|
ICR Abstracts: 5.2
|
Helena
|
Feb 01, 2007 13:35 PST
|
*********************************************************************
CALL FOR PARTICIPATION, SCHOLARSHIPS AND REGISTRATION INFORMATION NOW
AVAILABLE!!
The Institute for Community Research is sponsoring an international
conference, Crossroads II: Community-Based Collaborative Research for
Social Justice, June 7-9, 2007 in Hartford, CT!
Visit our website www.incommunityresearch.org/crossroadsconfII.htm for
more information
*********************************************************************
[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 (5.2: February 1, 2007)
1. Anderson, N. L., E. R. Calvillo, et al. (2007). Community-based
approaches to strengthen cultural competency in nursing education and
practice. _Journal of Transcultural Nursing_, 18 (Suppl 1), 49S-59S.
This article explores existing informal as well as formal approaches
that address health disparities in the communities where they occur,
enhancing the opportunity to strengthen the cultural competency of
providers, students, and faculty. A particular focus centers on the
community-based participatory research approaches that involve community
members, providing opportunities to develop mutually respectful,
trusting relationships through co-teaching and co-learning experiences.
With community-based participatory research approaches to community
involvement in place, the stage is set for partnerships between
communities and schools of nursing to collaboratively design, implement,
and integrate informal and formal cultural competence components in
nursing curricula.
2. Coppens, N. M., R. Page, et al. (2006). Reflections on the Evaluation
of a Cambodian Youth Dance Program. _American Journal of Community
Psychology_, 37(3-4), 321-331.
Evaluating a youth program whose goals are to provide instruction in
Cambodian dance, increase awareness and pride in Cambodian culture,
promote healthy behaviors, and create linkages within the community has
been a challenge. A primary source of conflict was incorporating
evaluation methods that were required of all funded programs with our
own specifically tailored measures. One of our concerns was that the
required tools were not culturally appropriate for our participants. Our
experiences reinforce the importance of forming partnerships that
embrace principles of respect, equity, and empowerment among all
involved before establishing a research agenda. The choices we made and
did not make contributed to our struggles and frustration and also to
the insight that was gained. Our analysis examines the importance of
clear communication, cultural awareness, tailoring evaluation, and
meaningful participation. We believe that the lessons we learned will
help facilitate the conduct of culturally sensitive community-based
research. (PsycINFO Database Record (c) 2006 APA, all rights reserved)
(journal abstract).
3. Easter, M. M., L. A. Linnan, et al. (2007). "Una Mujer Trabaja Doble
Aqui": Vignette-Based Focus Groups on Stress and Work for Latina
Blue-Collar Women in Eastern North Carolina. _Health Promotion
Practice_, 8(1), 41-49.
Latina women are a growing percentage of the working population, and
very little is known about their health needs and interests. The purpose
of this article is to share qualitative research results gathered from
Latina women with a particular focus on exploring stress and health.
This project was a substudy of Health Works in the Community, a 5-year
CDC-funded multiple risk-factor reduction trial using participatory
action research approaches to address smoking, healthy eating, stress,
and physical activity among blue-collar women from 12 manufacturing work
sites in rural, eastern North Carolina. Five focus groups were conducted
with trained, bilingual facilitators using a vignette-based moderator
guide that appeared particularly effective with this population. Results
from the focus groups are used to make recommendations for future
research with Latinas and for developing effective work-site-based
interventions to address issues of stress and health within this
population.
4. Freeman, E. R., D. Brugge, et al. (2006). Challenges of Conducting
Community-Based Participatory Research in Boston’s Neighborhoods to
Reduce Disparities in Asthma. _Journal of Urban Health_, 83(6),
1013-1021.
Boston is one of the preeminent health care and research centers in the
world, but for much of its urban core, these resources are largely out
of reach. Community Based Participatory Research (CBPR) provides a model
with the potential to bridge the gaps between its research prominence
and the health of its residents. We report here two case studies of
major research projects that were partnerships between universities in
Boston and community based organizations and city agencies. The Healthy
Public Housing Initiative (HPHI) and the Asthma Center on Community
Environment and Social Stress (ACCESS) are projects that provide
numerous lessons about the potential and challenges of conducting CBPR.
Ensuring that the projects were true partnerships emerged as key issues
in both, especially with respect to funding mechanisms and distribution
of resources, although the nature of the challenges differed
substantially in the two projects. We note that both academic and
community partners may harbor stereotypes about the other and that
generalizations about broad populations, academics or community members,
may not apply well to everyone. Aligning objectives and expectations
emerged as another key lesson. In HPHI, tension between service delivery
and research was both a source of conflict and a source of creative
development that led to divergent but interesting outcomes. In ACCESS,
the tensions revolved more around community capacity building while
attempting to build and maintain a large cohort for epidemiological
investigations. We conclude that open and frank discussion and a
transparent process upfront about project direction, finances,
expectations, and other dimensions are necessary but not sufficient to
address the inherent challenges in CBPR, and that even so, there are
likely to be differences in perspective in such partnerships that
require honest negotiation throughout the process of the project.
5. Israel, B. A., J. Krieger, et al. (2006). Challenges and Facilitating
Factors in Sustaining Community-Based Participatory Research
Partnerships: Lessons Learned from the Detroit, New York City and
Seattle Urban Research Centers. _Journal of Urban Health_, 83(6),
1022-1040.
In order to address the social, physical and economic determinants of
urban health, researchers, public health practitioners, and community
members have turned to more comprehensive and participatory approaches
to research and interventions. One such approach, community-based
participatory research (CBPR) in public health, has received
considerable attention over the past decade, and numerous publications
have described theoretical underpinnings, values, principles and
practice. Issues related to the long-term sustainability of partnerships
and activities have received limited attention. The purpose of this
article is to examine the experiences and lessons learned from three
Urban Research Centers (URCs) in Detroit, New York City, and Seattle,
which were initially established in 1995 with core support from the
Centers for Disease Control and Prevention (CDC). The experience of
these Centers after core funding ceased in 2003 provides a case study to
identify the challenges and facilitating factors for sustaining
partnerships. We examine three broad dimensions of CBPR partnerships
that we consider important for sustainability: (1) sustaining
relationships and commitments among the partners involved; (2)
sustaining the knowledge, capacity and values generated from the
partnership; and (3) sustaining funding, staff, programs, policy changes
and the partnership itself. We discuss the challenges faced by the URCs
in sustaining these dimensions and the strategies used to overcome these
challenges. Based on these experiences, we offer recommendations for:
strategies that partnerships may find useful in sustaining their CBPR
efforts; ways in which a Center mechanism can be useful for promoting
sustainability; and considerations for funders of CBPR to increase
sustainability.
6. Jones, L. and K. Wells. (2007). Strategies for Academic and Clinician
Engagement in Community-Participatory Partnered Research. _Journal of
the American Medical Association_, 297(4), 407-410.
1st 150 words. There have been recent practice and policy concerns over
the "quality chasm," or gap between the promise of evidence-based
medicine and the realities of community practice1 with little variation
by geographic and sociodemographic factors.2 Studies document
disparities in access of care for particular conditions, and there is
widespread concern about disparities in health status and health risk
factors disadvantaging underserved ethnic minority and
lower-socioeconomic status groups.3-4 Addressing quality gaps and health
disparities will require implementation of programs to address social
determinants of health and improve services delivery across diverse
communities. Doing so for underserved communities may be especially
challenging owing to resource constraints, underdevelopment of research,
and historical distrust in research and health care in some groups.
7. Lichtenstein, R., J. Banaszak-Holl, et al. (2006). Training welfare
caseworkers in service excellence: increasing children's Medicaid
coverage. _Journal of Health Care for the Poor & Underserved_, 17(3),
486-92.
Many low-income children who are eligible for public sector health
insurance remain uninsured. There are many barriers to enrolling these
children, but one key issue is parents' reluctance to use the services
of the local enrollment agency, which is usually the welfare office. The
Eastside Access Partnership, a community-academic coalition on the
Eastside of Detroit, addressed the problem of uninsured-but-eligible
children through a variety of interventions focused on (1) enhancing
community members' understanding of the enrollment process and (2)
reducing institutional barriers to enrollment. One of these
interventions addressed the institutional barriers by developing a
customer service excellence training program for welfare caseworkers.
The training program curriculum, which was developed following the
principles of community-based participatory research, included extensive
input from community residents, welfare agency staff, and academic
researchers. The training sessions received positive evaluations from
participants and agency executives. A more thorough evaluation of the
project is under way.
8. Liebman, M. (2005). Promoting healthy weight: Lessons learned from
WIN the Rockies and other key studies. _Journal of Nutrition Education
and Behavior_, 37, S95-S100.
In contrast to the traditional weight-centered approach, the Health At
Every Size (HAES) or nondieting approach is health centered, with no
focus on losing a predetermined amount of weight or fat. A key HAES
principle of advocating healthy changes in food selection rather than
adherence to prescriptive diets that involve calorie counting was
adopted by Wellness ill the Rockies (WIN the Rockies), a community-based
research, intervention, and outreach project that promoted healthy
lifestyles related to food, physical activity, and body image at the
individual and Community levels in Wyoming, Montana, and Idaho. The
results from the projects cross-sectional surveys indicated that
increased frequency of eating food while doing another activity, of
drinking sweetened beverages such as soft drinks, and of consuming foods
from fast-food restaurants were significant predictors of a high body
mass index (BMI). In terms of energy expenditure, other predictors of
high BMI from the WIN the Rockies cross-sectional surveys were lower
frequency of participation in physical activity and the perception of
not getting as much exercise as needed. The overall data provide support
for the view that small diet- and physical activity-related lifestyle
changes can cumulatively make a Significant contribution to maintenance
of healthy body weights. Although the community intervention emphasis of
WIN the Rockies did not allow a specific assessment of the efficacy of
HAES for individual participants in the project, this approach appears
to hold great potential for promoting healthful lifestyle changes that
improve quality of life.
9. Lipscomb, H. J., R. Argue, et al. (2005). Exploration of work and
health disparities among black women employed in poultry processing in
the rural South. _Environmental Health Perspectives_, 113(12),
1833-1840.
We describe an ongoing collaboration that developed as academic
investigators responded to a specific request from community members to
document health effects on black women of employment in
poultry-processing plants in rural North Carolina. Primary outcomes of
interest are upper extremity musculoskeletal disorders and function as
well as quality of life. Because of concerns of community women and the
history of poor labor relations, we decided to conduct this longitudinal
study in a manner that did not require involvement of the employer. To
provide more detailed insights into the effects of this type of
employment, the epidemiologic analyses are supplemented by ethnographic
interviews. The resulting approach requires community collaboration.
Community-based staff, as paid members of the research team, manage the
local project office, recruit and retain participants, conduct
interviews, coordinate physical assessments, and participate in
outreach. Other community members assisted in the design of the data
collection tools and the recruitment of longitudinal study participants
and took part in the ethnographic component of the study. This
presentation provides an example of one model through which academic
researchers and community members can work together productively under
challenging circumstances. Notable accomplishments include the
recruitment and retention of a cohort of low-income rural black women,
often considered hard to reach in research studies. This community-based
project includes a number of elements associated with community-based
participatory research.
10. Lowry, L. L. and J. K. Flohr (2006). "Strategies Used to Embed
Concepts of Sustainable Development in the Curriculum". _Inside and out:
Universities and education for sustainable development_. R. Forrant and
L. Silka. Amityville, NY, Baywood Publishing Co: 87-101.
(from the chapter) This chapter illuminates the experiential pedagogy
that was used to embed concepts of sustainability in the curriculum of
the Department of Hospitality and Tourism Management at the University
of Massachusetts Amherst and clarifies the educational benefits that
students gained from the process. The primary vehicle for discovery and
reflection is community-based research. The impetus for this form of
experiential teaching and learning came from the management academy's
need to grow leaders who could solve problems and manage diverse peoples
and situations in an increasingly complex world. The issue of
sustainable tourism development was selected as the context for
exploration as it is a serious challenge facing "destination
communities" and countries.
11. Meckler, G. D., M. N. Elliott, et al. (2006). Nondisclosure of
sexual orientation to a physician among a sample of gay, lesbian, and
bisexual youth. _Archives of Pediatric & Adolescent Medicine_, 160(12),
1248-54.
BACKGROUND: The American Medical Association, the American Academy of
Pediatrics, and the Society for Adolescent Medicine recommend discussing
sexual orientation as part of the health supervision of all adolescents.
Little is known about whether lesbian, gay, and bisexual (LGB) youth
hide their orientation from health care providers, which can potentially
lead to missed opportunities in identifying individual health risks and
provide appropriate screening and counseling. OBJECTIVES: To describe
the health care experiences of a nonclinical sample of LGB youth and
identify factors associated with disclosure and nondisclosure of
orientation to physicians. DESIGN: Community-based participatory study
using a self-administered questionnaire. SETTING: Los Angeles youth
empowerment conference held in October 2003 targeting high school-aged
LGB youth. PARTICIPANTS: One hundred thirty-one youth aged 14 to 18
years who identified themselves as LGB. Main Outcome Measure Physician's
knowledge of participant's sexual orientation. RESULTS: Thirty-five
percent of the sample reported that their physician knew they were LGB.
Bisexual youth were less likely than gay and lesbian youth to have
disclosed. The strongest predictor of disclosure was having discussed
sex or sexual health of any kind with a physician (odds ratio, 15.47;
95% confidence interval, 4.34-55.18). When asked what a physician could
do to make talking about being LGB more comfortable, 64% of participants
chose the survey response, "Just ask me." CONCLUSIONS: Even among a
nonclinical sample of LGB youth who were open enough about their
orientation to attend a conference on the subject, only 35% reported
that their physician knew their orientation. The results indicate that
physicians had not discussed sexuality with most LGB youth in the study
and that most youth would welcome such a discussion.
12. Mereu, A., C. Sardu, et al. (2007). Participative risk communication
in an industrial village in Sardinia. _Journal of Epidemiology and
Community Health_, 61(2), 122-7.
OBJECTIVE: In Italy the law on industrial risk has emphasised the
necessity of building a local information process to answer people's
questions on safety and provide greater community participation in risk
management. The aim of this research is to analyse the local
population's ideas and expectations of a participatory approach in risk
management in order to design a risk communication programme based on
health promotion principles. Design, SETTING AND PARTICIPANTS: The study
was carry out in Portoscuso (Italy), an industrial district. A
questionnaire was administrated through home interviews to 147 citizens.
MAIN RESULTS: Six risk management styles were identified on the basis of
citizens' trust in the different stakeholders. Additional parameters
(importance of information, organisations they would trust to get
information on industrial risks, preferred risk communication
methodologies) were analysed according to the management styles.
CONCLUSIONS: On the basis of these elements, a multi-approach strategy
could be proposed. Each management style can have different roles. A
programme of public forums could involve citizens with an interactive
approach, interactive courses could involve citizens with a
semi-participative approach, and leaflets and booklets could inform
citizens oriented towards unidirectional communication. The
participative process should always be open to new contributions from
citizens who are not directly involved, and should allow for flexibility
in the form and nature of partnership, as well as the details of
implementation.
13. Minkler, M., V. B. Vasquez, et al. (2006). Sowing the seeds for
sustainable change: A community-based participatory research partnership
for health promotion in Indiana, USA and its aftermath. _Health
Promotion International_, 21(4), 293-300.
SUMMARY Community-based participatory research (CBPR) increasingly is
being used in both developed and developing countries to study and
address community-identified issues through a collaborative and
empowering action-oriented process. In 2003-2005, a study was undertaken
to document the impacts of CBPR on healthy public policy in the US. From
an initial review of 80 partnership efforts, 10 were selected as best
capturing the range and diversity of projects meeting the study
criteria, and were the subject of in-depth case study analysis. This
article presents and analyzes one of these cases, a collaboration
between researchers at the Indiana University School of Nursing and the
Healthy Cities Committee of New Castle, IN, USA. With its action
component still underway a decade after the formal study's completion,
the partnership was selected to enable an examination of sustainable
change through CBPR. Beginning with a participatory door-to-door health
survey of 1000 households using a non-probability quota sampling
strategy, the project involved community members in many stages of the
research process. A smoking rate of twice the national average was among
the study findings that helped to galvanize the community into action. A
variety of health promoting environmental and 'small p policy' changes
were undertaken ranging from a bill restricting indoor smoking in public
places to an initiative to develop a system of trails throughout the
county to promote physical fitness and decreased reliance on
automobiles. This article examines the evolution of the original CBPR
partnership, its research methods and findings, and the environmental
changes it sought to promote healthier lifestyles. Success factors,
barriers and sustainability benchmarks are discussed. The case study
offers an example of the potential of CBPR for helping to lay the
groundwork for long-term sustainable change in support of healthier
communities.
14. Percy-Smith, B. (2006). From Consultation to Social Learning in
Community Participation with Young People. _Children, Youth and
Environments_, 16(2), 153-179.
When limited to consultation, participation, does not address
deep-rooted problems concerning young people’s use of neighborhood
space. Many initiatives to involve young people give little attention to
issues of conflict, power and diversity in neighborhood development.
Building cohesive communities with high levels of social capital that
acknowledge young people as “legitimate” shared users of space, requires
more elaborate approaches. The paper argues for the creation of spaces
where adults and young people can come together in dialogue, reflection
and social learning in communities as well as wider decision-making
processes. Drawing on principles of action research and participatory
inquiry, the paper elaborates a dialogical “social learning” model of
participation using an example from work in community health planning.
This approach can support young people’s participation in community
development and local decision-making processes.
Full text available online: http://www.colorado.edu/journals/cye.
15. Polcin, D. L. (2006). How health services research can help clinical
trials become more community relevant. _International Journal of Drug
Policy_, 17(3), 230-237.
U.S. agencies that fund addiction research have recently made major
efforts to bridge "the gap between research and treatment". One strategy
developed by the National Institute on Drug Abuse is the "Clinical
Trials Network", which is designed to conduct effectiveness studies in
real world, community-based programs rather than research settings.
While a step in the right direction, these studies have focused almost
exclusively on the effectiveness of standard treatment interventions
using limited research methodologies. Health services issues that will
determine the long-term acceptance or rejection of these interventions
in the community have been largely ignored: the effects of process
variables, how public health policy facilitates or hinders
implementation, the perspectives and experiences of various
stakeholders, and the relationships between addiction treatment and
other community-based services. This paper suggests that addiction
researchers need to look beyond the question of whether an intervention
is "effective" and examine the community context within which those
interventions are delivered. Adding this health services view to
compliment clinical trials research requires examination of new research
questions, broader designs of studies, modifications in the collection
of data, and assessment of addiction policy. Recent studies examining
recovery from addiction in sober living and Oxford houses are described
as examples of community relevant research that could benefit from
additional health services research. (PsycINFO Database Record (c) 2006
APA, all rights reserved) (journal abstract).
16. Reeb, R. N. (2006). Community Action Research: An Introduction.
_Journal of Prevention & Intervention in the Community_, 32(1-2), 1-3.
One goal of community psychology is to apply psychological theory and
research in ways that enhance the psychological wellness of community
members. As community psychology was developing a distinctive identity,
it became evident that community programs utilizing paraprofessionals
and volunteers were beneficial to community members. The first section
of this special volume, presents a sample of studies that (a) utilized
volunteers or paraprofessionals in the implementation of services or
social action, and (b) demonstrated benefits of the program to members
of the community. The second section of this special volume, presents
studies that demonstrate benefits in personal development for volunteers
and paraprofessionals providing services in community members. The
articles presented in this special volume advance our understanding of
the potential benefits of research that utilize volunteers or
paraprofessionals as change agents. It is hoped that these articles
stimulate further research examining the benefits of community-based
research projects for both (a) members of the community in need of
services, and (b) volunteers and paraprofessionals providing community
service.
17. Seifer, S. D. and S. Sisco. (2006). Mining the Challenges of CBPR
for Improvements in Urban Health. _Journal of Urban Health_, 83(6),
981-984.
18. Waller, T. (2006). “Don’t Come Too Close To My Octopus Tree”:
Recording and Evaluating Young Children’s. Perspectives on Outdoor
Learning. _Children, Youth and Environments_, 16(2), 75-104.
This paper examines how children’s experiences of an outdoor project can
challenge our understanding of participation. It discusses and evaluates
participative approaches and the inter-relationship between children’s
spaces, pedagogy and research. It draws on an ongoing multi-method study
in the United Kingdom of how young children can develop their own
learning paths. A critical discussion of participatory research with,
rather than on, children, acknowledges children’s agency and develops
the concept of “children’s spaces” in participatory research and early
years’ pedagogy. The paper also discusses the implications for adult
roles and methodological design and suggests a model for research as an
interpretive process of co-constructed knowledge starting from
children’s perspectives.
Full text available online: http://www.colorado.edu/journals/cye.
19. Wilcox, S., M. Laken, et al. (2007). Increasing physical activity
among church members community-based participatory research. _American
Journal of Preventive Medicine_, 32(2), 131-8.
BACKGROUND: Faith-based interventions using a community-based
participatory approach hold promise for eliminating ethnic health
disparities. This study evaluated the effects of a volunteer-led
statewide program to increase physical activity among members of
African-American churches. METHODS: African Methodist Episcopal churches
within six regions (Conferences) were randomly assigned to receive
training in the program immediately or 1 year later. A cohort of 20
randomly selected churches and 571 members within them took part in
telephone surveys at baseline (May-September 2003) and 1 year
(May-August 2004) and 2 years later (June-September 2005). Primary
outcomes were physical activity participation, meeting physical activity
recommendations, and stage of readiness for physical activity change.
Statistical analyses were completed in April 2006. RESULTS: Volunteers
(N=889) from 303 churches were trained. Among survey respondents,
physical activity did not increase significantly over time, although 67%
were aware of the program. Program awareness was significantly related
to all three physical activity outcomes and to fruit and vegetable
consumption. Pastoral support was significantly associated with physical
activity. CONCLUSIONS: Although this intervention reached a large number
of churches and created awareness of intervention components, no effects
on physical activity behaviors were found. Potential reasons for the
lack of significant effects are discussed.
20. Yonas, M. A., N. Jones, et al. (2006). The Art and Science of
Integrating Undoing Racism with CBPR: Challenges of Pursuing NIH Funding
to Investigate Cancer Care and Racial Equity. _Journal of Urban Health_,
83(6), 1004-1012.
In this nation, the unequal burden of disease among People of Color has
been well documented. One starting point to eliminating health
disparities is recognizing the existence of inequities in health care
delivery and identifying the complexities of how institutional racism
may operate within the health care system. In this paper, we explore the
integration of community-based participatory research (CBPR) principles
with an Undoing Racism process to conceptualize, design, apply for, and
secure National Institutes of Health (NIH) funding to investigate the
complexities of racial equity in the system of breast cancer care.
Additionally, we describe the sequence of activities and “necessary
conflicts” managed by our Health Disparities Collaborative to design and
submit an application for NIH funding. This process of integrating CBPR
principles with anti-racist community organizing presented unique
challenges that were negotiated only by creating a strong foundation of
trusting relationships that viewed conflict as being necessary. The
process of developing a successful NIH grant proposal illustrated a
variety of important lessons associated with the concepts of cultural
humility and cultural safety. For successfully conducting CBPR, major
challenges have included: assembling and mobilizing a partnership; the
difficulty of establishing a shared vision and purpose for the group;
the problem of maintaining trust; and the willingness to address
differences in institutional cultures. Expectation, acceptance and
negotiation of conflict were essential in the process of developing,
preparing and submitting our NIH application. Central to negotiating
these and other challenges has been the utilization of a CBPR approach.
|
|
 |
|
