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ICR Abstracts: 6.2  Helena
 Feb 21, 2008 09:32 PST 


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 (6.2: February 21, 2008)

1. Anderson, A. B. and C. Spence. (2008). Social Indicators in Surveys
of Urban Aboriginal Residents in Saskatoon. _Social Indicators
Research_, 85(1), 39-52.

The Bridges and Foundations Project on Urban Aboriginal Housing, a
Community University Research Alliance (CURA) project financed primarily
by the Social Sciences and Humanities Research Council of Canada (SSHRC)
and the Canada Mortgage and Housing Corporation (CMHC), has been
operational in Saskatoon since early 2001. During these past 5 years
over 50 specific research projects, community surveys, graduate theses,
workshops, conferences, seminars and other meetings have been conducted
under the auspices of the Bridges and Foundations Project as a whole.
This paper first discusses the various social indicators employed in
seven surveys, which probed deeply into the views of local Aboriginal
residents of their quality of life, particularly their living conditions
and affordable housing. The paper focuses less on the vast amount of
data gathered from some 2,000 residents than on the relevance of social
indicators used in these surveys, for example which were most or least
informative, and which were of most or least interest and pertinence to
the residents themselves. In the process it would seem pertinent to
discern which of various research approaches seemed, in retrospect, to
have been most appropriate, informative and beneficial. The paper then
proceeds to place our experience in the Bridges and Foundations Project
within a broader theoretical discussion of social indicator development;
and concludes with a brief commentary on the linkages between theory and
research and between academic and community-based research.

2. Brody, J. G., R. Morello-Frosch, et al. (2007). "Is it safe?": New
ethics for reporting personal exposures to environmental chemicals.
_American Journal of Public Health_, 97(9), 1547-1554.

The recent flood of research concerning pollutants in personal
environmental and biological samples--blood, urine, breastmilk,
household dust and air, umbilical cord blood, and other media--raises
questions about whether and how to report results to individual study
participants. Clinical medicine provides an expert-driven framework,
whereas community-based participatory research emphasizes participants'
right to know and the potential to inform action even when health
effects are uncertain. Activist efforts offer other models. We consider
ethical issues involved in the decision to report individual results in
exposure studies and what information should be included. Our discussion
is informed by our experience with 120 women in a study of 89 pollutants
in homes and by interviews with other researchers and institutional
review board staff

3. Caine, K. J., M. J. Salomons, et al. (2007). Partnerships for social
change in the Canadian North: Revisiting the insider-outsider dialectic.
_Development and Change_, 38(3), 447-471.

In the two decades since Alexander Lockhart's seminal article on the
insider-outsider dialectic in native socioeconomic development, a great
deal of change has occurred in the Canadian North and new challenges
have emerged for community-based participatory research and development.
This is particularly the case in the Northwest Territories, where
Aboriginal communities are facing for the first time the triple
challenges of Aboriginal land claims implementation, Aboriginal
self-government, and a boom in mining and petroleum development.
Increasingly, participatory methods in research and community
development are being co-opted to serve state or corporate interests,
far from their radical origins in movements for social change. A
historical analysis is called for that accounts for the contradictory
and contested social contexts in which participatory activities are
imbedded. This article suggests that a return to the roots of the
participatory method requires the creation of a new autonomous space of
resistance. The academic outsider is uniquely positioned to facilitate
critical interventions in both community and university contexts. The
resulting convergence of critical outsider and insider has great
potential in the forging of new knowledge that can contribute to
self-determination beyond the bounds of the state.

4. Campbell, M. K., M. A. Hudson, et al. (2007). Church-based health
promotion interventions: Evidence and lessons learned. _Annual Review of
Public Health_ 28, 213-234.

Church-based health promotion (CBHP) interventions can reach broad
populations and have great potential for reducing health disparities.
From a socioecological perspective, churches and other religious
organizations can influence members' behaviors at multiple levels of
change. Formative research is essential to determine appropriate
strategies and messages for diverse groups and denominations. A
collaborative partnership approach utilizing principles of
community-based participatory research, and involving churches in
program design and delivery, is essential for recruitment,
participation, and sustainability. For African Americans, health
interventions that incorporate spiritual and cultural contextualization
have been effective. Evidence indicates that CBHP programs have produced
significant impacts on a variety of health behaviors. Key elements of
CBHP are described with illustrations from the authors' research
projects.

5. Curd, P. R., S. J. Winter, et al. (2007). Participative planning to
enhance inmate wellness: Preliminary report of a correctional wellness
program. _Journal of Correctional Health Care_, 13(4), 296-308.

This report describes the implementation of a comprehensive wellness
intervention in a corrections-based substance abuse program. The
wellness program was modeled after successful work site wellness
initiatives. The PRECEDE-PROCEED (Predisposing, Reinforcing, and
Enabling Constructs in Educational/Environmental Diagnosis and
Evaluation--Policy, Regulatory, and Organizational Constructs in
Educational and Environmental Development) planning model and the
Community-Based Participatory Research model were used to facilitate a
participative process engaging both corrections administrators and
residents of the therapeutic community. A community representative
wellness committee developed and implemented an evidence-based strategic
plan with short- and long-term goals supported by numerous health
promotion activities. Data collection tools were used to evaluate the
implementation and impact of the wellness intervention. Observations on
the reasons for the program's success and barriers to overcome are
detailed.

6. Dohan, D., M. Levintova, et al. (2007). Barriers beyond words:
cancer, culture, and translation in a community of Russian speakers.
_Journal of General Internal Medicine_, 22 (Suppl 2), 300-305.

BACKGROUND: Language and culture relate in complex ways. Addressing this
complexity in the context of language translation is a challenge when
caring for patients with limited English proficiency (LEP). OBJECTIVE:
To examine processes of care related to language, culture and
translation in an LEP population is the objective of this study. DESIGN:
We used community based participatory research to examine the
experiences of Russian-speaking cancer patients in San Francisco,
California. A Russian Cancer Information Taskforce (RCIT), including
community-based organizations, local government, and clinics,
participated in all phases of the study. PARTICIPANTS: A purposeful
sample of 74 individuals were the participants of the study. APPROACH:
The RCIT shaped research themes and facilitated access to participants.
Methods were focus groups, individual interviews, and participant
observation. RCIT reviewed data and provided guidance in interpreting
results. RESULTS: Four themes emerged. (1) Local Russian-language
resources were seen as inadequate and relatively unavailable compared to
other non-English languages; (2) a taboo about the word "cancer" led to
language "games" surrounding disclosure; (3) this taboo, and other
dynamics of care, reflected expectations that Russian speakers derived
from experiences in their countries of origin; (4) using interpreters as
cultural brokers or establishing support groups for Russian speakers
could help address barriers. CONCLUSIONS: The language barriers
experienced by this LEP population reflect cultural and linguistic
issues. Providers should consider partnering with trained interpreters
to address the intertwining of language and culture.

7. Erinosho, T. and L. B. Dixon. (2007). Involvement of Nutrition and
Dietetic Students in a Community-Based Research Project. _Topics in
Clinical Nutrition_, 22(4), 367-377.

The article describes the participation of ten nutrition and dietetics
students in a community-based research project on childhood obesity at
New York daycare centers in 2006. Statistics show that 44% of these
children are overweight, while one third of all U.S. children are prone
to obesity. Research proves that eating fresh fruits and vegetables is
recommended to reduce the risk of obesity. The outcome of the research
project gave opportunity to community centers to advocate public
well-being and also help students gain knowledge in research.


8. George, M. A., P. Masotti, et al. (2006). Bridging the research gap:
aboriginal and academic collaboration in FASD prevention. The Healthy
Communities, Mothers and Children Project. _Alaska Medicine_, 49(2
Suppl), 139-41.

OBJECTIVES: The objective was to assist with the prevention of Fetal
Alcohol Spectrum Disorder through a participatory research approach
involving local women and health care workers. Our interest was in
understanding how well communities could develop culturally appropriate
methods of helping women to reduce their alcohol consumption during
pregnancy. STUDY DESIGN: Four geographically distant Aboriginal
communities were presented with a task of adapting a standard Brief
Alcohol Intervention, and in particular to develop a culturally
appropriate means of using the Intervention with women in the community.
METHODS: Academic and Aboriginal community researchers worked together
in partnership, using a participatory action research approach to
address alcohol use during pregnancy. RESULTS: The outcome of the
project was the design of four differing models of culturally
appropriate community interventions designed to support vulnerable women
in their childbearing years. The intervention models developed by the
four communities have five core characteristics: (1) identification of
women at risk; (2) assessment of the woman's drinking/ drug use; (3)
provision of information to the women; (4) delivery method facilitates
the decision to adopt healthier behaviors; and (5) means to monitor
changes. CONCLUSION: This project was considered successful in many
respects: (1) each community developed a culturally-relevant prevention
tool; (2) community involvement in the design lead to better
understanding of its usefulness; (3) considerable knowledge exchange
between academic and community partners took place; and (4) most
importantly, it was found that community members can be active members
in developing and implementing solutions to important public health
issues.

9. Jacobson, M. and C. Rugeley. (2007). Community-based participatory
research: Group work for social justice and community change. _Social
Work with Groups_, 30(4), 21-39.

Social workers today confront complex practice challenges as corporate
interests trump human need in a rapidly globalizing world economy. One
way to meet these challenges is through a social justice-oriented
approach to practice that recognizes the dynamic interplay of group
work, research, and community change. This article conceptualizes
community-based participatory research (CBPR) as social justice-oriented
group work and uses a case example to illustrate practice principles
that inform group work knowledge and skills and contribute to the
effectiveness of CBPR. Expanding the possibilities for social group work
thought and practice are discussed.

10. Liebman, A. K., P. M. Juarez, et al. (2007). A pilot program using
promotoras de salud to educate farmworker families about the risk from
pesticide exposure. _Journal of Agromedicine_, 12(2), 33-43.

This paper reviews a successful community-based education effort to
minimize pesticide exposure to migrant and seasonal farmworkers and
their families through innovative training curricula, informal
participatory educational techniques and culturally sensitive outreach
methods. In 2004, Migrant Clinicians Network, Inc., trained lay health
educators, or promotoras de salud, from local agencies in southern New
Mexico in pesticide safety and in ways to successfully promote safety
information in the farmworker community. Through home visits and small
group workshops, the promotoras trained 273 farmworkers and farmworker
family members on ways to reduce exposures to pesticides in their homes
and at work, with an emphasis on protecting children. The families
received a Spanish language comic book that reinforced the pesticide
safety information, emphasizing the health effects of acute and chronic
pesticide exposure and steps to protect farmworker children from
pesticide exposure. The project resulted in a significant increase in
knowledge regarding the routes of exposure, the vulnerability of
children, the signs and symptoms of pesticide poisonings and the ways to
minimize pesticide exposures. Additionally, the project showed improved
behaviors aimed at minimizing pesticide exposure through accidental
poisonings in the home. This pilot project proved the efficacy of an
in-home, one-on-one approach with a culturally appropriate educational
comic book as an instrument to help transfer education to the community.
Moreover, the educational method involving promotoras offers a
training-of- trainer approach that is easy to implement and potentially
replicate.

11. Macaulay, A. C. (2007). Promoting participatory research by family
physicians. _Annals of Family Medicine_, 5(6), 557-60.

In the past, researchers have inadvertently caused stigmatization of
various populations, first by not involving community members and then
through publishing negative findings. In contrast, participatory
research, which is based on a partnership between researchers and those
affected by the issue being studied, promotes the voice of those being
researched. This essay highlights key principles, processes,
complexities, and challenges of participatory research and outlines when
participatory research is not appropriate. It also reflects on the
training and skills of family physicians that make them especially
suited to participatory research. Family physicians have established
clinical partnerships with their patients and sometimes entire
communities, are trained in patient-centered care-a good basis for
community centered research-and are accustomed to working with
uncertainty. In addition, they are frequently pragmatic, interested in
questions arising from their patients and communities, and likely to
respond well to community requests. The main challenges to participatory
research are lack of funding, expertise, and time, which may improve as
more funding agencies and universities support this approach to
research.
Full text available online:
http://www.annfammed.org/cgi/content/full/5/6/557

12. Mohatt, G. V., S. M. Rasmus, et al. (2008). Risk, resilience, and
natural recovery: a model of recovery from alcohol abuse for Alaska
Natives. _Addiction_, 103(2), 205-215.

Aim The People Awakening (PA) study explored an Alaska Native (AN)
understanding of the recovery process from alcohol abuse and consequent
sobriety. Design PA utilized a cross-sectional, qualitative research
design and community-based participatory research methods. Setting and
participants The study included a state-wide convenience sample of 57
participants representing all five major AN groups: Aleut/Alutiiq,
Athabascan, Inupiaq, Yup'ik/Cup'ik and Tlingit/Haida/Tsimshian.
Participants were nominated and self-identified as being
alcohol-abstinent at least five years following a period of problem
drinking. Measurements Open-ended and semistructured interviews gathered
extensive personal life histories. A team of university and community
co-researchers analyzed narratives using grounded theory and consensual
data analysis techniques. Findings A heuristic model of AN recovery
derived from our participants' experiences describes recovery as a
development process understood through five interrelated sequences: (i)
the person entered into a reflective process of continually thinking
over the consequences of his/her alcohol abuse; (ii) that led to periods
of experimenting with sobriety, typically, but not always, followed by
repeated cycling through return to drinking, thinking it over, and
experimenting with sobriety; culminating in (iii) a turning point,
marked by the final decision to become sober. Subsequently, participants
engaged in (iv) Stage 1 sobriety, active coping with craving and urges
to drink followed for some participants, but not all, by (v) Stage 2
sobriety, moving beyond coping to what one participant characterized as
‘living life as it was meant to be lived. Conclusions The PA heuristic
model points to important cultural elements in AN conceptualizations of
recovery.

13. Overstreet, K. M., D. E. Moore Jr, et al. (2007). Addressing
disparities in diagnosing and treating depression: A promising role for
continuing medical education. _Journal of Continuing Education in the
Health Professions_, 27, 5-8.

Depression is a very common reason that individuals seek treatment in
the primary care setting. However, advances in depression management are
often not integrated into care for ethnic and racial minorities. This
supplement summarizes evidence in six key areas current practices in
diagnosis and treatment, disparities, treatment in managed care
settings, quality improvement, physician learning, and community-based
participatory research used to develop an intervention concept described
in the concluding article. Evidence of gaps in the care for minorities,
while discouraging, presents unique opportunities for medical educators
to develop interventions with the potential to change physician behavior
and thereby reduce disparities and enhance patient outcomes.

14. Paschal, A. M., S. R. Hawley, et al. (2007). Epilepsy patients'
perceptions about stigma, education, and awareness: Preliminary
responses based on a community participatory approach. _Epilepsy &
Behavior_, 11(3), 329-337.

As individuals directly impacted by their experience of epilepsy and
others' responses to it, epilepsy patients' opinions about education and
awareness issues are needed. A community-based participatory approach
was used to develop a survey of public and patient attitudes and
perceptions about epilepsy, which was administered to persons with
epilepsy. The majority of the 165 respondents (34% response rate)
indicated they perceive misperceptions and stigma related to epilepsy in
the general public, which they thought could be ameliorated through
educational interventions. Respondents indicated potential avenues of
educational intervention for the general public as well as for those
with epilepsy, with recommended content and intervention type depending
on target audience. The community-based participatory research process
and the patients' perceptions gathered through the resulting survey
indicate potential activities for overcoming stigma and increasing
education and awareness related to epilepsy.

15. Patterson, D. (2008). Research Ethics Boards as Spaces of
Marginalization: A Canadian Story. _Qualitative Inquiry_, 14(1), 18-27.

This article complicates how Canadian universities are pressured to
capitalize on research and how these same pressures affect both the
collaborative and community-based research within the academy by
privileging one type of research and relationships within community over
others. Through examining historical influences on Research Ethics
Boards in Canada, ways these pressures shape qualitative research and
disturb how and what we know, as well as what can be known about who and
how we work move in and out of focus. Questions are raised about living
ethically as qualitative researchers within an institutional context.

16. Pazoki, R., I. Nabipour, et al. (2007). Effects of a community-based
healthy heart program on increasing healthy women's physical activity: a
randomized controlled trial guided by Community-based Participatory
Research (CBPR). _BMC Public Health_, 7, 216.

BACKGROUND: Cardiovascular disease remains the leading killer of women
in most developed areas of the world. Rates of physical inactivity and
poor nutrition, which are two of the most important modifiable risk
factors for cardiovascular disease in women, are substantial. This study
sought to examine the effectiveness of a community-based
lifestyle-modification program on increasing women's physical activity
in a randomized trial guided by community-based participatory research
(CBPR) methods. METHODS: A total of 335 healthy, 25-64 years old women
who had been selected by a multiple-stage stratified cluster random
sampling method in Bushehr Port/I.R. Iran, were randomized into control
and intervention groups. The intervention group completed an 8-week
lifestyle modification program for increasing their physical activity,
based on a revised form of Choose to Move program; an American Heart
Association Physical Activity Program for Women. Audio-taped activity
instructions with music and practical usage of the educational package
were given to the intervention group in weekly home-visits by 53
volunteers from local non-governmental and community-based
organizations. RESULTS: Among the participants, the percentage who
reported being active (at lease 30 minutes of moderate intensity
physical activity for at least 5 days a week, or at least 20 minutes of
vigorous physical activity for at least three days a week) increased
from 3% and 2.7% at baseline to 13.4% and 3% (p < 0.0001) at the ending
of the program in the intervention and control groups, respectively. The
participants in the intervention group reported more minutes of physical
activity per week (mean = 139.81, SE = 23.35) than women in the control
group (mean = 40.14, SE = 12.65) at week 8 (p < 0.0001). The
intervention group subjects exhibited a significantly greater decrease
in systolic blood pressure (-10.0 mmHg) than the control group women
(+2.0. mmHg). The mean ranks for posttest healthy heart knowledge in the
intervention and control groups were 198.91 and 135.77, respectively (P
< 0.0001). CONCLUSION: An intervention based on CBPR methods can be
effective for the short-term adoption of physical activity behavior
among women. The development of participatory process to support the
adequate delivery of lifestyle-modification programs is feasible and an
effective healthcare delivery strategy for cardiovascular community
health promotion.

17. Stovall, D. (2007). Towards a politics of interruption: high school
design as politically relevant pedagogy. _International Journal of
Qualitative Studies in Education (QSE)_, 20(6), 681-691.

The following essay seeks to highlight the use of engaged qualitative
community-based research in education to respond to conditions of
structural inequality. As "the politics of interruption", the process of
creating neighborhood public high schools is centred in community
accountability. Responsibility in this mode "interrupts" the resurgence
of theories of social disorganization, social isolation, social
detachment, and culture of poverty used to stereotype working-class/low
income African American and Latino/a communities.

18. Tregaskis, S. (2007). Research for a New Age. _Human Ecology_,
35(2), 4-9.

The article reports that between 50 and 80 million Americans, as much as
25% of the U.S. population suffer from chronic pain, a condition that
disproportionately afflicts the elderly. Community-based participatory
research comes with a unique set of logistical challenges from
convincing community partners of the importance of randomized,
controlled experimental designs to managing the many relationships
necessary to complete a study. To lower the specific hurdles of
community-based research facing academics, Cornell Institute for
Translational Research on Aging supports a dynamic infrastructure to
ease researchers through the community-based participatory research
process, providing grants for pilot studies, mentorship of younger
researchers, and technical assistance.

19. Vasquez, V. B., D. Lanza, et al. (2007). Addressing food security
through public policy action in a community-based participatory research
partnership. _Health Promotion Practice_, 8(4), 342-9.

Community-based participatory research (CBPR) is an increasingly
utilized research approach that involves the affected community
identifying a health-related problem, developing a research agenda, and
planning an appropriate intervention to address the problem. This report
on a CBPR partnership in San Francisco's Bayview Hunters Point
neighborhood documents the rise of a community food security policy in
response to youth-involved research that found poor access to quality
food in an economically disadvantaged area of the city. To analyze the
impact of the research on public policy, a framework of specific steps
in the policy-making process is used to organize and better understand
the partnership's objectives, activities, strategies, and successes.
This community-health department partnership has been able to achieve an
innovative and sustainable public policy solution, the Good Neighbor
Program, by working closely with policy makers and local businesses to
expand community accessibility to healthy food.

20. Worthington, R. (2007). Community-based Research and Technoscience
Activism: A Report on the Living Knowledge 3 Conference. _Science as
Culture_, 16(4), 475-480.

The article explores community-based research (CBR) and technoscience
activism citing discussions at the Living Knowledge 3 Conference. The
conference entitled "Living Knowledge: The International Science Shop
Network," convened its third meeting from August 30 to September 1, 2007
in Paris, France. Discussions focused on developments in CBR and
strategies initiated to promote it.
	
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