1. Acción Para la Salud: A Story about Community-Driven Research Susan Kunz, MPH Director of Platicamos Salud (Health and Wellness) Mariposa Community Health Center Nogales, Arizona Representing the Arizona Prevention Research Center and the National Community Committee

2. Why Me? I am a member of the National Community Committee (NCC)

3. Community voice of the CDC Prevention Research Center Program Community members who represent 37 PRCs

4. CDC PRCs

5. How Did I Get Involved in the NCC? Elected by my Community Action Board (CAB) Arizona Prevention Research Center (AzPRC) University of Arizona

6. Arizona Prevention Research Center Mission is to partner with communities to improve the health and well being of people living in US- Mexico Border States through research, training, and advocacy.

7. What does the U.S.-Mexico Border have to do with Community Defined Measures? The AzPRC partnership exemplifies how good CBPR leads to good data.

8. Our Story… 2009 - We changed paths 10 years as a diabetes program intervention in 1 community to a CHW policy intervention in multiple communities.

9. Why the New Direction? 2007 – AzPRC asked the CAB members to define the core research. The community said: Involve the entire border region Focus on CHWs as change agents Address social determinants through policy

10. Wow, great idea! How are we going to do that? (Hmmm…sounds kind of soft. Will the CDC PRC Program fund that?)

11. We Dug Deep Together we trusted each other to use key CBPR principles to reach our goal (Israel, 1998) Build on strengths and resources within the community Use a power-sharing process in all phases of research to address social inequities Achieve a balance between knowledge generation and intervention for mutual benefit Focus on local health with an ecological perspective to address social determinants

12. Specific Aim 1 To determine the effectiveness of integrating community advocacy into CHW outreach and education activities in increasing community- driven policy change related to chronic disease prevention within organizations, systems, and the broader social and physical environment in communities along the Arizona-Mexico Border.

13. To create an evidence-based CHW advocacy model that provides a framework for community advocacy training and tracking, including indicators for measuring progress. Specific Aim 2

14. Phase II: CHW Advocacy and Policy Intervention Efforts

15. Who Picked the Data? Our Research Committee !!! PRC staff Representatives from all 7 community partners 5 intervention partners and 2 capacity building partners

17. What do We Want to Measure and How? Local ways and values (even if it slows the process down) Multiple methods of data collection to tell our story Demystify the policymaking process (Minkler and Wallestein, Policy Link 2012 publication)

18. Baseline (Phase I) and Follow-up Assessments (Phase III) – National CHW community advocacy survey – Local CHW community advocacy survey – Local measure of organizational commitment to community advocacy (Organizational Interview) – Local measure of community engagement in advocacy (Community Interview) Acción Activities

19. Intervention activities (Phase II) – Leadership and advocacy training (see Training PPT) – CHW community advocacy and policy change – CHW peer support network – Technical assistance Acción Activities

20. Back to the NCC AzPRC followed CBPR Best Practice Principles Recognized with NCC CBPR Best Practice Award

21. Created in 2010 to promote and recognize excellence in CBPR Practice XX PRCs have been awarded the two levels – Community Engagement Certificate – CBPR Best Practice Award

23. Bringining All Home Promotora (CHW) Alicia Sander presenting outcomes at CCPH Conference April 2012

24. To learn more: skunz@mariposachc.net