Community-based participatory research

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Community-based participatory research (CBPR) is an equitable approach to research in which researchers, organizations, and community members collaborate on all aspects of a research project. CBPR empowers all stakeholders to offer their expertise and partake in the decision-making process. CBPR projects aim to increase the body of knowledge and the public's awareness of a given phenomenon and apply that knowledge to create social and political interventions that will benefit the community. [1] CBPR projects range in their approaches to community engagement. Some practitioners are less inclusive of community members in the decision-making processes, whereas others empower community members to direct of the goals of the project. [2]

Contents

History

The historical roots of CBPR trace back to the development of participatory action research by Kurt Lewin and Orlando Fals Borda, and the popular education movement in Latin America associated with Paulo Freire. [3] [4]

Principles

CBPR offers nine guiding principles. These principles include: 1) acknowledging communities as "unities of identity", 2) building on existing community strengths and resources, 3) facilitating partnerships that are equitable, collaborative, empowering, and address social inequalities, 4) committing to co-learning and capacity building, 5) balancing knowledge generation and intervention to ensure mutual benefits for partners, 6) focusing on local issues of public concern, 7) utilizing a cyclical and repeatable process, 8) delivering results and knowledge to all partners, and 9) establishing sustainable, long-term partnerships with communities. [1] Partnerships may use these principles to inform their studies, but are not required to adhere to them entirely. Instead, each partnership should discuss and decide on their own guiding principles to best reflect their collective vision. [5]

Process

CBPR is an iterative process, incorporating research, reflection, and action in a cyclical process. A CBPR project starts with the community, which participates fully in every aspect of the research process. "Community" is often self-defined, but common definitions of community include a geographic community, a community of individuals with a common problem, or a community of individuals with a common interest or goal. CBPR encourages collaboration between "experts" and communities, provided that the researchers are committed to sharing leadership and producing outcomes that are usable to the community that they intend to collaborate with. Equitable partnerships require sharing power, resources, knowledge, results, and credit. Mapping the groups that make up a community can reveal power relationships and create opportunities for relationship building. Ideally, stakeholders should be from different positions of the community so that changes are implemented at all different levels. The policies and policymakers connected to the community problem should be identified. The next stages of CBPR include identifying the problem, research design, conducting research, interpreting the results, and determining how the results should be used for action.

CBPR interventions can take many forms, including media or other educational campaigns, subsidized medical testing and healthcare programs, establishing quality standards for healthcare services as well as bonuses for healthcare providers who refer patients to CBPR-related services. Some projects involve training for young people to learn how to educate and advocate for change in their communities.  

Environmental justice

Community-based participatory research plays a meaningful role in the environmental justice movement. CBPR is a collaborative effort between researchers, academics, and environmental justice (EJ) communities. In the United States, EJ communities are characterized by residents who are people of color, low-income, non-native English speakers (linguistic isolation), or foreign born. Due to their intersecting racial, national, and class identities, EJ communities have little control capacity and are the targets of negative externalities by polluting corporations. CBPR takes a procedural justice approach to EJ issues, addressing the structural causes of environmental injustices and illuminating the power structures at play. CBPR often takes the form of empirical research, [6] in which EJ community members observe environmental or health hazards in their communities and form hypotheses about the origins of these hazards. By bettering communities' understandings of the problems they face, CBPR supports environmental literacy [7] and knowledge justice. Community-based research is more likely to trigger public action and engagement with environmental issues than traditional research. [7] Bottom up community-based research in which community members oversee each phase of the research project is more likely to inspire structural reforms that are responsive to the needs of EJ communities. [6]

Research

CBPR research focuses on the relationships within the partnership and the overall goals, as opposed to strict research methods. [8] Scholarship in the area of CBPR is vast and spells out various approaches which consider multiple theoretical and methodological approaches. [9] The content areas include health, [10] [11] [12] [13] ethnic studies, [14] bullying, [15] environmental justice, [6] and indigenous communities. [16]

There is a lot of scholarship exploring how to teach students about CBPR or community-based research (CBR). Some have taken what could be called a critical approach to this by emphasizing the "institutional power inequalities" in community-based organization-university relationship building. There are successes and failures in using CBPR approaches in teaching, which practitioners can consider. [17] Others have argued that community-based work can provide several learning benefits, with pros and cons to the various approaches. [18] Scholars continue to problematize approaches that can engage instructors and students in imagining ways to work with communities. [19] [20] [21]

Research challenges

Scholarship has explored the potential barriers to collecting community-based participatory research data. The CBPR approach is in line with the body of sociological work that advocates for "protagonist driven ethnography". [22] The approach provides for and demands that researchers collaborate with communities throughout the research process. However, challenges can surface given the power relationship between researcher and communities. The CBPR approach proposes that researchers be mindful of this possibility. The researcher can expect to spend a lot of time navigating and building the researcher-community relationship. Additionally, through CBPR, researchers enable communities to hold them accountable to addressing ethical concerns inherent to collecting information from what are often marginalized communities. Sociologists have entered the discussion from the point of view of the ethnographer or participant observer, where some have argued against "exoticizing the ghetto" or "cowboy ethnography". [23] These works could be read as a check on the scholar centered work that can emerge when collecting ethnographic or participant observation data. The perception of researchers is something to weigh when considering this approach or other forms of field work. One researcher stated that "Researchers are like mosquitoes; they suck your blood and leave." [24] Through this lens, a focus on a CBPR project at the exclusion of the community could harm the goals of co-learning and shared goal accomplishment.

Applications

Applications of community-based participatory research are more common in medicine than other areas of research. Prevention, management, and awareness building about diabetes, [25] HIV/AIDS, [26] asthma, [27] cancer, [28] mental health, obesity, [29] and HPV vaccination [30] have been explored by CBPR studies. Because of its community-based, [31] [32] humanistic approach and public outreach potential, CBPR studies are commonly used with marginalized groups, such ethnic minorities and autistic people. [33]

Resources

There are a number of institutions that provide funding and other resources for CBPR studies. [34] Organizations and institutions support CBPR by focusing on youth, [35] and social justice. [36] Networks of researchers, professionals, and activists collaborate on CBPR projects. [37] [38]

Related Research Articles

The United Nations defines community development as "a process where community members come together to take collective action and generate solutions to common problems." It is a broad concept, applied to the practices of civic leaders, activists, involved citizens, and professionals to improve various aspects of communities, typically aiming to build stronger and more resilient local communities.

Adaptive management, also known as adaptive resource management or adaptive environmental assessment and management, is a structured, iterative process of robust decision making in the face of uncertainty, with an aim to reducing uncertainty over time via system monitoring. In this way, decision making simultaneously meets one or more resource management objectives and, either passively or actively, accrues information needed to improve future management. Adaptive management is a tool which should be used not only to change a system, but also to learn about the system. Because adaptive management is based on a learning process, it improves long-run management outcomes. The challenge in using the adaptive management approach lies in finding the correct balance between gaining knowledge to improve management in the future and achieving the best short-term outcome based on current knowledge. This approach has more recently been employed in implementing international development programs.

<span class="mw-page-title-main">Community health</span> Field of public health

Community health refers to non-treatment based health services that are delivered outside hospitals and clinics. Community health is a subset of public health that is taught to and practiced by clinicians as part of their normal duties. Community health volunteers and community health workers work with primary care providers to facilitate entry into, exit from and utilization of the formal health system by community members as well as providing supplementary services such as support groups or wellness events that are not offered by medical institutions.

Behavior change, in context of public health, refers to efforts put in place to change people's personal habits and attitudes, to prevent disease. Behavior change in public health can take place at several levels and is known as social and behavior change (SBC). More and more, efforts focus on prevention of disease to save healthcare care costs. This is particularly important in low and middle income countries, where supply side health interventions have come under increased scrutiny because of the cost.

<span class="mw-page-title-main">Participatory action research</span> Approach to research in social sciences

Participatory action research (PAR) is an approach to action research emphasizing participation and action by members of communities affected by that research. It seeks to understand the world by trying to change it, collaboratively and following reflection. PAR emphasizes collective inquiry and experimentation grounded in experience and social history. Within a PAR process, "communities of inquiry and action evolve and address questions and issues that are significant for those who participate as co-researchers". PAR contrasts with mainstream research methods, which emphasize controlled experimentation, statistical analysis, and reproducibility of findings.

Health promotion is, as stated in the 1986 World Health Organization (WHO) Ottawa Charter for Health Promotion, the "process of enabling people to increase control over, and to improve their health."

Photovoice is a qualitative research method used in community-based participatory research that gathers participant-taken photographs and narratives to translate experience into actionable knowledge. Photovoice is commonly used in the fields of community development, international development, public health, and education.

Public participation, also known as citizen participation or patient and public involvement, is the inclusion of the public in the activities of any organization or project. Public participation is similar to but more inclusive than stakeholder engagement.

<span class="mw-page-title-main">Participatory rural appraisal</span> Process in international development

Participatory rural appraisal (PRA) is an approach used by non-governmental organizations (NGOs) and other agencies involved in international development. The approach aims to incorporate the knowledge and opinions of rural people in the planning and management of development projects and programmes.

Public engagement or public participation is a concept that has recently been used to describe "the practice of involving members of the public in the agenda-setting, decision-making, and policy-forming activities of organizations/institutions responsible for policy development." It is focused on the participatory actions of the public to aid in policy making based in their values.

<span class="mw-page-title-main">West Harlem Environmental Action</span> Nonprofit organization

WE ACT for Environmental Justice is a nonprofit environmental justice organization based in Harlem, Manhattan, New York City. The organization was founded in March 1988 to mobilize community opposition to the city's operation of the North River Sewage Treatment Plant, and the siting of the sixth bus depot in Northern Manhattan.

Implementation research is the systematic study of methods that support the application of research findings and other evidence-based knowledge into policy and practice. It aims to understand the most effective pathways from research to practical application, particularly in areas such as health, education, psychology and management. Intervention research, also known as intervention science, evaluates how various interventions or approaches are adopted and applied in "real world" settings in order to establish an understanding of their effectiveness in different contexts.

Human-centered design is an approach to problem-solving commonly used in process, product, service and system design, management, and engineering frameworks that develops solutions to problems by involving the human perspective in all steps of the problem-solving process. Human involvement typically takes place in initially observing the problem within context, brainstorming, conceptualizing, developing concepts and implementing the solution.

Human-centered design is an approach to interactive systems development that aims to make systems usable and useful by focusing on the users, their needs and requirements, and by applying human factors/ergonomics, and usability knowledge and techniques. This approach enhances effectiveness and efficiency, improves human well-being, user satisfaction, accessibility and sustainability; and counteracts possible adverse effects of use on human health, safety and performance.

Health communication is the study and practice of communicating promotional health information, such as in public health campaigns, health education, and between doctor and patient. The purpose of disseminating health information is to influence personal health choices by improving health literacy. Health communication is a unique niche in healthcare that allows professionals to use communication strategies to inform and influence decisions and actions of the public to improve health.

Peer education is an approach to health promotion, in which community members are supported to promote health-enhancing change among their peers. Peer education is the teaching or sharing of health information, values and behavior in educating others who may share similar social backgrounds or life experiences.

<span class="mw-page-title-main">GIS and environmental governance</span> Tool for environmental management

Geographic information system (GIS) is a commonly used tool for environmental management, modelling and planning. As simply defined by Michael Goodchild, GIS is as "a computer system for handling geographic information in a digital form". In recent years it has played an integral role in participatory, collaborative and open data philosophies. Social and technological evolutions have elevated digital and environmental agendas to the forefront of public policy, the global media and the private sector.

Jean J. Schensul is a medical anthropologist and senior scientist at The Institute for Community Research, in Hartford, Connecticut. Dr. Schensul is most notable for her research on HIV/AIDS prevention and other health-related research in the United States, as well as her extensive writing on ethnographic research methods. She has made notable contributions to the field of applied anthropology, with her work on structural interventions to health disparities leading to the development of new organizations, community research partnerships, and community/university associations. Schensul’s work has been dedicated to community-based research on topics such as senior health, education, and substance abuse, among others.

The Akwesasne Task Force on the Environment (ATFE) is a community-based grassroots activist organization developed to address issues of environmental justice and contamination within the Mohawk Nation of Akwesasne. The mission of the ATFE is to preserve the Mohawk community's spiritual, cultural and biological integrity through activism, advocacy, and collaborative research. They achieve their efforts through projects related to political advocacy, environmental education and by conducting culturally-sensitive research to address the consequences of environmental injustices. The ATFE's influence has extended to surrounding public schools and has contributed to discussions on the introduction of Indigenous Knowledge into mainstream science curricula in the United States.

Community-engaged research (CEnR) is the process of working collaboratively with groups of people affiliated by geographic proximity, special interests, or similar situations with respect to issues affecting their well-being. One of the most widely used forms of community-engaged research is community-based participatory research (CBPR), though it also encompasses action research and participatory action research. Another form of community-engaged research is integrated knowledge translation (iKT), defined as "an approach to doing research that applies the principles of knowledge translation to the entire research process". The iKT evolves around the concept of engaging different levels of knowledge users as equal partners in the research activities so that research outputs are more relevant to, and more likely to be useful to, the knowledge users.

Meredith Minkler is an American public health researcher who is emeritus Professor at the University of California, Berkeley. She is known for her work on community-based participatory research and its use in public policy, criminal justice reform and democratizing access to food.

References

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