Community engagement in research: frameworks for education and peer review

Search terms and a validated brief search filter to retrieve publications on health-related values in Medline: a word frequency analysis study

OBJECTIVE

Healthcare debates and policy developments are increasingly concerned with a broad range of values-related areas. These include not only ethical, moral, religious, and other types of values 'proper', but also beliefs, preferences, experiences, choices, satisfaction, quality of life, etc. Research on such issues may be difficult to retrieve. This study used word frequency analysis to generate a broad pool of search terms and a brief filter to facilitate relevant searches in bibliographic databases.

METHODS

Word frequency analysis for 'values terms' was performed on citations on diabetes, obesity, dementia, and schizophrenia (Medline; 2004-2006; 4440 citations; 1,110,291 words). Concordance® and SPSS 14.0 were used. Text words and MeSH terms of high frequency and precision were compiled into a search filter. It was validated on datasets of citations on dentistry and food hypersensitivity.

RESULTS

144 unique text words and 124 unique MeSH terms of moderate and high frequency (≥ 20) and very high precision (≥ 90%) were identified. Of these, 19 text words and seven MeSH terms were compiled into a 'brief values filter'. In the derivation dataset, it had a sensitivity of 76.8% and precision of 86.8%. In the validation datasets, its sensitivity and precision were, respectively, 70.1% and 63.6% (food hypersensitivity) and 47.1% and 82.6% (dentistry).

CONCLUSIONS

This study provided a varied pool of search terms and a simple and highly effective tool for retrieving publications on health-related values. Further work is required to facilitate access to such research and enhance its chances of being translated into practice, policy, and service improvements.

ENGAGING THE COMMUNITY IN HEALTH RESEARCH IN INDIA

Community-engaged research approaches involve members of the community in various aspects of a research endeavor to improve the health of populations. Engaging the community in research is important in the development, dissemination, and evaluation of new interventions, technologies, and other medical advancements to improve population health globally. A review of published community-engaged research studies conducted in India was performed. Fifteen published studies were identified and reviewed to evaluate the state of community-engaged research in India. The review indicated that community-engaged research in India is limited. Most published community-engaged research focused on health promotion, especially in the prevention or management of HIV/AIDS and other STIs. Community members were involved in a variety of aspects of the research, but there was not one published article indicating that community members had defined the disease of focus. Community-engaged research often led to valuable insights into the views, experiences, and behaviors of community members and also led to increased community participation in health initiatives. It is anticipated that future community-engaged research will lead to improvements in global health through increased empowerment of communities and a better ability to implement new and innovative medical advances, technologies, and interventions.

Aligning the goals of community-engaged research: why and how academic health centers can successfully engage with communities to improve health

Community engagement (CE) and community-engaged research (CEnR) are increasingly viewed as the keystone to translational medicine and improving the health of the nation. In this article, the authors seek to assist academic health centers (AHCs) in learning how to better engage with their communities and build a CEnR agenda by suggesting five steps: defining community and identifying partners, learning the etiquette of CE, building a sustainable network of CEnR researchers, recognizing that CEnR will require the development of new methodologies, and improving translation and dissemination plans. Health disparities that lead to uneven access to and quality of care as well as high costs will persist without a CEnR agenda that finds answers to both medical and public health questions. One of the biggest barriers toward a national CEnR agenda, however, are the historical structures and processes of an AHC-including the complexities of how institutional review boards operate, accounting practices and indirect funding policies, and tenure and promotion paths. Changing institutional culture starts with the leadership and commitment of top decision makers in an institution. By aligning the motivations and goals of their researchers, clinicians, and community members into a vision of a healthier population, AHC leadership will not just improve their own institutions but also improve the health of the nation-starting with improving the health of their local communities, one community at a time.

Community-academic partnerships: how can communities benefit?

In answer to the question of how academic institutions will meet medical education needs and public health challenges of the 21st century, a strong, vibrant, and sustained community partnership has been developed to teach public health, address community public health needs, and develop health policy to sustain these improvements, all with a practical approach. In this paper, the partnership between the University of Vermont College of Medicine and various community agencies is described from the perspective of how the community can benefit from educational efforts in public health. Particular focus is given to the community-academic partnership model in public health, a strong and sustained partnership between the University of Vermont College of Medicine and the United Way of Chittenden County Volunteer Center that began in 2004. Public health projects are designed, through partnerships with community nonprofit agencies, to be effective in addressing community issues while helping prepare students to become problem-solvers in population health. Examples of benefits seen by the community are used to illustrate the success of this approach. Project examples and a brief case study illustrate how community-academic partnerships in medical education can serve as a "catalyst" to improving community health.

A review of current ethical concerns and challenges in substance use disorder research

PURPOSE OF REVIEW

To consider and summarize provocative and important publications from 2009 and 2010 related to the ethics of international substance use disorder research.

RECENT FINDINGS

This review highlights publications related to the interconnected areas of responsible conduct of research, human participant protections and the increasingly important area of community concerns in research, all within the larger realm of ethical concerns. Ongoing concerns highlighted include standards for conflict of interest, recruitment and remuneration practices. Other literature discussed expands the ethical dialogue to consider the community perspective on research, stigmatization of drug users from research and the absence of the 'moral voice' of drug users in ethical decision-making.

SUMMARY

Ethical dilemmas are inherent in the pursuit of any research; in substance use disorder research, often situated in a community with at-risk populations, questions such as who sets the research agenda and what norms are followed are critically important. Responsible research that protects participants and their communities internationally requires ongoing vigilance.

Building community-engaged health research and discovery infrastructure on the South Side of Chicago: science in service to community priorities

OBJECTIVE

To describe the roles community members can and should play in, and an asset-based strategy used by Chicago's South Side Health and Vitality Studies for, building sustainable, large-scale community health research infrastructure. The Studies are a family of research efforts aiming to produce actionable knowledge to inform health policy, programming, and investments for the region.

METHODS

Community and university collaborators, using a consensus-based approach, developed shared theoretical perspectives, guiding principles, and a model for collaboration in 2008, which were used to inform an asset-based operational strategy. Ongoing community engagement and relationship-building support the infrastructure and research activities of the studies.

RESULTS

Key steps in the asset-based strategy include: 1) continuous community engagement and relationship building, 2) identifying community priorities, 3) identifying community assets, 4) leveraging assets, 5) conducting research, 6) sharing knowledge and 7) informing action. Examples of community member roles, and how these are informed by the Studies' guiding principles, are provided.

CONCLUSIONS

Community and university collaborators, with shared vision and principles, can effectively work together to plan innovative, large-scale community-based research that serves community needs and priorities. Sustainable, effective models are needed to realize NIH's mandate for meaningful translation of biomedical discovery into improved population health.

Is community-based participatory research possible?

The researcher seeking guidance in conducting research that is truly community-participatory may fınd too much guidance rather than too little and must recognize that his or her project will be evaluated not only on the quality of the science, but on the extent to which it adheres to the principles of CBPR.

Ethical Challenges in a Randomized Controlled Trial of Peer Education Among Veterans Service Organizations

Efforts to increase community members' involvement in research may create novel ethical challenges. We describe an ongoing randomized trial of a peer-delivered intervention to encourage hypertension self-management. Community members serving as peer leaders participate in subject recruitment, the informed consent process, and intervention. We describe our experience with several ethical issues that may arise when conducting research in similar settings: (1) coercion of community members, by the community, to participate either as leaders or as study subjects; (2) threats to the privacy of health information; and (3) conflict between peer leaders' roles as community members and study team members.