A Review of Published Community-Based Participatory Research (CBPR) & Recommendations for Future Scholarly Work Darius Tandon, PhD Assistant Professor, Johns Hopkins University School of Medicine Deputy Editor, Progress in Community Health Partnerships Presentation at Academy Health Annual Meeting June 2-5, 2007, Orlando, Florida

Todays Presentation 1.Definition, Characteristics, Rationale for CBPR 2.Review of Published CBPR 3.Priority Areas for Future CBPR Publications

What is Community-Based Participatory Research (CBPR)? A collaborative approach to research that equitably involves all partners in the research process and recognizes the unique strengths that each brings. --W.K. Kellogg Foundation (2001)

What CBPR is NOT 1.Community-placed research 2.Sporadic or symbolic inclusion of communities 3.Basic research

Key Characteristics of CBPR 1.Active collaboration and participation from all partners at every stage of research 2.Co-learningi.e., community residents and researchers both contribute and learn from one another 3.Projects are community-driven 4.Results are disseminated in useful ways 5.Research and intervention strategies are culturally appropriate 6.Defines community as a unit of identity -OFallon & Dearry (2002)

Why CBPR? Growing recognition that traditional research: 1.Has failed to solve complex health problems 2.Is not well suited for translational research 3.Does not adequately address locally identified needs

A Vision for Progress in Community Health Partnerships (Tandon et al., 2007) Review of published CBPR in eight areas: 1.Original research 2.Work-in-progress/lessons learned 3.Theory and methods 4.Policy and practice 5.Education and training 6.Practical tools 7.Community perspective 8.Systematic reviews Recommendations for future CBPR publications

Methods: Recommendations for Future CBPR Publications Group judgment technique (i.e., Delphi Process) to elicit perspectives of leaders in the field of CBPR Stage 1: Idea Generation –17 Editors & Editorial Fellows of PCHP provided brief phrases on issues, problems, topics on which eight types of PCHP articles should focus Stage 2: Idea Prioritization –Specific recommendations emerging from Stage 1 given to PCHP External Editorial Board to prioritize which thematic concepts they felt were most important for CBPR articles submitted to PCHP to address.

Original Research Present Day Intervention & non- intervention studies Focused on an array of health issues Many racial/ethnic groups with whom studies have been conducted Future Work Translation of CBPR into policy How do partnership characteristics and processes influence health outcomes?

Work in Progress/Lessons Learned Present Day Formative research to help design and modify interventions Identify health problems on which a partnership should focus Challenges & obstacles related to study design and implementation Future Work Building community partnerships Challenges in conducting CBPR

Theory and Methods Present Day Theoretical influences on CBPR (e.g., feminist theory, critical social theory, action research) Theoretical frameworks for sustaining interventions; dealing with race, class, gender Use of non-traditional research methods (e.g., photovoice, Delphi process) Future Work Research methods Use of theoretical and conceptual frameworks to guide CBPR projects Research design issues

Policy and Practice Present Day Many examples of health domains in which CBPR has influenced policy (e.g., environmental health, smoking, violence prevention, occupational healthcare) Future Work Engaging community members in policy and practice How to implement policy/practice based on CBPR findings?

Education and Training Present Day IOM recommendation that CBPR be taught to all public health students Several masters and doctoral level courses Future Work CBPR curriculum and graduate medical education reform Training new investigators Training community partners

Community Perspective Present Day Little published work documenting community partners perspectives Most published work that include community co- authors do not distinguish academic and community partners perspectives Some exceptions: –Kelly et al. (2004) –Chene et al. (2006) Future Work Community perspectives on research usefulness Problems communities would like to see addressed by partnerships Community perspectives on roles in CBPR projects

Practical Tools Present Day Two CBPR textbooks offer several practical tools (Minkler & Wallerstein, 2003; Isreal et al., 2005) Instruments to determine whether project adheres to partnership principles Tools to help develop and sustain partnerships Future Work Resources/tools to develop community partners skills Resources re: evaluation strategies

Systematic Reviews Present Day AHRQ Evidence Report on CBPR (Viswanathan et al., 2004): –Quality of methodology –Community involvement –Desired health outcomes Future Work Reviews re: CBPR methods Reviews re: CBPR effectiveness

Closing Thoughts Need for well-written peer-reviewed journal articles that describe various aspects of CBPR –Such articles can facilitate the pace and process of CBPR adoption among researchers and communities

For More Information… Progress in Community Health Partnerships Darius Tandon

Exercise 1.For your assigned topic, review the recommendations found in Table 2 2.In your opinion… –Which recommendation is the highest priority? –Is there a recommendation that should be on the list but is not? 3.Report back to larger group