Karen Hacker, MD MPH Director Addressing Community Health Problems Using a Community-based Participatory Approach Karen Hacker, MD MPH Director

What is community-based participatory research? CBPR is a collaborative research approach that is designed to ensure and establish structures for participation by communities affected by the issue being studied…in all aspects of the research process to improve health and well-being through taking action, including social change” Viswanathan M, et al, Community-Based Participatory Research: Assessing the Evidence, AHRQ publication 2004

How does it differ from traditional research?

Why use CBPR? Addressing disparities requires community engagement Translational research requires partnerships for action CBPR helps build capacity CBPR holds the potential for change CBPR can enhance community empowerment

Principles of CBPR (Barbara Israel) Acknowledges community as a unit of identify Builds on strengths and resources within a community Facilitates a collaborative equitable, partnership in all phases of research involving an empowering and power-sharing process that attends to social inequalities Fosters co-learning and capacity building among all partners Integrates and achieves a balance between knowledge generation and intervention for the mutual benefit of all partners Focuses on the local relevance of public health problems and on ecological perspectives that attend to the multiple determinants of health Involves systems development using a cyclical and iterative process Disseminates result to all partners and involves them in the wider dissemination of results Involves a long-term process and commitment to sustainability.

Steps in CBPR First Stage: Defining the community, engaging the community, community needs assessment, identifying the research question Second stage: Design/hypothesis testing, roles and responsibilities for conduct of the research Third stage: Analysis, interpretation and results, dissemination and action

The cycle of CBPR

Engagement Who is the community? How do I engage them?

Production of knowledge Creation of opportunities for all members of a group to make meaningful contributions to the production of knowledge Knowledge is Power But, the production of knowledge is always a situated practice Recognition of knowledge as being the reflection of a partial perspective Movements seek to broaden the range of people who have access to such opportunities

Qualitative and quantitative data Qualitative is subjective Generally descriptive, focus groups, interviews Exploratory in nature Quantitative is numerical/objective Used to quantify things Collected using surveys, systematic studies

Applying CBPR principals to public health practice Does the proposed activity respond to the needs of this community and/or support existing infrastructure or networks? How will the community members/organizations be involved in the development and implementation of this particular project? Is there an understanding of the institution’s and community partners’ needs/capacity for development and implementation of planned activities? What is the community’s role in/expectation regarding the allocation of resources? How will results be communicated/disseminated?

The applications for the Opioid Epidemic in Allegheny County

Who are the partners? Organizations Government agencies Families Prevention Point Pittsburgh Government agencies Human Services Police Municipal leadership Families Users-current and recovering Coalitions Providers

What do they want to know? What data is available? How do you disseminate? Collaboration for solutions Action

Working with impacted communities

Heatmap of Opioid-Related Overdose Fatalities:2015–2016

Qualitative research Hillman Grant Interviews with key stakeholders Rapid translations of findings Community partners (prevention point, city of Pittsburgh, CONNECT, DHS)

Dissemination Website Pamphlets Forums Dashboard Reports

Overdose Trends 2014-2018

Questions?