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Transcript of Building Partnerships: Empowerment & Change through Community-Based Participatory Research (CBPR)...
Building Partnerships:Empowerment & Change through Community-Based Participatory
Research (CBPR)
Tracy Schroepfer, PhD, MSW, MAUniversity of Wisconsin-Madison
School of Social Work
Wisconsin Cancer DisparitiesAfrican American males have higher
rates of prostate cancer than whites & die at twice the rate
African American women less likely to get breast cancer than white women, but more likely to die
American Indian men more likely diagnosed with colorectal cancer than any group
Asian American women have highest rates of cervical cancer of any group
WI Comprehensive Cancer Control Plan
Acknowledges problems exposed by presence of disparate cancer burden in WI
Seeks to “ensure that priorities and strategies developed in the plan work to eliminate health disparities”
Research Model NeededRecognition issue cuts across
traditional boundariesRequires collaborations with
communitiesNeed for research model that:
Is replicableSensitive to unique culture and
climate of each communityAdopts a holistic approach
Challenges for Minority Communities
Lack resources
May not be many community members conducting research
Researchers already have set agenda, not necessarily compatible with community’s needs
Community Based Participatory Research (CBPR)
PrinciplesCollaborative, partnership approachJoint involvement in processPartners contribute expertiseShare responsibilities & ownershipIncrease understanding of issueLocal community capacity buildingEmpowering processBalance between research and
action
Components of Process
Travel to community & present project
Community defines its boundariesMemorandum of Understanding
(MOU) developedCommunity funds distributedYoung community members
actively engaged in the project
Pilot Communities
Sankofa ProjectWI Coalition of Mutual Assistance
AssocLatino Health Council of Dane County Gerald Ignace Health Center
MilwaukeeScenic Bluffs Community Health
Clinics
New CommunitiesLac Courte Oreilles Band of Lake
Superior ChippewaBad River Band of Lake Superior
ChippewaRed Cliff Band of Lake Superior
ChippewaSixteenth Street Community
Health CenterAmish Community (in process)
Components of ProcessPurpose: Measures degree
community is ready to address cancer health disparities
Instrument: Community Readiness Assessment (CRA) developed by Colorado State University’s Tri-Ethnic Center for Prevention Research
6-10 community leaders interviewed
Young professional community members trained to conduct interviews
Six DimensionsCommunity efforts to address cancer
Community knowledge of efforts
Leadership
Community Climate
Knowledge of the Issue
Resources for prevention efforts
Cultural beliefs, values & perceptions
Stages of Community Readiness
9. High Level ofCommunity Ownership
9. High Level ofCommunity Ownership
4. Preplanning4. Preplanning
5. Preparation5. Preparation
6. Initiation6. Initiation
8. Confirmation/Expansion
8. Confirmation/Expansion
7. Stabilization7. Stabilization
3. Vague Awareness3. Vague Awareness
2. Denial / Resistance2. Denial / Resistance
1. No Awareness1. No Awareness
Stage 2: Denial & Resistance Some community members
recognize it is a concern, but little recognition it might be occurring locally.
Goal: Raise awareness the problem or issue exists in this community.
Intervention Possibilities: Approach and engage local educational & health outreach programs to assist in the effort with flyers, posters, or brochures.
Prepare and submit articles for church bulletins, local & club newsletters, etc.
Present information to community groups.
Preliminary Results
Communities score low on readiness scale
Cultural beliefs, values & perceptions play an important role
Communities possess strengthsInterventions: thinking out of the
box
Components of Process
Purpose: Gain understanding of, and knowledge about, cancer treatment experiences of individuals from medically underserved communities
Interview 75 community members who have either had cancer, currently have cancer, or have a terminal cancer diagnosis
Areas Being Assessed
Demographics
Cancer Diagnosis & Screening
Cancer Specialist & Treatment
Social Support
Patient-Physician Relationship
End-of-Life Issues & Care
Process Considerations
Funding
Identifying the community
Equitable involvement in research and analysis
Sharing, ownership, and use of findings for action