Community‐engaged Research Approaches: Multiple Pathways To Health Equity

Abstract

The last few decades have seen growing acceptance and use of research approaches involving non-academic partners. As reflected in the two recent special issues/sections of this journal addressing community-based participatory research (CBPR; Suarez-Balcazar et al., 2020;Wallerstein, 2021), these approaches have moved fairly rapidly from the fringes of scholarly conversations to their current position in multiple disciplinary mainstreams, particularly in public health and community psychology. Termed variously (e.g., CBPR, participatory action research; PAR; and community-university partnerships), communityengaged approaches to research (CEnR approaches) now appear in wide range of academic funding mechanisms and research programs, many of which target conditions associated with health inequities.With the benefits and validity of CEnR becoming more established in the mainstream, we are seeing scholarly conversations focus increasingly on the training, funding, incentivization, and evaluation of these collaborative and partnership approaches. The Engage for Equity: Advancing Community Engaged Partnerships (E2) project, for example, has advanced a science of CBPR (Wallerstein et al., 2020), providing a conceptual foundation and model for linking partnership contexts and dynamics to intermediate and long-term health equity outcomes (Kastelic et al 2018;Wallerstein et al., 2008). Developed empirically from two large surveys of research partnerships and community consultations (Belone et al., 2016), their conceptual CBPR model identifies a range of factors including communities' and universities' capacity and readiness, historical context of collaboration, formal agreements, and congruence of partners' core values that may predict positive system and capacity outcomes. This framework provides a strong, unifying foundation for the growing field of CEnR, capturing much of what has been learned about effective partnerships in the last few decades.Surveying this special section (Wallerstein, 2021), the recent special issue on CBPR approaches to health equity (Suarez-Balcazar, et al., 2020) and the broader landscape of CEnR literature, however, we are struck by the breadth of collaborative structures, partner roles, group processes, research methodologies, and types of actions being employed in these projects. While rooted in the values that are often considered fundamental to CEnR (challenging dominant assumptions about who holds and creates knowledge; Wallerstein & Duran, 2018; involving actions that benefit all partners; Israel et al., 1998), these projects are otherwise remarkably diverse in their strategies. We question, therefore, whether unifying language and frameworks will continue to support this growing discourse.Over time, various terms have emerged to describe certain CEnR approaches. Some, such as Youth Participatory Action Research (YPAR), have provided a platform for researchers to discuss the specific assumptions, strategies, and challenges of engaging youth in research. Others, such as CBPR and CEnR, are w...

“Just because I have a medical degree does not mean I have the answers”: Using CBPR to enhance patient‐centered care within a primary care setting

“…For example, although Laya was initially nervous to present to church members about the project, with scaffolding from the rest of the team, she developed public speaking skills, presented to church members, and felt empowered as an advocate. Alternatively, during quantitative data collection and for the focus group, Laya requested to be “100% a patient.” This changing level of involvement throughout the project aligns with Haapanen and Christens (2021) argument for a more nuanced approach to understanding and supporting partner involvement in community‐engaged research, which integrates considerations for partners' interests, needs, and strengths, the context and goals of the collaborative effort, and the specific project phase. A tool to support conversations about shifting levels of partnership involvement could be useful for practitioners and researchers implementing CBPR, particularly for partners new to this approach.…”

“…Through reflexivity, researchers “turn the gaze on themselves,” by questioning their privilege in knowledge production and determining what knowledge is valued and who makes those decisions (Wallerstein et al, 2019). Many CBPR projects have illustrated the power of ensuring that “expert” knowledge and role do not further marginalize nonacademic partners (Haapanen & Christens, 2021). At the same time, a recent commentary calls for a distinction between involvement in the research and opportunities to control or inform certain phases of the project (Haapanen & Christens, 2021).…”

“…Many CBPR projects have illustrated the power of ensuring that “expert” knowledge and role do not further marginalize nonacademic partners (Haapanen & Christens, 2021). At the same time, a recent commentary calls for a distinction between involvement in the research and opportunities to control or inform certain phases of the project (Haapanen & Christens, 2021). For example, some community partners may have different expectations for a partnership, and reflexivity can be used to identify partners' desired degree of involvement throughout the research process, instead of making assumptions (Haapanen & Christens, 2021).…”

Resident-Led Research Policy and Power (RRPP): A Framework for Centering Community Voice in Participatory Research

“…This approach to research has particular appeal in the field of public health because community members with expertise on the dynamic social, environmental, and behavioral contexts that interact to impact health experiences and health outcomes are uniquely able to inform epidemiology and the development of effective preventative and remediating policies. In addition, community leadership and participation in health research and policy solutions through CBPR has the potential to transform the narrative on who is a part of, and whose interests are being served by the health research community [ 8 , 10 ] and could potentially increase trust in and uptake of public health initiatives [ 1 , 11 ]. Current public attention to developing more equitable systems means that this approach to research will likely grow in popularity and attempts at implementation.…”

Community and Partner Engagement in Dissemination and Implementation Research at the National Institutes of Health: An Analysis of Recently Funded Studies and Opportunities to Advance the Field

“…These identi ed pitfalls include re-creation of the research to practice gap, misalignment of timelines incentives and priorities with community partners, and complexity of strategies that may not match community needs. These authors offer several ways forward, many of which involve increased attention to better integration of engagement approaches to inform D&I efforts since community engaged research is rooted in social justice and advancing health equity (23)(24)(25).…”