A conceptual framework for evaluating health equity promotion within community-based participatory research partnerships

Abstract

Community-based participatory research (CBPR) approaches present strong opportunities to promote health equity by improving health within low-income communities and communities of color. CBPR principles and evaluation frameworks highlight an emphasis on equitable group dynamics (e.g., shared leadership and power, participatory decision-making, two-way open communication) that promote both equitable processes within partnerships and health equity in the communities with whom they engage. The development of an evaluation framework that describes the manner in which equitable group dynamics promote intermediate and long-term equity outcomes can aid partners in assessing their ability to work together effectively and improve health equity in the broader community. CBPR principles align with health equity evaluation guidelines recently developed for Health Impact Assessments (HIAs), which emphasize meaningful engagement of communities in decision-making processes that influence their health. In this paper, we propose a synergistic framework integrating contributions from CBPR and HIA evaluation frameworks in order to guide efforts to evaluate partnership effectiveness in addressing health inequities. We suggest specific indicators that might be used to assess partnership effectiveness in addressing health equity and discuss implications for evaluation of partnership approaches to address health equity.

Community-Engaged Approaches for Minority Recruitment Into Clinical Research: A Scoping Review of the Literature

“…Trust has been identified previously as a key indicator for the success of community-engaged partnerships in general 101 and for promoting health equity in particular. 102 Trust may be established through a commitment to longterm partnership processes that are mutually beneficial to community and academic partners. 103 Trust is also an important contextual factor for research participation, especially the contextual legacy of unethical and criminal research behaviors in the past that targeted racial and ethnic minority participants and communities.…”

Commentary on Community-Based Participatory Research and Community Engaged Research in Health for Journal of Participatory Research Methods

“…This review found 55 reviews reporting evidence of different outcomes (Ortiz et al, 2020). The importance of conceptual models has also grown in terms of identifying theories of change and pathways of practices contributing to outcomes (Eder et al, 2013;Greenhalgh et al, 2016;Jagosh et al, 2012;Oetzel et al, 2018;Ward et al, 2018).…”

Participatory action research to pilot a model of mental health service user involvement in an Ethiopian rural primary healthcare setting: study protocol

“…C) PAR also rejects objectivist assumptions that distance the researcher and the participants from one another [121,123]. The close proximity of working can promote inclusion and confront engrained stigma and prejudices [32,120,124]. In line with the contact hypothesis [125] and social contact theory [125,126], positive contact between service-users, health professionals and others within the health system, e.g.…”

“…These drawbacks may be minimized through the emancipatory and critical theoretical foundation of PAR that seeks to explicitly and intentionally work with a range of stakeholders, including those historically oppressed, disempowered, vulnerable and marginalized groups (e.g., service-users) [62,107,112]. The participatory commitment of PAR provides space for diverse forms of expertise and promotes understanding of the different life-worlds of participants [32,87,120]. Working in a collaborative and non-hierarchical manner may facilitate deeper understanding of how implementation can be achieved [56,84,100,112,121].…”