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Mrklas KJ, Boyd JM, Shergill S, Merali S, Khan M, Moser C, Nowell L, Goertzen A, Swain L, Pfadenhauer LM, Sibley KM, Vis-Dunbar M, Hill MD, Raffin-Bouchal S, Tonelli M, Graham ID. A scoping review of the globally available tools for assessing health research partnership outcomes and impacts. Health Res Policy Syst 2023; 21:139. [PMID: 38129871 PMCID: PMC10740226 DOI: 10.1186/s12961-023-00958-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Accepted: 01/03/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND Health research partnership approaches have grown in popularity over the past decade, but the systematic evaluation of their outcomes and impacts has not kept equal pace. Identifying partnership assessment tools and key partnership characteristics is needed to advance partnerships, partnership measurement, and the assessment of their outcomes and impacts through systematic study. OBJECTIVE To locate and identify globally available tools for assessing the outcomes and impacts of health research partnerships. METHODS We searched four electronic databases (Ovid MEDLINE, Embase, CINAHL + , PsychINFO) with an a priori strategy from inception to June 2021, without limits. We screened studies independently and in duplicate, keeping only those involving a health research partnership and the development, use and/or assessment of tools to evaluate partnership outcomes and impacts. Reviewer disagreements were resolved by consensus. Study, tool and partnership characteristics, and emerging research questions, gaps and key recommendations were synthesized using descriptive statistics and thematic analysis. RESULTS We screened 36 027 de-duplicated citations, reviewed 2784 papers in full text, and kept 166 studies and three companion reports. Most studies originated in North America and were published in English after 2015. Most of the 205 tools we identified were questionnaires and surveys targeting researchers, patients and public/community members. While tools were comprehensive and usable, most were designed for single use and lacked validity or reliability evidence. Challenges associated with the interchange and definition of terms (i.e., outcomes, impacts, tool type) were common and may obscure partnership measurement and comparison. Very few of the tools identified in this study overlapped with tools identified by other, similar reviews. Partnership tool development, refinement and evaluation, including tool measurement and optimization, are key areas for future tools-related research. CONCLUSION This large scoping review identified numerous, single-use tools that require further development and testing to improve their psychometric and scientific qualities. The review also confirmed that the health partnership research domain and its measurement tools are still nascent and actively evolving. Dedicated efforts and resources are required to better understand health research partnerships, partnership optimization and partnership measurement and evaluation using valid, reliable and practical tools that meet partners' needs.
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Affiliation(s)
- Kelly J Mrklas
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3D10-3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada.
- Strategic Clinical Networks™, Provincial Clinical Excellence, Alberta Health Services, Calgary, AB, Canada.
| | - Jamie M Boyd
- Knowledge Translation Program, St Michael's Hospital, Li Ka Shing Knowledge Institute, Unity Health Toronto, Toronto, ON, Canada
| | - Sumair Shergill
- Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Sera Merali
- Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
| | - Masood Khan
- Department of Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Cheryl Moser
- Department of Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Lorelli Nowell
- Faculty of Nursing, University of Calgary, Calgary, AB, Canada
| | - Amelia Goertzen
- Faculty of Science, University of Alberta, Edmonton, AB, Canada
| | - Liam Swain
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3D10-3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada
| | - Lisa M Pfadenhauer
- Institute for Medical Information Processing, and Epidemiology-IBE, Ludwig-Maximilians Universität Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - Kathryn M Sibley
- Department of Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada
- George & Fay Yee Centre for Healthcare Innovation, University of Manitoba, Winnipeg, MB, Canada
| | | | - Michael D Hill
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3D10-3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada
- Departments of Clinical Neurosciences, Medicine and Radiology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | | | - Marcello Tonelli
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Office of the Vice-President (Research), University of Calgary, Calgary, AB, Canada
| | - Ian D Graham
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
- Schools of Epidemiology and Public Health and Nursing, University of Ottawa, Ottawa, ON, Canada
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Zibrowski E, Carr T, McDonald S, Thiessen H, van Dusen R, Goodridge D, Haver C, Marciniuk D, Stobart C, Verrall T, Groot G. A rapid realist review of patient engagement in patient-oriented research and health care system impacts: part one. RESEARCH INVOLVEMENT AND ENGAGEMENT 2021; 7:72. [PMID: 34629118 PMCID: PMC8504114 DOI: 10.1186/s40900-021-00299-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 07/15/2021] [Indexed: 05/16/2023]
Abstract
BACKGROUND Patient-oriented research affords individuals with opportunities to genuinely contribute to health care research as members of research teams. While checklists and frameworks can support academic researchers' awareness of patient engagement methods, less guidance appears available to support their understanding of how to develop and maintain collaborative relationships with their patient partners. This knowledge is essential as patient partners report that the social atmospheres of research teams significantly impacts the quality of their experiences. This study sought to develop theory regarding how academic researchers support and sustain patient engagement in patient-oriented research. METHODS A six-step, rapid realist review was conducted: (1) research question development, (2) preliminary theory development, (3) search strategy development; (4) study selection and appraisal, (4) data extraction, analysis and synthesis (5) identification of relevant formal theories, and (6) theory refinement with stakeholders. Findings were additionally distilled by collective competence theory. RESULTS A program theory was developed from 62 international studies which illuminated mechanisms supporting academic researchers to engage patient partners, contexts supporting these mechanisms, and resources that enabled mechanism activation. Interaction between seven contexts (patient-oriented research belief, prior interaction with a healthcare system, prior interaction with a particular academic researcher, educational background of patient partner, prior experience with patient-oriented research, study type, and time lived in a rural-urban setting) and seven mechanisms (deciding to become involved in patient-oriented research, recognizing valuable experiential knowledge, cultural competence, reducing power differentials, respectful team environment, supporting patient partners to feel valued, and readiness to research) resulted in an intermediate outcome (sense of trust). Trust then acted as an eighth mechanism which triggered the final-level outcome (empowered patient-centred lens). CONCLUSIONS Our theory posits that if patient partners trust they are a member of a supportive team working alongside academic researchers who authentically want to incorporate their input, then they are empowered to draw upon their experiential knowledge of health care systems and contribute as researchers in patient-oriented research. Our theory extends conceptual thinking regarding the importance of trust on patient-oriented research teams, how patient partners' trust is shaped by team interactions, and the role that academic researchers have within those interactions.
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Affiliation(s)
- Elaine Zibrowski
- Department of Community Health and Epidemiology, University of Saskatchewan, 107 Wiggins Road, Saskatoon, SK, S7N 5E5, Canada
| | - Tracey Carr
- Department of Community Health and Epidemiology, University of Saskatchewan, 107 Wiggins Road, Saskatoon, SK, S7N 5E5, Canada
| | | | | | | | - Donna Goodridge
- University of Saskatchewan, College of Medicine, 107 Wiggins Road, Saskatoon, SK, S7N 5E5, Canada
| | - Charlene Haver
- Saskatchewan Centre for Patient-Oriented Research, Health Sciences Building, 107 Wiggins Road, Saskatoon, SK, S7N 5E5, Canada
| | - Darcy Marciniuk
- University of Saskatchewan, College of Medicine, 107 Wiggins Road, Saskatoon, SK, S7N 5E5, Canada
| | - Christine Stobart
- Saskatchewan Centre for Patient-Oriented Research, Health Sciences Building, 107 Wiggins Road, Saskatoon, SK, S7N 5E5, Canada
| | - Tanya Verrall
- Saskatchewan Health Quality Council, Atrium Building, Innovation Place, 241 - 111 Research Drive, Saskatoon, SK, S7N 3R2, Canada
| | - Gary Groot
- Department of Community Health and Epidemiology, University of Saskatchewan, 107 Wiggins Road, Saskatoon, SK, S7N 5E5, Canada.
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Stevens AB, Cho J, Thorud JL, Abraham S, Ory MG, Smith DR. The community-based LIVE WELL Initiative: Improving the lives of older adults. J Prev Interv Community 2021:1-20. [PMID: 34157245 DOI: 10.1080/10852352.2021.1930821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
A collaborative partnership among community-based organizations (CBOs) could strengthen local services and enhance the capacity of a community to provide services as well as meet the diverse needs of older adults. The United Way of Tarrant County developed the LIVE WELL Initiative, partnering with six CBOs to provide nine evidence-based or evidence-informed health interventions to improve the health and lower healthcare costs of vulnerable individuals at risk for poor health. The nine programs include specific target areas, such as falls prevention, chronic disease self-management, medication management, and diabetes screening and education. A total of 63,102 clients, nearly 70% of whom were older adults, were served through the Initiative. Significant improvements in self-reported health status were observed among served clients. The percentage of clients reporting self-rated health as good, very good, and excellent increased from 47.5% at baseline to 61.1% at follow-up assessment. The mean healthy days improved from 16.9 days at baseline to 20.6 days at follow-up assessment. Additional improvements in program-specific outcomes demonstrated significant impacts of targeted intervention focus among served clients by program. The findings of this study emphasize that the impact of a collaborative partnership with multiple CBOs could promote health and well-being for older adults.
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Affiliation(s)
- Alan B Stevens
- Baylor Scott & White Health, Temple, Texas, USA.,Texas A&M College of Medicine, Temple, Texas, USA
| | - Jinmyoung Cho
- Baylor Scott & White Health, Temple, Texas, USA.,Texas A&M School of Public Health, College Station, Texas, USA
| | | | | | - Marcia G Ory
- Texas A&M School of Public Health, College Station, Texas, USA
| | - Donald R Smith
- Area Agency on Aging, United Way of Tarrant County, Fort Worth, Texas, USA
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Baquero B, Kava CM, Ashida S, Daniel-Ulloa J, Laroche HH, Haines H, Bucklin R, Maldonado A, Coronado Garcia M, Berto S, Sewell D, Novak N, Janz K, Gates C, Parker EA. Active Ottumwa: Adapting Evidence-Based Recommendations to Promote Physical Activity in a Micropolitan New Destination Community. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15050917. [PMID: 29734709 PMCID: PMC5981956 DOI: 10.3390/ijerph15050917] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Revised: 04/26/2018] [Accepted: 04/30/2018] [Indexed: 11/16/2022]
Abstract
Background: Evidence-based interventions have been developed and tested to promote physical activity, but fewer studies have focused on identifying effective intervention strategies for mid-size rural communities, especially new immigrant destinations. We report here on the design and implementation of Active Ottumwa, a community-wide intervention using a lay health advisor approach to increase physical activity in a micropolitan new destination community in the rural state of Iowa. Methods: The Active Ottumwa study is part of a community-academic partnership in Ottumwa, IA. Evidence-based strategies recommended by the Community Guide for Preventive Services guided study implementation and included behavioral and social, campaign and informational, and environmental and policy approaches. Evaluation methods for this study are multi-faceted and include a cross-sectional community survey, longitudinal cohort assessment, observational data, key informant interviews, and project records. Results: We are currently in our second year of intervention implementation, with 45 lay health advisors (termed physical activity leaders here) trained to carry out behavioral and social intervention approaches, including walking groups, tai chi, and yoga. We have completed a communication and informational campaign utilizing five channels. Our longitudinal cohort has been recruited, with baseline and 12-month data collection completed. Conclusions: This study will assess the effectiveness and impact of a community-wide intervention to support physical activity.
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Affiliation(s)
- Barbara Baquero
- University of Iowa Prevention Research Center, Department of Community and Behavioral Health, University of Iowa College of Public Health, 145 N. Riverside Dr., Iowa City, IA 52240, USA.
| | - Christine M Kava
- University of Iowa Prevention Research Center, Department of Community and Behavioral Health, University of Iowa College of Public Health, 145 N. Riverside Dr., Iowa City, IA 52240, USA.
| | - Sato Ashida
- University of Iowa Prevention Research Center, Department of Community and Behavioral Health, University of Iowa College of Public Health, 145 N. Riverside Dr., Iowa City, IA 52240, USA.
| | - Jason Daniel-Ulloa
- University of Iowa Prevention Research Center, Department of Community and Behavioral Health, University of Iowa College of Public Health, 145 N. Riverside Dr., Iowa City, IA 52240, USA.
| | - Helena H Laroche
- Department of Internal Medicine, University of Iowa Carver College of Medicine, 451 Newton Rd., Iowa City, IA 52242, USA.
| | - Heidi Haines
- University of Iowa Prevention Research Center, Department of Community and Behavioral Health, University of Iowa College of Public Health, 145 N. Riverside Dr., Iowa City, IA 52240, USA.
| | - Rebecca Bucklin
- University of Iowa Prevention Research Center, Department of Community and Behavioral Health, University of Iowa College of Public Health, 145 N. Riverside Dr., Iowa City, IA 52240, USA.
| | - Adriana Maldonado
- University of Iowa Prevention Research Center, Department of Community and Behavioral Health, University of Iowa College of Public Health, 145 N. Riverside Dr., Iowa City, IA 52240, USA.
| | - Mayra Coronado Garcia
- Department of Biostatistics, University of Iowa College of Public Health, 145 N. Riverside Dr., Iowa City, IA 52240, USA.
| | - Sandy Berto
- University of Iowa Prevention Research Center, Department of Community and Behavioral Health, University of Iowa College of Public Health, 145 N. Riverside Dr., Iowa City, IA 52240, USA.
| | - Dan Sewell
- Department of Biostatistics, University of Iowa College of Public Health, 145 N. Riverside Dr., Iowa City, IA 52240, USA.
| | - Nicole Novak
- University of Iowa Prevention Research Center, Department of Community and Behavioral Health, University of Iowa College of Public Health, 145 N. Riverside Dr., Iowa City, IA 52240, USA.
| | - Kathleen Janz
- Department of Health and Human Physiology, University of Iowa College of Liberal Arts and Sciences, 240 Schaeffer Hall, Iowa City, IA 52242, USA.
| | - Claudia Gates
- Community Advisory Board representative, Ottumwa Prevention Research Center office, 205 E. Main St., Ottumwa, IA 52556, USA.
| | - Edith A Parker
- University of Iowa Prevention Research Center, Department of Community and Behavioral Health, University of Iowa College of Public Health, 145 N. Riverside Dr., Iowa City, IA 52240, USA.
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Nwanyanwu KH, Grossetta Nardini HK, Shaughness G, Nunez-Smith M, Newman-Casey PA. Systematic Review of Community-Engaged Research in Ophthalmology. EXPERT REVIEW OF OPHTHALMOLOGY 2017; 12:233-241. [PMID: 29333193 DOI: 10.1080/17469899.2017.1311787] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Introduction Community-engaged research (CEnR) allows researchers and community organizations to partner together to improve health outcomes and to decrease health disparities. While prevalent in other fields of medicine, it is rarely used in ophthalmology. Areas covered A comprehensive search of Ovid MEDLINE, NLM Pubmed, Ovid Embase, Scopus and the Cochrane Library for the Medical Subject Headings (MeSH) "Community-based participatory research" and text word variations including participatory research, community engagement, community research, partnered research, community-institutional relations, CENR, CBPR in addition to variations on ophthalmology, eye diseases, vision disorders and eye injuries yielded 451 unique references. Two ophthalmologists (KN, PANC) reviewed the titles and abstracts and identified 37 relevant studies. Expert consultation yielded an additional reference. After reviewing the full texts and excluding non-English texts, 18 articles met the necessary criteria. The eighteen articles all utilized at least one of the nine principles of CEnR. Expert commentary Ophthalmology is perfectly positioned to benefit from CEnR. Increased community engagement in ophthalmic research would expand the reach of our work and address some of the most difficult problems in vision disparities and outcomes.
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Affiliation(s)
| | | | | | - Marcella Nunez-Smith
- Associate Professor of Medicine and Epidemiology, Director, Equity Research and Innovation Center, Deputy Directory of Health Equity Research and Workforce Development, Yale Center for Clinical Investigation, Yale University
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DeBate RD, Plescia M. I Could Live other Places, but This is Where I Want to Be: Support for Natural Helper Initiatives. INTERNATIONAL QUARTERLY OF COMMUNITY HEALTH EDUCATION 2016. [DOI: 10.2190/1e5x-7mjh-qqlq-67t4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Charlotte REACH 2010 is an example of a multi-level intervention with the goal of reducing cardiovascular disease (CVD) and diabetes. Structured within a socio-ecological framework, lay health advisors are the link between the multi-level programs. An exploratory assessment was conducted using focus group methodology. Nine focus groups were conducted with the Charlotte REACH LHAs, residents who had participated in REACH program activities, and residents who had not participated in REACH activities. Results reveal two prominent themes: improvements in health practices and community competence. Both LHAs and community participants improved their knowledge of health enhancement behaviors, developed health enhancement skills and behaviors, and noted personal, familial, and community wide health improvements. Community competence was also observed with regard to community commitment, communication of health issues, and expanded social support networks. The results of this qualitative evaluation suggest the effectiveness of incorporating natural helper models as part of larger multi-level initiatives.
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Freudenberg N, Manoncourt E. Urban Health Promotion: Current Practices and New Directions. HEALTH EDUCATION & BEHAVIOR 2016. [DOI: 10.1177/109019819802500203] [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]
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8
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Ritchwood TD, Albritton T, Akers A, Dave G, Carthron D, Adimora A, Corbie-Smith G. The effect of Teach One Reach One (TORO) on youth acceptance of couple violence. JOURNAL OF CHILD AND FAMILY STUDIES 2015; 24:3805-3815. [PMID: 26783386 PMCID: PMC4714857 DOI: 10.1007/s10826-015-0188-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
This study evaluated the impact of the Teach One Reach One intervention, a community-based participatory research project designed to address the co-occurrence of adolescent risk behaviors on acceptance of teen dating violence. Data were derived from 331 rural African American youth between 10-14 years of age who participated in caregiver-youth dyads as either: 1) peer lay health advisor dyads, or Ambassadors, 2) caregiver-youth dyads recruited by Ambassadors, or Allies, or 3) comparison dyads. The following study focuses on participating youth only and our results indicated that: 1) Ambassadors and Allies reported less acceptance of couple violence than youth within the comparison group, and 2) less family cohesion, greater family conflict, and greater knowledge of healthy dating behaviors predicted greater acceptance of couple violence. Our findings highlight the efficaciousness of the TORO intervention, which directly engaged participants in prevention efforts through community-based participatory research methods and the use of lay heath advisors.
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Affiliation(s)
- Tiarney D. Ritchwood
- Center for Health Equity Research (CHER), Department of Social Medicine, University of North Carolina at Chapel Hill
| | - Tashuna Albritton
- CIRA, Yale University, 135 College Street, Suite 200, New Haven, CT 06510-2483
| | - Aletha Akers
- The Craig Dalsimer Division of Adolescent Medicine, The Children's Hospital of Philadelphia, 34th Street and Civic Center Boulevard, Suite 11 NW10 Philadelphia, PA 19104
| | - Gaurav Dave
- Center for Health Equity Research (CHER), Department of Social Medicine, University of North Carolina at Chapel Hill
| | - Dana Carthron
- Center for Health Equity Research (CHER), Department of Social Medicine, University of North Carolina at Chapel Hill
| | - Adaora Adimora
- School of Medicine, University of North Carolina at Chapel Hill
| | | | - Giselle Corbie-Smith
- Center for Health Equity Research (CHER), Department of Social Medicine, University of North Carolina at Chapel Hill
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Turinawe EB, Rwemisisi JT, Musinguzi LK, de Groot M, Muhangi D, de Vries DH, Mafigiri DK, Pool R. Selection and performance of village health teams (VHTs) in Uganda: lessons from the natural helper model of health promotion. HUMAN RESOURCES FOR HEALTH 2015; 13:73. [PMID: 26346431 PMCID: PMC4562111 DOI: 10.1186/s12960-015-0074-7] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2015] [Accepted: 08/27/2015] [Indexed: 05/28/2023]
Abstract
BACKGROUND Community health worker (CHW) programmes have received much attention since the 1978 Declaration of Alma-Ata, with many initiatives established in developing countries. However, CHW programmes often suffer high attrition once the initial enthusiasm of volunteers wanes. In 2002, Uganda began implementing a national CHW programme called the village health teams (VHTs), but their performance has been poor in many communities. It is argued that poor community involvement in the selection of the CHWs affects their embeddedness in communities and success. The question of how selection can be implemented creatively to sustain CHW programmes has not been sufficiently explored. In this paper, our aim was to examine the process of the introduction of the VHT strategy in one rural community, including the selection of VHT members and how these processes may have influenced their work in relation to the ideals of the natural helper model of health promotion. METHODS As part of a broader research project, an ethnographic study was carried out in Luwero district. Data collection involved participant observation, 12 focus group discussions (FGDs), 14 in-depth interviews with community members and members of the VHTs and four key informant interviews. Interviews and FGD were recorded, transcribed and coded in NVivo. Emerging themes were further explored and developed using text query searches. Interpretations were confirmed by comparison with findings of other team members. RESULTS The VHT selection process created distrust, damaging the programme's legitimacy. While the Luwero community initially had high expectations of the programme, local leaders selected VHTs in a way that sidelined the majority of the community's members. Community members questioned the credentials of those who were selected, not seeing the VHTs as those to whom they would go to for help and support. Resentment grew, and as a result, the ways in which the VHTs operated alienated them further from the community. Without the support of the community, the VHTs soon lost morale and stopped their work. CONCLUSION As the natural helper model recommends, in order for CHW programmes to gain and maintain community support, it is necessary to utilize naturally existing informal helping networks by drawing on volunteers already trusted by the people being served. That way, the community will be more inclined to trust the advice of volunteers and offer them support in return, increasing the likelihood of the sustainability of their service in the community.
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Affiliation(s)
| | | | | | | | | | | | | | - Robert Pool
- University of Amsterdam, Amsterdam, Netherlands.
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10
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Curtis A, Curtis JW, Shook E, Smith S, Jefferis E, Porter L, Schuch L, Felix C, Kerndt PR. Spatial video geonarratives and health: case studies in post-disaster recovery, crime, mosquito control and tuberculosis in the homeless. Int J Health Geogr 2015; 14:22. [PMID: 26253100 PMCID: PMC4528811 DOI: 10.1186/s12942-015-0014-8] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2015] [Accepted: 07/27/2015] [Indexed: 11/24/2022] Open
Abstract
Background A call has recently been made by the public health and medical communities to understand the neighborhood context of a patient’s life in order to improve education and treatment. To do this, methods are required that can collect “contextual” characteristics while complementing the spatial analysis of more traditional data. This also needs to happen within a standardized, transferable, easy-to-implement framework. Methods The Spatial Video Geonarrative (SVG) is an environmentally-cued narrative where place is used to stimulate discussion about fine-scale geographic characteristics of an area and the context of their occurrence. It is a simple yet powerful approach to enable collection and spatial analysis of expert and resident health-related perceptions and experiences of places. Participants comment about where they live or work while guiding a driver through the area. Four GPS-enabled cameras are attached to the vehicle to capture the places that are observed and discussed by the participant. Audio recording of this narrative is linked to the video via time stamp. A program (G-Code) is then used to geotag each word as a point in a geographic information system (GIS). Querying and density analysis can then be performed on the narrative text to identify spatial patterns within one narrative or across multiple narratives. This approach is illustrated using case studies on post-disaster psychopathology, crime, mosquito control, and TB in homeless populations. Results SVG can be used to map individual, group, or contested group context for an environment. The method can also gather data for cohorts where traditional spatial data are absent. In addition, SVG provides a means to spatially capture, map and archive institutional knowledge. Conclusions SVG GIS output can be used to advance theory by being used as input into qualitative and/or spatial analyses. SVG can also be used to gain near-real time insight therefore supporting applied interventions. Advances over existing geonarrative approaches include the simultaneous collection of video data to visually support any commentary, and the ease-of-application making it a transferable method across different environments and skillsets.
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Affiliation(s)
- Andrew Curtis
- Department of Geography, GIS Health and Hazards Lab, Kent State University, #413 McGilvrey Hall, Kent, OH, 44242, USA.
| | - Jacqueline W Curtis
- Department of Geography, GIS Health and Hazards Lab, Kent State University, #413 McGilvrey Hall, Kent, OH, 44242, USA.
| | - Eric Shook
- Department of Geography, High-Performance Computing and GIS Lab, Kent State University, #407a McGilvrey Hall, Kent, OH, 44242, USA.
| | - Steve Smith
- Geography, Department of Social Sciences, Missouri Southern State University, 3950 E. Newman Road, Joplin, MO, 64801, USA.
| | - Eric Jefferis
- Department of Social and Behavioral Science, College of Public Health, Kent State University, Kent, OH, USA.
| | - Lauren Porter
- Department of Criminology and Criminal Justice, University of Maryland, College Park, MD, USA.
| | - Laura Schuch
- Department of Geography, GIS Health and Hazards Lab, Kent State University, #413 McGilvrey Hall, Kent, OH, 44242, USA
| | - Chaz Felix
- Gould School of Law, USC, Los Angeles, CA, USA.
| | - Peter R Kerndt
- Tuberculosis Control Program, County of Los Angeles Department of Public Health, Los Angeles, CA, USA.
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Stanley D, Marshall Z, Lazarus L, LeBlanc S, Heighton T, Preater B, Tyndall M. Harnessing the power of community-based participatory research: examining knowledge, action, and consciousness in the PROUD study. SOCIAL WORK IN PUBLIC HEALTH 2015; 30:312-323. [PMID: 25774651 DOI: 10.1080/19371918.2014.1001935] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Community-based participatory research (CBPR) is an approach to research that recognizes the specific knowledge and abilities that individuals from diverse backgrounds bring to the generation of new knowledge for the purpose of social action aimed at improving public health and health equity. In this article, the authors apply Gaventa and Cornwall's dimensions of participatory research to the analysis of 12 semistructured interviews with members of our Community Advisory Committee for the Participatory Research in Ottawa: Understanding Drugs (PROUD) study. This process-to-outcomes framework may help projects more systematically explore their experiences in relation to common CBPR principles and lead to greater conceptual clarity.
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Affiliation(s)
- Daina Stanley
- a Ottawa Hospital Research Institute , Ottawa , Canada
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12
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Successful strategies to engage research partners for translating evidence into action in community health: a critical review. JOURNAL OF ENVIRONMENTAL AND PUBLIC HEALTH 2015; 2015:191856. [PMID: 25815016 PMCID: PMC4359847 DOI: 10.1155/2015/191856] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/17/2014] [Accepted: 02/01/2015] [Indexed: 11/18/2022]
Abstract
Objectives. To undertake a critical review describing key strategies supporting development of participatory research (PR) teams to engage partners for creation and translation of action-oriented knowledge. Methods. Sources are four leading PR practitioners identified via bibliometric analysis. Authors' publications were identified in January 1995–October 2009 in PubMed, Embase, ISI Web of Science and CAB databases, and books. Works were limited to those with a process description describing a research project and practitioners were first, second, third, or last author. Results. Adapting and applying the “Reliability Tested Guidelines for Assessing Participatory Research Projects” to retained records identified five key strategies: developing advisory committees of researchers and intended research users; developing research agreements; using formal and informal group facilitation techniques; hiring co-researchers/partners from community; and ensuring frequent communication. Other less frequently mentioned strategies were also identified. Conclusion. This review is the first time these guidelines were used to identify key strategies supporting PR projects. They proved effective at identifying and evaluating engagement strategies as reported by completed research projects. Adapting these guidelines identified gaps where the tool was unable to assess fundamental PR elements of power dynamics, equity of resources, and member turnover. Our resulting template serves as a new tool to measure partnerships.
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Stephens C. Urban inequities; urban rights: a conceptual analysis and review of impacts on children, and policies to address them. J Urban Health 2012; 89:464-85. [PMID: 22371276 PMCID: PMC3368043 DOI: 10.1007/s11524-011-9655-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
This paper explores current conceptual understanding of urban social, environmental, and health inequality and inequity, and looks at the impact of these processes on urban children and young people in the 21st century. This conceptual analysis was commissioned for a discussion paper for UNICEF's flagship publication: State of the World's Children 2012: Children in an Urban World. The aim of the paper is to examine evidence on the meaning of urban inequality and inequity for urban children and young people. It further looks at the controversial policies of targeting "vulnerable" young people, and policies to achieve the urban MDGs. Finally, the paper looks briefly at the potential of concepts such as environment justice and rights to change our understanding of urban inequality and inequity.
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14
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Sánchez J, Silva-Suarez G, Serna CA, De La Rosa M. The Latino Migrant Worker HIV Prevention Program: building a community partnership through a community health worker training program. FAMILY & COMMUNITY HEALTH 2012; 35:139-46. [PMID: 22367261 PMCID: PMC5636189 DOI: 10.1097/fch.0b013e3182465153] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
There is limited information on the impact of the HIV/AIDS epidemic on Latino migrant workers (LMWs), although available data indicate that this community is being disproportionally affected. The need for prevention programs that address the specific needs of LMWs is becoming well recognized. HIV prevention interventions that train and employ community health workers are a culturally appropriate way to address the issues of community trust and capacity building in this community. This article describes the Latino Migrant Worker HIV Prevention Program and its efforts to train and engage community health workers in the prevention of HIV among LMWs in South Florida.
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Affiliation(s)
- Jesús Sánchez
- Department of Sociobehavioral and Administrative Pharmacy, College of Pharmacy, Nova Southeastern University, Fort Lauderdale, Florida 33328, USA.
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15
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Durham D, Nichols TR. Development and Implementation of a Women’s Health Promotion Program. Health Promot Pract 2011; 12:529-37. [DOI: 10.1177/1524839909336507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The Moms for Moms (M4M) program provides mothers the arena necessary to explore new ideas and definitions about mothering as well as skills and strategies concerning parenting, family management, and healthy habits. A participatory approach has been used to understand the development and implementation of the program from the perspective of the participants and community agency staff in an urban city. This approach provides detailed descriptions and interpretations of the shared beliefs, behaviors, and values of the participants as well as how these attributes are shaped by involvement in M4M. The findings from a needs assessment and program feasibility study conducted from August 2006 to June 2008 are used to inform a recently launched Healthy Lifestyles Initiative at a community-based agency for women, to determine if M4M fits within the culture of the organization and to determine the relevance of participatory methods to engage mothers and community agencies in creating health promotion programming.
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Affiliation(s)
- Danielle Durham
- Carolina’s Center for Medical Excellence in Cary, North Carolina
| | - Tracy R. Nichols
- Department of Public Health Education at the University of North Carolina at Greensboro, North Carolina
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Terpstra J, Coleman KJ, Simon G, Nebeker C. The role of community health workers (CHWs) in health promotion research: ethical challenges and practical solutions. Health Promot Pract 2011; 12:86-93. [PMID: 19346410 PMCID: PMC3748275 DOI: 10.1177/1524839908330809] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This article aims to describe the role of community health workers (CHWs) in health promotion research and address the challenges and ethical concerns associated with this research approach. A series of six focus groups are conducted with project managers and investigators (n = 5 to 11 per session) who have worked with CHWs in health promotion research. These focus groups are part of a larger study funded by the National Institutes of Health titled "Training in Research Ethics and Standards" (Project TRES). Participants are asked to describe their training needs for CHWs with respect to human subject protections as well as to identify associated challenges regarding research practice (i.e., recruitment, random assignment, protocol implementation, etc.). Findings reveal a number of challenges that investigators and project managers encounter when working with CHWs on research projects involving the community. These include characteristics inherent to CHWs such as education level and personal beliefs about their own community and its needs, institutional regulations regarding research practice, and problems inherent to research studies such as training materials and protocols that cannot account for the complexity of conducting research in community settings. Investigators should carefully consider the role that CHWs have in their communities before creating research programs that depend on the CHWs' existing social networks and their propensity to be natural helpers. These strengths could lead to compromises in research requirements for random assignment, control groups, and fully informed consent.
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Affiliation(s)
- Jennifer Terpstra
- Interdisciplinary Studies Graduate Program, University of British Columbia in Vancouver, British Columbia, Canada
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17
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Corbie-Smith G, Yaggy SD, Lyn M, Green M, Ornelas IJ, Simmons T, Perez G, Blumenthal C. Development of an interinstitutional collaboration to support community-partnered research addressing the health of emerging Latino populations. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2010; 85:728-735. [PMID: 20354397 DOI: 10.1097/acm.0b013e3181d2b874] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Collaborative and participatory research approaches have received considerable attention as means to understanding and addressing disparities in health and health care. In this article, the authors describe the process of building a three-way partnership among two academic health centers-Duke University and the University of North Carolina-and members of the Latino community in North Carolina to develop and pilot test a lay health advisor program to improve Latina immigrants' mental health and coping skills. The authors applied the principles of participatory research to engage community and academic partners, to select the health topic and population, and to develop program goals and objectives. Key challenges were negotiating administrative structures and learning institutional cultures, as well as dealing with contextual issues such as mental health reform and antiimmigrant sentiment in the state.Some important lessons learned are to seek opportunities for taking advantage of existing relationships and expertise at each academic institution, to be respectful of the burden of research on vulnerable communities, and to involve community partners at all stages of the process.
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Affiliation(s)
- Giselle Corbie-Smith
- Department of Social Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
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18
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King DW, Snipes SA, Herrera AP, Jones LA. Health and healthcare perspectives of African American residents of an unincorporated community: a qualitative assessment. Health Place 2009; 15:420-428. [PMID: 18835739 PMCID: PMC2661620 DOI: 10.1016/j.healthplace.2008.07.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2008] [Revised: 07/15/2008] [Accepted: 07/16/2008] [Indexed: 11/19/2022]
Abstract
Residential perspectives about health in unincorporated communities are virtually unexplored. In this study, we conducted focus groups to assess individual and community health status, environmental health mediators, and systematic barriers to healthcare among African American residents of the unincorporated town, Fresno, Texas. Residents described their individual health status as excellent, but depicted the community's health status as fair. Unaffordable healthcare, limited access to healthcare, and environmental mediators were perceived to impact the Fresno community's health status. Our findings suggest a need to begin to examine health outcomes for minority residents in other unincorporated communities.
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Affiliation(s)
- Denae W King
- Department of Health Disparities Research, Center for Research on Minority Health, The University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Blvd, Unit 639, Houston, TX 77071, USA.
| | - S Amy Snipes
- Department of Health Disparities Research, Center for Research on Minority Health, The University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Blvd, Unit 639, Houston, TX 77071, USA
| | - Angelica P Herrera
- Department of Health Disparities Research, Center for Research on Minority Health, The University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Blvd, Unit 639, Houston, TX 77071, USA
| | - Lovell A Jones
- Department of Health Disparities Research, Center for Research on Minority Health, The University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Blvd, Unit 639, Houston, TX 77071, USA
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Nguyen TUN, Kagawa-Singer M. Overcoming barriers to cancer care through health navigation programs. Semin Oncol Nurs 2009; 24:270-8. [PMID: 19000601 DOI: 10.1016/j.soncn.2008.08.007] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To provide an overview of theoretical concepts in community-based, culturally tailored health navigation programs that have improved access to health care for ethnic minority populations, particularly for Asian Americans and Pacific Islanders. DATA SOURCES Published articles, reports, book chapters, government documents, research findings. CONCLUSION Community-based patient navigation interventions provide promising strategies for providing culturally tailored programs that are more likely to succeed in eliminating cancer disparities in screening and early detection of cancers for diverse cultural communities. IMPLICATIONS FOR NURSING PRACTICE Nurses need to be more involved in developing and delivering effective, culturally competent community-based cancer screening and treatment navigation programs through education, practice, research, and policy improvement.
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Cashman SB, Adeky S, Allen AJ, Corburn J, Israel BA, Montaño J, Rafelito A, Rhodes SD, Swanston S, Wallerstein N, Eng E. The power and the promise: working with communities to analyze data, interpret findings, and get to outcomes. Am J Public Health 2008; 98:1407-17. [PMID: 18556617 DOI: 10.2105/ajph.2007.113571] [Citation(s) in RCA: 194] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Although the intent of community-based participatory research (CBPR) is to include community voices in all phases of a research initiative, community partners appear less frequently engaged in data analysis and interpretation than in other research phases. Using 4 brief case studies, each with a different data collection methodology, we provide examples of how community members participated in data analysis, interpretation, or both, thereby strengthening community capacity and providing unique insight. The roles and skills of the community and academic partners were different from but complementary to each other. We suggest that including community partners in data analysis and interpretation, while lengthening project time, enriches insights and findings and consequently should be a focus of the next generation of CBPR initiatives.
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Affiliation(s)
- Suzanne B Cashman
- Department of Family Medicine and Community Health, A3-150 Benedict Bldg, University of Massachusetts Medical School, Worcester, MA 01655, USA.
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Cargo M, Mercer SL. The Value and Challenges of Participatory Research: Strengthening Its Practice. Annu Rev Public Health 2008; 29:325-50. [PMID: 18173388 DOI: 10.1146/annurev.publhealth.29.091307.083824] [Citation(s) in RCA: 534] [Impact Index Per Article: 33.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Margaret Cargo
- Department of Psychiatry and Douglas Mental Health University Institute, McGill University, Verdun, Quebec H4H 1R3, Canada
- Current address: School of Health Sciences, University of South Australia, City East Campus, Adelaide, South Australia 5001;
| | - Shawna L. Mercer
- The Guide to Community Preventive Services, Division of Health Communications, National Center for Health Marketing, Centers for Disease Control and Prevention, Atlanta, Georgia 30333;
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Plescia M, Groblewski M, Chavis L. A Lay Health Advisor Program to Promote Community Capacity and Change Among Change Agents. Health Promot Pract 2008; 9:434-9. [PMID: 17105806 DOI: 10.1177/1524839906289670] [Citation(s) in RCA: 36] [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 Charlotte REACH 2010 project focuses on cardiovascular disease and diabetes among African Americans in a geographically defined community. The goal of the project is to create changes in individual behaviors, community capacity, change agents, and systemic policies and actions that will result in the reduction of health disparities related to cardiovascular disease and diabetes. The project consists of three main components: lay health advisors as change agents, targeted interventions (exercise, nutrition, smoking cessation, primary care), and environmental and systemic interventions. The purpose of this article is to describe the lay health advisor intervention using qualitative methodologies that were developed to document changes in community capacity and change among change agents. Lay health advisors report that they have internalized their role as a community advocate and have made positive changes in their own personal health behavior. Their understanding of the underlying causes of poor health has expanded to include social and institutional factors and they have begun to shift their emphasis toward advocacy for social and institutional change.
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Affiliation(s)
- Marcus Plescia
- Chronic Disease and Injury Section, North Carolina Division of Public Health, University of North Carolina School of Medicine, USA
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Moore DE, Niebler SE, Schlundt DG, Pichert JW. A conceptual model for using action inquiry technologies to address disparities in depression. THE JOURNAL OF CONTINUING EDUCATION IN THE HEALTH PROFESSIONS 2007; 27 Suppl 1:S55-S64. [PMID: 18085578 DOI: 10.1002/chp.135] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Disparities in depression care remain an important problem in the United States. Action inquiry technologies may assist individuals and communities in their attempts to reduce or eliminate these disparities--and the multiple factors contributing to them--through a recurring cycle of planning, action, evaluation, and new actions based on reflections about what occurred during previous actions. This article will briefly review different action inquiry methods--specifically, participatory action research (PAR) in communities and action research in physicians' practices and offices of continuing medical education (CME). The authors develop a conceptual model in which those involved in providing, receiving, and improving depression care can use action inquiry strategies that are coordinated using the domains-based outcomes assessment model. This conceptual model may help CME planners collaborate with others to address disparities in depression care.
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Affiliation(s)
- Donald E Moore
- Division of Continuing Medical Education, Vanderbilt University School of Medicine, 320 Light Hall, 2215 Garland Avenue, Nashville, TN 37232, USA.
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Farquhar SA, Parker EA, Schulz AJ, Israel BA. Application of qualitative methods in program planning for health promotion interventions. Health Promot Pract 2006; 7:234-42. [PMID: 16585146 DOI: 10.1177/1524839905278915] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The use of qualitative methods can provide an in-depth understanding of the issues and barriers related to community health and can help to inform the planning of health promotion programs and interventions. Although there are many examples in the literature that describe the application of quantitative data to program planning, few articles explicitly describe the application of qualitative data, such as data gathered using focus groups, in-depth interviews, and windshield tours, in program planning. Using the East Side Village Health Worker Partnership in Detroit, Michigan, as a case study example, this article explains the methods of incorporating qualitative data into each stage of program planning and development, including community assessment, development of goals and objectives, implementation of activities, and program evaluation.
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25
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Ebbeling CB, Pearson MN, Sorensen G, Levine RA, Hebert JR, Salkeld JA, Peterson KE. Conceptualization and Development of a Theory-Based Healthful Eating and Physical Activity Intervention for Postpartum Women Who Are Low Income. Health Promot Pract 2006; 8:50-9. [PMID: 16840768 DOI: 10.1177/1524839905278930] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Eating and physical activity behaviors that confer risk for chronic disease are prominent among women from varying ethnic and racial groups who are low income. Conceptualization and development of a theory-based behavioral intervention to address their unique needs during the first year following childbirth comprised four steps: (a) translating public health guidelines and emerging epidemiologic data into specific intervention messages; (b) developing practical strategies to operationalize theoretical constructs, in the context of a social ecological framework; (c) stating achievementbased objectives and writing scripts for five home visits; and (d) conducting formative research. Focus group participants expressed a desire for a “health mentor,” not somebody who “nags” or “stresses you out.” Paraprofessionals from the Expanded Food and Nutrition Education Program (EFNEP) were directly involved in pretesting the intervention and remain involved as health mentors. This intervention can serve as a basis for future organizational partnerships to benefit the health of populations who are low income.
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26
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Schulz AJ, Gravlee CC, Williams DR, Israel BA, Mentz G, Rowe Z. Discrimination, symptoms of depression, and self-rated health among african american women in detroit: results from a longitudinal analysis. Am J Public Health 2006; 96:1265-70. [PMID: 16735638 PMCID: PMC1483853 DOI: 10.2105/ajph.2005.064543] [Citation(s) in RCA: 303] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES Our understanding of the relationships between perceived discrimination and health was limited by the cross-sectional design of most previous studies. We examined the longitudinal association of self-reported everyday discrimination with depressive symptoms and self-rated general health. METHODS Data came from 2 waves (1996 and 2001) of the Eastside Village Health Worker Partnership survey, a community-based participatory survey of African American women living on Detroit's east side (n=343). We use longitudinal models to test the hypothesis that a change in everyday discrimination over time is associated with a change in self-reported symptoms of depression (positive) and on self-reported general health status (negative). RESULTS We found that a change over time in discrimination was significantly associated with a change over time in depressive symptoms (positive) (b=0.125; P<.001) and self-rated general health (negative) (b=-0.163; P<.05) independent of age, education, or income. CONCLUSIONS The results reported here are consistent with the hypothesis that everyday encounters with discrimination are causally associated with poor mental and physical health outcomes. In this sample of African American women, this association holds above and beyond the effects of income and education.
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Affiliation(s)
- Amy J Schulz
- Department of Health Behavior and Health Education at the University of Michigan School of Public Health, Ann Arbor, MI 48109-2029, USA.
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Thompson B, Hannon PA, Bishop SK, West BE, Peterson AK, Beresford SAA. Factors related to participatory employee advisory boards in small, blue-collar worksites. Am J Health Promot 2005; 19:430-7. [PMID: 16022207 DOI: 10.4278/0890-1171-19.6.430] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE To identify factors related to formation, participation, and characteristics of employee advisory boards (EABs) in blue-collar worksites. DESIGN This study used a nonexperimental qualitative design to assess EAB formation, activity, and enthusiasm levels and examined those factors relative to employee participation in worksite-wide health promotion activities. SETTING Twenty-two blue-collar worksites with a total of 113 EAB members in the greater Seattle area. SUBJECTS Individuals who agreed to serve on EABs in the intervention worksites. INTERVENTION Participants received training in involving employees in the 5-A-Day project intervention activities. MEASURES Measures include type of worksite, number of EAB members, method of EAB recruitment, and variables describing EAB functioning, including attendance at meetings, assistance at project activities, and level of enthusiasm. RESULTS All worksites formed EABs. There was no association between the way the EAB was formed and subsequent EAB attendance at meetings, participation in project activities, representativeness of the EAB, or level of EAB enthusiasm. Enthusiasm of the EAB was associated with employee participation, and EABs with a higher level of enthusiasm showed more participation by employees than worksites with less enthusiastic EABs. CONCLUSIONS It is possible to develop participatory structures in small, blue-collar worksites. More information is needed about factors related to levels of enthusiasm of EABs.
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Affiliation(s)
- Beti Thompson
- Fred Hutchinson Cancer Research Center, 1100 Fairview Avenue N, M3-B232, Seattle, WA 98109, USA.
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Becker AB, Israel BA, Schulz AJ, Parker EA, Klem L. Age differences in health effects of stressors and perceived control among urban African American women. J Urban Health 2005; 82:122-41. [PMID: 15738329 PMCID: PMC3456625 DOI: 10.1093/jurban/jti014] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/28/2005] [Indexed: 11/12/2022]
Abstract
A conceptual model of the stress process has been useful in examining relationships among a variety of stressors, health status, and protective factors that modify the health-stress relationship. The model can contribute to an understanding of variations in health among people living in urban environments experiencing high degrees of stress. This study examines social contextual stressors in the neighborhood, health outcomes, and perceived control at multiple levels beyond the individual as a protective factor, among a random sample (N = 679) of predominantly low-income African American women who reside on Detroit's east side. Findings suggest that although stress has a consistently negative impact on health, perceived control may buffer against the deleterious effects of stress. The buffering role of perceived control, however, depends on age, the type of stressor examined, and the context or level at which perceived control is assessed (e.g., organizational, neighborhood, beyond the neighborhood). For young women, perceived control was found to be health protective. Among older women, perceived control in the face of stressors was inversely related to health. These findings suggest the need for health and social service programs and policy change strategies to both increase the actual influence and control of women living in low-income urban communities and to reduce the specific social contextual stressors they experience.
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Affiliation(s)
- A B Becker
- Department of Community Health Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana 70112, USA.
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Chávez V, Israel B, Allen AJ, DeCarlo MF, Lichtenstein R, Schulz A, Bayer IS, McGranaghan R. A Bridge Between Communities: Video-making using principles of community-based participatory research. Health Promot Pract 2004; 5:395-403. [PMID: 15358912 DOI: 10.1177/1524839903258067] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Health educators can play a critical role in bringing together the partners and resources to successfully make videos using principles of community-based participatory research (CBPR). This article is a "how-to" guide for making videos using community-based participatory research principles. The authors describe video-making and CBPR, then outline six steps on how to make a video using principles of CBPR: (a) engaging stakeholders, (b) soliciting funding and informed consent, (c) creation of shared ownership, (d) building cross-cultural collaborations, (e) writing the script together, and (f) pulling it all together: editing and music selection. Still photographs and key themes from the video A Bridge Between Communities are presented as a running case study to illustrate these steps. The article concludes with implications for health promotion research and practice.
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Affiliation(s)
- Vivian Chávez
- Department of Health Education, San Francisco State University, San Francisco, California, USA
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31
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Lewis TC, Robins TG, Joseph CLM, Parker EA, Israel BA, Rowe Z, Edgren KK, Salinas MA, Martinez ME, Brown RW. Identification of gaps in the diagnosis and treatment of childhood asthma using a community-based participatory research approach. J Urban Health 2004; 81:472-88. [PMID: 15273269 PMCID: PMC3455945 DOI: 10.1093/jurban/jth131] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
The goal of this investigation was to use a community-based participatory research approach to develop, pilot test, and administer an asthma screening questionnaire to identify children with asthma and asthma symptoms in a community setting. This study was conducted as the recruitment effort for Community Action Against Asthma, a randomized trial of a household intervention to reduce exposure to environmental triggers of asthma and was not designed as a classic prevalence study. An asthma screening questionnaire was mailed and/or hand delivered to parents of 9,627 children, aged 5 to 11 years, in two geographic areas of Detroit, Michigan, with predominantly African American and Hispanic populations. Additional questionnaires were distributed via community networking. Measurements included parent report of their child's frequency of respiratory symptoms, presence of physician diagnosis of asthma, and frequency of doctor-prescribed asthma medication usage. Among the 3,067 completed questionnaires, 1,570 (51.2% of returned surveys, 16.3% of eligible population) were consistent with asthma of any severity and 398 (12.9% of returned surveys, 4.1% of eligible population) met criteria for moderate-to-severe asthma. Among those meeting criteria for moderate-to-severe asthma, over 30% had not been diagnosed by a physician, over one half were not taking daily asthma medication, and one quarter had not taken any physician-prescribed asthma medication in the past year. Screening surveys conducted within the context of a community-based participatory research partnership can identify large numbers of children with undiagnosed and/or undertreated moderate-to-severe asthma. These children are likely to benefit from interventions to reduce morbidity and improve quality of life.
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Affiliation(s)
- Toby C Lewis
- Department of Pediatrics and Communicable Diseases, University of Michigan School of Medicine, Ann Arbor, MI, USA.
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Meyer MC, Torres S, Cermeño N, MacLean L, Monzón R. Immigrant women implementing participatory research in health promotion. West J Nurs Res 2003; 25:815-34. [PMID: 14596181 DOI: 10.1177/0193945903256707] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Few studies on women's health include immigrant women as participants, and fewer are conducted by immigrant women themselves. In this article, the authors present a model that allowed their full participation as researchers and authors. They describe their experiences using participatory research methods with Hispanic women in multiple ways to reach out to isolated women, collect data about community needs, and provide health education. They explore the advantages and challenges of being trained for both researcher and health educator roles, describe opportunities to use this approach to assess service needs, and discuss the potential for personal empowerment. They also report on the time commitment that such a bilingual project requires. In the process of interviewing marginalized women, they realized how much health promotion and participatory research complement each other. The authors conclude that combining participatory research with health promotion activities has promise to contribute toward increased empowerment of immigrant communities.
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Abstract
OBJECTIVE The aim of the article is to demonstrate the usefulness of participatory action research (PAR) in primary care. The author used PAR firstly to develop a deeper understanding of mutual participation in the doctor-patient encounter and secondly to apply this learning in a rural cross-cultural practice setting. METHOD PAR was done with four patient groups. Four patients with terminal illnesses formed groups with their family members, neighbours and friends. Seven meetings were held with each group over a period of 6 months. The meetings were conducted in Tsonga, which is the local vernacular. All the meetings were audio-taped. The primary question for each meeting was how the group could work together to achieve the best possible health outcome for the patient. Additionally, the author, who facilitated the meetings, kept a reflective diary, including field notes over the research period. One member of each group kept a written record of each meeting. Three free attitude interviews were conducted with the author over the research period to elicit the development of his understanding about mutual participation in the doctor-patient encounter. The recorded meetings and interviews were transcribed and translated and themes subsequently identified using the transcripts. The reflective diary was analysed similarly. A model was constructed to depict the themes and their interrelatedness. The model was interpreted and conclusions were drawn. RESULTS The PAR process had a positive effect on the doctor-patient encounter. PAR greatly resembles a mutual participatory doctor-patient encounter. The research facilitator had certain basic tenets in order to facilitate participation. The patients who participated actively benefited most. Basic interviewing techniques were used to facilitate the mutual participation in PAR. CONCLUSIONS PAR is very applicable in primary care. The principles of PAR such as mutual collaboration, reciprocal respect, co-learning and acting on results from the enquiry are essential in the doctor-patient relationship. Self-awareness, the ability to self-critique and reflect in a deep manner using such tools as a reflective diary are essential for nurturing the development of effective primary health care workers and consequently care structures for the patients and their families.
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Affiliation(s)
- Gert J O Marincowitz
- Department of Family Medicine and Primary Care, Limpopo Province Unit, Medical University of Southern Africa, Medunsa 0204, South Africa.
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van Olphen J, Schulz A, Israel B, Chatters L, Klem L, Parker E, Williams D. Religious involvement, social support, and health among African-American women on the east side of Detroit. J Gen Intern Med 2003; 18:549-57. [PMID: 12848838 PMCID: PMC1494889 DOI: 10.1046/j.1525-1497.2003.21031.x] [Citation(s) in RCA: 111] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND A significant body of research suggests that religious involvement is related to better mental and physical health. Religion or spirituality was identified as an important health protective factor by women participating in the East Side Village Health Worker Partnership (ESVHWP), a community-based participatory research initiative on Detroit's east side. However, relatively little research to date has examined the mechanisms through which religion may exert a positive effect on health. OBJECTIVE The research presented here examines the direct effects of different forms of religious involvement on health, and the mediating effects of social support received in the church as a potential mechanism that may account for observed relationships between church attendance and health. DESIGN This study involved a random sample household survey of 679 African-American women living on the east side of Detroit, conducted as part of the ESVHWP. MAIN RESULTS Results of multivariate analyses show that respondents who pray less often report a greater number of depressive symptoms, and that faith, as an important source of strength in one's daily life, is positively associated with chronic conditions such as asthma or arthritis. Tests of the mediating effect of social support in the church indicated that social support received from church members mediates the positive relationship between church attendance and specific indicators of health. CONCLUSIONS These findings are consistent with the hypothesis that one of the major ways religious involvement benefits health is through expanding an individual's social connections. The implications of these findings for research and practice are discussed.
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Affiliation(s)
- Juliana van Olphen
- San Francisco State University, Department of Health Education, 1600 Holloway Ave., HSS 312, San Francisco, CA 94132-4161, USA.
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Haire-Joshu D, Brownson RC, Nanney MS, Houston C, Steger-May K, Schechtman K, Auslander W. Improving dietary behavior in African Americans: the Parents As Teachers High 5, Low Fat Program. Prev Med 2003; 36:684-91. [PMID: 12744911 DOI: 10.1016/s0091-7435(03)00053-7] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND The High 5, Low Fat Program (H5LF) for African American parents was developed in partnership with the Parents As Teachers program, and was designed to test a dietary intervention appropriate for national adoption. METHODS H5LF used a group randomized, nested cohort design with 738 parents. Consistent with organizational goals and methods, parent educators delivered a dietary change program via personal visits, newsletters, and group meetings. Primary outcomes were reducing percentage calories from fat and increasing fruit and vegetable consumption among participating parents; intermediate aims included improving in nutrition-related skills and parental modeling of dietary behaviors. RESULTS H5LF parents achieved a 0.53 increase in fruit and vegetable consumption (P = 0.03), and a higher proportion of H5LF parents reduced their intake to less than 30% calories from fat (chi(2) = 4.8, P < 0.03; -1.7% calories from fat, p = 0.07) and improved performance of dietary behaviors (F = 14.2, P = 0.004). Improvements in parental modeling were not statistically significant. CONCLUSIONS H5LF is an effective intervention that is appropriate for national adoption by over 2000 Parents As Teachers sites with the potential to impact dietary intake of African American parents nationwide.
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Affiliation(s)
- Debra Haire-Joshu
- Saint Louis University School of Public Health, St. Louis, MO 63104, USA.
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Metzler MM, Higgins DL, Beeker CG, Freudenberg N, Lantz PM, Senturia KD, Eisinger AA, Viruell-Fuentes EA, Gheisar B, Palermo AG, Softley D. Addressing urban health in Detroit, New York City, and Seattle through community-based participatory research partnerships. Am J Public Health 2003; 93:803-11. [PMID: 12721148 PMCID: PMC1447843 DOI: 10.2105/ajph.93.5.803] [Citation(s) in RCA: 109] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVE This study describes key activities integral to the development of 3 community-based participatory research (CBPR) partnerships. METHODS We compared findings from individual case studies conducted at 3 urban research centers (URCs) to identify crosscutting adaptations of a CBPR approach in the first 4 years of the partnerships' development. RESULTS Activities critical in partnership development include sharing decision-making, defining principles of collaboration, establishing research priorities, and securing funding. Intermediate outcomes were sustained CBPR partnerships, trust within the partnerships, public health research programs, and increased capacity to conduct CBPR. Challenges included the time needed for meaningful collaboration, concerns regarding sustainable funding, and issues related to institutional racism. CONCLUSIONS The URC experiences suggest that CBPR can be successfully implemented in diverse settings.
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Affiliation(s)
- Marilyn M Metzler
- Centers for Disease Control and Prevention, Mail Stop K67, 4770 Buford Highway NE, Atlanta, GA 30341-3717, USA.
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Becker AB, Israel BA, Schulz AJ, Parker EA, Klem L. Predictors of perceived control among African American women in Detroit: exploring empowerment as a multilevel construct. HEALTH EDUCATION & BEHAVIOR 2002; 29:699-715. [PMID: 12456130 DOI: 10.1177/109019802237939] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Efforts to enhance empowerment toward the aim of improved health require an understanding of factors that contribute to perceived control at multiple levels, as a dimension of empowerment. In this article, the authors examine hypothesized predictors of perceived control at multiple levels among urban, African American women. Variables that predict perceived control include greater participation in change-related action; level of activity within respondents' most important organizations; and attempts made by those organizations to influence public officials, businesses, and other groups. Results suggest that (1) perceived control is a context-specific, multilevel construct; (2) citizen participation is an important factor in control and influence at multiple levels; and (3) organizations that are involved within neighborhoods and in the broader community can help to increase control and influence at multiple levels in marginalized communities. Implications for health education practice and research are discussed.
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Affiliation(s)
- Adam B Becker
- Tulane University School of Public Health and Tropical Medicine, New Orleans, LA 70112, USA.
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Schulz AJ, Israel BA, Parker EA, Lockett M, Hill Y, Wills R. The East Side Village Health Worker Partnership: integrating research with action to reduce health disparities. Public Health Rep 2002. [PMID: 12196614 DOI: 10.1016/s0033-3549(04)50087-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
This article describes the work of the East Side Village Health Worker Partnership as a case study of an initiative that seeks to reduce the disproportionate health risks experienced by residents of Detroit's east side. The Partnership is a community-based participatory research and intervention collaboration among academia, public health practitioners, and the east side Detroit community. The Partnership is guided by a steering committee that is actively involved in all aspects of the research, intervention, and dissemination process, made up of representatives of five community-based organizations, residents of Detroit's east side, the local health department, a managed care provider, and an academic institution. The major goal of the East Side Village Health Worker Partnership is to address the social determinants of health on Detroit's east side, using a lay health advisor intervention approach. Data collected from 1996 to 2001 are used here to describe improvements in research methods, practice activities, and community relationships that emerged through this academic-practice-community linkage.
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Affiliation(s)
- A J Schulz
- School of Public Health, University of Michigan, 1420 Washington Heights, Ann Arbor, MI 48109, USA.
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Schulz AJ, Parker EA, Israel BA, Allen A, Decarlo M, Lockett M. Addressing social determinants of health through community-based participatory research: the East Side Village Health Worker Partnership. HEALTH EDUCATION & BEHAVIOR 2002; 29:326-41. [PMID: 12038742 DOI: 10.1177/109019810202900305] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The authors describe the use of a stress process model by the East Side Village Health Worker Partnership (ESVHWP), a project of the Detroit Community-Academic Urban Research Center, as a framework for understanding social determinants of health. Specifically, the authors describe the development by the ESVHWP Steering Committee of a context-specific stress process model for east side Detroit residents. The authors examine data from in-depth interviews to illuminate actions taken by community members to reduce stressors or minimize their impact on health. Finally, the authors describe the use of this context-specific stress process model and data gathered regarding actions to address community stressors to inform the development of interventions by the ESVHWP to reduce stressors or strengthen the conditioning factors that reduce the impact of stress on health. On the basis of these results, the authors discuss opportunities and challenges for partnership approaches to addressing social determinants of health in urban communities.
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Affiliation(s)
- Amy J Schulz
- School of Public Health, University of Michigan, Ann Arbor 48109-2029, USA.
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Israel BA, Farquhar SA, Schulz AJ, James SA, Parker EA. The relationship between social support, stress, and health among women on Detroit's East Side. HEALTH EDUCATION & BEHAVIOR 2002; 29:342-60. [PMID: 12038743 DOI: 10.1177/109019810202900306] [Citation(s) in RCA: 72] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
A conceptual model of the stress process has been useful in examining relationships between numerous social determinants (e.g., chronic stress), protective factors (e.g., social support), and health status. In this article, the authors examine multiple sources of chronic stress, instrumental and emotional support, and health outcomes among a random sample (N = 679) of predominantly low-income African American women who reside on Detroit's east side. The findings suggest that a number of chronic stressors have an impact on depressive symptoms and general health and that even though instrumental and emotional support each have a significant effect over and above the effects of the stressors, when both are included in the model, instrumental support, and not emotional support, remains as a significant predictor of health outcomes. These findings suggest the need for health education interventions and policy strategies that strengthen social support and aim at macro-level changes necessary to reduce chronic stressful conditions.
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Affiliation(s)
- Barbara A Israel
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor 48109-2029, USA.
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Lantz PM, Viruell-Fuentes E, Israel BA, Softley D, Guzman R. Can communities and academia work together on public health research? Evaluation results from a community-based participatory research partnership in Detroit. J Urban Health 2001; 78:495-507. [PMID: 11564852 PMCID: PMC3455911 DOI: 10.1093/jurban/78.3.495] [Citation(s) in RCA: 168] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
This article reports the results of a formative evaluation of the first 4 years of the Detroit Community-Academic Urban Research Center (URC), a community-based participatory research partnership that was founded in 1995 with core funding from the Centers for Disease Control and Prevention (CDC). Several organizations are members of this partnership, including a university, six community-based organizations, a city health department, a health care system, and CDC. The Detroit URC is a strong partnership that has accomplished many of its goals, including the receipt of over $11 million in funding for 12 community-based participatory research projects during its initial 4 years. Detroit URC Board members identified a number of facilitating factors for their growth and achievements, such as (1) developing a sound infrastructure and set of processes for making decisions and working together, (2) building trust among partners, (3) garnering committed and active leadership from community partners, and (4) receiving support from CDC. Board members also identified a number of ongoing challenges, including organizational constraints, time pressures, and balancing community interests in interventions and academic research needs. Overall, the Detroit URC represents a partnership approach to identifying community health concerns and implementing potential solutions.
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Affiliation(s)
- P M Lantz
- The University of Michigan School of Public Health, 109 Observatory Drive, Ann Arbor, MI 48109-2029, USA.
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Parker EA, Lichtenstein RL, Schulz AJ, Israel BA, Schork MA, Steinman KJ, James SA. Disentangling measures of individual perceptions of community social dynamics: results of a community survey. HEALTH EDUCATION & BEHAVIOR 2001; 28:462-86. [PMID: 11465157 DOI: 10.1177/109019810102800407] [Citation(s) in RCA: 59] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study examined how different measures of individual perceptions of community social dynamics relate to each other and how these measures relate to self-reported general health and depressive symptoms. Results of a principal components analysis conducted to investigate the interrelationships between these individual measures suggest that these measures measure separate phenomena. In addition, in results of multiple-regression analyses conducted to examine associations between the various measures of individual perceptions of community social dynamics and the dependent variables of self-reported general health and depressive symptoms, sense of community, perceived neighborhood control, and neighborhood participation were all associated with the outcome variables in separate regression models. In a regression model with these three variables added to control variables, only sense of community was significantly, albeit modestly, associated with depressive symptoms and self-reported general health.
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Affiliation(s)
- E A Parker
- University of Michigan, School of Public Health, Department of Health Behavior and Health Education, Ann Arbor 48109-2029, USA.
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43
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Process Evaluation Methods of a Peer-Delivered Health Promotion Program for African American Women. Health Promot Pract 2001. [DOI: 10.1177/152483990100200209] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The Eat Well, Live Well (EWLW) Nutrition Program was a community-based, dietary change program delivered by peer educators to low-income African American women. To ensure that the program was delivered as intended, a process evaluation was conducted to determine the extent to which the content was accurate and comprehensive. The methodology included developing checklists for each of the intervention sessions, audiotaping randomly selected sessions, and independently rating the audiotapes. Overall comprehensiveness of the content delivered by the peer educators was 91.42%. Cohen’s kappa () for each data collection interval ranged from 0.95 to 0.97. Overall accuracy of information delivered was 88.52%. A process evaluation as described for the EWLW program is essential for peer-led health promotion programs and necessary to ensure program integrity. Practice implications are discussed.
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Freudenberg N. Health promotion in the city: a review of current practice and future prospects in the United States. Annu Rev Public Health 2001; 21:473-503. [PMID: 10884962 DOI: 10.1146/annurev.publhealth.21.1.473] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
To achieve its health goals, the United States must reduce the disproportionate burden of illness and poor health borne by urban populations. In the 20th century, patterns of immigration and migration, changes in the global economy, increases in income inequality, and more federal support for suburbanization have made it increasingly difficult for cities to protect the health of all residents. In the last 25 years, epidemics of human immunodeficiency virus infections and substance abuse and increases in homelessness, lack of health insurance, rates of violence, and concentrations of certain pollutants have also damaged the health of urban residents. Several common strategies for health promotion are described, and their relevance to the unique characteristics of urban populations is assessed. To identify ways to strengthen health promotion practices in U.S. cities, lessons have been taken from five related fields of endeavor: human rights, church- and faith-based social action, community economic development, youth development, and the new social movements. By integrating lessons from these areas into their practice, public health professionals can help to revitalize the historic mission of public health, contribute to creating healthier cities, and better achieve national health objectives.
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Affiliation(s)
- N Freudenberg
- Program in Urban Public Health, Hunter College School of Health Sciences, City University of New York, New York 10010, USA.
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Higgins DL, Maciak B, Metzler M. CDC Urban Research Centers: community-based participatory research to improve the health of urban communities. JOURNAL OF WOMEN'S HEALTH & GENDER-BASED MEDICINE 2001; 10:9-15. [PMID: 11224940 DOI: 10.1089/152460901750067070] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- D L Higgins
- Division of Prevention Research and Analytic Methods, Epidemiology Program Office, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA
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46
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Schulz A, Israel B, Williams D, Parker E, Becker A, James S. Social inequalities, stressors and self reported health status among African American and white women in the Detroit metropolitan area. Soc Sci Med 2000; 51:1639-53. [PMID: 11072884 DOI: 10.1016/s0277-9536(00)00084-8] [Citation(s) in RCA: 155] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
This article examines the cumulative effects of multiple stressors on women's health, by race and area of residence. Specifically, we examine socioeconomic status, experiences of unfair treatment and acute life events by race and residential location, and their cumulative effects on the health status of African American and white women living within the city of Detroit and in the surrounding metropolitan area. African American women, regardless of whether they live inside or outside the city, report more frequent encounters with everyday unfair treatment than white women. African American women who live in the city report a greater number of acute life events than white women who live outside the city. Regression analyses used to examine the cumulative effects of exposure to these stressors by race and area of residence show that: (1) socioeconomic status, everyday experiences with unfair treatment and acute life events each make a significant contribution to differences in health status; and (2) the contribution of each of these variables to explaining variations in health status varies by area of residence. We suggest that differences in socioeconomic status, exposure to unfair treatment or discrimination and experiences of acute life events make significant contributions to racial differences in women's health status.
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Affiliation(s)
- A Schulz
- Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor 48109-2029, USA
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Buller DB, Morrill C, Taren D, Aickin M, Sennott-Miller L, Buller MK, Larkey L, Alatorre C, Wentzel TM. Randomized trial testing the effect of peer education at increasing fruit and vegetable intake. J Natl Cancer Inst 1999; 91:1491-500. [PMID: 10469751 DOI: 10.1093/jnci/91.17.1491] [Citation(s) in RCA: 134] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The National Cancer Institute recommends that Americans eat at least five daily servings of fruits and vegetables. National strategies to increase consumption may not reach minority and lower socioeconomic populations. In a randomized trial, peer education was tested for effectiveness at increasing fruit and vegetable intake among lower socioeconomic, multicultural labor and trades employees. METHODS Employees (n = 2091) completed a baseline survey and received an 18-month intervention program through standard communication channels (e.g., workplace mail, cafeteria promotions, and speakers). Ninety-three social networks (cliques) of employees were identified, which were pair matched on intake. At an interim survey (during months 8 and 9), 11 cliques no longer existed and 41 matched pairs of cliques containing 905 employees remained, with one clique per pair being randomly assigned to the peer education intervention. Employees who were central in the communication flow of the peer intervention cliques served as peer educators during the last 9 months of the intervention program. Fruit and vegetable intake was measured with 24-hour intake recall and with food-frequency questions in baseline, outcome (i.e., at 18 months), and 6-month follow-up surveys. All P values are two-sided. RESULTS By use of multiple regression, statistically significant overall effects of the peer education program were seen in the intake recall (increase of 0.77 total daily servings; P<.0001) and the food-frequency (increase of 0.46 total daily servings; P =.002) questions at the outcome survey. The effect on the total number of servings persisted at the 6-month follow-up survey when measured by the intake recall (increase of 0.41 total daily servings; P =.034) but not the food-frequency (decrease of 0.04 total daily servings; P =.743) questions. CONCLUSIONS Peer education appears to be an effective means of achieving an increase in fruit and vegetable intake among lower socioeconomic, multicultural adult employees.
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Affiliation(s)
- D B Buller
- D.B. Buller, AMC Cancer Research Center, Denver, CO, USA.
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Díaz M, Simmons R, Díaz J, Gonzalez C, Makuch MY, Bossemeyer D. Expanding contraceptive choice: findings from Brazil. Stud Fam Plann 1999; 30:1-16. [PMID: 10216892 DOI: 10.1111/j.1728-4465.1999.00001.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
This article presents findings from a participatory action research project in a municipality in southern Brazil that models a new and holistic approach to broadening women's contraceptive choices. The project encourages a collaborative process between researchers, community members, and public health managers to diagnose service-delivery problems, to design and implement interventions, and to evaluate their effectiveness. Findings from the baseline evaluation revealed major constraints in availability of and access to family planning and reproductive health services for women, as well as severe deficiencies in quality of care. Interventions designed to address these weaknesses, bound by the limited resources of the public sector, focused on training, restructuring of providers' roles and service-delivery patterns, the management process, the creation of a referral center, and the introduction of injectables, vasectomy services, and a program for adolescents. Evaluation results show the project's considerable impact in broadening reproductive options, although not all issues, especially those related to sustainability, have been resolved.
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Affiliation(s)
- M Díaz
- Department of Education, Training and Communication, CEMICAMP, Campinas, SP, Brazil
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Wang CC. Photovoice: a participatory action research strategy applied to women's health. J Womens Health (Larchmt) 1999; 8:185-92. [PMID: 10100132 DOI: 10.1089/jwh.1999.8.185] [Citation(s) in RCA: 441] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Photovoice is a participatory action research strategy that may offer unique contributions to women's health. It is a process by which people can identify, represent, and enhance their community through a specific photographic technique. Photovoice has three main goals: to enable people (1) to record and reflect their community's strengths and concerns, (2) to promote critical dialogue and knowledge about personal and community issues through large and small group discussion of their photographs, and (3) to reach policymakers. This report gives an overview of the origins, key concepts, methods, and uses of photovoice as a strategy to enhance women's health.
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Affiliation(s)
- C C Wang
- School of Public Health, University of Michigan, Ann Arbor, USA
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50
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Parker EA, Eng E, Schulz AJ, Israel BA. Evaluating community-based health programs that seek to increase community capacity. ACTA ACUST UNITED AC 1999. [DOI: 10.1002/ev.1144] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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