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King KM, Morris D, Jones L, Lucas-Wright A, Jones F, del Pino HE, Porter C, Vargas R, Kahn K, Brown AF, Norris KC. The Los Angeles Healthy Community Neighborhood Initiative: A Ten Year Experience in Building and Sustaining a Successful Community-Academic Partnership. HSOA JOURNAL OF COMMUNITY MEDICINE & PUBLIC HEALTH CARE 2015; 2:007. [PMID: 27747314 PMCID: PMC5061128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
BACKGROUND Developing effective Community-Academic Partnerships (CAPs) is challenging, and the steps to build and sustain them have not been well documented. This paper describes efforts to form and sustain the Healthy Community Neighborhood Initiative (HCNI), a CAP to improve health in a low-income community in South Los Angeles. METHODS Moderated, semi-structured discussions with HCNI community and academic partners were used to develop a framework for CAP formation. RESULTS We identified two key features, shared values and respect, as critical to the decision to form the HCNI. Five elements were identified as necessary for building and sustaining the HCNI: trust, transparency, equity and fairness, adequate resources and developing protocols to provide structure. We also identified several challenges and barriers and the strategies used in the HCNI to mitigate these challenges. CONCLUSION We developed a framework to incorporate and reinforce the key elements identified as crucial in building and sustaining a CAP in a low-income community.
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Affiliation(s)
- Keyonna M King
- Division of General Internal Medicine and Health Services Research, University of California, Los Angeles
| | - D’Ann Morris
- Division of General Internal Medicine and Health Services Research, Los Angeles Urban League, University of California, Los Angeles, California, USA
| | - Loretta Jones
- Healthy African American Families, University of California, Los Angeles, California, USA
| | - Aziza Lucas-Wright
- Healthy African American Families, University of California, Los Angeles, California, USA
| | - Felica Jones
- Healthy African American Families, University of California, Los Angeles, California, USA
| | - Homero E del Pino
- Division of General Internal Medicine and Health Services Research, University of California, Los Angeles
- Department of Aging, Charles R Drew University, Los Angeles, California, USA
| | - Courtney Porter
- Division of General Internal Medicine and Health Services Research, Los Angeles Urban League, University of California, Los Angeles, California, USA
- Department of Aging, Charles R Drew University, Los Angeles, California, USA
| | - Roberto Vargas
- Division of General Internal Medicine and Health Services Research, University of California, Los Angeles
- Department of Aging, Charles R Drew University, Los Angeles, California, USA
| | - Katherine Kahn
- Division of General Internal Medicine and Health Services Research, University of California, Los Angeles
| | - Arleen F Brown
- Division of General Internal Medicine and Health Services Research, University of California, Los Angeles
| | - Keith C Norris
- Division of General Internal Medicine and Health Services Research, University of California, Los Angeles
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902
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Capurchande RD, Coene G, Roelens K, Meulemans H. Between compliance and resistance: exploring discourses on family planning in Community Health Committees in Mozambique. BMJ Open 2015; 5:e006529. [PMID: 26009572 PMCID: PMC4452751 DOI: 10.1136/bmjopen-2014-006529] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES Although the Mozambican government has implemented a community-based approach to family planning (FP), little is known about the appropriateness of this process. We explore how members of Community Health Committees (CHCs) address and act regarding FP. METHODS/SETTINGS An in-depth qualitative study of CHCs was conducted at two sites in Maputo province--Ndlavela and Boane--using focus group discussions (n=6), informal conversations (n=4) and observation. The analysis followed a phenomenological approach. RESULTS CHCs in Ndlavela appeared to transfer more of the expected information than those in Boane. However, in the CHCs at both study sites, we found heterogeneity in CHCs' perspectives leading to conflicting views among committee members (CMs). Arising issues included contraceptive type, target groups, the desirable number of children per family as well as the way FP was to be represented. Moreover, weak communication between CMs and health workers, and lack of payment for CMs' activities influenced promotion of FP. CONCLUSIONS The two CHCs framed FP in different ways leading to inconsistent participation of CHC members in promoting FP. Policymakers should consider the diversity of discourses and aspirations of these committees when delivering information to them.
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Affiliation(s)
- Rehana Dauto Capurchande
- Department of Sociology, Eduardo Mondlane University, Maputo, Mozambique
- Vrije Universiteit Brussel (Brussels University), Centre for Research in Gender and Diversity, Brussels, Belgium
| | - Gily Coene
- Department of Philosophy and Ethics, Vrije Universiteit Brussel (Brussels University), Centre for Research in Gender and Diversity, Brussels, Belgium
| | - Kristien Roelens
- Department of Obstetrics and Gynecology, Universiteit Gent (Ghent University), Ghent, Belgium
| | - Herman Meulemans
- Department of Sociology, Universiteit Antwerpen (Antwerp University), Centre for Longitudinal and Life Course Studies, Antwerpen, Belgium
- Centre for Health Systems Research and Development (CHSR&D), University of the Free State, Bloemfontein, South Africa
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903
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Granberry PJ, Torres MI, Allison JJ, Rosal MC, Rustan S, Colón M, Fontes M, Cruz I. Developing Research and Community Literacies to Recruit Latino Researchers and Practitioners to Address Health Disparities. J Racial Ethn Health Disparities 2015; 3:138-44. [PMID: 26896113 DOI: 10.1007/s40615-015-0123-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2015] [Revised: 04/20/2015] [Accepted: 04/24/2015] [Indexed: 10/23/2022]
Abstract
Engaging community residents and undergraduate Latino students in developing research and community literacies can expose both groups to resources needed to address health disparities. The bidirectional learning process described in this article developed these literacies through an ethnographic mapping fieldwork activity that used a learning-by-doing method in combination with reflection on the research experience. The active efforts of research team members to promote reflection on the research activities were integral for developing research and community literacies. Our findings suggest that, through participating in this field research activity, undergraduate students and community residents developed a better understanding of resources for addressing health disparities. Our research approach assisted community residents and undergraduate students by demystifying research, translating scientific and community knowledge, providing exposure to multiple literacies, and generating increased awareness of research as a tool for change among community residents and their organizations. The commitment of the community and university leadership to this pedagogical method can bring out the full potential of mentoring, both to contribute to the development of the next generation of Latino researchers and to assist community members in their efforts to address health disparities.
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Affiliation(s)
- Phillip J Granberry
- University of Massachusetts Boston, 100 Morrissey Boulevard, Boston, MA, 02125, USA.
| | - María Idalí Torres
- University of Massachusetts Boston, 100 Morrissey Boulevard, Boston, MA, 02125, USA.
| | - Jeroan J Allison
- University of Massachusetts Medical School, 55 North Lake Avenue, Worcester, MA, 01655, USA.
| | - Milagros C Rosal
- University of Massachusetts Medical School, 55 North Lake Avenue, Worcester, MA, 01655, USA.
| | - Sarah Rustan
- University of Massachusetts Boston, 100 Morrissey Boulevard, Boston, MA, 02125, USA.
| | - Melissa Colón
- University of Massachusetts Boston, 100 Morrissey Boulevard, Boston, MA, 02125, USA.
| | - Mayara Fontes
- University of Massachusetts Boston, 100 Morrissey Boulevard, Boston, MA, 02125, USA.
| | - Ivettte Cruz
- Puerto Rican Cultural Center of Western Massachusetts, 38 School Street, Springfield, MA, 01105, USA.
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904
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Upadhyaya M, May M, Highfield L. Integrating classroom, community, mixed-methods research, and community-based participatory research to teach public health practice. Public Health Rep 2015; 130:286-92. [PMID: 25931635 DOI: 10.1177/003335491513000317] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Mudita Upadhyaya
- Mudita Upadhyaya is a Doctor of Public Health Candidate in Management, Policy, and Community Health at the University of Texas School of Public Health, Division of Epidemiology, Human Genetics, and Environmental Sciences in Houston, Texas. Marlynn May is a Professor Emeritus at the Texas A&M University System Department of Social and Behavioral Health in College Station, Texas. Linda Highfield is an Assistant Professor at the University of Texas School of Public Health, Division of Management, Policy, and Community Health
| | - Marlynn May
- Mudita Upadhyaya is a Doctor of Public Health Candidate in Management, Policy, and Community Health at the University of Texas School of Public Health, Division of Epidemiology, Human Genetics, and Environmental Sciences in Houston, Texas. Marlynn May is a Professor Emeritus at the Texas A&M University System Department of Social and Behavioral Health in College Station, Texas. Linda Highfield is an Assistant Professor at the University of Texas School of Public Health, Division of Management, Policy, and Community Health
| | - Linda Highfield
- Mudita Upadhyaya is a Doctor of Public Health Candidate in Management, Policy, and Community Health at the University of Texas School of Public Health, Division of Epidemiology, Human Genetics, and Environmental Sciences in Houston, Texas. Marlynn May is a Professor Emeritus at the Texas A&M University System Department of Social and Behavioral Health in College Station, Texas. Linda Highfield is an Assistant Professor at the University of Texas School of Public Health, Division of Management, Policy, and Community Health
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905
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Blue Bird Jernigan V, Peercy M, Branam D, Saunkeah B, Wharton D, Winkleby M, Lowe J, Salvatore AL, Dickerson D, Belcourt A, D'Amico E, Patten CA, Parker M, Duran B, Harris R, Buchwald D. Beyond health equity: achieving wellness within American Indian and Alaska Native communities. Am J Public Health 2015; 105 Suppl 3:S376-9. [PMID: 25905823 DOI: 10.2105/ajph.2014.302447] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Valarie Blue Bird Jernigan
- Valarie Blue Bird Jernigan and Alicia L. Salvatore are with the College of Public Health, University of Oklahoma Health Sciences Center, Tulsa. Michael Peercy and Bobby Saunkeah are with the Health Services Division, Chickasaw Nation of Oklahoma, Ada. Dannielle Branam and David Wharton are with the Health Services Division, Choctaw Nation of Oklahoma, Talihina. Marilyn Winkleby is with the Stanford Prevention Research Center, Stanford School of Medicine, Stanford, CA. John Lowe is with the Christine E. Lynn College of Nursing, Florida Atlantic University, Gainesville. Daniel Dickerson is with the Integrated Substance Abuse Programs, University of California School of Medicine, Los Angeles. Annie Belcourt is with the Department of Health Services, University of Montana, Missoula. Elizabeth D'Amico is with the RAND Corporation, Santa Monica, CA. Christi A. Patten is with the Mayo Clinic, Rochester, MN. Myra Parker and Bonnie Duran are with the Indigenous Wellness Research Institute, University of Washington, Seattle. Raymond Harris and Dedra Buchwald are with the Partnerships for Native Health, University of Washington
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906
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Oetzel JG, Villegas M, Zenone H, White Hat ER, Wallerstein N, Duran B. Enhancing stewardship of community-engaged research through governance. Am J Public Health 2015; 105:1161-7. [PMID: 25880952 DOI: 10.2105/ajph.2014.302457] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We explored the relationship of community-engaged research final approval type (tribal government, health board, or public health office (TG/HB); agency staff or advisory board; or individual or no community approval) with governance processes, productivity, and perceived outcomes. METHODS We identified 294 federally funded community-engaged research projects in 2009 from the National Institutes of Health's Research Portfolio Online Reporting Tools, Centers for Disease Control and Prevention's Prevention Research Centers, and Native American Research Centers for Health databases. Two hundred (68.0%) investigators completed a survey about governance processes and productivity measures; 312 partners (77.2% of 404 invited) and 138 investigators (69.0% of 200 invited) completed a survey about perceived outcomes. RESULTS Projects with TG/HB approval had increased likelihood of community control of resources (odds ratios [ORs] ≥ 4.80). Projects with other approvals had decreased likelihood of development or revision of institutional review board policies (ORs ≤ 0.37), having written agreements (ORs ≤ 0.17), and agreements about publishing (ORs ≤ 0.28), data use (ORs ≤ 0.17), and publishing approval (ORs ≤ 0.14). CONCLUSIONS Community-engaged research projects with TG/HB approval had strong stewardship of project resources and agreements. Governance as stewardship protects community interests; thus, is an ethical imperative for communities, especially native communities, to adopt.
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Affiliation(s)
- John G Oetzel
- John G. Oetzel is with the Department of Management Communication, University of Waikato, New Zealand. Malia Villegas and Heather Zenone are with the Policy Research Center at the National Congress of American Indians, Washington, DC. Emily R. White Hat is with the Collaborative Research Center for American Indian Health at Sanford Research, Sioux Falls, SD. Nina Wallerstein is with the Center for Participatory Research at the University of New Mexico, Albuquerque. Bonnie Duran is with the School of Public Health, School of Social Work, and the Indigenous Wellness Research Institute at the University of Washington, Seattle
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907
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Garcia-Huidobro D, Allen M, Rosas-Lee M, Maldonado F, Gutierrez L, Svetaz MV, Wieling E. Understanding Attendance in a Community-Based Parenting Intervention for Immigrant Latino Families. Health Promot Pract 2015; 17:57-69. [PMID: 25869496 DOI: 10.1177/1524839915582155] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Community-based participatory research (CBPR) can help increase the attendance in community programs. Padres Informados, Jovenes Preparados (PIJP) is a program that aims to prevent tobacco and other substance use among Latino youth by promoting positive parenting. Although the trial used CBPR approaches, attendance was inconsistent. In the present study, factors associated with attendance and nonattendance and recommendations to maximize participation were explored in 12 brief feedback discussions (BFDs) with participants and in 10 in-depth interviews (IDIs) with facilitators who delivered PIJP. Content analysis guided two pairs of researchers, who independently coded emerging themes and categories (κ = .86 for BFDs and .73 for IDIs). Data from BFDs and IDIs were merged and interpreted together. We grouped factors that positively affected participation into three categories: individual and family (e.g., motivation), program (e.g., offering food and childcare and having facilitators who are trusted), and research (e.g., having incentives). Barriers to participation were grouped into four categories: individual and family (e.g., family conflicts), sociocultural (e.g., community and cultural beliefs), program (e.g., fixed schedules), and research (e.g., recruitment procedures). Participants provided recommendations to address all types of barriers. Although PIJP used CBPR, complete satisfaction of community needs is difficult. Effective community programs must address participants' needs and preferences.
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Affiliation(s)
- Diego Garcia-Huidobro
- School of Medicine Pontificia Universidad Catolica de Chile, Santiago, Chile University of Minnesota, Minneapolis, MN, USA
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908
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Community-based research as a mechanism to reduce environmental health disparities in american Indian and alaska native communities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 12:4076-100. [PMID: 25872019 PMCID: PMC4410234 DOI: 10.3390/ijerph120404076] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/07/2015] [Revised: 03/21/2015] [Accepted: 04/02/2015] [Indexed: 01/23/2023]
Abstract
Racial and ethnic minority communities, including American Indian and Alaska Natives, have been disproportionately impacted by environmental pollution and contamination. This includes siting and location of point sources of pollution, legacies of contamination of drinking and recreational water, and mining, military and agricultural impacts. As a result, both quantity and quality of culturally important subsistence resources are diminished, contributing to poor nutrition and obesity, and overall reductions in quality of life and life expectancy. Climate change is adding to these impacts on Native American communities, variably causing drought, increased flooding and forced relocation affecting tribal water resources, traditional foods, forests and forest resources, and tribal health. This article will highlight several extramural research projects supported by the United States Environmental Protection Agency (USEPA) Science to Achieve Results (STAR) tribal environmental research grants as a mechanism to address the environmental health inequities and disparities faced by tribal communities. The tribal research portfolio has focused on addressing tribal environmental health risks through community based participatory research. Specifically, the STAR research program was developed under the premise that tribal populations may be at an increased risk for environmentally-induced diseases as a result of unique subsistence and traditional practices of the tribes and Alaska Native villages, community activities, occupations and customs, and/or environmental releases that significantly and disproportionately impact tribal lands. Through a series of case studies, this article will demonstrate how grantees—tribal community leaders and members and academic collaborators—have been addressing these complex environmental concerns by developing capacity, expertise and tools through community-engaged research.
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909
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Adams SA, Heiney SP, Brandt HM, Wirth MD, Khan S, Johnson H, Davis L, Wineglass CM, Warren-Jones TY, Felder TM, Drayton RF, Davis B, Farr DE, Hébert JR. A comparison of a centralized versus de-centralized recruitment schema in two community-based participatory research studies for cancer prevention. J Community Health 2015; 40:251-9. [PMID: 25086566 PMCID: PMC4315761 DOI: 10.1007/s10900-014-9924-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Use of community-based participatory research (CBPR) approaches is increasing with the goal of making more meaningful and impactful advances in eliminating cancer-related health disparities. While many reports have espoused its advantages, few investigations have focused on comparing CBPR-oriented recruitment and retention. Consequently, the purpose of this analysis was to report and compare two different CBPR approaches in two cancer prevention studies. We utilized frequencies and Chi-squared tests to compare and contrast subject recruitment and retention for two studies that incorporated a randomized, controlled intervention design of a dietary and physical activity intervention among African Americans (AA). One study utilized a de-centralized approach to recruitment in which primary responsibility for recruitment was assigned to the general AA community of various church partners whereas the other incorporated a centralized approach to recruitment in which a single lay community individual was hired as research personnel to lead recruitment and intervention delivery. Both studies performed equally well for both recruitment and retention (75 and 88 % recruitment rates and 71 and 66 % retention rates) far exceeding those rates traditionally cited for cancer clinical trials (~5 %). The de-centralized approach to retention appeared to result in statistically greater retention for the control participants compared to the centralized approach (77 vs. 51 %, p < 0.01). Consequently, both CBPR approaches appeared to greatly enhance recruitment and retention rates of AA populations. We further note lessons learned and challenges to consider for future research opportunities.
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Affiliation(s)
- Swann Arp Adams
- Associate Professor, College of Nursing, Department of Epidemiology & Biostatistics, Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, 1601 Greene Street, Williams Brice Bldg, Rm 618, Columbia, SC 29208, USA, , Ph: 803-777-7635
| | - Sue P. Heiney
- Dunn-Shealy Professor of Nursing, College of Nursing, University of South Carolina, 1601 Greene Street, Columbia, SC 29208, USA,
| | - Heather M. Brandt
- Associate Professor, Department of Health Promotion, Education, and Behavior, Core Faculty, Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, 915 Greene Street, Columbia, SC 29208, USA,
| | - Michael D. Wirth
- Research Assistant Professor, Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, 915 Greene Street, Columbia, SC 29208, USA,
| | - Samira Khan
- Research Associate\Data manager Cancer Prevention and Control Program Arnold School of Public Health University of South Carolina, 915 Greene Street, Columbia, SC 29208, USA
| | - Hiluv Johnson
- Project Coordinator, South Carolina Cancer Disparities Community Network II, Arnold School of Public Health, Cancer Prevention and Control Program, 915 Greene Street, Columbia, SC 29208, USA,
| | - Lisa Davis
- HEALS Program Coordinator, Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, 915 Greene Street, Columbia, SC 29208, USA,
| | - Cassandra M. Wineglass
- SISTAS Program Coordinator I Cancer Prevention and Control Program Arnold School of Public Health University of South Carolina, 915 Greene Street, Columbia, SC 29208, USA
| | - Tatiana Y. Warren-Jones
- Department of Exercise Science, Arnold School of Public Health, Public Health Research Center, University of South Carolina, 921 Assembly Street-318A, Columbia, SC 29208, USA,
| | - Tisha M. Felder
- Research Assistant Professor, College of Nursing, Cancer Prevention & Control Program, Arnold School of Public Health, University of South Carolina, 1601 Greene Street, Columbia, SC 29208, USA,
| | - Ruby F. Drayton
- Field Coordinator, Community Clinical Trials Team Cancer Prevention and Control Program Arnold School of Public Health, University of South Carolina, 915 Greene Street, Columbia, SC 29208, USA,
| | - Briana Davis
- HEALS Intervention Coordinator, Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, 915 Greene Street, Columbia, SC 29208, USA,
| | - Deeonna E. Farr
- Department of Health Promotion, Education, and Behavior, Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, 915 Greene Street, Columbia SC 29208, USA,
| | - James R. Hébert
- Health Sciences Distinguished Professor, Carolina Trustees Professor, Department of Epidemiology and Biostatistics, Director, Statewide Cancer Prevention & Control Program, Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, 915 Greene Street, Suite 241-2, Columbia, SC 29208, USA,
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910
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Muzik M, Kirk R, Alfafara E, Jonika J, Waddell R. Teenage mothers of black and minority ethnic origin want access to a range of mental and physical health support: a participatory research approach. Health Expect 2015; 19:403-15. [PMID: 25824153 DOI: 10.1111/hex.12364] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/10/2015] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND In high risk, economically disadvantaged neighbourhoods, such as those primarily resident by black and minority ethnic groups (BME), teenage pregnancies are relatively more frequent. Such families often have limited access to and/or knowledge of services, including prenatal and post-partum physical and mental health support. OBJECTIVE To explore preferences held by vulnerable young mothers of BME origin and those close to them about existing and desired perinatal health services. DESIGN, SETTING AND PARTICIPANTS Drawing on a community-based participatory approach, a community steering committee with local knowledge and experience of teenage parenthood shaped and managed an exploratory qualitative study. In collaboration with a local agency and academic research staff, community research assistants conducted two focus groups with 19 members and 21 individual semi-structured interviews with young mothers of BME origin and their friends or relatives. These were coded, thematically analysed, interpreted and subsequently triangulated through facilitator and participant review and discussion. RESULTS Despite perceptions of a prevalent local culture of mistrust and suspicion, a number of themes and accompanying recommendations emerged. These included a lack of awareness by mothers of BME origin about current perinatal health services, as well as programme inaccessibility and inadequacy. There was a desire to engage with a continuum of comprehensive and well-publicized, family-focused perinatal health services. Participants wanted inclusion of maternal mental health and parenting support that addressed the whole family. CONCLUSIONS It is both ethical and equitable that comprehensive perinatal services are planned and developed following consultation and participation of knowledgeable community members including young mothers of BME origin, family and friends.
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Affiliation(s)
- Maria Muzik
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Rosalind Kirk
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Emily Alfafara
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | | | - Rachel Waddell
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
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911
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Switzer S, Guta A, de Prinse K, Chan Carusone S, Strike C. Visualizing harm reduction: Methodological and ethical considerations. Soc Sci Med 2015; 133:77-84. [PMID: 25841098 DOI: 10.1016/j.socscimed.2015.03.040] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The use of visual methods is becoming increasingly common and accepted in health research. This paper explores the opportunities and constraints of using photo-based methods in the context of a community-based participatory research study on how to engage people living with HIV in conversations about a hospital's recently introduced harm reduction policy. Using a blended approach of photovoice and photo-elicited interviews, we provided participants (n = 16) with cameras and asked them to take a series of photos that "show how you feel about or have experienced harm reduction as a Casey House client." We reflect on methodological insights from the study to think through the process of doing photo-based work on a stigmatized topic in a small hospital setting by foregrounding: 1) how the act of taking photos assisted participants in visualizing connections between space, harm reduction, and substance use; 2) expectations of participation and navigating daily health realities; and 3) issues of confidentiality, anonymity and stigma in clinical settings. These reflections provide a case study on the importance of critically examining the process of engaging with photo-based methods. We conclude the paper by re-thinking issues of context and photo-based methods. Rather than viewing context as a neutral backdrop to apply a method, context should be viewed as an active force in shaping what can or cannot be done or produced within the space. Photo-based methods may offer an effective community-engagement strategy but may require modification for use in a clinical setting when working on a stigmatized topic with individuals with complex health care needs. Given the potential of visual methods as a community engagement strategy, research teams are advised to understand the entire process as a data collection opportunity so that these methods can be further explored in a variety of contexts.
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Affiliation(s)
- S Switzer
- Faculty of Environmental Studies, York University, Toronto, Canada.
| | - A Guta
- Faculty of Arts & Social Sciences, Carleton University, Canada; Department of Gender, Sexuality, and Women's Studies, Simon Fraser University, Canada
| | | | - S Chan Carusone
- Casey House Hospital, Toronto, Canada; Department of Clinical Epidemiology and Biostatistics, McMaster University, Canada
| | - C Strike
- University of Toronto, Dalla Lana School of Public Health, Toronto, Canada
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912
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Woolf SH, Purnell JQ, Simon SM, Zimmerman EB, Camberos GJ, Haley A, Fields RP. Translating evidence into population health improvement: strategies and barriers. Annu Rev Public Health 2015; 36:463-82. [PMID: 25581146 PMCID: PMC8489033 DOI: 10.1146/annurev-publhealth-082214-110901] [Citation(s) in RCA: 64] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/03/2023]
Abstract
Among the challenges facing research translation-the effort to move evidence into policy and practice-is that key questions chosen by investigators and funders may not always align with the information priorities of decision makers, nor are the findings always presented in a form that is useful for or relevant to the decisions at hand. This disconnect is a problem particularly for population health, where the change agents who can make the biggest difference in improving health behaviors and social and environmental conditions are generally nonscientists outside of the health professions. To persuade an audience that does not read scientific journals, strong science may not be enough to elicit change. Achieving influence in population health often requires four ingredients for success: research that is responsive to user needs, an understanding of the decision-making environment, effective stakeholder engagement, and strategic communication. This article reviews the principles and provides examples from a national and local initiative.
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Affiliation(s)
- Steven H Woolf
- Center on Society and Health, Virginia Commonwealth University, Richmond, Virginia 23298-0251; , , ,
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913
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Brody H, Croisant SA, Crowder JW, Banda JP. Ethical issues in patient-centered outcomes research and comparative effectiveness research: a pilot study of community dialogue. J Empir Res Hum Res Ethics 2015; 10:22-30. [PMID: 25742663 DOI: 10.1177/1556264614568426] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Community bioethics dialogues were held on the topic of patient-centered outcomes research (PCOR) and comparative effectiveness research (CER). Participants were 65 and older and represented either a lower income, African American group (A) or a higher income White group (B). Participants were presented with a variety of background reading and study materials. Meetings were held 2 hr per week for 6 weeks. The groups showed both independence in judgment from the investigators and diversity of opinion between the two groups. Group B addressed more topics than Group A and in some instances explored additional policy nuances. Members of Group A appeared more cognizant of issues of social justice that affect vulnerable populations and appeared leery of approaches that suggested possible disrespect for their own personal experiences. Future plans call for both repeating the dialogue with additional, diverse community groups and repeating community bioethics dialogues on new topics with the same groups.
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Affiliation(s)
- Howard Brody
- University of Texas Medical Branch, Galveston, USA
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914
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Sangalang CC, Chen ACC, Kulis SS, Yabiku ST. Development and Validation of a Racial Discrimination Measure for Cambodian American Adolescents. ASIAN AMERICAN JOURNAL OF PSYCHOLOGY 2015; 6:56-65. [PMID: 26388972 PMCID: PMC4570621 DOI: 10.1037/a0036706] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
To date, the majority of studies examining experiences of racial discrimination among youth use measures initially developed for African American and Latino adults or college students. Few studies have attended to the ways in which discrimination experiences may be unique for Asian American youth, particularly subgroups such as Southeast Asians. The purpose of this study was twofold: (a) to describe the development of a racial discrimination measure using community-based participatory research with Cambodian American adolescents and (b) to psychometrically test the measure with respect to validity and reliability. This research used mixed-methods and comprised 3 phases. Phase 1 consisted of qualitative focus group research to assess community-identified needs. Phase 2 included quantitative survey development with community members and resulted in an 18-item measure assessing the frequency of ethnicity-based discrimination. Phase 3 involved psychometric testing of the measure's validity and reliability (n = 423). Exploratory factor analysis procedures yielded a 3-factor structure describing peer, school, and police discrimination from all items, capturing 96% of the combined variance. Using confirmatory factor analysis, the data demonstrated good fit with the 3-factor structure (CFI = .98; RMSEA = .054), with factor loadings ranging from .59 to .96 and all estimates statistically significant at the p < .05 level. Correlational analyses of racial discrimination subfactors and depression supported concurrent validity. In sum, this measure can be used to examine the degree and sources of racial discrimination reported by Cambodian American adolescents and potentially other adolescents of Southeast Asian descent living in diverse urban communities.
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915
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Successful strategies to engage research partners for translating evidence into action in community health: a critical review. JOURNAL OF ENVIRONMENTAL AND PUBLIC HEALTH 2015; 2015:191856. [PMID: 25815016 PMCID: PMC4359847 DOI: 10.1155/2015/191856] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/17/2014] [Accepted: 02/01/2015] [Indexed: 11/18/2022]
Abstract
Objectives. To undertake a critical review describing key strategies supporting development of participatory research (PR) teams to engage partners for creation and translation of action-oriented knowledge. Methods. Sources are four leading PR practitioners identified via bibliometric analysis. Authors' publications were identified in January 1995–October 2009 in PubMed, Embase, ISI Web of Science and CAB databases, and books. Works were limited to those with a process description describing a research project and practitioners were first, second, third, or last author. Results. Adapting and applying the “Reliability Tested Guidelines for Assessing Participatory Research Projects” to retained records identified five key strategies: developing advisory committees of researchers and intended research users; developing research agreements; using formal and informal group facilitation techniques; hiring co-researchers/partners from community; and ensuring frequent communication. Other less frequently mentioned strategies were also identified. Conclusion. This review is the first time these guidelines were used to identify key strategies supporting PR projects. They proved effective at identifying and evaluating engagement strategies as reported by completed research projects. Adapting these guidelines identified gaps where the tool was unable to assess fundamental PR elements of power dynamics, equity of resources, and member turnover. Our resulting template serves as a new tool to measure partnerships.
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916
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Abstract
Nurse scientists are increasingly recognizing the necessity of conducting research with community groups to effectively address complex health problems and successfully translate scientific advancements into the community. Although several barriers to conducting research with community groups exist, community-based participatory research (CBPR) has the potential to mitigate these barriers. CBPR has been employed in programs of research that respond in culturally sensitive ways to identify community needs and thereby address current health disparities. This article presents case studies that demonstrate how CBPR principles guided the development of (a) a healthy body weight program for urban, underserved African American women; (b) a reproductive health educational intervention for urban, low-income, underserved, ethnically diverse women; and (c) a pilot anxiety/depression intervention for urban, low-income, underserved, ethnically diverse women. These case studies illustrate the potential of CBPR as an orientation to research that can be employed effectively in non-research-intensive academic environments.
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917
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Spiegel JM, Breilh J, Yassi A. Why language matters: insights and challenges in applying a social determination of health approach in a North-South collaborative research program. Global Health 2015; 11:9. [PMID: 25880442 PMCID: PMC4353467 DOI: 10.1186/s12992-015-0091-2] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2014] [Accepted: 01/27/2015] [Indexed: 01/21/2023] Open
Abstract
Background Focus on “social determinants of health” provides a welcome alternative to the bio-medical illness paradigm. However, the tendency to concentrate on the influence of “risk factors” related to living and working conditions of individuals, rather than to more broadly examine dynamics of the social processes that affect population health, has triggered critical reaction not only from the Global North but especially from voices the Global South where there is a long history of addressing questions of health equity. In this article, we elaborate on how focusing instead on the language of “social determination of health” has prompted us to attempt to apply a more equity-sensitive approaches to research and related policy and praxis. Discussion In this debate, we briefly explore the epistemological and historical roots of epidemiological approaches to health and health equity that have emerged in Latin America to consider its relevance to global discourse. In this region marked by pronounced inequity, context-sensitive concepts such as “collective health” and “critical epidemiology” have been prominent, albeit with limited acknowledgement by the Global North. We illustrate our attempts to apply a social determination approach (and the “4 S” elements of bio-Security, Sovereignty, Solidarity and Sustainability) in five projects within our research collaboration linking researchers and knowledge users in Ecuador and Canada, in diverse settings (health of healthcare workers; food systems; antibiotic resistance; vector borne disease [dengue]; and social circus with street youth). Conclusions We argue that the language of social determinants lends itself to research that is more reductionist and beckons the development of different skills than would be applied when adopting the language of social determination. We conclude that this language leads to more direct analysis of the systemic factors that drive, promote and reinforce disparities, while at the same time directly considering the emancipatory forces capable of countering negative health impacts. It follows that “reverse innovation” must not only recognize practical solutions being developed in low and middle income countries, but must also build on the strengths of the theoretical-methodological reasoning that has emerged in the South.
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Affiliation(s)
- Jerry M Spiegel
- School of Population and Public Health, Department of Medicine, the University of British Columbia, Rm. 430 - 2206 East Mall, Vancouver, V6T 1Z3, BC, Canada.
| | - Jaime Breilh
- Health Sciences Area, University Andina Simon Bolivar, Quito, Ecuador.
| | - Annalee Yassi
- School of Population and Public Health, Department of Medicine, the University of British Columbia, Rm. 430 - 2206 East Mall, Vancouver, V6T 1Z3, BC, Canada.
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918
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Huebner CE, Milgrom P. Evaluation of a parent-designed programme to support tooth brushing of infants and young children. Int J Dent Hyg 2015; 13:65-73. [PMID: 25070036 PMCID: PMC4486350 DOI: 10.1111/idh.12100] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/03/2014] [Indexed: 11/30/2022]
Abstract
OBJECTIVES This study developed and tested an intervention to help parents establish a routine of brushing their young children's teeth twice a day. METHODS Community-based participatory research methods were used to engage parents in the design of the intervention to maximize its relevance and acceptability to others. Input was obtained by interviews and focus groups. The resulting intervention was four 90-min small-group sessions that provided educational information, direct instruction, practice and peer-to-peer problem-solving. A pre- to post-non-randomized design was used to evaluate the intervention's effect to increase or maintain parents' twice daily brushing. RESULTS Intervention participants were 67 primary caregivers of children under six years of age. Of the 67 initial participants, 50 completed a post-intervention questionnaire administered 4 to 8 weeks following the intervention. The proportion of parents who reported brushing their young children's teeth twice a day increased significantly from 59 per cent prior to the intervention to 89 per cent post-intervention (McNemar's X(2) = 10.71, P = 0.002). There were concomitant and statistically significant increases over the study period in parents' confidence for brushing twice a day, attitudes about the importance of brushing and their self-efficacy for tooth brushing. Parents' knowledge of children's oral health, assessed by a 15-item scale developed for this study ('Things to Know About Baby Teeth'), also increased significantly. CONCLUSIONS Twice daily tooth brushing is a low-cost, effective strategy to reduce the risk of childhood caries. As demonstrated here, community-based efforts can help parents achieve this important health behaviour.
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Affiliation(s)
- C E Huebner
- Department of Health Services, University of Washington, Seattle, WA, USA
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919
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Knudsen HK, Roman PM. Innovation attributes and adoption decisions: perspectives from leaders of a national sample of addiction treatment organizations. J Subst Abuse Treat 2015; 49:1-7. [PMID: 25218918 PMCID: PMC4277913 DOI: 10.1016/j.jsat.2014.08.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2014] [Revised: 07/30/2014] [Accepted: 08/08/2014] [Indexed: 11/30/2022]
Abstract
Drawing on diffusion theory to further knowledge about evidence-based practices (EBPs) in the treatment of substance use disorders (SUDs), this study describes the perceived importance of innovation attributes in adoption decisions within a national sample of SUD treatment organizations. Face-to-face interviews were conducted with leaders of 307 organizations. A typology differentiated organizations reporting: (1) adoption of a treatment innovation in the past year ("recent adoption"), (2) plans to adopt an innovation in the upcoming year ("planned adoption"), or (3) no actual or planned adoption ("non-adoption"). About 30.7% of organizations reported recent adoption, 20.5% indicated planned adoption, and 48.8% were non-adopters. Leaders of organizations reporting recent adoption (n=93) or planned adoption (n=62) rated the importance of innovation attributes, including relative advantage, compatibility, complexity, and observability, on these adoption decisions using a Likert scale that ranged from 0 to 5. Innovation attributes most strongly endorsed were consistency with the program's treatment philosophy (mean=4.47, SD=1.03), improvement in the program's reputation with referral sources (mean=4.00, SD=1.33), reputational improvement with clients and their families (mean=3.98, SD=1.31), and reductions in treatment dropout (mean=3.75, SD=1.54). Innovation characteristics reflecting organizational growth and implementation costs were less strongly endorsed. Adopters and planners were generally similar in their importance ratings. There were modest differences in importance ratings when pharmacological innovations were compared to psychosocial interventions. These findings are consistent with diffusion theory and suggest that efforts to link EBPs with client satisfaction and potential reputational benefits may enhance the diffusion of EBPs. Attention to these attributes when developing and evaluating SUD treatment interventions may enhance efforts to increase subsequent adoption.
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Affiliation(s)
- Hannah K Knudsen
- University of Kentucky, Department of Behavioral Science, 141 Medical Behavioral Science Building, Lexington, KY 40536-0086.
| | - Paul M Roman
- University of Georgia, Owens Institute for Behavioral Research and Department of Sociology, 106 Barrow Hall, Athens, GA, 30602-2401.
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920
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Rosenthal MS, Barash J, Blackstock O, Ellis-West S, Filice C, Furie G, Greysen SR, Malone S, Tinney B, Yun K, Lucas GI. Building community capacity: sustaining the effects of multiple, two-year community-based participatory research projects. Prog Community Health Partnersh 2015; 8:365-74. [PMID: 25435563 DOI: 10.1353/cpr.2014.0049] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND The time-limited nature of health and public health research fellowships poses a challenge to trainees' and community partners' efforts to sustain effective, collaborative, community-based participatory research (CBPR) relationships. OBJECTIVES This paper presents CBPR case studies of partnerships between health services research trainees and community organization leaders in a medium-sized city to describe how participation in the partnership altered community partners' understanding and willingness to conduct research and to engage with research-derived data. METHODS Trainees and faculty used participatory methods with community leaders to identify research questions, and conduct and disseminate research. Throughout the process, trainees and faculty included research capacity building of community partners as a targeted outcome. Community partners were asked to reflect retrospectively on community research capacity building in the context of CBPR projects. Reflections were discussed and categorized by the authorship team, who grouped observations into topics that may serve as a foundation for development of future prospective analyses. RESULTS Important ideas shared include that trainee participation in CBPR may have an enduring impact on the community by increasing the capacity of community partners and agencies to engage in research beyond that which they are conducting with the current trainee. CONCLUSION We posit that CBPR with research trainees may have an additive effect on community research capacity when it is conducted in collaboration with community leaders and focuses on a single region. More research is needed to characterize this potential outcome.
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921
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Baird MB, Domian EW, Mulcahy ER, Mabior R, Jemutai-Tanui G, Filippi MK. Creating a Bridge of Understanding between Two Worlds: Community-Based Collaborative-Action Research with Sudanese Refugee Women. Public Health Nurs 2015; 32:388-96. [DOI: 10.1111/phn.12172] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Martha B. Baird
- School of Nursing; University of Kansas Medical Center; Kansas City Kansas
| | | | | | - Rebecca Mabior
- Behavioral Health; Truman Medical Center; Kansas City Missouri
| | | | - Melissa K. Filippi
- Family Medicine; Center for American Indian Community Health; University of Kansas Medical Center; Kansas City Kansas
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922
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Yi Y, Chongsuvivatwong V, Sriplung H, Hu G, McNeil E, Feng Q, Zhou H, Wei B. Unmet needs in continuing medical education programs for rural Chinese township health professionals. JOURNAL OF EDUCATIONAL EVALUATION FOR HEALTH PROFESSIONS 2015; 12:25. [PMID: 26072903 PMCID: PMC4536342 DOI: 10.3352/jeehp.2015.12.25] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2015] [Accepted: 06/13/2015] [Indexed: 05/15/2023]
Abstract
PURPOSE This study aimed to describe the system of continuing medical education (CME) in the Guangxi Zhuang Autonomous Region and to ascertain the perceived needs related to that system, in order to improve the performance of health professionals in Chinese township health centers (THCs). METHODS In-depth key informant interviews were conducted to gain insights into the current CME system. A cross-sectional survey using a self-administered structured questionnaire was also carried out from March to August 2014 in order to identify perceived needs among THC personnel in the Guangxi Zhuang Autonomous Region. Logistic regression was used to identify factors related to respondents' interest in pursuing different levels of degree study. RESULTS The areas of need perceived by the respondents included general clinical competence and emergency or first aid knowledge. Most respondents wanted to study at medical colleges in order to obtain a higher degree. Respondents aged below 45 years with neutral or positive attitudes about the benefit of degree study for the licensure examination were more likely to attend a bachelor-level CME program than their older peers and respondents with negative attitudes towards degree study. Female respondents and respondents aged below 45 years were more likely to attend a junior college CME program than males and older respondents, respectively. CONCLUSION It is necessary to develop degree-linked CME programs to meet the need for young health professionals in Chinese THCs; therefore, this programs can improve the expertise of poorly educated young health workers, who overwhelm rural Chinese heath systems.
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Affiliation(s)
- Yanhua Yi
- School for International Education, Guangxi Medical University, Nanning, China
- *Corresponding
| | | | - Hutcha Sriplung
- Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkla, Thailand
| | - Guijie Hu
- The Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, China
| | - Edward McNeil
- Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkla, Thailand
| | - Qiming Feng
- Department of Public Health, Guangxi Medical University, Nanning, China
| | - Hongxia Zhou
- Department of Public Health, Guangxi Medical University, Nanning, China
| | - Bo Wei
- Department of Public Health, Guangxi Medical University, Nanning, China
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923
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Friedman DB, Toumey C, Porter DE, Hong J, Scott GI, Lead JR. Communicating with the public about environmental health risks: a community-engaged approach to dialogue about metal speciation and toxicity. ENVIRONMENT INTERNATIONAL 2015; 74:9-12. [PMID: 25305416 DOI: 10.1016/j.envint.2014.09.015] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2014] [Revised: 09/18/2014] [Accepted: 09/26/2014] [Indexed: 05/09/2023]
Affiliation(s)
- Daniela B Friedman
- Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA.
| | - Christopher Toumey
- Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA.
| | - Dwayne E Porter
- Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA.
| | - Jie Hong
- Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA.
| | - Geoffrey I Scott
- Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA.
| | - Jamie R Lead
- Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA.
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924
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Hébert JR, Satariano WA, Friedman DB, Armstead CA, Greiner A, Felder TM, Coggins TA, Tanjasiri S, Braun KL. Fulfilling Ethical Responsibility: Moving Beyond the Minimal Standards of Protecting Human Subjects from Research Harm. Prog Community Health Partnersh 2015; 9 Suppl:41-50. [PMID: 26213403 PMCID: PMC4659710 DOI: 10.1353/cpr.2015.0021] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
PROBLEM Rules for protecting human subjects, in place federally since 1974, have focused primarily on guarding against placing research subjects at social, physical, or psychological risk or violating their privacy and confidentiality. Nevertheless, high-risk communities are routinely subjected to "sins of omission," which limit access to potentially significant research opportunities and result in the absence of studies that could confer high degree of community beneficence. PURPOSE OF ARTICLE To describe "sins of omission" and provide examples from the Community Networks Program Centers (CNPC) to illustrate how community-based participatory research (CBPR) can prevent them. KEY POINTS CBPR is an effective antidote to sins of omission. Activities undertaken by the CNPCs illustrate how adherence to CBPR principles can improve research access and outcomes. CONCLUSIONS By working with community members as partners, we expand the concept of beneficence to include "community beneficence," thus reducing the probability of "sins of omission."
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925
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Hébert JR, Braun KL, Meade CD, Bloom J, Kobetz E. Community-Based Participatory Research Adds Value to the National Cancer Institute's Research Portfolio. Prog Community Health Partnersh 2015; 9 Suppl:1-4. [PMID: 26213397 PMCID: PMC4703947 DOI: 10.1353/cpr.2015.0022] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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926
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Ingram M, Sabo SJ, Gomez S, Piper R, de Zapien JG, Reinschmidt KM, Schachter KA, Carvajal SC. Taking a community-based participatory research approach in the development of methods to measure a community health worker community advocacy intervention. Prog Community Health Partnersh 2015; 9:49-56. [PMID: 25981424 PMCID: PMC6681905 DOI: 10.1353/cpr.2015.0001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Public health advocacy is by necessity responsive to shifting sociopolitical climates, and thus a challenge of advocacy research is that the intervention must by definition be adaptive. Moving beyond the classification of advocacy efforts to measurable indicators and outcomes of policy, therefore, requires a dynamic research approach. OBJECTIVES The purposes of this article are to (1) describe use of the CBPR approach in the development and measurement of a community health worker (CHW) intervention designed to engage community members in public health advocacy and (2) provide a model for application of this approach in advocacy interventions addressing community-level systems and environmental change. METHODS The Kingdon three streams model of policy change provided a theoretical framework for the intervention. Research and community partners collaboratively identified and documented intervention data. We describe five research methods used to monitor and measure CHW advocacy activities that both emerged from and influenced intervention activities. DISCUSSION Encounter forms provided a longitudinal perspective of how CHWs engaged in advocacy activities in the three streams. Strategy maps defined desired advocacy outcomes and health benefits. Technical assistance notes identified and documented intermediate outcomes. Focus group and interview data reflected CHW efforts to engage community members in advocacy and the development of community leaders. APPLICATION OF LESSONS LEARNED: We provide a model for application of key principles of CPBR that are vital to effectively capturing the overarching and nuanced aspects of public health advocacy work in dynamic political and organizational environments.
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927
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Sangalang CC, Ngouy S, Lau AS. Using community-based participatory research to identify health issues for Cambodian American youth. FAMILY & COMMUNITY HEALTH 2015; 38:55-65. [PMID: 25423244 PMCID: PMC7053668 DOI: 10.1097/fch.0000000000000056] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Lack of data disaggregated by ethnic group and the widespread perception of Asian Americans as "model minorities" often masks the health needs of specific groups within the Asian American population. Limited research focuses on health and psychological well-being among Cambodian American youth despite risk of negative educational and behavioral outcomes as well as high levels of trauma and psychiatric symptoms among first-generation Cambodian refugee adults. This article describes the development of a health survey with Cambodian American youth using community-based participatory research (and illustrates how youth can actively engage in research to inform change in health-related programs and policies.
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Affiliation(s)
- Cindy C Sangalang
- School of Social Work, Arizona State University (Dr Sangalang); University of La Verne (Ms Ngouy); and University of California, Los Angeles (Dr Lau)
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928
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Garnett BR, Wendel J, Banks C, Goodridge A, Harding R, Harris R, Hacker K, Chomitz VR. Challenges of Data Dissemination Efforts Within a Community-Based Participatory Project About Persistent Racial Disparities in Excess Weight. Prog Community Health Partnersh 2015; 9:289-98. [PMID: 26412770 PMCID: PMC5665364 DOI: 10.1353/cpr.2015.0047] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
BACKGROUND Despite universal environmental and policy-focused initiatives that resulted in declines in obesity among children in Cambridge, Massachusetts, disparities persist among racial/ethnic groups. In response, a community coalition formed the Healthy Eating and Living Project (HELP), to investigate and disseminate findings regarding disparities in excess weight among Cambridge Black youth (ages 6-14), with the aim of facilitating reciprocal learning and community mobilization to ultimately increase community engagement and inform prevention efforts. OBJECTIVES This paper details the theoretical framework, methods, and results of disseminating HELP findings to various sectors of the Cambridge Black/African American (Black) community. METHODS First, using a community-based participatory research (CBPR) approach, the HELP coalition analyzed existing data and conducted qualitative studies with Cambridge Black families to better understand the sociocultural and familial determinants of excess weight. We then developed presentation and print materials and used different dissemination approaches. We solicited feedback to inform the dissemination process and mobilization of obesity prevention efforts. RESULTS We disseminated information through six community groups (parents, students, pastors, men's health group, community leaders, and a health coalition), email lists, and websites. Reciprocal learning among and between HELP and community members yielded data presentation challenges, as well as prevention effort ideas and barriers. CONCLUSION Dissemination of local health data should be considered both as a strategy to increase community engagement and as an intervention to promote collective efficacy and community change. Careful attention should be dedicated to the language used when communicating racial disparities in excess weight to various community groups.
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929
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Reich SM, Kay JS, Lin GC. Nourishing a partnership to improve middle school lunch options: a community-based participatory research project. FAMILY & COMMUNITY HEALTH 2015; 38:77-86. [PMID: 25423246 DOI: 10.1097/fch.0000000000000055] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Community-based participatory research is predicated on building partnerships that tackle important issues to the community and effectively improve these issues. Community-based participatory research can also be an empowering experience, especially for children. This article describes a university-community partnership in which students at a low-income middle school worked to improve the quality of the cafeteria food provided to the 986 students eligible for free and reduced price lunches. The project led to menu changes, improved communication between youth, school administrators, and district staff, and enabled youth to enact school improvements that were beneficial for their health.
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Affiliation(s)
- Stephanie M Reich
- School of Education (Dr Reich and Ms Lin) and Department of Psychology and Social Behavior, School of Social Ecology (Mr Kay), University of California, Irvine
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930
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Felder TM, Braun KL, Brandt HM, Khan S, Tanjasiri S, Friedman DB, Armstead CA, Okuyemi KS, Hébert JR. Mentoring and Training of Cancer-Related Health Disparities Researchers Committed to Community-Based Participatory Research. Prog Community Health Partnersh 2015; 9 Suppl:97-108. [PMID: 26213409 PMCID: PMC4703034 DOI: 10.1353/cpr.2015.0020] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND AND OBJECTIVE The National Cancer Institute's (NCI) Community Networks Program Centers (CNPCs) provide community-based participatory research (CBPR)-oriented mentoring and training to prepare early-stage/midcareer investigators and student trainees (trainees) in disparities reduction. This paper describes the academic, mentoring, training, and work-life balance experiences of CNPC-affiliated trainees. METHODS We used a collaborative and iterative process to develop a 57-item, web-based questionnaire completed by trainees from the 23 CNPCs between August 2012 and February 2013. Their CNPC mentors completed a 47-item questionnaire. Descriptive statistics were calculated. RESULTS The final analytic sample included 189 of 269 individuals (70%) identified as active participants in CNPC research or training/mentoring. Mentors (n=45) were mostly non-Hispanic White (77.8%) and 48.9% were male. Mentors published a median of 6 (interquartile range [IQR], 3-12) first-authored and 15 (IQR, 6-25) senior authored manuscripts, and secured 15 (IQR, 11-29) grants from the National Institutes of Health (NIH) and other sources in the previous 5 years. Most trainees (n=144) were female (79.2%), 43.7% were underrepresented racial/ethnic minorities, and 36.8% were first-generation college graduates. Over the previous 5 years, trainees reported a median of 4 (IQR, 1-6) publications as first author and 4 (IQR, 2-8) as co-author; 27.1% reported having one or more NIH R01s. Trainees reported satisfaction with their CNPC mentor (79.1%) and confidence in demonstrating most CBPR competencies. CONCLUSION The CNPC training program consists of a scientifically productive pool of mentors and trainees. Trainees reported rates of scholarly productivity comparable to other national training programs and provided insights into relationships with mentors, academic pressures, and professional-personal life balance.
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931
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Braun KL, Stewart S, Baquet C, Berry-Bobovski L, Blumenthal D, Brandt HM, Buchwald DS, Campbell JE, Coe K, Cooper LC, Espinoza P, Henry-Tillman R, Hargreaves M, James A, Salmon Kaur J, Viswanath K, Ma GX, Mandelblatt J, Meade C, Ramirez A, Scarinci I, Park Tanjasiri S, Thompson B, Vines AI, Dignan M. The National Cancer Institute's Community Networks Program Initiative to Reduce Cancer Health Disparities: Outcomes and Lessons Learned. Prog Community Health Partnersh 2015; 9 Suppl:21-32. [PMID: 26213401 PMCID: PMC4698458 DOI: 10.1353/cpr.2015.0017] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
BACKGROUND We describe reach, partnerships, products, benefits, and lessons learned of the 25 Community Network Programs (CNPs) that applied community-based participatory research (CBPR) to reduce cancer health disparities. METHODS Quantitative and qualitative data were abstracted from CNP final reports. Qualitative data were grouped by theme. RESULTS Together, the 25 CNPs worked with more than 2,000 academic, clinical, community, government, faith-based, and other partners. They completed 211 needs assessments, leveraged funds for 328 research and service projects, trained 719 new investigators, educated almost 55,000 community members, and published 991 articles. Qualitative data illustrated how use of CBPR improved research methods and participation; improved knowledge, interventions, and outcomes; and built community capacity. Lessons learned related to the need for time to nurture partnerships and the need to attend to community demand for sustained improvements in cancer services. IMPLICATIONS Findings demonstrate the value of government-supported, community-academic, CBPR partnerships in cancer prevention and control research.
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Allen M, Cushing-Leubner J, Adam K, Bigelow M, Hang M, Ortega L, Pergament S, Prifrel B, Susens S. Promoting resilience in diverse classrooms: The answers are not in the back of the book. MINNETESOL JOURNAL (2014) 2015; 31:http://minnetesoljournal.org/wp-content/uploads/2015/05/Cushing-Leubner-et-al-2015-ProjectTRUST.pdf. [PMID: 29333529 PMCID: PMC5766288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Affiliation(s)
- Michele Allen
- Associate Professor, Department of Family Medicine and Community Health, Investigator, Program in Health Disparities Research, University of Minnesota, 717 Delaware St. SE, Suite 166, Minneapolis, MN 55414
| | | | | | - Martha Bigelow
- Second Languages and Cultures Education, University of Minnesota
| | - Mikow Hang
- Deborah E. Powell Center for Women's Health, University of Minnesota
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933
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Salway S, Chowbey P, Such E, Ferguson B. Researching health inequalities with Community Researchers: practical, methodological and ethical challenges of an 'inclusive' research approach. RESEARCH INVOLVEMENT AND ENGAGEMENT 2015; 1:9. [PMID: 29062498 PMCID: PMC5611626 DOI: 10.1186/s40900-015-0009-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2015] [Accepted: 07/20/2015] [Indexed: 05/14/2023]
Abstract
PLAIN ENGLISH SUMMARY Public health research sometimes uses members of communities as researchers. These are called Community Researchers. The advantage of using Community Researchers is that it enables people who live in communities to participate in research by designing the research, gathering data and being involved in analysis. This 'participatory' approach also has the potential to reach communities that might otherwise not be included in research. There are few studies that report the experiences of Community Researchers who take part in such research. This study helps fill this gap by exploring the issues and challenges faced by Community Researchers involved in a study of health and poverty in ethnically mixed areas of east London, UK. Through the accounts of 12 researchers, the study reveals that being a community 'insider' had advantages: many felt they had been able to gain the trust of respondents and access people for the research that would have otherwise been missed. The role of Community Researcher was, however, difficult to manage with some researchers feeling burdened by their role and the increased knowledge they had about the lives of those in their community. In addition to the personal challenges for the Community Researchers, the findings raise various ethical and methodological issues that need consideration in participatory research. ABSTRACT Background Inclusive research approaches are increasingly employed by public health researchers. Recent methodological development includes the engagement of Community Researchers (CRs), who use their knowledge and networks to facilitate research with the community with which they identify. Few studies have explored the experiences of CRs in the research process, an important element of any comprehensive assessment of the pros and cons of such research endeavours. We report here on the experiences of CRs engaged in a study of health inequalities and poverty in ethnically diverse and disadvantaged areas of London, UK. Methods We draw on the experiences of 12 CRs. Two sets of data were generated, analysed and integrated: debriefing/active reflection exercises throughout the 18-month research process and individual qualitative interviews with CRs, conducted at the end of the project (n = 9). Data were organised using NVivo10 and coded line-by-line using a framework developed iteratively. Synthesis and interpretation were achieved through a series of reflective team exercises involving input from 4 of the CRs. Final consolidation of key themes was conducted by SS and ES. Results Being an 'insider' to the communities brought distinct advantages to the research process but also generated complexities. CRs highlighted how 'something would be lost' without their involvement but still faced challenges in gathering and analysing data. Some CRs found it difficult to practice reflexivity, and problems of ethnic stereotyping were revealed. Conflict between roles as community members and investigators was at times problematic. The approach promoted some aspects of personal empowerment, but CRs were frustrated by the limited impact of the research at the local level. Conclusions Working with CRs offers distinct practical, ethical and methodological advantages to public health researchers, but these are limited by a range of challenges related to 'closeness', orthodox research structures and practices and the complexities of dynamic identities. For research of this type to meet its full potential and avoid harm, there is a need for careful support to CRs and long-term engagement between funders, research institutions and communities.
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Affiliation(s)
- Sarah Salway
- Health Equity and Inclusion Research Group, School of Health & Related Research, University of Sheffield, Sheffield, UK
| | - Punita Chowbey
- Centre for Health and Social Care Research, Sheffield Hallam University, Sheffield, UK
| | - Elizabeth Such
- Health Equity and Inclusion Research Group, School of Health & Related Research, University of Sheffield, Sheffield, UK
| | - Beverly Ferguson
- Department of Nursing and Midwifery, Sheffield Hallam University, Sheffield, UK
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934
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Lee JP, Moore RS, Roberts J, Nelson N, Calac D, Gilder DA, Ehlers CL. Off-premise alcohol outlets on and around tribal land: risks for rural California Indian youth. J Ethn Subst Abuse 2014; 14:59-78. [PMID: 25529892 DOI: 10.1080/15332640.2014.958643] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Investigating the alcohol environment for rural American Indian youth, we conducted 70 interviews with leading members and youth representatives of nine Southern California tribes. We also conducted brief observations in all 13 stores licensed to sell alcohol on and close to the reservation lands of the nine tribes. Underage youth may obtain alcoholic beverages at stores either directly through illegal sales to minors or indirectly through social sources. Stores are also environments within which alcoholic beverages and heavy drinking may become normalized for youth. Limitations and implications for convenience store-based prevention research on alcohol retail environment for youth in rural populations areas are discussed.
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Affiliation(s)
- Juliet P Lee
- a Pacific Institute for Research and Evaluation , Oakland , California
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935
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Aarons GA, Green AE, Willging CE, Ehrhart MG, Roesch SC, Hecht DB, Chaffin MJ. Mixed-method study of a conceptual model of evidence-based intervention sustainment across multiple public-sector service settings. Implement Sci 2014; 9:183. [PMID: 25490886 PMCID: PMC4272775 DOI: 10.1186/s13012-014-0183-z] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2014] [Accepted: 11/24/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This study examines sustainment of an EBI implemented in 11 United States service systems across two states, and delivered in 87 counties. The aims are to 1) determine the impact of state and county policies and contracting on EBI provision and sustainment; 2) investigate the role of public, private, and academic relationships and collaboration in long-term EBI sustainment; 3) assess organizational and provider factors that affect EBI reach/penetration, fidelity, and organizational sustainment climate; and 4) integrate findings through a collaborative process involving the investigative team, consultants, and system and community-based organization (CBO) stakeholders in order to further develop and refine a conceptual model of sustainment to guide future research and provide a resource for service systems to prepare for sustainment as the ultimate goal of the implementation process. METHODS A mixed-method prospective and retrospective design will be used. Semi-structured individual and group interviews will be used to collect information regarding influences on EBI sustainment including policies, attitudes, and practices; organizational factors and external policies affecting model implementation; involvement of or collaboration with other stakeholders; and outer- and inner-contextual supports that facilitate ongoing EBI sustainment. Document review (e.g., legislation, executive orders, regulations, monitoring data, annual reports, agendas and meeting minutes) will be used to examine the roles of state, county, and local policies in EBI sustainment. Quantitative measures will be collected via administrative data and web surveys to assess EBI reach/penetration, staff turnover, EBI model fidelity, organizational culture and climate, work attitudes, implementation leadership, sustainment climate, attitudes toward EBIs, program sustainment, and level of institutionalization. Hierarchical linear modeling will be used for quantitative analyses. Qualitative analyses will be tailored to each of the qualitative methods (e.g., document review, interviews). Qualitative and quantitative approaches will be integrated through an inclusive process that values stakeholder perspectives. DISCUSSION The study of sustainment is critical to capitalizing on and benefiting from the time and fiscal investments in EBI implementation. Sustainment is also critical to realizing broad public health impact of EBI implementation. The present study takes a comprehensive mixed-method approach to understanding sustainment and refining a conceptual model of sustainment.
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Affiliation(s)
- Gregory A Aarons
- Department of Psychiatry, University of California, La Jolla, San Diego, CA, USA.
| | - Amy E Green
- Department of Psychiatry, University of California, La Jolla, San Diego, CA, USA.
| | | | - Mark G Ehrhart
- Department of Psychology, San Diego State University, San Diego, CA, USA.
| | - Scott C Roesch
- Department of Psychology, San Diego State University, San Diego, CA, USA.
| | - Debra B Hecht
- Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
| | - Mark J Chaffin
- School of Public Health, Georgia State University, Atlanta, GA, USA.
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936
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Ahmed SM, Nelson D, Kissack A, Franco Z, Whittle J, Kotchen T, Meurer JR, Morzinski J, Brandenburg T. Towards Building a Bridge between Community Engagement in Research (CEnR) and Comparative Effectiveness Research (CER). Clin Transl Sci 2014; 8:160-5. [PMID: 25441215 DOI: 10.1111/cts.12236] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
A major national priority is establishing an effective infrastructure for translation of scientific discoveries into the community. Knowledge and practice continue to accelerate in health research yet healthcare recommendation adoption remains slow for practitioners, patients, and communities. Two areas of research placed in the later stages of the translational research spectrum, Community Engagement in Research and Comparative Effectiveness Research, are ideal for approaching this challenge collaboratively. The Clinical and Translational Science Institute of Southeastern Wisconsin convened academics and community-based organizations familiar with these fields of research in a 1-day workshop to establish an initial dialogue on similarities and differences with a goal of exploring ways to operationalize a collective effort. Participants represented four academic institutions and twelve other healthcare and community-based service organizations. Primary fields of study included community engaged research, comparative effectiveness research, psychology, clinical research, administration, nursing, public health, education, and other professionals. This initial report outlines the results of this diverse discussion and provides insights into the priorities, diverging issues, and areas for future examination and practice. Key discoveries reveal clear crosscutting issues, value in philosophical and provocative discussions among investigators, a need for practice and lessons learned, and bidirectional exchange with community representation.
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Affiliation(s)
- Syed M Ahmed
- Department of Family and Community Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
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937
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Toledo RFD, Giatti LL, Jacobi PR. A pesquisa-ação em estudos interdisciplinares: análise de critérios que só a prática pode revelar. INTERFACE-COMUNICACAO SAUDE EDUCACAO 2014. [DOI: 10.1590/1807-57622014.0026] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Este artigo propõe uma reflexão sobre critérios para a metodologia da pesquisa-ação, visando contribuir para o atendimento de premissas necessárias à aplicação e melhoria da qualidade de investigações participativas, em contextos socioambientais e de saúde. Para a construção desta estrutura de abordagem, foram utilizados resultados da análise de dissertações e teses sobre pesquisa-ação de caráter interdisciplinar, na interface das áreas saúde, educação e ambiental. A análise de situações práticas permitiu identificar elementos favoráveis ao alcance dos objetivos de uma pesquisa-ação e compreensão de sua dinâmica organizacional. Foram estabelecidos os seguintes critérios: flexibilidade metodológica; combinação de múltiplos instrumentos de pesquisa e intervenção; e o nível de participação e cooperação dos/e entre sujeitos e pesquisadores. A pesquisa-ação revela-se como uma adequada proposta frente a desafios interdisciplinares quando executada contemplando os critérios aqui estudados.
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938
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Fernández ME, Melvin CL, Leeman J, Ribisl KM, Allen JD, Kegler MC, Bastani R, Ory MG, Risendal BC, Hannon PA, Kreuter MW, Hebert JR. The cancer prevention and control research network: An interactive systems approach to advancing cancer control implementation research and practice. Cancer Epidemiol Biomarkers Prev 2014; 23:2512-21. [PMID: 25155759 PMCID: PMC6013073 DOI: 10.1158/1055-9965.epi-14-0097] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Although cancer research has advanced at a rapid pace, a gap remains between what is known about how to improve cancer prevention and control (CPC) and what is implemented as best practices within health care systems and communities. The Cancer Prevention and Control Research Network (CPCRN), with more than 10 years of dissemination and implementation research experience, aims to accelerate the uptake and use of evidence-based CPC interventions. METHODS The collective work of the CPCRN has facilitated the analysis and categorization of research and implementation efforts according to the Interactive Systems Framework for Dissemination and Implementation (ISF), providing a useful heuristic for bridging the gap between prevention research and practice. The ISF authors have called for examples of its application as input to help refine the model. RESULTS We provide examples of how the collaborative activities supported by the CPCRN, using community-engaged processes, accelerated the synthesis and translation of evidence, built both general and innovation-specific capacity, and worked with delivery systems to advance cancer control research and practice. CONCLUSIONS The work of the CPCRN has provided real-world examples of the application of the ISF and demonstrated that synthesizing and translating evidence can increase the potential that evidence-based CPC programs will be used and that capacity building for both the support system and the delivery system is crucial for the successful implementation and maintenance of evidence-based cancer control. IMPACT Adoption and implementation of CPC can be enhanced by better understanding ISF systems and intervening to improve them.
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Affiliation(s)
- María E Fernández
- Division of Health Promotion and Behavioral Sciences, School of Public Health, University of Texas Health Science Center at Houston, Houston, Texas.
| | - Cathy L Melvin
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, South Carolina
| | - Jennifer Leeman
- School of Nursing, University of North Carolina, Chapel Hill, North Carolina. Center for Health Promotion and Disease Prevention and Lineberger Comprehensive Cancer Center, and
| | - Kurt M Ribisl
- Center for Health Promotion and Disease Prevention and Lineberger Comprehensive Cancer Center, and Department of Health Behavior, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Jennifer D Allen
- Department of Public Health and Community Medicine, Tufts University, Medford, Massachusetts
| | - Michelle C Kegler
- Department of Behavioral Sciences and Health Education, Emory Prevention Research Center, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Roshan Bastani
- UCLA Department of Health Policy and Management, Center for Cancer Prevention and Control Research, Fielding School of Public Health and Jonsson Comprehensive Cancer Center, Los Angeles, California
| | - Marcia G Ory
- Texas A&M Health Science Center, School of Public Health, Department of Health Promotion and Community Health Sciences, College Station, Texas
| | - Betsy C Risendal
- University of Colorado School of Public Health, Denver, Colorado
| | - Peggy A Hannon
- Health Promotion Research Center, Department of Health Services, School of Public Health, University of Washington, Seattle, Washington
| | - Matthew W Kreuter
- Health Communication Research Laboratory, Brown School, Washington University in St Louis, Missouri
| | - James R Hebert
- Department of Biostatistics and Epidemiology and Statewide Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
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939
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Holden K, McGregor B, Thandi P, Fresh E, Sheats K, Belton A, Mattox G, Satcher D. Toward culturally centered integrative care for addressing mental health disparities among ethnic minorities. Psychol Serv 2014; 11:357-68. [PMID: 25383991 PMCID: PMC4228792 DOI: 10.1037/a0038122] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Despite decades of research, recognition and treatment of mental illness and its comorbidities still remain a significant public health problem in the United States. Ethnic minorities are identified as a population that is vulnerable to mental health disparities and face unique challenges pertaining to mental health care. Psychiatric illness is associated with great physical, emotional, functional, and societal burden. The primary health care setting may be a promising venue for screening, assessment, and treatment of mental illnesses for ethnic minority populations. We propose a comprehensive, innovative, culturally centered integrated care model to address the complexities within the health care system, from the individual level, which includes provider and patient factors, to the system level, which includes practice culture and system functionality issues. Our multidisciplinary investigative team acknowledges the importance of providing culturally tailored integrative health care to holistically concentrate on physical, mental, emotional, and behavioral problems among ethnic minorities in a primary care setting. It is our intention that the proposed model will be useful for health practitioners, contribute to the reduction of mental health disparities, and promote better mental health and well-being for ethnic minority individuals, families, and communities.
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Affiliation(s)
- Kisha Holden
- Department of Psychiatry and Behavioral Sciences, Morehouse School of Medicine
| | - Brian McGregor
- Department of Psychiatry and Behavioral Sciences, Morehouse School of Medicine
| | - Poonam Thandi
- Department of Psychiatry and Behavioral Sciences, Morehouse School of Medicine
| | - Edith Fresh
- Department of Family Medicine, Morehouse School of Medicine
| | - Kameron Sheats
- Satcher Health Leadership Institute, Morehouse School of Medicine
| | - Allyson Belton
- Satcher Health Leadership Institute, Morehouse School of Medicine
| | - Gail Mattox
- Department of Psychiatry and Behavioral Sciences, Morehouse School of Medicine
| | - David Satcher
- Satcher Health Leadership Institute, Morehouse School of Medicine
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940
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Hill JL, You W, Zoellner JM. Disparities in obesity among rural and urban residents in a health disparate region. BMC Public Health 2014; 14:1051. [PMID: 25297840 PMCID: PMC4198673 DOI: 10.1186/1471-2458-14-1051] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2014] [Accepted: 09/24/2014] [Indexed: 11/15/2022] Open
Abstract
Background The burden of obesity and obesity-related conditions is not borne equally and disparities in prevalence are well documented for low-income, minority and rural adults in the United States. The current literature on rural versus urban disparities is largely derived from national surveillance data which may not reflect regional nuances. There is little practical research that supports the reality of local service providers such as county health departments that may serve both urban and rural residents in a given area. Conducted through a community-academic partnership, the primary aim of this study is to quantify the current levels of obesity (BMI), fruit and vegetable (FV) intake and physical activity (PA) in a predominately rural health disparate region. Secondary aims are to determine if a gradient exists within the region in which rural residents have poorer outcomes on these indicators compared to urban residents. Methods Conducted as part of a larger ongoing community-based participatory research (CBPR) initiative, data were gathered through a random digit dial telephone survey using previously validated measures (n = 784). Linear, logistic and quantile regression models are used to determine if residency (i.e. rural, urban) predicts outcomes of FV intake, PA and BMI. Results The majority (72%) of respondents were overweight (BMI = 29 ± 6 kg/m2), with 29% being obese. Only 9% of residents met recommendations for FV intake and 38% met recommendations for PA. Statistically significant gradients between urban and rural and race exist at the upper end of the BMI distribution. In other words, the severity of obesity is worse among black compared to white and for urban residents compared to rural residents. Conclusions These results will be used by the community-academic partnership to guide the development of culturally relevant and sustainable interventions to increase PA, increase FV intake and reduce obesity within this health disparate region. In particular, local stakeholders may wish to address disparities in BMI by allocating resources to the vulnerable groups identified.
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Affiliation(s)
- Jennie L Hill
- Department of Human Nutrition, Foods and Exercise, Virginia Tech, Blacksburg, Virginia, USA.
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941
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Giatti LL, Landin R, de Toledo RF. [The applicability of the ecology of knowledge in health and environment and its permeability in the scientific literature]. CIENCIA & SAUDE COLETIVA 2014; 19:4091-102. [PMID: 25272118 DOI: 10.1590/1413-812320141910.08902014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2014] [Accepted: 07/11/2014] [Indexed: 11/22/2022] Open
Abstract
A new epistemology makes it imperative for different knowledge to be incorporated in order to understand and interact with the complex problems that affect humanity, especially those associated with health and the environment. The study aims to explore the applicability of the ecology of knowledge in the midst of traditional scientific literature, focusing on participatory approaches to questions of health and the environment. The methodology involved a bibliographic review of an international scientific database, with the inclusion of 170 papers that were classified by their participatory approaches as: timely; multi-tool; and ongoing/cyclic. Although timely and multi-tool approaches may be effective in terms of aggregating popular knowledge, which is systematically marginalized by traditional science, it is in the ongoing/cyclic approaches that a higher level of potential dialogue is achieved, since it is possible to identify aspects inherent to more symmetric participation processes, with the prospect of empowerment of the social actors and legitimate incorporation of subjectivity and diversity. This corresponds to the premise that promoting global cognitive justice is indispensable for achieving global social justice.
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942
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Jamshidi E, Morasae EK, Shahandeh K, Majdzadeh R, Seydali E, Aramesh K, Abknar NL. Ethical Considerations of Community-based Participatory Research: Contextual Underpinnings for Developing Countries. Int J Prev Med 2014; 5:1328-36. [PMID: 25400893 PMCID: PMC4223954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2014] [Accepted: 08/21/2014] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND The nature of community-based participatory research (CBPR) poses distinctive ethical challenges. In the absence of organized guidelines, a remarkable amount of researchers' time and energy will be spent tackling these ethical challenges. The study aimed to explore ethical issues and principles potentially arising when conducting CBPR. METHODS This qualitative study conducted in CBPR Center of Tehran University of Medical Sciences. Required data were gathered through systematic literature review and semi-structured interviews. Representatives of community, academia, and nongovernmental organizations (NGOs) participated in our study. Ten interviews with representatives of partner organizations, four group interviews with academic staff, and four with representatives of community were conducted. Repeated thematic analysis was used to elicit ethics-related overarching themes from transcribed interviews. As recommendations, these themes were then organized into a set of CBPR-related ethical issues and principles. RESULTS Four CBPR ethical guidelines (including 173 articles) were selected from a systematic review. Overarching themes relating to ethical principles which emerged from interviews were as follows: Trust, transparency and accountability, equity and inclusion, power imbalance, tolerance and conflict management, and attention to cultural sensitivity. Practical principles that emerged included: Consensus rather than informed consent, ownership of data and research achievements, and sustainability and maintenance of relationships. According to findings and in comparison to international guidelines, the present study put more emphasis on cultural sensitivity and sustainability as CBPR ethical tangles. CONCLUSIONS Community-based participatory research ethical challenges are of the same kind in most parts of the world. However, some discrepancies exist that calls for local scrutiny. Future use and critic of current explored ethical issues and principles are highly encouraged.
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Affiliation(s)
- Ensiyeh Jamshidi
- Community Based Participatory Research Center, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran,Department of Health Education and Promotion, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Esmaeil Khedmati Morasae
- Community Based Participatory Research Center, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
| | - Khandan Shahandeh
- Community Based Participatory Research Center, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran,Department of Health Education and Promotion, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran,Correspondence to: Mrs. Khandan Shahandeh, No. 1547, Enghlab Square, Kargar Street, Flat 7, Floor 9, Community Based Participatory Research Center, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran. E-mail:
| | - Reza Majdzadeh
- Community Based Participatory Research Center, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran,Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Elham Seydali
- Bushehr University of Medical Sciences, Bushehr, Iran
| | - Kiarash Aramesh
- Medical Ethics and History of Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Nina Loori Abknar
- Community Based Participatory Research Center, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
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Dang JHT, Rodriguez EM, Luque JS, Erwin DO, Meade CD, Chen MS. Engaging diverse populations about biospecimen donation for cancer research. J Community Genet 2014; 5:313-27. [PMID: 24664489 PMCID: PMC4159470 DOI: 10.1007/s12687-014-0186-0] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2013] [Accepted: 03/10/2014] [Indexed: 01/14/2023] Open
Abstract
Clinical research increasingly relies upon the availability of appropriate genetic materials; however, the proportion of biospecimens from racial/ethnic minority patients and healthy controls are underrepresented, which preclude equitable research across all patient groups for cancer treatment. National Cancer Institute-funded Community Network Program Centers in California, Florida, and New York collaborated with local community partners to conduct three independent formative research studies with diverse (African American, Asian American, Hispanic, and White) participants to explore their knowledge, attitudes, and beliefs about biobanking, and their experiences with the donation of biospecimens. Our findings demonstrated similarities in overall low knowledge and understanding about the use of biospecimens for research. This was exacerbated for non-English speakers. Racial and ethnic groups differed with regard to a number of factors that are obstacles for participation, e.g., continuing medical mistrust (African Americans), lack of benefit (Hispanics), apprehension about the physical toll of donating (Vietnamese), usage of biospecimen for research (Hmong and Chinese), and suspicion of exploitation by corporate entities (Whites). However, participants uniformly reported general interest and willingness to participate in biobanking for altruistic purposes, particularly to benefit future generations. This interest was framed with a strong admonition that donations should be accompanied by transparency about study sponsorship and ownership, distribution and use of biospecimens, and study information that fit participants' backgrounds and experiences. This cross-cultural regional analysis offers significant insights into the similarities and variations in opinions and perceptions about biobanking and the collection of biospecimens for use in cancer research.
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Affiliation(s)
- Julie H. T. Dang
- />UC Davis Comprehensive Cancer Center, 4800 2nd Avenue, FSSB, Suite 2200, Sacramento, CA 95817 USA
| | - Elisa M. Rodriguez
- />Cancer Prevention and Population Sciences, Center for Personalized Medicine, Rosewell Park Cancer Institute, Elm & Carlton Streets, Buffalo, NY 14263 USA
| | - John S. Luque
- />Jiann-Ping Hsu College of Public Health, Georgia Southern University, PO Box 8015, Statesboro, GA 30460 USA
| | - Deborah O. Erwin
- />Cancer Prevention and Population Sciences, Rosewell Park Cancer Institute, Elm & Carlton Streets, Buffalo, NY 14263 USA
| | - Cathy D. Meade
- />Division of Population Science, Health Outcomes & Behavior, Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, FL 33612 USA
| | - Moon S. Chen
- />UC Davis Comprehensive Cancer Center, 4800 2nd Avenue, FSSB, Suite 2200, Sacramento, CA 95817 USA
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Teufel-Shone NI, Gamber M, Watahomigie H, Siyuja TJ, Crozier L, Irwin SL. Using a participatory research approach in a school-based physical activity intervention to prevent diabetes in the Hualapai Indian community, Arizona, 2002-2006. Prev Chronic Dis 2014; 11:E166. [PMID: 25254984 PMCID: PMC4176473 DOI: 10.5888/pcd11.130397] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Introduction In the United States, type 2 diabetes has reached epidemic proportions among indigenous people. Community-based participatory research offers American Indian communities and university partners an opportunity to integrate skills in community action and systematic inquiry to develop locally acceptable primary prevention interventions to combat diabetes risk factors. The Hualapai Tribe and the University of Arizona designed, implemented, and assessed a school-based physical activity intervention to reduce diabetes risk factors among youth. Methods During a 2-year period, trained community members led in-school physical activity classes 2 times per week among students in grades 3 through 8. Body mass index (BMI), fitness measures, and fasting blood glucose level were measured on 6 occasions. Descriptive statistics and t tests were used to assess change in outcome measures. Results Of the more than 100 youth who took part in the physical activity classes for 2 years, 71 youth (38 male, 33 female) participated in 3 or more data collection sessions. Over time, the percentage of youth with a high fasting blood glucose level of more than 125 mg/dL decreased concurrently with significant improvements in fitness measures. However, BMI increased in both male and female participants. The high number of youth who missed more than 3 data collection sessions was attributed to poor school attendance and tardiness. Conclusion Classes led by lay physical activity leaders can affect diabetes risk factors in youth. Incongruous health and fitness outcomes suggest that one indicator does not adequately define the risk profile; BMI alone may not be sufficient as a measure of diabetes risk in youth.
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Affiliation(s)
- Nicolette I Teufel-Shone
- Mel and Enid Zuckerman College of Public Health, University of Arizona, PO Box 245209, Tucson, AZ 85724. E-mail:
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Abstract
In order to understand and take action in complex health and environmental issues, we intend to analyse the conditions that are needed for those at risk to participate in research and intervention projects. In this study, we describe and discuss an action research experience carried out with an indigenous community in the Brazilian Amazon that suffers from serious sanitary problems, where cultural aspects in the relationship with the environment and health are particularly relevant. Different types of tools were deployed and combined and were subsequently classified according to their dialectic efficacy and ability to both conduct and steer the research and encourage the participation of social actors within a process of feedback. Even tools that were considered to be non-dialectic proved to be important sources of feedback. We present a research flow as a model of analysis and a framework for implementing action research, in which challenges to the participation of social actors are classified according to their priority through a critical review of the methodology developed. These challenges are social mobilization, co-operation, appropriation and a proactive stance. We conclude that a cyclic combination of dialectic and non-dialectic tools can increase participation, which though difficult to achieve is nevertheless necessary. During the development of this process, social mobilization is a prerequisite, whereas a proactive stance, the highest level of participation, requires continuous effort and the successive deployment of a variety of tools.
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Affiliation(s)
| | - Leandro Luiz Giatti
- Department of Environmental Health, School of Public Health, University of São Paulo, São Paulo, Brazil
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Holzer J, Kass N. Understanding the supports of and challenges to community engagement in the CTSAs. Clin Transl Sci 2014; 8:116-22. [PMID: 25196710 DOI: 10.1111/cts.12205] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND The Clinical and Translational Science Award (CTSA) program has raised the profile and the available funding for engagement in biomedical research. Such increased funding and attention may address known barriers to engagement. However, little work has been done to describe experiences across multiple CTSAs, especially how the CTSA structure supports or challenges engagement. OBJECTIVE We sought to understand the supports and challenges experienced by multiple CTSAs as they pursued community engagement. This knowledge may help guide future efforts to support and enhance community engagement in biomedical research. METHODS We conducted semi-structured, in-depth interviews with CTSA community engagement core leaders and staff from the 2006 cohort of CTSAs (n = 12). RESULTS A total of 17 interviews with respondents from nine institutions identified three support themes, including: funding, existing relationships with communities, and leadership and a partnership approach at the institution. Six challenge themes arose: need for capacity development, lack of positive relationships with communities, lack of leadership, funding constraints, time and staff constraints, and unsustainable models. CONCLUSION The CTSAs have brought much-needed attention to community engagement in research, but more can be done to adequately support engagement. Challenges remain that need to be addressed to achieve the potential benefits of engagement.
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Affiliation(s)
- Jessica Holzer
- Department of Health Policy and Management, Yale School of Public Health, New Haven, Connecticut, USA
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Roberts LW, Kim JP. Giving voice to study volunteers: comparing views of mentally ill, physically ill, and healthy protocol participants on ethical aspects of clinical research. J Psychiatr Res 2014; 56:90-7. [PMID: 24931849 PMCID: PMC4109648 DOI: 10.1016/j.jpsychires.2014.05.007] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2014] [Revised: 05/06/2014] [Accepted: 05/09/2014] [Indexed: 11/25/2022]
Abstract
MOTIVATION Ethical controversy surrounds clinical research involving seriously ill participants. While many stakeholders have opinions, the extent to which protocol volunteers themselves see human research as ethically acceptable has not been documented. To address this gap of knowledge, authors sought to assess views of healthy and ill clinical research volunteers regarding the ethical acceptability of human studies involving individuals who are ill or are potentially vulnerable. METHODS Surveys and semi-structured interviews were used to query clinical research protocol participants and a comparison group of healthy individuals. A total of 179 respondents participated in this study: 150 in protocols (60 mentally ill, 43 physically ill, and 47 healthy clinical research protocol participants) and 29 healthy individuals not enrolled in protocols. Main outcome measures included responses regarding ethical acceptability of clinical research when it presents significant burdens and risks, involves people with serious mental and physical illness, or enrolls people with other potential vulnerabilities in the research situation. RESULTS Respondents expressed decreasing levels of acceptance of participation in research that posed burdens of increasing severity. Participation in protocols with possibly life-threatening consequences was perceived as least acceptable (mean = 1.82, sd = 1.29). Research on serious illnesses, including HIV, cancer, schizophrenia, depression, and post-traumatic stress disorder, was seen as ethically acceptable across respondent groups (range of means = [4.0, 4.7]). Mentally ill volunteers expressed levels of ethical acceptability for physical illness research and mental illness research as acceptable and similar, while physically ill volunteers expressed greater ethical acceptability for physical illness research than for mental illness research. Mentally ill, physically ill, and healthy participants expressed neutral to favorable perspectives regarding the ethical acceptability of clinical research participation by potentially vulnerable subpopulations (difference in acceptability perceived by mentally ill - healthy = -0.04, CI [-0.46, 0.39]; physically ill - healthy = -0.13, CI [-0.62, -.36]). CONCLUSIONS Clinical research volunteers and healthy clinical research-"naïve" individuals view studies involving ill people as ethically acceptable, and their responses reflect concern regarding research that poses considerable burdens and risks and research involving vulnerable subpopulations. Physically ill research volunteers may be more willing to see burdensome and risky research as acceptable. Mentally ill research volunteers and healthy individuals expressed similar perspectives in this study, helping to dispel a misconception that those with mental illness should be presumed to hold disparate views.
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Affiliation(s)
- Laura Weiss Roberts
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, USA.
| | - Jane Paik Kim
- Instructor, Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine
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Kilanowski JF. Challenges in community-based research with Latino migrant farmworker children and families. J Pediatr Health Care 2014; 28:461-5. [PMID: 25063347 PMCID: PMC4139441 DOI: 10.1016/j.pedhc.2014.05.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2014] [Revised: 05/20/2014] [Accepted: 05/22/2014] [Indexed: 11/29/2022]
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Data collection challenges in community settings: insights from two field studies of patients with chronic disease. Qual Life Res 2014; 24:1043-55. [PMID: 25154464 DOI: 10.1007/s11136-014-0780-y] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/08/2014] [Indexed: 01/16/2023]
Abstract
PURPOSE Collecting information about health and disease directly from patients can be fruitfully accomplished using contextual approaches, ones that combine more and less structured methods in home and community settings. This paper's purpose was to describe and illustrate a framework of the challenges of contextual data collection. METHODS A framework is presented based on prior work in community-based participatory research and organizational science, comprised of ten types of challenges across four broader categories. Illustrations of challenges and suggestions for addressing them are drawn from two mixed method, contextual studies of patients with chronic disease in two regions of the USA. RESULTS The first major category of challenges was concerned with the researcher-participant partnership, for example, the initial lack of mutual trust and understanding between researchers, patients, and family members. The second category concerned patient characteristics such as cognitive limitations and a busy personal schedule that created barriers to successful data collection. The third concerned research logistics and procedures such as recruitment, travel distances, and compensation. The fourth concerned scientific quality and interpretation, including issues of validity, reliability, and combining data from multiple sources. The two illustrative studies faced both common and diverse research challenges and used many different strategies to address them. CONCLUSION Collecting less structured data from patients and others in the community is potentially very productive but requires the anticipation, avoidance, or negotiation of various challenges. Future work is necessary to better understand these challenges across different methods and settings, as well as to test and identify strategies to address them.
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Main ME, Jones MS. Linking community partners to increase tetanus immunizations among farmers. Workplace Health Saf 2014; 62:476-81; quiz 482. [PMID: 25102478 DOI: 10.3928/21650799-20140804-05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2014] [Accepted: 07/10/2014] [Indexed: 11/20/2022]
Abstract
Increasing the number of individuals adequately immunized to prevent illness is a goal of community health nursing, but achieving this goal among occupational groups such as farmers remains a challenge. This article shares the process and outcome of a community-based participatory research project designed to provide tetanus immunizations to farmers. Key agricultural partners were identified in south central Kentucky and these individuals coordinated the site selection, advertisement, and recruitment for a tetanus immunization program. A total of 280 farmers or individuals associated with farming were surveyed over a 7-month period. The participants had limited knowledge of tetanus etiology and 84% of the participants either reported no tetanus booster in the past 10 years or did not know their tetanus immunization status. Positive outcomes included increasing the tetanus immunization rate among participating farmers and facilitating partnerships with community agencies and organizations.
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