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Chow EHY, Tiwari A. Perceptions of abused Chinese women on community-based participatory approach programme in addressing their needs. Int J Qual Stud Health Well-being 2024; 19:2331107. [PMID: 38564773 PMCID: PMC10989199 DOI: 10.1080/17482631.2024.2331107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 03/12/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND The community-based participatory approach (CBPA) has gained increasing recognition worldwide for enhancing the effectiveness of intervention. It is relatively new in Chinese societies and participants' perceptions are underexplored. This study aims to explore abused Chinese women's perceptions on the CBPA programme in addressing their needs. METHODS A total of 11 abused Chinese women were recruited for a focus group and individual interviews. A semi-structured interview guide was used. All interviews were audio-recorded and data were transcribed verbatim. Conventional content analysis was used for analysis. RESULTS Four themes were identified regarding the women's perceptions and experiences of the community-based participatory approach programme: (1) Women's perceived acceptability of the CBPA programme; (2) Women's perceived usefulness of the CBPA programme; (3) Women's perceived feasibility of the CBPA programme; and (4) Empowering the women through participating in CBPA. CONCLUSIONS Abused Chinese women had high perceived acceptance and positive experiences towards the community-based participatory approach. Women benefited from their robust participation throughout the process. The findings confirm the potential of using the community-based participatory approach in designing interventions for future programme planning and intervention to address the needs of abused Chinese women.
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Affiliation(s)
| | - Agnes Tiwari
- School of Nursing, Hong Kong Sanatorium & Hospital Limited, Hong Kong, China
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2
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Glass DJ, al-Tameemi Z, Farquhar S. Advancing an individual-community health nexus: Survey, visual, and narrative meanings of mental and physical health for Arab emerging adults. SSM - MENTAL HEALTH 2023; 4:100281. [PMID: 38188867 PMCID: PMC10767648 DOI: 10.1016/j.ssmmh.2023.100281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2024] Open
Affiliation(s)
- Delaney J. Glass
- The University of Washington, Departments of Anthropology and Epidemiology, USA
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Plunk AD, Hannon K, Carver A, Cooper D, Grant D, Greene S, Morgan E, Gehlert S. Developing a peer-led intervention to promote COVID-19 testing in low-income housing settings. Front Public Health 2023; 11:1096246. [PMID: 37213622 PMCID: PMC10196028 DOI: 10.3389/fpubh.2023.1096246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 04/05/2023] [Indexed: 05/23/2023] Open
Abstract
Background The Housing Collaborative project at Eastern Virginia Medical School has developed a method of adapting public health guidance from public housing communities, which face tremendous health challenges in cardiometabolic health, cancer, and other major health conditions. In this paper, we describe how academic and community partners in the Housing Collaborative came together to do this work with a focus on COVID-19 testing in the context of the emerging pandemic. Methods The academic team used virtual community engagement methods to interact with the Housing Collaborative Community Advisory Board (HCCAB) and a separate cohort of research participants (N = 102) recruited into a study of distrust in COVID-19 guidance. We conducted a series of 44 focus group interviews with participants on related topics. Results from these interviews were discussed with the HCCAB. We used the collaborative intervention planning framework to inform adaptation of public health guidance on COVID-19 testing delivered in low-income housing settings by including all relevant perspectives. Results Participants reported several important barriers to COVID-19 testing related to distrust in the tests and those administering them. Distrust in housing authorities and how they might misuse positive test results seemed to further undermine decision making about COVID-19 testing. Pain associated with testing was also a concern. To address these concerns, a peer-led testing intervention was proposed by the Housing Collaborative. A second round of focus group interviews was then conducted, in which participants reported their approval of the proposed intervention. Conclusion Although the COVID-19 pandemic was not our initial focus, we were able to identify a number of barriers to COVID-19 testing in low-income housing settings that can be addressed with adapted public health guidance. We struck a balance between community input and scientific rigor and obtained high quality, honest feedback to inform evidence-based recommendations to guide decisions about health.
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Affiliation(s)
- Andrew D. Plunk
- Department of Pediatrics, Eastern Virginia Medical School, Norfolk, VA, United States
- *Correspondence: Andrew D. Plunk,
| | - Kapri Hannon
- Department of Pediatrics, Eastern Virginia Medical School, Norfolk, VA, United States
| | - Alexandra Carver
- Department of Pediatrics, Eastern Virginia Medical School, Norfolk, VA, United States
| | - Diane Cooper
- Housing Collaborative Community Advisory Board, Norfolk, VA, United States
| | - Debra Grant
- Housing Collaborative Community Advisory Board, Norfolk, VA, United States
| | - Sudie Greene
- Housing Collaborative Community Advisory Board, Norfolk, VA, United States
| | - Emma Morgan
- Housing Collaborative Community Advisory Board, Norfolk, VA, United States
| | - Sarah Gehlert
- Brown School of Social Work, Washington University, St. Louis, MO, United States
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Boone H, Snow NJ, Allison J, Sturge Sparkes C, Dawe R. Community engagement by faculties of medicine: A scoping review of current practices and practical recommendations. MEDICAL TEACHER 2022; 44:772-780. [PMID: 35166621 DOI: 10.1080/0142159x.2022.2035339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
PURPOSE Social accountability (SA) is the responsibility of faculties of medicine (FoMs) to address the health priorities of the communities they serve. Community engagement (CE) is a vital, but often ambiguous, component of SA. Practical guidance on how to engage community partners (CPs) is key for meaningful CE. We conducted a systematic scoping review of CE involving FoMs to map out how FoMs engage their communities, to provide practical recommendations for FoMs to take part in CE, and to highlight gaps in the literature. MATERIALS AND METHODS We searched electronic databases for articles describing projects or programs involving FoMs and CPs. Descriptive information was analyzed thematically. RESULTS Thirty-eight of 1406 articles were included, revealing three themes: (1) Partners (Who to Engage)-deciding who to engage establishes the basis for responsibility and creates space for communities to engage FoMs; (2) Partnerships (How to Engage)-fostering creative and authentic collaboration, enabling meaningful community contributions; and (3) Projects and Programs (With What to Engage)-identifying opportunities for communities to have a voice in many spaces within FoMs. Under these themes emerged 32 practical recommendations. CONCLUSION Practical guidance facilitates meaningful commitments to communities. The literature is rich with examples of community-FoM partnerships. We provide recommendations for CE that are clear, evidence-based, and responsive.
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Affiliation(s)
- Hannah Boone
- Faculty of Medicine, Memorial University of Newfoundland, St. John's, Canada
| | - Nicholas Jacob Snow
- Faculty of Medicine, Memorial University of Newfoundland, St. John's, Canada
| | - Jill Allison
- Faculty of Medicine, Memorial University of Newfoundland, St. John's, Canada
| | | | - Russell Dawe
- Faculty of Medicine, Memorial University of Newfoundland, St. John's, Canada
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Manson SM, Buchwald DS. Aging and Health of American Indians and Alaska Natives: Contributions from the Native Investigator Development Program. J Aging Health 2021; 33:3S-9S. [PMID: 34167345 PMCID: PMC8627114 DOI: 10.1177/08982643211014399] [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: 11/15/2022]
Abstract
Objectives: To describe recent advances in our knowledge regarding the health and illness of older American Indians and Alaska Natives, and factors underlying why this special population lives 5.5 years less than the 78.5 years of U.S. all races. Methods: The articles in this supplemental issue, authored by participants in a National Institutes of Health-sponsored early research career development program, examine high priority health concerns that contribute to the increased risk of Native elders for chronic disease and resulting impairment that compromise their life expectancy. Results: Important insights into the roles that racial discrimination, food security, hypertension, alcohol consumption, memory problems, and military service play in the health and well-being of older American Indians and Alaska Natives. Discussion: Early career faculty development programs focused on increasing the diversity of the scientific workforce not only promote greater racial and ethnic minority representation in the field of aging, but can simultaneously add to the knowledge base regarding the health status and function of often ignored, vulnerable older members of communities that suffer significant health disparities.
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Affiliation(s)
- Spero M. Manson
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Dedra S. Buchwald
- Institute for Research and Education to Advance Community Health, Washington State University, Seattle, WA, USA
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Revens KE, Gutierrez D, Paul R, Reynolds AD, Price R, DeHaven MJ. Social Support and Religiosity as Contributing Factors to Resilience and Mental Wellbeing in Latino Immigrants: A Community-Based Participatory Research Study. J Immigr Minor Health 2021; 23:904-916. [PMID: 33715112 DOI: 10.1007/s10903-021-01179-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/03/2021] [Indexed: 11/28/2022]
Abstract
Latino immigrants are at increased risk for mental disorders due to social/economic disadvantages and stressful conditions associated with migration. Resilience-the ability to recover from stress-may provide protection given its association with lower rates of anxiety and depression. This study examines the relationship between protective factors, resilience, and psychological distress in Latino immigrants. A community-based participatory research study conducted with a Latino agency using in-person surveys to obtain the following data: Brief Resilience Scale, Brief Symptom Inventory, Duke University Religion Index, Multi-group Ethnic Identity measure, and the Interpersonal Support Evaluation List. Linear regression, and mediation analysis was performed using SPSS. There are 128 participants. Resilience was positively related to social support (p = 0.001) and religiosity (p = 0.006); inversely related to psychological distress (p = 0.001); and mediated the relationship between the two (p = 0.006). Promoting social support and religion in Latino communities can improve wellbeing by increasing resilience and reducing distress.
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Affiliation(s)
- Keri E Revens
- Camino Community Center, 133 Stetson Dr., Charlotte, 28262, USA.
| | | | - Rajib Paul
- University of North Carolina at Charlotte, Charlotte, NC, USA
| | | | - Rusty Price
- Camino Community Center, 133 Stetson Dr., Charlotte, 28262, USA
| | - Mark J DeHaven
- University of North Carolina at Charlotte, Charlotte, NC, USA
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Betancourt TS, Keegan K, Farrar J, Brennan RT. The intergenerational impact of war on mental health and psychosocial wellbeing: lessons from the longitudinal study of war-affected youth in Sierra Leone. Confl Health 2020; 14:62. [PMID: 32884581 PMCID: PMC7461150 DOI: 10.1186/s13031-020-00308-7] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 08/21/2020] [Indexed: 11/10/2022] Open
Abstract
Background Globally, one in four children lives in a country affected by armed conflict or disaster often accompanied by exposure to a range of adversities including violent trauma and loss. Children involved with armed groups (often referred to as "child soldiers") typically exhibit high levels of mental health needs linked to their experiences. The Longitudinal Study of War-Affected Youth (LSWAY) in Sierra Leone is a seventeen-year prospective longitudinal study of the long-term effects of children's experiences in the country's eleven-year (1991-2002) civil war on their adult mental health and functioning in addition to exploring the potential mechanisms by which intergenerational transmission of emotional and behavioral disruptions due to war trauma may operate. LSWAY illuminates how war-related and post-conflict experiences shape long-term adult functioning, family dynamics, and developmental outcomes in offspring. Discussion The LSWAY study utilizes mixed methodologies that incorporate qualitative and quantitative data to unpack risk and protective factors involved in social reintegration, psychosocial adjustment, parenting, and interpersonal relationships. To date, study findings demonstrate striking levels of persistent mental health problems among former child soldiers as adults with consequences for their families, but also risk and protective patterns that involve family- and community-level factors. This case study examines the course of LSWAY from inception through implementation and dissemination, including building on the study results to design and evaluate several intervention models. Conclusion The case study offers a unique perspective on challenges and field realities of health research in a fragile, post-conflict setting common in the context of humanitarian emergencies. LSWAY findings along with lessons learned from the field can inform future research as well as intervention research and implementation science to address the mental health and development of war-affected young people. With four waves of data collection and a planned fifth wave, LSWAY also provides rare insights into the intergenerational effects of humanitarian crises on children, youth, and families across generations.
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Affiliation(s)
- Theresa S Betancourt
- Research Program on Children and Adversity, Boston College School of Social Work, Chestnut Hill, MA USA
| | - Katrina Keegan
- Research Program on Children and Adversity, Boston College School of Social Work, Chestnut Hill, MA USA
| | - Jordan Farrar
- Research Program on Children and Adversity, Boston College School of Social Work, Chestnut Hill, MA USA
| | - Robert T Brennan
- Research Program on Children and Adversity, Boston College School of Social Work, Chestnut Hill, MA USA.,Women's Studies Research Center, Brandeis University, Waltham, MA USA
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Brown G, Brady G. Collaborative research: Working together to deliver land-based prison initiatives. METHODOLOGICAL INNOVATIONS 2020. [DOI: 10.1177/2059799120927333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Collaborative research offers an opportunity to access experiential knowledge, rooted in a process that aims to move beyond traditional research relationships and boundaries. Collaborative research does not always change the power differential; nonetheless, it has the potential to lead to ethical relationships and for partnership working that supports ‘change’. Working in this way aids in understanding and advancing ideas for change, grounded in the views and experiences of all involved. In this article, we share our experiences of carrying out two collaborative land-based prison-based evaluations. These programmes, delivered by third sector organisations, have both worked with men in prison but differed in relation to focus, approach, timescale and the specific group of men targeted within the prison population. This work highlights how working collaboratively lends itself to a way of engaging, through building a range of relationships with key stakeholders, men in prison, prison staff and practitioners, a channel to ‘knowing differently’ and potential for creating humanising spaces within the prison environment. This article details the rewards, tensions and challenges we have encountered when carrying out land-based studies, illuminating additional dimensions for consideration when adopting this approach.
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Affiliation(s)
- Geraldine Brown
- Centre for Agroecology, Water and Resilience, Coventry University, Coventry, UK
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Chandanabhumma PP, Duran BM, Peterson JC, Pearson CR, Oetzel JG, Dutta MJ, Wallerstein NB. Space within the Scientific Discourse for the Voice of the Other? Expressions of Community Voice in the Scientific Discourse of Community-Based Participatory Research. HEALTH COMMUNICATION 2020; 35:616-627. [PMID: 30786730 DOI: 10.1080/10410236.2019.1581409] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Community-based participatory research (CBPR) has captured public health attention and support because it is positioned as an approach that involves researchers and communities as equitable partners in addressing health disparities. However, it is unknown the extent to which CBPR creates a participatory space in the scientific discourse to signal "community voice," which we define as textual expression of community-centered perspectives on collective roles, interests, and worldviews. In this study, we utilized the culture-centered approach to examine the expression of community voice in the abstracts and public health relevance statements of 253 extramural CBPR projects in the U.S. that received funding from the National Institute of Health and Centers for Disease Control and Prevention in 2009. We found that project abstracts and public health relevance statements contain four textual domains, or potential sites of contest to signal the articulation of community agency and voice within the CBPR projects. These domains include: 1) the rationale for the community health issue, 2) the roles of community partners, 3) community-centered outcomes of the partnership, and 4) elements of participatory research process. The degree of culture-centeredness of the texts is suggested in the extent to which articulations of community agency and voice are signaled across the four domains. We conclude that the dynamics of CBPR may shape culture-centered expressions of problem identification, solution configuration, structural transformations, reflexivity, values, and agency in the project abstracts and public health relevance statements.
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Affiliation(s)
| | - Bonnie M Duran
- Indigenous Wellness Research Institute National Center of Excellence, University of Washington
| | | | - Cynthia R Pearson
- Indigenous Wellness Research Institute National Center of Excellence, University of Washington
| | - John G Oetzel
- Department of Management Communication, University of Waikato
| | - Mohan J Dutta
- School of Communication, Journalism and Marketing, Massey University
| | - Nina B Wallerstein
- Center for Participatory Research, Department of Family and Community Medicine, University of New Mexico
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Biggs BK, Tolleson E, Millerbernd J, Bronars C, Meiers SJ, Slowiak K, Olson M, Lebow J, Ridgeway JL, Patten CA, Clark MM, Sia IG, Wieland ML. Identifying Opportunities to Promote Physical Activity in a Diverse Low-Income Population: A Mixed-Method Study at a Boys & Girls Club Site. CHILD & YOUTH CARE FORUM 2020; 49:171-200. [PMID: 33833490 PMCID: PMC8025775 DOI: 10.1007/s10566-019-09521-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Prevalence and consequences of obesity and sedentary lifestyle are well-documented public health concerns for youth in the United State of America (U.S.A) that disproportionally affect children from low income and minority families. OBJECTIVE This mixed-method study focused on estimating levels of physical activity and sedentary behavior and prevalence of overweight and obesity among the child members served in one Boys and Girls Club in the Midwest U.S.A. We aimed to better understand opportunities for improving children's engagement in physical activity through focus groups with members, staff, and parents/caregivers of members. METHODS Social cognitive learning theory, the ecological model of health behavior, and community based participatory research principles provided the study framework. Members completed assessments of physical activity, sedentary activity, height, and weight. Focus groups with members, staff, and parents/caregivers identified barriers, facilitators, and opportunities for promoting physical activity. RESULTS: Nearly 50% of members were overweight or obese. Most (87%) participants reported at least 60 minutes physical activity every day across the 3-day recall. Fewer than half (41%) reported 2 hours or less of sedentary screen time every day across the 3 day recall. Focus group themes identified opportunities for addressing needs associated with health disparities in physical activity and pediatric obesity. CONCLUSIONS Findings suggest stakeholder interest in physical activity promotion through afterschool programs. We discuss study implications regarding needs specific to individuals from diverse, low-income households that may not be adequately addressed with existing empirically-supported treatments and opportunities to address health disparities in physical activity and pediatric obesity through afterschool programs.
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Bess KD, Frerichs L, Young T, Corbie-Smith G, Dave G, Davis K, McFarlin S, Watson S, Wynn M, Cene CW. Adaptation of an Evidence-Based Cardiovascular Health Intervention for Rural African Americans in the Southeast. Prog Community Health Partnersh 2019; 13:385-396. [PMID: 31866593 PMCID: PMC8238056 DOI: 10.1353/cpr.2019.0060] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND African Americans (AA) living in the southeast United States have the highest prevalence of cardiovascular diseases (CVD) and rural minorities bear a significant burden of co-occurring CVD risk factors. Few evidence-based interventions (EBI) address social and physical environmental barriers in rural minority communities. We used intervention mapping together with community-based participatory research (CBPR) principles to adapt objectives of a multi-component CVD lifestyle EBI to fit the needs of a rural AA community. We sought to describe the process of using CPBR to adapt an EBI using intervention mapping to an AA rural setting and to identify and document the adaptations mapped onto the EBI and how they enhance the intervention to meet community needs. METHODS Focus groups, dyadic interviews, and organizational web-based surveys were used to assess content interest, retention strategies, and incorporation of auxiliary components to the EBI. Using CBPR principles, community and academic stakeholders met weekly to collaboratively integrate formative research findings into the intervention mapping process. We used a framework developed by Wilstey Stirman et al. to document changes. RESULTS Key changes were made to the content, context, and training and evaluation components of the existing EBI. A matrix including behavioral objectives from the original EBI and new objectives was developed. Categories of objectives included physical activity, nutrition, alcohol, and tobacco divided into three levels, namely, individual, interpersonal, and environmental. CONCLUSIONS Intervention mapping integrated with principles of CBPR is an efficient and flexible process for adapting a comprehensive and culturally appropriate lifestyle EBI for a rural AA community context.
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Community participation in general health initiatives in high and upper-middle income countries: A systematic review exploring the nature of participation, use of theories, contextual drivers and power relations in community participation. Soc Sci Med 2018; 213:106-122. [PMID: 30075416 DOI: 10.1016/j.socscimed.2018.07.019] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Revised: 07/06/2018] [Accepted: 07/11/2018] [Indexed: 11/22/2022]
Abstract
Community participation is commonly regarded as pivotal in enabling the success of many health initiatives. However, the theoretical constructs, and evidence about the contextual drivers and relational issues that shape participation is lacking. The aim of this systematic review was to examine the evidence for published academic literature on community participation in relation to general, non-disease specific health initiatives, including the use of theories to inform community participation, and the study of contextual drivers and relational issues that influence community participation, with a focus on high and upper-middle income countries. We searched multiple databases including Medline, Embase, Scopus, LILACs and Global Health from January 2000 to September 2016. We screened papers for inclusion, then conducted data extraction and a narrative synthesis of the data. Only papers that focused on general health were included. Disease-specific literature was excluded. 27,232 records were identified, with 23,468 after duplicate removal. 79 papers met our final inclusion criteria. Overall, our findings show that strategies to encourage community participation in health initiatives can be categorized along a continuum that varies from less to more participation and control among the community. Our analysis of reported outcomes demonstrates that community participation in general health initiatives can contribute to positive process, social and health outcomes. Social outcomes are more often associated with increasing community participation in our selection of papers. Overall, our findings reaffirm the understanding that community participation is a complex process that is strongly influenced by the context in which it occurs, and that social factors such as power relations must be carefully considered. There is a need for more robustly designed studies to improve the theorization of community participation, and to draw out a better understanding of how tangible and intangible elements such as power, influence community participation and its outcomes.
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Fraser S, Vrakas G, Laliberté A, Mickpegak R. Everyday ethics of participation: a case study of a CBPR in Nunavik. Glob Health Promot 2017; 25:82-90. [PMID: 28353402 DOI: 10.1177/1757975917690496] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Multiple reports highlight the need for community-based family-oriented prevention services for Aboriginal peoples in order to address important health and social inequalities. Participatory, empowerment-based approaches are generally favoured for these means. Faced with important social issues, in a context of colonisation and complex power dynamics, we question how community members experience participation, as well as the everyday dynamics that take place when attempting to create community-level change. CONTEXT The initial steps of this community-based participatory research (CBPR) took place over a two-year period in a community of Nunavik, a large northern region of the province of Quebec. The objective of the CBPR was to develop a community-driven project aimed at supporting families to be able to keep children within their homes or communities, rather than having to be placed under child welfare services. METHOD We participated in, and documented, various group meetings, community workshops, informal reflexive discussions, and formal interviews with community partners to explore their everyday experiences of participation in community-based change. RESULTS We describe some of the initial actions taken in this project. We describe how certain social and power dynamics infiltrated into the process of participation leading to various tensions, personal and interpersonal experiences and needs. DISCUSSION We discuss how these experiences led to everyday ethical dilemmas regarding participation. We conclude that although participatory approaches towards community change may be effective, they are also ethically challenging and at times disempowering for those who participate. We describe some of the approaches used to work with these ethical challenges.
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Affiliation(s)
- Sarah Fraser
- 1 Department of Psychoeducation, University of Montreal, Montreal, Quebec, Canada.,2 Institut Universitaire SHERPA, CSSS de la Montagne, Quebec, Canada
| | - Georgia Vrakas
- 3 Department of Psychoeducation, University of Quebec in Trois-Rivières, Quebec City, Quebec, Canada
| | - Arlene Laliberté
- 4 Department of Psychoeducation, Université du Québec en Abitibi-Témiscamingue, Saint-Jérôme, Quebec, Canada
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Chrisman NJ. Extending Cultural Competence Through Systems Change: Academic, Hospital, and Community Partnerships. J Transcult Nurs 2016; 18:68S-76S; discussion 77S-85S. [PMID: 17204815 DOI: 10.1177/1043659606295692] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Work on cultural competence has a long history in nursing, yet we have not successfully institutionalized these attitudes and skills throughout education and practice. An effective approach to promoting widespread cultural competence is to work at the system level in which coalitions of community agencies partner with academic and health care organizations. A systems approach includes all health practitioners, reducing current discrepancies across disciplines, and establishes cultural competence as the standard. Work in and with communities places students and practitioners more consistently in cross-cultural circumstances. Implementing this vision will require national as well as local leadership across public and private sectors.
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Conducting longitudinal, process-oriented research with conflict-affected youth: Solving the inevitable challenges. Dev Psychopathol 2016; 29:85-92. [PMID: 27866491 DOI: 10.1017/s0954579416001176] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The reader might get the impression that the four projects described in this Special Section proceeded in a systematic and predictable way. Of course, those of us engaged in each research project encountered pitfalls and challenges along the way. A main goal of this Special Section is to provide pathways and encouragement for those who may be interested in advancing high-quality research on this topic. In this paper, we describe a set of practical and ethical challenges that we encountered in conducting our longitudinal, process-oriented, and translational research with conflict-affected youth, and we illustrate how problems can be solved with the goal of maintaining the internal and external validity of the research designs. We are hopeful that by describing the challenges of our work, and how we overcame them, which are seldom treated in this or any other literature on research on child development in high-risk contexts, we can offer a realistic and encouraging picture of conducting methodologically sound research in conflict-affected contexts.
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Williams KJ, Gail Bray P, Shapiro-Mendoza CK, Reisz I, Peranteau J. Modeling the Principles of Community-Based Participatory Research in a Community Health Assessment Conducted by a Health Foundation. Health Promot Pract 2016; 10:67-75. [PMID: 17652187 DOI: 10.1177/1524839906294419] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The authors discuss strategies used and lessons learned by a health foundation during development of a community health assessment model incorporating community-based participatory research (CBPR) approaches. The assessment model comprises three models incorporating increasing amounts of CPBR principles. Model A combines local-area analysis of quantitative data, qualitative information (key informants, focus groups), and asset mapping. Model B, a community-based participatory model, emphasizes participatory rural appraisal approaches and quantitative assessment using rapid epidemiological assessment. Model C, a modified version of Model B, is financially more sustainable for our needs than Model B. The authors (a) describe origins of these models and illustrate practical applications and (b) explore the lessons learned in their transition from a traditional, nonparticipatory, quantitative approach to participatory approaches to community-health assessment. It is hoped that this article will contribute to the growing body of knowledge of practical aspects of incorporating CBPR approaches into community health assessments.
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Affiliation(s)
- Karen Jaynes Williams
- Center for Excellence in Health Disparities Research, Cardiovascular Disease and Stroke at Texas Southern University, Houston, TX, USA
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Kowitt SD, Emmerling D, Gavarkavich D, Mershon CH, Linton K, Rubesin H, Agnew-Brune C, Eng E. A Pilot Evaluation of an Art Therapy Program for Refugee Youth From Burma. ART THERAPY 2016. [DOI: 10.1080/07421656.2015.1127739] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Weiss D, Lillefjell M, Magnus E. Facilitators for the development and implementation of health promoting policy and programs - a scoping review at the local community level. BMC Public Health 2016; 16:140. [PMID: 26869177 PMCID: PMC4751684 DOI: 10.1186/s12889-016-2811-9] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2015] [Accepted: 02/02/2016] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Health promotion, with a focus on multidimensional upstream factors and an ecological, life-course approach, is establishing itself as the guiding philosophy for addressing public health. Action at the political and programmatic level on the Social Determinants of Health has proven effective for promoting and building public health at all levels but has been particularly evident at the national and international levels - due in large part to available documents and guidelines. Although research and experience establish that health promotion is most effective when settings-based, the development of health promoting policies and programs at the local level is still difficult. This study intended to investigate available knowledge on the development and implementation of health promoting policies and programs at the local level and identify factors most important for facilitating capacity building and outcome achievement. METHODS We used a scoping review in order to review the current literature on local policy development and program implementation. Keywords were chosen based on results of a previous literature review. A total of 53 articles were divided into two categories: policy and implementation. Critical analysis was conducted for each article and a summary assembled. Data was charted with specific focus on the aims of the study, data acquisition, key theories/concepts/frameworks used, outcome measures, results, and conclusions. RESULTS The articles included in this study primarily focused on discussing factors that facilitate the development of health promoting policy and the implementation of health promotion programs. Most significant facilitators included: collaborative decision-making, agreement of objectives and goals, local planning and action, effective leadership, building and maintaining trust, availability of resources, a dynamic approach, a realistic time-frame, and trained and knowledgeable staff. Within each of these important facilitating factors, various elements supporting implementation were discussed and highlighted in this study. CONCLUSION Our results indicate that clear and consistent facilitators exist for supporting health promoting policy development and program implementation at the local level. These results offer a starting point for local action on the Social Determinants of Health and have the potential to contribute to the development of a framework for improving action at the local level.
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Affiliation(s)
- Daniel Weiss
- Department of Occupational Therapy, Norwegian University of Science and Technology, Faculty of Health and Social Science, NO-7491, Trondheim, Norway.
| | - Monica Lillefjell
- Department of Occupational Therapy, Norwegian University of Science and Technology, Faculty of Health and Social Science, NO-7491, Trondheim, Norway.
| | - Eva Magnus
- Department of Occupational Therapy, Norwegian University of Science and Technology, Faculty of Health and Social Science, NO-7491, Trondheim, Norway.
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Menzel J, Wollesen B, Fendel R, Mattes K. Erfolgsfaktoren zur Umsetzung von Betrieblicher Gesundheitsförderung in kleinen und mittelständischen Unternehmen. ACTA ACUST UNITED AC 2015. [DOI: 10.1007/s11612-015-0287-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Wilson P, Mathie E, Keenan J, McNeilly E, Goodman C, Howe A, Poland F, Staniszewska S, Kendall S, Munday D, Cowe M, Peckham S. ReseArch with Patient and Public invOlvement: a RealisT evaluation – the RAPPORT study. HEALTH SERVICES AND DELIVERY RESEARCH 2015. [DOI: 10.3310/hsdr03380] [Citation(s) in RCA: 112] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BackgroundPatient and public involvement (PPI) is a prerequisite for many funding bodies and NHS research ethics approval. PPI in research is defined as research carried out with or by the public rather than to, about or for them. While the benefits of PPI have been widely discussed, there is a lack of evidence on the impact and outcomes of PPI in research.ObjectivesTo determine the types of PPI in funded research, describe key processes, analyse the contextual and temporal dynamics of PPI and explore the experience of PPI in research for all those involved. Mechanisms contributing to the routine incorporation of PPI in the research process were assessed, the impact of PPI on research processes and outcomes evaluated, and barriers and enablers to effective PPI identified.DesignA three-staged realist evaluation drawing on Normalisation Process Theory to understand how far PPI was embedded within health-care research in six areas: diabetes mellitus, arthritis, cystic fibrosis, dementia, public health and learning disabilities. The first two stages comprised a scoping exercise and online survey to chief investigators to assess current PPI activity. The third stage consisted of case studies tracked over 18 months through interviews and document analysis. The research was conducted in four regions of England.ParticipantsNon-commercial studies currently running or completed within the previous 2 years eligible for adoption on the UK Clinical Research Network portfolio. A total of 129 case study participants included researchers and PPI representatives from 22 research studies, and representatives from funding bodies and PPI networks.ResultsIn the scoping 51% (n = 92) of studies had evidence of PPI and in the survey 79% (n = 80), with funder requirements and study design the strongest influence on the extent of PPI. There was little transparency about PPI in publicly accessible information. In case studies, context–mechanism–outcome configurations suggested that six salient actions were required for effective PPI. These were a clear purpose, role and structure for PPI; ensuring diversity; whole research team engagement with PPI; mutual understanding and trust between the researchers and lay representatives; ensuring opportunities for PPI throughout the research process; and reflecting on, appraising and evaluating PPI within a research study. PPI models included a ‘one-off’ model with limited PPI, a fully intertwined model in which PPI was fully embedded and an outreach model with lay representatives linking to broader communities. Enabling contexts included funder, topic/design, resources, research host, organisation of PPI and, most importantly, relationships. In some case studies, lack of coherence in defining PPI persisted, with evidence of a dual role of PPI representative/study participant. Evidence of PPI outcomes included changes to study design, improvements to recruitment materials and rates, and dissemination.ConclusionsSix salient actions were required for effective PPI and were characterised by a shared understanding of moral and methodological purposes of PPI, a key individual co-ordinating PPI, ensuring diversity, a research team positive about PPI input and fully engaged with it, based on relationships that were established and maintained over time, and PPI being evaluated in a proactive and systematic approach. Future work recommendations include exploring the impact of virtual PPI, cost analysis and economic evaluation of the different models of PPI, and a longer-term follow-up study of the outcomes of PPI on research findings and impact on services and clinical practice.FundingThe National Institute for Health Research Health Services and Delivery Research programme.
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Affiliation(s)
- Patricia Wilson
- Centre for Research in Primary and Community Care, University of Hertfordshire, Hatfield, UK
- Centre for Health Services Studies, University of Kent, Canterbury, UK
| | - Elspeth Mathie
- Centre for Research in Primary and Community Care, University of Hertfordshire, Hatfield, UK
| | - Julia Keenan
- Norwich Medical School, University of East Anglia, Norwich, UK
- School of Health Sciences, University of East Anglia, Norwich, UK
| | - Elaine McNeilly
- Centre for Research in Primary and Community Care, University of Hertfordshire, Hatfield, UK
| | - Claire Goodman
- Centre for Research in Primary and Community Care, University of Hertfordshire, Hatfield, UK
| | - Amanda Howe
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - Fiona Poland
- Norwich Medical School, University of East Anglia, Norwich, UK
- School of Rehabilitation Sciences, University of East Anglia, Norwich, UK
| | | | - Sally Kendall
- Centre for Research in Primary and Community Care, University of Hertfordshire, Hatfield, UK
| | - Diane Munday
- Public Involvement in Research Group, University of Hertfordshire, Hatfield, UK
| | - Marion Cowe
- Public Involvement in Research Group, University of Hertfordshire, Hatfield, UK
| | - Stephen Peckham
- Centre for Health Services Studies, University of Kent, Canterbury, UK
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Salihu HM, Salinas-Miranda AA, Wang W, Turner D, Berry EL, Zoorob R. Community Priority Index: Utility, Applicability and Validation for Priority Setting in Community-Based Participatory Research. J Public Health Res 2015; 4:443. [PMID: 26425490 PMCID: PMC4568419 DOI: 10.4081/jphr.2015.443] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2014] [Revised: 03/04/2015] [Accepted: 03/06/2015] [Indexed: 11/24/2022] Open
Abstract
Background Providing practitioners with an intuitive measure for priority setting that can be combined with diverse data collection methods is a necessary step to foster accountability of the decision-making process in community settings. Yet, there is a lack of easy-to-use, but methodologically robust measures, that can be feasibly implemented for reliable decision-making in community settings. To address this important gap in community based participatory research (CBPR), the purpose of this study was to demonstrate the utility, applicability, and validation of a community priority index in a community-based participatory research setting. Design and Methods Mixed-method study that combined focus groups findings, nominal group technique with six key informants, and the generation of a Community Priority Index (CPI) that integrated community importance, changeability, and target populations. Bootstrapping and simulation were performed for validation. Results For pregnant mothers, the top three highly important and highly changeable priorities were: stress (CPI=0.85; 95%CI: 0.70, 1.00), lack of affection (CPI=0.87; 95%CI: 0.69, 1.00), and nutritional issues (CPI=0.78; 95%CI: 0.48, 1.00). For non-pregnant women, top priorities were: low health literacy (CPI=0.87; 95%CI: 0.69, 1.00), low educational attainment (CPI=0.78; 95%CI: 0.48, 1.00), and lack of self-esteem (CPI=0.72; 95%CI: 0.44, 1.00). For children and adolescents, the top three priorities were: obesity (CPI=0.88; 95%CI: 0.69, 1.00), low self-esteem (CPI=0.81; 95%CI: 0.69, 0.94), and negative attitudes toward education (CPI=0.75; 95%CI: 0.50, 0.94). Conclusions This study demonstrates the applicability of the CPI as a simple and intuitive measure for priority setting in CBPR. Significance for public health Community-based participatory research (CBPR) has been credited to be a promising approach for the reduction of health disparities and as an effective way to create sustainable community outcomes. Priority setting is an essential decision-making step in community-based participatory research. Issue prioritization must be driven not just by the importance of the issue, but also what realistically can be changed with available funds. However, there is little guidance on how to approach priority setting with objective and subjective measures while implementing CBPR. This study depicts the invention of a Community Priority Index (CPI), which can be used to prioritize community health issues by combining subjective and objective markers into a single measure. The CPI shown in this study represents a viable systematic approach to improve the objectivity and reliability of community-based decision-making.
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Affiliation(s)
- Hamisu M Salihu
- Department of Family and Community Medicine, Baylor College of Medicine , Houston, TX, USA
| | - Abraham A Salinas-Miranda
- Department of Epidemiology and Biostatistics, College of Public Health, University of South Florida , Tampa, FL, USA
| | - Wei Wang
- Department of Epidemiology and Biostatistics, College of Public Health, University of South Florida , Tampa, FL, USA
| | - DeAnne Turner
- Department of Community and Family Health, College of Public Health, University of South Florida , Tampa, FL, USA
| | | | - Roger Zoorob
- Department of Family and Community Medicine, Baylor College of Medicine , Houston, TX, USA
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Nelson-Peterman JL, Toof R, Liang SL, Grigg-Saito DC. Long-Term Refugee Health: Health Behaviors and Outcomes of Cambodian Refugee and Immigrant Women. HEALTH EDUCATION & BEHAVIOR 2015; 42:814-23. [PMID: 26157042 DOI: 10.1177/1090198115590779] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Refugees in the United States have high rates of chronic disease. Both long-term effects of the refugee experience and adjustment to the U.S. health environment may contribute. While there is significant research on health outcomes of newly resettled refugees and long-term mental health experiences of established refugees, there is currently little information about how the combined effects of the refugee experience and the U.S. health environment are related to health practices of refugees in the years and decades after resettlement. We examined cross-sectional survey data for Cambodian refugee and immigrant women 35 to 60 years old (n = 160) from an established refugee community in Lowell, Massachusetts, to examine the potential contributors to health behaviors and outcomes among refugees and immigrants postresettlement. In our representative sample, we found that smoking and betel nut use were very low (4% each). Fewer than 50% of respondents walked for at least 10 minutes on 2 or more days/week. Using World Health Organization standards for overweight/obese for Asians, 73% of respondents were overweight/obese and 56% were obese, indicating increased risk of chronic disease. Depression was also high in this sample (41%). In multivariate models, higher acculturation and age were associated with walking more often; lower education and higher acculturation were related to higher weight; and being divorced/separated or widowed and being older were related to higher risk of depression. The interrelated complex of characteristics, health behaviors, and health outcomes of refugees merits a multifaceted approach to health education and health promotion for long-term refugee health.
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Affiliation(s)
| | - Robin Toof
- University of Massachusetts Lowell, Lowell, MA, USA
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Anderson LM, Adeney KL, Shinn C, Safranek S, Buckner‐Brown J, Krause LK. Community coalition-driven interventions to reduce health disparities among racial and ethnic minority populations. Cochrane Database Syst Rev 2015; 2015:CD009905. [PMID: 26075988 PMCID: PMC10656573 DOI: 10.1002/14651858.cd009905.pub2] [Citation(s) in RCA: 84] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Racial and ethnic disparities in health status are pervasive at all stages of the life cycle. One approach to reducing health disparities involves mobilizing community coalitions that include representatives of target populations to plan and implement interventions for community level change. A systematic examination of coalition-led interventions is needed to inform decision making about the use of community coalition models. OBJECTIVES To assess effects of community coalition-driven interventions in improving health status or reducing health disparities among racial and ethnic minority populations. SEARCH METHODS We searched MEDLINE, EMBASE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Central Register of Controlled Trials (CENTRAL), PsycINFO, Social Science Citation Index, Dissertation Abstracts, System for Information on Grey Literature in Europe (SIGLE) (from January 1990 through September 30, 2013), and Global Health Library (from January 1990 through March 31, 2014). SELECTION CRITERIA Cluster-randomized controlled trials, randomized controlled trials, quasi-experimental designs, controlled before-after studies, interrupted time series studies, and prospective controlled cohort studies. Only studies of community coalitions with at least one racial or ethnic minority group representing the target population and at least two community public or private organizations are included. Major outcomes of interest are direct measures of health status, as well as lifestyle factors when evidence indicates that these have an effect on the direct measures performed. DATA COLLECTION AND ANALYSIS Two review authors independently extracted data and assessed risk of bias for each study. MAIN RESULTS Fifty-eight community coalition-driven intervention studies were included. No study was considered to be at low risk of bias. Behavioral change outcomes and health status change outcomes were analyzed separately. Outcomes are grouped by intervention type. Pooled effects across intervention types are not presented because the diverse community coalition-led intervention studies did not examine the same constructs or relationships, and they used dissimilar methodological designs. Broad-scale community system level change strategies led to little or no difference in measures of health behavior or health status (very low-certainty evidence). Broad health and social care system level strategies leds to small beneficial changes in measures of health behavior or health status in large samples of community residents (very low-certainty evidence). Lay community health outreach worker interventions led to beneficial changes in health behavior measures of moderate magnitude in large samples of community residents (very low-certainty evidence). Lay community health outreach worker interventions may lead to beneficial changes in health status measures in large samples of community residents; however, results were not consistent across studies (low-certainty evidence). Group-based health education led by professional staff resulted in moderate improvement in measures of health behavior (very low-certainty evidence) or health status (low-certainty evidence). Adverse outcomes of community coalition-led interventions were not reported. AUTHORS' CONCLUSIONS Coalition-led interventions are characterized by connection of multi-sectoral networks of health and human service providers with ethnic and racial minority communities. These interventions benefit a diverse range of individual health outcomes and behaviors, as well as health and social care delivery systems. Evidence in this review shows that interventions led by community coalitions may connect health and human service providers with ethnic and racial minority communities in ways that benefit individual health outcomes and behaviors, as well as care delivery systems. However, because information on characteristics of the coalitions themselves is insufficient, evidence does not provide an explanation for the underlying mechanisms of beneficial effects. Thus, a definitive answer as to whether a coalition-led intervention adds extra value to the types of community engagement intervention strategies described in this review remains unattainable.
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Affiliation(s)
- Laurie M Anderson
- University of WashingtonDepartment of Epidemiology, School of Public HealthP.O. Box 357236SeattleWAUSA98195‐7236
| | - Kathryn L Adeney
- Washington State Institute for Public PolicyEpidemiology and Public Health110 Fifth Avenue SE, Suite 214SeattleWAUSA98504
| | - Carolynne Shinn
- New Hampshire Department of Health and Human ServicesNew Hampshire Division of Public Health ServicesConcordNew HampshireUSA03301‐3852
| | - Sarah Safranek
- University of WashingtonHealth Sciences Library1959 NE Pacific StreetSeattleWAUSA98195‐7155
| | - Joyce Buckner‐Brown
- Centers for Disease Control and PreventionNational Center for Chronic Disease Prevention and Health Promotion, Division of Community Health, Research Surveillance & Evaluation Branch4770 Buford Hwy NE, Mailstop K81AtlantaGeorgiaUSA30341
| | - L Kendall Krause
- Bill & Melinda Gates FoundationEpidemiology and Surveillance DivisionSeattleWAUSA
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Case AD, Byrd R, Claggett E, DeVeaux S, Perkins R, Huang C, Sernyak MJ, Steiner JL, Cole R, LaPaglia DM, Bailey M, Buchanan C, Johnson A, Kaufman JS. Stakeholders' perspectives on community-based participatory research to enhance mental health services. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2014; 54:397-408. [PMID: 25245601 PMCID: PMC10512440 DOI: 10.1007/s10464-014-9677-8] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Historically, consumers of mental health services have not been given meaningful roles in research and change efforts related to the services they use. This is quickly changing as scholars and a growing number of funding bodies now call for greater consumer involvement in mental health services research and improvement. Amidst these calls, community-based participatory research (CBPR) has emerged as an approach which holds unique promise for capitalizing on consumer involvement in mental health services research and change. Yet, there have been few discussions of the value added by this approach above and beyond that of traditional means of inquiry and enhancement in adult mental health services. The purpose of this paper is to add to this discussion an understanding of potential multilevel and multifaceted benefits associated with consumer-involved CBPR. This is accomplished through presenting the first-person accounts of four stakeholder groups who were part of a consumer-involved CBPR project purposed to improve the services of a local community mental health center. We present these accounts with the hope that by illustrating the unique outcomes associated with CBPR, there will be invigorated interest in CBPR as a vehicle for consumer involvement in adult mental health services research and enhancement.
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Affiliation(s)
- Andrew D Case
- Division of Prevention and Community Research, The Consultation Center, New Haven, CT, USA,
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DeSmet A, Palmeira A, Beltran A, Brand L, Davies VF, Thompson D. The Yin and Yang of Formative Research in Designing Serious (Exer-)games. Games Health J 2014; 4:63-6. [PMID: 26181683 DOI: 10.1089/g4h.2014.0123] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Despite its relevance, formative research on games may be an undervalued part of the game development process. At the 2014 International Society of Behavioral Nutrition and Physical Activity exergaming preconference satellite meeting, a roundtable discussion was held to assemble experiences and suggestions on enhancing the use of formative research in the development of active videogames (i.e., exergames). This article presents a summary of the concepts discussed. The discussants concluded that, although formative research may slightly expand the project timeline, the potential benefits include a game more in line with preferences of the intended users, with better operationalized theoretical constructs and broader stakeholder support, facilitating implementation and sustainability. It also improves the efficiency of other research parts because of a lower dropout rate of participants. Formative, qualitative research is thus a necessary complement to quantitative measurements of intervention outcomes, in a sort of Yin and Yang dynamic. An adapted version of formative research that casts a wider net may, however, be needed, involving both behavioral scientists and game developers, expanding the topics beyond the game's looks and soliciting the opinions of a larger group of stakeholders, such as implementers, gatekeepers, and funders.
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Affiliation(s)
- Ann DeSmet
- 1 Department of Movement and Sports Sciences, Faculty of Medicine and Health Sciences, Ghent University , Ghent, Belgium
| | - António Palmeira
- 2 Lusophone University of Humanities and Technology Faculty of Physical Education and Sports; and CIPER, Faculty of Human Movement, University of Lisbon , Lisbon, Portugal
| | - Alicia Beltran
- 2 Lusophone University of Humanities and Technology Faculty of Physical Education and Sports; and CIPER, Faculty of Human Movement, University of Lisbon , Lisbon, Portugal
| | - Leah Brand
- 3 USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine , Houston, Texas
| | - Vanessa Fernandes Davies
- 4 Graduate Program in Public Health, Center for Health Sciences at The Federal University of Santa Catarina , Santa Catarina, Brazil
| | - Debbe Thompson
- 3 USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine , Houston, Texas
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Mohamed AA, Hassan AM, Weis JA, Sia IG, Wieland ML. Physical activity among Somali men in Minnesota: barriers, facilitators, and recommendations. Am J Mens Health 2014; 8:35-44. [PMID: 23697961 DOI: 10.1177/1557988313489132] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Immigrants and refugees arrive to the United States healthier than the general population, but this advantage declines with increasing duration of residence. One factor contributing to this decline is suboptimal physical activity, but reasons for this are poorly understood. Persons from Somalia represent the largest African refugee population to the United States, yet little is known about perceptions of physical activity among Somali men. Somali members of a community-based participatory research partnership implemented three age-stratified focus groups and three semistructured interviews among 20 Somali men in Rochester, Minnesota. Team-based inductive analysis generated themes for barriers and facilitators to physical activity. Barriers to physical activity included less walking opportunities in the United States, embarrassment about exercise clothing and lack of familiarity with exercise equipment/modalities, fear of harassment, competing priorities, facility costs, transportation, and winter weather. Facilitators to physical activity included high knowledge about how to be active, success stories from others in their community as inspiration, and community cohesion. Findings may be used to derive interventions aimed to promote physical activity among Somali men in the United States.
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A Systematic Review of the Impact of Patient and Public Involvement on Service Users, Researchers and Communities. PATIENT-PATIENT CENTERED OUTCOMES RESEARCH 2014; 7:387-95. [DOI: 10.1007/s40271-014-0065-0] [Citation(s) in RCA: 354] [Impact Index Per Article: 35.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Tiedje K, Wieland ML, Meiers SJ, Mohamed AA, Formea CM, Ridgeway JL, Asiedu GB, Boyum G, Weis JA, Nigon JA, Patten CA, Sia IG. A focus group study of healthy eating knowledge, practices, and barriers among adult and adolescent immigrants and refugees in the United States. Int J Behav Nutr Phys Act 2014; 11:63. [PMID: 24886062 PMCID: PMC4030459 DOI: 10.1186/1479-5868-11-63] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2013] [Accepted: 05/12/2014] [Indexed: 11/23/2022] Open
Abstract
Background Immigrants and refugees to the United States exhibit lower dietary quality than the general population, but reasons for this disparity are poorly understood. In this study, we describe the meanings of food, health and wellbeing through the reported dietary preferences, beliefs, and practices of adults and adolescents from four immigrant and refugee communities in the Midwestern United States. Methods Using a community based participatory research approach, we conducted a qualitative research study with 16 audio-recorded focus groups with adults and adolescents who self-identified as Mexican, Somali, Cambodian, and Sudanese. Focus group topics were eating patterns, perceptions of healthy eating in the country of origin and in the U.S., how food decisions are made and who in the family is involved in food preparation and decisions, barriers and facilitators to healthy eating, and gender and generational differences in eating practices. A team of investigators and community research partners analyzed all transcripts in full before reducing data to codes through consensus. Broader themes were created to encompass multiple codes. Results Results show that participants have similar perspectives about the barriers (personal, environmental, structural) and benefits of healthy eating (e.g., ‘junk food is bad’). We identified four themes consistent across all four communities: Ways of Knowing about Healthy Eating (‘Meanings;’ ‘Motivations;’ ‘Knowledge Sources’), Eating Practices (‘Family Practices;’ ‘Americanized Eating Practices’ ‘Eating What’s Easy’), Barriers (‘Taste and Cravings;’ ‘Easy Access to Junk Food;’ ‘Role of Family;’ Cultural Foods and Traditions;’ ‘Time;’ ‘Finances’), and Preferences for Intervention (‘Family Counseling;’ Community Education;’ and ‘Healthier Traditional Meals.’). Some generational (adult vs. adolescents) and gender differences were observed. Conclusions Our study demonstrates how personal, structural, and societal/cultural factors influence meanings of food and dietary practices across immigrant and refugee populations. We conclude that cultural factors are not fixed variables that occur independently from the contexts in which they are embedded.
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Affiliation(s)
| | - Mark L Wieland
- Department of Medicine, Mayo Clinic, 200 First St, SW, Rochester, MN 55905, USA.
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Charlebois K, Loignon C, Boudreault-Fournier A, Dupéré S, Grabovschi C. [The involvement of vulnerable people in participatory research in primary care: a literature review]. Glob Health Promot 2014; 21:38-45. [PMID: 24662011 DOI: 10.1177/1757975913517123] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Malgré un vif intérêt pour la participation des patients à la gestion et à la prestation des soins de santé primaires, il n’existe aucune revue de la littérature sur le rôle des personnes vulnérables dans les projets de recherche participative menés dans le domaine des soins primaires. Une revue de la littérature de type narrative a été menée afin de combler cette lacune. L’objectif principal de cette revue a été d’évaluer le rôle des personnes vulnérables au sein de projets de recherche participative. Notre revue a recensé 26 articles et analysé 33 projets de recherche ou d’intervention en soins primaires. Elle révèle de nombreux écueils concernant l’implication des personnes vulnérables. Ces personnes ont joué un rôle varié, mais surtout modeste ou limité au sein des différents projets. Leur implication a surtout eu lieu à l’étape de la collecte des données. Peu de projets ont permis aux personnes vulnérables de prendre part à l’analyse des données ou à la diffusion des connaissances. Les tensions entre les chercheurs et les personnes vulnérables et la tendance à intégrer des acteurs organisés au sein des projets ont contribué à affaiblir le degré de participation des personnes vulnérables, et ce, à diverses étapes du processus de recherche et du développement d’intervention. Malgré tout, plusieurs retombées positives ont été identifiées, tant pour la communauté et les personnes vulnérables que pour les chercheurs. Entre autres, les projets ont permis aux chercheurs non universitaires d’acquérir de nouvelles compétences. De plus, certains projets ont favorisé la mise en place de nouveaux modèles de prestations de soins. Enfin, différents mécanismes permettant de rehausser la réciprocité entre les chercheurs et les personnes vulnérables sont proposés comme solutions pour réduire les inégalités et les tensions et, ultimement, favoriser l’implication des personnes vulnérables.
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Affiliation(s)
- Kathleen Charlebois
- Centre de recherche de l'Hôpital Charles LeMoyne, Université de Sherbrooke, Québec, Canada
| | - Christine Loignon
- Centre de recherche de l'Hôpital Charles LeMoyne, Université de Sherbrooke, Québec, Canada
| | | | - Sophie Dupéré
- Faculté des Sciences Infirmières, Université Laval, Québec, Canada
| | - Cristina Grabovschi
- Centre de recherche de l'Hôpital Charles LeMoyne, Université de Sherbrooke, Québec, Canada
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McKee M, Schlehofer D, Thew D. Ethical issues in conducting research with deaf populations. Am J Public Health 2013; 103:2174-8. [PMID: 24134363 DOI: 10.2105/ajph.2013.301343] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Deaf American Sign Language (ASL) users represent a small population at risk for marginalization from research and surveillance activities resulting from cultural, language, and ethical challenges. The Deaf community's view of deafness as a cultural identity, rather than a disability, contradicts the medical community's perception of deafness as a disease or deficiency in need of correction or elimination. These differences continue to have significant cultural and social implications within the Deaf community, resulting in mistrust of research opportunities. Two particularly contentious ethical topics for the Deaf community are the absence of community representation in genetic research and the lack of accessible informed consents and research materials. This article outlines a series of innovative strategies and solutions to these issues, including the importance of community representation and collaboration with researchers studying deaf populations.
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Affiliation(s)
- Michael McKee
- Michael McKee is with the Department of Family Medicine and the National Center for Deaf Health Research, University of Rochester School of Medicine and Dentistry, Rochester, NY. Deirdre Schlehofer is with the Department of American Sign Language and Interpreting Education, National Technical Institute for the Deaf, Rochester Institute of Technology, Rochester, NY. Denise Thew is with the Department of Public Health Science, University of Rochester School of Medicine and Dentistry, Rochester, NY
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Young-Lorion J, Davis MM, Kirks N, Hsu A, Slater JK, Rollins N, Aromaa S, McGinnis P. Rural Oregon community perspectives: introducing community-based participatory research into a community health coalition. Prog Community Health Partnersh 2013; 7:313-22. [PMID: 24056513 DOI: 10.1353/cpr.2013.0032] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
The Community Health Improvement Partnership (CHIP) model has supported community health development in more than 100 communities nationally. In 2011, four rural Oregon CHIPs collaborated with investigators from the Oregon Rural Practice-based Research Network (ORPRN), a component of the Oregon Clinical and Translational Research Institute (OCTRI), to obtain training on research methods, develop and implement pilot research studies on childhood obesity, and explore matches with academic partners. This article summarizes the experiences of the Lincoln County CHIP, established in 2003, as it transitioned from CHIP to Community Health Improvement and Research Partnership (CHIRP). Our story and lessons learned may inform rural community-based health coalitions and academicians who are engaged in or considering Community-based participatory research (CBPR) partnerships. Utilizing existing infrastructure and relationships in community and academic settings provides an ideal starting point for rural, bidirectional research partnerships.
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Abstract
BACKGROUND A 2005 Institute of Medicine report argues that "prevention of obesity in children and youth is, ultimately, about community," yet the literature lacks empirical research on what communities are doing to prevent childhood obesity. This research helps fill this gap and highlights promising practices. CASES This research entailed exploratory analysis of three descriptive case studies of community efforts to prevent childhood obesity in the northeastern United States: Shape Up Somerville in Massachusetts, MA (urban), Whole Community Project in New York, NY (semiurban), and Eat Well Play Hard Chemung in NY (semirural). Data included stakeholder interviews (n=23), participant observation (n ≥ 7 events and meetings/case), and document analysis (n≈100/case) from project inceptions until March, 2010. Meeting participation was tracked. Data were coded for actions and strategies. Actions were mapped to an adapted version of the ANalysis Grid for Environments Linked to Obesity (ANGELO) framework. DISCUSSION These three projects were successful in changing physical environments for food and activity through program and event offerings. The projects were less active in generating policy and economic change. The scale and scope of actions related to project longevity. Demographics of key project stakeholders may have hinged on individual and institutional identities of project facilitators and on intentionality of inclusion strategies. CONCLUSION Such projects could likely generate greater scope and scale of environmental changes to prevent childhood obesity if funding agencies provided long-term financial support and technical assistance, even if at lower levels. Diversity of participation would also benefit from stable support and from dispersal of decision-making powers, including through distributed funding.
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Yamatani H, Mann A, Feit M. Avoiding type III, IV, and V errors through collaborative research. JOURNAL OF EVIDENCE-BASED SOCIAL WORK 2013; 10:358-364. [PMID: 23879359 DOI: 10.1080/15433714.2012.664050] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Major types of empirical errors reviewed by a number of leading research textbooks include discussions of Type I and Type II errors. However, applied human service researchers can commit other types of errors that should be avoided. The potential benefits of the applied, collaborative research (in contrast to traditional participatory research) include an assurance that the study begins with the "right" questions that are important for community residents. Such research practice also helps generate useful research findings for decisions regarding redistribution of resources and resolving community issues. The aim of collaborative research is not merely to advance scientific understanding, but also to produce empirical findings that are usable for addressing priority needs and problems of distressed communities. A review of a case example (Garfield Community Assessment Study) illustrates the principles and practices of collaborative research.
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Affiliation(s)
- Hide Yamatani
- School of Social Work, University of Pittsburgh, Pittsburgh, PA 15260, USA.
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Brennan LK, Brownson RC, Kelly C, Ivey MK, Leviton LC. Concept mapping: priority community strategies to create changes to support active living. Am J Prev Med 2012; 43:S337-50. [PMID: 23079266 PMCID: PMC4766839 DOI: 10.1016/j.amepre.2012.07.015] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2012] [Revised: 06/26/2012] [Accepted: 07/02/2012] [Indexed: 11/27/2022]
Abstract
BACKGROUND From 2003 to 2008, a total of 25 cross-sector, multidisciplinary community partnerships funded through the Active Living by Design (ALbD) national program designed, planned, and implemented policy and environmental changes, with complementary programs and promotions. PURPOSE This paper describes the use of concept mapping methods to gain insights into promising active living intervention strategies based on the collective experience of community representatives implementing ALbD initiatives. METHODS Using Concept Systems software, community representatives (n=43) anonymously generated actions and changes in their communities to support active living (183 original statements, 79 condensed statements). Next, respondents (n=26, from 23 partnerships) sorted the 79 statements into self-created categories, or active living intervention approaches. Respondents then rated statements based on their perceptions of the most important strategies for creating community changes (n=25, from 22 partnerships) and increasing community rates of physical activity (n=23, from 20 partnerships). Cluster analysis and multidimensional scaling were used to describe data patterns. RESULTS ALbD community partnerships identified three active living intervention approaches with the greatest perceived importance to create community change and increase population levels of physical activity: changes to the built and natural environment, partnership and collaboration efforts, and land-use and transportation policies. The relative importance of intervention approaches varied according to subgroups of partnerships working with different populations. CONCLUSIONS Decision makers, practitioners, and community residents can incorporate what has been learned from the 25 community partnerships to prioritize active living policy, physical project, promotional, and programmatic strategies for work in different populations and settings.
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McKee M, Thew D, Starr M, Kushalnagar P, Reid JT, Graybill P, Velasquez J, Pearson T. Engaging the Deaf American sign language community: lessons from a community-based participatory research center. Prog Community Health Partnersh 2012; 6:321-9. [PMID: 22982845 DOI: 10.1353/cpr.2012.0037] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Numerous publications demonstrate the importance of community-based participatory research (CBPR) in community health research, but few target the Deaf community. The Deaf community is understudied and underrepresented in health research despite suspected health disparities and communication barriers. OBJECTIVES The goal of this paper is to share the lessons learned from the implementation of CBPR in an understudied community of Deaf American Sign Language (ASL) users in the greater Rochester, New York, area. METHODS We review the process of CBPR in a Deaf ASL community and identify the lessons learned. RESULTS Key CBPR lessons include the importance of engaging and educating the community about research, ensuring that research benefits the community, using peer-based recruitment strategies, and sustaining community partnerships. These lessons informed subsequent research activities. CONCLUSIONS This report focuses on the use of CBPR principles in a Deaf ASL population; lessons learned can be applied to research with other challenging-to-reach populations.
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Affiliation(s)
- Michael McKee
- Department of Family Medicine, University of Rochester, USA
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36
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Yoshihama M, Ramakrishnan A, Hammock AC, Khaliq M. Intimate partner violence prevention program in an Asian immigrant community: integrating theories, data, and community. Violence Against Women 2012; 18:763-83. [PMID: 22865356 DOI: 10.1177/1077801212455163] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
To fill an existing gap in research and practice on intimate partner violence (IPV) in immigrant communities, the authors developed an IPV prevention program, called the Shanti Project, in an Asian Indian community in the Midwest. Building on the notion of shanti (harmony/peace), a cherished value and strength of the community, we created a communications campaign that combined social marketing and community-based participatory approaches. Recognizing the interactive influences of multiple levels of social ecology, campaign activities were designed to bring about changes at the individual, relationship/family, organization, and community levels. This article presents the development of this theoretically, empirically, and community-based IPV prevention program.
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Postma J. Balancing power among academic and community partners: the case of El Proyecto Bienestar. J Empir Res Hum Res Ethics 2012; 3:17-32. [PMID: 19385743 DOI: 10.1525/jer.2008.3.2.17] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Balancing power among academic and community partners, addressing community-identified needs, and strengthening community capacity are ethical values unique to community-based participatory research (CBPR). Negotiation of these values in one CBPR environmental justice project was evaluated to advance the environmental and occupational health of a Hispanic agricultural community in central Washington State. Data were collected through document review and participant observation. Applied conversation and discourse analysis were used to interpret the data. Within the organization, farmworkers primarily served an advisory role. Facilitation style influenced how participants negotiated environmental justice. Research goals were advanced in the project, but no direct actions were taken to improve farmworker health. Implementing CBPR's ethical values requires a willingness to confront institutional and interpersonal challenges, and offers a vision of research that builds knowledge and strengthens communities.
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Keygnaert I, Vettenburg N, Temmerman M. Hidden violence is silent rape: sexual and gender-based violence in refugees, asylum seekers and undocumented migrants in Belgium and the Netherlands. CULTURE, HEALTH & SEXUALITY 2012; 14:505-20. [PMID: 22468763 PMCID: PMC3379780 DOI: 10.1080/13691058.2012.671961] [Citation(s) in RCA: 82] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2011] [Revised: 02/28/2012] [Indexed: 05/17/2023]
Abstract
Although women, young people and refugees are vulnerable to sexual and gender-based violence (SGBV) worldwide, little evidence exists concerning SGBV against refugees in Europe. Using community-based participatory research, 223 in-depth interviews were conducted with refugees, asylum seekers and undocumented migrants in Belgium and the Netherlands. Responses were analysed using framework analysis. The majority of the respondents were either personally victimised or knew of a close peer being victimised since their arrival in the European Union. A total of 332 experiences of SGBV were reported, mostly afflicted on them by (ex-)partners or asylum professionals. More than half of the reported violent experiences comprised sexual violence, including rape and sexual exploitation. Results suggest that refugees, asylum seekers and undocumented migrants in Belgium and the Netherlands are extremely vulnerable to violence and, specifically, to sexual violence. Future SGBV preventive measures should consist of rights-based, desirable and participatory interventions, focusing on several socio-ecological levels concurrently.
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Affiliation(s)
- Ines Keygnaert
- International Centre for Reproductive Health - Faculty of Medicine & Health Sciences, Ghent University, Ghent, Belgium.
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39
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Davis MV, Cilenti D, Gunther-Mohr C, Baker EL. Participatory research partnerships: addressing relevant public health system challenges. Public Health Rep 2012; 127:230-5. [PMID: 22379226 DOI: 10.1177/003335491212700214] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Mary V Davis
- North Carolina Institute for Public Health (NCIPH), UNC GSGPH, Chapel Hill, NC 27599, USA.
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Everett M. PRACTICING ANTHROPOLOGY ON A COMMUNITY-BASED PUBLIC HEALTH COALITION: LESSONS FROM HEAL. ANNALS OF ANTHROPOLOGICAL PRACTICE 2011. [DOI: 10.1111/j.2153-9588.2011.01079.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Wieland ML, Weis JA, Palmer T, Goodson M, Loth S, Omer F, Abbenyi A, Krucker K, Edens K, Sia IG. Physical activity and nutrition among immigrant and refugee women: a community-based participatory research approach. Womens Health Issues 2011; 22:e225-32. [PMID: 22154889 DOI: 10.1016/j.whi.2011.10.002] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2011] [Revised: 08/23/2011] [Accepted: 10/25/2011] [Indexed: 01/01/2023]
Abstract
BACKGROUND Immigrant and refugee populations arrive to the U.S. healthier than the general population, but the longer they reside, the more they approximate the cardiovascular risk profiles of the country. Among women, these declines are partly mediated by less physical activity and lower dietary quality upon immigration. Given the complex forces that influence these behaviors, a community-based participatory research (CBPR) approach is appropriate. Therefore, a socioculturally responsive physical activity and nutrition program was created with and for immigrant and refugee women in Rochester, Minnesota, through a CBPR approach. METHODS Focus groups informed program content and revealed principles for designing the sessions. A 6-week program with two, 90-minute classes per week was conducted among 45 women (Hispanic, Somali, Cambodian, and non-immigrant African American). Average attendance was 22.5 women per class; 34 women completed the evaluation. RESULTS Evaluation revealed high acceptability (average overall score of 4.85 out of 5 on the Physical Activity Class Satisfaction Questionnaire). After the intervention, participants were more likely to exercise regularly (p ≤ .001). They reported higher health-related quality of life (p ≤ .001) and self-efficacy for diet (p = .36) and exercise (p = .10). Likewise, there were trends for weight loss (87 vs 83.4 kg; p = .65), decreased waist circumference (99.6 vs 95.5 cm; p = .35), and lower blood pressure (125/80 vs 122/76 mm/Hg; p = .27). CONCLUSION A CBPR approach to design and implement a socioculturally responsive fitness program was highly acceptable to immigrant and refugee women and demonstrated promising outcomes. Further testing of physical activity and nutrition interventions that arise organically from target communities are needed.
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Affiliation(s)
- Mark L Wieland
- Division of Primary Care Internal Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
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Aysola J, Orav EJ, Ayanian JZ. Neighborhood Characteristics Associated With Access To Patient-Centered Medical Homes For Children. Health Aff (Millwood) 2011; 30:2080-9. [DOI: 10.1377/hlthaff.2011.0656] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Jaya Aysola
- Jaya Aysola ( ) is a research fellow in the Department of Health Care Policy at Harvard Medical School and at Brigham and Women’s Hospital, in Boston, Massachusetts
| | - E. John Orav
- John Z. Ayanian (
) is a professor of medicine and health care policy at Harvard Medical School and a professor of health policy and management at the Harvard School of Public Health
| | - John Z. Ayanian
- E. John Orav is an associate professor of biostatistics at the Harvard School of Public Health and an associate professor of medicine (biostatistics) at Harvard Medical School
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Carney JK, Maltby HJ, Mackin KA, Maksym ME. Community-academic partnerships: how can communities benefit? Am J Prev Med 2011; 41:S206-13. [PMID: 21961666 DOI: 10.1016/j.amepre.2011.05.020] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2011] [Revised: 05/11/2011] [Accepted: 05/26/2011] [Indexed: 10/17/2022]
Abstract
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.
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Affiliation(s)
- Jan K Carney
- Department of Medicine, University of Vermont College of Medicine, Burlington, Vermont 05405, USA.
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Gehlert S, Colditz GA. Cancer disparities: unmet challenges in the elimination of disparities. Cancer Epidemiol Biomarkers Prev 2011; 20:1809-14. [PMID: 21784956 DOI: 10.1158/1055-9965.epi-11-0628] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND The first 20 years of publication of Cancer Epidemiology, Biomarkers & Prevention occurred during a period of increased attention to health disparities and advances in knowledge about their determinants. Yet, despite clear documentation of disparities and advanced understanding of determinants, we have made little headway in reducing disparities at the population level. Multilevel models, such as one produced by the Centers for Population Health and Health Disparities (CPHHD), hold promise for understanding the complex determinants of cancer disparities and their interactions as well as translating scientific discoveries into solutions. The CPHHD model maps across a range of scientific disciplines, from the biological to the social, each with its own disciplinary language and methods. The ability to work effectively across disciplinary boundaries is essential to framing comprehensive solutions. METHODS After briefly characterizing the current state of knowledge about health disparities, we outline three major challenges faced by disparities researchers and practitioners and offer suggestions for addressing these challenges. RESULTS These challenges are how to consider race and ethnicity in disparities research, how best to translate discoveries into public health solutions to cancer disparities, and how to create a research environment that supports the successful execution of multilevel research. CONCLUSIONS Attention to all three of the challenges outlined above is urgently needed to advance our efforts to eliminate cancer disparities. IMPACT Addressing the challenges outlined above will help to eliminate disparities in the future.
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Affiliation(s)
- Sarah Gehlert
- The Brown School, Box 1196, Washington University, One Brookings Drive, St. Louis, MO 63130, USA.
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Abstract
OBJECTIVE In response to The New Nutrition Science Project's Giessen Declaration, we provide here a case for a more fully described and integrated 'social' dimension within the nutrition sciences. DESIGN This paper explores what we mean when we argue for socially engaged nutrition sciences (SENS), and describes the disciplinary fields, epistemologies and methodologies that contribute to SENS' potential rich diversity and value. Additionally, the current positioning of 'social nutrition' research within the nutrition sciences is critiqued. RESULTS There is fairly broad acceptance of the 'social' as an important contributor to successful public health nutrition situation analyses, intervention planning and implementation. However, we assert that the 'social' is not merely a contributor, the usual position, but is central. Implications for policy and practice that could follow from this shift in approach are outlined. CONCLUSIONS We call for researchers, educators, policy makers and practitioners alike to re-imagine the role and purpose of social science enquiry that could enable the delivery of more socially engaged nutrition sciences.
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Spector AY. CBPR with service providers: arguing a case for engaging practitioners in all phases of research. Health Promot Pract 2011; 13:252-8. [PMID: 21677113 DOI: 10.1177/1524839910382081] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This review synthesizes the literature on CBPR with service providers to identify the benefits to, unique contributions of, and challenges experienced by professional service providers engaged in collaborative research. Service providers benefited by obtaining research-based knowledge to help the communities they serve, gaining research skills, professional relationships, professional development, and new programs. They contributed by informing research aims, designing interventions, conducting recruitment, informing overall study design, and dissemination. Challenges include time, resources, organizational factors, and disconnects between researchers and service providers. Policy and practice implications are explored.
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Liu J, McCauley L, Leung P, Wang B, Needleman H, Pinto-Martin J. Community-based participatory research (CBPR) approach to study children's health in China: experiences and reflections. Int J Nurs Stud 2011; 48:904-13. [PMID: 21601204 DOI: 10.1016/j.ijnurstu.2011.04.003] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2010] [Revised: 04/05/2011] [Accepted: 04/15/2011] [Indexed: 10/18/2022]
Abstract
BACKGROUND Community-based participatory research principles have been successfully applied to public health research in U.S. settings. While there is a long history of collaboration between government and communities in China, to date, community-based participatory research has not been used in children's environmental health studies. METHOD This article describes how community-based participatory research principles were applied by an international research group to the China Jintan Child Cohort Study, a longitudinal study of malnutrition and lead exposure on cognitive and neurobehavioral development. Challenges emerged and lessons learned from implementing the study were discussed and recommendations were presented. CONCLUSION We conclude that the community-based participatory research model can be applied in conducting and promoting environmental health research in China and researchers should be prepared for special challenges and cultural constraints in the implementation of the research in regards to human subject regulations, information dissemination, and culture.
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Cheadle A, Bourcier E, Krieger J, Beery W, Smyser M, Vinh DV, Lessler D, Alfonsi L. The Impact of a Community-Based Chronic Disease Prevention Initiative: Evaluation Findings From Steps to Health King County. HEALTH EDUCATION & BEHAVIOR 2011; 38:222-30. [DOI: 10.1177/1090198110371463] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Steps to Health King County ( Steps KC; Seattle, Washington) was one of 40 community-level initiatives funded in 2003 as part of the Steps to a HealthierUS initiative. Steps KC goals included reducing the impact of chronic diseases through a comprehensive, coordinated approach and reducing health disparities due to chronic illness. Steps KC intervention activities took place on two levels: the overall Steps KC collaborative and individual funded programs. Collaborative-level activities included policy and systems change initiatives and efforts to better integrate the funded-program organizations. The funded programs ranged from group health promotion programs to intensive case management. Steps KC was successful in creating a large, diverse community collaborative and funding 14 separate programs that reached approximately 8,000 community residents with medium- and high-intensity programs of demonstrated effectiveness. Systems change initiatives within school districts and government agencies led to a greater institutional emphasis on health promotion and on partnership with communities to address health inequities.
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Affiliation(s)
| | - Emily Bourcier
- Center for Community Health and Evaluation, Group Health Research Institute, Seattle, WA, USA
| | - James Krieger
- Public Health - Seattle & King County, Seattle, WA, USA
| | - William Beery
- Center for Community Health and Evaluation, Group Health Research Institute, Seattle, WA, USA
| | | | - Diana V. Vinh
- Public Health - Seattle & King County, Seattle, WA, USA
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Danis M, Kotwani N, Garrett J, Rivera I, Davies-Cole J, Carter-Nolan P. Priorities of low-income urban residents for interventions to address the socio-economic determinants of health. J Health Care Poor Underserved 2011; 21:1318-39. [PMID: 21099082 DOI: 10.1353/hpu.2010.0929] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVES To determine the priorities of low-income urban residents for interventions that address the socio-economic determinants of health. METHODS We selected and estimated the cost of 16 interventions related to education, housing, nutrition, employment, health care, healthy behavior, neighborhood improvement, and transportation. Low-income residents of Washington, D.C. (N=431) participated in decision exercises to prioritize these interventions. RESULTS Given a budget valued at approximately twice an estimated cost of medical and dental care ($885), the interventions ultimately prioritized by the greatest percentage of individuals were: health insurance (95%), housing vouchers (82%) dental care (82%), job training (72%), adult education (63%), counseling (68%), healthy behavior incentives (68%), and job placement (67%). The percentages of respondents who received support for housing, adult education, and job training and placement were far less than the percentage who prioritized these interventions. CONCLUSIONS Poor and low-income residents' priorities may usefully inform allocation of social services that affect health.
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Affiliation(s)
- Marion Danis
- Bioethics Consultation Service, Dept. of Bioethics; Clinical Center, National Institutes of Health, Bldg. 10, Rm. 1C118, Bethesda, MD 20892-1156, USA.
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Downey LH, Castellanos DC, Yadrick K, Avis-Williams A, Graham-Kresge S, Bogle M. Perceptions of community-based participatory research in the Delta Nutrition Intervention Research Initiative: an academic perspective. Health Promot Pract 2010; 12:744-52. [PMID: 20530639 DOI: 10.1177/1524839909353743] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Lower Mississippi Delta Nutrition Intervention Research Initiative (Delta NIRI) is an academic-community partnership between seven academic institutions and three communities in Mississippi, Arkansas, and Louisiana. A range of community-based participatory methods have been used to develop sustainable nutrition intervention strategies. Focus groups were conducted with 22 faculty and staff members from the academic partners on the project to document their perceptions of community-based participatory processes in a federally funded, multi-academic-community partnership spanning a decade. Focus groups were conducted to glean insights or lessons from the experiences of academic personnel. Focus groups were transcribed and analyzed using the constant comparative method. Two researchers analyzed each transcript independently and reached consensus on the consistent themes. Participants candidly shared their experiences of working with community members to devise research plans, implement programs, and evaluate outcomes. The majority of faculty and staff members were attracted to this project by an excitement for conducting a more egalitarian and potentially more successful type of research. Yet each academic partner voiced that there was an underlying disconnect between community practices and research procedures during the project. Additional barriers to collaboration and action, located in communities and academic institutions, were described. Academic partners stressed the importance of open and ongoing communication, collective decision-making strategies, and techniques that support power sharing between all parties involved in the project. Findings from this research can inform academic-community partnerships and hopefully improve the community-based participatory research process implemented by academic institutions and communities.
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Affiliation(s)
- Laura Hall Downey
- Department of Community Health Sciences at the University of Southern Mississippi, Hattiesburg, MS 39406, USA.
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