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>> Tiffany Powell-Wiley:
Hello, my name is Dr. Tiffany

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Powell-Wiley and I'm
chief of the Social

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Determinants of Obesity
and Cardiovascular Risks

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laboratory

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at the National Heart,
Lung, and Blood Institute.

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Today I will be talking
about community engagement

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and Community Based
Participatory Research.

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And this is part three of
a three-part series.

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In this talk, I will describe
the phases of conducting

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Community Based Participatory
Research or CBPR,

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the challenges in CBPR,
and the benefits of CBPR.

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As depicted in this figure,
there are seven broad components

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in conducting CBPR.

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The first core component
is forming a CBPR partnership.

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And this involves processes

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such as identifying potential
partners and communities

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to be involved, building
trust and relationships,

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establishing operating
norms and CBPR principles,

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and creating an infrastructure

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for carrying out the
research process.

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The second component
is assessing

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community strengths
and dynamics.

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This involves asking
questions such as,

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what are the strengths
and resources in the community?

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Which are the influential
organizations?

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Where's the power
in the community?

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Who needs to be involved
to ensure community buy-in?

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The third component
is identifying priority

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local health concerns
and research questions.

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Equate -- a key
question here is,

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how do we figure out what are
the major health problems

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that impact the community,

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and that the partnership
might address.

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The fourth component
involves designing, conducting,

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and disseminating
the intervention

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or policy or
etiological research.

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And this involves deciding
which research design

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and data collection
methods to use,

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and what is the most appropriate
intervention strategy.

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The fifth component
is feeding back

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and interpreting the findings
within the partnership.

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And this involves sharing the
findings from the research,

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such as the results
of the analysis of data,

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and engaging partners
to make sense of what was found.

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The next component
is disseminating

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and translating the
research findings.

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And critical questions here
include what is most important

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from the findings to
share with the community?

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How are the results
disseminated to the community?

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And then what is the role
of community partners

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in publishing results?

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The last core component
is maintaining, sustaining,

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and evaluating the partnership.
And as depicted in the figure,

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and as it's important that this
is at the center of the work

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that is done, as this
is an ongoing process

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that occurs throughout
all of the phases.

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And relevant questions to
address this part of the process

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is how well is the
partnership going?

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And how can the partnership
process be improved?

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In step one of CBPR,

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it is important to take a
moment for self-reflection,

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and identify how partnerships
are going to be built

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for the CBPR work.

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It's important to reflect
on your intentions

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as a researcher, your
team's capacity,

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and capabilities, as well
as any potential liabilities.

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It's also important to consider
your institution's strengths

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and liabilities

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as you start to build
these CBPR partnerships.

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The next part of
step one in CBPR

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is to identify
potential partners

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and negotiate targets for
the collaborative work.

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It's important here to take
time for self-reflection,

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as this will make it much
easier to be realistic

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about what you can

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and cannot bring to the table
as a part of the partnership.

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The final phase of step one
is to bring together partners

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and to begin to create

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and build the structures
of the partnership

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between academia
and the community,

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and this work involves
designing the principles

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that will govern the
decision-making process

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within the partnership.

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These principles really
will govern and control

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all aspects of the project,

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including how the budgets
will be controlled,

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how data collection
will be controlled,

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and who has access
and control of data.

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The second step in CBPR

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is to identify research
questions and methods.

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And this step is what really
distinguishes CBPR

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from community outreach.

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It is critical to decide
where the questions come from,

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do they come from the community,
or from academia or from both?

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It's also important to decide
the role of an advisory

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committee or community advisory
board in its process.

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It's important to decide whether
the advisory board will have

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continual participation
throughout the research process,

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which informs the
design of the study,

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or will they have input
at key time points

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to determine necessary
changes in the study?

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In step three of CBPR,

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we begin the participatory
data collection.

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And this comes after the study
is designed and is key --

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is a key step where
academia and community

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members work in partnership.

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Community members can serve
in many different roles

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in this data
collection process,

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including training staff,
to serve as interviewers,

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data collectors or
facilitators of focus groups.

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And this is where having
community members serve

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in these roles is key
to enabling a better response

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as a part of this study
from study participants.

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It's also important to work
with community members

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and to emphasize the importance
of confidentiality,

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particularly when community
members working on the study

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may have access to sensitive
data from their peers.

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In step four of the
CBPR process,

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we begin to work towards
participatory data analysis.

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And this is where academic
partners and community partners

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bring unique strengths.

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Academic partners
or university partners

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can bring expertise around
statistical programs

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that can be used
in data analysis,

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expertise in formatting data for
interpretation or presentation,

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and can work to train community
members in using these tools.

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Community partners are critical
in this part of the process

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to bring expertise

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in interpreting the findings
of a study in the context

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of the communities'
experiences and needs.

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And community partners provide
key input on how study findings

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can be translated
into the next steps

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for new research questions,

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or for developing the next
phase for an intervention.

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Most of all, community partners
provide input on the --

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from the perspective
of protecting

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and preserving the assets
of the community.

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Step five in the CBPR
process is participatory

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and dissemination
of study finding.

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And this is where accountability

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to both the needs
of community members

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and to protecting the community
resources is critical.

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Dissemination can
take many forms

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and can happen
through manuscripts,

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briefs, white papers,
or through digital media.

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For manuscripts published
in peer reviewed journals,

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it is important for both
community and academic partners

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to serve as authors.

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It's also important to consider
issues around publications

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early in the partnership.

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This is important given the time
that is needed for CBPR

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and that this time may not
always fit with the needs

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for publications for
academic partners,

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especially those who
are junior faculty.

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The time needed for publication

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may not always benefit
community partners,

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who may need more from policy
briefs that can be used to help

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in promoting advocacy
for policy changes.

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There are many challenges
that can exist

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in academic and community
partnerships in CBPR.

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There are questions
of participation

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and community consent,

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if there are segments
of a community

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participating in a
research study

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while other parts
of the community or not,

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there can be issues related
to power differentials

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and privilege

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depending on who sets
the research question,

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or who has the power of
knowledge and the partnership.

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One must also always recognize
that historical research abuse,

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stereotyping, racism,
and bias can sow distrust

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between academic
and community partners.

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And throughout the partnership,
it's important to be willing

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to face these negative
historical events

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or even present-day events
that may promote discord

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between academic
and community partners.

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And it's important to face
these challenges head on,

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to try to foster
productive dialogue.

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Other challenges to consider are
differences in the requirements

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for publishing
versus taking action

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that exists between academic
partners and community partners.

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And CBPR is not always as clear
as other types of research.

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In CBPR, research goals
can change over time

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and that can impact
partnerships that exist.

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And ultimately, it's
important for all members

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of the research team to
engage in cultural humility,

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active listening
and shared decision

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making as a part
of the CBPR partnership.

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There are many benefits
of course of CBPR.

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CBPR can enhance the relevance
of research questions

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for the community,

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particularly communities who are
at highest risk for disease.

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It can also enhance
the reliability and validity

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of research
instruments that are used.

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CBPR can improve
the response rate

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to studies and enhance
recruitment and retention.

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And CBPR can serve as a way
to strengthen interventions

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that are tailored to cultural
beliefs within a community.

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Other benefits of CBPR
include increasing accurate

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and culturally
sensitive interpretation

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of study findings,

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CBPR can facilitate effective
dissemination of findings

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to impact public
health and policy

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CBPR can increase
translation of evidence

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based research into sustainable
community change

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in increased research trust,

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and most of all, CBPR can bring
sustainable tools, resources,

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and benefits to
communities for our --

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who have been
historically underserved,

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and create partnerships
with diverse expertise.

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In summary, there are
key steps to consider

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in the CBPR approach.

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And a key part of the process
is dissemination

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and translation of research
findings to the community.

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And there are numerous
benefits to CBPR

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including working in partnership
to build sustainable programs

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for improving community health.

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Our first question is which of
the following is a core

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component or phase of Community
Based Participatory Research? A)

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Identifying community
weaknesses to use as leverage

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and working with community? B)

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Dictating the focus
of the research

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based on the needs
of the academic partners?

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C) Dissemination and
translation of study findings

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to the target community? D)
Interpret the study findings

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without input from
the community?

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The answer is C)

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Dissemination and translation
of study findings

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to the target community.

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The next question is which
of the following

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is a benefit of Community
Based Participatory Research?

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A) Increases accurate

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and culturally sensitive
interpretation of findings

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to local groups of common
public health concerns.

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B) Facilitates
effective dissemination

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of findings to impact
public health and policy.

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C) Provides resources
to communities, or D)

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All of the above?

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And the answer is D)
All of the above.

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Thank you for your attention.