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ICR Abstracts: 5.7
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Helena
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Jul 23, 2007 06:41 PDT
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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 (5.7: July 23, 2007)
1. Bailey, J., C. Veitch, et al. (2006). Developing research capacity
building for Aboriginal & Torres Strait Islander health workers in
health service settings. _Rural Remote Health_, 6(4), 556.
INTRODUCTION: Aboriginal and Torres Strait Islander health workers
(hereafter called Health workers) can play a major role in facilitating
culturally appropriate health care delivery and program development
through the acquisition of improved skills in the planning, monitoring
and evaluation of these programs (RCB). However, many Aboriginal and
Torres Strait Islander people and communities remain concerned about
research and related activities. Health workers are well placed to
assist communities to not only embrace research, but to be active
players and promoters of relevant, appropriate and acceptable research.
One means of achieving the twin goals of RCB and community acceptance
and involvement in research, is through health workers undertaking
research of health priority issues and evaluation of activities, such as
program delivery, that are of direct relevance to their community's aim
of improving or enhancing service delivery. This article outlines the
development and content of a community-based RCB framework for health
workers. The focus is on the major issues that enhance a proactive
service delivery model using culturally appropriate research methods.
Development process: The RCB framework described here was developed,
over a period of time, through community workshops and consultations
aimed at deriving general consensus on the key issues and components of
a culturally-appropriate, community-based training process. The
framework has subsequently been reviewed by Aboriginal and Torres Strait
Islander community representatives from across Australia. The overall
aim of the framework is to supplement current (institutionally-based)
education and training resources for health workers with community-based
research training modules. These modules can be tailored to provide
research and evaluation skills relevant to health workers taking a more
proactive role in facilitating health and wellbeing programs in their
own communities. The use of collaborative consultation and participatory
methods are intended to be a two-way education process. Course content:
A visual pathway is used that encompasses the impact of health and
practice in the community for health workers at a grass-roots level.
This enables elements of the RCB process to be divided into a series of
connected modules. These are: (i 'assessing' Existing Services; (ii)
methods and measures for Identifying Need at various levels; (iii)
important issues in Program Development; (iv) how the former contributes
to Service Improvement; (v) resultant Outcomes that will impact on
community and service provision; and (vi) Evaluation Methods and
applying findings to service delivery. Conclusions: Active participation
by the Aboriginal and Torres Strait Islander community is fundamental
for effective research practices and outcomes. The aim is to provide
health workers and community members with a working knowledge of
research ethics and methods so that they can assist, monitor and steer
the development of culturally appropriate research activities that will
lead to provision of the highest quality services 'back' to the
community. This RCB framework will enable health workers to be more
proactive, self-reliant and self-sufficient within their community and
healthcare settings.
2. Barnes, S., M. Gott, et al. (2005). Recruiting older people into a
large, community-based study of heart failure. _Chronic Illness_, 1(4),
321-9.
This paper highlights some of the challenges encountered when recruiting
older people with heart failure into longitudinal, community-based
research. It draws on the experience gained in a study to provide
insights into the palliative care needs of older people with heart
failure and the timing and need for service interventions. Five hundred
and forty-two people with heart failure (New York Heart Association
(NYHA) stages II-IV) and 213 of their informal carers were recruited
from primary care practices in four areas of the UK. Ethical issues
arising around gate-keeping, terminology and participant burden are
discussed along with challenges faced during the recruitment process.
Strategies to increase general practitioner and patient recruitment are
provided. The paper concludes that prospective longitudinal studies are
of particular relevance to chronic illness, and the complexity of
setting up such research must be acknowledged and appropriately
resourced.
3. Blumenthal, D. S. and D. S. Blumenthal. (2006). A community coalition
board creates a set of values for community-based research. _Preventing
Chronic Disease_, 3(1), A16.
BACKGROUND: Researchers generally agree that communities should
participate in the community-based research process, but neither a
universally accepted approach to community participation nor a set of
guiding principles exists. CONTEXT: The Morehouse School of Medicine
Prevention Research Center was established in 1999 with the support of a
grant from the Centers for Disease Control and Prevention. Its partners
include a low-income, predominantly African American community, six
public agencies, and two other academic institutions. A Community
Coalition Board was established to represent the partners. The majority
of the board is community members; it serves in a governance rather than
an advisory capacity, with the community acting as the senior partner in
interactions with the medical school, the agencies, and other academic
institutions. METHODS: The Community Coalition Board developed a set of
research priorities and a set of 10 community values, or principles, to
guide research. A board committee reviews each protocol to ensure they
uphold the values. CONSEQUENCES: The Community Coalition Board has been
using the values since 1999, and in this article we describe its
experience. After an initial period that included some disagreements
between researchers and community members on the board, relationships
have been good, and protocols have been approved with only minor
changes. INTERPRETATION: Although the established community values
reflect universally acknowledged principles of research ethics, they
also address local concerns. An equal partnership between community
members and researchers is most beneficial if the partners can agree on
a set of values to govern research.
4. Casapia, M., S. A. Joseph, et al. (2007). Multidisciplinary and
participatory workshops with stakeholders in a community of extreme
poverty in the Peruvian Amazon: Development of priority concerns and
potential health, nutrition and education interventions. _International
Journal for Equity in Health_, 6(1), 6.
ABSTRACT: BACKGROUND: Communities of extreme poverty suffer
disproportionately from a wide range of adverse outcomes, but are often
neglected or underserved by organized services and research attention.
In order to target the first Millennium Development Goal of eradicating
extreme poverty, thereby reducing health inequalities, participatory
research in these communities is needed. Therefore, the purpose of this
study was to determine the priority problems and respective potential
cost-effective interventions in Belen, a community of extreme poverty in
the Peruvian Amazon, using a multidisciplinary and participatory focus.
METHODS: Two multidisciplinary and participatory workshops were
conducted with important stakeholders from government, non-government
and community organizations, national institutes and academic
institutions. In Workshop 1, participants prioritized the main health
and health-related problems in the community of Belen. Problem trees
were developed to show perceived causes and effects for the top five
problems. In Workshop 2, following presentations describing data from
recently completed field research in school and household populations of
Belen, participants listed potential interventions for the priority
problems, including associated barriers, enabling factors, costs and
benefits. RESULTS: The top ten priority problems in Belen were
identified as: 1) infant malnutrition; 2) adolescent pregnancy; 3)
diarrhoea; 4) anaemia; 5) parasites; 6) lack of basic sanitation; 7) low
level of education; 8) sexually transmitted diseases; 9) domestic
violence; and 10) delayed school entry. Causes and effects for the top
six problems, proposed interventions, and factors relating to the
implementation of interventions were multidisciplinary in nature and
included health, nutrition, education, social and environmental issues.
CONCLUSIONS: The two workshops provided valuable insight into the main
health and health-related problems facing the community of Belen. The
participatory focus of the workshops ensured the active involvement of
important stakeholders from Belen. Based on the results of the
workshops, effective and essential interventions are now being planned
which will contribute to reducing health inequalities in the community.
5. Cash, R. A. and R. A. Cash. (2006). What is owed to the community
before, during and following research: an ethical dialogue. _Eastern
Mediterranean Health Journal_, 12 Suppl 1, S37-41.
The paper briefly outlines some of the ethical issues involved in
community-based research particularly in developing countries. It
focuses on informed consent, confidentially and the obligations to the
community or its members who participate in the study. Most ethical
guidelines are focused on the individual participants. Yet increasingly
the community may be the unit of study. More attention will need to be
directed towards developing guidelines for community-based research.
6. Fielden, S. J., M. L. Rusch, et al. (2007). Key considerations for
logic model development in research partnerships: A Canadian case study.
_Evaluation and Program Planning_, 30(2), 115-124.
Community-academic partnership research is a fairly new genre of
community-based participatory research. It has arisen in part, from
recognition of the potential role of alliances in the development and
translation of applied knowledge and the elimination of health
disparities. This paper reports on the learning process of academic and
community members who worked together in developing a logic model for a
research program focusing on partnerships with vulnerable populations.
The Partners in Community Health Research is a 6-year training program
that seeks to combine research, training, and practice through the work
of its "learning clusters". As these types of partnerships proliferate,
the articulation and exploration of clear models will assist in their
implementation. The authors, coming from both academia and community
agencies, present a logic model meant to facilitate program management.
Key considerations in the model's development are discussed in the
context of an ongoing research partnership; namely, the complexity of
the research partnership, power and accountability, alignment with
health promotion policy, and the iterative nature of program design.
Recommendations challenge academics, policy-makers, service providers,
and community members to reflect on the elements needed to support and
manage research partnerships and the tools necessary to ensure continued
collaboration.
7. Gilbert, S. G. and S. G. Gilbert. (2006). Supplementing the
traditional institutional review board with an environmental health and
community review board. _Environmental Health Perspectives_, 114(10),
1626-9.
BACKGROUND: Community-based research often involves additional ethical,
legal, and social considerations beyond those of the specific
individuals involved in the study. The traditional institutional review
board (IRB) typically focuses on protecting the rights and ensuring the
safety of the individuals involved. For projects involving community
members, IRBs should be more sensitive to issues related to the broader
community concerns. OBJECTIVES: The objective of this article is to
discuss the concept of community-based participatory research and the
shortcomings of the traditional IRBs in dealing with ethical issues
associated with broader community concerns such as implications for
family members, neighborhood groups, and local businesses. I examine the
rationale and benefits for expanding the roles and responsibilities of
review boards related to community-based issues. DISCUSSION: I propose
the development of environmental health and community review boards
(EHCRBs) that combine the fundamental responsibilities and ethical
concept of the traditional review boards with an expanded ethical
construct of dignity, veracity, sustainability, and justice, with an
added emphasis on community. CONCLUSIONS: Only by acknowledging the
needs of and working with the community can we ensure ethically based
and socially responsible research. An EHCRB will allow researchers and
community members to more fully address their mutual interest in
conducting scientific, ethical, and socially responsible research.
8. Jackson, F. E., K. C. Chu, et al. (2006). Special Populations
Networks--how this innovative community-based initiative affected
minority and underserved research programs. _Cancer_, 107(8 Suppl),
1939-44.
The Special Populations Networks (SPN) Program was created to address
both community needs for cancer information and NCI's desire to obtain
community-based answers to research questions and promote training
opportunities for racial/ethnic minority and underserved researchers in
populations with an unequal burden of cancer. The SPN program included 3
components: 1) infrastructure and capacity building combined with cancer
awareness, 2) community-based research, and 3) community-centered
training. The 18 SPN grantees conducted more than 1000 cancer awareness
activities. More than 2000 community lay health workers were trained.
Communities formalized more than 300 partnerships with Memoranda of
Understanding (MOU). More than 255 pilot research project applications
were submitted by junior researchers and over 135 were funded.
Approximately 90% of the applications were submitted by minority junior
researchers; of which more than 100 were funded. More than 290
scientific publications thus far have resulted from the work of the
SPNs. In the first 3 years of the program, the SPNs also secured an
additional $20 million in outside funding. The SPN program effected a
paradigm shift for minority research programs by combining
community-based cancer awareness, research, and training into a single
program. By engaging research leaders of minority and underserved
populations to aid their own, train their own, and develop research to
help their own, the SPN program activated the power of their commitment
to their own. That commitment was reflected in the trust and
participation offered by their communities. Cancer 2006. (c) 2006
American Cancer Society.
9. Krishnan, S. and S. Krishnan. (2005). Dynamic relationships in
community-based research. _Indian Journal of Medical Ethics_, 2(1), 25.
10. Leadbeater, B., A. Marshall, et al. (2007). Building strengths
through practice-research-policy collaborations. _Child & Adolescent
Psychiatric Clinics of North America_, 16(2), 515-32.
Solving long-standing, sensitive social problems through
community-based, collaborative partnerships requires more than rushed
policies and program efforts that react to sudden crises. Efforts to
support resilient trajectories in children dealing with adversities like
peer victimization or adolescents' searching for engagements and
identities in communities struggling with a dramatic change in its
economic base requires a sustained and coordinated effort based on the
best knowledge that we have. But action must not only be knowledge
based, it must also be relevant, and the "buy-in" of or "pull from"
those who are affected by the action as recipients or as implementers
needs to be secured. Collaboration of policy makers, practitioners, and
researchers can advance this agenda. Involving decision-makers and
knowledge users in the formulation of knowledge has been highlighted as
the best predictor for the application of research knowledge.
Community-based research can ensure that research results are relevant
to a wider audience and thus hasten adoption beyond the immediate
communities.
11. Lopez, E. D., R. Lichtenstein, et al. (2006). Drawing From Freirian
Empowerment Methods to Develop and Use Innovative Learning Maps:
Increasing Enrollment of Uninsured Children on Detroit's Eastside.
_Health Promotion Practice_ 8(2), 181-191.
In 2001, virtually every child on Detroit's eastside was eligible for
health coverage, yet approximately 3,000 children remained uninsured.
The primary aim of the Eastside Access Partnership (EAP), a
community-based participatory research collaboration, was to increase
enrollment of uninsured children in state programs. To achieve this aim,
one of the approaches that EAP is using is the innovative Learning
Map((c)) titled Choosing the Healthy Path, which was developed in
collaboration with Root Learning, Inc. Although Learning Maps were
originally developed to assist corporations in implementing strategic
change, their integration of visualization and interactive dialogue
incorporates Freirian principles of empowerment education, making them a
viable option for providing meaningful learning opportunities for
community residents. This article presents the collaborative process
involving the University of Michigan, local community-based
organizations, community members, and Root Learning consultants to
develop a visual map that enables community residents to understand and
overcome the barriers that prevent them from obtaining health insurance
for their children.
12. Manderson, L., E. Hoban, et al. (2006). Cervical cancer services for
Indigenous women: advocacy, community-based research and policy change
in Australia. _Women & Health_, 43(4), 69-88.
Collaborative research undertaken in the state of Queensland, Australia,
resulted in major changes in cervical cancer screening and treatment for
Indigenous women. Guided by an Indigenous statewide reference group and
with an Indigenous researcher playing a lead role, qualitative data were
collected using interviews, focus groups, larger community meetings; and
case studies were conducted with health workers and community members
from diverse rural, remote and urban communities, to explore the
different cultural and structural factors affecting understanding and
awareness of cervical cancer and Indigenous women's use of and access to
health services for screening, diagnosis and treatment. These data were
supplemented by an analysis of clinical data and health service
checklists. We discuss the methodology and summarize the key social and
structural factors that discourage women from presenting for screening
or returning for follow-up. These include women's misunderstanding of
cervical cancer screening, fear of cancer, and distrust of health
services, poor recall and follow-up systems, and the economic and social
burden to women to presenting for treatment. We describe how the
research process and subsequent activities provided Indigenous women
with a vehicle for their own advocacy, resulting in important policy and
program changes.
13. Moreno-John, G., C. Fleming, et al. (2007). Mentoring in
community-based participatory research: the RCMAR experience. _Ethnicity
& Disease_, 17(1 Suppl 1), S33-43.
Community-based participatory research (CBPR) has been identified as a
useful strategy to overcome disparities in minority elders. However,
little consensus exists with respect to appropriate CBPR training and
mentoring mechanisms. In this paper, we summarize the mentoring
activities in each of the six currently funded Resource Centers on
Minority Aging Research (RCMAR). In addition to mentoring trainees
and/or junior faculty, we also explore the bi-directional mentoring that
occurs when faculty at academic health centers develop partnerships with
members of their target communities.
14. Noe, T. D., S. M. Manson, et al. (2007). The influence of
community-based participatory research principles on the likelihood of
participation in health research in American Indian communities.
_Ethnicity & Disease_, 17(1 Suppl 1), S6-14.
OBJECTIVES: Advocates of community-based participatory research (CBPR)
have emphasized the need for such efforts to be collaborative, and close
partnerships with the communities of interest are strongly recommended
in developing study designs. However, to date, no systematic, empiric
inquiry has been made into whether CBPR principles might influence an
individual's decision to participate in research. DESIGN, SETTING, AND
PARTICIPANTS: Using vignettes that described various types of research,
we surveyed 1066 American Indian students from three tribal
colleges/universities to ascertain the extent to which respondent age,
gender, education, cultural affiliation, tribal status, and prior
experience with research may interact with the implementation of
critical CBPR principles to increase or decrease the likelihood of
participating in health research. RESULTS: Many factors significantly
increased odds of participation and included the study's being conducted
by a tribal college/university or national organization, involving the
community in study development, an American Indian's leading the study,
addressing serious health problems of concern to the community, bringing
money into the community, providing new treatments or services,
compensation, anonymity, and using the information to answer new
questions. Decreased odds of participation were related to possible
discrimination against one's family, tribe, or racial group; lack of
confidentiality; and possible physical harm. CONCLUSIONS: Employing CBPR
principles such as community involvement in all phases of the research,
considering the potential benefits of the research, building on
strengths and resources within the community and considering how results
will be used is essential to conceptualizing, designing, and
implementing successful health research in partnership with American
Indians.
15. Ompad, D. C., S. Galea, et al. (2007). Access to influenza vaccine
in East Harlem and the Bronx during a national vaccine shortage.
_Journal of Community Health_, 32(3), 195-202.
In October 2004, one of the major producers of the U.S. influenza
vaccine supply announced that their vaccine would not be available
because of production problems, resulting in approximately half of the
anticipated supply suddenly becoming unavailable. This study was part of
a larger effort using community-based participatory research (CBPR)
principles to distribute influenza vaccine to hard-to-reach populations.
Given the extant literature suggesting economic and racial disparities
in influenza vaccine access in times of adequate supply and our
inability to distribute vaccine due to the shortage, we sought to
examine vaccine access as well as awareness of the vaccine shortage and
its impact on health-seeking behaviors in eight racially-diverse and
economically-disadvantaged neighborhoods in New York City (NYC) during
the shortage. In our study few people had been vaccinated, both among
the general community and among high risk groups; vaccination rates for
adults in priority groups and non-priority groups were 21.0% and 3.5%.
Awareness of the 2004 vaccine shortage was widespread with over 90%
being aware of the shortage. While most attributed the shortage to
production problems, almost 20% said that it was due to the government
not wanting to make the vaccine available. Many respondents said they
would be more likely to seek vaccination during the current and
subsequent influenza seasons because of the shortage. The target
neighborhoods were significantly affected by the national influenza
vaccine shortage. This study highlights the challenges of meeting the
preventive health care needs of hard-to-reach populations in times of
public health crisis.
16. Pereira Lima, V. L., J. M. Arruda, et al. (2007). Analyzing the
outcomes of health promotion practices. _Promotion & Education_, Suppl
1, 21-6.
This article focuses on health promotion (HP) outcomes, illustrated
through evaluation of case studies and identification of strategies
which have contributed to their success and sustainability. Evaluation
research and practice in three distinct sceneries are discussed: (i)
institutional and governmental agencies; (ii) communities in the
"Manguinhos Complex" and Nova Iguaqu Municipality, and (iii) building of
potentially healthy municipality networks. The effectiveness of a social
program in a health promotion perspective was based in the "School for
Parents" program, undertaken by the First Court of Childhood and Youth
of Rio de Janeiro, between 2001 and 2004. The analysis was grounded in
the monitoring of 48 parents in charge of children under 18, who were
victims of abuse, violence or negligence, and social exclusion, most of
all. The study's objectives were: illustrating the evidence of
effectiveness of health promotion, discussing the concept of HP
effectiveness under macro unfavorable conditions, and identifying
strategies that foster sustainability of results. Institutional
resources included a multi-professional staff, multidisciplinary
approaches, participatory workshops, family case management, partnership
with public and private institutions, and volunteer and civil society
sponsorship of the families. Evaluation was based on social impact
indicators, and psychosocial and contextual determinants. Evaluation
methods included program monitoring and quantitative-qualitative
methods, through a longitudinal evaluation of 3 years, including one
year post program. The evaluation showed highly favorable results
concerning "family integration', "quality of family relations" and
"human rights mobilization". Unsatisfactory results such as "lack of
access to formal employment" are likely related to structural factors
and the need for new public policies in areas such as education,
professional training, housing, and access to formal employment. The
training process of social actors in environmental management and
housing, supported by the Public Health Technology Development Project
of the Oswaldo Cruz Foundation, was employed as a tool of environmental
education and healthy housing. The purpose of this study was to
construct an integrated and participatory model of environment
management. The methodology included training, research and evaluation
of participants, from 21 to 50 years of age, who participated in
building Thematic Learning Books and Community Guides about water
quality monitoring. Participants'evaluations emphasized the training
process, encouraging them to become multiplier agents of environmental
education in their communities and to continue learning how to bring
together sectors for problems solving. The Potentially Healthy
Districts' Network (RMPS) aimed at increasing knowledge and building
capacity to develop actions which originate from each of the local
units, based on their characteristics and practices. Developed by the
Preventive and Social Department of Campinas State University with
PAHO/WHO and the Society Special Research Institute (IPES), RMPS's
mission was to cooperate in the construction of healthy public policies
in a participatory and articulated way through different municipal
representatives. The network offered tools to municipal administrations
to develop integrated projects that brought together government,
managers, technicians, academy and organizations for the construction of
public policies aimed at health promotion and quality of life. The
methodology is based in the construction of knowledge and action
networks by social actors, stimulating trans-sectorial and
inter-district actions. The outcome evaluation is based on case studies,
focus groups, oral stories, documents and image analyses.
17. Ramaswami, A., J. B. Zimmerman, et al. (2007). Integrating developed
and developing world knowledge into global discussions and strategies
for sustainability. 2. Economics and governance. _Environmental Science
& Technology_, 41(10), 3422-30.
Knowledge transfer from the developing to the developed world is
described in the domain of economics and governance for sustainable
development. Three system areas are explored: the structure of commons
governance institutions, the process of community-based participatory
action research, and the role of microfinance and microenterprise for
the development, adoption, and diffusion of sustainable technologies.
Case studies from both the developed and developing world demonstrate
the effectiveness of social networks and community cooperative
strategies in a wide range of sectors. Developing world experiences are
shown to be particularly rich in the application of local knowledge and
social capital toward sustainable development.
18. Spiegel, J., M. Garcia, et al. (2006). Learning together: a
Canada-Cuba research collaboration to improve the sustainable management
of environmental health risks. _Canadian Journal of Public Health, Revue
Canadienne de Sante Publique_, 97(1), 50-5.
OBJECTIVE: To build a national Cuban capacity for training environmental
health professionals directly linked to the needs of policy-makers and
communities. PARTICIPANTS: The University of Manitoba and University of
British Columbia collaborated with an established training centre in
Cuba (the Instituto Nacional de Higiene y Epidemiologia--INHEM) and new
centres in the Central (Santa Clara) and Eastern (Santiago) regions of
the country. SETTING: Cuba. INTERVENTION: In the mid-1990s, a
comprehensive curriculum (masters and diploma programs) was
collaboratively developed, applying interactive teaching methods, and
was delivered through a series of workshops and other interactions in
Cuba, and short-term visits to Canada by Cuban PhD students. OUTCOMES:
The collaboration was successful in fulfilling capacity-building targets
(over 50 Masters graduates, 467 Diploma graduates, over 30 trained core
faculty in all regional centres as well as new curriculum and new
accredited regional programs). Alongside this, a number of collaborative
community-based research projects were undertaken in all three regions
(drinking water in Santiago; housing and urban renewal, and dengue
control in Havana; and tourism-related effects, and effective
intersectoral management of population health determinants in Santa
Clara). CONCLUSION: The collaboration led to adopting new strategies for
challenges such as a dengue epidemic in 2002, and new research on the
effectiveness of intersectoral management of risks of particular
interest to both Cuban and Canadian policy-makers. It triggered an
ambitious collaboration between the Canadian-Cuban team and colleagues
in Ecuador in order to build a similar national network there, built on
South-South and North-South links.
19. Stahl, S. M. and A. A. Hahn. (2007). The Resource Centers for
Minority Aging Research (RCMAR): Community/researcher interaction and
relationships. _Ethnicity & Disease_, 17(1 Suppl 1), S1-2.
For more than a decade, the National Institute on Aging (NIA) has led a
program called the Resource Centers for Minority Aging Research (RCMAR).
One of the four key components of the RCMARs is a Community Liaison Core
whose objectives are to conduct research on recruiting community members
for scientific studies and to facilitate working relationships with host
communities. The articles in this supplement represent some of the
scientific knowledge available on community-based participatory research
(CBPR) at the RCMARs. The hope is that this supplement will motivate
others involved in CBPR to more fully engage in the conduct of science
related to relationships that mutually benefit communities and
researchers.
20. Willison, K. D. (2006). Promoting Self-Care and Chronic Disease
Management through Community Based Research. _Ontario Health Promotion
E-Bulletin (OHPE)_.
Full text available online:
http://www.ohpe.ca/index.php?option=com_content&task=view&id=7747&Itemid=78
21. Willison, K. D. (2007). Assessing chronic disease management
strategies through community based participatory research. _Journal of
Chinese Clinical Medicine_, 2(6), 336-340.
Comprehensive chronic disease management (CDM) strategies aim to improve
such aspects as continuity of care, health-related quality of life and,
overall population health. Here, consideration is made of how CDM may be
enhanced through a more integrated and holistic health care system by
incorporating a community based participatory research (CBPR) approach.
This has the potential to provide meaningful participation by citizens
in public health policy development. That CBPR may garner improved
assessment of the effectiveness of existing CDM strategies, as imbedded
in such practices as (regulated) complementary/alternative medicine
(CAM), public health, and transcultural health care initiatives, should
not be overlooked.
Full text available online:
http://www.cjmed.net/upload/pdf/200707041726074303.pdf
Helena Hilario
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