REVIEW OF COMMUNITY-BASED RESEARCH: Assessing Partnership Approaches to Improve Public Health

1. REVIEW OF COMMUNITY-BASED RESEARCH: Assessing Partnership Approaches to Improve Public Health By Barbara A. Israel, Amy J. Schulz, Edith A. Parker, and Adam B. Becker ALONSO OLIVEROS (Part 1) CAITLIN FLETCHER (Part 2) H571

2. EMERGENCE OF COMMUNITY-BASED RESEARCH • Combination of critical reflection within public health and new opportunities for funding • Various terms used include: “community-based/involved/collaborative/centered-research.” • Similar approaches to research include: -”participatory research” -”action research” -”participatory action research” -“action science/inquiry” -”feminist research” -”cooperative inquiry” -”participatory evaluation” -”empowerment evaluation”

3. POSITIVIST vs. ALTERNATIVE INQUIRY PARADIGMS • Paradigms: basic set of beliefs about the nature of reality and what can be known about it, the relationship between the knower and what is known or knowable, and how the knower can find out what can be known. • Positivist paradigm, which emphasizes a static, objective knowledge that is separate from the knower, has been dominant. • Postpositivism,” “Critical Theory,” and “Constructivism” offer alternate perspectives but only the latter two are particularly applicable to public health.

5. ALTERNATIVE INQUIRY PARADIGMS (con’t.) • CBR draws upon constructivist and critical theoretical perspectives that addresses some of the criticism of positivist science. • Specific research methods used determined by: -Purpose of the study, -How the information is to be used, -Context and setting, -Theoretical perspectives. • Both quantitative and qualitative methods may be employed to develop an understanding of the phenomenon under study.

6. COMMUNITY-BASED RESEARCH OVERVIEW • Many uses and multiple terms are sometimes used interchangeably: -”community-wide research” -”community-involved research” -”community-centered research” • Emphasis on the participation and influence of nonacademic researchers in the process of creating knowledge. • Conducting research in a community as a place or setting (no active involvement) vs. conducting research with a community with the active engagement and influence of community members.

7. COMMUNITY-BASED RESEARCH OVERVIEW (con’t.) • Involves community members, organizational representatives, and researchers in all aspects of the research process. • Emphasizes the “unique strengths and shared responsibilities” of partners to enhance understanding of a given phenomenon, as well as social and cultural dynamics of the community, • Integrates knowledge gained with action to improve the health and well-being of community members.

8. KEY PRINCIPLES • 1. Recognition of community as a unit of identity (“communities of identify”). • 2. Builds on strengths and resources within the community. • 3. Facilitates collaborative partnerships in all phases of the research. • 4. Integrates knowledge and action for mutual benefit of all partners. • 5. Promotes a co-learning and empowering process that attends to social inequalities.

9. KEY PRINCIPLES (con’t.) • 6. Involves a cyclical and iterative process. • 7. Addresses health from both positive and ecological perspectives. • 8. Disseminates findings and knowledge gained to all partners. • 9. Involves a long-term commitment: partnership continues after grants have come to an end and look for new funding, if necessary.

10. RATIONALE FOR USE OF CBR • Why do community-based research? -Many advantages associated with the changing trends and critiques of public health research and practice. -Critique of the positivist research paradigm • Key rationales: -Enhance the relevance, usefulness, and use of the research data by all partners involved. -Joins together partners with diverse skills, knowledge, expertise, and sensitivities to address complex problems.

11. RATIONALE (con’t.) -Improves the quality and validity of research by engaging local knowledge and local theory based on the lived experience of the people involved. -Recognizes the limitations of the concept of a “value-free” science and encourages a self-reflective, engaged and self-critical role of the researchers (“critical subjectivity”). -Acknowledges that “knowledge is power” and thus the knowledge gained can be used by all parties involved to direct resources and influence policies that will be beneficial to the community. -Strengthens the research and program development capacity of the partners.

12. RATIONALE (con’t.) -Creates theory that is grounded in social experience, and creates better informed/more effective practice that is guided by such theories. -Increases the possibility of overcoming the understandable distrust of research on the part of communities that have historically been the “subjects” of such research. -Has the potential to “bridge the cultural gaps that may exist” between the partners involved. -Overcomes the fragmentation and separation of the individual from his/her culture and context that is often evident in more narrowly-defined categorical approaches. -Provides additional funds and possible employment opportunities for community partners.

13. RATIONALE (con’t.) -Aims to improve the health and well-being of the communities involved, both directly through examining and addressing identified needs and indirectly through increasing power and control over the research process. -Involves communities that have been marginalized on the basis of race, ethnicity, class, gender, and sexual orientation in examining the impact of marginalization and attempting to reduce and eliminate it.

15. COMMUNITY PARTICIPATION IS NOT ALWAYS CBR -IF the Advisory Board members, named by their position and/or experience and who may not live in the community, offer input to researchers on a research agenda/topic BUT community residents are unaware of the project, THEN this is not CBR. -IF the Project Advisors, who are leaders from the community, endorse the project BUT researchers maintain control and community involvement is passive, THEN this is not CBR. -IF Community Leaders guide the process of hiring community residents to work in the project and/or recruiting participants for the study BUT community involvement is partial and manipulated, THEN this is not CBR.

16. HOWEVER, IF Community Representatives contribute and negotiate the different activities of the project, THEN this is CBR!

18. A CONTINUUM OF POSSIBILITIES

19. APPROACH TO REINFORCE TTI