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García JIR, Oro V, Budd EL, Mauricio AM, Cioffi CC, Anda SD, McWhirter EH, DeGarmo DS, Leve LD. A Translational Case Study of a Multisite COVID-19 Public Health Intervention Across Sequenced Research Trials: Embedding Implementation in a Community Engagement Phased Framework. Am J Public Health 2024; 114:S396-S401. [PMID: 38776498 PMCID: PMC11111377 DOI: 10.2105/ajph.2024.307669] [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: 03/22/2024] [Indexed: 05/25/2024]
Abstract
Through a COVID-19 public health intervention implemented across sequenced research trials, we present a community engagement phased framework that embeds intervention implementation: (1) consultation and preparation, (2) collaboration and implementation, and (3) partnership and sustainment. Intervention effects included mitigation of psychological distress and a 0.28 increase in the Latinx population tested for SARS-CoV-2. We summarize community engagement activities and implementation strategies that took place across the trials to illustrate the value of the framework for public health practice and research. (Am J Public Health. 2024;114(S5):S396-S401. https://doi.org/10.2105/AJPH.2024.307669).
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Affiliation(s)
- Jorge I Ramírez García
- Jorge I. Ramírez García is with the University of Oregon, Prevention Science Institute, Eugene and the Oregon Research Institute, Springfield. Veronica Oro and Camille C. Cioffi are with the University of Oregon, Prevention Science Institute, Eugene. Ellen Hawley McWhirter is with the Department of Counseling Psychology and Human Services, University of Oregon, Eugene. Elizabeth L. Budd, Anne Marie Mauricio, David S. DeGarmo, and Leslie D. Leve are with the University of Oregon, Prevention Science Institute, Eugene and the Department of Counseling Psychology and Human Services, University of Oregon, Eugene. Stephanie De Anda is with the University of Oregon, Prevention Science Institute, Eugene and the Department of Special Education and Clinical Sciences, University of Oregon, Eugene
| | - Veronica Oro
- Jorge I. Ramírez García is with the University of Oregon, Prevention Science Institute, Eugene and the Oregon Research Institute, Springfield. Veronica Oro and Camille C. Cioffi are with the University of Oregon, Prevention Science Institute, Eugene. Ellen Hawley McWhirter is with the Department of Counseling Psychology and Human Services, University of Oregon, Eugene. Elizabeth L. Budd, Anne Marie Mauricio, David S. DeGarmo, and Leslie D. Leve are with the University of Oregon, Prevention Science Institute, Eugene and the Department of Counseling Psychology and Human Services, University of Oregon, Eugene. Stephanie De Anda is with the University of Oregon, Prevention Science Institute, Eugene and the Department of Special Education and Clinical Sciences, University of Oregon, Eugene
| | - Elizabeth L Budd
- Jorge I. Ramírez García is with the University of Oregon, Prevention Science Institute, Eugene and the Oregon Research Institute, Springfield. Veronica Oro and Camille C. Cioffi are with the University of Oregon, Prevention Science Institute, Eugene. Ellen Hawley McWhirter is with the Department of Counseling Psychology and Human Services, University of Oregon, Eugene. Elizabeth L. Budd, Anne Marie Mauricio, David S. DeGarmo, and Leslie D. Leve are with the University of Oregon, Prevention Science Institute, Eugene and the Department of Counseling Psychology and Human Services, University of Oregon, Eugene. Stephanie De Anda is with the University of Oregon, Prevention Science Institute, Eugene and the Department of Special Education and Clinical Sciences, University of Oregon, Eugene
| | - Anne Marie Mauricio
- Jorge I. Ramírez García is with the University of Oregon, Prevention Science Institute, Eugene and the Oregon Research Institute, Springfield. Veronica Oro and Camille C. Cioffi are with the University of Oregon, Prevention Science Institute, Eugene. Ellen Hawley McWhirter is with the Department of Counseling Psychology and Human Services, University of Oregon, Eugene. Elizabeth L. Budd, Anne Marie Mauricio, David S. DeGarmo, and Leslie D. Leve are with the University of Oregon, Prevention Science Institute, Eugene and the Department of Counseling Psychology and Human Services, University of Oregon, Eugene. Stephanie De Anda is with the University of Oregon, Prevention Science Institute, Eugene and the Department of Special Education and Clinical Sciences, University of Oregon, Eugene
| | - Camille C Cioffi
- Jorge I. Ramírez García is with the University of Oregon, Prevention Science Institute, Eugene and the Oregon Research Institute, Springfield. Veronica Oro and Camille C. Cioffi are with the University of Oregon, Prevention Science Institute, Eugene. Ellen Hawley McWhirter is with the Department of Counseling Psychology and Human Services, University of Oregon, Eugene. Elizabeth L. Budd, Anne Marie Mauricio, David S. DeGarmo, and Leslie D. Leve are with the University of Oregon, Prevention Science Institute, Eugene and the Department of Counseling Psychology and Human Services, University of Oregon, Eugene. Stephanie De Anda is with the University of Oregon, Prevention Science Institute, Eugene and the Department of Special Education and Clinical Sciences, University of Oregon, Eugene
| | - Stephanie De Anda
- Jorge I. Ramírez García is with the University of Oregon, Prevention Science Institute, Eugene and the Oregon Research Institute, Springfield. Veronica Oro and Camille C. Cioffi are with the University of Oregon, Prevention Science Institute, Eugene. Ellen Hawley McWhirter is with the Department of Counseling Psychology and Human Services, University of Oregon, Eugene. Elizabeth L. Budd, Anne Marie Mauricio, David S. DeGarmo, and Leslie D. Leve are with the University of Oregon, Prevention Science Institute, Eugene and the Department of Counseling Psychology and Human Services, University of Oregon, Eugene. Stephanie De Anda is with the University of Oregon, Prevention Science Institute, Eugene and the Department of Special Education and Clinical Sciences, University of Oregon, Eugene
| | - Ellen Hawley McWhirter
- Jorge I. Ramírez García is with the University of Oregon, Prevention Science Institute, Eugene and the Oregon Research Institute, Springfield. Veronica Oro and Camille C. Cioffi are with the University of Oregon, Prevention Science Institute, Eugene. Ellen Hawley McWhirter is with the Department of Counseling Psychology and Human Services, University of Oregon, Eugene. Elizabeth L. Budd, Anne Marie Mauricio, David S. DeGarmo, and Leslie D. Leve are with the University of Oregon, Prevention Science Institute, Eugene and the Department of Counseling Psychology and Human Services, University of Oregon, Eugene. Stephanie De Anda is with the University of Oregon, Prevention Science Institute, Eugene and the Department of Special Education and Clinical Sciences, University of Oregon, Eugene
| | - David S DeGarmo
- Jorge I. Ramírez García is with the University of Oregon, Prevention Science Institute, Eugene and the Oregon Research Institute, Springfield. Veronica Oro and Camille C. Cioffi are with the University of Oregon, Prevention Science Institute, Eugene. Ellen Hawley McWhirter is with the Department of Counseling Psychology and Human Services, University of Oregon, Eugene. Elizabeth L. Budd, Anne Marie Mauricio, David S. DeGarmo, and Leslie D. Leve are with the University of Oregon, Prevention Science Institute, Eugene and the Department of Counseling Psychology and Human Services, University of Oregon, Eugene. Stephanie De Anda is with the University of Oregon, Prevention Science Institute, Eugene and the Department of Special Education and Clinical Sciences, University of Oregon, Eugene
| | - Leslie D Leve
- Jorge I. Ramírez García is with the University of Oregon, Prevention Science Institute, Eugene and the Oregon Research Institute, Springfield. Veronica Oro and Camille C. Cioffi are with the University of Oregon, Prevention Science Institute, Eugene. Ellen Hawley McWhirter is with the Department of Counseling Psychology and Human Services, University of Oregon, Eugene. Elizabeth L. Budd, Anne Marie Mauricio, David S. DeGarmo, and Leslie D. Leve are with the University of Oregon, Prevention Science Institute, Eugene and the Department of Counseling Psychology and Human Services, University of Oregon, Eugene. Stephanie De Anda is with the University of Oregon, Prevention Science Institute, Eugene and the Department of Special Education and Clinical Sciences, University of Oregon, Eugene
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Regan EW, Toto P, Brach J. A Community Needs Assessment and Implementation Planning for a Community Exercise Program for Survivors of Stroke: Protocol for a Pilot Hybrid Type I Clinical Effectiveness and Implementation Study. JMIR Res Protoc 2024; 13:e55432. [PMID: 38603776 PMCID: PMC11046392 DOI: 10.2196/55432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 03/07/2024] [Accepted: 03/11/2024] [Indexed: 04/13/2024] Open
Abstract
BACKGROUND Physical activity and exercise are important aspects of maintaining health. People with mobility impairments, including survivors of stroke, are less likely to exercise and at greater risk of developing or worsening chronic health conditions. Increasing accessible, desired options for exercise may address the gap in available physical activity programs, provide an opportunity for continued services after rehabilitation, and cultivate social connections for people after stroke and others with mobility impairments. Existing evidence-based community programs for people after stroke target cardiovascular endurance, mobility, walking ability, balance, and education. While much is known about the effectiveness of these programs, it is important to understand the local environment as implementation and sustainment strategies are context-specific. OBJECTIVE This study protocol aims to evaluate community needs and resources for exercise for adults living with mobility impairments with initial emphasis on survivors of stroke in Richland County, South Carolina. Results will inform a hybrid type I effectiveness and implementation pilot of an evidence-based group exercise program for survivors of stroke. METHODS The exploration and preparation phases of the EPIS (Exploration, Preparation, Implementation, and Sustainment) implementation model guide the study. A community needs assessment will evaluate the needs and desires of survivors of stroke through qualitative semistructured interviews with survivors of stroke, rehabilitation professionals, and fitness trainers serving people with mobility impairments. Additional data will be collected from survivors of stroke through a survey. Fitness center sites will be assessed through interviews and the Accessibility Instrument Measuring Fitness and Recreation Environments inventory. Qualitative data will be evaluated using content analysis and supported by mean survey results. Data will be categorized by the community (outer context), potential participants (outer context), and fitness center (inner context) and evaluate needs, resources, barriers, and facilitators. Results will inform evidence-based exercise program selection, adaptations, and specific local implementation strategies to influence success. Pilot outcome measures for participants (clinical effectiveness), process, and program delivery levels will be identified. An implementation logic model for interventions will be created to reflect the design elements for the pilot and their complex interactions. RESULTS The study was reviewed by the institutional review board and exempt approved on December 19, 2023. The study data collection began in January 2024 and is projected to be completed in June 2024. A total of 17 participants have been interviewed as of manuscript submission. Results are expected to be published in early 2025. CONCLUSIONS Performing a needs assessment before implementing it in the community allows for early identification of complex relationships and preplanning to address problems that cannot be anticipated in controlled effectiveness research. Evaluation and preparation prior to implementation of a community exercise program enhance the potential to be successful, valued, and sustained in the community. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/55432.
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Affiliation(s)
- Elizabeth Wherley Regan
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
| | - Pamela Toto
- Department of Occupational Therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA, United States
| | - Jennifer Brach
- Department of Physical Therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA, United States
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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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Lokot M, Hartman E, Hashmi I. Participatory approaches and methods in gender equality and gender-based violence research with refugees and internally displaced populations: a scoping review. Confl Health 2023; 17:58. [PMID: 38066619 PMCID: PMC10704759 DOI: 10.1186/s13031-023-00554-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 11/22/2023] [Indexed: 01/05/2024] Open
Abstract
Using participatory approaches or methods are often positioned as a strategy to tackle power hierarchies in research. Despite momentum on decolonising aid, humanitarian actors have struggled to describe what 'participation' of refugees and internally displaced persons (IDPs) means in practice. Efforts to promote refugee and IDP participation can be tokenistic. However, it is not clear if and how these critiques apply to gender-based violence (GBV) and gender equality-topics that often innately include power analysis and seek to tackle inequalities. This scoping review sought to explore how refugee and IDP participation is conceptualised within research on GBV and gender equality. We found that participatory methods and approaches are not always clearly described. We suggest that future research should articulate more clearly what constitutes participation, consider incorporating feminist research methods which have been used outside humanitarian settings, take more intentional steps to engage refugees and IDPs, ensure compensation for their participation, and include more explicit reflection and strategies to address power imbalances.
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Affiliation(s)
- Michelle Lokot
- London School of Hygiene and Tropical Medicine, London, UK.
| | - Erin Hartman
- London School of Hygiene and Tropical Medicine, London, UK
| | - Iram Hashmi
- London School of Hygiene and Tropical Medicine, London, UK
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Tuitt NR, Wexler LM, Kaufman CE, Whitesell NR, Rink E, Anastario M, Ivanich JD, Belone L, Moore RS, Huh D, Campbell TE, Allen J. Unsettling Settler Colonialism in Research: Strategies Centering Native American Experience and Expertise in Responding to Substance Misuse and Co-occurring Sexual Risk-Taking, Alcohol-Exposed Pregnancy, and Suicide Prevention Among Young People. ADVERSITY AND RESILIENCE SCIENCE 2023; 4:389-400. [PMID: 38045956 PMCID: PMC10688593 DOI: 10.1007/s42844-023-00100-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/07/2023] [Indexed: 12/05/2023]
Abstract
Native American (NA) populations in the USA (i.e., those native to the USA which include Alaska Natives, American Indians, and Native Hawaiians) have confronted unique historical, sociopolitical, and environmental stressors born of settler colonialism. Contexts with persistent social and economic disadvantage are critical determinants of substance misuse and co-occurring sexual risk-taking and suicide outcomes, as well as alcohol exposed pregnancy among NA young people (i.e., adolescents and young adults). Despite intergenerational transmission of resistance and resiliencies, NA young people face continued disparities in substance misuse and co-occurring outcomes when compared to other racial and ethnic groups in the USA. The failure in progress to address these inequities is the result of a complex set of factors; many of which are structural and rooted in settler colonialism. One of these structural factors includes barriers evident in health equity research intended to guide solutions to address these disparities yet involving maintenance of a research status quo that has proven ineffective to developing these solutions. Explicitly or implicitly biased values, perspectives, and practices are deeply rooted in current research design, methodology, analysis, and dissemination and implementation efforts. This status quo has been supported, intentionally and unintentionally, by researchers and research institutions with limited experience or knowledge in the historical, social, and cultural contexts of NA communities. We present a conceptual framework illustrating the impact of settler colonialism on current research methods and opportunities to unsettle its influence. Moreover, our framework illustrates opportunities to resist settler colonialism in research. We then focus on case examples of studies from the Intervention Research to Improve Native American Health program, funded by the NIH, that impact substance use and co-occurring health conditions among NA young people.
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Affiliation(s)
- Nicole R. Tuitt
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Lisa M. Wexler
- School of Social Work, University of Michigan, Ann Arbor, MI, USA
| | - Carol E. Kaufman
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Nancy Rumbaugh Whitesell
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Elizabeth Rink
- Center for American Indian and Rural Health Equity, College of Education, Health, and Human Resources, Montana State University, Bozeman, MT, USA
| | - Michael Anastario
- Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA
| | - Jerreed D. Ivanich
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Lorenda Belone
- Center for Participatory Research, Department of Health, Exercise, and Sports Science, University of New Mexico Health Sciences Center, Albuquerque, NM, USA
| | - Roland S. Moore
- Pacific Institute for Research and Evaluation, Albuquerque, NM, USA
| | - David Huh
- School of Social Work, University of Washington, Seattle, WA, USA
| | | | - James Allen
- Department of Family Medicine and Biobehavioral Health, University of Minnesota, Minneapolis, MN, USA
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Singh S, Polavarapu M, Vallerand K, Bhoge Y, Noviski KM. Assessing Organizational Capacity to Advance Health Equity: Mixed-Methods Approach at a Local Health Department. COMMUNITY HEALTH EQUITY RESEARCH & POLICY 2023:2752535X231219297. [PMID: 38019708 DOI: 10.1177/2752535x231219297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/01/2023]
Abstract
Local health departments (LHDs) play a leading role in eliminating health inequities as they proactively identify and address barriers to optimal health within the community they serve. This study evaluated a Midwestern County LHD's commitment, collaborations, and capacity to advance health equity in their organization. A total of 81 employees completed the online survey (response rate = 51%) and 12 among randomly selected employees completed the qualitative interviews (31.5%). More than 75% of participants reported that all departments had explicit work plans and 50% had a strong capacity to address social determinants of health. Almost 50% of the participants reported strong internal collaboration, but less than 25% indicated that no external partners were involved during the program planning process. Finally, a few participants identified the need for increased diversity in leadership and expressed the importance of quality training and feedback.
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Affiliation(s)
- Shipra Singh
- Department of Population Health, College of Health & Human Services, University of Toledo, Toledo, OH, USA
- Health Equity Research Center (HERC), University of Toledo, Toledo, OH, USA
- School for the Advancement of Interprofessional Education (IPE), University of Toledo, Toledo, OH, USA
| | - Mounika Polavarapu
- Department of Population Health, College of Health & Human Services, University of Toledo, Toledo, OH, USA
| | - Katharine Vallerand
- Department of Population Health, College of Health & Human Services, University of Toledo, Toledo, OH, USA
| | | | - Krista McCarthy Noviski
- Judith Herb College of Education, University of Toledo, Toledo, OH, USA
- Department of Sociology and Anthropology, University of Toledo, Toledo, OH, USA
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Angelino AC, Burns J, Deen JF, Empey A. Late, Again: Moving Beyond ACEs in American Indian Communities. Pediatrics 2023; 152:e2023062207. [PMID: 37855053 DOI: 10.1542/peds.2023-062207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/02/2023] [Indexed: 10/20/2023] Open
Affiliation(s)
- Alessandra C Angelino
- Division of Adolescent and Young Adult Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Joseph Burns
- Division of Pediatric Cardiology, Texas Children's Hospital, Houston, Texas
| | - Jason F Deen
- Department of Pediatrics, University of Washington, Seattle, Washington (Blackfeet)
| | - Allison Empey
- Department of Pediatrics, School of Medicine, Oregon Health & Science University, Portland, Oregon, (Confederated Tribes of Grand Ronde)
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April K, Stenersen MR, Deslandes M, Ford TC, Gaylord P, Patterson J, Wilson B, Kaufman JS. "Give up your mic": Building capacity and sustainability within community-based participatory research initiatives. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2023; 72:203-216. [PMID: 37058338 DOI: 10.1002/ajcp.12674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Revised: 02/17/2023] [Accepted: 03/07/2023] [Indexed: 06/19/2023]
Abstract
Community-based participatory research (CBPR) partnerships strive to promote community capacity building and sustainability, yet initiatives often suffer when grants or relationships with academic partners end. To address these concerns, researchers hoping to develop truly sustainable CBPR partnerships should consider factors that promote the development of community capacity and, ultimately, independence. In this first-person account, using perspectives gathered from FAVOR, a Connecticut-based family-led advocacy organization and an academic researcher, we examine the practices and experiences of the members of a CBPR partnership focused on using community voice to inform changes in the state's children's behavioral health system of care. These practices ultimately led to FAVOR developing the necessary skills to assume full ownership of the community data-gathering initiative, ensuring that the initiative would be sustained. Through the perspectives of five FAVOR staff and an academic researcher, we describe the factors that contributed to the organization being able to develop the capacity to independently continue their community data-gathering initiative, including description of the training process and staff members' perspectives on training, autonomy, community value, and lessons learned. We use these stories and experiences to provide recommendations for other partnerships striving to promote capacity building and sustainability through community ownership of the research process.
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Affiliation(s)
- Keisha April
- School of Criminal Justice, Rutgers University, Newark, New Jersey, USA
- Division of Prevention and Community Research, Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Madeline R Stenersen
- Division of Prevention and Community Research, Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
- Department of Psychology, Saint Louis University, St. Louis, Missouri, USA
| | | | | | | | | | | | - Joy S Kaufman
- Division of Prevention and Community Research, Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
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Sbaffi L, Zamani E, Kalua K. Promoting Well-being Among Informal Caregivers of People With HIV/AIDS in Rural Malawi: Community-Based Participatory Research Approach. J Med Internet Res 2023; 25:e45440. [PMID: 37166971 DOI: 10.2196/45440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 04/07/2023] [Accepted: 04/13/2023] [Indexed: 05/12/2023] Open
Abstract
BACKGROUND People living with HIV/AIDS and their informal caregivers (usually family members) in Malawi do not have adequate access to patient-centered care, particularly in remote rural areas of the country because of the high burden of HIV/AIDS, coupled with a fragmented and patchy health care system. Chronic conditions require self-care strategies, which are now promoted in both developed and developing contexts but are still only emerging in sub-Saharan African countries. OBJECTIVE This study aims to explore the effects of the implementation of a short-term intervention aimed at supporting informal caregivers of people living with HIV/AIDS in Malawi in their caring role and improving their well-being. The intervention includes the dissemination of 6 health advisory messages on topics related to the management of HIV/AIDS over a period of 6 months, via the WhatsApp audio function to 94 caregivers attending peer support groups in the rural area of Namwera. METHODS We adopted a community-based participatory research approach, whereby the health advisory messages were designed and formulated in collaboration with informal caregivers, local medical physicians, social care workers, and community chiefs and informed by prior discussions with informal caregivers. Feedback on the quality, relevance, and applicability of the messages was gathered via individual interviews with the caregivers. RESULTS The results showed that the messages were widely disseminated beyond the support groups via word of mouth and highlighted a very high level of adoption of the advice contained in the messages by caregivers, who reported immediate (short-term) and long-term self-assessed benefits for themselves, their families, and their local communities. CONCLUSIONS This study offers a novel perspective on how to combine community-based participatory research with a cost-effective, health-oriented informational intervention that can be implemented to support effective HIV/AIDS self-care and facilitate informal caregivers' role.
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Affiliation(s)
- Laura Sbaffi
- Information School, University of Sheffield, Sheffield, United Kingdom
| | - Efpraxia Zamani
- Information School, University of Sheffield, Sheffield, United Kingdom
| | - Khumbo Kalua
- Blantyre Institute for Community Outreach, Blantyre, Malawi
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Mrklas KJ, Boyd JM, Shergill S, Merali S, Khan M, Nowell L, Goertzen A, Pfadenhauer LM, Paul K, Sibley KM, Swain L, Vis-Dunbar M, Hill MD, Raffin-Bouchal S, Tonelli M, Graham ID. Tools for assessing health research partnership outcomes and impacts: a systematic review. Health Res Policy Syst 2023; 21:3. [PMID: 36604697 PMCID: PMC9817421 DOI: 10.1186/s12961-022-00937-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 11/08/2022] [Indexed: 01/07/2023] Open
Abstract
OBJECTIVE To identify and assess the globally available valid, reliable and acceptable tools for assessing health research partnership outcomes and impacts. METHODS We searched Ovid MEDLINE, Embase, CINAHL Plus and PsycINFO from origin to 2 June 2021, without limits, using an a priori strategy and registered protocol. We screened citations independently and in duplicate, resolving discrepancies by consensus and retaining studies involving health research partnerships, the development, use and/or assessment of tools to evaluate partnership outcomes and impacts, and reporting empirical psychometric evidence. Study, tool, psychometric and pragmatic characteristics were abstracted using a hybrid approach, then synthesized using descriptive statistics and thematic analysis. Study quality was assessed using the quality of survey studies in psychology (Q-SSP) checklist. RESULTS From 56 123 total citations, we screened 36 027 citations, assessed 2784 full-text papers, abstracted data from 48 studies and one companion report, and identified 58 tools. Most tools comprised surveys, questionnaires and scales. Studies used cross-sectional or mixed-method/embedded survey designs and employed quantitative and mixed methods. Both studies and tools were conceptually well grounded, focusing mainly on outcomes, then process, and less frequently on impact measurement. Multiple forms of empirical validity and reliability evidence was present for most tools; however, psychometric characteristics were inconsistently assessed and reported. We identified a subset of studies (22) and accompanying tools distinguished by their empirical psychometric, pragmatic and study quality characteristics. While our review demonstrated psychometric and pragmatic improvements over previous reviews, challenges related to health research partnership assessment and the nascency of partnership science persist. CONCLUSION This systematic review identified multiple tools demonstrating empirical psychometric evidence, pragmatic strength and moderate study quality. Increased attention to psychometric and pragmatic requirements in tool development, testing and reporting is key to advancing health research partnership assessment and partnership science. PROSPERO CRD42021137932.
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Affiliation(s)
- K. J. Mrklas
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3D10, 3280 Hospital Drive NW, Calgary, AB T2N 4Z6 Canada
- Strategic Clinical Networks™, Provincial Clinical Excellence, Alberta Health Services, Calgary, AB Canada
| | - J. M. Boyd
- Knowledge Translation Program, St Michael’s Hospital, Li Ka Shing Knowledge Institute, Unity Health Toronto, Toronto, ON Canada
| | - S. Shergill
- Cumming School of Medicine, University of Calgary, Calgary, AB Canada
| | - S. Merali
- Faculty of Kinesiology, University of Calgary, Calgary, AB Canada
| | - M. Khan
- Department of Community Health Sciences, University of Manitoba, Winnipeg, MB Canada
| | - L. Nowell
- Faculty of Nursing, University of Calgary, Calgary, AB Canada
| | - A. Goertzen
- Faculty of Science, University of Alberta, Edmonton, AB Canada
| | - L. M. Pfadenhauer
- Institute for Medical Information Processing, Biometry, and Epidemiology–IBE, Ludwig-Maximilian Universität Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - K. Paul
- University of Calgary Summer Studentships Program, Calgary, AB Canada
| | - K. M. Sibley
- Department of Community Health Sciences, University of Manitoba, Winnipeg, MB Canada
- George & Fay Yee Centre for Healthcare Innovation, University of Manitoba, Winnipeg, MB Canada
| | - L. Swain
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3D10, 3280 Hospital Drive NW, Calgary, AB T2N 4Z6 Canada
| | - M. Vis-Dunbar
- University of British Columbia - Okanagan, Kelowna, BC Canada
| | - M. D. Hill
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3D10, 3280 Hospital Drive NW, Calgary, AB T2N 4Z6 Canada
- Departments of Clinical Neurosciences, Medicine and Radiology, Cumming School of Medicine, University of Calgary, Calgary, AB Canada
- Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, AB Canada
| | | | - M. Tonelli
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB Canada
- Office of the Vice-President (Research), University of Calgary, Calgary, AB Canada
| | - I. D. Graham
- Centre for Implementation Research, Ottawa Hospital Research Institute, Ottawa, ON Canada
- School of Epidemiology and Public Health & School of Nursing, University of Ottawa, Ottawa, ON Canada
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Mrklas KJ, Merali S, Khan M, Shergill S, Boyd JM, Nowell L, Pfadenhauer LM, Paul K, Goertzen A, Swain L, Sibley KM, Vis-Dunbar M, Hill MD, Raffin-Bouchal S, Tonelli M, Graham ID. How are health research partnerships assessed? A systematic review of outcomes, impacts, terminology and the use of theories, models and frameworks. Health Res Policy Syst 2022; 20:133. [PMID: 36517852 PMCID: PMC9753311 DOI: 10.1186/s12961-022-00938-8] [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: 04/06/2022] [Accepted: 11/09/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Accurate, consistent assessment of outcomes and impacts is challenging in the health research partnerships domain. Increased focus on tool quality, including conceptual, psychometric and pragmatic characteristics, could improve the quantification, measurement and reporting partnership outcomes and impacts. This cascading review was undertaken as part of a coordinated, multicentre effort to identify, synthesize and assess a vast body of health research partnership literature. OBJECTIVE To systematically assess the outcomes and impacts of health research partnerships, relevant terminology and the type/use of theories, models and frameworks (TMF) arising from studies using partnership assessment tools with known conceptual, psychometric and pragmatic characteristics. METHODS Four electronic databases were searched (MEDLINE, Embase, CINAHL Plus and PsycINFO) from inception to 2 June 2021. We retained studies containing partnership evaluation tools with (1) conceptual foundations (reference to TMF), (2) empirical, quantitative psychometric evidence (evidence of validity and reliability, at minimum) and (3) one or more pragmatic characteristics. Outcomes, impacts, terminology, definitions and TMF type/use were abstracted verbatim from eligible studies using a hybrid (independent abstraction-validation) approach and synthesized using summary statistics (quantitative), inductive thematic analysis and deductive categories (qualitative). Methodological quality was assessed using the Quality Assessment Tool for Studies with Diverse Designs (QATSDD). RESULTS Application of inclusion criteria yielded 37 eligible studies. Study quality scores were high (mean 80%, standard deviation 0.11%) but revealed needed improvements (i.e. methodological, reporting, user involvement in research design). Only 14 (38%) studies reported 48 partnership outcomes and 55 impacts; most were positive effects (43, 90% and 47, 89%, respectively). Most outcomes were positive personal, functional, structural and contextual effects; most impacts were personal, functional and contextual in nature. Most terms described outcomes (39, 89%), and 30 of 44 outcomes/impacts terms were unique, but few were explicitly defined (9, 20%). Terms were complex and mixed on one or more dimensions (e.g. type, temporality, stage, perspective). Most studies made explicit use of study-related TMF (34, 92%). There were 138 unique TMF sources, and these informed tool construct type/choice and hypothesis testing in almost all cases (36, 97%). CONCLUSION This study synthesized partnership outcomes and impacts, deconstructed term complexities and evolved our understanding of TMF use in tool development, testing and refinement studies. Renewed attention to basic concepts is necessary to advance partnership measurement and research innovation in the field. Systematic review protocol registration: PROSPERO protocol registration: CRD42021137932 https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=137932 .
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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
| | - Sera Merali
- Faculty of Kinesiology, University of Calgary, Calgary, AB Canada
| | - Masood Khan
- Department of Community Health Sciences, University of Manitoba, Winnipeg, MB Canada
| | - Sumair Shergill
- Cumming School of Medicine, University of Calgary, Calgary, AB Canada
| | - Jamie M. Boyd
- Knowledge Translation Program, St Michael’s Hospital, Li Ka Shing Knowledge Institute, Unity Health Toronto, Toronto, ON Canada
| | - Lorelli Nowell
- Faculty of Nursing, University of Calgary, Calgary, AB Canada
| | - Lisa M. Pfadenhauer
- Institute for Medical Information Processing, Biometry, and Epidemiology-IBE, Ludwig-Maximilian Universität Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - Kevin Paul
- University of Calgary Summer Studentships Program, 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
| | - 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
- Centre for Implementation Research, Ottawa Hospital Research Institute, Ottawa, ON Canada
- School of Epidemiology and Public Health & School of Nursing, University of Ottawa, Ottawa, ON Canada
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Tang Yan C, Bachour A, Pérez CJ, Ansaldo LP, Santiago D, Jin Y, Li Z, Mok YS, Weng Y, Martinez LS. Partnering with immigrant families to promote language justice and equity in education. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2022; 70:433-457. [PMID: 35621207 DOI: 10.1002/ajcp.12604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 04/01/2022] [Accepted: 04/15/2022] [Indexed: 06/15/2023]
Abstract
Despite US federal legislation mandates institutions to provide meaningful access and participation to students and families in educational settings, culturally and linguistically diverse (CLD) families and caregivers of children in special education experience cultural and linguistic barriers. A Community Advisory Team (CAT) of parents, advocates, community interpreters and translators, researchers, and teachers explored CLD families' experiences and advocacy efforts. Critical bifocality and circuits of dispossession, privilege, and resistance informed the documentation of inequities and resistance to understand the linkages of structural arrangements of power. Focus groups with families (n = 21) speakers of Spanish, Portuguese, and Cantonese were conducted. Findings indicate perceived discrimination, poor and inadequate interpretation and translation services impact children's access to special education services, hinder family's communication with schools and reduce the perceptions of schools as trustworthy institutions. Families advocate relentlessly for their children and recommend schools listen to families and hire culturally and linguistically competent interpreters and translators. Community psychologists can make significant contributions to promote language justice in education settings through participatory approaches to inquiry that value CLD families' knowledge and expertise.
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Affiliation(s)
| | - Angélica Bachour
- Parent Advocate, Community Interpreter and Translator, CAT Member, Chelsea, Massachusetts, USA
| | - Consuelo J Pérez
- Artist, Parent Advocate, Community Interpreter and Translator, CAT Member, Somerville, Massachusetts, USA
| | - Loreto P Ansaldo
- MST, CI, Community Interpreter and Translator, Teacher, CAT Member, Boston, Massachusetts, USA
| | - Diana Santiago
- Esq., Senior Attorney, Massachusetts Advocates for Children (MAC), CAT Member, Boston, Massachusetts, USA
| | - Yichen Jin
- Boston University School of Social Work, Boston, Massachusetts, USA
| | - Zihui Li
- Parent Educator, Community Interpreter and Translator, Quincy, Massachusetts, USA
| | - Yu S Mok
- Community Interpreter and Translator, Malden, Massachusetts, USA
| | - Yanyi Weng
- MSW, LCSW, Social Worker, Boston, Massachusetts, USA
| | - Linda S Martinez
- Boston University School of Social Work, Boston, Massachusetts, USA
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Rice K, Seidman J, Mahoney O. A Health Equity–Oriented Research Agenda Requires Comprehensive Community Engagement. J Particip Med 2022; 14:e37657. [PMID: 36178726 PMCID: PMC9568816 DOI: 10.2196/37657] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 08/02/2022] [Accepted: 08/14/2022] [Indexed: 11/18/2022] Open
Abstract
Health policy and research communities have taken new approaches to addressing health equity, going beyond traditional methods that often excluded the contributions of health care consumers and persons with lived experience. This reevaluation has the potential to drive critical improvements in how we conduct research and innovate policy toward reducing health and health care disparities in the United States. Such considerations have led Fountain House, the founder of the Clubhouse model for peer-based psychosocial rehabilitation for persons with histories of serious mental illness, to incorporate community-based participatory action research (CBPAR) protocols within their research and service programs. The combination of CBPAR research methods within novel participatory care settings like Clubhouse programs presents unique and informative opportunities for the advancement of innovative health equity approaches to consumer empowerment in health care.
In this piece, the authors (two staff researchers and one member researcher) propose how CBPAR research methods conducted in Clubhouses can uniquely advance equity-focused research methods, and how the benefit and enhancements from equity-focused research are continuously applied, practiced, and accountable to the communities within which the research is conducted. Embedding CBPAR practices within participatory care settings like Clubhouses, creates novel opportunities for research work to not only become more equitable but also become a part of the rehabilitative process, empowering the main beneficiaries of the research with the means to sustain and achieve further improvements for themselves. Such experiences are particularly important within rehabilitation settings, where there is a process of reclaiming empowerment and self-efficacy over a disability or illness and the social circumstances surrounding those conditions.
Different stakeholders can all play important roles in advancing health equity–oriented research agendas by leveraging CBPAR principles. Academics and others in the research community can more comprehensively embed CBPAR methods into the design of their research studies. A critical link exists among how researchers conduct their studies, how providers organize care delivery and support, and how health plans pay for and evaluate care. CBPAR-generated research needs to fully engage clinical teams to ensure that ongoing community-involved care settings have direct applications to real-world care delivery. It is equally important that providers fully engage with their communities as they adjust their approaches to supporting the populations they serve.
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Affiliation(s)
- Kevin Rice
- Fountain House, New York, NY, United States
| | | | - Oneil Mahoney
- Fountain House, New York, NY, United States
- Columbia University, New York, NY, United States
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14
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Evaluating Levels of Community Participation in a University-Community Partnership: The Jackson Heart Study. Diseases 2022; 10:diseases10040068. [PMID: 36278567 PMCID: PMC9589967 DOI: 10.3390/diseases10040068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 09/17/2022] [Accepted: 09/19/2022] [Indexed: 11/16/2022] Open
Abstract
Objective: This research was designed to evaluate the perceptions of the Jackson Heart Study (JHS) community relating to their levels of involvement in JHS activities that were developed to address health disparities and promote health education and health promotion. Methods: The participants for this study comprised 128 community members, who included JHS participants, as well as family members and other friends of the JHS who resided in the JHS community of Hinds, Madison, and Rankin Counties in Mississippi and attended the JHS Annual Celebration of Life. We used the Chi-Square test to analyze the participants’ responses to the survey questions developed to address the six areas of focus: (1) ways to increase participation in community outreach activities; (2) reasons for participating in community outreach activities; (3) interest in research participation; (4) factors influencing engagement; (5) Participants’ preferences for communicating; (6) Chronic disease prevalence. Results: Participants residing in rural counties perceived television and radio as a medium to increase participation; More female respondents cited trust working with the JSU JHS Community Outreach Center (CORC) as a reason for remaining engaged in the community outreach activities; younger participants under 66 years of age recommended social media as a way to increase participation; participants residing in the rural areas saw their participation in the community outreach activities as a way to address community health problems. Conclusions: The knowledge gained from the details provided by the JHS community members can be used to refine research studies in existence, while promoting their sustainability.
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Yuhas M, Moore CF, Garay J, Brown SD. Improving Maternal Cardiovascular Health in Underserved Populations: a Narrative Review of Behavioral Intervention Trials Targeting Postpartum Weight Retention. Curr Atheroscler Rep 2022; 24:689-699. [PMID: 35781777 PMCID: PMC10373576 DOI: 10.1007/s11883-022-01045-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/13/2022] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW Racial/ethnic minority and socioeconomically disadvantaged individuals experience greater postpartum weight retention, which has been linked to the development of cardiovascular disease. This article reviews recent literature on behavioral interventions targeting postpartum weight retention in these populations. RECENT FINDINGS Seven randomized controlled trials published since 2010 were selected for this review. Four were successful in reducing or preventing postpartum weight retention. Recruitment primarily occurred in low-income urban areas. All interventions reported using the Social Cognitive Theory and targeted mostly individual-level behavior change focused on diet and physical activity. Four were technology-based, and most implemented strategies to increase cultural relevance of the intervention. Opportunities for future interventions include expand target population to enroll individuals starting in pregnancy and address rural populations; incorporate empirically tested retention strategies; increase focus on psychosocial factors, particularly chronic stress; utilize multilevel approaches; continue to leverage technology; and maximize efforts to increase cultural relevancy.
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Affiliation(s)
- Maryam Yuhas
- Department of Nutrition and Food Studies, Syracuse University, 558 White Hall, Syracuse, NY, 13244, USA.
| | - Caroline Fletcher Moore
- Department of Nutrition and Food Studies, Syracuse University, 558 White Hall, Syracuse, NY, 13244, USA
| | - Jessica Garay
- Department of Nutrition and Food Studies, Syracuse University, 558 White Hall, Syracuse, NY, 13244, USA
| | - Susan D Brown
- Department of Internal Medicine, Davis School of Medicine, University of California, Sacramento, CA, USA
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Soltoff A, Purvis S, Ravicz M, Isaacson MJ, Duran T, Johnson G, Sargent M, LaPlante JR, Petereit D, Armstrong K, Daubman BR. Factors Influencing Palliative Care Access and Delivery for Great Plains American Indians. J Pain Symptom Manage 2022; 64:276-286. [PMID: 35618250 PMCID: PMC10230738 DOI: 10.1016/j.jpainsymman.2022.05.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 05/06/2022] [Accepted: 05/09/2022] [Indexed: 11/22/2022]
Abstract
CONTEXT Despite the known importance of culturally tailored palliative care (PC), American Indian people (AIs) in the Great Plains lack access to such services. While clinicians caring for AIs in the Great Plains have long acknowledged major barriers to serious illness care, there is a paucity of literature describing specific factors influencing PC access and delivery for AI patients living on reservation land. OBJECTIVES This study aimed to explore factors influencing PC access and delivery on reservation land in the Great Plains to inform the development culturally tailored PC services for AIs. METHODS Three authors recorded and transcribed interviews with 21 specialty and 17 primary clinicians. A data analysis team of seven authors analyzed transcripts using conventional content analysis. The analysis team met over Zoom to engage in code negotiation, classify codes, and develop themes. RESULTS Qualitative analysis of interview data revealed four themes encompassing factors influencing palliative care delivery and access for Great Plains American Indians: health care system operations (e.g., hospice and home health availability, fragmented services), geography (e.g., weather, travel distances), workforce elements (e.g., care continuity, inadequate staffing, cultural familiarity), and historical trauma and racism. CONCLUSION Our findings emphasize the importance of addressing the time and cost of travel for seriously ill patients, increasing home health and hospice availability on reservations, and improving trust in the medical system. Strengthening the AI medical workforce, increasing funding for the Indian Health Service, and transitioning the governance of reservation health care to Tribal entities may improve the trustworthiness of the medical system.
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Affiliation(s)
- Alexander Soltoff
- Department of Medicine (A.S., S.P., M.R.), Massachusetts General Hospital, Boston, MA, USA.
| | - Sara Purvis
- Department of Medicine (A.S., S.P., M.R.), Massachusetts General Hospital, Boston, MA, USA
| | - Miranda Ravicz
- Department of Medicine (A.S., S.P., M.R.), Massachusetts General Hospital, Boston, MA, USA
| | - Mary J Isaacson
- College of Nursing South Dakota State University (M.J.I.), Rapid City, SD, USA
| | - Tinka Duran
- Community Health Prevention Programs (T.D., G.J.), Great Plains Tribal Leaders Health Board, Rapid City, SD, USA
| | - Gina Johnson
- Community Health Prevention Programs (T.D., G.J.), Great Plains Tribal Leaders Health Board, Rapid City, SD, USA
| | - Michele Sargent
- Walking Forward (M.S., D.P.), Avera Research Institute, Avera Health, Rapid City, SD, USA
| | - J R LaPlante
- American Indian Health Initiative (J.R.L.), Avera Health, Sioux Falls, SD, USA
| | - Daniel Petereit
- Walking Forward (M.S., D.P.), Avera Research Institute, Avera Health, Rapid City, SD, USA
| | | | - Bethany-Rose Daubman
- Massachusetts General Hospital, Division of Palliative Care and Geriatric Medicine (B.R.D.), Boston, MA, USA
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Mosley EA, Ayala S, Jah Z, Hailstorks T, Dixon Diallo D, Hernandez N, Jackson K, Hairston I, Hall KS. Community-led research for reproductive justice: Exploring the SisterLove Georgia Medication Abortion project. Front Glob Womens Health 2022; 3:969182. [PMID: 36033920 PMCID: PMC9412101 DOI: 10.3389/fgwh.2022.969182] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 07/26/2022] [Indexed: 11/15/2022] Open
Abstract
Introduction While reproductive injustice indicators are improving globally, they are worsening in the United States particularly for Black and other marginalized communities. Eugenics and obstetric violence against low-income and communities of color create well-founded distrust of sexual and reproductive health (SRH). Transformational, reparative ways of conducting SRH research are needed. Proposed principles of community-led research for reproductive justice Drawing on our collective experience as reproductive justice leaders, SRH researchers, and clinicians, we propose the following principles of community-led research for reproductive justice: 1) Center the marginalized community members most affected by SRH inequities as leaders of research; 2) Facilitate equitable, collaborative partnership through all phases of SRH research; 3) Honor multiple ways of knowing (experiential, cultural, empirical) for knowledge justice and cross-directional learning across the team; 4) Build on strengths (not deficits) within the community; 5) Implement the tenets of reproductive justice including structural-level analysis and the human rights framework; 6) Prioritize disseminating useful findings to community members first then to other audiences; 7) Take action to address social and reproductive injustices. SisterLove's community-led georgia medication abortion project We offer the community-led Georgia Medication Abortion (GAMA) Project by reproductive justice organization SisterLove from 2018-2022 as a case study to demonstrate these principles along with the strengths and challenges of reproductive justice research. Discussion Community-led reproductive justice research offers innovative and transformational methods for truly advancing SRH in an era of increasing policy restrictions and decreasing access to care. Yet existing funding, research administrative, and publishing systems will require structural change.
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Affiliation(s)
- Elizabeth A. Mosley
- Center for Reproductive Health Research in the Southeast (RISE), Emory University School of Public Health, Atlanta, GA, United States
| | | | - Zainab Jah
- SisterLove, Inc., Atlanta, GA, United States
- National Birth Equity Collaborative, Washington, DC, United States
| | - Tiffany Hailstorks
- Center for Reproductive Health Research in the Southeast (RISE), Emory University School of Public Health, Atlanta, GA, United States
- Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA, United States
| | | | - Natalie Hernandez
- Center for Maternal Health Equity, Morehouse School of Medicine, Atlanta, GA, United States
| | | | | | - Kelli S. Hall
- Center for Reproductive Health Research in the Southeast (RISE), Emory University School of Public Health, Atlanta, GA, United States
- Department of Population and Family Health, Columbia University Mailman School of Public Health, New York, NY, United States
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Nagorcka-Smith P, Bolton KA, Dam J, Nichols M, Alston L, Johnstone M, Allender S. The impact of coalition characteristics on outcomes in community-based initiatives targeting the social determinants of health: a systematic review. BMC Public Health 2022; 22:1358. [PMID: 35841018 PMCID: PMC9288063 DOI: 10.1186/s12889-022-13678-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Accepted: 06/22/2022] [Indexed: 11/23/2022] Open
Abstract
Background Coalitions are a popular mechanism for delivering community-based health promotion. The aim of this systematic review was to synthesize research that has quantitatively analyzed the association between coalition characteristics and outcomes in community-based initiatives targeting the social determinants of health. Coalition characteristics described elements of their structure or functioning, and outcomes referred to both proximal and distal community changes. Methods Authors searched six electronic databases to identify peer reviewed, published studies that analyzed the relationship between coalition characteristics and outcomes in community-based initiatives between 1980 and 2021. Studies were included if they were published in English and quantitatively analyzed the link between coalition characteristics and outcomes. Included studies were assessed for quality using the Joanna Briggs Institute analytical cross-sectional studies assessment tool. Results The search returned 10,030 unique records. After screening, 26 studies were included from six countries. Initiatives targeted drug use, health equity, nutrition, physical activity, child and youth development, crime, domestic violence, and neighbourhood improvement. Community outcomes measured included perceived effectiveness (n=10), policy, systems or environment change (n=9), and community readiness or capacity (n=7). Analyses included regression or correlation analysis (n=16) and structural equation or pathway modelling (n=10). Studies varied in quality, with a lack of data collection tool validation presenting the most prominent limitation to study quality. Statistically significant associations were noted between community outcomes and wide range of coalition characteristics, including community context, resourcing, coalition structure, member characteristics, engagement, satisfaction, group facilitation, communication, group dynamics, relationships, community partnership, and health promotion planning and implementation. Conclusion Existing literature demonstrates that coalition characteristics, including best practice health promotion planning and evaluation, influence community outcomes. The field of coalition research would benefit from more consistent description and measurement of coalition characteristics and outcomes, and efforts to evaluate coalitions in a wider range of countries around the world. Further research using empirical community outcome indicators, and methods that consider the interrelationship of variables, is warranted. Trial registration A protocol for this review was registered with PROSPERO (CRD42020205988). Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13678-9.
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Affiliation(s)
- Phoebe Nagorcka-Smith
- Deakin University, Global Obesity Centre (GLOBE), Institute for Health Transformation, School of Health and Social Development, 1 Gheringhap Street, Geelong, VIC, 3220, Australia.
| | - Kristy A Bolton
- Deakin University, Global Obesity Centre (GLOBE), Institute for Health Transformation, School of Health and Social Development, 1 Gheringhap Street, Geelong, VIC, 3220, Australia.,Deakin University, Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, 1 Gheringhap Street, Geelong, VIC, 3220, Australia
| | - Jennifer Dam
- Monash University, Monash Sustainable Development Institute, 8 Scenic Boulevard, Clayton, VIC, 3800, Australia
| | - Melanie Nichols
- Deakin University, Global Obesity Centre (GLOBE), Institute for Health Transformation, School of Health and Social Development, 1 Gheringhap Street, Geelong, VIC, 3220, Australia
| | - Laura Alston
- Deakin University, Global Obesity Centre (GLOBE), Institute for Health Transformation, School of Health and Social Development, 1 Gheringhap Street, Geelong, VIC, 3220, Australia.,Deakin University, Deakin Rural Health, Faculty of Health, Princes Hwy, Warrnambool, VIC, 3280, Australia.,Research Unit, Colac Area Health, 2-28 Connor St, Colac, Victoria, 3250, Australia
| | - Michael Johnstone
- Deakin University, Institute for Intelligent Systems Research and Innovation, 75 Pigdons Road, Waurn Ponds, VIC, 3216, Australia
| | - Steven Allender
- Deakin University, Global Obesity Centre (GLOBE), Institute for Health Transformation, School of Health and Social Development, 1 Gheringhap Street, Geelong, VIC, 3220, Australia
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Duea SR, Zimmerman EB, Vaughn LM, Dias S, Harris J. A Guide to Selecting Participatory Research Methods Based on Project and Partnership Goals. JOURNAL OF PARTICIPATORY RESEARCH METHODS 2022; 3:10.35844/001c.32605. [PMID: 35799626 PMCID: PMC9258244 DOI: 10.35844/001c.32605] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Participatory research engages community stakeholders in the research process, from problem identification and developing the research question, to dissemination of results. There is increasing recognition in the field of health research that community-engaged methods can be used throughout the research process. The volume of guidance for engaging communities and conducting participatory research has grown steadily in the past 40+ years, in many countries and contexts. Further, some institutions now require stakeholder engagement in research as a condition of funding. Interest in collaborating in the research process is also growing among patients and the public. This article provides an overview for selecting participatory research methods based on project and partnerships goals.
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Affiliation(s)
| | - Emily B. Zimmerman
- Department of Family Medicine and Population Health, Division of Epidemiology, VCU Center on Society and Health, Virginia Commonwealth University
| | - Lisa M. Vaughn
- College of Medicine, Cincinnati Children’s Hospital Medical Center/University of Cincinnati
| | - Sónia Dias
- Public Health Research Center, NOVA National School of Public Health
| | - Janet Harris
- School of Health & Related Research, University of Sheffield
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Ortiz CE, Dourron HM, Sweat NW, Garcia-Romeu A, MacCarthy S, Anderson BT, Hendricks PS. Special considerations for evaluating psilocybin-facilitated psychotherapy in vulnerable populations. Neuropharmacology 2022; 214:109127. [DOI: 10.1016/j.neuropharm.2022.109127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 04/25/2022] [Accepted: 05/09/2022] [Indexed: 10/18/2022]
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D’Agostino EM, Haroz EE, Linde S, Layer M, Green M, Ko LK. School-Academic Partnerships in Support of Safe Return to Schools During the COVID-19 Pandemic. Pediatrics 2022; 149:e2021054268C. [PMID: 34737180 PMCID: PMC9647737 DOI: 10.1542/peds.2021-054268c] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/20/2021] [Indexed: 02/03/2023] Open
Abstract
Safely returning underserved youth to school during the coronavirus disease 2019 (COVID-19) pandemic through diagnostic testing and health education is imperative to mitigate the ongoing negative impact of COVID-19 and reduce health inequalities in underserved communities. The Rapid Acceleration of Diagnostics-Underserved Populations program is a consortium of research projects across the United States funded by the National Institutes of Health to understand the factors associated with the disproportionate burden of the pandemic among underserved populations and to leverage mitigation strategies, including diagnostic testing, with a focus on reducing health disparities. In this article, we provide an overview and introduce the articles from 8 Rapid Acceleration of Diagnostics-Underserved Populations projects featured in the supplement "Navigating a Pandemic in the K-12 Setting: Keeping Our School Communities Safe" published in Pediatrics. These projects funded in the program's first phase focus on COVID-19 diagnostic testing approaches for youth and employees at schools in underserved communities to support safe in-person learning. In the articles comprising the supplement, researchers present barriers and facilitators of the community engagement process necessary to establish school-academic partnerships. These efforts showcase school-based implementation testing strategies during the COVID-19 pandemic but are translatable to tackling other challenges related to reducing health disparities.
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Affiliation(s)
- Emily M. D’Agostino
- Departments of Orthopaedic Surgery
- Population Health Sciences, School of Medicine, Duke University, Durham, North Carolina
| | - Emily E. Haroz
- Johns Hopkins Center for American Indian Health, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Sandra Linde
- Astria Sunnyside Hospital, Sunnyside, Washington
| | - Marcus Layer
- Duke Clinical Research Institute, Durham, North Carolina
| | - Melissa Green
- Center for Health Equity Research, School of Medicine, University of North Carolina, Chapel Hill, North Carolina
| | - Linda K. Ko
- University of Washington, Seattle, Washington
- Fred Hutchinson Cancer Research Center, Seattle, Washington
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22
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"It has to be designed in a way that really challenges people's assumptions": preparing scholars to build equitable community research partnerships. J Clin Transl Sci 2021; 5:e182. [PMID: 34849257 PMCID: PMC8596064 DOI: 10.1017/cts.2021.858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 09/09/2021] [Accepted: 09/10/2021] [Indexed: 11/07/2022] Open
Abstract
Introduction: Clinical and Translational Award (CTSA) programs are developing relevant training for researchers and community stakeholders participating in community-engaged research (CEnR). However, there is limited research exploring the ways community stakeholders and partners with key CEnR experiences can inform and shape training priorities for prospective CEnR scholars to build meaningful and equitable partnerships. Methods: This study conducted and analyzed online individual semi-structured in-depth interviews with community stakeholders (n = 13) engaged in CEnR to identify training priorities for graduate students and emerging scholars. Findings: Thematic analysis of 13 interview transcripts revealed four major training priorities for prospective scholars interested in engaging in CEnR: 1) researcher’s positionality, 2) equitable power sharing, 3) funding, and 4) ethics. Conclusion: Building equitable research partnerships was a central theme woven across all four training priorities. Further research should focus on examining the development, implementation, and evaluation of CEnR training in partnership with community stakeholders and partners with relevant CEnR experience. Adopting a collaborative approach to incorporate both community stakeholders and researchers’ priorities can align training competencies to better prepare scholars to engage in building research partnerships.
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23
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DeHaven MJ, Gimpel NA, Kitzman H. Working with communities: Meeting the health needs of those living in vulnerable communities when Primary Health Care and Universal Health Care are not available. J Eval Clin Pract 2021; 27:1056-1065. [PMID: 33051956 DOI: 10.1111/jep.13495] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 09/10/2020] [Accepted: 09/21/2020] [Indexed: 01/01/2023]
Abstract
RATIONALE, AIMS, AND OBJECTIVES The health care delivery model in the United States does not work; it perpetuates unequal access to care, favours treatment over prevention, and contributes to persistent health disparities and lack of insurance. The vast majority of those who suffer from preventable diseases and health disparities, and who are at greatest risk of not having insurance, are low-income minorities (Native Americans, Hispanics, and African-Americans) who live in high risk and vulnerable communities. The historical lack of support in the United States for Universal Health Care (UHC) and Primary Health Care (PHC)-with their emphasis on health care for all, population health, and social determinants of health-requires community health scientists to develop innovative local solutions for addressing unmet community health needs. METHODS We developed a model community health science approach for improving health in fragile communities, by combining community-oriented primary care (COPC), community-based participatory research (CBPR), asset-based community development, and service learning principles. During the past two decades, our team has collaborated with community residents, local leaders, and many different types of organizations, to address the health needs of vulnerable patients. The approach defines health as a social outcome, resulting from a combination of clinical science, collective responsibility, and informed social action. RESULTS From 2000 to 2020, we established a federally funded research programme for testing interventions to improve health outcomes in vulnerable communities, by working in partnership with community organizations and other stakeholders. The partnership goals were reducing chronic disease risk and multimorbidity, by stimulating lifestyle changes, increasing healthy behaviours and health knowledge, improving care seeking and patient self-management, and addressing the social determinants of health and population health. Our programmes have also provided structured community health science training in high-risk communities for hundreds of doctors in training. CONCLUSION Our community health science approach demonstrates that the factors contributing to health can only be addressed by working directly with and in affected communities to co-develop health care solutions across the broad range of causal factors. As the United States begins to consider expanding health care options consistent with PHC and UHC principles, our community health science experience provides useful lessons in how to engage communities to address the deficits of the current system. Perhaps the greatest assets US health care systems have for better addressing population health and the social determinants of health are the important health-related initiatives already underway in most local communities. Building partnerships based on local resources and ongoing social determinants of health initiatives is the key for medicine to meaningfully engage communities for improving health outcomes and reducing health disparities. This has been the greatest lesson we have learned the past two decades, has provided the foundation for our community health science approach, and accounts for whatever success we have achieved.
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Affiliation(s)
- Mark J DeHaven
- Academy for Research on Community Health, Engagement, and Services (ARCHES), University of North Carolina at Charlotte, Charlotte, North Carolina, USA
| | - Nora A Gimpel
- Department of Family and Community Medicine, UT Southwestern Medical Center, Dallas, Texas, USA
| | - Heather Kitzman
- Robbins Institute for Health Policy & Leadership, Baylor Scott & White Health and Wellness, Dallas, Texas, USA
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Ellis C, Jacobs M, Kendall D. The Impact of Racism, Power, Privilege, and Positionality on Communication Sciences and Disorders Research: Time to Reconceptualize and Seek a Pathway to Equity. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2021; 30:2032-2039. [PMID: 34019772 DOI: 10.1044/2021_ajslp-20-00346] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Purpose The purpose of this article is to explore how racism, privilege, power, and positionality negatively impact clinical research conducted in the discipline of communication sciences and disorders. Conclusions Evidence suggests solutions will not emerge from a minor revision or adjustment of current research approaches. Instead, to make deep and necessary changes, a complete restructuring of the research process is needed. This restructuring calls for a reconceptualization of how research questions and hypotheses are formed, how methods are selected, how data are analyzed and interpreted, and who is at the table throughout this process of knowledge generation. Such an overhaul of current research approaches will offer the field a solution-oriented roadmap for scientific investigation that facilitates greater equity in the research enterprise that translates into improved clinical outcomes for all clients served.
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Affiliation(s)
- Charles Ellis
- Department of Communication Sciences and Disorders, East Carolina University, Greenville, NC
| | - Molly Jacobs
- Department of Health Services and Information Management, East Carolina University, Greenville, NC
| | - Diane Kendall
- Department of Speech and Hearing Sciences, University of Washington, Seattle
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Sanchez-Youngman S, Boursaw B, Oetzel J, Kastellic S, Devia C, Scarpetta M, Belone L, Wallerstein N. Structural Community Governance: Importance for Community-Academic Research Partnerships. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2021; 67:271-283. [PMID: 33890308 DOI: 10.1002/ajcp.12505] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Community based participatory research (CBPR) emphasizes democratic knowledge production and joint action between academics and communities to promote health equity through multilevel interventions. While much scholarship has expressed a commitment to collaboration between researchers and communities, effective methods of structural governance between community and academic stakeholders is under explored. We fill this gap by presenting a conceptual and empirical analysis describing multiple dimensions of structural governance in CBPR partnerships. First, we integrate public policy evidence on effective collaborative governance designs with the emerging literature in CBPR to create a conceptual model. Next, we utilize internet surveys of 179 federally funded community engaged research projects to construct and assess a measure of structural governance across multiple dimensions using confirmatory factor analysis. We explore whether antecedent factors such as the stage of the partnership and ethnic composition are associated with these dimensions and we examine associations for each of these components on positive perceptions of community involvement of research and collective empowerment. We develop a robust multidimensional measure of structural governance that is positively associated with perceptions of increased community involvement in research and collective empowerment.
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Affiliation(s)
| | | | - John Oetzel
- University of Waikato, Hamilton, New Zealand
| | - Sara Kastellic
- National Indian Child Welfare Association, Portland, OR, USA
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26
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Wallerstein N. Engage for Equity: Advancing the Fields of Community-Based Participatory Research and Community-engaged Research in Community Psychology and the Social Sciences. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2021; 67:251-255. [PMID: 34237169 DOI: 10.1002/ajcp.12530] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Community Based Participatory Research (CBPR), as the most cited Community-Engaged Research (CEnR) approach in the health fields, mirrors community-psychology's long-term interest in participatory action research and community empowerment. This article introduces the Engage for Equity study, a long-term National Institutes of Health-funded inquiry to identify best partnering and collaborative practices that contribute to community capacity, empowerment and policy outcomes, and to long-term improved health and health equity. Four articles present facets of the study: psychometrics of partnering process and outcome measures, measures and outcomes of shared governance, and description of the CBPR Model as a new equity- and partnership based implementation framework; and as a tool for organizational learning and quality improvement. Finally a review of CBPR and CEnR in psychology offers recommendations for the field. Though focusing on CBPR and CEnR, Engage for Equity offers lessons for all forms of participatory action research.
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Affiliation(s)
- Nina Wallerstein
- College of Population Health, University of New Mexico, Albuquerque, NM, USA
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27
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Chanchien Parajón L, Hinshaw J, Sanchez V, Minkler M, Wallerstein N. Practicing Hope: Enhancing Empowerment in Primary Health Care through Community-based Participatory Research. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2021; 67:297-311. [PMID: 34114236 DOI: 10.1002/ajcp.12526] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
The World Health Organization's (WHO's) Declaration of Alma Ata in 1978 made Primary Health Care (PHC) the official health policy of all WHO member countries, stressing the importance of multisectoral collaboration and community empowerment as critical for delivering quality primary healthcare and public health services to achieve social justice and health equity. Over forty years later, a divide remains between seeing individual patients in the traditional biomedical model and addressing population-level social determinants of health. One promising approach for the intentional and active integration of multi-sectoral partnering practices and community empowerment into Primary Health Care is the use of community-based participatory research (CBPR). The power of CBPR lies in its systematic approach to facilitating equitable collaboration of partners based on community priorities and strengths and is increasingly recognized for improving health equity outcomes. This paper highlights the use of CBPR as a promising practice for healthcare organizations to bridge the gap between the traditional individual patient focus and the comprehensive primary healthcare approach from WHO. We use a narrative case study from A Ministry of Sharing (AMOS) Health and Hope, a PHC organization in Nicaragua, to illustrate the use of the CBPR model as an implementation framework that facilitated the transformation of structures, policies, and practices as AMOS created multi-sector partnerships and embraced community empowerment as part of its strategic and comprehensive approach to health equity.
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Affiliation(s)
| | | | | | - Meredith Minkler
- University of California Berkeley School of Public Health, Berkeley, CA, USA
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28
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Boursaw B, Oetzel JG, Dickson E, Thein TS, Sanchez-Youngman S, Peña J, Parker M, Magarati M, Littledeer L, Duran B, Wallerstein N. Scales of Practices and Outcomes for Community-Engaged Research. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2021; 67:256-270. [PMID: 33599288 PMCID: PMC8355013 DOI: 10.1002/ajcp.12503] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Despite the growth of research on community-engaged research (CEnR), recent reviews suggest there has been limited development of validated scales to measure key contexts, mechanisms, and outcomes, impairing testing and refinement of theoretical models. The purpose of this study is to present the psychometric properties of scales from the Engage for Equity (E2) project, stemming from a long-term research partnership examining community-engaged research projects. This study used a three-stage, cross-sectional format: (a) a sampling frame of 413 CEnR projects was identified; (b) 210 principal investigators completed a project-level survey and nominated partners for another survey; (c) 457 investigators and partners completed a survey about project contexts, processes, interventions, and outcomes. Factorial validity was established through confirmatory factor analysis supporting seven scales: contextual capacity, commitment to collective empowerment, relationships, community engagement in research actions, synergy, partner and partnership transformation, and projected outcomes. Convergent validity was established through examining covariances among the scales. This study largely yielded results consistent with a previous psychometric study of related measures, while demonstrating improved ceiling effects of the items and refined conceptualization of core theoretical constructs.
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Elm JHL, Handeland T. Momentum and Longevity for Tribally Driven Health Equity Science: Evidence from the Gathering for Health Project. Hum Biol 2021; 91:153-162. [PMID: 32549036 DOI: 10.13110/humanbiology.91.3.05] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Accepted: 03/19/2020] [Indexed: 01/10/2023]
Abstract
American Indian health disparities have reached crisis levels, and there is a need to develop culturally congruent interventions through meaningful tribal involvement and ethical community-oriented approaches. Hence, it is imperative that researchers and university administrators better understand how research translation occurs for tribally driven health-equity research projects. Utilizing thematic analysis methods, the authors examined documents from a 12-year community-based participatory research partnership to elucidate factors that ignite momentum and support partnership longevity. The overarching finding was that trust and respect provide a foundation for momentum and longevity and are closely intertwined with other themes identified in analyses. Seven themes were extrapolated and classified into two domains: (1) investments, which are catalyzing factors that advance research, and (2) intermediate processes, which link investments to success. Investment themes include Indigenous scholar involvement, time and effort, establishing rapport, and clear and appropriate communication. Intermediate process themes include generative colearning, active participation, and recognition and celebration. Community-based participatory research principles were reflected in these findings. This study also upholds prior published work on Indigenous research methodologies, promotes the lived experiences of Indigenous people, and contributes to Indigenous theory building and science.
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Affiliation(s)
- Jessica H L Elm
- Center for American Indian Health, Bloomberg School of Public Health, Johns Hopkins University, Great Lakes Hub, Duluth, Minnesota, USA, .,Citizen of the Oneida Nation, Descendant of the Stockbridge-Munsee Band of the Mohicans
| | - Tina Handeland
- Community Research Council Member, Gathering for Health study.,Citizen of the Lac du Flambeau Band of Lake Superior Chippewa Indians
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30
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Dissemination of an American Indian Culturally Centered Community-Based Participatory Research Family Listening Program: Implications for Global Indigenous Well-Being. GENEALOGY 2020. [DOI: 10.3390/genealogy4040099] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
We introduce a culture-centered indigenous program called the Family Listening Program (FLP), which was developed through a long-standing community-based participatory research (CBPR) partnership involving tribal research teams (TRTs) from three American Indian communities (Apache, Navajo, and Pueblo) with the University of New Mexico’s Center for Participatory Research (UNM-CPR). This paper provides background information on the TRT/UNM-CPR multi-generational FLP intervention funded by the National Institute on Drug Abuse and how it is poised to take the next steps of dissemination and implementation (D&I). In preparing for the next steps, the TRT/UNM-CPR team piloted two FLP dissemination activities, first at the state-level and then nationally; this paper describes these activities. Based on the learnings from the pilot dissemination, the TRT/UNM-CPR team developed an innovative D&I model by integrating a community-based participatory research culture-centered science (CBPR-CCS) approach with the Interactive Systems Framework (ISF) to examine the uptake, cultural acceptance, and sustainability of the FLP as an evidence-based indigenous family program.
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31
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Montoya-Williams D, Peña MM, Fuentes-Afflick E. In Pursuit of Health Equity in Pediatrics. THE JOURNAL OF PEDIATRICS: X 2020; 5. [PMID: 33733084 PMCID: PMC7963264 DOI: 10.1016/j.ympdx.2020.100045] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Affiliation(s)
- Diana Montoya-Williams
- Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania
| | | | - Elena Fuentes-Afflick
- Zuckerberg San Francisco General Hospital, University of California, San Francisco, California
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Kerner JF, Kavanaugh-Lynch MHE, Baezconde-Garbanati L, Politis C, Prager A, Brownson RC. Doing What We Know, Knowing What to Do: Californians Linking Action with Science for Prevention of Breast Cancer (CLASP-BC). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E5050. [PMID: 32674312 PMCID: PMC7399883 DOI: 10.3390/ijerph17145050] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 07/06/2020] [Accepted: 07/07/2020] [Indexed: 12/24/2022]
Abstract
Given the lack of progress in breast cancer prevention, the California Breast Cancer Research Program (CBCRP) plans to apply current scientific knowledge about breast cancer to primary prevention at the population level. This paper describes the first phase of Californians Linking Action with Science for Prevention of Breast Cancer (CLASP-BC). The foci of Phase 1 are building coalitions and coalition capacity building through community engagement in community-based participatory research (CBPR) and dissemination and implementation (D&I) research training. Based on the successful implementation and evaluation of Phase 1, the foci of Phase 2 (presented separately in this special issue) will be to translate the California Breast Cancer Prevention Plan overarching goal and specific intervention goals for 23 breast cancer risk and protective factors strategies into evidence-informed interventions (EIIs) that are disseminated and implemented across California. CLASP-BC is designed to identify, disseminate and implement high-impact, population-based prevention approaches by funding large scale EIIs, through multi-jurisdictional actions, with the intent to decrease the risk of breast cancer and other chronic diseases (sharing common risk factors), particularly among racial/ethnic minorities and medically underserved populations in California.
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Affiliation(s)
- Jon F. Kerner
- California Breast Cancer Research Program, Bethesda, MD 20186, USA
| | - Marion H. E. Kavanaugh-Lynch
- California Breast Cancer Research Program University of California, Office of the President, Oakland, CA 94612, USA;
| | - Lourdes Baezconde-Garbanati
- Preventive Medicine, Community Initiatives, Keck School of Medicine (KSOM), University of California, Los Angeles, CA 90033, USA;
- Community Engagement, Norris Comprehensive Cancer Center, University of California, Los Angeles, CA 90033, USA
- Center for Health Equity in the Americas, KSOM, University of Southern California, Los Angeles, CA 90007, USA
| | - Christopher Politis
- Cancer Screening, Canadian Partnership Against Cancer, Toronto, ON M5H 1J8, Canada;
| | - Aviva Prager
- California Pan-Ethnic Health Network, Oakland, CA 94612, USA;
| | - Ross C. Brownson
- Brown School, Washington University in St. Louis, St. Louis, MO 63130, USA;
- Department of Surgery (Division of Public Health Sciences) and Alvin J. Siteman Cancer Center, School of Medicine, Washington University, St. Louis, MO 63110, USA
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Wallerstein N, Oetzel JG, Sanchez-Youngman S, Boursaw B, Dickson E, Kastelic S, Koegel P, Lucero JE, Magarati M, Ortiz K, Parker M, Peña J, Richmond A, Duran B. Engage for Equity: A Long-Term Study of Community-Based Participatory Research and Community-Engaged Research Practices and Outcomes. HEALTH EDUCATION & BEHAVIOR 2020; 47:380-390. [PMID: 32437293 PMCID: PMC8093095 DOI: 10.1177/1090198119897075] [Citation(s) in RCA: 79] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Community-based participatory research (CBPR) and community-engaged research have been established in the past 25 years as valued research approaches within health education, public health, and other health and social sciences for their effectiveness in reducing inequities. While early literature focused on partnering principles and processes, within the past decade, individual studies, as well as systematic reviews, have increasingly documented outcomes in community support and empowerment, sustained partnerships, healthier behaviors, policy changes, and health improvements. Despite enhanced focus on research and health outcomes, the science lags behind the practice. CBPR partnering pathways that result in outcomes remain little understood, with few studies documenting best practices. Since 2006, the University of New Mexico Center for Participatory Research with the University of Washington's Indigenous Wellness Research Institute and partners across the country has engaged in targeted investigations to fill this gap in the science. Our inquiry, spanning three stages of National Institutes of Health funding, has sought to identify which partnering practices, under which contexts and conditions, have capacity to contribute to health, research, and community outcomes. This article presents the research design of our current grant, Engage for Equity, including its history, social justice principles, theoretical bases, measures, intervention tools and resources, and preliminary findings about collective empowerment as our middle range theory of change. We end with lessons learned and recommendations for partnerships to engage in collective reflexive practice to strengthen internal power-sharing and capacity to reach health and social equity outcomes.
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Affiliation(s)
| | | | | | | | | | - Sarah Kastelic
- National Indian Child Welfare Association, Portland, OR, USA
| | | | | | | | - Kasim Ortiz
- University of New Mexico, Albuquerque, NM, USA
| | | | - Juan Peña
- University of New Mexico, Albuquerque, NM, USA
| | - Alan Richmond
- Community Campus Partnerships for Health, Raleigh, NC, USA
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Parker M, Wallerstein N, Duran B, Magarati M, Burgess E, Sanchez-Youngman S, Boursaw B, Heffernan A, Garoutte J, Koegel P. Engage for Equity: Development of Community-Based Participatory Research Tools. HEALTH EDUCATION & BEHAVIOR 2020; 47:359-371. [PMID: 32437292 PMCID: PMC10792999 DOI: 10.1177/1090198120921188] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2024]
Abstract
We developed a set of four community-based participatory research (CBPR) partnership tools aimed at supporting community-academic research partnerships in strengthening their research processes, with the ultimate goal of improving research outcomes. The aim of this article is to describe the tools we developed to accomplish this goal: (1) the River of Life Exercise; (2) a Partnership Visioning Exercise; (3) a personalized Partnership Data Report of data from academic and community research partners; and (4) a Promising Practices Guide with aggregated survey data analyses on promising CBPR practices associated with CBPR and health outcomes from two national samples of CBPR projects that completed a series of two online surveys. Relying on Paulo Freire's philosophy of praxis, or the cycles of collective reflection and action, we developed a set of tools designed to support research teams in holding discussions aimed at strengthening research partnership capacity, aligning research partnership efforts to achieve grant aims, and recalling and operationalizing larger social justice goals. This article describes the theoretical framework and process for tool development and provides preliminary data from small teams representing 25 partnerships who attended face-to-face workshops and provided their perceptions of tool accessibility and intended future use.
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Ortiz K, Nash J, Shea L, Oetzel J, Garoutte J, Sanchez-Youngman S, Wallerstein N. Partnerships, Processes, and Outcomes: A Health Equity-Focused Scoping Meta-Review of Community-Engaged Scholarship. Annu Rev Public Health 2020; 41:177-199. [PMID: 31922931 PMCID: PMC8095013 DOI: 10.1146/annurev-publhealth-040119-094220] [Citation(s) in RCA: 77] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
In recent decades, there has been remarkable growth in scholarship examining the usefulness of community-engaged research (CEnR) and community-based participatory research (CBPR) for eliminating health inequities.This article seeks to synthesize the extant literature of systematic reviews, scoping reviews, and other related reviews regarding the context, processes, and research designs and interventions underlying CEnR that optimize its effectiveness. Through a scoping review, we have utilized an empirically derived framework of CBPR to map this literature and identify key findings and priorities for future research. Our study found 100 reviews of CEnR that largely support the CBPR conceptual framework.
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Affiliation(s)
- Kasim Ortiz
- Department of Sociology and Criminology, University of New Mexico, Albuquerque, New Mexico 87131, USA;
- College of Population Health, Center for Participatory Research, University of New Mexico, Albuquerque, New Mexico 87131, USA
- Institute for the Study of "Race" and Social Justice, University of New Mexico, Albuquerque, New Mexico 87131, USA
| | - Jacob Nash
- College of Population Health, Center for Participatory Research, University of New Mexico, Albuquerque, New Mexico 87131, USA
| | - Logan Shea
- College of Population Health, Center for Participatory Research, University of New Mexico, Albuquerque, New Mexico 87131, USA
| | - John Oetzel
- Waikato Management School, University of Waikato, 3240 Hamilton, New Zealand
| | - Justin Garoutte
- College of Population Health, Center for Participatory Research, University of New Mexico, Albuquerque, New Mexico 87131, USA
- Behavioral Health Research Center of the Southwest (BHRCS), Pacific Institute for Research and Evaluation (PIRE), Albuquerque, New Mexico 87106, USA
| | - Shannon Sanchez-Youngman
- College of Population Health, Center for Participatory Research, University of New Mexico, Albuquerque, New Mexico 87131, USA
- Center for Social Policy, University of New Mexico, Albuquerque, New Mexico 87131, USA
- School of Public Administration, University of New Mexico, Albuquerque, New Mexico 87131, USA
| | - Nina Wallerstein
- College of Population Health, Center for Participatory Research, University of New Mexico, Albuquerque, New Mexico 87131, USA
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