Public Health Research Methods for Partnerships and Practice

Melody S. Goodman, Vetta Sanders Thompson, Melody S. Goodman, Vetta Sanders Thompson

• Publisher: Routledge
• Year: 2017
• ISBN:
  9781351651776
• Edition: 1
• Topic: Medicina
• Subtopic: Salud pública, administración y atención

Translating research into practice involves creating interventions that are relevant to improving the lives of a target population. Community engaged research has emerged as an evidence-based approach to better address the complex issues that affect the health of marginalized populations.

Written by leading community-engaged researchers across disciplines, each chapter covers a different topic with comprehensive guides for start-to-finish planning and execution. The book provides a training curriculum that supports a common vision among stakeholders as well as a survey of methods based on core MPH curriculum. Practical appendices and homework samples can be found online.

Public Health Research Methods for Partnerships and Practice will appeal to researchers and practitioners in community or government sectors interested in conducting community-engaged work.

1Community-based participatory research

Vetta Sanders Thompson and Sula Hood

Learning Objectives

• Describe history and principles of Community-Based Participatory Research (CBPR) project.
• Critically evaluate participants’ positions within their communities and their potential roles within CBPR projects.
• Describe methods to ensure that CBPR research benefits all partners.
• Share lessons learned from CBPR.

Self-Assessment—What Do You Know?

1. What is community engagement?
2. What two research trends contributed to the development of CBPR?
3. What are the principles of CBPR?
4. What are the benefits of CBPR?
5. In a CBPR project, who determines the health problem to be studied or analyzed?
6. What are the key components of a partnership plan?

Introduction

A core value of the public participation process is that those who are affected by a decision have a right to be involved in the decision-making process.1 Public participation allows an organization to consult with important stakeholders—such as interested or affected people, organizations, and government entities—before making a decision; it requires, at minimum, two-way communication, collaborative problem solving, and attempts to obtain better and more acceptable decisions.1 Community engagement is a component of public participation and is believed to achieve its aims by bringing together community stakeholders to reach mutually agreed-upon goals or to resolve mutually agreed-upon concerns.2

Community engagement can be conducted through partnerships, collaborations, and coalitions that help to mobilize resources to influence systems and that help to improve equity in the relationships among those engaged.3 The results of community engagement serve as catalysts for changing policies, programs, and practices.3 To be effective, the resulting interactions and collaborations rely on the establishment of trust—building and enhancing community relationships, resources, and capacity.2,3 Fundamental to community engagement is a requirement of respect for the community and the incorporation of community attitudes, beliefs, and insights regarding needs and problems when developing programs, interventions, and research.3,4 Ideally, community engagement strategies are implemented in ways that assure that the communities and members most likely to be affected by decisions about programs, services, and resources have involvement and voice from the point of activity initiation to the completion of relevant projects and services.5 These principles apply to the research enterprise, as well as other civic or social change and engagement endeavors.2

It is increasingly acknowledged that although research can and should benefit communities, many examples exist of the failure to do so, in addition to instances of harm.6 Examples of harm have included exposure of marginalized communities to greater likelihood of poor health outcomes and the potential for stigma and discrimination in the case of small, identifiable groups of people negatively perceived in society.6 Theoretically, engagement strategies that allow communities to be fully engaged in the process of mobilization and organization for change can address these issues.6 In addition, community engagement strategies increase the likelihood that programs and policies designed to improve well-being are accepted by those they are designed to serve and that they are also successful.7–9

Community-based participatory research (CBPR) is one of several community engagement models. According to Wallerstein and Duran, CBPR “bridges the gap between science and practice through community engagement and social action.”10 With a goal of societal transformation,11 CBPR involves community partners in all aspects of the research process, with all partners contributing expertise and sharing decision-making.11,12 By promoting equitable power and strong collaborative partnerships, CBPR offers a positive alternative to traditional “top-down research,”13 and, although very prominent in public health research, it is increasingly applied across disciplines as diverse as nursing, sociology, social work, psychology, and others.14

This chapter provides a brief history of CBPR and, then, describes key concepts and principles of the model. The steps required to initiate and sustain CPBR are discussed, and an example of a successful CBPR partnership is presented. The chapter ends with a discussion of strategies to improve partnership functioning and sustainability.

Definitions of community

What does community mean to you?

Before discussing implementation of CBPR, it is important to understand the complexity of defining community. It is common to define community on the basis of geographic characteristics, using a synonym of community in the term neighborhood. Administrative boundaries (e.g., census tracks, blocks) and areas between natural or man-made barriers are often used to define the relevant location.6 However, some people within a geographic area do not have the same sense of group belonging, which has implications for participation, defining issues, and setting the goals and objectives of interventions, research, and activities designed to promote change.

Community may also be socially or psychologically defined on the basis of group identity, affiliation, or membership.15 Groups may be based on shared characteristics such as race, ethnic...