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ICR Abstracts: 4.4
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The Institute for Community Research
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Apr 25, 2006 10:35 PDT
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Community-Based Collaborative Research Conference, June 7-9, 2007 in
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[Editor's note: The following articles have been selected because they
collectively deal with a variety of issues related to community-based
research (e.g., collaboration, ethics, methods) and they cover various
disciplines. If you have suggestions for articles/publications for
future postings, or other feedback in the
presentation, simply reply to this email. Thanks for joining!]
ICR Abstracts (4.4: April 25, 2006)
1. Arcury, T. A., Quandt, S. A., & Dearry, A. (2001). Farmworker
pesticide exposure and community-eased participation research: Rationale
and practical applications. _Environmental Health Perspectives_,
109(Suppl 3), 429-434.
The consequences of agricultural pesticide exposure continue to be major
environmental health problems in rural communities. Community-based
participatory research (CBPR) is an important approach to redressing
health disparities resulting from environmental causes. In this article
we introduce a collection of articles that describe projects using CBPR
to address the health disparities resulting from pesticide exposure in
agricultural communities, particularly the communities of migrant and
seasonal farmworkers. The articles in this collection are based on a
workshop convened at the 1999 American Public Health Association
meeting. The goals in presenting this collection are to provide those
endeavoring to initiate CBPR projects needed information, guidelines,
and procedures to improve the quality of the CBPR experience; to
increase the scientific validity of CBPR projects; and to reduce the
potential difficulties and stress of these collaborations. In this
introduction we discuss the context in which these projects operate,
summarizing background information about farmworkers in the United
States, what is known about farmworker pesticide exposure, and the
concept of community-based participatory research. Finally, the articles
in this collection are summarized, and major themes common to successful
CBPR projects are identified. These common features are taking the time
to interact with the community, using multiple approaches to engage the
different parts of the community, understanding different participants
often have different goals, appreciating each group's strengths, valuing
community knowledge, and being flexible and creative in conducting
research. The final article in this collection describes the
translational research program at the National Institute of
Environmental Health Sciences (NIEHS) highlighting activities pertinent
to the health of rural communities, giving an overview of
NIEHS-supported projects addressing health concerns of Native Americans
and rural African-American communities in addition to farmworkers, and
discussing future plans for CBPR at NIEHS.
2. Barnes, S. L. (2005). Black Church Culture and Community Action.
_Social Forces_, 84(2), 967-994.
Cultural theory posits that social groups possess a cultural repertoire
or "tool kit" that reflects beliefs, ritual practices, stories and
symbols that provide meaning and impetus for resource mobilization.
However, little research based on quantitative techniques has been
forwarded relative to the relationship between longstanding Black Church
cultural components -- specifically, scripture, songs, prayers and
sermons -- and activism among Black churches. Using a large national
sample of Black congregations across seven denominations, I test aspects
of cultural theory. Findings support the consistent, direct relationship
between prayer groups and gospel music and various forms of community
action and less influence by spirituals and the general usage of sacred
scripture.
3. Brownstein, J. N., Bone, L. R., Dennison, C. R., Hill, M. N., Kim, M.
T., & Levine, D. M. (2005). Community health workers as interventionists
in the prevention and control of heart disease and stroke. _American
Journal of Preventive Medicine_, 29(5), 128-133.
A considerable body of research indicates that community health workers
(CHWs) are effective in improving chronic disease care and health
outcomes. Much of the focus of cardiovascular research involving CHWs
has been on hypertension because of its high prevalence and because it
is a major risk factor for cardiovascular, cerebrovascular, and renal
diseases. Adding CHWs to the patient-provider team has a beneficial
effect on the quality of care for populations most in need. CHWs have
contributed to significant improvements in community members' access to
and continuity of care and adherence to treatment for the control of
hypertension. CHWs assume multiple roles, including patient and
community education, patient counseling, monitoring patient health
status, linking people with health and human services, and enhancing
provider patient communication and adherence to care. Current
recommendations for CHWs to be interventionists on healthcare teams and
in community-based research increase opportunities for CHWs to play an
important role in eliminating disparities in heart disease and stroke.
Adequate translation of research into clinical practice remains a major
challenge, however. Addressing this issue, which has national
implications, will require sustainable funding; appropriate
reimbursement; enhanced efforts to incorporate CHWs into healthcare
teams; better utilization of their skills; improved CHW supervision,
training, and career development; policy changes; and ongoing
evaluation, including a reporting of costs.
4. Carpiano, R. M. (2006). Toward a neighborhood resource-based theory
of social capital for health: Can Bourdieu and sociology help? _Social
Science & Medicine_, 62(1), 165-175.
Within the past several years, a considerable body of research on social
capital has emerged in public health. Although offering the potential
for new insights into how community factors impact health and well
being, this research has received criticism for being undertheorized and
methodologically flawed. In an effort to address some of these
limitations, this paper applies Pierre Bourdieu's (1986) [Bourdieu, P.
(1986). Handbook of theory and research for the sociology of education
(pp. 241-258). New York: Greenwood] social capital theory to create a
conceptual model of neighborhood socioeconomic processes, social capital
(resources inhered within social networks), and health. After briefly
reviewing the social capital conceptualizations of Bourdieu and Putnam,
I attempt to integrate these authors' theories to better understand how
social capital might operate within neighborhoods or local areas. Next,
I describe a conceptual model that incorporates this theoretical
integration of social capital into a framework of neighborhood social
processes as health determinants. Discussion focuses on the utility of
this Bourdieu-based neighborhood social capital theory and model for
examining several under-addressed issues of social capital in the
neighborhood effects literature and generating specific, empirically
testable hypotheses for future research.
5. Fenton, K. A., Chinouya, M., Davidson, O., & Copas, A. (2002). HIV
testing and high risk sexual behaviour among London's migrant African
communities: A participatory research study. _Sexually Transmitted
Infections_, 78(4), 241-245.
Objectives: To describe the demographic and behavioural factors
associated with HIV testing among migrant Africans in London. Methods: A
cross sectional survey of migrants from five sub-Saharan African
communities (Congo, Kenya, Uganda, Zambia, Zimbabwe) resident in London
was carried out. The study formed part of a larger community based
participatory research initiative with migrant African communities in
London-the MAYISHA project. Trained, ethnically matched interviewers
recruited study participants in a variety of community venues. A brief
self completion questionnaire collected data on demographic
characteristics, utilisation of sexual health services, HIV testing
history, sexual behaviour, and attitudes. Results: Valid questionnaires
were obtained from 748 participants (396 men and 352 women), median ages
31 and 27 years, respectively. Median length of UK residence was 6
years. 34% of men and 30% of women reported ever having had an HIV test.
HIV testing was significantly associated with age and previous STI
diagnosis among women; and additionally, nationality, education,
employment, and self perceived risk of acquiring HIV among men. After
controlling for significant demographic variables, previous diagnosis of
an STI (adjusted odds ratio and 95% confidence interval for men: 2.96,
1.63 to 5.38, and women 2.03, 1.06 to 3.88) and perceived risk of
acquiring HIV for men (adjusted OR 2.28, 95% CI 1.34 to 3.90) remained
independently associated. Conclusion: Among these high HIV prevalence
migrant communities, these data suggest that HIV testing remains largely
associated with an individual's STI history or self perceived risk. This
strategy may be inappropriate given the potential for onward and
vertical transmission. Antenatal HIV testing combined with proactive
targeted HIV testing promotion should be prioritised.
6. Gittelsohn, J., Steckler, A., & Johnson, C. C. (2006). Formative
Research in School and Community-Based Health Programs and Studies:
"State of the Art" and the TAAG Approach. _Health Education & Behavior_,
33(1), 25-39.
Part of a special issue on formative research for the Trial for Activity
in Adolescent Girls (TAAG), a study of 36 middle schools aimed at
reducing the decline in physical activity among adolescent females. An
overview of formative research in TAAG is provided. This overview covers
the background to formative research, theories for conducting formative
research, uses of formative research, and formative research approaches,
instruments, and methods implemented in TAAG.
7. Gittelsohn, J. e., Young, D. R. e., & Steckler, A. e. (2006).
Formative Research for the Trial for Activity in Adolescent Girls
(TAAG). _Health Education & Behavior_, 33(1), 12-11.
A special issue on formative research for the Trial for Activity in
Adolescent Girls (TAAG), a study of 36 middle schools aimed at reducing
the decline in physical activity among adolescent females, is provided.
Articles discuss formative research results from TAAG, formative
research in school- and community-based health programs and studies,
attitudes toward girls' physical activity among male and female
students, segmentation of female students for the purposes of promoting
TAAG, the use of formative research to develop a multisite physical
education intervention, the use of formative research to develop
interventions that increase physical activity among adolescent females,
and physical activity attitudes, preferences, and practices among
Caucasian, African-American, and Hispanic girls.
8. Goodkind, J. R. (2005). Effectiveness of a Community-Based Advocacy
and Learning Program for Hmong Refugees. _American Journal of Community
Psychology_, 36(3/4), 387-408.
The effectiveness of a community-based advocacy and learning
intervention for Hmong refugees was assessed using a comprehensive,
multi-method strategy, which included a within-group longitudinal design
with four data collection points and in-depth qualitative recruitment
and post-intervention interviews. The intervention's impact on five
aspects of refugee well-being was examined: Participants' psychological
well-being, quality of life, access to resources, English proficiency,
and knowledge for the U.S. citizenship exam. Twenty-eight Hmong adults
and 27 undergraduate students participated together in the intervention,
which had two major components: (1) Learning Circles, which involved
cultural exchange and one-on-one learning opportunities for Hmong
adults, and (2) an advocacy component that involved undergraduates
advocating for and transferring advocacy skills to Hmong families to
increase their access to resources in their communities. Undergraduate
paraprofessionals and Hmong participants worked together for 6-8 hr per
week for 6 months. Growth trajectory analysis revealed promising
quantitative findings. Participants' quality of life, satisfaction with
resources, English proficiency, and knowledge for the U.S. citizenship
test increased and their levels of distress decreased over the course of
the intervention. Mediating analyses suggested that participants'
increased quality of life could be explained by their improved
satisfaction with resources. Qualitative data helped to support and
explain the quantitative data, as well as providing insight into other
outcomes and processes of the intervention. Policy, practice, and
research implications are discussed.
9. Gor, B. J., Jones, L. A., Hwang, J., Wei, Q. Y., & Hoang, T. (2005).
Houston AANCART Best Practices: From vision to synergy to reality.
_Cancer_, 104(12), 2909-2915.
The theme for the 2004 AANCART Academy, "Community Partnerships for
Cancer Control: From Vision to Synergy to Reality", characterizes Best
Practices for the Houston AANCART site. Researchers and community
members share a common vision for addressing the cancer and health
disparities that exist in our Asian community. They banded together
synergistically to bring to reality the programs and projects that are
enabling more Asian Americans to understand their risks for cancer,
receive screening and education, and access treatment and survivorship
support. Along the way, Houston AANCART was also able to conduct
meaningful and relevant community-based participatory research and to
train young Asian and other investigators in how to reach out to this
community in a culturally sensitive and appropriate manner.
10. Green, L. W. (2006). Public Health Asks of Systems Science: To
Advance Our Evidence-Based Practice, Can You Help Us Get More
Practice-Based Evidence? _American Journal of Public Health_, 96(3),
406-409.
Public health asks of systems science, as it did of sociology 40 years
ago, that it help us unravel the complexity of causal forces in our
varied populations and the ecologically layered community and societal
circumstances of public health practice. We seek a more evidence-based
public health practice, but too much of our evidence comes from
artificially controlled research that does not fit the realities of
practice., What can we learn from our experience with sociology in the
past that might guide us in drawing effectively on systems science.
11. Hagen-Foley, D. L., Rosenthal, D. A., & Thomas, D. F. (2005).
Informed Consumer Choice in Community Rehabilitation Programs.
_Rehabilitation Counseling Bulletin_, 48(2), 110-117.
This study investigated consumer and staff member perceptions regarding
the extent of consumer choice and participatory planning in
community-based rehabilitation programs (CRPs) and the relationship
between these elements, satisfaction, and outcomes. Consumers reported
moderate to high levels of choice in services and employment goals, and
persons with greater functional limitations perceived themselves as
significantly less informed. Consumer perceptions of informed choice
were significantly related to greater satisfaction with services
received and outcomes attained. Those reporting greater perceived choice
also received significantly more services. Lastly, significant
differences in informed consumer choice were identified by type of
disability. Implications for rehabilitation professionals and future
research are discussed.
12. Hensleigh, K. (2005). Community-based Health Research: Issues and
Methods. _American Journal of Health Behavior_, 29(5), 474-476.
Reviews the book, "Community-based Health Research: Issues and Methods,"
edited by Daniel S. Blumenthal and Ralph J. DiClemente. The book is
written primarily for health professionals who have an interest in
conducting contemporary community-based research. However, students and
public health practitioners would benefit from reading the key concepts
of community- based research identified throughout, along with the
illustrations of applied research methods and lessons from well-known
studies, such as the Tuskegee Syphilis Study, the Stanford Five-City
Project, and the Community Intervention Trial for Smoking Cessation
(COMMIT). In addition to a critical overview of the fundamentals of
conducting research within community settings, the book does an
exemplary job of providing timely examples of community-based research,
such as a qualitative case study on HIV/ AIDS and a study regarding
cardiovascular risk reduction. Chapter 6 is dedicated solely to
describing the history of the development of the Behavioral Risk Factor
Surveillance System (BRFSS). The BRFSS's sample design, data
dissemination strategies, utilization among federal and state agencies,
and the strengths and weaknesses of the design and use of the system are
all explored. Overall, this book would be a great selection for health
students and professionals interested in conducting community health
research, and for practitioners interested in identifying key concepts
that are applicable to any type of research.
13. Islam, N., Kwon, S. C., Ahsan, H., & Senie, R. T. (2005). New York
AANCART - Using participatory research to address the health needs of
South Asian and Korean Americans in New York City. _Cancer_, 104(12),
2931-2936.
Since its inception in April 2000, the New York Asian American Network
for Cancer Awareness, Research, and Training (NY AANCART) has conducted
cancer control education, research, and infrastructure-building
activities in collaboration with the agenda of the national AANCART
project, one of the Special Population Networks funded by the National
Cancer Institute. In New York, the AANCART program was developed based
on the principles of community-based participatory research (CBPR), a
research approach that is centered on community strengths and issues and
that engages the community in the research process. NY AANCART has been
dedicated to developing leadership within and collaboration with
community-based organizations (CBOs) to address the needs of medically
underserved New York Asian-American populations. In particular, NY
AANCART has worked with CBOs to develop and implement a diverse public
health agenda that addresses the concerns of the communities that are
served by these organizations. Using case studies from two
community-based partnerships that were developed by NY AANCART, the
current report describes how the principles of CBPR were applied in two
rapidly growing Asian-American communities in New York City.
14. Kloos, B., Gross, S. M., & Meese, K. J. (2005). Negotiating Risk:
Knowledge and Use of HIV Prevention by Persons With Serious Mental
Illness Living in Supportive Housing. _American Journal of Community
Psychology_, 36(3/4), 357-372.
As a population, persons with serious mental illness (SMI) have an
elevated risk for HIV infection. However, relatively little is known
about how the risk of HIV has affected their lives, how persons with SMI
evaluate their HIV risk, and what preventive measures they undertake.
Furthermore, relatively little is known about community-based HIV
prevention for persons with SMI as most interventions have been
restricted to clinical settings. This report presents findings on the
HIV-related experiences of persons with SMI living in supportive housing
programs, one possible setting for implementing community-based HIV
prevention with this population. The qualitative investigation
interviewed 41 men and women living in five supportive housing programs.
In-depth, qualitative interviews elicited discussion of research
participants' (a) experiences with HIV, (b) knowledge about HIV and HIV
prevention, (c) assessments of their own risk, (d) descriptions of how
they apply their prevention knowledge, and (e) reports of barriers for
HIV prevention. Research participants describe social networks that have
substantial contact with persons affected by HIV. However, contrary to
some expectations of persons with SMI, research participants report
using HIV prevention knowledge in negotiating their risk of contracting
HIV. The implications of these findings are discussed in terms of their
relevance for implementing community-based HIV prevention for persons
with SMI.
15. Lundy, P., & McGovern, M. (2006). Participation, truth and
partiality: Participatory action research, community-based truth-telling
and post-conflict transtion in Northern Ireland. _Sociology-the Journal
of the British Sociological Association_, 40(1), 71-88.
The article assesses some methodological and ethical issues raised by a
Participatory Action Research (PAR) 'truth-telling' project conducted in
Northern Ireland. The authors reflect on their role in the Ardoyne
Commemoration Project (ACP), a community-based study that recorded and
published relatives' testimonies of victims of the Northern Ireland
conflict. The article addresses two major areas of concern. First, it
explores the potential value for post-conflict transition in carrying
out PAR-informed, single-identity, community-based research work in a
violently divided society. The authors argue that such 'insider'
research can make an important contribution to developing strategies of
conflict resolution, although significant limits need also to be
recognized. Second, the article critically assesses the validity of
claims to telling the 'truth' that such a project involves. The end of
legitimating popular knowledge is key to a PAR-based approach and this
can have important consequences for post-conflict transition, However,
in a divided society such a goal also raises significant questions
concerning the issue of partiality and the limits this sets for the
nature of the 'truth' that may be told.
16. Ma, G. X., Toubbeh, J. I., Su, X., Edwards, R. L., Ma, G. X.,
Toubbeh, J. I., et al. (2004). ATECAR: An Asian American community-based
participatory research model on tobacco and cancer control. _Health
Promotion Practice_, 5(4), 382-394.
In the past few decades, community-based participatory research, which
underscores the indispensable role of the community in all phases of the
research process, has been recognized as a viable approach to working
constructively with communities to achieve mutually beneficial goals.
This article presents a history of the Asian Tobacco Education, Cancer
Awareness and Research's pioneering efforts in conducting
community-based participatory research among Asian Americans in the
Delaware Valley region of Pennsylvania and New Jersey. Information about
project background, target populations, and the rationale for the
conduct of community-based participatory research in American
communities is provided. It also delineates the manner in which the
principles of community-based participatory research were applied as
guides for the development of partnership infrastructures, research
programs, and the challenges and barriers that were encountered.
Facilitating factors in partnership building, and implications of
employing this model in this ethnically and racially diverse population,
are further discussed.
17. Powell, M. E., Carter, V., Bonsi, E., Johnson, G., Williams, L.,
Taylor-Smith, L., et al. (2005). Increasing mammography screening among
African American women in rural areas. _Journal of Health Care for the
Poor and Underserved_, 16(4), 11-21.
The objective of this study was to evaluate the effectiveness of a
church-based breast cancer screening education program on mammography
attainment by African American women 40 years old and older in rural
Alabama. The sample consisted of 192 women who volunteered to
participate in the study through 13 African American churches in a
rural, economically-depressed Alabama county The design was
quasi-experimental and had some features of community-based
participatory research. Churches were randomly assigned to three groups
(full program, partial program and control). The full program (group
educational session plus an in-home visit from a Home Health Educator)
positively affected mammography attainment (38% increase from baseline
to Time 2). In addition, barriers to mammography attainment were reduced
for women who had not obtained a mammogram by follow-up. Community-based
participatory projects in collaboration with churches and cooperative
extension programs have the potential to reduce racial disparities in
breast cancer in rural areas.
18. Schell, L. M., Ravenscroft, J., Cole, M., Jacobs, A., & Newman, J.
(2005). Health disparities and toxicant exposure of Akwesasne Mohawk
young adults: A partnership approach to research. _Environmental Health
Perspectives_, 113(12), 1826-1832.
In this article we describe a research partnership between the Akwesasne
Mohawk Nation and scientists at the University at Albany, State
University of New York, initiated to address community and scientific
concerns regarding environmental contamination and its health
consequences (thyroid hormone function, social adjustment, and school
functioning). The investigation focuses on cultural inputs into health
disparities. It employs a risk-focusing model of biocultural
interaction: behaviors expressing cultural identity and values allocate
or focus risk, in this instance the risk of toxicant exposure, which
alters health status through the effects of toxicants. As culturally
based behaviors and activities fulfill a key role in the model, accurate
assessment of subtle cultural and behavioral variables is required and
best accomplished through integration of local expert knowledge from the
community. As a partnership project, the investigation recognizes the
cultural and socioeconomic impacts of research in small communities
beyond the production of scientific knowledge. The components of
sustainable partnerships are discussed, including strategies that helped
promote equity between the partners such as hiring community members as
key personnel, integrating local expertise into research design, and
developing a local Community Outreach and Education Program. Although
challenges a-rose during the design and implementation of the research
project, a collaborative approach has benefited the community and
facilitated research.
19. Singer, M. (2006). What is the "Drug User Community"?: Implications
for Public Health. _Human Organization_, 65(1), 72-80.
Through an exploration of a group that is beginning to be labeled in the
public health and drug research literature "the drug user community,"
this paper engages the challenges of achieving a shared research
definition of the oft used term "community." While this term has been a
central concept in public health since the international Alma Alta
conference of 1978, it remains "slippery" and hard to pin down, however
useful. While drug users commonly are disparaged as a threat to
community--indeed, the very embodiment of such threats, as a result of
the AIDS epidemic, postmodernism, and the harm reduction
movement--illicit drug users are now increasingly being accorded
community status among drug interventionists and researchers alike. This
paper examines the development of this trend, the community (and
anti-community) features of drug users based on research in Hartford,
CT, and the public health implications of conceiving (or failing to
conceive) of drug users in this way.
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