>> Tiffany Powell-Wiley: Hello, my name is Dr. Tiffany
Powell-Wiley and I'm chief of the Social
Determinants of Obesity and Cardiovascular Risks
laboratory
at the National Heart, Lung, and Blood Institute.
Today I will be talking about community engagement
and Community Based Participatory Research.
And this is part three of a three-part series.
In this talk, I will describe the phases of conducting
Community Based Participatory Research or CBPR,
the challenges in CBPR, and the benefits of CBPR.
As depicted in this figure, there are seven broad components
in conducting CBPR.
The first core component is forming a CBPR partnership.
And this involves processes
such as identifying potential partners and communities
to be involved, building trust and relationships,
establishing operating norms and CBPR principles,
and creating an infrastructure
for carrying out the research process.
The second component is assessing
community strengths and dynamics.
This involves asking questions such as,
what are the strengths and resources in the community?
Which are the influential organizations?
Where's the power in the community?
Who needs to be involved to ensure community buy-in?
The third component is identifying priority
local health concerns and research questions.
Equate -- a key question here is,
how do we figure out what are the major health problems
that impact the community,
and that the partnership might address.
The fourth component involves designing, conducting,
and disseminating the intervention
or policy or etiological research.
And this involves deciding which research design
and data collection methods to use,
and what is the most appropriate intervention strategy.
The fifth component is feeding back
and interpreting the findings within the partnership.
And this involves sharing the findings from the research,
such as the results of the analysis of data,
and engaging partners to make sense of what was found.
The next component is disseminating
and translating the research findings.
And critical questions here include what is most important
from the findings to share with the community?
How are the results disseminated to the community?
And then what is the role of community partners
in publishing results?
The last core component is maintaining, sustaining,
and evaluating the partnership. And as depicted in the figure,
and as it's important that this is at the center of the work
that is done, as this is an ongoing process
that occurs throughout all of the phases.
And relevant questions to address this part of the process
is how well is the partnership going?
And how can the partnership process be improved?
In step one of CBPR,
it is important to take a moment for self-reflection,
and identify how partnerships are going to be built
for the CBPR work.
It's important to reflect on your intentions
as a researcher, your team's capacity,
and capabilities, as well as any potential liabilities.
It's also important to consider your institution's strengths
and liabilities
as you start to build these CBPR partnerships.
The next part of step one in CBPR
is to identify potential partners
and negotiate targets for the collaborative work.
It's important here to take time for self-reflection,
as this will make it much easier to be realistic
about what you can
and cannot bring to the table as a part of the partnership.
The final phase of step one is to bring together partners
and to begin to create
and build the structures of the partnership
between academia and the community,
and this work involves designing the principles
that will govern the decision-making process
within the partnership.
These principles really will govern and control
all aspects of the project,
including how the budgets will be controlled,
how data collection will be controlled,
and who has access and control of data.
The second step in CBPR
is to identify research questions and methods.
And this step is what really distinguishes CBPR
from community outreach.
It is critical to decide where the questions come from,
do they come from the community, or from academia or from both?
It's also important to decide the role of an advisory
committee or community advisory board in its process.
It's important to decide whether the advisory board will have
continual participation throughout the research process,
which informs the design of the study,
or will they have input at key time points
to determine necessary changes in the study?
In step three of CBPR,
we begin the participatory data collection.
And this comes after the study is designed and is key --
is a key step where academia and community
members work in partnership.
Community members can serve in many different roles
in this data collection process,
including training staff, to serve as interviewers,
data collectors or facilitators of focus groups.
And this is where having community members serve
in these roles is key to enabling a better response
as a part of this study from study participants.
It's also important to work with community members
and to emphasize the importance of confidentiality,
particularly when community members working on the study
may have access to sensitive data from their peers.
In step four of the CBPR process,
we begin to work towards participatory data analysis.
And this is where academic partners and community partners
bring unique strengths.
Academic partners or university partners
can bring expertise around statistical programs
that can be used in data analysis,
expertise in formatting data for interpretation or presentation,
and can work to train community members in using these tools.
Community partners are critical in this part of the process
to bring expertise
in interpreting the findings of a study in the context
of the communities' experiences and needs.
And community partners provide key input on how study findings
can be translated into the next steps
for new research questions,
or for developing the next phase for an intervention.
Most of all, community partners provide input on the --
from the perspective of protecting
and preserving the assets of the community.
Step five in the CBPR process is participatory
and dissemination of study finding.
And this is where accountability
to both the needs of community members
and to protecting the community resources is critical.
Dissemination can take many forms
and can happen through manuscripts,
briefs, white papers, or through digital media.
For manuscripts published in peer reviewed journals,
it is important for both community and academic partners
to serve as authors.
It's also important to consider issues around publications
early in the partnership.
This is important given the time that is needed for CBPR
and that this time may not always fit with the needs
for publications for academic partners,
especially those who are junior faculty.
The time needed for publication
may not always benefit community partners,
who may need more from policy briefs that can be used to help
in promoting advocacy for policy changes.
There are many challenges that can exist
in academic and community partnerships in CBPR.
There are questions of participation
and community consent,
if there are segments of a community
participating in a research study
while other parts of the community or not,
there can be issues related to power differentials
and privilege
depending on who sets the research question,
or who has the power of knowledge and the partnership.
One must also always recognize that historical research abuse,
stereotyping, racism, and bias can sow distrust
between academic and community partners.
And throughout the partnership, it's important to be willing
to face these negative historical events
or even present-day events that may promote discord
between academic and community partners.
And it's important to face these challenges head on,
to try to foster productive dialogue.
Other challenges to consider are differences in the requirements
for publishing versus taking action
that exists between academic partners and community partners.
And CBPR is not always as clear as other types of research.
In CBPR, research goals can change over time
and that can impact partnerships that exist.
And ultimately, it's important for all members
of the research team to engage in cultural humility,
active listening and shared decision
making as a part of the CBPR partnership.
There are many benefits of course of CBPR.
CBPR can enhance the relevance of research questions
for the community,
particularly communities who are at highest risk for disease.
It can also enhance the reliability and validity
of research instruments that are used.
CBPR can improve the response rate
to studies and enhance recruitment and retention.
And CBPR can serve as a way to strengthen interventions
that are tailored to cultural beliefs within a community.
Other benefits of CBPR include increasing accurate
and culturally sensitive interpretation
of study findings,
CBPR can facilitate effective dissemination of findings
to impact public health and policy
CBPR can increase translation of evidence
based research into sustainable community change
in increased research trust,
and most of all, CBPR can bring sustainable tools, resources,
and benefits to communities for our --
who have been historically underserved,
and create partnerships with diverse expertise.
In summary, there are key steps to consider
in the CBPR approach.
And a key part of the process is dissemination
and translation of research findings to the community.
And there are numerous benefits to CBPR
including working in partnership to build sustainable programs
for improving community health.
Our first question is which of the following is a core
component or phase of Community Based Participatory Research? A)
Identifying community weaknesses to use as leverage
and working with community? B)
Dictating the focus of the research
based on the needs of the academic partners?
C) Dissemination and translation of study findings
to the target community? D) Interpret the study findings
without input from the community?
The answer is C)
Dissemination and translation of study findings
to the target community.
The next question is which of the following
is a benefit of Community Based Participatory Research?
A) Increases accurate
and culturally sensitive interpretation of findings
to local groups of common public health concerns.
B) Facilitates effective dissemination
of findings to impact public health and policy.
C) Provides resources to communities, or D)
All of the above?
And the answer is D) All of the above.
Thank you for your attention.