Using Community-Based Participatory Research to Address Social Determinants of Health: Lessons Learned from Seattle Partners for Healthy Communities

Abstract

Seattle Partners for Healthy Communities (SPHC) is a multidisciplinary collaboration of community agencies, community activists, public health professionals, academics, and health providers who conduct research aimed at improving the health of urban, socioeconomically marginalized Seattle communities. SPHC uses a community-based participatory research approach to address social factors that affect the health of these communities. This article describes three SPHC projects that focus on social determinants of health, particularly the development of social support and improving housing quality. The characteristics of community participation in each of these projects are discussed and show a spectrum of participation. Although projects successfully addressed proximal social factors affecting health, influencing more distal underlying factors was more difficult. Implications for researchers using a community-based participatory research approach and public health practitioners seeking to engage communities in addressing social determinants of health are presented.

ReseArch with Patient and Public invOlvement: a RealisT evaluation – the RAPPORT study

“…[88][89][90] Dissemination of research findings is also reported as gaining from PPI networks to increase access to peers 81 and relevant sections of the community, 15 and making information more broadly readable. 31,72 There are fewer published claims for PPI as playing a significant role in implementing findings, but, in a US public health research programme, Krieger et al 86 report PPI-related implementation of changes by increasing their cultural relevance. Several researchers have identified that PPI has helped them address ethical dilemmas, 17,71,78,85,91 for example ethically appropriate ways of contacting women with recently diagnosed breast cancer and the use of routine patient data.…”

“…However, there was no evidence on how this affected research outcomes. This effect of PPI on study recruitment has been reported widely elsewhere, 70,[78][79][80][81][82][83][84][85][86]88 but the range of case studies within the RAPPORT study allows the specific components to be teased out ( Figure 19). …”

“…58,93,95 Within community-based public health research, benefits of PPI are also reported in enhancing the capacity of community-based organisations to raise their value to their communities. 86 Finally, there are claims that PPI brings benefits to researchers beyond just the research study. Working with the public and service users is found to be a process whereby researchers learn to share control and develop facilitation skills.…”

“…84 More active involvement in mainly qualitative data analysis has been identified as improving interpretation of findings through the drawing out of relevant themes. 79,[85][86][87] Moreover, qualitative data collection by service users as co-researchers has been claimed to improve validity and provide better-quality data. [88][89][90] Dissemination of research findings is also reported as gaining from PPI networks to increase access to peers 81 and relevant sections of the community, 15 and making information more broadly readable.…”

“…Recruitment was the most frequently mentioned area in which PPI was seen as having a 'visible' impact, and is a recurring focus in the literature. 70,[78][79][80][81][82][83][84][85][86] Recruitment processes were part of the overall research design and provided a natural entry for PPI. Case studies had evidence of PPI impact on other elements of the design such as choice of outcome measures, ensuring tools were participant-sensitive or involvement in developing the intervention.…”