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Madden EB, Hindorff LA, Bonham VL, Akintobi TH, Burchard EG, Baker KE, Begay RL, Carpten JD, Cox NJ, Di Francesco V, Dillard DA, Fletcher FE, Fullerton SM, Garrison NA, Hammack-Aviran CM, Hiratsuka VY, Hildreth JEK, Horowitz CR, Hughes Halbert CA, Inouye M, Jackson A, Landry LG, Kittles RA, Leek JT, Limdi NA, Lockhart NC, Ofili EO, Pérez-Stable EJ, Sabatello M, Saulsberry L, Schools LE, Troyer JL, Wilfond BS, Wojcik GL, Cho JH, Lee SSJ, Green ED. Advancing genomics to improve health equity. Nat Genet 2024; 56:752-757. [PMID: 38684898 PMCID: PMC11096049 DOI: 10.1038/s41588-024-01711-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 03/08/2024] [Indexed: 05/02/2024]
Abstract
Health equity is the state in which everyone has fair and just opportunities to attain their highest level of health. The field of human genomics has fallen short in increasing health equity, largely because the diversity of the human population has been inadequately reflected among participants of genomics research. This lack of diversity leads to disparities that can have scientific and clinical consequences. Achieving health equity related to genomics will require greater effort in addressing inequities within the field. As part of the commitment of the National Human Genome Research Institute (NHGRI) to advancing health equity, it convened experts in genomics and health equity research to make recommendations and performed a review of current literature to identify the landscape of gaps and opportunities at the interface between human genomics and health equity research. This Perspective describes these findings and examines health equity within the context of human genomics and genomic medicine.
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Affiliation(s)
- Ebony B Madden
- Office of the Director, National Human Genome Research Institute, Bethesda, MD, USA.
| | - Lucia A Hindorff
- Office of the Director, National Human Genome Research Institute, Bethesda, MD, USA
| | - Vence L Bonham
- Office of the Director, National Human Genome Research Institute, Bethesda, MD, USA
| | - Tabia Henry Akintobi
- Department of Community Health and Preventative Medicine, Morehouse School of Medicine, Atlanta, GA, USA
| | - Esteban G Burchard
- Department of Bioengineering and Therapeutic Sciences, University of California, San Francisco, CA, USA
| | | | - Rene L Begay
- Centers for American Indian and Alaska Native Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - John D Carpten
- Comprehensive Cancer Center, City of Hope, Duarte, CA, USA
| | - Nancy J Cox
- Vanderbilt Genetics Institute, Vanderbilt University, Nashville, TN, USA
| | | | - Denise A Dillard
- Department of Medical Education and Clinical Sciences, Washington State University College of Medicine, Seattle, WA, USA
| | - Faith E Fletcher
- Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, TX, USA
| | | | - Nanibaa' A Garrison
- Institute for Society and Genetics, University of California, Los Angeles, Los Angeles, CA, USA
- Institute for Precision Health, UCLA David Geffen School of Medicine, Los Angeles, CA, USA
- Division of General Internal Medicine and Health Services Research, UCLA David Geffen School of Medicine, Los Angeles, CA, USA
| | | | - Vanessa Y Hiratsuka
- Center for Human Development, University of Alaska Anchorage, Anchorage, AK, USA
| | | | | | - Chanita A Hughes Halbert
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
| | - Michael Inouye
- Department of Public Health and Primary Care, University of Cambridge Victor Phillip Dahdaleh Heart and Lung Research Institute, Cambridge, UK
| | - Amber Jackson
- Office of the Director, National Human Genome Research Institute, Bethesda, MD, USA
| | - Latrice G Landry
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | | | - Jeff T Leek
- Fred Hutchinson Cancer Research Center, University of Washington, Seattle, WA, USA
| | - Nita A Limdi
- Department of Neurology, University of Alabama, Birmingham School of Medicine, Birmingham, AL, USA
| | - Nicole C Lockhart
- Office of the Director, National Human Genome Research Institute, Bethesda, MD, USA
| | - Elizabeth O Ofili
- Department of Medicine, Morehouse School of Medicine, Atlanta, GA, USA
| | | | - Maya Sabatello
- Center for Precision Medicine and Genomics, Columbia University, New York, NY, USA
- Department of Medical Humanities and Ethics, Columbia University, New York, NY, USA
| | - Loren Saulsberry
- Department of Public Health Sciences, The University of Chicago, Chicago, IL, USA
| | | | - Jennifer L Troyer
- Office of the Director, National Human Genome Research Institute, Bethesda, MD, USA
| | | | - Genevieve L Wojcik
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Judy H Cho
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Sandra S-J Lee
- Department of Medical Humanities and Ethics, Columbia University, New York, NY, USA
| | - Eric D Green
- Office of the Director, National Human Genome Research Institute, Bethesda, MD, USA
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Enlow PT, Thomas C, Osorio AM, Lee M, Miller JM, Pelaez L, Kazak AE, Phan TLT. Community Partnership to Co-Develop an Intervention to Promote Equitable Uptake of the COVID-19 Vaccine Among Pediatric Populations. Dela J Public Health 2024; 10:30-38. [PMID: 38572140 PMCID: PMC10987021 DOI: 10.32481/djph.2024.03.06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2024] Open
Abstract
Objective To describe the process of engaging community, caregiver, and youth partners in codeveloping an intervention to promote equitable uptake of the COVID-19 vaccine in non-Hispanic Black (Black) and Hispanic youth who experience higher rates of COVID-19 transmission, morbidity, and mortality but were less likely to receive the COVID-19 vaccine. Methods A team of 11 Black and Hispanic community partners was assembled to codevelop intervention strategies with our interdisciplinary research team. We used a mixed-methods crowdsourcing approach with Black and Hispanic youth (n=15) and caregivers of Black and Hispanic youth (n=20) who had not yet been vaccinated against COVID-19, recruited from primary care clinics, to elicit perspectives on the acceptability of these intervention strategies. Results We codeveloped five strategies: (1) community-tailored handouts and posters, (2) videos featuring local youth, (3) family-centered language to offer vaccines in the primary care clinic, (4) communication-skills training for primary care providers, and (5) use of community health workers to counsel families about the vaccine. The majority (56-96.9%) of youth and caregivers rated each of these strategies as acceptable, especially because they addressed common concerns and facilitated shared decision-making. Conclusions Engaging community and family partners led to the co-development of culturally- and locally-tailored strategies to promote dialogue and shared decision-making about the COVID-19 vaccine. This process can be used to codevelop interventions to address other forms of public health disparities. Policy Implications Intervention strategies that promote dialogues with trusted healthcare providers and support shared decision-making are acceptable strategies to promote COVID-19 vaccine uptake among youth from historically underserved communities. Stakeholder-engaged methods may also help in the development of interventions to address other forms of health disparities.
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Affiliation(s)
- Paul T Enlow
- Center for Healthcare Delivery Science, Nemours Children's Hospital Delaware; Department of Pediatrics, Sidney Kimmel Medical College, Thomas Jefferson University
| | - Courtney Thomas
- Center for Healthcare Delivery Science, Nemours Children's Hospital Delaware
| | - Angel Munoz Osorio
- Center for Healthcare Delivery Science, Nemours Children's Hospital Delaware
| | - Marshala Lee
- Harrington Value Institute Community Partnership Fund, ChristianaCare Health System
| | - Jonathan M Miller
- Inclusion, Diversity, Equity, and Alignment, Nemours Children's Health; Department of Pediatrics, Sidney Kimmel Medical College, Thomas Jefferson University
| | - Lavisha Pelaez
- Inclusion, Diversity, Equity, and Alignment, Nemours Children's Health
| | - Anne E Kazak
- Center for Healthcare Delivery Science, Nemours Children's Hospital Delaware; Department of Pediatrics, Sidney Kimmel Medical College, Thomas Jefferson University
| | - Thao-Ly T Phan
- Center for Healthcare Delivery Science, Nemours Children's Hospital Delaware; Department of Pediatrics, Sidney Kimmel Medical College, Thomas Jefferson University
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Mrklas KJ, Boyd JM, Shergill S, Merali S, Khan M, Moser C, Nowell L, Goertzen A, Swain L, Pfadenhauer LM, Sibley KM, Vis-Dunbar M, Hill MD, Raffin-Bouchal S, Tonelli M, Graham ID. A scoping review of the globally available tools for assessing health research partnership outcomes and impacts. Health Res Policy Syst 2023; 21:139. [PMID: 38129871 PMCID: PMC10740226 DOI: 10.1186/s12961-023-00958-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Accepted: 01/03/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND Health research partnership approaches have grown in popularity over the past decade, but the systematic evaluation of their outcomes and impacts has not kept equal pace. Identifying partnership assessment tools and key partnership characteristics is needed to advance partnerships, partnership measurement, and the assessment of their outcomes and impacts through systematic study. OBJECTIVE To locate and identify globally available tools for assessing the outcomes and impacts of health research partnerships. METHODS We searched four electronic databases (Ovid MEDLINE, Embase, CINAHL + , PsychINFO) with an a priori strategy from inception to June 2021, without limits. We screened studies independently and in duplicate, keeping only those involving a health research partnership and the development, use and/or assessment of tools to evaluate partnership outcomes and impacts. Reviewer disagreements were resolved by consensus. Study, tool and partnership characteristics, and emerging research questions, gaps and key recommendations were synthesized using descriptive statistics and thematic analysis. RESULTS We screened 36 027 de-duplicated citations, reviewed 2784 papers in full text, and kept 166 studies and three companion reports. Most studies originated in North America and were published in English after 2015. Most of the 205 tools we identified were questionnaires and surveys targeting researchers, patients and public/community members. While tools were comprehensive and usable, most were designed for single use and lacked validity or reliability evidence. Challenges associated with the interchange and definition of terms (i.e., outcomes, impacts, tool type) were common and may obscure partnership measurement and comparison. Very few of the tools identified in this study overlapped with tools identified by other, similar reviews. Partnership tool development, refinement and evaluation, including tool measurement and optimization, are key areas for future tools-related research. CONCLUSION This large scoping review identified numerous, single-use tools that require further development and testing to improve their psychometric and scientific qualities. The review also confirmed that the health partnership research domain and its measurement tools are still nascent and actively evolving. Dedicated efforts and resources are required to better understand health research partnerships, partnership optimization and partnership measurement and evaluation using valid, reliable and practical tools that meet partners' needs.
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Affiliation(s)
- Kelly J Mrklas
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3D10-3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada.
- Strategic Clinical Networks™, Provincial Clinical Excellence, Alberta Health Services, Calgary, AB, Canada.
| | - Jamie M Boyd
- Knowledge Translation Program, St Michael's Hospital, Li Ka Shing Knowledge Institute, Unity Health Toronto, Toronto, ON, Canada
| | - Sumair Shergill
- Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Sera Merali
- Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
| | - Masood Khan
- Department of Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Cheryl Moser
- Department of Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Lorelli Nowell
- Faculty of Nursing, University of Calgary, Calgary, AB, Canada
| | - Amelia Goertzen
- Faculty of Science, University of Alberta, Edmonton, AB, Canada
| | - Liam Swain
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3D10-3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada
| | - Lisa M Pfadenhauer
- Institute for Medical Information Processing, and Epidemiology-IBE, Ludwig-Maximilians Universität Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - Kathryn M Sibley
- Department of Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada
- George & Fay Yee Centre for Healthcare Innovation, University of Manitoba, Winnipeg, MB, Canada
| | | | - Michael D Hill
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3D10-3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada
- Departments of Clinical Neurosciences, Medicine and Radiology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | | | - Marcello Tonelli
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Office of the Vice-President (Research), University of Calgary, Calgary, AB, Canada
| | - Ian D Graham
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
- Schools of Epidemiology and Public Health and Nursing, University of Ottawa, Ottawa, ON, Canada
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Attell BK, Kingery K, Adimu T, Butts J, Howard P, Saha S, Minyard K. Development and Validation of a Measure to Assess Readiness to Advance Health and Equity: The Assessment for Advancing Community Transformation (AACT). Eval Health Prof 2023; 46:309-319. [PMID: 36373963 PMCID: PMC10637080 DOI: 10.1177/01632787221139244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2023]
Abstract
Multi-sector partnerships are core in efforts to improve population health but are often not as fully developed or positioned to advance health and equity in their communities as believed to be. Therefore, measuring the collaborations multi-sector partnerships undertake is important to document the inputs, processes, and outcomes that evolve as they work together towards achieving their goals, which ultimately creates a greater sense of shared accountability. In this study we present the development and validation of the Assessment for Advancing Community Transformation (AACT), a new tool designed to measure readiness to advance health and health equity. Development of the AACT included initial item pool creation, external evaluation from five subject matter experts, and pilot testing (including user feedback surveys) among 103 individuals. Validation of the AACT was performed using a series of confirmatory factor analyses on an expanded dataset representing 352 individuals from 49 multi-sector collaboratives across the United States. The results of our study indicate the items in the AACT align to six domains created during the scale development process, and that the tool demonstrates desirable measurement characteristics for use in research, evaluation, and practice.
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Affiliation(s)
- Brandon K. Attell
- Georgia Health Policy Center, Georgia State University, Atlanta, GA, USA
| | - Kate Kingery
- University of Wisconsin-Madison, Madison, WI, USA
| | - Tanisa Adimu
- Georgia Health Policy Center, Georgia State University, Atlanta, GA, USA
| | - John Butts
- Georgia Health Policy Center, Georgia State University, Atlanta, GA, USA
| | - Paul Howard
- Institute for Healthcare Improvement, Boston, MA, USA
| | - Somava Saha
- Well-Being and Equity (WE) in the World, City of Industry, CA, USA
| | - Karen Minyard
- Georgia Health Policy Center, Georgia State University, Atlanta, GA, USA
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Snelling A, Hawkins M, McClave R, Irvine Belson S. The Role of Teachers in Addressing Childhood Obesity: A School-Based Approach. Nutrients 2023; 15:3981. [PMID: 37764765 PMCID: PMC10535151 DOI: 10.3390/nu15183981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 09/07/2023] [Accepted: 09/12/2023] [Indexed: 09/29/2023] Open
Abstract
Childhood obesity is one of the most prevalent public health challenges in the United States, and although rates are declining overall, rates among children living in underserved neighborhoods are increasing. This five-year intervention project seeks to empower teachers (n = 92) to invest in their own health and then integrate nutrition concepts into core subjects' lessons in elementary schools. The professional development sessions reflect the concepts in the Whole Child, Whole School, Whole Community model. Results indicate that teachers who attended professional development sessions were more likely to implement nutrition lessons in the classroom (r = 0.54, p < 0.01), and students demonstrated a significant increase in nutrition knowledge (p < 0.001, df = 2, F = 9.66). Investing in school-based programs that ensure teacher well-being and professional development can yield positive benefits for both teachers and students.
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Affiliation(s)
- Anastasia Snelling
- Department of Health Studies, College of Arts & Sciences, American University, Washington, DC 20016, USA; (M.H.); (R.M.)
| | - Melissa Hawkins
- Department of Health Studies, College of Arts & Sciences, American University, Washington, DC 20016, USA; (M.H.); (R.M.)
| | - Robin McClave
- Department of Health Studies, College of Arts & Sciences, American University, Washington, DC 20016, USA; (M.H.); (R.M.)
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Sibley KM, Khan M, Touchette AJ, Crockett LK, Driedger SM, Gainforth HL, Prabhu D, Steliga D, Tefft O, Graham ID. Characterizing Canadian funded partnered health research projects between 2011 and 2019: a retrospective analysis. Health Res Policy Syst 2023; 21:92. [PMID: 37684637 PMCID: PMC10492355 DOI: 10.1186/s12961-023-01046-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 08/23/2023] [Indexed: 09/10/2023] Open
Abstract
BACKGROUND AND AIMS Involving research users in collaborative research approaches may increase the relevance and utility of research findings. Our primary objectives were to (i) identify and describe characteristics of Canadian federally and provincially funded health research projects that included research users and were funded between 2011 and 2019; (ii) explore changes over time; and (iii) compare characteristics between funder required and optional partnerships. METHODS Retrospective analysis. Inclusion criteria were projects that included research users. We analyzed publicly available project variables, and coded field and type of research using established classification systems. We summarized data with descriptive statistics and compared variables across three funding year blocks and partnership requirement status. RESULTS We identified 1153 partnered health research projects, representing 137 fields of research and 37 types of research categories. Most projects included a required partnership (80%) and fell into health and social care services research (66%). Project length and funding amount increased from average of 24.8 months and $266 248 CAD in 2011-2013 to 31.6 months and $438 766 CAD in 2017-2019. There were significantly fewer required partnerships in 2017-2019. CONCLUSIONS Between 2011 and 2019 Canadian federally and provincially funded partnered health research reflected primarily care services research across many fields. The observed breadth suggests that partnered health research approaches are applicable in many fields of research. Additional work to support partnered research across all types of health research (especially biomedical research) is warranted. The administration of larger grants that are funded for longer time periods may address previously identified concerns among research teams engaging in partnered research but may mean that fewer teams receive funding and risk delaying responding to time-sensitive data needs for users. Our process and findings can be used as a starting point for international comparison.
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Affiliation(s)
- Kathryn M Sibley
- Department of Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada.
- Knowledge Translation, George & Fay Yee Centre for Healthcare Innovation, Winnipeg, MB, Canada.
| | - Masood Khan
- Knowledge Translation, George & Fay Yee Centre for Healthcare Innovation, Winnipeg, MB, Canada
| | - Alexie J Touchette
- Knowledge Translation, George & Fay Yee Centre for Healthcare Innovation, Winnipeg, MB, Canada
| | - Leah K Crockett
- Department of Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada
- Knowledge Translation, George & Fay Yee Centre for Healthcare Innovation, Winnipeg, MB, Canada
| | - S Michelle Driedger
- Department of Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Heather L Gainforth
- School of Health and Exercise Sciences, University of British Columbia, Kelowna, BC, Canada
- International Collaboration on Repair Discoveries, University of British Columbia, Kelowna, BC, Canada
| | - Devashree Prabhu
- Knowledge Translation, George & Fay Yee Centre for Healthcare Innovation, Winnipeg, MB, Canada
| | - Dawn Steliga
- Knowledge Translation, George & Fay Yee Centre for Healthcare Innovation, Winnipeg, MB, Canada
| | - Olivia Tefft
- Knowledge Translation, George & Fay Yee Centre for Healthcare Innovation, Winnipeg, MB, Canada
| | - Ian D Graham
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
- Centre for Implementation Research, Ottawa Hospital Research Institute, Ottawa, ON, Canada
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Mrklas KJ, Boyd JM, Shergill S, Merali S, Khan M, Nowell L, Goertzen A, Pfadenhauer LM, Paul K, Sibley KM, Swain L, Vis-Dunbar M, Hill MD, Raffin-Bouchal S, Tonelli M, Graham ID. Tools for assessing health research partnership outcomes and impacts: a systematic review. Health Res Policy Syst 2023; 21:3. [PMID: 36604697 PMCID: PMC9817421 DOI: 10.1186/s12961-022-00937-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 11/08/2022] [Indexed: 01/07/2023] Open
Abstract
OBJECTIVE To identify and assess the globally available valid, reliable and acceptable tools for assessing health research partnership outcomes and impacts. METHODS We searched Ovid MEDLINE, Embase, CINAHL Plus and PsycINFO from origin to 2 June 2021, without limits, using an a priori strategy and registered protocol. We screened citations independently and in duplicate, resolving discrepancies by consensus and retaining studies involving health research partnerships, the development, use and/or assessment of tools to evaluate partnership outcomes and impacts, and reporting empirical psychometric evidence. Study, tool, psychometric and pragmatic characteristics were abstracted using a hybrid approach, then synthesized using descriptive statistics and thematic analysis. Study quality was assessed using the quality of survey studies in psychology (Q-SSP) checklist. RESULTS From 56 123 total citations, we screened 36 027 citations, assessed 2784 full-text papers, abstracted data from 48 studies and one companion report, and identified 58 tools. Most tools comprised surveys, questionnaires and scales. Studies used cross-sectional or mixed-method/embedded survey designs and employed quantitative and mixed methods. Both studies and tools were conceptually well grounded, focusing mainly on outcomes, then process, and less frequently on impact measurement. Multiple forms of empirical validity and reliability evidence was present for most tools; however, psychometric characteristics were inconsistently assessed and reported. We identified a subset of studies (22) and accompanying tools distinguished by their empirical psychometric, pragmatic and study quality characteristics. While our review demonstrated psychometric and pragmatic improvements over previous reviews, challenges related to health research partnership assessment and the nascency of partnership science persist. CONCLUSION This systematic review identified multiple tools demonstrating empirical psychometric evidence, pragmatic strength and moderate study quality. Increased attention to psychometric and pragmatic requirements in tool development, testing and reporting is key to advancing health research partnership assessment and partnership science. PROSPERO CRD42021137932.
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Affiliation(s)
- K. J. Mrklas
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3D10, 3280 Hospital Drive NW, Calgary, AB T2N 4Z6 Canada
- Strategic Clinical Networks™, Provincial Clinical Excellence, Alberta Health Services, Calgary, AB Canada
| | - J. M. Boyd
- Knowledge Translation Program, St Michael’s Hospital, Li Ka Shing Knowledge Institute, Unity Health Toronto, Toronto, ON Canada
| | - S. Shergill
- Cumming School of Medicine, University of Calgary, Calgary, AB Canada
| | - S. Merali
- Faculty of Kinesiology, University of Calgary, Calgary, AB Canada
| | - M. Khan
- Department of Community Health Sciences, University of Manitoba, Winnipeg, MB Canada
| | - L. Nowell
- Faculty of Nursing, University of Calgary, Calgary, AB Canada
| | - A. Goertzen
- Faculty of Science, University of Alberta, Edmonton, AB Canada
| | - L. M. Pfadenhauer
- Institute for Medical Information Processing, Biometry, and Epidemiology–IBE, Ludwig-Maximilian Universität Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - K. Paul
- University of Calgary Summer Studentships Program, Calgary, AB Canada
| | - K. M. Sibley
- Department of Community Health Sciences, University of Manitoba, Winnipeg, MB Canada
- George & Fay Yee Centre for Healthcare Innovation, University of Manitoba, Winnipeg, MB Canada
| | - L. Swain
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3D10, 3280 Hospital Drive NW, Calgary, AB T2N 4Z6 Canada
| | - M. Vis-Dunbar
- University of British Columbia - Okanagan, Kelowna, BC Canada
| | - M. D. Hill
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3D10, 3280 Hospital Drive NW, Calgary, AB T2N 4Z6 Canada
- Departments of Clinical Neurosciences, Medicine and Radiology, Cumming School of Medicine, University of Calgary, Calgary, AB Canada
- Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, AB Canada
| | | | - M. Tonelli
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB Canada
- Office of the Vice-President (Research), University of Calgary, Calgary, AB Canada
| | - I. D. Graham
- Centre for Implementation Research, Ottawa Hospital Research Institute, Ottawa, ON Canada
- School of Epidemiology and Public Health & School of Nursing, University of Ottawa, Ottawa, ON Canada
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Mrklas KJ, Merali S, Khan M, Shergill S, Boyd JM, Nowell L, Pfadenhauer LM, Paul K, Goertzen A, Swain L, Sibley KM, Vis-Dunbar M, Hill MD, Raffin-Bouchal S, Tonelli M, Graham ID. How are health research partnerships assessed? A systematic review of outcomes, impacts, terminology and the use of theories, models and frameworks. Health Res Policy Syst 2022; 20:133. [DOI: 10.1186/s12961-022-00938-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 11/09/2022] [Indexed: 12/15/2022] Open
Abstract
Abstract
Background
Accurate, consistent assessment of outcomes and impacts is challenging in the health research partnerships domain. Increased focus on tool quality, including conceptual, psychometric and pragmatic characteristics, could improve the quantification, measurement and reporting partnership outcomes and impacts. This cascading review was undertaken as part of a coordinated, multicentre effort to identify, synthesize and assess a vast body of health research partnership literature.
Objective
To systematically assess the outcomes and impacts of health research partnerships, relevant terminology and the type/use of theories, models and frameworks (TMF) arising from studies using partnership assessment tools with known conceptual, psychometric and pragmatic characteristics.
Methods
Four electronic databases were searched (MEDLINE, Embase, CINAHL Plus and PsycINFO) from inception to 2 June 2021. We retained studies containing partnership evaluation tools with (1) conceptual foundations (reference to TMF), (2) empirical, quantitative psychometric evidence (evidence of validity and reliability, at minimum) and (3) one or more pragmatic characteristics. Outcomes, impacts, terminology, definitions and TMF type/use were abstracted verbatim from eligible studies using a hybrid (independent abstraction–validation) approach and synthesized using summary statistics (quantitative), inductive thematic analysis and deductive categories (qualitative). Methodological quality was assessed using the Quality Assessment Tool for Studies with Diverse Designs (QATSDD).
Results
Application of inclusion criteria yielded 37 eligible studies. Study quality scores were high (mean 80%, standard deviation 0.11%) but revealed needed improvements (i.e. methodological, reporting, user involvement in research design). Only 14 (38%) studies reported 48 partnership outcomes and 55 impacts; most were positive effects (43, 90% and 47, 89%, respectively). Most outcomes were positive personal, functional, structural and contextual effects; most impacts were personal, functional and contextual in nature. Most terms described outcomes (39, 89%), and 30 of 44 outcomes/impacts terms were unique, but few were explicitly defined (9, 20%). Terms were complex and mixed on one or more dimensions (e.g. type, temporality, stage, perspective). Most studies made explicit use of study-related TMF (34, 92%). There were 138 unique TMF sources, and these informed tool construct type/choice and hypothesis testing in almost all cases (36, 97%).
Conclusion
This study synthesized partnership outcomes and impacts, deconstructed term complexities and evolved our understanding of TMF use in tool development, testing and refinement studies. Renewed attention to basic concepts is necessary to advance partnership measurement and research innovation in the field.
Systematic review protocol registration: PROSPERO protocol registration: CRD42021137932 https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=137932.
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Oetzel JG, Boursaw B, Magarati M, Dickson E, Sanchez-Youngman S, Morales L, Kastelic S, Eder MM, Wallerstein N. Exploring theoretical mechanisms of community-engaged research: a multilevel cross-sectional national study of structural and relational practices in community-academic partnerships. Int J Equity Health 2022; 21:59. [PMID: 35501798 PMCID: PMC9063068 DOI: 10.1186/s12939-022-01663-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 04/17/2022] [Indexed: 11/10/2022] Open
Abstract
Background Community-Based Participatory Research (CBPR) is often used to address health inequities due to structural racism. However, much of the existing literature emphasizes relationships and synergy rather than structural components of CBPR. This study introduces and tests new theoretical mechanisms of the CBPR Conceptual Model to address this limitation. Methods Three-stage online cross-sectional survey administered from 2016 to 2018 with 165 community-engaged research projects identified through federal databases or training grants. Participants (N = 453) were principal investigators and project team members (both academic and community partners) who provided project-level details and perceived contexts, processes, and outcomes. Data were analyzed through structural equation modeling and fuzzy-set qualitative comparison analysis. Results Commitment to Collective Empowerment was a key mediating variable between context and intervention activities. Synergy and Community Engagement in Research Actions were mediating variables between context/partnership process and outcomes. Collective Empowerment was most strongly aligned with Synergy, while higher levels of Structural Governance and lower levels of Relationships were most consistent with higher Community Engagement in Research Actions. Conclusions The CBPR Conceptual Model identifies key theoretical mechanisms for explaining health equity and health outcomes in community-academic partnerships. The scholarly literature’s preoccupation with synergy and relationships overlooks two promising practices—Structural Governance and Collective Empowerment—that interact from contexts through mechanisms to influence outcomes. These results also expand expectations beyond a “one size fits all” for reliably producing positive outcomes. Supplementary Information The online version contains supplementary material available at 10.1186/s12939-022-01663-y.
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Affiliation(s)
- John G Oetzel
- University of Waikato, Waikato Management School, Hamilton, New Zealand.
| | - Blake Boursaw
- University of New Mexico, College of Nursing, Albuquerque, USA
| | - Maya Magarati
- Department of Psychiatric and Behavioral Sciences, University of Washington, Seven Directions: A Center for Indigneous Public Health, Center for the Study of Health and Risk Behaviors, School of Medicine, Seattle, USA
| | | | | | - Leo Morales
- University of Washington, School of Medicine, Seattle, USA
| | - Sarah Kastelic
- National Indian Child Welfare Association, Portland, USA
| | - Milton Mickey Eder
- Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, USA
| | - Nina Wallerstein
- University of New Mexico, Center for Participatory Research, Albuquerque, USA
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10
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Wallerstein N. Engage for Equity: Advancing the Fields of Community-Based Participatory Research and Community-engaged Research in Community Psychology and the Social Sciences. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2021; 67:251-255. [PMID: 34237169 DOI: 10.1002/ajcp.12530] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Community Based Participatory Research (CBPR), as the most cited Community-Engaged Research (CEnR) approach in the health fields, mirrors community-psychology's long-term interest in participatory action research and community empowerment. This article introduces the Engage for Equity study, a long-term National Institutes of Health-funded inquiry to identify best partnering and collaborative practices that contribute to community capacity, empowerment and policy outcomes, and to long-term improved health and health equity. Four articles present facets of the study: psychometrics of partnering process and outcome measures, measures and outcomes of shared governance, and description of the CBPR Model as a new equity- and partnership based implementation framework; and as a tool for organizational learning and quality improvement. Finally a review of CBPR and CEnR in psychology offers recommendations for the field. Though focusing on CBPR and CEnR, Engage for Equity offers lessons for all forms of participatory action research.
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Affiliation(s)
- Nina Wallerstein
- College of Population Health, University of New Mexico, Albuquerque, NM, USA
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11
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Haapanen KA, Christens BD. Community-engaged Research Approaches: Multiple Pathways To Health Equity. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2021; 67:331-337. [PMID: 34312882 DOI: 10.1002/ajcp.12529] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
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12
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Boursaw B, Oetzel JG, Dickson E, Thein TS, Sanchez-Youngman S, Peña J, Parker M, Magarati M, Littledeer L, Duran B, Wallerstein N. Scales of Practices and Outcomes for Community-Engaged Research. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2021; 67:256-270. [PMID: 33599288 PMCID: PMC8355013 DOI: 10.1002/ajcp.12503] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Despite the growth of research on community-engaged research (CEnR), recent reviews suggest there has been limited development of validated scales to measure key contexts, mechanisms, and outcomes, impairing testing and refinement of theoretical models. The purpose of this study is to present the psychometric properties of scales from the Engage for Equity (E2) project, stemming from a long-term research partnership examining community-engaged research projects. This study used a three-stage, cross-sectional format: (a) a sampling frame of 413 CEnR projects was identified; (b) 210 principal investigators completed a project-level survey and nominated partners for another survey; (c) 457 investigators and partners completed a survey about project contexts, processes, interventions, and outcomes. Factorial validity was established through confirmatory factor analysis supporting seven scales: contextual capacity, commitment to collective empowerment, relationships, community engagement in research actions, synergy, partner and partnership transformation, and projected outcomes. Convergent validity was established through examining covariances among the scales. This study largely yielded results consistent with a previous psychometric study of related measures, while demonstrating improved ceiling effects of the items and refined conceptualization of core theoretical constructs.
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13
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DeCamp LR, Acosta J, Bou Delgado L, Guerrero Vazquez M, Polk S. Community partnerships in emerging immigrant communities: Lessons learned addressing Latino childhood weight disparities. Public Health Nurs 2021; 38:288-295. [PMID: 33586139 DOI: 10.1111/phn.12875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 12/03/2020] [Accepted: 01/11/2021] [Indexed: 11/29/2022]
Abstract
Latino children have disproportionately high childhood obesity rates, and U.S.-born Latino children of immigrant parents experience higher overweight/obesity rates than other Latino children. Community-based participatory research (CBPR) to engage Latino immigrant families and Latino-serving community organizations is one mechanism to address the lack of effective and practical interventions addressing childhood obesity disparities among Latino children. We present lessons learned from applying CBPR methods to a partnership focused on developing a child obesity treatment program for Latino immigrant families in an emerging Latino immigrant destination to inform the use of CBPR methods in other partnerships in emerging immigrant communities. We encountered challenges working within the partnership related to entrenched sociopolitical hierarchies that were not inclusive of immigrant community leaders, capacity building for partners with limited literacy and administrative experience, and how best to use complementary methods and frameworks to support a community-engaged research process. This work is one way to promote shared learning among the community of researchers using CBPR and other engagement methods to partner with emerging immigrant communities. Together with our community partners, we can identify strategies to more effectively partner to promote health equity and work toward social justice for all members of our communities.
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Affiliation(s)
- Lisa Ross DeCamp
- ACCORDS (Adult and Child Consortium for Health Outcomes Research and Delivery Science), Department of Pediatrics, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, CO, USA.,Latino Research and Policy Center, Colorado School of Public Health, Aurora, CO, USA
| | - Jennifer Acosta
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA.,Center for Salud/Health and Opportunity for Latinos, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Laura Bou Delgado
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA.,Center for Salud/Health and Opportunity for Latinos, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Monica Guerrero Vazquez
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA.,Center for Salud/Health and Opportunity for Latinos, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Sarah Polk
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA.,Center for Salud/Health and Opportunity for Latinos, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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14
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Coombe CM, Chandanabhumma PP, Bhardwaj P, Brush BL, Greene-Moton E, Jensen M, Lachance L, Lee SD, Meisenheimer M, Minkler M, Muhammad M, Reyes AG, Rowe Z, Wilson-Powers E, Israel BA. A Participatory, Mixed Methods Approach to Define and Measure Partnership Synergy in Long-standing Equity-focused CBPR Partnerships. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2020; 66:427-438. [PMID: 32744781 PMCID: PMC7772255 DOI: 10.1002/ajcp.12447] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
Abstract
Understanding what contributes to success of community-based participatory research (CBPR) partnerships is essential to ensuring their effectiveness in addressing health disparities and health inequities. Synergy, the concept of accomplishing more together than separately, is central to partnership effectiveness. However, synergy specific to long-standing, equity-focused CBPR partnerships has not been closely examined. To address this, we defined and developed measures of partnership synergy as one dimension of a participatory mixed methods study, Measurement Approaches to Partnership Success (MAPS), to develop a validated instrument to measure success in long-standing CBPR partnerships. Framed by a conceptual model and scoping literature review, we conducted in-depth interviews with a national panel of academic and community experts in CBPR and equity to develop partnership synergy measures. Items were refined through an iterative process, including a three-stage Delphi process, comparison with existing measures, cognitive interviews, and pilot testing. Seven questionnaire items were developed to measure synergy arising from equitable partnerships bringing together diverse partners across power differences to promote equity. Defining and measuring synergy in the context of long-standing partnership success is central to understanding the role of synergy in collaborative approaches to research and action and can strengthen CBPR partnerships to promote healthy communities and advance health equity.
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Affiliation(s)
- Chris M. Coombe
- University of Michigan School of Public Health, Ann Arbor, MI
| | | | - Prachi Bhardwaj
- University of Michigan School of Public Health, Ann Arbor, MI
| | | | | | - Megan Jensen
- University of Michigan School of Public Health, Ann Arbor, MI
| | - Laurie Lachance
- University of Michigan School of Public Health, Ann Arbor, MI
| | - S.Y. Daniel Lee
- University of Michigan School of Public Health, Ann Arbor, MI
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15
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Tremblay M, Gokiert R, Kingsley B, Mottershead K, Pei J. Using developmental evaluation and community-based participatory research to develop a model of supportive housing. EVALUATION AND PROGRAM PLANNING 2020; 82:101849. [PMID: 32679353 DOI: 10.1016/j.evalprogplan.2020.101849] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 03/16/2020] [Accepted: 07/05/2020] [Indexed: 06/11/2023]
Abstract
Community-based participatory research (CBPR) and developmental evaluation (DE) have emerged over recent decades as separate approaches for addressing complex social issues. Current literature offers little with respect to the use of CBPR and DE in combination, although the two approaches are complementary. Through the current paper, we outline how CBPR and DE were used to develop a model of supportive housing for teen families. More specifically, we describe the structures and processes that contributed to this development, including (1) our partnership approach, (2) pooled resources, (3) regular opportunities for collaboration and reflection, (4) integration of multiple data sources, (5) ongoing feedback and knowledge dissemination, and (6) adjustments to program practices. We end by providing insights into the lessons that we learned through this project. Through this paper, we describe how researchers and community partners can collaboratively use CBPR and DE to develop a program model in complex community settings. Insights are offered that will be important for researchers, evaluators, and practitioners seeking to develop programming in response to complex community issues.
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Affiliation(s)
- Melissa Tremblay
- Department of Educational Psychology, University of Alberta, 5-127, 116 St. and 85 Ave., Edmonton, Alberta, T6G 2R3, Canada.
| | - Rebecca Gokiert
- Department of Educational Psychology, University of Alberta, 5-127, 116 St. and 85 Ave., Edmonton, Alberta, T6G 2R3, Canada
| | - Bethan Kingsley
- Department of Educational Psychology, University of Alberta, 5-127, 116 St. and 85 Ave., Edmonton, Alberta, T6G 2R3, Canada
| | | | - Jacqueline Pei
- Department of Educational Psychology, University of Alberta, 5-127, 116 St. and 85 Ave., Edmonton, Alberta, T6G 2R3, Canada
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16
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Wallerstein N, Oetzel JG, Sanchez-Youngman S, Boursaw B, Dickson E, Kastelic S, Koegel P, Lucero JE, Magarati M, Ortiz K, Parker M, Peña J, Richmond A, Duran B. Engage for Equity: A Long-Term Study of Community-Based Participatory Research and Community-Engaged Research Practices and Outcomes. HEALTH EDUCATION & BEHAVIOR 2020; 47:380-390. [PMID: 32437293 PMCID: PMC8093095 DOI: 10.1177/1090198119897075] [Citation(s) in RCA: 79] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Community-based participatory research (CBPR) and community-engaged research have been established in the past 25 years as valued research approaches within health education, public health, and other health and social sciences for their effectiveness in reducing inequities. While early literature focused on partnering principles and processes, within the past decade, individual studies, as well as systematic reviews, have increasingly documented outcomes in community support and empowerment, sustained partnerships, healthier behaviors, policy changes, and health improvements. Despite enhanced focus on research and health outcomes, the science lags behind the practice. CBPR partnering pathways that result in outcomes remain little understood, with few studies documenting best practices. Since 2006, the University of New Mexico Center for Participatory Research with the University of Washington's Indigenous Wellness Research Institute and partners across the country has engaged in targeted investigations to fill this gap in the science. Our inquiry, spanning three stages of National Institutes of Health funding, has sought to identify which partnering practices, under which contexts and conditions, have capacity to contribute to health, research, and community outcomes. This article presents the research design of our current grant, Engage for Equity, including its history, social justice principles, theoretical bases, measures, intervention tools and resources, and preliminary findings about collective empowerment as our middle range theory of change. We end with lessons learned and recommendations for partnerships to engage in collective reflexive practice to strengthen internal power-sharing and capacity to reach health and social equity outcomes.
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Affiliation(s)
| | | | | | | | | | - Sarah Kastelic
- National Indian Child Welfare Association, Portland, OR, USA
| | | | | | | | - Kasim Ortiz
- University of New Mexico, Albuquerque, NM, USA
| | | | - Juan Peña
- University of New Mexico, Albuquerque, NM, USA
| | - Alan Richmond
- Community Campus Partnerships for Health, Raleigh, NC, USA
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17
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Parker M, Wallerstein N, Duran B, Magarati M, Burgess E, Sanchez-Youngman S, Boursaw B, Heffernan A, Garoutte J, Koegel P. Engage for Equity: Development of Community-Based Participatory Research Tools. HEALTH EDUCATION & BEHAVIOR 2020; 47:359-371. [PMID: 32437292 PMCID: PMC10792999 DOI: 10.1177/1090198120921188] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2024]
Abstract
We developed a set of four community-based participatory research (CBPR) partnership tools aimed at supporting community-academic research partnerships in strengthening their research processes, with the ultimate goal of improving research outcomes. The aim of this article is to describe the tools we developed to accomplish this goal: (1) the River of Life Exercise; (2) a Partnership Visioning Exercise; (3) a personalized Partnership Data Report of data from academic and community research partners; and (4) a Promising Practices Guide with aggregated survey data analyses on promising CBPR practices associated with CBPR and health outcomes from two national samples of CBPR projects that completed a series of two online surveys. Relying on Paulo Freire's philosophy of praxis, or the cycles of collective reflection and action, we developed a set of tools designed to support research teams in holding discussions aimed at strengthening research partnership capacity, aligning research partnership efforts to achieve grant aims, and recalling and operationalizing larger social justice goals. This article describes the theoretical framework and process for tool development and provides preliminary data from small teams representing 25 partnerships who attended face-to-face workshops and provided their perceptions of tool accessibility and intended future use.
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