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Community-Based Participatory Research: Lessons from the Centers for Children's Environmental Health and Disease Prevention Research - A Quick Reference Guide

Authors

Barbara A. Israel, Edith A. Parker, Zachary Rowe, Alicia Salvatore, Meredith Minkler, Jesus Lopez, Arlene Butz, Adrian Mosley, Lucretia Coates, George Lamert, Paul A. Potito, Barbara Brenner, Maribel Rivera, Harry Romero, Beti Thompson, Gloria Coronado, and Sandy Halstead

 

Summary

This article provides one definition of community-based participatory research (CPBR), benefits and challenges to this approach based on the experiences of six Children's Centers.  This article also discusses how to establish and maintain successful CBPR partnerships that are aimed at understanding and addressing the multiple factors of children's health.

Article definition of CBPR:  CBPR in public health is a partnership approach to research that equitably involves, for example, community members, organziational representatives, and researchers in all aspects of the research process, in which all partners contribute expertise and share decision making and responsibilities (Israel et al., 1998, 2003).

 

Type of Data/Science

In California, Maryland, and Michigan, the centers' research focused on regional health intervention studies on overall children's environmental health.  New York and Wasthington State's survey and intervention study focused on pesticide use and exposure, and New Jersey focused on autism.

There is also data on the actual CBPR processes for the six centers, that compare and constrast the methods and tools used in each partnership with local community organizations.

 

Type of Community Action

These studies invariably lead to community-based and led health interventions in the specific communities.

 

Lessons Learned

Benefits of CBPR

Relevant Research.  The research topic comes from and reflects a major concern of the local community.  The partnership also enhances the application of the research data by all partners involved.

More is more.  Bringing together more partners brings different skills, knowledge, and expertise to address complex problems.  The quality, validity, sensitivity, and practicality of the research is enhanced by involving the local knowledge of the communities. 

Old barriers are broken down.  The CBPR approach allows for more chances to overcome the distrust of research by communities that have traditionally been the "subjects" of the research.

Defining the problems and solutions begins and stays in the community.  Throughout the entire process, the research aims to improve the health and well-being of the involved communities.  Communities have ownership of the solutions to implement throughout and after the research is done.

Barriers and Challenges

Lack of sufficient resources.  There are many costs to community and academic partners participating in a successful CBPR partnership.  Successful partnerships require an intense amount of time to attend meetings, jointly participate in all phases of the research, and maintain trust with each other.  All partners require sufficient reimbursement for their time spent participating as well as time taken away from their other job responsibilities.  

Institutional restraints, such as bureaucracy, and rigid processes slow down the CBPR process.  Often, processes such as internal reviews, overhead issues, and delays with data analysis and returning results to communities do not take into account the needs of CBPR projects, mainly the need for flexibility and revising plans based on community input.

Long history of distrust and lack of respect.  Many partners, academia and community, as well as within communities, have historically adversarial relationships. CBPR parnterships should consider when the right time to bring on various partners based on this history and context of relationships within a certain community.

Ensuring consistent community participation and influence is difficult.  The lack of time and sufficient resources to fund community participation are the biggest barriers.  The success of CBPR partnerships is dependent upon an adequate amount of resources and commitment to a long-term process.

Community and academic partners have different emphasis on goals, values, priorities, and perspectives.   For example, a community may want to distribute findings to affect change immediately.  Whereas, academic partners do not want to contaminate study findings with premature dissemination of results.  The differences in emphases should be considered in the beginning of the process with the development of core values and principles of the collaboration.

Different languages and styles of communication often slowed the partnership.  Literal differences in language can be a barrier without sufficient translation resources, people or technology.  Academic jargon and community colloquialisms also can create confusion and miscommunication.  Academic partners who largely relied on email communication often did not anticipate the complete lack of access to email by community partners or a lack of comfort or familiarity with email-heavy communitcation. 

General Lessons Learned

Defining communities too rigidly may limit the study.  Geographic boundaries proved to be too large, capturing a diverse set of neighborhoods and communities.  Often, defining communities by shared demographics and/or high incidence and prevalence of a particular environmental issue or health problem led to a richer study.  Centers often worked with "communities of identity" (Steuart, 1993), who had considerable strengths such as social networks and community organizations.

Build on prior positive working relationships.  Several Children's Centers identified community partners from existing successful relationships that existed between academia and involved communities.  Years of collaboration in East Harlem and Detroit, made it easier to develop full CBPR partnerships.

Community partners and local staff are NECESSARY to build successful bridges between all participants.  All of the six centers cited staff hired from the local community as a key component to the success of the CBPR partnership.  Local staff ensured cultural and linguistic appropriateness and effectiveness of processes and all written materials.  Furthermore, local staff provided the regular interaction needed to build and maintain trust between researchers, community partners, intervention participants, and community members-at-large.

Find and create a sufficient amount of time, resources, and benefits for all partners.  This allows for the most effective action, meaningful participation, and building and maintaining of trust. 

Jointly develop and follow operating norms and CBPR principles and core values at the very onset of the partnership.  This leads to clearer expectations and processes for maintaining the partnership even in the midst of disagreement and tension.

There must be a commitment to translating the research findings into interventions and policies.  Many community partners will not take ownership of the research if the research does not produce real change in their lives and communities.

 

For More Information: NIEHS Website

 

 

 

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