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ICR Abstracts: 6.3
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Helena
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Mar 18, 2008 12:24 PST
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ICR Abstracts (6.3: March 18, 2008)
1. Allman, D., T. Myers, et al. (2007). Improving health and social care
relationships for harm reduction. _International Journal of Drug
Policy_, 18(3), 194-203.
This paper explores elements of the relationships that develop between
people who use illicit drugs and people who provide services to them. It
focuses on expectations people who use drugs and service providers have
of health and social care relationships for harm reduction, as well as
facilitators and barriers to effective and ineffective interactions, and
to what governments might better do to help strengthen interactions.
Prior to Canada's inaugural national harm reduction conference, informal
discussion groups were organized to source local views regarding policy
reform for harm reduction. One component of these discussion groups
focused upon improving health and social care relationships for harm
reduction. Community-based organizations providing services for harm
minimisation were consulted to help develop themes and questions.
Discussion groups conducted in French or English were held in 10 cities
across Canada. Groups were audio-recorded, transcribed and thematically
analysed. Disjuncture between understandings of the nature of health and
social care relationships for harm reduction were found. Interpersonal
and structural factors functioned both for and against the development
of effective interactions. Differences in expectation sets held by
illicit drug users and service providers may reflect the fluid
experience of boundaries as a population on society's margins moves
between harm-causing and harm-reducing behaviours and identities. The
research described in this paper targeted those most directly involved
in receiving, developing and delivering harm reduction programmes across
a very diverse nation. It did so by including representatives of those
most directly involved in utilizing and providing services within the
research process itself. By incorporating a process that was
community-based, user-driven, and which strived to be non-judgmental,
the research was able to explore suggestions for improving health and
social care relationships for harm reduction proffered by professionals
actively providing services, as well as a variety of users, including
some isolated or structurally excluded from service access by geography,
illiteracy and/or street-involvement.
2. Barata, P. C., E. Gucciardi, et al. (2006). Cross-cultural
perspectives on research participation and informed consent. _Social
Science & Medicine_, 62(2), 479-490.
This study examined Portuguese Canadian and Caribbean Canadian
immigrants' perceptions of health research and informed consent
procedures. Six focus groups (three in each cultural group) involving 42
participants and two individual interviews were conducted. The focus
groups began with a general question about health research. This was
followed by three short role-plays between the moderator and the
assistant. The role-plays involved a fictional health research study in
which a patient is approached for recruitment, is read a consent form,
and is asked to sign. The role-plays stopped at key moments at which
time focus group participants were asked questions about their
understanding and their perceptions. Focus group transcripts were coded
in QSR NUDIST software using open coding and then compared across
cultural groups. Six overriding themes emerged: two were common in both
the Portuguese and Caribbean transcripts, one emphasized the importance
of trust and mistrust, and the other highlighted the need and desire for
more information about health research. However, these themes were
expressed somewhat differently in the two groups. In addition, there
were four overriding themes that were specific to only one cultural
group. In the Portuguese groups, there was an overwhelming positive
regard for the research process and an emphasis on verbal as opposed to
written information. The Caribbean participants qualified their
participation in research studies and repeatedly raised images of
invasive research.
3. Castleden, H., T. Garvin, et al. (2008). Modifying Photovoice for
community-based participatory Indigenous research. _Social Science &
Medicine_, 66(6), 1393-1405.
Scientific research occurs within a set of socio-political conditions,
and in Canada research involving Indigenous communities has a historical
association with colonialism. Consequently, Indigenous peoples have been
justifiably sceptical and reluctant to become the subjects of academic
research. Community-Based Participatory Research (CBPR) is an attempt to
develop culturally relevant research models that address issues of
injustice, inequality, and exploitation. The work reported here
evaluates the use of Photovoice, a CBPR method that uses
participant-employed photography and dialogue to create social change,
which was employed in a research partnership with a First Nation in
Western Canada. Content analysis of semi-structured interviews (n = 45)
evaluated participants' perspectives of the Photovoice process as part
of a larger study on health and environment issues. The analysis
revealed that Photovoice effectively balanced power, created a sense of
ownership, fostered trust, built capacity, and responded to cultural
preferences. The authors discuss the necessity of modifying Photovoice,
by building in an iterative process, as being key to the methodological
success of the project.
4. Dick, B. (2006). Action research literature 2004-2006: Themes and
trends. _Action Research_, 4(4), 439-458.
This review of recent action research books covers the period from about
mid-2004 to mid-2006, complementing an earlier review (Dick, 2004).
After noting some important recent additions to the action research
literature, I address the literature on several different applications
of action research including education, community, participatory
development, and organizations. There are briefer sections on other
topics. Action research journals and special issues of other journals
are also identified. Finally, I identify some themes and trends in the
action research literature.
5. Flaskerud, J. H. (2008). Who has the Right? And Who the
Responsibility? _Issues in Mental Health Nursing_ 29(1), 85 - 87.
The article reflects the author's perspective on community-based
participatory research (CBPR), a research approach that focuses on
inclusiveness. According to her, researchers are encouraged to conduct
CBPR with populations experiencing disparities in the prevention and
treatment of major diseases. She then draws several issues that may
arise in conducting CBPR. In addition, she attempts to explore on who
has the right and who has the responsibility, between the researcher and
participants who do not share race/ethnicity and culture, especially
when the research focus is on health disparities.
6. Flicker, S. (2006). Who Benefits From Community-Based Participatory
Research? A Case Study of the Positive Youth Project. _Health Education
& Behavior_, 35(1), 70-86.
Community-based participatory research (CBPR) has evolved as a popular
new paradigm in health research. This shift is exciting, yet there is
still much to discover about how various stakeholders are affected. This
article uses a critical social science perspective to explore who
benefits from these changes through an analysis of a CBPR case study
(The Positive Youth Project). Two major categories of beneficiaries
emerged: the research itself and the partner-stakeholders. The benefits,
however, were not gained without substantial human resource investment,
nor were they necessarily equitably spread. Participation costs included
heavy demands of time, an added burden of work, frustration with the
process, missing other opportunities, risking loss of anonymity, and
loss of control. Care needs to be taken to ensure that concrete benefits
accrue for all project partners and costs are minimized. Another way of
framing benefits is to look at the community capacities built to address
future health and social issues.
7. Grineski, S. E. (2006). Local Struggles for Environmental Justice:
Activating Knowledge for Change. _Journal of Poverty_, 10(3), 25-49.
Environmental knowledge and how it is acquired and deployed are
important features of local environmental politics in the US. This paper
is an ethnography of a community-based participatory research effort for
environmental justice in Phoenix, Arizona. Residents, professional
community activists, and university-based researchers worked together to
conduct a health and environmental concerns survey and monitor air
quality in a low-income Latino neighborhood. Analysis of this case
explores how neighborhood struggles for environmental justice can result
in socioenvironmental change through the activation of knowledge in
certain political-legal frames. The interpenetration of lay knowledge
and expert knowledge during community-based participatory research is
theorized to spur environmental justice action when enabled by
political-legal structures, and subvert the supposed binary between
science and advocacy. The role of the university in community-based
participatory research is also examined. Catalysis through involvement,
more so than research results, emerges as an important role for the
university in influencing environmental justice action. Adapted from the
source document.
8. Hatton, D. C., D. Kleffel, et al. (2006). Prisoners’ Perspectives of
Health Problems and Healthcare in a US Women’s Jail. _Women & Health_,
44(1), 119-136.
In the last decade, the number of women in US jails has increased at an
annual average of 7.0%. These women typically suffer from untreated,
serious health problems. This participatory research project explored
health problems and healthcare from the perspective of women
incarcerated in a county detention facility located in the western US. A
convenience sample of 78 inmates and former inmates participated in 10
focus groups. Using the constant comparative method, the data analysis
revealed that they suffered from physical, mental, and iatrogenic health
problems. Barriers to care included concerns about privacy and dignity
as well as waiting time for treatment, co-payments, and concealing
problems in order to obtain work opportunities. Women in the project
identified solutions for these problems and analyzed why incarceration
made them aware of previously ignored health concerns. The findings
suggest the importance of further research with this vulnerable, hidden
population.
9. Jakariya, M. and P. Bhattacharya. (2007). Use of GIS in local level
participatory planning for arsenic mitigation: a case study from Matlab
Upazila, Bangladesh. _Journal of Environmental Science and Health. Part
A,Toxic/hazardous Substances & Environmental Engineering_, 42(12),
1933-44.
A Participatory Geographical Information System (PGIS) has been
developed recently to design and adapt Geographic Information System
(GIS) that draws on the diversity of experiences associated with
"participatory development" and involves communities in the production
of GIS data and spatial decision-making tools. Participatory approach in
the development of GIS helps to develop local knowledge processes. This
knowledge process creates a channel of coordination between local people
and the experts. The paper deals with the possibility of using spatial
maps in consultation with local communities to develop an effective and
sustainable distribution planning to maximize as well as ensure safe
water coverage for the arsenic (As) exposed population in Matlab Upazila
in southeastern Bangladesh. Participatory Rural Appraisal (PRA) methods
along with GIS were used to obtain relevant information from the field.
Participants from different focus-groups were asked to determine their
"own priorities" for spatial planning of alternative As-safe drinking
water options. The study reveals that about 70% of the alternative safe
water options were distributed after consultation with people. These
distributed options were found to be superimposed within the existing
safe water buffer zones which otherwise could have been avoided and thus
increased the safe water coverage if the spatial maps were also
consulted before selection of final installation sites. The study based
on the community perspectives on demand-based safe water options thus
reveals the suitability of using PGIS techniques for rational
distribution of safe water options. The process of participatory mapping
within focus-groups further makes a platform to enhance information
about community needs of suitable safe water options in the study area.
10. Kegeles, S. M., M. O. Johnson, et al. (2006). How Should HIV Vaccine
Efficacy Trials be Conducted? Diverse U.S. Communities Speal Out. _AIDS
Education & Prevention_, 18(6), 560-572.
Developing an effective vaccine remains a critical long-term approach to
HIV prevention. Every efficacy trial should be responsive to the
concerns of participating communities because the successful development
of an HIV preventive vaccine will require long-term involvement of
people who have been marginalized and who distrust the government and
biomedical research. Using qualitative interviews and purposive
sampling, we elicited recommendations regarding how vaccine efficacy
trials should be conducted from 90 members of communities chat have been
disproportionately affected by HIV/AIDS: injection drug users, gay men,
and African Americans. The most common recommendation was for complete
disclosure of all aspects of the trial. Other themes included
participant and community education, who to include in trials,
preventing harm, trust, community involvement, researcher attributes,
and respect for participants. Developing positive, respectful and
collaborative experiences with community members will facilitate vaccine
research because negative experiences and unfavorable community
reactions can greatly impede success in future trials.
11. Mendel, P., L. S. Meredith, et al. (2008). Interventions in
organizational and community context: a framework for building evidence
on dissemination and implementation in health services research.
_Administration and Policy in Mental Health_, 35(1-2), 21-37.
The effective dissemination and implementation of evidence-based health
interventions within community settings is an important cornerstone to
expanding the availability of quality health and mental health services.
Yet it has proven a challenging task for both research and community
stakeholders. This paper presents the current framework developed by the
UCLA/RAND NIMH Center to address this research-to-practice gap by: (1)
providing a theoretically-grounded understanding of the multi-layered
nature of community and healthcare contexts and the mechanisms by which
new practices and programs diffuse within these settings; (2)
distinguishing among key components of the diffusion process-including
contextual factors, adoption, implementation, and sustainment of
interventions-showing how evaluation of each is necessary to explain the
course of dissemination and outcomes for individual and organizational
stakeholders; (3) facilitating the identification of new strategies for
adapting, disseminating, and implementing relatively complex,
evidence-based healthcare and improvement interventions, particularly
using a community-based, participatory approach; and (4) enhancing the
ability to meaningfully generalize findings across varied interventions
and settings to build an evidence base on successful dissemination and
implementation strategies.
12. Minkler, M., V. B. Vasquez, et al. (2008). Promoting Environmental
Justice Through Community-Based Participatory Research: The Role of
Community and Partnership Capacity. _Health Education & Behavior_,
35(1), 119-137.
Community-based participatory research (CBPR) increasingly is being used
to study and address environmental justice. This article presents the
results of a cross-site case study of four CBPR partnerships in the
United States that researched environmental health problems and worked
to educate legislators and promote relevant public policy. The authors
focus on community and partnership capacity within and across sites,
using as a theoretical framework Goodman and his colleagues' dimensions
of community capacity, as these were tailored to environmental health by
Freudenberg, and as further modified to include partnership capacity
within a systems perspective. The four CBPR partnerships examined were
situated in NewYork, California, Oklahoma, and North Carolina and were
part of a larger national study. Case study contexts and
characteristics, policy-related outcomes, and findings related to
community and partnership capacity are presented, with implications
drawn for other CBPR partnerships with a policy focus.
13. Ravesloot, C. H., T. Seekins, et al. (2007). Health promotion for
people with disabilities: development and evaluation of the Living Well
with a Disability program. _Health Education Research_, 22(4), 522-31.
People with disabilities can benefit from health promotion opportunities
to reduce the incidence and severity of secondary conditions that
further limit their participation in society. This paper describes
participatory action research (PAR) methods we used to develop,
implement and evaluate the Living Well with a Disability program.
Community-based agencies that provide information and referral services
to people with disabilities (independent living centers funded under
Title VII, Rehabilitation Act) recruited a convenience sample of 246
people with mobility impairments to participate in a randomly assigned,
wait-list control health promotion intervention study. Paper-and-pencil
outcome measures included the secondary conditions surveillance
instrument, unhealthy days and health care utilization. Logistic
regression on outcomes controlling for demographic variables and
pre-test measures indicated reductions in all three outcome variables.
People with mobility impairments who participated in the Living Well
with a Disability program reported less limitation from secondary
conditions, fewer unhealthy days and less health care utilization. PAR
methods are particularly important to design useful interventions for
this population.
14. Salmon, A. (2007). Walking the Talk: How Participatory Interview
Methods Can Democratize Research. _Qualitative Health Research_, 17(7),
982-993.
In this article, the author explores the importance of participatory,
respectful, and community-specific approaches to research relationships
across differences in social location and experience. Drawing on
transcripts from group interviews with 6 young Aboriginal mothers from
Vancouver's Downtown Eastside who had experienced substance use during
pregnancy and fetal alcohol syndrome/fetal alcohol effects, she
discusses three practical strategies used in her doctoral research to
address the empirical and methodological implications of this work: the
provision of honoraria, collaborating with community leaders in
participant recruitment, and the use of shared analysis in group
interviews. Shared analysis in the group interviews was integral to
supporting policy analysis that challenges the privatization of
mothering and substance use. Group interviews can benefit both the
participants and the research, support womens' agency, and democratize
the research process while mitigating the potential for the
misrepresentation and appropriation of women's experiences.
15. Scharff, D. P. and K. Mathews. (2008). Working With Communities to
Translate Research Into Practice. _Journal of Public Health Management &
Practice_ 14(2), 94-98.
16. Shannon, K., T. Kerr, et al. (2008). Social and structural violence
and power relations in mitigating HIV risk of drug-using women in
survival sex work. _Social Science & Medicine_, 66(4), 911-921.
High rates of violence among street-level sex workers have been
described across the globe, while in cities across Canada the
disappearance and victimization of drug-using women in survival sex work
is ongoing. Given the pervasive levels of violence faced by sex workers
over the last decades, and extensive harm reduction and HIV prevention
efforts operating in Vancouver, Canada, this research aimed to explore
the role of social and structural violence and power relations in
shaping the HIV risk environment and prevention practices of women in
survival sex work. Through a participatory-action research project, a
series of focus group discussions were conceptualized and co-facilitated
by sex workers, community and research partners with a total of 46 women
in early 2006. Based on thematic, content and theoretical analysis, the
following key factors were seen to both directly and indirectly mediate
women's agency and access to resources, and ability to practice HIV
prevention and harm reduction: at the micro-level, boyfriends as pimps
and the 'everyday violence' of bad dates; at the meso-level, a lack of
safe places to take dates, and adverse impacts of local policing; and at
the macro-level, dopesickness and the need to sell sex for drugs.
Analysis of the narratives and daily lived experiences of women sex
workers highlight the urgent need for a renewed HIV prevention strategy
that moves beyond a solely individual-level focus to structural and
environmental interventions, including legal reforms, that facilitate
'enabling environments' for HIV prevention.
17. Simon, C., M. Mosavel, et al. (2007). Ethical challenges in the
design and conduct of locally relevant international health research.
_Social Science & Medicine_, 64(9), 1960-1969.
In this paper, we consider some of the challenges associated with the
ethical need to conduct locally relevant international health research.
We examine a cervical cancer research initiative in a resource-poor
community in South Africa, and consider the extent to which this
research was relevant to the expressed needs and concerns of community
members. Results from informal discussions and a series of 27 focus
groups conducted in the community provide insight into the community's
needs and concerns, and its recommendations for how the research could
be made more relevant to the community. We discuss these findings in the
context of recent theory and literature on the role of community
engagement in promoting local relevance and responsiveness in
community-based health research. We anticipate that the paper's findings
may help international health researchers better identify and assess the
challenges of conducting locally relevant research across major global
gaps in wealth and health.
18. Tanjasiri, S. P., J. H. Tran, et al. (2007). Network Analysis of an
Organizational Collaboration for Pacific Islander Cancer Control
_Journal of Health Care for the Poor and Underserved_ 18(4), 184-196.
Community-based participatory research (CPBR) represents a growing
research approach for addressing health disparities disfavoring members
of racial/ethnic minorities and other underserved populations in the
U.S. While such endeavors are often guided by explicit principles
regarding the relationships between communities and universities, few
studies have reported on the development or strength of such
relationships. This paper describes the methods and preliminary results
of a cross-sectional analysis of the ties between community and
university organizations in a CBPR network to address cancer disparities
between Pacific Islanders in Southern California and the general
population. These analyses afford a means of representing the
collaborative relationships and may enhance tracking improvements in
CBPR links for cancer education, research, and training. Such tracking
will help concerned parties understand how academic and community groups
collaborate and coordinate their efforts to reach shared and overlapping
goals.
19. Wainberg, M. L., K. McKinnon, et al. (2007). A Model for Adapting
Evidence-based Behavioral Interventions to a New Culture: HIV Prevention
for Psychiatric Patients in Rio de Janeiro, Brazil. _AIDS & Behavior_,
11 (6), 872-883.
As in other countries worldwide, adults with severe mental illness in
Brazil have elevated rates of HIV infection relative to the general
population. However, no HIV prevention interventions have been tested
for efficacy with psychiatric patients in Brazil. We conducted
participatory research with local providers, community leaders, patient
advocates, and patients using an intervention adaptation process
designed to balance fidelity to efficacious interventions developed
elsewhere with fit to a new context and culture. Our process for
adapting these interventions comprised four steps: (1) optimizing
fidelity; (2) optimizing fit; (3) balancing fidelity and fit; and (4)
pilot testing and refining the intervention. This paper describes how
these steps were carried out to produce a Brazilian HIV prevention
intervention for people with severe mental illness. Our process may
serve as a model for adapting existing efficacious interventions to new
groups and cultures, whether at a local, national, or international
level.
20. Yeh, C. J., A. B. Kim, et al. (2008). Poverty, Loss, and Resilience:
The Story of Chinese Immigrant Youth. _Journal of Counseling
Psychology_, 55(1), 34-48.
A total of 10 focus groups were conducted with students, parents,
teachers, and school counseling and support personnel to investigate the
cultural adjustment process of Chinese immigrant youth using an
ecological framework. Multi-informant data were analyzed using the
grounded theory ( A. Strauss & J. M. Corbin, 1998) method. Findings
reveal 6 main themes: socioeconomic changes due to immigrant status;
English proficiency as a barrier to adjustment; changes in family
structure and dynamics, racism, and invisibility; challenges to social
support systems; and interdependent strategies for navigating in the
United States. Results highlight the dynamic interaction and tensions
created across themes and ecological contexts. The need for school- and
community-based counseling interventions that address Chinese immigrant
youths' losses and foster their resiliency and supportive networks are
discussed.
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