951
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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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952
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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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953
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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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954
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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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955
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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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956
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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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957
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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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958
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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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959
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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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960
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Magnusson M, Hallmyr Lewis M, Smaga-Blom M, Lissner L, Pickering C. Health Equilibrium Initiative: a public health intervention to narrow the health gap and promote a healthy weight in Swedish children. BMC Public Health 2014; 14:763. [PMID: 25074482 PMCID: PMC4131039 DOI: 10.1186/1471-2458-14-763] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2014] [Accepted: 07/04/2014] [Indexed: 11/17/2022] Open
Abstract
Background Inequity in health is a global concern. Even in Sweden there are considerable health gaps between different social groups, not least concerning life-style related conditions. Interventions drawing on Community-based participatory research (CBPR) have potential to build prerequisites for complex, supportive structures that constitute basis for implementation of sustainable health promoting programs. CBPR rests on principles of empowerment. The researchers are responsible for the scientific quality and that ethical standards are met. Health Equilibrium Initiative (HEI) aims at narrowing the health gap and promoting healthy weight in children; “healthy weight” including both anthropometric criteria and aspects having to do with self-esteem and self-efficacy. Evaluation objectives are to compare outcome between children in intervention and control areas, conduct health economic assessments (HEA) and evaluate the processes of the project. Methods/design HEI is a repeated cross-sectional and longitudinal study. The Program Logic Model is based on Social Cognitive Theory and Intervention Mapping. Primary contact groups are children in disadvantaged communities. Core efforts are to confirm and convey knowledge, elucidate and facilitate on-going health work and support implementation of continuous health work. Socioeconomic status is assessed on area level by the parameters yearly average income, degree of employment, tertiary education and percent of inhabitants born in countries where violent conflicts recently have taken place or were ongoing. Anthropometry, food patterns, physical activity and belief in ability to affect health; together with learning, memory and attention assessment will be assessed in 350 children (born 2006). Examinations will be repeated after two years, forming the basis of a health economic analysis. The process evaluation procedure will use document analysis (such as structured reports from meetings and dialogues, school/workplaces policies and curriculum, food service menus); key informant interviews and focus groups with parents, children and professionals. Discussion Inviting, awaiting and including local perspectives create mutual confidence and collaboration. Enhanced self-efficacy and access to relevant knowledge has potential to enable individuals and communities to choose alternatives that are relevant for their health and well-being in a long perspective. The economic of this study may contribute in decision- making processes regarding appropriate public health interventions.
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Affiliation(s)
- Maria Magnusson
- Department of Public Health and Community Medicine, Unit of Public Health Epidemiology, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Box 454, SE-405 30 Gothenburg, Sweden.
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961
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Martínez G, Sardiñas LM, Acosta-Perez E, Medina L, Rivera M, Pattatucci A. Capacity needs in community-based organizations for enhancing translational research in Puerto Rico. Prog Community Health Partnersh 2014; 8:53-60. [PMID: 24859102 DOI: 10.1353/cpr.2014.0009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND In an effort to form and sustain community-academic partnerships (CAPs) to enhance clinical and translational research, an assessment of needs for selecting and implementing evidence-based programs (EBPs) was conducted among a group of community-based organizations (CBOs) throughout Puerto Rico. METHODS The survey was based on an instrument developed by the Cancer Prevention and Control Research Network. It assessed specific service information, program selection/implementation processes, knowledge and perception of EBPs, funding venues, evaluation processes, and capacity and training needs. Recruitment consisted of contacting 100 nonprofit organizations in Puerto Rico that work or address specific health areas, namely, cancer, neurological disorders, HIV, and cardiovascular health. RESULTS The survey revealed wide variability in understanding what constitutes an EBP. Training needs for building a productive translational research process also were identified. Prominent among these were securing funding for ongoing operations, utilizing data for decision making, developing collaborations, managing information, conducting community needs assessments, and program evaluation. CONCLUSIONS These findings point to important implications for promoting community-campus partnerships for advancing clinical and translational research.
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962
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Friedman DB, Brandt HM, Freedman DA, Adams SA, Young VM, Ureda JR, McCracken JL, Hébert JR. Innovative and community-driven communication practices of the South Carolina cancer prevention and control research network. Prev Chronic Dis 2014; 11:E127. [PMID: 25058673 PMCID: PMC4112920 DOI: 10.5888/pcd11.140151] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
The South Carolina Cancer Prevention and Control Research Network (SC-CPCRN) is 1 of 10 networks funded by the Centers for Disease Control and Prevention and the National Cancer Institute (NCI) that works to reduce cancer-related health disparities. In partnership with federally qualified health centers and community stakeholders, the SC-CPCRN uses evidence-based approaches (eg, NCI Research-tested Intervention Programs) to disseminate and implement cancer prevention and control messages, programs, and interventions. We describe the innovative stakeholder- and community-driven communication efforts conducted by the SC-CPCRN to improve overall health and reduce cancer-related health disparities among high-risk and disparate populations in South Carolina. We describe how our communication efforts are aligned with 5 core values recommended for dissemination and implementation science: 1) rigor and relevance, 2) efficiency and speed, 3) collaboration, 4) improved capacity, and 5) cumulative knowledge.
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Affiliation(s)
- Daniela B Friedman
- University of South Carolina, Arnold School of Public Health, Cancer Prevention and Control Program, 915 Greene St, Suite 235, Columbia, SC. E-mail:
| | | | - Darcy A Freedman
- Case Western Reserve University and the Prevention Research Center for Healthy Neighborhoods, Cleveland, Ohio
| | | | - Vicki M Young
- South Carolina Primary Health Care Association, Columbia, South Carolina
| | - John R Ureda
- Insights Consulting, Inc, Columbia, South Carolina
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963
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Rigg KK, Cook HH, Murphy JW. Expanding the scope and relevance of health interventions: moving beyond clinical trials and behavior change models. Int J Qual Stud Health Well-being 2014; 9:24743. [PMID: 25053530 PMCID: PMC4107301 DOI: 10.3402/qhw.v9.24743] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/27/2014] [Indexed: 11/28/2022] Open
Abstract
An overemphasis on clinical trials and behavior change models has narrowed the knowledge base that can be used to design interventions. The overarching point is that the process of overanalyzing variables is impeding the process of gaining insight into the everyday experiences that shape how people define health and seek treatment. This claim is especially important to health decision-making and behavior change because subtle interpretations often influence the decisions that people make. This manuscript provides a critique of traditional approaches to developing health interventions, and theoretically justifies what and why changes are warranted. The limited scope of these models is also discussed, and an argument is made to adopt a strategy that includes the perceptions of people as necessary for understanding health and health-related decision-making. Three practical strategies are suggested to be used with the more standard approaches to assessing the effectiveness and relevance of health interventions.
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Affiliation(s)
- Khary K Rigg
- Department of Mental Health Law & Policy, Louis de la Parte Florida Mental Health Institute, University of South Florida, Tampa, FL, USA;
| | - Hilary H Cook
- Social Sciences Department, Miami-Dade College, Miami, FL, USA
| | - John W Murphy
- Department of Sociology, University of Miami, Coral Gables, FL, USA
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964
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Tapp H, White L, Steuerwald M, Dulin M. Use of community-based participatory research in primary care to improve healthcare outcomes and disparities in care. J Comp Eff Res 2014; 2:405-19. [PMID: 24236682 DOI: 10.2217/cer.13.45] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Community-based participatory research (CBPR) has emerged to bridge the gap between research and primary-care practice through community engagement and social action to increase health equity. It is widely acknowledged that access to high-quality primary care services is important to the overall health of a community. Here, CBPR studies in a primary care setting are reviewed to assess the use of CBPR associated with common health problems seen in primary care such as access to care and disparities in chronic disease management across vulnerable populations. CBPR involves building relationships with local communities, determining areas of need and establishing priorities for health concerns. Studies showing improved access to care for a Hispanic population, reduced asthma symptoms and weight loss are highlighted.
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Affiliation(s)
- Hazel Tapp
- Carolinas HealthCare System, PO Box 32861, NC, USA
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965
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Gagnon MP, Candas B, Desmartis M, Gagnon J, La Roche D, Rhainds M, Coulombe M, Dipankui MT, Légaré F. Involving patient in the early stages of health technology assessment (HTA): a study protocol. BMC Health Serv Res 2014; 14:273. [PMID: 24950739 PMCID: PMC4072844 DOI: 10.1186/1472-6963-14-273] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2013] [Accepted: 06/16/2014] [Indexed: 11/19/2022] Open
Abstract
Background Public and patient involvement in the different stages of the health technology assessment (HTA) process is increasingly encouraged. The selection of topics for assessment, which includes identifying and prioritizing HTA questions, is a constant challenge for HTA agencies because the number of technologies requiring an assessment exceeds the resources available. Public and patient involvement in these early stages of HTA could make assessments more relevant and acceptable to them. Involving them in the development of the assessment plan is also crucial to optimize their influence and impact on HTA research. The project objectives are: 1) setting up interventions to promote patient participation in three stages of the HTA process: identification of HTA topics, prioritization, and development of the assessment plan of the topic prioritized; and 2) assessing the impact of patient participation on the relevance of the topics suggested, the prioritization process, and the assessment plan from the point of view of patients and other groups involved in HTA. Methods Patients and their representatives living in the catchment area of the HTA Roundtable of Université Laval’s Integrated University Health Network (covering six health regions of the Province of Quebec, Canada) will be involved in the following HTA activities: 1) identification of potential HTA topics in the field of cancer; 2) revision of vignettes developed to inform the prioritization of topics; 3) participation in deliberation sessions for prioritizing HTA topics; and 4) development of the assessment plan of the topic prioritized. The research team will coordinate the implementation of these activities and will evaluate the process and outcomes of patient involvement through semi-structured interviews with representatives of the different stakeholder groups, structured observations, and document analysis, mainly involving the comparison of votes and topics suggested by various stakeholder groups. Discussion This project is designed as an integrated approach to knowledge translation and will be conducted through a close collaboration between researchers and knowledge users at all stages of the project. In response to the needs expressed by HTA producers, the knowledge produced will be directly useful in guiding practices regarding patient involvement in the early phases of HTA.
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Affiliation(s)
- Marie-Pierre Gagnon
- Research Centre of the CHU de Québec, Hôpital Saint-François d'Assise, 10 rue de l'Espinay, D6-726, Quebec City, QC G1L 3L5, Canada.
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966
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Winter SJ, Buman MP, Sheats JL, Hekler EB, Otten JJ, Baker C, Cohen D, Butler BA, King AC. Harnessing the potential of older adults to measure and modify their environments: long-term successes of the Neighborhood Eating and Activity Advocacy Team (NEAAT) Study. Transl Behav Med 2014; 4:226-7. [PMID: 24904707 DOI: 10.1007/s13142-014-0264-1] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
- Sandra J Winter
- Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, CA USA ; Healthy Aging Research and Technology Solutions (HARTS) Lab, Stanford Prevention Research Centre, Stanford University School of Medicine, Suite 100, 1070 Arastradero Road, Palo Alto, CA 94304-1334 USA
| | - Matthew P Buman
- School of Nutrition and Health Promotion, Arizona State University, Phoenix, AZ USA
| | - Jylana L Sheats
- Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, CA USA
| | - Eric B Hekler
- School of Nutrition and Health Promotion, Arizona State University, Phoenix, AZ USA
| | - Jennifer J Otten
- School of Public Health, Department of Health Services, Nutritional Sciences Program, University of Washington, Washington, WA USA
| | - Cathleen Baker
- Health Policy and Planning, San Mateo County Health System, San Mateo, CA USA
| | | | - Brent A Butler
- East Palo Alto Planning Division, City of East Palo Alto, CA USA
| | - Abby C King
- Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, CA USA ; Department of Health Research and Policy, Stanford University School of Medicine, Stanford, CA USA
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967
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Kaholokula JK, Wilson RE, Townsend CKM, Zhang GX, Chen J, Yoshimura SR, Dillard A, Yokota JW, Palakiko DM, Gamiao S, Hughes CK, Kekauoha BK, Mau MK. Translating the Diabetes Prevention Program in Native Hawaiian and Pacific Islander communities: the PILI 'Ohana Project. Transl Behav Med 2014; 4:149-59. [PMID: 24904698 PMCID: PMC4041922 DOI: 10.1007/s13142-013-0244-x] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Native Hawaiians/Pacific Islanders experience a high prevalence of overweight/obesity. The Diabetes Prevention Program Lifestyle Intervention (DPP-LI) was translated into a 3-month community-based intervention to benefit these populations. The weight loss and other clinical and behavioral outcomes of the translated DPP-LI and the socio-demographic, behavioral, and biological factors associated with the weight loss were examined. A total of 239 Native Hawaiian/Pacific Islander adults completed the translated DPP-LI through four community-based organizations (CBOs). Changes from pre- to post-intervention assessments in weight, blood pressure, physical functioning, exercise frequency, and fat in diet were measured. Significant improvements on all variables were found, with differences observed across the four CBOs. CBOs with predominately Native Hawaiian and ethnically homogenous intervention groups had greater weight loss. General linear modeling indicated that larger baseline weight and CBO predicted weight loss. The translated DPP-LI can be effective for Native Hawaiians/Pacific Islanders, especially when socio-cultural, socio-economic, and CBO-related contextual factors are taken into account.
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Affiliation(s)
- J K Kaholokula
- />Department of Native Hawaiian Health, John A. Burns School of Medicine, University of Hawai‘i, 677 Ala Moana Boulevard, Suite 1016B, Honolulu, HI 96813 USA
| | - R E Wilson
- />Department of Native Hawaiian Health, John A. Burns School of Medicine, University of Hawai‘i, 677 Ala Moana Boulevard, Suite 1016B, Honolulu, HI 96813 USA
| | - C K M Townsend
- />Department of Native Hawaiian Health, John A. Burns School of Medicine, University of Hawai‘i, 677 Ala Moana Boulevard, Suite 1016B, Honolulu, HI 96813 USA
| | - G X Zhang
- />Biostatistics and Data Management Core, John A. Burns School of Medicine, University of Hawai‘i, Honolulu, HI USA
| | - J Chen
- />Biostatistics and Data Management Core, John A. Burns School of Medicine, University of Hawai‘i, Honolulu, HI USA
| | - S R Yoshimura
- />Kōkua Kalihi Valley Comprehensive Family Services, Honolulu, HI USA
| | - A Dillard
- />Kula no nā Po‘e Hawai‘i, Honolulu, HI USA
| | - J W Yokota
- />Kōkua Kalihi Valley Comprehensive Family Services, Honolulu, HI USA
| | - D M Palakiko
- />Ke Ola Mamo, Native Hawaiian Health Care System O‘ahu, Honolulu, HI USA
| | - S Gamiao
- />Hawai‘i Maoli of the Association for Hawaiian Civic Clubs, Honolulu, HI USA
| | - C K Hughes
- />Hawai‘i Maoli of the Association for Hawaiian Civic Clubs, Honolulu, HI USA
| | | | - M K Mau
- />Department of Native Hawaiian Health, John A. Burns School of Medicine, University of Hawai‘i, 677 Ala Moana Boulevard, Suite 1016B, Honolulu, HI 96813 USA
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968
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Nunn A, Sanders J, Carson L, Thomas G, Cornwall A, Towey C, Lee H, Tasco M, Shabazz-El W, Yolken A, Smith T, Bell G, Feller S, Smith E, James G, Shelton Dunston B, Green D. African American community leaders' policy recommendations for reducing racial disparities in HIV infection, treatment, and care: results from a community-based participatory research project in Philadelphia, Pennsylvania. Health Promot Pract 2014; 16:91-100. [PMID: 24879446 DOI: 10.1177/1524839914534855] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
African Americans account for 45% of new HIV infections in the United States. Little empirical research investigates African American community leaders' normative recommendations for addressing these disparities. Philadelphia's HIV infection rate is 5 times the national average, nearly 70% of new infections are among African Americans, and 2% of African Americans in Philadelphia are living with HIV/AIDS. Using a community-based participatory research approach, we convened focus groups among 52 African American community leaders from diverse backgrounds to solicit normative recommendations for reducing Philadelphia's racial disparities in HIV infection. Leaders recommended that (a) Philadelphia's city government should raise awareness about HIV/AIDS with media campaigns featuring local leaders, (b) local HIV-prevention interventions should address social and structural factors influencing HIV risks rather than focus exclusively on mode of HIV transmission, (c) resources should be distributed to the most heavily affected neighborhoods of Philadelphia, and (d) faith institutions should play a critical role in HIV testing, treatment, and prevention efforts. We developed a policy memo highlighting these normative recommendations for how to enhance local HIV prevention policy. This policy memo led to Philadelphia City Council hearings about HIV/AIDS in October 2010 and subsequently informed local HIV/AIDS prevention policy and development of local HIV prevention interventions. This community-based participatory research case study offers important lessons for effectively engaging community leaders in research to promote HIV/AIDS policy change.
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Affiliation(s)
- Amy Nunn
- The Miriam Hospital, Providence, RI, USA
| | | | - Lee Carson
- Black Gay Men's Leadership Council, Philadelphia, PA, USA
| | | | | | | | | | - Marian Tasco
- Philadelphia City Council, Philadelphia, PA, USA
| | | | | | - Tyrone Smith
- Black Gay Men's Leadership Council, Philadelphia, PA, USA
| | - Gary Bell
- Bebashi, Inc., Philadelphia, PA, USA
| | | | | | - George James
- Council for Relationships, Philadelphia, PA, USA
| | | | - Derek Green
- Philadelphia City Council, Philadelphia, PA, USA
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969
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James R, Tsosie R, Sahota P, Parker M, Dillard D, Sylvester I, Lewis J, Klejka J, Muzquiz L, Olsen P, Whitener R, Burke W. Exploring pathways to trust: a tribal perspective on data sharing. Genet Med 2014; 16:820-6. [PMID: 24830328 DOI: 10.1038/gim.2014.47] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2013] [Accepted: 04/07/2014] [Indexed: 11/09/2022] Open
Abstract
The data-sharing policies of the National Institutes of Health aim to maximize public benefit derived from genetic studies by increasing research efficiency and use of a pooled data resource for future studies. Although broad access to data may lead to benefits for populations underrepresented in genetic studies, such as indigenous groups, tribes have ownership interest in their data. The Northwest-Alaska Pharmacogenetic Research Network, a partnership involving tribal organizations and universities conducting basic and translational pharmacogenetic research, convened a meeting to discuss the collection, management, and secondary use of research data, and of the processes surrounding access to data stored in federal repositories. This article reports the tribal perspectives that emerged from the dialogue and discusses the implications of tribal government sovereign status on research agreements and data-sharing negotiations. There is strong tribal support for efficient research processes that expedite the benefits from collaborative research, but there is also a need for data-sharing procedures that take into account tribal sovereignty and appropriate oversight of research--such as tribally based research review processes and review of draft manuscripts. We also note specific ways in which accountability could be encouraged by the National Institutes of Health as part of the research process.
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Affiliation(s)
- Rosalina James
- Department of Bioethics and Humanities, University of Washington, Seattle, Washington, USA
| | - Rebecca Tsosie
- Indian Legal Program, Sandra Day O'Conner College of Law, Arizona State University, Tempe, Arizona, USA
| | - Puneet Sahota
- Department of Psychiatry, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Myra Parker
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, USA
| | | | | | - John Lewis
- Inter Tribal Council of Arizona, Phoenix, Arizona, USA
| | - Joseph Klejka
- Yukon-Kuskokwim Health Corporation, Bethel, Alaska, USA
| | - LeeAnna Muzquiz
- Confederated Salish and Kootenai Tribes, Pablo, Montana, USA
| | - Polly Olsen
- Indigenous Wellness Research Institute, School of Social Work, University of Washington, Seattle, Washington, USA
| | - Ron Whitener
- Native American Law Center, University of Washington, Seattle, Washington, USA
| | - Wylie Burke
- Department of Bioethics and Humanities, University of Washington, Seattle, Washington, USA
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970
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Cariou C, Gonzales M, Krebill H. Adapting and implementing an evidence-based sun-safety education program in rural Idaho, 2012. Prev Chronic Dis 2014; 11:E77. [PMID: 24809363 PMCID: PMC4015303 DOI: 10.5888/pcd11.130268] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Melanoma incidence and mortality rates in Idaho are higher than national averages. The importance of increased awareness of skin cancer has been cited by state and local organizations. St. Luke's Mountain States Tumor Institute (MSTI) prioritized educational outreach efforts to focus on the implementation of a skin cancer prevention program in rural Idaho. COMMUNITY CONTEXT As a community cancer center, MSTI expanded cancer education services to include dedicated support to rural communities. Through this expansion, an MSTI educator sought to partner with a community organization to provide sun-safety education. MSTI selected, adapted, and implemented an evidence-based program, Pool Cool. METHODS The education program was implemented in 5 phases. In Phase I, we identified and recruited a community partner; in Phase 2, after thorough research, we selected a program, Pool Cool; in Phase 3, we planned the details of the program, including identification of desired short- and long-term outcomes and adaptation of existing program materials; in Phase 4, we implemented the program in summer 2012; in Phase 5, we assessed program sustainability and expansion. OUTCOME MSTI developed a sustainable partnership with Payette Municipal Pool, and in summer 2012, we implemented Pool Cool. Sun-safety education was provided to more than 700 young people aged 2 to 17 years, and educational signage and sunscreen benefitted hundreds of additional pool patrons. INTERPRETATION Community cancer centers are increasingly being asked to assess community needs and implement evidence-based prevention and screening programs. Clinical staff may become facilitators of evidence-based public health programs. Challenges of implementing evidence-based programs in the context of a community cancer centers are staffing, leveraging of resources, and ongoing training and support.
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Affiliation(s)
- Charlene Cariou
- Idaho Department of Health and Welfare, 450 W State St, Boise, ID 83720. E-mail:
| | | | - Hope Krebill
- Midwest Cancer Alliance, University of Kansas Medical Center, Kansas City, Kansas
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971
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Foster J, Gossett S, Burgos R, Cáceres R, Tejada C, Dominguez García L, Ambrosio Rosario A, Almonte A, Perez LJ. Improving maternity care in the Dominican Republic: a pilot study of a community-based participatory research action plan by an international healthcare team. J Transcult Nurs 2014; 26:254-60. [PMID: 24793488 DOI: 10.1177/1043659614524252] [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: 11/16/2022] Open
Abstract
This article is a report of the process and results of a feasibility pilot study to improve the quality of maternity care in a sample of 31 women and their newborns delivering in a public, tertiary hospital in the Dominican Republic. The pilot study was the first "action step" taken as a result of a formative, community-based participatory research (CBPR) study conducted between 2008 and 2010 by an interdisciplinary, international partnership of U.S. academic researchers, Dominican medical/nursing personnel, and Dominican community health workers. Health personnel and community health workers separately identified indicators most important to measure quality of antepartum maternity care: laboratory and diagnostic studies and respectful, interpersonal communication. At the midpoint and the completion of data collection, the CBPR team evaluated the change in quality indicators to assess improvement in care. The pilot study supports the idea that joint engagement of community health workers, health personnel, and academic researchers with data creation and patient monitoring is motivating for all to continue to improve services in the cultural context of the Dominican Republic.
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Affiliation(s)
| | | | - Rosa Burgos
- Hospital Universitario Regional San Vicente de Paúl, San Francisco de Macorís, Dominican Republic
| | - Ramona Cáceres
- Hospital Universitario Regional San Vicente de Paúl, San Francisco de Macorís, Dominican Republic
| | - Carmen Tejada
- Hospital Universitario Regional San Vicente de Paúl, San Francisco de Macorís, Dominican Republic
| | - Luis Dominguez García
- Hospital Universitario Regional San Vicente de Paúl, San Francisco de Macorís, Dominican Republic
| | - Angel Ambrosio Rosario
- Hospital Universitario Regional San Vicente de Paúl, San Francisco de Macorís, Dominican Republic
| | - Asela Almonte
- Hospital Universitario Regional San Vicente de Paúl, San Francisco de Macorís, Dominican Republic
| | - Lydia J Perez
- Hospital Universitario Regional San Vicente de Paúl, San Francisco de Macorís, Dominican Republic
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972
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Baron SL, Beard S, Davis LK, Delp L, Forst L, Kidd-Taylor A, Liebman AK, Linnan L, Punnett L, Welch LS. Promoting integrated approaches to reducing health inequities among low-income workers: applying a social ecological framework. Am J Ind Med 2014; 57:539-56. [PMID: 23532780 PMCID: PMC3843946 DOI: 10.1002/ajim.22174] [Citation(s) in RCA: 105] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/22/2013] [Indexed: 12/20/2022]
Abstract
BACKGROUND Nearly one of every three workers in the United States is low-income. Low-income populations have a lower life expectancy and greater rates of chronic diseases compared to those with higher incomes. Low- income workers face hazards in their workplaces as well as in their communities. Developing integrated public health programs that address these combined health hazards, especially the interaction of occupational and non-occupational risk factors, can promote greater health equity. METHODS We apply a social-ecological perspective in considering ways to improve the health of the low-income working population through integrated health protection and health promotion programs initiated in four different settings: the worksite, state and local health departments, community health centers, and community-based organizations. RESULTS Examples of successful approaches to developing integrated programs are presented in each of these settings. These examples illustrate several complementary venues for public health programs that consider the complex interplay between work-related and non work-related factors, that integrate health protection with health promotion and that are delivered at multiple levels to improve health for low-income workers. CONCLUSIONS Whether at the workplace or in the community, employers, workers, labor and community advocates, in partnership with public health practitioners, can deliver comprehensive and integrated health protection and health promotion programs. Recommendations for improved research, training, and coordination among health departments, health practitioners, worksites and community organizations are proposed.
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Affiliation(s)
- Sherry L Baron
- Division of Surveillance, Hazard Evaluations, and Field Studies, National Institute for Occupational Safety and Health, Cincinnati, Ohio
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973
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Goris ED, Schutte DL, Rivard JL, Schutte BC. Community Leader Perceptions of the Health Needs of Older Adults. West J Nurs Res 2014; 37:599-618. [DOI: 10.1177/0193945914530046] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The purpose of this needs assessment was to determine community leader perceptions of health-related needs and resources available to rural-dwelling older adults as part of a community–academic partnership in the rural Midwest. A community advisory board, in accordance with community-based participatory research principles, was influential in study design and implementation. Key informant interviews ( N = 30) were conducted with community leaders including professionals from schools, businesses, churches, and health care as well as government officials. Thematic analysis revealed “Family Is Central,” “Heritage,” “Strength,” and “Longevity” as important themes related to older adults and their health care needs within the community. “Close-knit” and “Church Is Central” were also identified as important aspects of elder care. Community leaders perceived the “Rural Economy,” “Distance to Resources,” and “Seasonal Resources” as significant barriers for older adults. This work contributes important insights into community leaders’ perceptions of health needs and challenges faced by older adults in rural settings.
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974
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HIV Prevention Messages Targeting Young Latino Immigrant MSM. AIDS Res Treat 2014; 2014:353092. [PMID: 24864201 PMCID: PMC4016876 DOI: 10.1155/2014/353092] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2014] [Accepted: 03/30/2014] [Indexed: 11/18/2022] Open
Abstract
Young Latino immigrant men who have sex with men (MSM) are at risk for HIV and for delayed diagnosis. A need exists to raise awareness about HIV prevention in this population, including the benefits of timely HIV testing. This project was developed through collaboration between University of WA researchers and Entre Hermanos, a community-based organization serving Latinos. Building from a community-based participatory research approach, the researchers developed a campaign that was executed by Activate Brands, based in Denver, Colorado. The authors (a) describe the development of HIV prevention messages through the integration of previously collected formative data; (b) describe the process of translating these messages into PSAs, including the application of a marketing strategy; (c) describe testing the PSAs within the Latino MSM community; and (c) determine a set of important factors to consider when developing HIV prevention messages for young Latino MSM who do not identify as gay.
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975
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Smith M, Morita H, Mateo KF, Nye A, Hutchinson C, Cohall AT. Development of a Culturally Relevant Consumer Health Information Website for Harlem, New York. Health Promot Pract 2014; 15:664-74. [DOI: 10.1177/1524839914530401] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The process of creating a geographically tailored health information website with ongoing feedback from community members is one of inquiry and discovery, frustration and triumph, and development and reevaluation. This article reviews the development and implementation of GetHealthyHarlem.org , a health literacy level-appropriate consumer health information website tailored to consumers in Harlem, New York City. From 2004 to 2009, the Harlem Health Promotion Center, one of 37 Prevention Research Centers in the United States, sought to determine the use and seeking of online health information in Harlem, New York City in order to further explore the possibility of providing online health information to this community. Specifically, this article details how we sought to identify gaps, concerns, and uses of online health information and health care seeking in this local, predominantly racial and ethnic minority population. We review how we identified and addressed the multitude of variables that play a role in determining the degree of success in finding and using online health information, and include discussions about the genesis of the website and our successes and challenges in the development and implementation stages.
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976
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Oetzel JG, Zhou C, Duran B, Pearson C, Magarati M, Lucero J, Wallerstein N, Villegas M. Establishing the psychometric properties of constructs in a community-based participatory research conceptual model. Am J Health Promot 2014; 29:e188-202. [PMID: 24720389 DOI: 10.4278/ajhp.130731-quan-398] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE The purpose of this study is to establish the psychometric properties of 22 measures from a community-based participatory research (CBPR) conceptual model. DESIGN The design of this study was an online, cross-sectional survey of academic and community partners involved in a CPBR project. SETTING CPBR projects (294) in the United States with federal funding in 2009. SUBJECTS Of the 404 academic and community partners invited, 312 (77.2%) participated. Of the 200 principal investigators/project directors invited, 138 (69.0%) participated. MEASURES Twenty-two measures of CBPR context, group dynamics, methods, and health-related outcomes were examined. ANALYSIS Confirmatory factor analysis to establish factorial validity and Pearson correlations to establish convergent and divergent validity were used. RESULTS Confirmatory factor analysis demonstrated strong factorial validity for the 22 constructs. Pearson correlations (p < .001) supported the convergent and divergent validity of the measures. Internal consistency was strong, with 18 of 22 measures achieving at least a .78 Cronbach α. CONCLUSION CBPR is a key approach for health promotion in underserved communities and/or communities of color, yet the basic psychometric properties of CBPR constructs have not been well established. This study provides evidence of the factorial, convergent, and discriminant validity and the internal consistency of 22 measures related to the CBPR conceptual model. Thus, these measures can be used with confidence by both CBPR practitioners and researchers to evaluate their own CBPR partnerships and to advance the science of CBPR.
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977
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Solomon S, Eakin B, Kirk R, Piechowski P, Thomas B. Piloting a nationally disseminated, interactive human subjects protection program for community partners: design, content, and evaluation. Clin Transl Sci 2014; 7:177-83. [PMID: 24720288 DOI: 10.1111/cts.12154] [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: 12/01/2022] Open
Abstract
Funders, institutions, and research organizations are increasingly recognizing the need for human subjects protections training programs for those engaged in academic research. Current programs tend to be online and directed toward an audience of academic researchers. Research teams now include many nonacademic members, such as community partners, who are less likely to respond to either the method or the content of current online trainings. A team at the CTSA-supported Michigan Institute for Clinical and Health Research at the University of Michigan developed a pilot human subjects protection training program for community partners that is both locally implemented and adaptable to local contexts, yet nationally consistent and deliverable from a central administrative source. Here, the developers and the analysts of this program discuss its development, its content, and the results of its evaluation.
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Affiliation(s)
- Stephanie Solomon
- Albert Gnaegi Center for Health Care Ethics, Saint Louis University, Saint Louis, Missouri, USA
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978
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Zoellner J, Thomson JL, Landry AS, Anderson-Lewis C, Connell C, Molaison EF, Yadrick K. Improvements in blood pressure among undiagnosed hypertensive participants in a community-based lifestyle intervention, Mississippi, 2010. Prev Chronic Dis 2014; 11:E53. [PMID: 24698531 PMCID: PMC3976232 DOI: 10.5888/pcd11.130269] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Introduction Effective strategies are needed to reach and treat people who lack awareness of or have uncontrolled hypertension. We used data from a community-based participatory research initiative, Hub City Steps, to quantify the prevalence of undiagnosed hypertension and determine the relationship between hypertension status at baseline and postintervention improvements in blood pressure and health-related quality of life. Methods Hub City Steps was a 6-month preintervention–postintervention lifestyle intervention targeting hypertension risk factors. Outcome measures were collected at baseline, 3 months, and 6 months. Generalized linear mixed models were used to test for effects by time and hypertension status. Results Of the enrolled sample (N = 269), most were overweight or obese (91%), African American (94%), and women (85%). When considering hypertension status, 42% had self-reported diagnosis of hypertension (self-reported subgroup; 84% with antihypertensive medication use); 36% had no self-reported medical history of hypertension, but when blood pressure was measured they had a clinical diagnosis of prehypertension or hypertension (undiagnosed subgroup); and 22% had no self-reported or clinical hypertension diagnosis (no hypertension subgroup). From baseline to 6 months, systolic blood pressure significantly improved for participants with self-reported hypertension [8.2 (SD, 18.2) mm Hg] and undiagnosed hypertension [12.3 (SD, 16.3) mm Hg], with undiagnosed participants experiencing the greatest improvements (P < .001). Effects remained significant after controlling for covariates. Health-related quality of life significantly improved for all 3 hypertension subgroups, with no apparent subgroup differences. Conclusion This study reveals advantages of a culturally appropriate community-based participatory research initiative to reach those with undetected hypertension and effectively improve blood pressure status and health-related quality of life.
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Affiliation(s)
- Jamie Zoellner
- Virginia Tech, Department of Human Nutrition, Foods and Exercise, Integrated Life Sciences Building 23, Room 1034 (0913), 1981 Kraft Dr, Blacksburg, VA 24061. E-mail:
| | - Jessica L Thomson
- US Department of Agriculture, Agricultural Research Service, Stoneville, Mississippi
| | - Alicia S Landry
- The University of Southern Mississippi, Hattiesburg, Mississippi
| | | | - Carol Connell
- The University of Southern Mississippi, Hattiesburg, Mississippi
| | | | - Kathleen Yadrick
- The University of Southern Mississippi, Hattiesburg, Mississippi
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979
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An implementation evaluation of the community engagement and planning intervention in the CPIC Depression Care Improvement Trial. Community Ment Health J 2014; 50:312-24. [PMID: 23625140 PMCID: PMC3758395 DOI: 10.1007/s10597-012-9586-y] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2012] [Accepted: 12/25/2012] [Indexed: 12/11/2022]
Abstract
The goal of this paper is to document and evaluate the process of implementing an evidence-based depression intervention in community settings through the use of community-academic partnered approaches. We discuss how and to what extent the goals of community engagement and collaborative planning were achieved in the intervention arm of the Community Partners in Care study that aimed to adapt evidence-based depression care toolkits for diverse agencies in Hollywood and South Los Angeles. We find that partnered research strategies have a potential to effectively engage community members around depression and involve them in intervention planning activities. Our results suggest that successful collaboration among diverse agencies requires that they understand what is expected of them, are comfortable with the role they choose to perform, and have organizational support to contribute to the project. To facilitate the development of collaborative relationships, time and effort should be devoted to explaining how collaboration among diverse agencies may take place.
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980
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Ameling JM, Ephraim PL, Bone LR, Levine DM, Roter DL, Wolff JL, Hill-Briggs F, Fitzpatrick SL, Noronha GJ, Fagan PJ, Lewis-Boyer L, Hickman D, Simmons M, Purnell L, Fisher A, Cooper LA, Aboumatar HJ, Albert MC, Flynn SJ, Boulware LE. Adapting hypertension self-management interventions to enhance their sustained effectiveness among urban African Americans. FAMILY & COMMUNITY HEALTH 2014; 37:119-33. [PMID: 24569158 PMCID: PMC4002996 DOI: 10.1097/fch.0000000000000020] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
African Americans suffer disproportionately poor hypertension control despite the availability of efficacious interventions. Using principles of community-based participatory research and implementation science, we adapted established hypertension self-management interventions to enhance interventions' cultural relevance and potential for sustained effectiveness among urban African Americans. We obtained input from patients and their family members, their health care providers, and community members. The process required substantial time and resources, and the adapted interventions will be tested in a randomized controlled trial.
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Affiliation(s)
- Jessica M Ameling
- Departments of Medicine (Mss Ameling, Bone, Flynn, and Lewis-Boyer and Drs Levine, Hill-Briggs, Fitzpatrick, Noronha, Cooper, Aboutamar, Albert and Boulware) and Psychiatry and Behavioral Sciences (Dr Fagan) and Division of Geriatric Medicine and Gerontology (Dr Wolff), Johns Hopkins University School of Medicine, Baltimore Maryland; Welch Center for Prevention, Epidemiology and Clinical Research (Mss Ameling, Ephraim, Lewis-Boyer, and Flynn and Drs Hill-Briggs, Fitzpatrick, Cooper, and Boulware) and Johns Hopkins Community Physicians (Dr Albert), Johns Hopkins Medical Institutions, Baltimore, Maryland; Departments of Epidemiology (Ms Ephraim and Drs Cooper and Boulware), Health Behavior and Society (Ms Bone and Drs Roter, Hill-Briggs, and Cooper) and Health Policy and Management (Drs Levine and Wolff) Johns Hopkins Bloomberg School of Public Health, Baltimore Maryland; Department of Preventive Medicine, Rush University Medical Center, Chicago, Illinois (Dr Fitzpatrick); Center for Primary Care, University of Rochester School of Medicine and Dentistry, Rochester, New York (Dr Noronha); Johns Hopkins Health Care, LLC, Glen Burnie, Maryland (Drs Noronha and Fagan); Sister Together and Reaching, Inc, Baltimore, Maryland (Ms. Hickman); Community Advisory Board, Johns Hopkins Center to Eliminate Cardiovascular Health Disparities, Baltimore, Maryland (Mss Hickman, Simmons, and Fisher and Mr Purnell); The Men and Families Center Inc., Baltimore, Maryland (Mr Purnell); American Heart Association, Baltimore Branch, Baltimore, Maryland (Ms Fisher); Armstrong Institute for Patient Safety and Quality, Johns Hopkins Medicine, Baltimore, Maryland (Dr Aboutamar); and Division of General Internal Medicine, Duke University School of Medicine, Durham, North Carolina (Dr Boulware)
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981
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Palmas W, Findley SE, Mejia M, Batista M, Teresi J, Kong J, Silver S, Fleck EM, Luchsinger JA, Carrasquillo O. Results of the northern Manhattan diabetes community outreach project: a randomized trial studying a community health worker intervention to improve diabetes care in Hispanic adults. Diabetes Care 2014; 37:963-9. [PMID: 24496805 PMCID: PMC3964489 DOI: 10.2337/dc13-2142] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE The Northern Manhattan Diabetes Community Outreach Project evaluated whether a community health worker (CHW) intervention improved clinically relevant markers of diabetes care in adult Hispanics. RESEARCH DESIGN AND METHODS Participants were adult Hispanics, ages 35-70 years, with recent hemoglobin A1c (A1C) ≥8% (≥64 mmol/mol), from a university-affiliated network of primary care practices in northern Manhattan (New York City, NY). They were randomized to a 12-month CHW intervention (n = 181), or enhanced usual care (educational materials mailed at 4-month intervals, preceded by phone calls, n = 179). The primary outcome was A1C at 12 months; the secondary outcomes were systolic blood pressure (SBP), diastolic blood pressure, and LDL-cholesterol levels. RESULTS There was a nonsignificant trend toward improvement in A1C levels in the intervention group (from unadjusted mean A1C of 8.77 to 8.40%), as compared with usual care (from 8.58 to 8.53%) (P = 0.131). There was also a nonsignificant trend toward an increase in SBP and LDL cholesterol in the intervention arm. Intervention fidelity, measured as the number of contacts in the intervention arm (visits, phone contacts, group support, and nutritional education), showed a borderline association with greater A1C reduction (P = 0.054). When assessed separately, phone contacts were associated with greater A1C reduction (P = 0.04). CONCLUSIONS The trend toward A1C reduction with the CHW intervention failed to achieve statistical significance. Greater intervention fidelity may achieve better glycemic control, and more accessible treatment models, such as phone-based interventions, may be more efficacious in socioeconomically disadvantaged populations.
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982
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Andrasik MP, Chandler C, Powell B, Humes D, Wakefield S, Kripke K, Eckstein D. Bridging the divide: HIV prevention research and Black men who have sex with men. Am J Public Health 2014; 104:708-14. [PMID: 24524520 PMCID: PMC4025717 DOI: 10.2105/ajph.2013.301653] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/03/2013] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We obtained contextual information regarding documented barriers to HIV clinical trial participation among Black men who have sex with men (MSM), and explored current preventive HIV clinical trial attitudes, beliefs, and perceptions among Black MSM leaders in the United States. METHODS We conducted 2 focus groups with Black MSM leaders attending an annual African American MSM Leadership Conference on HIV/AIDS. Focus group questions explored biomedical research perceptions and attitudes, barriers to participation in biomedical prevention research, and steps that need to be taken to address these barriers. A feedback and member checking (participants presented with final themes to provide feedback and guidance) session was also held at the 2012 conference. RESULTS Three distinct themes emerged regarding Black MSM engagement and participation in HIV vaccine research: (1) community-based organizations as true partners, (2) investment in the Black gay community, and (3) true efforts to inform and educate the community. CONCLUSIONS A key focus for improving efforts to engage the Black MSM community in preventive HIV clinical trials is building and maintaining equitable and reciprocal partnerships among research institutions, Black-led AIDS service organizations and community-based organizations, and community members.
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Affiliation(s)
- Michele Peake Andrasik
- Michele Peake Andrasik and Steven Wakefield are with the HIV Vaccine Trials Network (HVTN), Fred Hutchinson Cancer Research Center (FHCRC), Seattle, WA. Christian Chandler is with the University of South Florida, Morsani College of Medicine, Tampa. At the time of writing and data collection, respectively, Borris Powell and Damon Humes were with HVTN Legacy Project, FHCRC, Seattle. Katharine Kripke is with Futures Institute, Washington, DC. Daniel Eckstein is with NOVA Research Company, Bethesda, MD
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983
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Engaging diverse populations about biospecimen donation for cancer research. J Community Genet 2014. [PMID: 24664489 DOI: 10.1007/s12687-014-0186-0.] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/29/2022] 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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984
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Ammerman A, Smith TW, Calancie L. Practice-Based Evidence in Public Health: Improving Reach, Relevance, and Results. Annu Rev Public Health 2014; 35:47-63. [DOI: 10.1146/annurev-publhealth-032013-182458] [Citation(s) in RCA: 107] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Alice Ammerman
- Center for Health Promotion and Disease Prevention,
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina 27599-7426; , ,
| | - Tosha Woods Smith
- Center for Health Promotion and Disease Prevention,
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina 27599-7426; , ,
| | - Larissa Calancie
- Center for Health Promotion and Disease Prevention,
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina 27599-7426; , ,
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985
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Maxwell AE, Danao LL, Cayetano RT, Crespi CM, Bastani R. Adoption of an evidence-based colorectal cancer screening promotion program by community organizations serving Filipino Americans. BMC Public Health 2014; 14:246. [PMID: 24618267 PMCID: PMC3995646 DOI: 10.1186/1471-2458-14-246] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2013] [Accepted: 03/05/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Filipino Americans have low rates of colorectal cancer (CRC) screening and high CRC mortality. To reduce this disparity, we conducted a dissemination trial in which we offered two levels of technical assistance to community organizations to disseminate an evidence-based CRC screening promotion program among their Filipino American members. This report describes the recruitment of organizations and adoption - the proportion and representativeness of organizations that decided to implement the program. METHODS During the recruitment phase, we completed organizational assessments with 44 community-based organizations (previous partners in research, organizations that were referred to us, or new organizations) to assess their eligibility to participate (having≥150 Filipino American members age 50+). We compared organizational characteristics of organizations that did and did not adopt our CRC screening promotion program. RESULTS Twenty two of the 44 community organizations that completed the assessment adopted the CRC screening promotion program (50%). Adoption was highest among organizations that had previously partnered with us (11/14=79%) and among organizations that were referred to us by community partners (5/10=50%) and lowest among new organizations (6/20=30%). Few organizational differences were found between adopters and non-adopters. CONCLUSIONS The high rate of adoption among organizations that were referred by community partners or had partnered with us in the past underscores the importance of community resources, community-academic relationships, and partnership in the dissemination process. However, the moderate rate of adoption among new organizations and the demands of completing documentation and assessments in our trial to advance dissemination research raise questions regarding the generalizability of study findings.
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Affiliation(s)
- Annette E Maxwell
- Fielding School of Public Health and Jonsson Comprehensive Cancer Center, University of California Los Angeles, 650 Charles Young Dr, South A2-125 CHS, Box 956900, Los Angeles, CA 90095-6900, USA.
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986
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Gibbs L, Waters E, de Silva A, Riggs E, Moore L, Armit C, Johnson B, Morris M, Calache H, Gussy M, Young D, Tadic M, Christian B, Gondal I, Watt R, Pradel V, Truong M, Gold L. An exploratory trial implementing a community-based child oral health promotion intervention for Australian families from refugee and migrant backgrounds: a protocol paper for Teeth Tales. BMJ Open 2014; 4:e004260. [PMID: 24622949 PMCID: PMC3963385 DOI: 10.1136/bmjopen-2013-004260] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
INTRODUCTION Inequalities are evident in early childhood caries rates with the socially disadvantaged experiencing greater burden of disease. This study builds on formative qualitative research, conducted in the Moreland/Hume local government areas of Melbourne, Victoria 2006-2009, in response to community concerns for oral health of children from refugee and migrant backgrounds. Development of the community-based intervention described here extends the partnership approach to cogeneration of contemporary evidence with continued and meaningful involvement of investigators, community, cultural and government partners. This trial aims to establish a model for child oral health promotion for culturally diverse communities in Australia. METHODS AND ANALYSIS This is an exploratory trial implementing a community-based child oral health promotion intervention for Australian families from refugee and migrant backgrounds. Families from an Iraqi, Lebanese or Pakistani background with children aged 1-4 years, residing in metropolitan Melbourne, were invited to participate in the trial by peer educators from their respective communities using snowball and purposive sampling techniques. Target sample size was 600. Moreland, a culturally diverse, inner-urban metropolitan area of Melbourne, was chosen as the intervention site. The intervention comprised peer educator led community oral health education sessions and reorienting of dental health and family services through cultural Competency Organisational Review (CORe). ETHICS AND DISSEMINATION Ethics approval for this trial was granted by the University of Melbourne Human Research Ethics Committee and the Department of Education and Early Childhood Development Research Committee. Study progress and output will be disseminated via periodic newsletters, peer-reviewed research papers, reports, community seminars and at National and International conferences. TRIAL REGISTRATION NUMBER Australian New Zealand Clinical Trials Registry (ACTRN12611000532909).
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Affiliation(s)
- Lisa Gibbs
- Jack Brockhoff Child Health and Wellbeing Program, Melbourne School of Population and Global Health, University of Melbourne, Carlton, Victoria, Australia
| | - Elizabeth Waters
- Jack Brockhoff Child Health and Wellbeing Program, Melbourne School of Population and Global Health, University of Melbourne, Carlton, Victoria, Australia
| | - Andrea de Silva
- Jack Brockhoff Child Health and Wellbeing Program, Melbourne School of Population and Global Health, University of Melbourne, Carlton, Victoria, Australia
- Dental Health Services Victoria, Carlton, Victoria, Australia
| | - Elisha Riggs
- Jack Brockhoff Child Health and Wellbeing Program, Melbourne School of Population and Global Health, University of Melbourne, Carlton, Victoria, Australia
- Healthy Mothers Healthy Families Research Group, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Laurence Moore
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, Scotland
| | - Christine Armit
- Merri Community Health Services, Brunswick, Victoria, Australia
| | - Britt Johnson
- Jack Brockhoff Child Health and Wellbeing Program, Melbourne School of Population and Global Health, University of Melbourne, Carlton, Victoria, Australia
| | - Michal Morris
- Centre for Culture, Ethnicity and Health, Richmond, Victoria, Australia
| | - Hanny Calache
- Dental Health Services Victoria, Carlton, Victoria, Australia
| | - Mark Gussy
- Department of Dentistry and Oral Health, La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia
| | - Dana Young
- Jack Brockhoff Child Health and Wellbeing Program, Melbourne School of Population and Global Health, University of Melbourne, Carlton, Victoria, Australia
| | - Maryanne Tadic
- Merri Community Health Services, Brunswick, Victoria, Australia
| | - Bradley Christian
- Jack Brockhoff Child Health and Wellbeing Program, Melbourne School of Population and Global Health, University of Melbourne, Carlton, Victoria, Australia
| | - Iqbal Gondal
- Faculty of Information Technology, Monash University and Pakistan Australia Association Melbourne, Caulfield, Victoria, Australia
| | - Richard Watt
- Epidemiology and Public Health, University College London, London, UK
| | - Veronika Pradel
- Merri Community Health Services, Brunswick, Victoria, Australia
| | - Mandy Truong
- Jack Brockhoff Child Health and Wellbeing Program, Melbourne School of Population and Global Health, University of Melbourne, Carlton, Victoria, Australia
| | - Lisa Gold
- Deakin Health Economics, Deakin University, Burwood, Victoria, Australia
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987
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Kaufman CE, Black K, Keane EM, Big Crow CK, Shangreau C, Arthur-Asmah R, Keith C, Morse B, Schaffer G, Tuitt N. Planning for a group-randomized trial with American Indian youth. J Adolesc Health 2014; 54:S59-63. [PMID: 24560078 DOI: 10.1016/j.jadohealth.2013.12.028] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2013] [Revised: 12/12/2013] [Accepted: 12/13/2013] [Indexed: 11/29/2022]
Abstract
PURPOSE To describe lessons learned working with tribal communities in the Northern Plains to plan and implement a group randomized trial of multimedia Circle of Life (mCOL), a sexual risk reduction program designed for American Indian (AI) youth. METHODS Project records including emails, travel reports, and meeting minutes were reviewed and synthesized to describe participatory development of the project. RESULTS Several challenges were identified including: discussing sexual health interventions for preteens with communities; developing a culturally appropriate research design; managing costs of conducting research in remote and culturally distinct tribal communities; and building research infrastructure of partner organizations. Opportunities for strengthening research partnerships included transparency, openness to bi-directional learning, planning for change, flexibility, and strategic use of technology. CONCLUSIONS Findings suggest that meaningful AI community participation in research trials is achievable and a critical step towards generating evidence for interventions in settings where they are most needed. Substantial investments in time, resources, and relationship-building are necessary.
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Affiliation(s)
- Carol E Kaufman
- Centers for American Indian and Alaska Native Health, University of Colorado-Anschutz Medical Campus, Aurora, Colorado.
| | - Kirsten Black
- Centers for American Indian and Alaska Native Health, University of Colorado-Anschutz Medical Campus, Aurora, Colorado
| | - Ellen M Keane
- Centers for American Indian and Alaska Native Health, University of Colorado-Anschutz Medical Campus, Aurora, Colorado
| | - Cecelia K Big Crow
- Northern Plains Regional Field Office, Pine Ridge, South Dakota, Centers for American Indian and Alaska Native Health, University of Colorado-Anschutz Medical Campus, Aurora, Colorado
| | - Carly Shangreau
- Northern Plains Regional Field Office, Pine Ridge, South Dakota, Centers for American Indian and Alaska Native Health, University of Colorado-Anschutz Medical Campus, Aurora, Colorado
| | - Ruth Arthur-Asmah
- Centers for American Indian and Alaska Native Health, University of Colorado-Anschutz Medical Campus, Aurora, Colorado
| | - Colette Keith
- Northern Plains Regional Field Office, Pine Ridge, South Dakota, Centers for American Indian and Alaska Native Health, University of Colorado-Anschutz Medical Campus, Aurora, Colorado
| | - Bradley Morse
- Centers for American Indian and Alaska Native Health, University of Colorado-Anschutz Medical Campus, Aurora, Colorado
| | - Greg Schaffer
- Centers for American Indian and Alaska Native Health, University of Colorado-Anschutz Medical Campus, Aurora, Colorado
| | - Nicole Tuitt
- Centers for American Indian and Alaska Native Health, University of Colorado-Anschutz Medical Campus, Aurora, Colorado; Center for Public Health Practice, Colorado School of Public Health, University of Colorado-Anschutz Medical Campus, Aurora, Colorado
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988
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Kupersmith J, LaBarca D. Using comparative effectiveness research to remedy health disparities. J Comp Eff Res 2014; 3:177-84. [DOI: 10.2217/cer.14.1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Health disparities are an important and continuing problem of considerable research importance. Comparative effectiveness research (CER) is an excellent vehicle to evaluate interventions to remedy disparities. We classify CER for disparities at three levels of science: basic biology, care and systems, and social and cultural context. In basic biology, genomics will delineate treatments for specific individuals and populations. Care and systems interventions are most important research areas to improve process and quality measures. However, there is evidence that correction of healthcare processes disparities will not be sufficient to improve health and that social and cultural research may be key in this regard. The methodology of CER for disparities is the same as that of other research with randomized controlled trials the gold standard and database analysis, and other observational and quasi-experimental methods important and effective. In addition, mixed methods and multilevel modeling offer promise. Community involvement in research and patient preferences among high-quality choices need to be included in planning of CER.
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Affiliation(s)
- Joel Kupersmith
- Georgetown University Medical Center, Washington, DC, USA
- Kupersmith Associates, Washington, DC, USA
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989
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Haldeman KM, Cadigan RJ, Davis A, Goldenberg A, Henderson GE, Lassiter D, Reavely E. Community engagement in US biobanking: multiplicity of meaning and method. Public Health Genomics 2014; 17:84-94. [PMID: 24556734 DOI: 10.1159/000357958] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2013] [Accepted: 11/28/2013] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND/AIMS Efforts to improve individual and population health increasingly rely on large-scale collections of human biological specimens and associated data. Such collections or 'biobanks' are hailed as valuable resources for facilitating translational biomedical research. However, biobanks also raise important ethical considerations, such as whether, how and why biobanks might engage with those who contributed specimens. This paper examines perceptions and practices of community engagement (CE) among individuals who operate 6 diverse biobanks in the US. METHODS Twenty-four people from a diverse group of 6 biobanks were interviewed in-person or via telephone from March to July 2011. Interview transcripts were coded and analyzed for common themes. RESULTS Emergent themes include how biobank personnel understand 'community' and CE as it pertains to biobank operations, information regarding the diversity of practices of CE, and the reasons why biobanks conduct CE. CONCLUSION Despite recommendations from federal agencies to conduct CE, the interpretation of CE varies widely among biobank employees, ultimately affecting how CE is practiced and what goals are achieved.
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Affiliation(s)
- K M Haldeman
- Department of Social Medicine, University of North Carolina, Chapel Hill, N.C., USA
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990
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Zoellner J, Connell C, Madson MB, Thomson JL, Landry AS, Fontenot Molaison E, Blakely Reed V, Yadrick K. HUB city steps: a 6-month lifestyle intervention improves blood pressure among a primarily African-American community. J Acad Nutr Diet 2014; 114:603-12. [PMID: 24534602 DOI: 10.1016/j.jand.2013.11.020] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2013] [Accepted: 11/21/2013] [Indexed: 10/25/2022]
Abstract
The effectiveness of community-based participatory research (CBPR) efforts to address the disproportionate burden of hypertension among African Americans remains largely untested. The objective of this 6-month, noncontrolled, pre-/post-experimental intervention was to examine the effectiveness of a CBPR intervention in achieving improvements in blood pressure, anthropometric measures, biological measures, and diet. Conducted in 2010, this multicomponent lifestyle intervention included motivational enhancement, social support provided by peer coaches, pedometer diary self-monitoring, and monthly nutrition and physical activity education sessions. Of 269 enrolled participants, 94% were African American and 85% were female. Statistical analysis included generalized linear mixed models using maximum likelihood estimation. From baseline to 6 months, blood pressure decreased significantly: mean (± standard deviation) systolic blood pressure decreased from 126.0 ± 19.1 to 119.6 ± 15.8 mm Hg, P=0.0002; mean diastolic blood pressure decreased from 83.2 ± 12.3 to 78.6 ± 11.1 mm Hg, P<0.0001). Sugar intake also decreased significantly as compared with baseline (by approximately 3 tsp; P<0.0001). Time differences were not apparent for any other measures. Results from this study suggest that CBPR efforts are a viable and effective strategy for implementing nonpharmacologic, multicomponent, lifestyle interventions that can help address the persistent racial and ethnic disparities in hypertension treatment and control. Outcome findings help fill gaps in the literature for effectively translating lifestyle interventions to reach and engage African-American communities to reduce the burden of hypertension.
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991
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Basu Roy U, Michel T, Carpenter A, Lounsbury DW, Sabino E, Stevenson AJ, Combs S, Jacobs J, Padgett D, Rapkin BD. Community-led cancer action councils in Queens, New York: process evaluation of an innovative partnership with the Queens library system. Prev Chronic Dis 2014; 11:130176. [PMID: 24503342 PMCID: PMC3921904 DOI: 10.5888/pcd11.130176] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Community-based participatory research (CBPR) has great potential to address cancer disparities, particularly in racially and ethnically diverse and underserved neighborhoods. The objective of this study was to conduct a process evaluation of an innovative academic-community partnership, Queens Library HealthLink, which aimed to reduce cancer disparities through neighborhood groups (Cancer Action Councils) that convened in public libraries in Queens, New York. METHODS We used a mixed-methods approach to conduct 69 telephone survey interviews and 4 focus groups (15 participants) with Cancer Action Council members. We used 4 performance criteria to inform data collection: action or attention to sustainability, library support for the council, social cohesion and group leadership, and activity level. Focus group transcripts were independently coded and cross-checked for consensus until saturation was achieved. RESULTS Members reported benefits and barriers to participation. Thirty-three original focus group transcript codes were organized into 8 main themes related to member experiences: 1) library as a needed resource, 2) library as a reputable and nondenominational institution, 3) value of library staff, 4) need for a HealthLink specialist, 5) generation of ideas and coordination of tasks, 6) participation challenges, 7) use of community connections, and 8) collaboration for sustainability. CONCLUSION In response to the process evaluation, Cancer Action Council members and HealthLink staff incorporated member suggestions to improve council sustainability. The councils merged to increase intercouncil collaboration, and institutional changes were made in funding to sustain a HealthLink specialist beyond the grant period.
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Affiliation(s)
- Upal Basu Roy
- New York University School of Medicine, New York, New York
| | | | | | - David W Lounsbury
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, 1300 Morris Park Ave, Belfer Building, Room 1312D, Bronx, NY 10461. E-mail:
| | | | | | - Sarah Combs
- Albert Einstein College of Medicine, Bronx, New York
| | | | - Deborah Padgett
- Silver School of Social Work, New York University, New York, New York
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992
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Henderson G, Maman S, Huang Y, Muessig K, Pan S. Social contexts of heterosexual transmission of HIV/STI in Liuzhou City, China. AIDS Behav 2014; 18 Suppl 2:S111-7. [PMID: 24337698 DOI: 10.1007/s10461-013-0666-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
In this special issue of AIDS and Behavior, we focus on the social contexts of sexual transmission of HIV/STI in one South China city. Our multiple projects grew from partnerships across the social and biomedical sciences, and with public health experts in Liuzhou City, to address critical gaps in knowledge about how social factors drive heterosexual transmission. The eleven articles that comprise this special issue feature multidisciplinary and mixed method approaches, collecting data in Liuzhou from different populations, environments, and social venues where individuals often find sexual partners. They document heterosexual behaviors and their meanings. They investigate the experiences and behaviors of women and men in social venues, exploring the networks of people within these venues, how they relate to one another, share information, and influence each other. The articles also examine the experiences of people living with HIV, again collecting data from multiple levels and sources, and revealing the ongoing power of stigma to shape these lives. Taken together, the articles demonstrate the critical role of social contexts in shaping behaviors and meanings, which are linked to heterosexual transmission of HIV/STI, and which must be taken into account for the development of appropriate and effective public health interventions.
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Affiliation(s)
- Gail Henderson
- Department of Social Medicine, University of North Carolina School of Medicine, 333 South Columbia St., 347 MacNider, Chapel Hill, NC, 27599-7240, USA,
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993
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Pearson CR, Parker M, Fisher CB, Moreno C. Capacity building from the inside out: development and evaluation of a CITI ethics certification training module for American Indian and Alaska Native community researchers. J Empir Res Hum Res Ethics 2014; 9:46-57. [PMID: 24572083 PMCID: PMC4004423 DOI: 10.1525/jer.2014.9.1.46] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Current human subject research training modules fail to capture ethically relevant cultural aspects of research involving American Indian and Alaska Native (AI/AN) community members. Applying a Community Engaged Research (CEnR) approach, we adapted the Collaborative IRB Training Initiative training module "assessing risk and benefits." In a two-arm randomized controlled trial, followed by debriefing interviews, we evaluated module acceptability and understandability (test scores) among 40 reservation-based community members. Participants who took the adapted module, compared to those who took the standard module, reported higher scores on relevance of the material overall satisfaction, module quiz scores, and a trend toward higher self-efficacy. Implications of the efficacy of this approach for enhancing ethics training and community participation in research within AI/AN and other cultural populations within and outside the United States are discussed.
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994
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Holzer J, Kass N. Community engagement strategies in the original and renewal applications for CTSA grant funding. Clin Transl Sci 2014; 7:38-43. [PMID: 24528898 PMCID: PMC5414461 DOI: 10.1111/cts.12125] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
PURPOSE The Clinical and Translational Science Award (CTSA) program has highlighted community engagement in research by requiring institutions to develop bidirectional relationships with communities to obtain funding. Little is known about how institutions have operationalized that requirement. This study aimed to describe the strategies proposed by the first institutions to receive CTSA funding and to undergo the CTSA renewal process. METHODS The authors conducted a qualitative document analysis of the community engagement section of 12 original and 10 renewal grant applications of the 12 institutions awarded CTSA funding in 2006 and renewed in 2010. RESULTS Institutions employed - and research engagement strategies. Capacity-building strategies included education, pilot grants, connecting potential partners, and community research centers. Research engagement strategies ranged from those that allowed for very little input from communities, such as announcements, to those that allowed for a high amount of input from communities, such as community-researcher teams. CONCLUSION CTSA funding has supported capacity-building for institutions and communities to partner. Engagement strategies employed by the institutions are largely known from prior community-engaged research. Based on the grants from these institutions, the CTSA funding has largely enabled institutions to develop capacity to engage.
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Affiliation(s)
- Jessica Holzer
- Department of Health Policy and ManagementYale School of Public HealthNew HavenConnecticutUSA
| | - Nancy Kass
- Department of Health Policy and ManagementJohns Hopkins Bloomberg School of Public HealthBaltimoreMarylandUSA
- Johns Hopkins Berman Institute of BioethicsBaltimoreMarylandUSA
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995
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Allen ML, Svetaz AV, Hurtado GA, Linares R, Garcia-Huidobro D, Hurtado M. The developmental stages of a community-university partnership: the experience of Padres Informados/Jovenes Preparados. Prog Community Health Partnersh 2014; 7:271-9. [PMID: 24056509 DOI: 10.1353/cpr.2013.0029] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Strong and sustained community-university partnerships are necessary for community-based participatory translational research. Little attention has been paid to understanding the trajectory of research partnerships from a developmental perspective. OBJECTIVE To propose a framework describing partnership development and maturation based on Erikson's eight stages of psychosocial development and describe how our collaboration is moving through those stages. METHODS Collaborators engaged in three rounds of iterative reflection regarding characteristics and contributors to the maturation of the Padres Informados/Jovenes Preparados (Informed Parents/Prepared Youth [PI/JP]) partnership. LESSONS LEARNED Each stage is characterized by broad developmental partnership tasks. Conflict or tension within the partnership is often a part of achieving the associated tasks. The strengths developed at each stage prepare the partnership for challenges associated with subsequent stages. CONCLUSIONS This framework could provide a means for partnerships to reflect on their strengths and challenges at a given time point, and to help understand why some partnerships fail whereas others achieve maturity.
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996
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Kochhar S, Rath B, Seeber LD, Rundblad G, Khamesipour A, Ali M. Introducing new vaccines in developing countries. Expert Rev Vaccines 2014; 12:1465-78. [DOI: 10.1586/14760584.2013.855612] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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997
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Tovar A, Must A, Metayer N, Gute DM, Pirie A, Hyatt RR, Economos CD. Immigrating to the US: what Brazilian, Latin American and Haitian women have to say about changes to their lifestyle that may be associated with obesity. J Immigr Minor Health 2014; 15:357-64. [PMID: 22736266 DOI: 10.1007/s10903-012-9665-8] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Our goal was to explore the perceived determinants of obesity in Brazilian, Latin American and Haitian women. This is part of an ongoing community-based participatory intervention. Focus groups by immigrant group were conducted and themes extracted. Women expressed differences in beliefs, attitudes, and barriers regarding diet and physical activity in the US versus their home country. Participants thought food in the US is "less natural," there is less time for preparation, and there is more variety. The weather is a barrier to physical activity in the US and work is more physically demanding. Job-related efforts were not considered physical activity. They reported higher levels of stress, less control of their time and less social support in the US. Providing immigrants with appropriate support and education early in the acculturation process has the potential to help prevent obesity.
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Affiliation(s)
- Alison Tovar
- John Hancock Research Center on Physical Activity, Nutrition, and Obesity Prevention, Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, 150 Harrison Avenue, Boston, MA 02111, USA.
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998
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Allen ML, Hurtado GA, Yon KJ, Okuyemi KS, Davey CS, Marczak MS, Stoppa P, Svetaz VM. Feasibility of a parenting program to prevent substance use among Latino youth: a community-based participatory research study. Am J Health Promot 2014; 27:240-4. [PMID: 23448413 DOI: 10.4278/ajhp.110204-arb-52] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE Family-skills training programs prevent adolescent substance use, but few exist for immigrant Latino families. This study assesses the feasibility of a family-skills training intervention developed using a community-based participatory research framework, and explores parental traditional values as a modifier of preliminary effects. DESIGN One-group pretest-posttest. SETTING Four Latino youth-serving sites (school, clinic, church, social-service agency). SUBJECTS Immigrant Latino parents of adolescents aged 10 to 14 years (N = 83). INTERVENTION Eight-session program in Spanish to improve parenting practices and parent-youth interpersonal relations designed with Latino parents and staff from collaborating organizations. MEASURES Feasibility was assessed through retention, program appropriateness, and group interaction quality. Preliminary outcomes evaluated were (1) parenting self-efficacy, discipline, harsh parenting, monitoring, conflict, attachment, acceptance, and involvement, and (2) parent perception of adolescent internalizing, externalizing, and substance use behaviors. Covariates included sociodemographics and parental endorsement of traditional values. ANALYSIS Feasibility outcomes were assessed with descriptive statistics. Paired t-tests measured changes in parenting outcomes. Adjusted multiple regression models were conducted for change in each outcome, and t-tests compared mean changes in outcomes between parents with high and low traditional values scores. RESULTS Program appropriateness and group interaction scores were positive. Improvement was noted for eight parenting outcomes. Parents perceived that adolescent internalizing behaviors decreased. Parents with lower endorsement of traditional values showed greater pretest-posttest change in attachment, acceptance, and involvement. CONCLUSION This intervention is feasible and may influence parenting contributors to adolescent substance use.
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Affiliation(s)
- Michele L Allen
- Department of Family Medicine, University of Minnesota, 717 Delaware St SE, Minneapolis, MN 55414, USA.
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999
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Cervical cancer control for Hispanic women in Texas: strategies from research and practice. Gynecol Oncol 2014; 132 Suppl 1:S26-32. [PMID: 24398135 DOI: 10.1016/j.ygyno.2013.12.038] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2013] [Revised: 12/19/2013] [Accepted: 12/27/2013] [Indexed: 01/24/2023]
Abstract
OBJECTIVE Hispanic women in Texas have among the highest rates of cervical cancer incidence and mortality in the country. Increasing regular Papanicolaou test screening and HPV vaccination are crucial to reduce the burden of cervical cancer among Hispanics. This paper presents lessons learned from community-based cervical cancer control programs for Hispanics and highlights effective intervention programs, methods and strategies. METHODS We reviewed and summarized cervical cancer control efforts targeting Hispanic women, focusing on interventions developed by researchers at the University of Texas, School of Public Health. We identified commonalities across programs, highlighted effective methods, and summarized lessons learned to help guide future intervention efforts. RESULTS Community-academic partnerships were fundamental in all steps of program development and implementation. Programs reviewed addressed psychosocial, cultural, and access barriers to cervical cancer control among low-income Hispanic women. Intervention approaches included lay health worker (LHW) and navigation models and used print media, interactive tailored media, photonovellas, client reminders, one-on-one and group education sessions. CONCLUSIONS Small media materials combined with LHW and navigation approaches were effective in delivering Pap test screening and HPV vaccination messages and in linking women to services. Common theoretical methods included in these approaches were modeling, verbal persuasion, and facilitating access. Adaptation of programs to an urban environment revealed that intensive navigation was needed to link women with multiple access barriers to health services. Collectively, this review reveals 1) the importance of using a systematic approach for planning and adapting cervical cancer control programs; 2) advantages of collaborative academic-community partnerships to develop feasible interventions with broad reach; 3) the use of small media and LHW approaches and the need for tailored phone navigation in urban settings; and 4) coordination and technical assistance of community-based efforts as a way to maximize resources.
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1000
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Williams L, Gorman R, Hankerson S. Implementing a mental health ministry committee in faith-based organizations: the promoting emotional wellness and spirituality program. SOCIAL WORK IN HEALTH CARE 2014; 53:414-34. [PMID: 24717187 PMCID: PMC4000587 DOI: 10.1080/00981389.2014.880391] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
Social workers have successfully collaborated with African-American faith-based organizations to improve health outcomes for numerous medical conditions. However, the literature on Faith-Based Health Promotion for major depression is sparse. Thus, the authors describe a program used to implement a Mental Health Ministry Committee in African-American churches. Program goals are to educate clergy, reduce stigma, and promote treatment seeking for depression. Key lessons learned are to initially form partnerships with church staff if there is not a preexisting relationship with the lead pastor, to utilize a community-based participatory approach, and to have flexibility in program implementation.
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Affiliation(s)
- Laverne Williams
- a Mental Health Association in New Jersey , Verona , New Jersey , USA
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