. Bringing together best practices from literature, case study examples, and engagement with citizens through a focus group session, the process resulted in a submission of policy recommendations to City staff. This article aims to contribute to the practice of CBR by highlighting the benefits and barriers encountered in one CBR process.

Evaluating Youth Sexual Health Peer Education Programs: Challenges and Suggestions for Effective Evaluation Practices

Although peer sexual health education is a common form of sexual health promotion for youth, systematic reviews of these programs are relatively rare. In this study we interviewed youth peer educators to inquire about their experience of program evaluation and their perception of what is needed to develop effective evaluation practices. Data were collected from eighteen participants in semi-structured qualitative interviews of youth (aged 16-28 years) sexual health peer educators in Ontario, Canada. Community-based research principles were employed throughout the project with youth involved in all stages of the research. Analysis of the data revealed four key themes relating to youth sexual health peer education evaluation: i) varied program goals; ii) benefits to peer educators; iii) diverse evaluation methods; and iv) challenges in conducting evaluation. We discuss the relevance of our findings for evaluation practices of peer sexual health education programs.

Governing through community allegiance: a qualitative examination of peer research in community-based participatory research

The disappointing results of many public health interventions have been attributed in part to the lack of meaningful community engagement in the planning, implementation, and evaluation of these initiatives. Community-based participatory research (CBPR) has emerged as an alternative research paradigm that directly involves community members in all aspects of the research process. Their involvement is often said to be an empowering experience that builds capacity. In this paper, we interrogate these assumptions, drawing on interview data from a qualitative study investigating the experiences of 18 peer researchers (PRs) recruited from nine CBPR studies in Toronto, Canada. These individuals brought to their respective projects experience of homelessness, living with HIV, being an immigrant or refugee, identifying as transgender, and of having a mental illness. The reflections of PRs are compared to those of other research team members collected in separate focus groups. Findings from these interviews are discussed with an attention to Foucault’s concept of ‘governmentality’, and compared against popular community-based research principles developed by Israel and colleagues. While PRs spoke about participating in CBPR initiatives to share their experience and improve conditions for their communities, these emancipatory goals were often subsumed within corporatist research environments that limited participation. Overall, this study offers a much-needed theoretical engagement with this popular research approach and raises critical questions about the limits of community engagement in collaborative public health research.

Mapping human dimensions of climate change research in the Canadian Arctic.

This study maps current understanding and research trends on the human dimensions of climate change (HDCC) in the eastern and central Canadian Arctic. Developing a systematic literature review methodology, 117 peer reviewed articles are identified and examined using quantitative and qualitative methods. The research highlights the rapid expansion of HDCC studies over the last decade. Early scholarship was dominated by work documenting Inuit observations of climate change, with research employing vulnerability concepts and terminology now common. Adaptation studies which seek to identify and evaluate opportunities to reduce vulnerability to climate change and take advantage of new opportunities remain in their infancy. Over the last 5 years there has been an increase social science-led research, with many studies employing key principles of community-based research. We currently have baseline understanding of climate change impacts, adaptation, and vulnerability in the region, but key gaps are evident. Future research needs to target significant geographic disparities in understanding, consider risks and opportunities posed by climate change outside of the subsistence hunting sector, complement case study research with regional analyses, and focus on identifying and characterizing sustainable and feasible adaptation interventions.

Aspirations for Higher Education among Newcomer Refugee Youth in Toronto: Expectations, Challenges, and Strategies

A large percentage of refugees have low levels of education and official language fluency upon arrival in Canada. Thi spaper discusses educational goals of newcomer refugee youth from three communities in Toronto (Afghan, Karen, and Sudanese), and explores how these are linked to premigration and post-migration determinants. Guided by community-based research principles, we collaborated with eight refugee youth peer researchers and conducted ten focus groups and thirteen interviews with refugee youth. Results show that newcomer refugee youth develop strong aspirations for higher education in Canada as a proactive response to overcome pre-migration experiences of forced migration and educational disruptions. We then discuss how these youth negotiate educational goals in post-migration context in relation to shifts in family responsibilities and everyday encounter with multiple systemic barriers in Canada. In doing this, we examine the thin line between vulnerability and empowerment that refugee youth straddle and reveal policy gaps and contradictions in the depoliticized humanitarianism within refugee resettlement in Canada.

Provoking Change in Researchers’ Roles: Using a Community-Based Research Approach to Address Research Needs in the Community

This article is based on a community-based research practicum conducted with a Headstart program in western Canada. The purpose of the text is to describe the progression of one researcher’s roles from inception to completion of a year-long research project while working in collaboration with a community partner. Following a brief review of principles of community-based research, a case study is used to show how principles were adhered to in a practicum. A variation of traditional role theory is introduced as a useful framework to navigate burgeoning researcher roles and role multiplicity. These are (a) researcher as researcher, (b) researcher as collaborator, (c) researcher as relationship builder, (d) researcher as teacher, and (e) researcher as learner. Considerations for ways to promote researchers—students and academics—to develop skills to correspond with changing researcher roles are presented, along with future directions to empirically examine researcher roles in community-based research.

Alberta Aboriginal Head Start in Urban and Northern Communities: longitudinal study pilot phase

Aboriginal Head Start in Urban and Northern Communities (AHSUNC) is a federally funded, national, early childhood intervention strategy that addresses the needs of Aboriginal preschool children and their families. A pilot study, based on principles of community-based research, evaluated an Alberta Aboriginal Head Start (AHS) program offered off-reserve in Alberta. Overall, the results pertaining to children having followed an AHS program are positive. This phase 1 of a broader longitudinal evaluation study of all AHS sites in Alberta has led to the creation of several recommendations, which reinforce this type of evaluation and look to mitigate the limitations encountered in phase 1 (around available data, tools and context).

Using a Community-Based Health Survey as a Tool for Informing Local Health Policy

The Speak to Your Health! community survey is a biennial community-based survey designed and implemented by the Prevention Research Center of Michigan whose central mission is to strengthen the capacity of the community to improve health. The survey was developed collaboratively by the university and community partners that comprise the Prevention Research Center of Michigan and focuses on health and social issues at the heart of the community of Genesee County, Michigan. The results of this survey have been used to shape policy changes and strategic planning at the county health department and in local health intervention programs. This project has demonstrated that useful quantitative data for addressing local public health policy and planning can be collected using the principles of community-based research.

High–risk behaviours following an HIV diagnosis

The majority of people who receive an HIV diagnosis reduce and eliminate any existing high-risk behaviours that could put themselves or others at risk. However, some people who receive a diagnosis of HIV maintain and even increase their high-risk behaviours. The present study, guided by the principles of community-based research, qualitative case study methodology, and philosophical hermeneutics, explored the experiences of 12 people who continued their high-risk behaviours following a diagnosis of HIV. The present paper highlights common high-risk behaviours that participants engaged in following diagnosis and also describes multiple factors that may have been related to their high-risk choices. Implications for health professionals are suggested.

Knowing the brain, unknowing the body

Increasingly knowledge of right brain function is thought to legitimise therapeutic practices which emphasise that the therapist be experienced as being in a state of affective attunement to the client. In thinking about how neuroscience makes its way into the consulting room the paper considers the idea that while in general neuroscientific and hermeneutical knowledge might combine to form a more complete account of client distress, the specific locus for this epistemological combining will always also be the therapist and his or her relationship to this knowledge. In thinking about the ontological specificity of the therapist, the paper considers the idea that therapeutic knowledge is itself a kind of object relation which the therapist holds in mind within the setting. And in considering the specificity of neuroscience as an object relation, the paper posits that the therapist’s relation to neuroscience is felt right on the body through the introduction of affect attunement based praetioes. Elaborating on this hypothesis the paper considers that a counselling psychological holding in mind of neuroscience might lie in thinking the therapist’s body as a specifically relational presence.

Advancing biocultural models by working with communities: A partnership approach

Culture and human behavior are recognized today as major forces acting on human biological variation around the world. Studies of the relationships between biology and processes, such as modernization, urbanization, and social stratification, are prominent in our journals and meetings. An ongoing study of the interrelationships between toxicant exposure (organochlorines, lead, and mercury), health, and culture among youth of the Mohawk Nation at Akwesasne is located within this context and is used to analyze the strengths and challenges of a partnership approach to biocultural research. To assist in modeling the complex relationships between health, behavior, and culture, we have employed concepts from contemporary social theory, integrated qualitative and quantitative research, and implemented community-based research principles to develop a partnership approach to research in human biology. The community is directly involved in identifying research goals, developing research protocols appropriate for local cultural sensitivities and complexities, implementing the protocols in the field, and collaborating in the analysis and publication of results. We show the utility of this approach for understanding the relationships of toxicants to behavior and biological outcomes (adolescent growth, sexual maturation, and endocrine system alteration); as well as how it facilitates the agency of participants and communities involved in research, and brings greater social engagement to the development of the new human biology.

Methods to Optimize Recruitment and Retention to an Exercise Study in Chinese Immigrants

To counter pervasive disparities in healthcare and guide public health prevention programs, culturally sensitive recruitment and retention strategies for Chinese immigrants participating in health-related research studies are needed. The aim of this study was to develop and implement recruitment and retention strategies with Chinese immigrants in a Tai Chi exercise study. After substantial project planning and incorporating community-based research principles, a multidimensional approach was used to ensure minimal loss to follow-up. Recruitment strategies included partnering with a community-based agency, distributing study information using a multimedia approach, communicating in the native language, and demonstrating cultural sensitivity. Retention strategies included establishing a tracking method during recruitment, providing personalized feedback, maintaining the same location for all aspects of the study, eliminating potential linguistic barriers, providing personal attention and encouragement, monitoring attendance, utilizing a charismatic Tai Chi instructor, respecting Chinese culture, providing appropriate incentives, and maintaining good communication. Sixty persons showed interest in the study, 52 persons were screened, and 39 persons were enrolled. Recruitment was completed within 3 weeks. An advertisement in the Chinese newspaper was the most fruitful recruitment source, yielding approximately 60% of the study participants. Retention in the study was also very high (97%, n = 38). The successful recruitment and retention of Chinese immigrants in this Tai Chi exercise study are due to a variety of factors on many levels, including the participants, study investigator, and community-based agency.

Implementing a community-based social marketing project to improve agricultural worker health.

The Together for Agricultural Safety project is a community-based social marketing project working to reduce the adverse health effects of pesticide exposure among fernery and nursery workers in Florida. In 3 years, the collaboration between university and community researchers has embodied many of the principles of community-based research while completing multiple stages of formative data collection required for a social marketing project. This hybrid approach to developing a health intervention for a minority community has been successful in its early stages because the community partners are organized, empowered, and motivated to execute research activities with the assistance of academic partners. However, this work has also been labor intensive and costly. This article describes the lessons learned by project partners and considers the limitations of this approach for agricultural health research.

A community participatory oral health promotion program in an inner-city Latino community.

This paper reports the planning, implementation, process evaluation, and refinement of an oral health community participatory project in Mount Pleasant, an inner-city Latino neighborhood of Washington, DC. The main goal was to explore the feasibility of implementing such a project. The PRECEDE-PROCEED model was used to guide the planning and process evaluation of this project, in conjunction with community organizational methods. A steering committee, which met periodically, was formed to assist in program planning, implementation, and evaluation. The needs assessment of the community identified extensive dental health problems among children and deficiencies in their parents' oral health knowledge, opinions, and practices. In response, culturally appropriate health education and promotion activities were planned and implemented in collaboration with local community organizations, volunteers, and local practitioners. Process evaluation was used to provide feedback into the refinement of the community approach, which included record keeping and an inventory approach to activities completed and resources used. The overall impact and usefulness of this program were assessed informally using an anonymous open-ended questionnaire directed to members of the steering committee, and an outreach survey using a convenience sample at a local Latino health fair. The implementation of such a community participatory approach was feasible and useful for building upon existing local resources and addressing oral health concerns in a community not reached by traditional dental care and health promotion initiatives. Individuals in this community showed a substantial interest in oral health matters and participated in a variety of oral health prevention activities. The community approach adhered to community-based research principles.