Community-Based Participatory Research: A Capacity-Building Approach for Policy Advocacy Aimed at Eliminating Health Disparities

Israel, Barbara A.; Coombe, Chris M.; Cheezum, Rebecca R.; Schulz, Amy J.; McGranaghan, Robert; Lichtenstein, Richard; Reyes, Ángela; Clement, Jaye; Burris, Akosua N.

doi:10.2105/ajph.2009.170506

Cited by 640 publications

(558 citation statements)

References 35 publications

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“…Community-based research has the potential to contribute to capacity building and community development (Caine & Mill, 2016;Hacker et al, 2012;Israel et al, 2010) and to benefit both the research endeavor and the stakeholders involved (Flicker, Savan, Kolenda, Mildenberger, 2007). Our inclusion of PLWH as co-investigators and advisors to this research, as well as PLWH mentor participants, ensured that the research was grounded in Greater Involvement of People living with AIDS principles (Travers et al, 2008).…”

Section: Study Design Approaches and Principlesmentioning

confidence: 99%

A Mixed-Methods Outcome Evaluation of a Mentorship Intervention for Canadian Nurses in HIV Care

Worthington

O’Brien

Mill

et al. 2016

Journal of the Association of Nurses in AIDS Care

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We assessed the impact of an HIV care mentorship intervention on knowledge, attitudes, and practices with nurses and people living with HIV (PLWH) in Canada. We implemented the intervention in two urban and two rural sites with 16 mentors (eight experienced HIV nurses and eight PLWH) and 40 mentees (nurses with limited HIV experience). The 6-to 12-month intervention included face-to-face workshops and monthly meetings. Using a mixed-methods approach, participants completed pre-and postintervention questionnaires and engaged in semistructured interviews at intervention initiation, mid-point, and completion. Data from 28 mentees (70%) and 14 mentors (87%) were included in the quantitative analysis. We analyzed questionnaire data using McNemar test, and interview data using content analysis. Results indicated positive changes in knowledge, attitudes, and practices among nurse mentees, with qualitative interviews highlighting mechanisms by which change occurred. Mentorship interventions have the potential to engage and educate nurses in HIV treatment and care. *Correspondence to: vera.caine@ualberta.ca. DisclosuresThe authors report no real or perceived vested interests that relate to this article that could be construed as a conflict of interest. PLWH;Mill, Edwards, Jackson, MacLean, & Chaw-Kant, 2010;Mill et al., 2013). Stigma may result in people at risk for HIV delaying testing (Pottie et al., 2014) and lead to HCP providing differential care to PLWH (Mill et al., 2013). Stigma perpetuated by nurses may be related to a lack of knowledge and educational preparation about HIV clinical management and counseling, religious background, or workplace culture (Waluyo, Culbert, Levy, & Norr, 2015).HIV education for HCP is important to promote best practices. Education increases knowledge and promotes positive changes in attitudes, making it key to addressing HIV stigma in health care settings (Aggleton, Yankah, & Crewe, 2011). Despite the benefits, limited evidence exists to evaluate the impact of different approaches to HIV education for HCP (Aggleton et al., 2011). The Canadian Association of Nurses in AIDS Care (CANAC, 2013) recently highlighted deficits in education for nurses in HIV care. CANAC argued that nurses were graduating with insufficient theoretical and clinical experience in HIV care and with "… limited understanding of the broader social, cultural, and historical contexts with which HIV/AIDS is located" (CANAC, 2013, p. 2). WHO (2013) suggested that nurses were in key positions to provide HIV care, treatment, and prevention, and thus it was essential to prepare nurses at the undergraduate and graduate levels, as well as those in practice, to successfully engage in these roles. However, the impact of HIV education programming for nurses to advance knowledge, and practice and address stigma was unclear. Mentorship is one strategy to increase knowledge and skills in HCP. In order to advance education programming for nurses, we implemented and evaluated a mentorship intervention in HIV care for nu...

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Section: Study Design Approaches and Principlesmentioning

confidence: 99%

A Mixed-Methods Outcome Evaluation of a Mentorship Intervention for Canadian Nurses in HIV Care

Worthington

O’Brien

Mill

et al. 2016

Journal of the Association of Nurses in AIDS Care

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“…11 Given the success of CBPR methods to reduce disparities, 12 organizations like the National Healthy Start Program (NHSP) have welcomed CBPR as a useful model for organizational empowerment among diverse stakeholders in settings where recognized methods for evaluation and program design have previously fallen short. 13,14 Might a CBPR approach, fostering a co-developed rather than an imposed solution, overcome perceived barriers to the adoption of SDM?…”

Section: Community-based Participatory Research-a Potential Solutionmentioning

confidence: 99%

Physicians as Part of the Solution? Community-Based Participatory Research as a Way to Get Shared Decision Making into Practice

2013

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Although support among policy makers and academics for the wide scale adoption of shared decision making (SDM) is growing, actual implementation is slow, and faces many challenges. Extensive systemic barriers exist that prevent physicians from being able to champion SDM and lead practice change. In other areas of public health where implementation has been a challenge, community-based participatory research (CBPR) has effectively engaged resistant stakeholders to improve practice and the delivery of care. Might CBPR, defined broadly as research that engages participants in the conception, design, and implementation of relevant health programs, be a more effective way to engage physicians, patients, and managers in the implementation process? Consequently, we argue that adopting a participatory approach may help to overcome recognized barriers to progress in this area.KEY WORDS: shared decision making; community-based participatory research; implementation; patient engagement; clinical practice.

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“…In all CE projects, community partners are involved in all phases of research for the purposes of achieving mutual benefit and disseminating findings among stakeholders; however, the degree to which the community is involved and engaged in key roles may differ . At one end of the "engagement" continuum is community-based participatory research (CBPR) (Hood et al 2010), which is an intense collaboration between community stakeholders and academics in which power and decision-making are shared throughout the research process to change internal structures; build community capacity; and in a health context, reduce health disparities (Israel et al 2010;Israel et al 1998;Smith et al 2012). On the other end of the spectrum, communities are asked to participate in a study primarily conceptualized and designed by academic researchers with minimal input from community members (Hood et al 2010).…”

Section: Introductionmentioning

confidence: 99%

Community Engagement as a Process and an Outcome of Developing Culturally Grounded Health Communication Interventions: An Example from the DECIDE Project

Palmer-Wackerly

Krok

Dailey

et al. 2014

American J of Comm Psychol

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Community engagement is a process often used in developing effective health communication interventions, especially in traditionally underserved cultural contexts. While the potentially positive outcomes of community engagement are well established, the communication processes that result in engagement with cultural groups are less apparent. The focus on the outcomes of engagement at the expense of describing how engagement occurs makes it difficult for methods to be improved upon and replicated by future studies. The purpose of the current manuscript is to illustrate the process of achieving community engagement through the development of a culturally grounded health communication intervention. We offer practical suggestions for implementing community engagement principles, as well as the benefits and challenges inherent in this approach to research. Key points are illustrated using examples from the DECIDE Project, a culturally grounded intervention for improving communication about clinical trials in the medically underserved Appalachian region.

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Community-Based Participatory Research: A Capacity-Building Approach for Policy Advocacy Aimed at Eliminating Health Disparities

Cited by 640 publications

References 35 publications

A Mixed-Methods Outcome Evaluation of a Mentorship Intervention for Canadian Nurses in HIV Care

A Mixed-Methods Outcome Evaluation of a Mentorship Intervention for Canadian Nurses in HIV Care

Physicians as Part of the Solution? Community-Based Participatory Research as a Way to Get Shared Decision Making into Practice

Community Engagement as a Process and an Outcome of Developing Culturally Grounded Health Communication Interventions: An Example from the DECIDE Project

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