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ICR Abstracts: 6.5  Helena
 May 20, 2008 08:14 PDT 

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ICR Abstracts (6.5: May 20, 2008)

1. Aronson, R. E., A. B. Wallis, et al. (2007). Neighborhood Mapping and
Evaluation: A Methodology for Participatory Community Health
Initiatives. _Maternal & Child Health Journal_, 11 (4): 373-383 (4),

Objectives: This paper describes the use of neighborhood mapping as a
key element in an ecological study of a community-based urban infant
mortality prevention program. We propose the use of neighborhood mapping
in evaluation research to more fully examine the local context of
community health programs. Mapping can be used to study community change
and to describe community assets and structural, epidemiological, and
social features of neighborhoods that may influence program
implementation and outcomes. Methods: Data on physical features were
collected by community residents during street-by-street neighborhood
walkthroughs. Other data sources included program records, Census, birth
certificate, and state and city data. Analytic methods included
geo-coding, exploratory factor analysis to create spatial density
indicators of neighborhood features at the Census block group level, and
analysis of associations between neighborhood features and outcomes.
Results: Point and chloropleth maps provide a powerful illustration of
neighborhood features (e.g., vacant buildings), client distribution and
participation, health outcomes, and change over time. Factor analysis
indicated two salient clusters of non-residential land use: (1)
legitimate daily usage (liquor stores and other businesses) and (2)
non-legitimate daily use (houses of worship and vacant buildings). A
composite scale was created to indicate overall risk related to physical
neighborhood features. Conclusions: Neighborhood mapping is a powerful
tool that brings participants and residents into the research process.
Moreover, it can improve understanding of the role of neighborhood
ecology in program implementation and outcomes.

2. Artinian, N. T., R. B. Warnecke, et al. (2007). Advancing the science
of health disparities research. _Ethnicity & Disease_, 17(3), 427-33.

Research to eliminate health disparities in the United States is best
approached from the perspective of population health. The objectives of
this paper are to: (a) describe how ongoing research at the eight
national Centers for Population Health and Health Disparities (CPHHD) is
using a population health perspective and a community-based approach to
advance the field of health disparities research; and (b) to discuss
potential implications of such research for health policies that target
some of the determinants of population health.

3. Buchanan, D. R. (2008). Autonomy, Paternalism, and Justice: Ethical
Priorities in Public Health. _American Journal of Public Health_, 98(1),

With attention to the field of public health ethics growing, significant
time has been devoted to identifying a sound ethical justification for
paternalistic interventions that override individual autonomy to prevent
people from adopting unhealthy behaviors. Efforts focused on specifying
the conditions that warrant paternalism, however, are largely misplaced.
On empirical and ethical grounds, public health should seek instead to
expand individual autonomy to improve population health. To promote
autonomy, the field should redirect current efforts toward clarifying
principles of justice. Although public health's most highly visible
stance is associated with an egalitarian conception of "social justice,"
it is imperative that public health professionals address gaping
divisions in public understandings of justice. I present recommendations
for initiating this process.

4. Burgess, J. (2006). Participatory action research: First-person
perspectives of a graduate student. _Action Research_, 4(4), 419-437.

This article examines the tensions and challenges of a graduate student
maneuvering the institutional hierarchies in her journey of
participatory action research (PAR). By using a first-person action
research framework, the researcher moves back and forth exploring the
prose of others, and revealing her reflexive self-inquiry of underlying
assumptions and beliefs. Iterations of insider-outsider positionality,
drawing on and integrating paradigms, reconciling multiple roles and
perspectives, exploring the complexity of power relations, and
uncovering the promises and perils of PAR, moves the researcher toward a
partnership with her community of inquiry. First-person action research
unfolds a process of self-transformation.

5. Chigudu, H. (2007). Deepening our understanding of community-based
participatory research: lessons from work around reproductive rights in
Zimbabwe. _Gender & Development_, 15(2), 259 - 270.

The Community Working Group on Health (CWGH) is an organisation that
promotes community participation in health, especially in the area of
HIV and AIDS and reproductive health. During the course of its work, it
realised that there was a lack of community-generated information on
which to base its activities. CWGH therefore initiated community-based
participatory action research on various topics related to reproductive
rights. The research, which was conducted by young people in their
communities, provided a platform for provocative discussion in the
community and contributed to the promotion of a community-based agenda
for transformation in gender relations. The research provided an
opportunity for the communities to reclaim their political space,
stimulated exchange of information, and injected energy into the
communities lobbying initiatives.

6. Corburn, J. (2005). "Street Science: Community Knowledge and
Environmental Health Justice". Cambridge, MA: MIT Press.

When environmental health problems arise in a community, policymakers
must be able to reconcile the first-hand experience of local residents
with recommendations by scientists. In this highly original look at
environmental health policymaking, Jason Corburn shows the ways that
local knowledge can be combined with professional techniques to achieve
better solutions for environmental health problems. He traces the
efforts of a low-income community in Brooklyn to deal with health
problems in its midst and offers a framework for understanding "street
science" -- decision making that draws on community knowledge and
contributes to environmental justice.

Like many other low-income urban communities, the
Greenpoint/Williamsburg neighborhood of Brooklyn suffers more than its
share of environmental problems, with a concentration of polluting
facilities and elevated levels of localized air pollutants. Corburn
looks at four instances of street science in Greenpoint/Williamsburg,
where community members and professionals combined forces to address the
risks from subsistence fishing from the polluted East River, the asthma
epidemic in the Latino community, childhood lead poisoning, and local
sources of air pollution. These episodes highlight both the successes
and the limits of street science and demonstrate ways residents can
establish their own credibility when working with scientists. Street
science, Corburn argues, does not devalue science; it revalues other
kinds of information and democratizes the inquiry and decision-making

7. de Leeuw, E., A. McNess, et al. (2008). Theoretical reflections on
the nexus between research, policy and practice. _Critical Public
Health_, 18(1), 5 - 20.

The health field is being subjected to a dictate that policy, practice
and research should be informed by evidence. The mere generation of
evidence, however, does not mean that policy and practice will act upon
it. Utilisation and application of research findings (often equalled
with 'evidence') is a political process following rationalities that are
not necessarily similar to those of researchers. In response to this
issue that evidence does not naturally finds its way into policy and
practice (and back into research), the concept of 'knowledge translatio'
is becoming increasingly popular. In this article we demonstrate that
'translation' can have different meanings, and that current perspectives
(both Knowledge Translation and the Actor-Network Theory) do not reflect
appropriately on actions that can be taken at the nexus between
research, policy and practice in order to facilitate more integration.
We have developed seven conceptual categories suggesting different
action modalities. Actors and actants in this game should be aware of
the complex political nature of these modalities.

8. Flicker, S., B. Savan, et al. (2007). A snapshot of community-based
research in Canada: Who? What? Why? How? _Health Education Research_, 23
(1), 106-114.

Community-Based Research (CBR) is rapidly gaining recognitions as an
important tool in addressing complex environmental, health and social
problems. However, little is known about the Canadian CBR context. A
web-based survey including 25 questions was circulated on listservs and
via targeted e-mails to investigate the status of CBR in Canada.
Univariate and bivariate statistical analyses were performed to examine
variables and relationships of interest. Our sample included a
cross-section of CBR community and academic practitioners (n = 308).
Respondents reported a wide range of project foci, experience, operating
budgets and reasons for engaging in their last CBR endeavor. Academic
partners were perceived to be most involved at all stages of the
research process except dissemination. Service providers were also
perceived as being very involved in most stages of research. Community
members were substantially less engaged. High levels of satisfaction
were reported for both CBR processes and outcomes. Respondents reported
a number of positive outcomes as a result of their research endeavors,
including changes in both agency and government policies and programs.
Our study shows that CBR practitioners are engaged in research on a wide
array of Canadian health and social issues that is making a difference.
Finding appropriate levels of participation for community members in CBR
remains an ongoing challenge.

9. Hergenrather, K. C. and S. D. Rhodes (2008). _Community-based
participatory research: Applications for research in health and
disability_. "Focus on Disability: Trends in Research and Application".
T. Kroll. New York, Nova Science. 2: 59-87.

10. Horowitz, C. R., J. Z. Goldfinger, et al. (2008). A model for using
community-based participatory research to address the diabetes epidemic
in East Harlem. _The Mount Sinai Journal of Medicine_, 75(1), 13-21.

Objective: Diabetes prevalence and mortality are increasing, with
minority populations disproportionately affected. Despite evidence that
weight loss due to improved nutrition and increased physical activity
can prevent or control diabetes, there is often a disconnect between
this evidence and individuals' lifestyles. Methods: East Harlem is a
predominantly African-American and Latino neighborhood that has the
highest rates of diabetes prevalence and mortality in New York City. The
East Harlem Diabetes Center of Excellence is a community-centered
coalition. To help direct their work, the coalition used their
experiences, research, outreach, and literature review to build a
conceptual model describing how local factors affect health behaviors
and health outcomes such as obesity and diabetes. Results: This model
describes the relationship between the physical environment, the
social/medical environment and individual factors including demographic
data, food and exercise beliefs and behaviors, and health outcomes. The
coalition inserted local data from surveys and focus groups into the
model to identify targets for future interventions, research, and
activism. Conclusions: This type of collaboration and the model may be
useful tools to help communities identify and address the deficits that
prevent their residents from enjoying the health benefits of improved
nutrition and increased physical activity, and that also lead to racial
and ethnic disparities in health.

11. Johnson, J. L., J. Gryczynski, et al. (2007). HIV/AIDS, Substance
Abuse, and Hepatitis Prevention Needs of Native Americans Living in
Baltimore: In Their Own Words. _AIDS Education & Prevention_, 19(6),

This article prevents a needs assessment, which was conducted by the
Center of Substance Abuse Prevention to determine the health related
needs of Native Americans in Baltimore, Maryland. The assessment
evaluated Native Americans who may be living with HIV/AIDS, hepatitis,
or those who may be abusing substances. Focus groups and surveys were
used to produce a holistic assessment of health-risk situations, needs
and strengths. The research concludes that support is necessary to
develop a more effective help network.

12. Larson, C. O., D. Schlundt, et al. (2008). Validity of the SF-12 for
use in a low-income African American community-based research initiative
(REACH 2010). _Preventing Chronic Disease_, 5(2), A44.

INTRODUCTION: The objective of our study was to assess the psychometric
properties of the Medical Outcomes Study's 12-Item Short Form Survey
Instrument (SF-12) for use in a low-income African American community.
The SF-12, a commonly used functional health status assessment, was
developed based on responses of an ethnically homogeneous sample of
whites. Our assessment addressed the appropriateness of the instrument
for establishing baseline indicators for mental and physical health
status as part of Nashville, Tennessee's, Racial and Ethnic Approaches
to Community Health (REACH) 2010 initiative, a community-based
participatory research study. METHODS: A cross-sectional random
residential sample of 1721 African Americans responded to a telephone
survey that included the SF-12 survey items and other indicators of
mental and physical health status. The SF-12 was assessed by examining
item-level characteristics, estimates of scale reliability (internal
consistency), and construct validity. RESULTS: Construct validity
assessed by the method of extreme groups determined that SF-12 summary
scores varied for individuals who differed in self-reported medical
conditions. Convergent and discriminate validity assessed by multitrait
analysis yielded satisfactory coefficients. Concurrent validity was also
shown to be satisfactory, assessed by correlating SF-12 summary scores
with independent measures of physical and mental health status. 13.
CONCLUSION: The SF-12 appears to be a valid measure for assessing health
status of low-income African Americans.

13. Lindamer, L. A., B. D. Lebowitz, et al. (2008). Public-academic
partnerships: improving care for older persons with schizophrenia
through an academic-community partnership. _Psychiatric Services_,
59(3), 236-9.

Translating evidence-based mental health interventions designed in
research settings into community practice is a priority for multiple
stakeholders. Partnerships between academic and public institutions can
facilitate this translation. To improve care for middle-aged and older
adults with schizophrenia, the authors developed a collaboration between
a university research center and a public mental health service system
using principles from community-based participatory research and
cultural exchange theory. They describe the process that has led to a
number of mutually beneficial products. Despite the challenges involved,
building and maintaining academic-public collaborations will be
essential for improving mental health care for persons with

14. Mantoura, P., S. Gendron, et al. (2007). Participatory research in
public health: Creating innovative alliances for health. _Health &
Place_, 13(2), 440-51.

This article discusses alliances within local socio-sanitary space, one
in which community sector and health sector actors, public health
researchers and funding bodies meet. The discussion is based on the
study of a research space made up of representatives of actors found at
the local level. Both the minutes of the discussions of 12 meetings of
the research team, and the collaborative outputs produced throughout the
research initiative provide the empirical data for a qualitative
analysis. The findings reveal a research space concomitantly constituted
by aspects of "non-cooperative games" and of networks based on
innovation-fostering knowledge exchanges, which can be viewed, from the
perspective of a reflexive epistemology, as a tool for implementing
innovative alliances in local, health-promoting socio-sanitary space.

15. Mehra, B. and R. Srinivasan. (2007). The library-community
convergence framework for community action: Libraries as catalysts of
social change. _LIBRI_ 57(3), 123-139.

This paper presents a library-community convergence framework (LCCF) to
extend the role of all libraries to participate more fully in community
action and enhance their function as proactive catalysts of social
change, as compared to a sometimes perceived role of bystanders.
Although the paper highlights deliberations about the involvement of
public libraries in their local communities, and shares experiences of
community interactions between library and information professionals and
minority and underserved groups in American academic library settings,
yet the proposed framework of convergence between the library-community
and the methods/approaches of community action are applicable across a
variety of library contexts. The paper discusses select application of
the LCCF for community action in two qualitative research studies, with
local immigrant communities and sexual minorities, that use methods
pioneered in ethnographic outreach and participatory action research
(PAR) respectively. The results of these studies show that the LCCF is
applicable in the development of various forms of services in different
library environments. Ethnographic methods in the first study provide
understanding of cross-cultural issues and uncover how local immigrant
classifications can be induced from an ethnographic perspective to
generate library classifications and information services that are
locally relevant and participant-empowering.

PAR ideologies in the second study underlie implementation of library
and information interventions and community action while partnering with
local sexual minorities and their allies, to address specific and
contextualized community facets in ways that may promote community-wide
social changes. Points of intersection from the two studies help
identify key elements in the LCCF framework that can extend the role of
all kinds of libraries as leaders and cultural planners of progressive
community-based action.

16. Mendel, P., L. 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 and Mental Health Services
Research_, 35(1), 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.

17. Morsillo, J. and I. Prilleltensky. (2007). Social action with youth:
Interventions, evaluation, and psychopolitical validity. _Journal of
Community Psychology_, 35(6), 725-740.

We describe two interventions designed to encourage community action
with youth in a school and a community service setting. The school
intervention took place with a Year 10 class, while the community-based
intervention took place with a group of same-sex attracted youth. Using
a participatory action research framework, youth in both settings
devised a series of community projects to promote personal, group, and
community wellness. Projects included drama presentations addressing
homophobia, designing an aboriginal public garden, children's activities
in a cultural festival for refugees, a drug-free underage dance party, a
community theatre group, and a student battle of the bands. We evaluated
the various community projects using self-reports, videotapes, and
ethnographic data. While goals of personal and group wellness were
meaningfully met, wellness at the community level was harder to achieve.
Introducing a tool for the evaluation of psychopolitical validity, we
examined the degree of both epistemic and transformational validity
present in the interventions. Our assessment indicates that (a)
psychological changes are easier to achieve than political
transformations, (b) epistemic validity is easier to accomplish than
transformational validity, and (c) changes at the personal and group
levels are easier to achieve than changes at the community level.

18. Postma, J. (2008). Elucidating empowerment in El Proyecto Bienestar
(the Well-Being Project). _Journal of Advanced Nursing_, 62(4), 441-50.

AIM: This paper describes differences in how socioculturally diverse
participants in one community-based participatory research project
negotiated 'empowerment', and the implications of those differences for
nurses involved in farmworker health and safety efforts. BACKGROUND:
Internationally, empowerment and community participation are
increasingly being used as strategies to reduce health disparities.
Theories of empowerment vary in the academic literature and their
connotations vary across cultures. METHOD: Study participants were part
of El Proyecto Bienestar, a community-based participatory research
(CBPR) project whose aim was to identify and respond to occupational and
environmental health threats in one Mexican-American farmworker
community in the United States of America. Participant observation was
used to audiorecord 18 participants in the third year (2006) of this
4-year project discussing future project activities. Discourse analysis
was used to analyse the transcripts. RESULTS: While participants agreed
that 'empowerment' was central to the project, they had different
perspectives on what the term meant and the role that the project should
play in empowering the farmworker community. Empowerment discourses
positioned the project in three ways: (1) as an instrument used to
strengthen farmworkers' collective political voice, (2) as an instrument
used to represent multiple community interests and (3) as an instrument
used to advocate on behalf of farmworkers. Individuals used multiple
discourses signifying the complexity in participants' roles and
obligations. CONCLUSIONS: Balancing power and developing knowledge
collaboratively requires understanding multiple approaches to
empowerment. Community empowerment as an outcome should not come at the
expense of individual empowerment as part of the CBPR process.

19. Rhodes, S. D., K. C. Hergenrather, et al. (2007). Condom Acquisition
and Preferences within a Sample of Sexually Active Gay and Bisexual Men
in the Southern United States. _AIDS Patient Care & STDs_ 21(11),

Health departments, community-based organizations (CBOs), and AIDS
service organizations (ASOs) in the United States and abroad distribute
large quantities of free condoms to sexually active individuals;
however, little is known about where individuals who use condoms
actually acquire them. This community-based participatory research
(CBPR) study was designed to identify factors associated with the use of
free condoms during most recent anal intercourse among self-identifying
gay and bisexual men who reported condom use. Data were collected using
targeted intercept interviewing during North Carolina Pride Festival
events in Fall 2006, using the North Carolina Condom Acquisition and
Preferences Assessment (NC-CAPA). Of the 606 participants who completed
the assessment, 285 met the inclusion criteria. Mean age of participants
was 33 (+-10.8) years. The sample was predominantly white (80%), 50%
reported being single or not dating anyone special, and 38% reported the
use of free condoms during most recent anal intercourse. In
multivariable analysis, participants who reported using free condoms
during most recent anal sex were more likely to report increased age;
dating someone special or being partnered; and having multiple male
sexual partners in the past 3 months. These participants were less
likely to report ever having had a sexually transmitted disease. Despite
being in the third decade of the HIV epidemic, little is known about
condom acquisition among, and condom preferences of, gay and bisexual
men who use condoms. Although more research is needed, our findings
illustrate the importance of free condom distribution.

20. Savitz, L. A. (2007). Managing effective participatory research
partnerships. _Joint Commission Journal on Quality and Patient Safety_
33(12 Suppl), 7-15.

BACKGROUND: The purpose of the partnership science subcommittee's
collective discussions and reactions to tools and strategies was to
promote and support effective management of organizational-based,
participatory research (OBPR) partnerships. RESEARCH PARTNERSHIPS:
Research partnerships are broadly defined to include interorganizational
relationships where resources are shared to advance a collective
purpose-in this case, applied, participatory research. Several major
funding agencies have recognized their role in supporting research
partnerships and have used a "push" strategy via earmarked funds for
such activities. OPBR partnerships made possible through support can
engage multiple entities to enhance the generalizability and potential
for modeling and spread of findings. THE PARTNERSHIP STRENGTH SURVEY:
Effective management of the research partnership should stimulate
collaborative problem solving based on organizational priorities for
shared learning and spread of research results. Current surveys were
drawn on to create a participant survey for continuously improving and
monitoring partnership strength and synergy. IMPLICATIONS FOR PRACTICE:
The in-depth exploration of participatory research is intended to move
health system-based staff from a passive to an active role in the
research process and to encourage executives to support and encourage
research participation.

21. Spoth, R., M. Greenberg, et al. (2008). Preventive interventions
addressing underage drinking: state of the evidence and steps toward
public health impact. _Pediatrics_, 121 Suppl 4, S311-36.

The epidemiological features of underage drinking and evidence of its
social, health, and economic consequences suggest compelling reasons for
the development and dissemination of effective preventive interventions.
To clarify the nature and extent of the current evidence base on
preventive interventions addressing underage drinking, a review of the
literature was conducted through extensive searches of the research
literature on outcome evaluations, existing reviews of this body of
outcome research (N = 25), and summary reports of evidence on specific
interventions. More than 400 interventions were identified and screened,
and the evidence for 127 was reviewed. Criteria for the evaluation of
evidence were established for intervention studies with alcohol-specific
outcome measures for 3 developmental periods (< 10, 10-15, and 16 to >
or = 20 years of age). Ultimately, 12 interventions met criteria for
"most promising" evidence and 29 met criteria for "mixed or emerging"
evidence. Conducting this review revealed clear advances in the number
of evidence-based interventions available and the quality of outcome
research; however, much work remains to achieve greater public health
impact through evidence-based interventions. This work should consider
(1) the great need for intervention research related to understudied
developmental phases, intervention domains (eg, family, school,
community, and media), and populations (eg, early tweens, late teens,
young adults not attending college, and nonmajority populations); (2)
the critical importance of addressing key issues in research design and
methods (eg, limited longitudinal studies, replication studies, and
dissemination research); and (3) the need for improved consistency in
application of evidence and reporting standards. Finally, we recommend
the application of emerging consumer-oriented and
community-participatory models for intervention development and
research, designed to increase the likelihood of "real-world" public
health impact through improved translation of intervention science into

22. Wethington, E., R. Breckman, et al. (2007). The CITRA Pilot Studies
Program: Mentoring Translational Research. _The Gerontologist_, 47(6),

Purpose: We developed an innovative pilot studies program to foster
partnerships between university researchers and agencies serving older
people in New York City. The development of researchers willing to
collaborate with frontline service agencies and service agencies ready
to partner with researchers is critical for translating scientific
research into evidence-based practice that benefits community-dwelling
older adults.Design and Methods: We adapted the traditional academic
pilot studies model to include key features of community-based
participatory research. Results: In partnership with a network of 265
senior centers and service agencies, we built a multistep program to
recruit and educate scientific investigators and agencies in the
principles of community-based research and to fund research partnerships
that fulfilled essential elements of research translation from
university to community: scientific rigor, sensitivity to community
needs, and applicability to frontline practice. We also developed an
educational and monitoring infrastructure to support projects.
Implications: Pilot studies programs developing community-based
participatory research require an infrastructure that can supplement
individual pilot investigator efforts with centralized resources to
ensure proper implementation and dissemination of the research. The
financial and time investment required to maintain programs such as
those at the Cornell Institute for Translational Research on Aging, or
CITRA, may be a barrier to establishing similar programs.

Helena Hilario
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