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Community Based Participatory Research 101:

From a Community Partner Perspective

Ann-Gel S. Palermo, MPH,

Chair, The Harlem Community & Academic Partnershipy p

March 8th, 2012

New York City Community Partner Summit

Objectives

Be able to define what community-based yparticipatory research (CBPR) is.

Be able to understand the application of CBPR using the Harlem Community & Academic Partnership as a model

My perspective on CBPR

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Community Partner definition:

A stakeholder bound by a common commitment and vision for the CBPR project who brings relevant knowledge and for the CBPR project who brings relevant knowledge and expertise; is not limited by geographic boundaries; and has agreed to adhere to CBPR principles for this project. Community members may have different levels of awareness of the details of the project, and their involvement may vary depending on the stage of the project.

Source: Community Based Participatory Research, Chapter 1. A Manual for Community-Based Participatory Research: Using Research to improve practice and inform policy in assisted living. CEAL-UNC Collaborative, 2009.

Research Partner Definition

An individual who, regardless of his/her affiliation, brings to the partnership expertise to frame the research question(s), determine the research methods, collect and analyze the research data, and interpret the research results. The community partners have a role in these activities as well, as they have an insiders’ view on matters such as collecting and interpreting the data. What they typically lack are the technical skills to conduct research, which is what the research partners provide.

Source: Community Based Participatory Research, Chapter 1. A Manual for Community-Based Participatory Research: Using Research to improve practice and inform policy in assisted living. CEAL-UNC Collaborative, 2009.

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1. A collaborative approach to the research (and ultimately policy analysis and advocacy) process that equitably involves

What is CBPR? Remember these three attributes!

policy analysis and advocacy) process that equitably involves all partners (i.e. community, academic, practitioners, policymakers) in all aspects of the research process and recognizes the unique strengths that each partner brings to the process

CBPR Vs Traditional Research Approach

CBPR

Traditional Research Approach

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1. A collaborative approach to the research (and ultimately policy analysis and advocacy) process that equitably involves

What is CBPR? Remember these three attributes!

policy analysis and advocacy) process that equitably involves all partners (i.e. community, academic, practitioners, policymakers) in all aspects of the research process and recognizes the unique strengths that each partner brings to the process

2. Combines action and advocacy with the research process 2. Combines action and advocacy with the research process to cause positive social change, achieve social justice and health equity

3. A pathway to develop community activists researchers

Key Principles of CBPR

Recognizes community as a unit of identity

Builds on the strengths and resources of the communityBuilds on the strengths and resources of the community

Facilitates collaborative partnerships in all phases of research

Integrates knowledge and action for mutual benefit of all partners

Promotes a co-learning empowering process that attends to social inequalities

Involves a cyclical and iterative process

Addresses health from positive and ecological perspectives

Disseminates findings and knowledge gained to all partners

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What might be the rationale for using a CBPR approach to research?

Improves the quality and validity of research by engaging local knowledge and local theory based engaging local knowledge and local theory based on the lived experience of the people involved

Involves communities that have been marginalized on the basis of, for example, race, ethnicity, class, gender, and sexual orientation in examining the impact of marginalization and g p gattempting to reduce and eliminate it.

Those individuals/groups/communities most impacted by the issue can participate in the design and implementation of solutions

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Harlem Community and Academic Partnership (HCAP)• A diverse partnership of community residents,

community-based organizations and service providers, d i d bli h lth i tit tiacademia, and public health institutions.

• Roots in substance use and infectious disease and hard-to-reach populations

• Use a Community-Based Participatory Research (CBPR) approach to focus on identifying “what works” to effectively address the social determinants of health to improve the health of East and Central Harlem residents and other similar communities

Community & Academic Partners

Intervention Work Groups (IWGs)

InterventionsInterventions

Outcomes & Products

Dissemination

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Purpose Statement

HCAP was formed for the exclusive purpose to provide information about social determinants of health in underserved communities to community-based organizations, academia, public health practitioners, and policymakers to

t it t d d h lth promote community centered good health and well being for all residents.

HCAP is committed to community-centered good health and well-being for all residents. In pursuit of this goal, we strive to:

HCAP’s Mission Statement

Identify Social Determinants of Health

Advocate for Community-centered public health initiatives

Implement Community-Based interventions to improve health and well-being, using a Community-Based Participatory Research approach

Influence health policy formulation and implementation

Facilitate community and academic partnerships for research and policy

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CBPR Vs Traditional Research Approach

CBPR

Some of our Products

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The Community-based Policy Analysis and Advocacy Cycle

Identifying & Evaluating

Taking Action, Affecting Change

Assessing the Political Environment, Mustering Resources

Evaluating Community

Issues

Developing Action Strategies, Building

Support

Source: Ritas, Cassandra. "Speaking Truth, Creating Power: A guide to Policy Work for Community-based Participatory Research Practitioners.“ July 2003 for CCPH -http://depts.washington.edu/ccph/commbas.html

Survival GuideA users’ guide intended to: Provide information to

decrease drug and sexual risk decrease drug and sexual risk behavior

Provide specific information to improve access to services like drug treatment

Survey research and focus groups guided the contentgroups guided the content

“Look” and format of guide was developed through art workshops facilitated by a local artist

Pilot-tested with consumers

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Welcome To The Faces of Urban Health Forum!A Forum to Share Community‐Based Strategies to Address 

Health Inequity in Urban Communities

OCTOBER 2010 

Jose Martin Garcia Orduna

Congregation of Notre Dame

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From Community Partner Perspective…

1. Important to be aware of how CBPR can be understood in the academic world

2. Important to be aware about certain aspects of CBPR that may not always be obvious or acknowledged by those doing this work

What you should know about CBPR in the academic world

1. Understand how researchers talk about CBPR

2. Be able to distinguish which faculty are really doing CBPR; this includes knowing their publications; funded projects, and talking with affiliated community partners,

3. Understand the role of the Project Manager or Project Director

4. Funding climate of CBPR and what % (overhead/indirect costs) goes to the academic institution goes to the academic institution

5. Be aware of the academic pressures around faculty development and promotion

6. Identify academic incentives

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10 Important Academic Incentives for Researchers to engage in CBPR

1. Enhances relevance and use of data

2. Join partners with diverse expertise

3. Improves quality and validity of research

4. Enhances knowledge that can be used to inform teaching and community service, integrating research, teaching and service

5. Increase possibility to over come community distrust of research

6. Knowledge benefits the community

7. Potential to bridge cultural gaps

8. Overcomes separation of individual from culture and context that often occurs with categorical approaches

9. Provides resources for communities

10. Aims to improve health and well-being of communities involved

What you should know about CBPR in the academic world

1. Understand how researchers talk about CBPR

2 Be able to distinguish which faculty are really doing CBPR; this includes 2. Be able to distinguish which faculty are really doing CBPR; this includes knowing their publications; funded projects, and talking with affiliated community partners,

3. Understand the role of the Project Manager or Project Director

4. Funding climate of CBPR and what % (overhead/indirect costs) goes to the academic institution

5. Be aware of the academic pressures around faculty development and promotion

6. Identify academic incentives

7. Know when CBPR IS NOT CBPR (next 6 slides, source: Examining Community-Institutional Partnerships for Prevention Research Group. Training Curriculum for Developing and Sustaining Community-Based Participatory Research Partnerships. 2005. pps. 19-24 )

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When CBPR is not CBPR (1): Is opportunism and self-interest driving the agenda?

Self-interest on the part of researchers drives the interest in CBPR. E l f thi i ht i l dExamples of this might include:

Need for grant funding to support their academic position

Recruitment of underserved populations drives their interest in CBPR

Opportunism on the part of the community members drives the Opportunism on the part of the community members drives the interest in developing partnerships with academic institutions. Examples of this might include: 1. Recognition2. Employment3. Money

When CBPR is not CBPR (2): When the research team doesn’t have the necessary skills?

Conducting research with underserved communities brings forth issues of power, race, communication and respect. Specific skills that facilitate building relationships between researchers and communities include:

Cultural Competence which requires a set of knowledge, skills, and attitudes that allow individuals, organizations and systems to work effectively with diverse racial, ethnic, religious, and social groups.

Communication skills - in particular, the ability to provide on-going, regular feedback to the community partners throughout the life of the research project in ways that are meaningful and accessible

Listening skills can be open to feedback and insights from both Listening skills – can be open to feedback and insights from both community partners and researchers about research methods and approaches.

Sharing power/control over decisions – many researchers arrive in a community with a set protocol and are unwilling to make changes or share decision-making about methods and approaches with non-researchers.

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When CBPR is not CBPR (3): When the is researcher uncomfortable with changing the methods and/or approach to working with participants

CBPR involves a set of core principles that include a commitment: to the co-learning process and involving the community in every step of the process. You might find it challenging to participate in a co-learning and reciprocal research relationship especially if it means using and reciprocal research relationship, especially if it means using different research approaches and methods that you are less familiar with;

The researcher is comfortable with a linear approach to research (i.e., not iterative or cyclical)

The researcher is continuously questioning the validity and reliability of CBPR designs;

The researcher is ncertain abo t the scientific objecti it of CBPR The researcher is uncertain about the scientific objectivity of CBPR research findings

The academic institution is not open to CBPR and it may significantly reduce the researcher’s opportunities for tenure and/or promotion

The researcher has concerns about achieving measurable results and changes in health outcomes within the longer timeframe often required in CBPR designs, i.e., it takes too long to show results

When CBPR is not CBPR (4):Are you a community member who simply wants an intervention or community service but who has no interest in research questions?

If it b i i t t i If as a community member, your primary interest is only on services and local interventions, then participating in a research project may not be for you.

Community service projects have different time lines and objectives than a research intervention. If jyou are unable to agree to the direct research objective then participating in a CBPR partnership would likely be frustrating.

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When CBPR is not CBPR (5):When the ethical considerations related to burden and benefits to the community outweigh potential research benefits

Time – does the researcher or community partner have adequate time to invest in developing a CBPR partnership? invest in developing a CBPR partnership?

Burden on the community – many communities in close proximity of universities are accustomed to being the subject of research studies.

Research objectives and anticipated results will/may provide minimal benefit to the community – a study that produces interesting results for science but limited results for those participating in the study can be problematic if limited results for those participating in the study can be problematic if community expectations have been raised through the CBPR process for more direct, tangible results.

When CBPR is not CBPR (6):When you and or the researcher don’t ‘buy into’ the CBPR principles

Questions for both the community and the researcher to consider:

Do you have a clear community of identity to work with? y y y

Do you believe that attending to social inequities should be part of a research agenda?

Do you question the need to address health – and therefore your research – from an ecological perspective?

Do you perceive community participation as exploitative rather than empowering?

Are you committed to a participatory process, to community participation in the entire research process, to delivering meaningful value/benefits to the community?

Does your institution/organization buy into and support CBPR?

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Strategies to consider…

Cross reference published authors with your local university faculty via references and citations;

Look for community partner organizations identified in publications and contact them to learn their experiences in working with the learn their experiences in working with the academic partner or faculty member

Build capacity to conduct your own research – become research ready!

Important aspects of CBPR that may not always be obvious or acknowledged

Social justice is a critical component of CBPR and may not be a favorable aspect among academic institutions and yet this is one aspect of CBPR that cannot be compromisedp

Formulate the policy questions with the research questions!

In CBPR, community partners fundamentally maintain the power in maintaining and sustaining the research agenda

Build alliances with other CBOs who have similar research ideas, areas of interest, or questions before approaching an academic partner

Utilize seasoned community partners as coaches and mentors (locally Utilize seasoned community partners as coaches and mentors (locally, regionally, or nationally) who have experience in doing CBPR and engaging academic institutions.

There isn’t one way of structuring a partnership – tailor the partnership to your needs

Advisory does not equal Action

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THANK YOU!

QUESTIONS/DISCUSSION