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Cunningham‐Erves J, Mayo‐Gamble T, Campbell L, Barlow BC, Barajas C, Jones JL, Winkfield K. The Bidirectional Engagement and Equity (BEE) Research Framework to Guide Community-Academic Partnerships: Developed From a Narrative Review and Diverse Stakeholder Perspectives. Health Expect 2024; 27:e14161. [PMID: 39087753 PMCID: PMC11292665 DOI: 10.1111/hex.14161] [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: 02/21/2024] [Revised: 06/15/2024] [Accepted: 07/16/2024] [Indexed: 08/02/2024] Open
Abstract
BACKGROUND The engagement of community partners in equitable partnerships with academic teams is necessary to achieve health equity. However, there is no standardized approach to support bidirectional engagement among research stakeholders in the context of partnership equity at each phase of the research process. OBJECTIVE We describe the development of a systematic framework along with competencies and tools promoting bidirectional engagement and equity within community-academic partnerships at each phase of the research process. DESIGN We conducted a four-step research process between November 2020 and December 2023 for framework development: (1) a narrative literature review; (2) expansion of existing bidirectional, equitable framework; (3) a scientific review with two groups of cognitive interviews (five community engagement researchers and five community leaders and members); and (4) three community-based organization leader focus groups. Thematic analysis was used to analyse focus group data. RESULTS Using results of each step, the framework was iteratively developed, yielding four phases of the bidirectional engagement and equity (BEE) research framework: Relationship building and assessment of goals and resources (Phase I); form a community-academic partnership based on shared research interests (may include multilevel stakeholders) (Phase II); develop a research team comprising members from each partnering organization (Phase III); and implement the six-step equitable research process (Phase IV). Bidirectional learning and partnership principles are at the core of the partnership, particularly in Phases II-IV. Competencies and tools for conducting an equitable, engaged research process were provided. DISCUSSION This conceptual framework offers a novel, stepwise approach and competencies for community-academic partners to successfully partner and conduct the research process equitably. CONCLUSION The BEE research framework can be implemented to standardize the conduct of an equitable, engaged research process within a community-academic partnership, while improving knowledge and trust across partners and, ultimately, an increased return on investment and sustainability to benefit both partners in the area of health outcomes and ultimately health equity. PATIENT OR PUBLIC CONTRIBUTION The development of this framework was co-led with a community organization in which two leaders in the organization were equitably involved in each phase of the research process, including grant development, study design, participant recruitment, protocol development for focus groups and community and researcher review, framework design and content and dissemination of this manuscript as a co-author. For grant development, the community leader completed the give-get grid components for them as a partner. They also wrote up their lived experience in the research process for the progress report. For the focus groups, one community leader co-led the focus group with the academic partner. For the narrative review, the community leaders did not actively conduct the narrative review but observed the process through the academic partners. One community leader wrote the section 'relationship building' and 'bidirectional learning' sections with the assistance of the academic partner, while they both equally provided input on other sections of the manuscript alongside academic partners. The community leaders have extensive experience in leading programmes, along with partnering with researchers to address health equity issues and improve health outcomes.
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Affiliation(s)
- Jennifer Cunningham‐Erves
- Division of Public Health PracticeMeharry Medical CollegeNashvilleTennesseeUSA
- Department of Health PolicyVanderbilt University Medical CenterNashvilleUSA
| | - Tilicia Mayo‐Gamble
- Department Community Health Behavior and EducationGeorgia Southern UniversityStatesboroGeorgiaUSA
| | - LaNese Campbell
- Second Missionary Baptist Cooperative MinistriesNashvilleTennesseeUSA
| | | | - Claudia Barajas
- Vanderbilt Ingram Cancer CenterVanderbilt University Medical CenterNashvilleTennesseeUSA
| | | | - Karen Winkfield
- Vanderbilt Ingram Cancer CenterVanderbilt University Medical CenterNashvilleTennesseeUSA
- Meharry Vanderbilt AllianceNashvilleTennesseeUSA
- Department of Radiation OncologyVanderbilt University Medical CenterNashvilleTennesseeUSA
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Jack HE, Giusto A, Rose AL, Mwamuka R, Brown I, Bere T, Verhey R, Wainberg M, Myers B, Kohrt B, Wingood G, DiClemente R, Magidson JF. Mutual capacity building model for adaptation (MCB-MA): a seven-step procedure bidirectional learning and support during intervention adaptation. Glob Health Res Policy 2024; 9:25. [PMID: 38956652 PMCID: PMC11218126 DOI: 10.1186/s41256-024-00369-8] [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: 02/03/2024] [Accepted: 06/19/2024] [Indexed: 07/04/2024] Open
Abstract
Global health reciprocal innovation emphasizes the movement of technologies or interventions between high- and low-income countries to address a shared public health problem, in contrast to unidirectional models of "development aid" or "reverse innovation". Evidence-based interventions are frequently adapted from the setting in which they were developed and applied in a new setting, presenting an opportunity for learning and partnership across high- and low-income contexts. However, few clear procedures exist to guide researchers and implementers on how to incorporate equitable and learning-oriented approaches into intervention adaptation across settings. We integrated theories from pedagogy, implementation science, and public health with examples from experience adapting behavioral health interventions across diverse settings to develop a procedure for a bidirectional, equitable process of intervention adaptation across high- and low-income contexts. The Mutual capacity building model for adaptation (MCB-MA) is made up of seven steps: 1) Exploring: A dialogue about the scope of the proposed adaptation and situational appraisal in the new setting; 2) Developing a shared vision: Agreeing on common goals for the adaptation; 3) Formalizing: Developing agreements around resource and data sharing; 4) Sharing complementary expertise: Group originating the intervention supporting the adapting group to learn about the intervention and develop adaptations, while gleaning new strategies for intervention implementation from the adapting group; 5) Reciprocal training: Originating and adapting groups collaborate to train the individuals who will be implementing the adapted intervention; 6) Mutual feedback: Originating and adapting groups share data and feedback on the outcomes of the adapted intervention and lessons learned; and 7) Consideration of next steps: Discuss future collaborations. This evidence-informed procedure may provide researchers with specific actions to approach the often ambiguous and challenging task of equitable partnership building. These steps can be used alongside existing intervention adaptation models, which guide the adaptation of the intervention itself.
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Affiliation(s)
- Helen E Jack
- Division of General Internal Medicine, Department of Medicine, University of Washington, Harborview Medical Center, Box 359780, Seattle, Washington, 325 9th Ave98104, USA.
| | - Ali Giusto
- Department of Psychiatry, Columbia University Irving Medical Center, New York State Psychiatric Institute, 1051 Riverside Dr, New York, NY, 10032, USA
| | - Alexandra L Rose
- Department of Psychology, University of Maryland, 4094 Campus Dr, College Park, MD, 20742, USA
| | - Rukudzo Mwamuka
- Graduate School for Health Sciences, University of Bern, Uni Mittelstrasse, Mittelstrasse 43, Bern, 3012, Switzerland
| | - Imani Brown
- Department of Psychology, University of Maryland, 4094 Campus Dr, College Park, MD, 20742, USA
| | - Tarisai Bere
- Mental Health Department, Faculty of Medicine, University of Zimbabwe, Mazowe Street, Avondale, Harare, Zimbabwe
| | - Ruth Verhey
- Friendship Bench Zimbabwe, 4 Weale Rd, Harare, Zimbabwe
| | - Milton Wainberg
- Department of Psychology, University of Maryland, 4094 Campus Dr, College Park, MD, 20742, USA
| | - Bronwyn Myers
- Mental Health, Alcohol, Substance Use, and Tobacco Research Unit, South African Medical Research Council, Parow, South Africa
- Department of Psychiatry and Mental Health, University of Cape Town, Neuroscience Institute, Groote Schuur Hospital, Observatory, Anzio Road, 1st Floor, Cape Town, South Africa
- Curtin enAble Institute, Faculty of Health Sciences, Curtin University, GPO Box U1987, Perth, WA, 6845, Australia
| | - Brandon Kohrt
- Center for Global Mental Health Equity, The George Washington University School of Medicine and Health Sciences, 2120 L Street NW, 6th Floor, Washington, DC, 20037, USA
| | - Gina Wingood
- Mailman School of Public Health, Columbia University, 722 West 168th Street, New York, NY, 10032, USA
| | - Ralph DiClemente
- School of Global Public Health, New York University, 708 Broadway, New York, NY, 10003, USA
| | - Jessica F Magidson
- Department of Psychology, University of Maryland, 4094 Campus Dr, College Park, MD, 20742, USA
- Center for Substance Use, Addiction & Health Research (CESAR), University of Maryland College Park, 1114 Chincoteague Hall, 7401 Preinkert Drive, College Park, MD, 20742, USA
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Farrar B, Middleton A, Thompson L, Akiwumi AM, Gallo IV, Munoz P, Nuño MA, Alaniz M. Experiences and Lessons Learned From the RADx-UP Consortium Community Engagement Projects. Am J Public Health 2024; 114:S405-S409. [PMID: 38547468 PMCID: PMC11111365 DOI: 10.2105/ajph.2024.307615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/26/2024] [Indexed: 05/24/2024]
Abstract
In this study, we used emerging community engagement frameworks to describe the structure and outcomes of a large-scale, community-engaged, research-to-practice initiative, RADx-UP. Qualitative methods were used to analyze survey and meeting data from 2022 for RADx-UP projects. Most projects had diverse partners, achieved moderate levels of community engagement, and experienced positive outcomes. Challenges related to engagement readiness and partnership functioning. These findings demonstrate that community engagement is measurable and valuable. However, additional support is needed to achieve the highest engagement. (Am J Public Health. 2024;114(S5):S405-S409. https://doi.org/10.2105/AJPH.2024.307615).
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Affiliation(s)
- Brandy Farrar
- Brandy Farrar, Ann Middleton, Lee Thompson, and Ann-Marie Akiwumi are with the American Institutes for Research, Washington, DC. Inigo Verduzco Gallo, Miriam A. Nuño, and Mariela Alaniz are with the University of California, Davis. Perfecto Munoz is with the West Modesto Community Collaborative, Modesto, CA. Miriam Nuño was also a Guest Editors for this supplemental issue
| | - Ann Middleton
- Brandy Farrar, Ann Middleton, Lee Thompson, and Ann-Marie Akiwumi are with the American Institutes for Research, Washington, DC. Inigo Verduzco Gallo, Miriam A. Nuño, and Mariela Alaniz are with the University of California, Davis. Perfecto Munoz is with the West Modesto Community Collaborative, Modesto, CA. Miriam Nuño was also a Guest Editors for this supplemental issue
| | - Lee Thompson
- Brandy Farrar, Ann Middleton, Lee Thompson, and Ann-Marie Akiwumi are with the American Institutes for Research, Washington, DC. Inigo Verduzco Gallo, Miriam A. Nuño, and Mariela Alaniz are with the University of California, Davis. Perfecto Munoz is with the West Modesto Community Collaborative, Modesto, CA. Miriam Nuño was also a Guest Editors for this supplemental issue
| | - Ann-Marie Akiwumi
- Brandy Farrar, Ann Middleton, Lee Thompson, and Ann-Marie Akiwumi are with the American Institutes for Research, Washington, DC. Inigo Verduzco Gallo, Miriam A. Nuño, and Mariela Alaniz are with the University of California, Davis. Perfecto Munoz is with the West Modesto Community Collaborative, Modesto, CA. Miriam Nuño was also a Guest Editors for this supplemental issue
| | - Inigo Verduzco Gallo
- Brandy Farrar, Ann Middleton, Lee Thompson, and Ann-Marie Akiwumi are with the American Institutes for Research, Washington, DC. Inigo Verduzco Gallo, Miriam A. Nuño, and Mariela Alaniz are with the University of California, Davis. Perfecto Munoz is with the West Modesto Community Collaborative, Modesto, CA. Miriam Nuño was also a Guest Editors for this supplemental issue
| | - Perfecto Munoz
- Brandy Farrar, Ann Middleton, Lee Thompson, and Ann-Marie Akiwumi are with the American Institutes for Research, Washington, DC. Inigo Verduzco Gallo, Miriam A. Nuño, and Mariela Alaniz are with the University of California, Davis. Perfecto Munoz is with the West Modesto Community Collaborative, Modesto, CA. Miriam Nuño was also a Guest Editors for this supplemental issue
| | - Miriam A Nuño
- Brandy Farrar, Ann Middleton, Lee Thompson, and Ann-Marie Akiwumi are with the American Institutes for Research, Washington, DC. Inigo Verduzco Gallo, Miriam A. Nuño, and Mariela Alaniz are with the University of California, Davis. Perfecto Munoz is with the West Modesto Community Collaborative, Modesto, CA. Miriam Nuño was also a Guest Editors for this supplemental issue
| | - Mariela Alaniz
- Brandy Farrar, Ann Middleton, Lee Thompson, and Ann-Marie Akiwumi are with the American Institutes for Research, Washington, DC. Inigo Verduzco Gallo, Miriam A. Nuño, and Mariela Alaniz are with the University of California, Davis. Perfecto Munoz is with the West Modesto Community Collaborative, Modesto, CA. Miriam Nuño was also a Guest Editors for this supplemental issue
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Enlow PT, Thomas C, Osorio AM, Lee M, Miller JM, Pelaez L, Kazak AE, Phan TLT. Community Partnership to Co-Develop an Intervention to Promote Equitable Uptake of the COVID-19 Vaccine Among Pediatric Populations. Dela J Public Health 2024; 10:30-38. [PMID: 38572140 PMCID: PMC10987021 DOI: 10.32481/djph.2024.03.06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2024] Open
Abstract
Objective To describe the process of engaging community, caregiver, and youth partners in codeveloping an intervention to promote equitable uptake of the COVID-19 vaccine in non-Hispanic Black (Black) and Hispanic youth who experience higher rates of COVID-19 transmission, morbidity, and mortality but were less likely to receive the COVID-19 vaccine. Methods A team of 11 Black and Hispanic community partners was assembled to codevelop intervention strategies with our interdisciplinary research team. We used a mixed-methods crowdsourcing approach with Black and Hispanic youth (n=15) and caregivers of Black and Hispanic youth (n=20) who had not yet been vaccinated against COVID-19, recruited from primary care clinics, to elicit perspectives on the acceptability of these intervention strategies. Results We codeveloped five strategies: (1) community-tailored handouts and posters, (2) videos featuring local youth, (3) family-centered language to offer vaccines in the primary care clinic, (4) communication-skills training for primary care providers, and (5) use of community health workers to counsel families about the vaccine. The majority (56-96.9%) of youth and caregivers rated each of these strategies as acceptable, especially because they addressed common concerns and facilitated shared decision-making. Conclusions Engaging community and family partners led to the co-development of culturally- and locally-tailored strategies to promote dialogue and shared decision-making about the COVID-19 vaccine. This process can be used to codevelop interventions to address other forms of public health disparities. Policy Implications Intervention strategies that promote dialogues with trusted healthcare providers and support shared decision-making are acceptable strategies to promote COVID-19 vaccine uptake among youth from historically underserved communities. Stakeholder-engaged methods may also help in the development of interventions to address other forms of health disparities.
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Affiliation(s)
- Paul T Enlow
- Center for Healthcare Delivery Science, Nemours Children's Hospital Delaware; Department of Pediatrics, Sidney Kimmel Medical College, Thomas Jefferson University
| | - Courtney Thomas
- Center for Healthcare Delivery Science, Nemours Children's Hospital Delaware
| | - Angel Munoz Osorio
- Center for Healthcare Delivery Science, Nemours Children's Hospital Delaware
| | - Marshala Lee
- Harrington Value Institute Community Partnership Fund, ChristianaCare Health System
| | - Jonathan M Miller
- Inclusion, Diversity, Equity, and Alignment, Nemours Children's Health; Department of Pediatrics, Sidney Kimmel Medical College, Thomas Jefferson University
| | - Lavisha Pelaez
- Inclusion, Diversity, Equity, and Alignment, Nemours Children's Health
| | - Anne E Kazak
- Center for Healthcare Delivery Science, Nemours Children's Hospital Delaware; Department of Pediatrics, Sidney Kimmel Medical College, Thomas Jefferson University
| | - Thao-Ly T Phan
- Center for Healthcare Delivery Science, Nemours Children's Hospital Delaware; Department of Pediatrics, Sidney Kimmel Medical College, Thomas Jefferson University
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Solomon SR, Belfiglio A, Tuton LW, Thomas NA. Training Community Leaders to Serve as Equal Partners in Research: Penn Community Scholars Program, 2015-2023. Am J Public Health 2024; 114:284-288. [PMID: 38271652 PMCID: PMC10882383 DOI: 10.2105/ajph.2023.307549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2024]
Abstract
An implementation and effectiveness evaluation of the Community Scholars Program was conducted at the University of Pennsylvania to enhance community capacity to collaborate with academics in mutually beneficial, equitable, and transformative research. Mixed methods were employed using administrative data, surveys, and key informant interviews. Participants expressed high satisfaction, valued interactive learning, and identified areas for improvement. The program increased knowledge and self-confidence in research-related skills and trust in the research process. The program serves as an institutional model to create long-term, mutually beneficial community-academic partnerships. (Am J Public Health. 2024;114(3):284-288. https://doi.org/10.2105/AJPH.2023.307549).
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Affiliation(s)
- Sara R Solomon
- Sara R. Solomon, Andrew Belfiglio, Lucy Wolf Tuton, and Nicole A. Thomas are with the Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Andrew Belfiglio
- Sara R. Solomon, Andrew Belfiglio, Lucy Wolf Tuton, and Nicole A. Thomas are with the Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Lucy Wolf Tuton
- Sara R. Solomon, Andrew Belfiglio, Lucy Wolf Tuton, and Nicole A. Thomas are with the Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Nicole A Thomas
- Sara R. Solomon, Andrew Belfiglio, Lucy Wolf Tuton, and Nicole A. Thomas are with the Perelman School of Medicine, University of Pennsylvania, Philadelphia
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Allweiss T, Schaefer I, Krieger T, Amort FM, Wright M, Dresen A. [Planning, Reflecting and Evaluating Participatory Health Research: Adaptation and Piloting of the "Community Based Participatory Research (CBPR) Model" for German-Speaking Countries]. DAS GESUNDHEITSWESEN 2024; 86:111-117. [PMID: 38128570 PMCID: PMC10883004 DOI: 10.1055/a-2167-2100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2023]
Abstract
Participatory research approaches are becoming increasingly established in both academic and practice settings. The participation of people with varied lived experiences and professional backgrounds can help academia and practitioners to learn from and empower each other. In the exchange of different perspectives, needs and ideas, it is possible to plan, reflect on, implement and evaluate projects in the health sector jointly and with attention to the needs of all stakeholders. The Community Based Participatory Research (CBPR) Model is often used internationally to guide participatory processes. However, an accessible translation has been lacking for application in German-speaking countries. To address this problem, a multidisciplinary working group composed of academic researchers and practitioners came together within the German-speaking Participatory Health Research Network (PartNet) to adapt the CBPR model for German-speaking countries and to test the adapted version with potential users. The adaptation was more than a translation, as the four model components "Contexts", "Partnership Processes", "Intervention & Research" and "Outcomes" as well as their associated contents are not directly applicable to the socio-structural and political contexts of the German-speaking countries. This article describes the process of adapting the model. This includes how translation drafts for German-speaking countries were first discussed in detail and then agreed upon as an initial template for testing in practice. Subsequently, various users reflected on the German-language model based on their experience of testing it in different projects, focusing on accuracy, comprehensibility and applicability. At the same time, the model was presented and discussed at conferences. The diverse feedback was incorporated into further revisions of the model. The result is a German-language version called "Modell für partizipative Gesundheitsforschung (PGF-Modell)".
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Affiliation(s)
- Theresa Allweiss
- Institut für Soziale Gesundheit, Katholische Hochschule für Sozialwesen Berlin, Berlin, Germany
| | - Ina Schaefer
- Partizipative Ansätze in den Sozial- und Gesundheitswissenschaften, Alice Salomon Hochschule Berlin, Berlin, Germany
| | - Theresia Krieger
- Institut für Medizinische Psychologie - Neuropsychologie und Gender Studies, Universität zu Köln Medizinische Fakultät, Köln, Germany
| | - Frank M Amort
- Institut Gesundheits- und Tourismusmanagement, FH Joanneum GmbH Institut Gesundheits- und Tourismusmanagement, Bad Gleichenberg, Austria
| | - Michael Wright
- Institut für Soziale Gesundheit, Katholische Hochschule für Sozialwesen Berlin, Berlin, Germany
| | - Antje Dresen
- Institut für Medizinsoziologie, Versorgungsforschung und Rehabilitationswissenschaft, Universität zu Köln Medizinische Fakultät, Köln, Germany
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Thompson D, Callender C, Dave JM, Jibaja-Weiss ML, Montealegre JR. Health equity in action: using community-engaged research to update an intervention promoting a healthy home food environment to Black/African American families. Cancer Causes Control 2024; 35:311-321. [PMID: 37736870 DOI: 10.1007/s10552-023-01753-4] [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: 02/17/2023] [Accepted: 07/05/2023] [Indexed: 09/23/2023]
Abstract
PURPOSE Describe the method for conducting community-engaged research to identify needed changes for an existing evidence-based intervention, and prepare it for implementation in a community setting within the Dan L Duncan Comprehensive Cancer Center catchment area in an effort to achieve more equitable outcomes in diet-related disease risk factors. METHODS The intervention, Family Eats, was developed over 10 years ago. It works directly with parents of Black/African American 9-12 year old children to create a healthy home food environment to support prevention of obesity and related cancers. Data collection with community stakeholders occurred through a series of Community Advisory Board (CAB) meetings guided by the Delphi Technique, an iterative approach for gaining group consensus on a topic. RESULTS Key information on needed changes and potential implementation strategies were identified. Perceived level of engagement among CAB members was high overall and in terms of both quantity and quality. CONCLUSION The Delphi Technique shows promise as a method for conducting community-engaged research that promotes engagement and identifies key information needed to adapt and implement an existing intervention in a community setting.
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Affiliation(s)
- Debbe Thompson
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA.
| | - Chishinga Callender
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | - Jayna M Dave
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | - Maria L Jibaja-Weiss
- School of Health Professions, Baylor College of Medicine, Houston, TX, USA
- Dan L Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX, USA
| | - Jane R Montealegre
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
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Odedina FT, Wieland ML, Barbel-Johnson K, Crook JM. Community Engagement Strategies for Underrepresented Racial and Ethnic Populations. Mayo Clin Proc 2024; 99:159-171. [PMID: 38176825 DOI: 10.1016/j.mayocp.2023.07.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 07/17/2023] [Accepted: 07/18/2023] [Indexed: 01/06/2024]
Abstract
The representation of racial and ethnic minority populations in clinical trials continues to be a challenge despite mandates, good intentions, and concerted efforts by funding agencies, regulatory bodies, and researchers to close the clinical trials gap. A lack of diversity in research results in both continued disparities and poorer health outcomes. It is thus imperative that investigators understand and effectively address the challenges of clinical trials participation by underrepresented populations. In this paper, we expound on best practices for participatory research by clearly defining the community, highlighting the importance of proper identification and engagement of strong community partners, and exploring patient- and provider-level barriers and facilitators that require consideration. A clearer understanding of the balance of power between researchers and community partners is needed for any approach that addresses clinical trials representation. Unintended biases in study design and methods may continue to prevent racial and ethnic minority participants from taking part, and significant organizational changes are necessary for efficient and transparent relationships. Comprehensive community engagement in research includes dissemination of clinical trial results within and in partnership with community partners. Through careful deliberation and honest reflection, investigators, institutions, and community partners can develop the tailored blueprints of research collaborations essential for true equity in clinical trials.
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Affiliation(s)
| | - Mark L Wieland
- Division of Community Internal Medicine, Geriatrics, and Palliative Care, Mayo Clinic, Rochester, MN
| | | | - Jennifer M Crook
- Mayo Clinic Comprehensive Cancer Center, Mayo Clinic, Jacksonville, FL
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Sprague Martinez L, Howard RC, Schotland M, Lobb R, Battaglia T, Stone S, Auerswald C, Ozer E. Community engagement and financial arrangements: Navigating institutional change. J Clin Transl Sci 2023; 7:e261. [PMID: 38229900 PMCID: PMC10790102 DOI: 10.1017/cts.2023.683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Revised: 11/03/2023] [Accepted: 11/10/2023] [Indexed: 01/18/2024] Open
Abstract
Despite their documented benefits, the widespread adoption of community-engaged and participatory approaches among health researchers remains limited. Institutional practices and policies influence the uptake of community engagement and participatory approaches. We examine the role of financial arrangements between university researchers and community partners, by exploring efforts to bridge the gap between research administration and researchers at two research-intensive institutions. The type of financial arrangement a researcher has with a community partner plays an important role in setting the stage for the structure of the partnership as it relates to shared decision-making and ownership of the research. Continued efforts to clarify and streamline subcontracting processes are needed as is infrastructure to support community partners and researchers as they navigate financial arrangements if progress is to be made.
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Affiliation(s)
- Linda Sprague Martinez
- Boston University School of Social Work, Boston, MA, USA
- Boston University Clinical Translational Science Institute, Community Engagement Program, Boston, MA, USA
| | - Riana C. Howard
- Boston University School of Social Work, Boston, MA, USA
- Boston University Clinical Translational Science Institute, Community Engagement Program, Boston, MA, USA
| | - Marieka Schotland
- University of California Berkeley, School of Public Health, Berkely, CA, USA
| | - Rebecca Lobb
- Boston University Clinical Translational Science Institute, Community Engagement Program, Boston, MA, USA
| | - Tracy Battaglia
- Boston University Clinical Translational Science Institute, Community Engagement Program, Boston, MA, USA
- Boston University School of Medicine, Boston, MA, USA
- Boston Medical Center, Boston, MA, USA
| | - Susan Stone
- University of California Berkeley, School of Social Welfare, Berkely, CA, USA
| | - Coco Auerswald
- University of California Berkeley, School of Public Health, Berkely, CA, USA
| | - Emily Ozer
- University of California Berkeley, School of Public Health, Berkely, CA, USA
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Ramji R, Rämgård M, Carlson E, Shleev S, Awad E, Cirovic S, Kottorp A. Health and quality of life among women after participation in a CBPR-informed physical activity intervention: with a pandemic perspective. Sci Rep 2023; 13:17972. [PMID: 37863947 PMCID: PMC10589350 DOI: 10.1038/s41598-023-45239-4] [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: 06/13/2023] [Accepted: 10/17/2023] [Indexed: 10/22/2023] Open
Abstract
The lack of culturally and contextually oriented interventions promoting physical activity (PA) has led to increased physical inactivity among women living in disadvantaged neighbourhoods in Sweden. In this study one such intervention informed by community-based participatory research (CBPR) has been evaluated among 34 women from a disadvantaged neighbourhood before and during COVID-19. Health-related quality of life (HRQOL), behavioural and biomedical outcomes were assessed directly prior and post-intervention, followed by evaluations at 6-months and 18-months follow-up during COVID-19. The results revealed that HRQOL, particularly psychological, social, and environmental health significantly increased post-intervention compared to prior to intervention but reversed back at 6-months follow-up. Perceived health satisfaction and environmental health increased at 18-months follow-up during COVID-19. Participation in PA improved post-intervention and at 6-months follow-up. Everyday activities and fruit and vegetable intake continued to increase through all timepoints. Systolic blood pressure significantly decreased post-intervention and 6-months follow-up; blood flow rate increased significantly at all timepoints. Overall, the findings underscores the potential effectiveness of CBPR approaches in promoting and sustaining healthy lifestyles, even during acute situations such as the COVID-19. It may even serve as a future model for promoting health and addressing health disparities in similar groups.
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Affiliation(s)
- Rathi Ramji
- Department of Care Science, Faculty of Health and Society, Malmö University, Jan Waldenströms Gata 25, 20506, Malmö, Sweden.
| | - Margareta Rämgård
- Department of Care Science, Faculty of Health and Society, Malmö University, Jan Waldenströms Gata 25, 20506, Malmö, Sweden
| | - Elisabeth Carlson
- Department of Care Science, Faculty of Health and Society, Malmö University, Jan Waldenströms Gata 25, 20506, Malmö, Sweden
| | - Sergey Shleev
- Department of Biomedical Science, Faculty of Health and Society, Malmö University, Jan Waldenströms Gata 25, 20506, Malmö, Sweden
| | - Eman Awad
- Department of Biomedical Science, Faculty of Health and Society, Malmö University, Jan Waldenströms Gata 25, 20506, Malmö, Sweden
| | - Stefan Cirovic
- Department of Biomedical Science, Faculty of Health and Society, Malmö University, Jan Waldenströms Gata 25, 20506, Malmö, Sweden
| | - Anders Kottorp
- Department of Care Science, Faculty of Health and Society, Malmö University, Jan Waldenströms Gata 25, 20506, Malmö, Sweden
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11
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Sanchez-Youngman S, Adsul P, Gonzales A, Dickson E, Myers K, Alaniz C, Wallerstein N. Transforming the field: the role of academic health centers in promoting and sustaining equity based community engaged research. Front Public Health 2023; 11:1111779. [PMID: 37457247 PMCID: PMC10345346 DOI: 10.3389/fpubh.2023.1111779] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 05/08/2023] [Indexed: 07/18/2023] Open
Abstract
Community-based participatory research (CBPR) and community engaged research (CEnR) are key to promoting community and patient engagement in actionable evidence-based strategies to improve research for health equity. Rapid growth of CBPR/CEnR research projects have led to the broad adoption of partnering principles in community-academic partnerships and among some health and academic organizations. Yet, transformation of principles into best practices that foster trust, shared power, and equity outcomes still remain fragmented, are dependent on individuals with long term projects, or are non-existent. This paper describes how we designed our Engage for Equity PLUS intervention that leverages the leadership and membership of champion teams (including community-engaged faculty, community partners and patient advocates) to improve organizational policies and practices to support equity based CBPR/CEnR. This article describes the feasibility and preliminary findings from engaging champion teams from three very different academic health centers. We reflect on the learnings from Engage for Equity PLUS; the adaptation of the intervention design and implementation, including the development of a new institutional assessment using mixed research methods; and our organizational theory of change. In summary, our design and preliminary data from the three academic health centers provide support for new attention to the role of institutional practices and processes needed to sustain equity-based patient and community-engaged research and CBPR and transform the field.
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Affiliation(s)
| | - Prajakta Adsul
- Department of Internal Medicine, University of New Mexico, Albuquerque, NM, United States
| | - Amber Gonzales
- College of Population Health, University of New Mexico, Albuquerque, NM, United States
| | - Elizabeth Dickson
- College of Nursing, University of New Mexico, Albuquerque, NM, United States
| | - Katie Myers
- School of Medicine, University of New Mexico, Albuquerque, NM, United States
| | - Christina Alaniz
- College of Population Health, University of New Mexico, Albuquerque, NM, United States
| | - Nina Wallerstein
- College of Population Health, University of New Mexico, Albuquerque, NM, United States
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12
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Kuppen R, de Leede M, Lindenberg J, van Bodegom D. Collective Prevention of Non-Communicable Diseases in an Ageing Population with Community Care. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3134. [PMID: 36833834 PMCID: PMC9961588 DOI: 10.3390/ijerph20043134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 01/23/2023] [Accepted: 01/25/2023] [Indexed: 06/18/2023]
Abstract
The Dutch population is rapidly ageing, and a growing number of people are suffering from age-related health problems such as obesity, cardiovascular diseases and diabetes. These diseases can be prevented or delayed by adapting healthy behaviours. However, making long-lasting lifestyle changes has proven to be challenging and most individual-based lifestyle interventions have not been effective on the long-term. Prevention programs focused on lifestyle should involve the physical and social context of individuals, because the (social) environment plays a large role in both conscious and unconscious lifestyle choices. Collective prevention programmes are promising strategies to mobilize the potential of the (social) environment. However, little is known about how such collective prevention programs could work in practice. Together with community care organization Buurtzorg, we have started a 5 year evaluation project to study how collective prevention can be practised in communities. In this paper, we discuss the potential of collective prevention and explain the methods and goals of our study.
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Affiliation(s)
- Regina Kuppen
- Department of Public Health and Primary Care, Leiden University Medical Centre, Hippocratespad 21, 2333 RC Leiden, The Netherlands
- Leyden Academy on Vitality and Ageing, Rijnsburgerweg 10, 2333 AA Leiden, The Netherlands
| | - Mirjam de Leede
- Department of Public Health and Primary Care, Leiden University Medical Centre, Hippocratespad 21, 2333 RC Leiden, The Netherlands
- Buurtzorg Nederland, Head Office, Postbus 69, 7600 AB Almelo, The Netherlands
| | - Jolanda Lindenberg
- Department of Public Health and Primary Care, Leiden University Medical Centre, Hippocratespad 21, 2333 RC Leiden, The Netherlands
- Leyden Academy on Vitality and Ageing, Rijnsburgerweg 10, 2333 AA Leiden, The Netherlands
| | - David van Bodegom
- Department of Public Health and Primary Care, Leiden University Medical Centre, Hippocratespad 21, 2333 RC Leiden, The Netherlands
- Leyden Academy on Vitality and Ageing, Rijnsburgerweg 10, 2333 AA Leiden, The Netherlands
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13
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Wieland ML, Njeru JW, Weis JA, Lohr A, Nigon JA, Goodson M, Osman A, Molina L, Ahmed Y, Capetillo GP, Nur O, Sia IG. Rochester Healthy Community Partnership: Then and now. Front Public Health 2023; 10:1090131. [PMID: 36703848 PMCID: PMC9871468 DOI: 10.3389/fpubh.2022.1090131] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 12/21/2022] [Indexed: 01/12/2023] Open
Abstract
Community-engaged research partnerships promote health equity through incorporation of regional contexts to inform partnership dynamics that shape research and interventions that reflect community voice and priorities. Long-term partnerships build trusted relationships and promote capacity building among community and academic partners, but there are many structural barriers to sustaining long-term partnerships. Here we describe lessons learned from sustaining Rochester Healthy Community Partnership (RHCP), an 18-year community-based participatory research (CBPR) partnership in Southeast Minnesota. RHCP collaborates with immigrant and refugee populations to co-create interventions that promote health equity for community health priorities. Challenges to sustainability include a tension between project-based funding and the needs of long-term community-based research infrastructure. These challenges can be met with a focus on shared CBPR principles, operating norms, partnership dynamics, and governance. RHCP began in 2004 through identification of a community health priority, defining the community, and establishment of CBPR principles. It grew through identification of broader community health priorities, capacity building for community and academic partners, and integration of diverse learners. We describe the capacity for RHCP to respond to new societal contexts, the importance of partnership dynamics as a barometer for partnership health, and lessons learned about sustainability of the CBPR partnership.
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Affiliation(s)
- Mark L. Wieland
- Division of Community Internal Medicine, Geriatrics, and Palliative Care, Mayo Clinic, Rochester, MN, United States,Rochester Healthy Community Partnership, Rochester, MN, United States,*Correspondence: Mark L. Wieland ✉
| | - Jane W. Njeru
- Division of Community Internal Medicine, Geriatrics, and Palliative Care, Mayo Clinic, Rochester, MN, United States,Rochester Healthy Community Partnership, Rochester, MN, United States
| | - Jennifer A. Weis
- Rochester Healthy Community Partnership, Rochester, MN, United States,Center for Clinical and Translational Science, Mayo Clinic, Rochester, MN, United States
| | - Abby Lohr
- Division of Community Internal Medicine, Geriatrics, and Palliative Care, Mayo Clinic, Rochester, MN, United States,Rochester Healthy Community Partnership, Rochester, MN, United States
| | - Julie A. Nigon
- Rochester Healthy Community Partnership, Rochester, MN, United States,Hawthorne Education Center, Rochester, MN, United States
| | - Miriam Goodson
- Rochester Healthy Community Partnership, Rochester, MN, United States,Alliance of Chicanos, Hispanics, and Latin Americans, Rochester, MN, United States
| | - Ahmed Osman
- Rochester Healthy Community Partnership, Rochester, MN, United States,Intercultural Mutual Assistance Association, Rochester, MN, United States
| | - Luz Molina
- Rochester Healthy Community Partnership, Rochester, MN, United States,Division of Public Health, Infectious Diseases, and Occupational Medicine, Mayo Clinic, Rochester, MN, United States
| | - Yahye Ahmed
- Rochester Healthy Community Partnership, Rochester, MN, United States,Somali American Social Service Association, Rochester, MN, United States
| | - Graciela Porraz Capetillo
- Rochester Healthy Community Partnership, Rochester, MN, United States,Division of Public Health, Infectious Diseases, and Occupational Medicine, Mayo Clinic, Rochester, MN, United States
| | - Omar Nur
- Rochester Healthy Community Partnership, Rochester, MN, United States,Somali American Social Service Association, Rochester, MN, United States
| | - Irene G. Sia
- Rochester Healthy Community Partnership, Rochester, MN, United States,Division of Public Health, Infectious Diseases, and Occupational Medicine, Mayo Clinic, Rochester, MN, United States
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14
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Ramji R, Carlson E, Kottorp A, Rämgård M. Impact of a CBPR-informed physical activity intervention before and during COVID-19 among women from a disadvantaged neighborhood in Sweden. Front Public Health 2022; 10:997329. [PMID: 36478727 PMCID: PMC9719947 DOI: 10.3389/fpubh.2022.997329] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 10/07/2022] [Indexed: 11/22/2022] Open
Abstract
Background Public health practitioners have been striving to reduce the social gradient and promote physical activity among citizens living in disadvantaged neighborhoods. The emergence of the COVID-19 pandemic, which has affected these citizens extensively, has posed a significant challenge to efforts to maintain a physically active lifestyle. Thus, the aim of this study was to explore the impact of a CBPR-informed physical activity intervention before and during the COVID-19 pandemic from the perspective of women from a socially disadvantaged neighborhood. Methods A total of 34 women participated in a CBPR-informed physical activity intervention previously developed in collaboration with lay health promoters and other citizens from the same neighborhood. Focus group discussions were conducted at four time points, namely, at baseline prior to the intervention, post-intervention, 6 months after the intervention ended, and during the COVID-19 pandemic. The data were analyzed using qualitative content analysis following an inductive approach. Results In total, four themes emerged from the discussions: "Wavering between frustration and action," "Shifting from prioritizing family needs to taking control of self," "Between isolation and social support," and "Restricted access to health-related knowledge vs. utilizing internalized knowledge". Conclusion The results of this study reveal that building on CBPR-informed health promotion initiatives has the potential to foster individual empowerment and assist during acute situations like the COVID-19 pandemic through mobilizing communities and their resources, which leads to increased community resilience and health. This study is regarded as unique in that it involves evaluation of a CBPR intervention that was initiated ahead of the pandemic and followed even during the pandemic.
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