CBPR: An innovative CBPR: An innovative approach for practice approach for practice

based research based research networksnetworks

Maghboeba Mosavel, PhDMaghboeba Mosavel, PhD

Center for Reducing Health Center for Reducing Health DisparitiesDisparities

May 10, 2006May 10, 2006

OutlineOutline

•Key principles of CBPRKey principles of CBPR•CBPR in South AfricaCBPR in South Africa•CBPR in ClevelandCBPR in Cleveland•PBRN and CBPRPBRN and CBPR•ChallengesChallenges

Relevance of CBPR to Relevance of CBPR to PBRNPBRN

• PBRN can expand research and PBRN can expand research and knowledge base by incorporating a knowledge base by incorporating a CBPR approach (Macaulay, 2006)CBPR approach (Macaulay, 2006)

• Expand the researcher-clinician Expand the researcher-clinician partnership to include broad-based partnership to include broad-based community stakeholders (patients community stakeholders (patients and other stakeholders)and other stakeholders)

Key principles of CBPRKey principles of CBPR

• CollaborationCollaboration

• Capacity Building Capacity Building

• It is about the research, the process, as well as It is about the research, the process, as well as the researcherthe researcher

• Reduce distance between academic, clinician, Reduce distance between academic, clinician, and communityand community

• Social ActionSocial Action

Context of “traditional” Context of “traditional” researchresearch

• Communities have often been colonized Communities have often been colonized by researchers (Wallerstein & Duran, by researchers (Wallerstein & Duran, 2003)2003)

• ““helicopter research” (Deloria, 1992) or helicopter research” (Deloria, 1992) or “hello-goodbye approach” (Huberman, “hello-goodbye approach” (Huberman, 1991)1991)

• CBPR researchers must take into CBPR researchers must take into account the historical context of how account the historical context of how research has been conducted in research has been conducted in marginalized communitiesmarginalized communities

ParticipationParticipation

• Who represents the community?Who represents the community?

• ““There is a First World in every Third There is a First World in every Third World community” (Ong, 1991)World community” (Ong, 1991)

• Participation means least to most Participation means least to most powerful members of community must powerful members of community must be included in the decision making be included in the decision making processprocess

Steps in the processSteps in the process

• Defining the research questionDefining the research question• Designing the researchDesigning the research• Implementing the research designImplementing the research design• Analyzing the research dataAnalyzing the research data• Reporting the research resultsReporting the research results• Acting on the research resultsActing on the research results

CBPR in South AfricaCBPR in South AfricaBackgroundBackground

• Placement in Case Comprehensive Cancer Placement in Case Comprehensive Cancer

CenterCenter

• Interest in Community-based researchInterest in Community-based research

• Connection to South AfricaConnection to South Africa

• Researchers’ interest in cervical cancerResearchers’ interest in cervical cancer

• Access to resources, time, epidemiological dataAccess to resources, time, epidemiological data

Defining the research Defining the research questionquestion

• A chance to use power for goodA chance to use power for good

• Lay the groundworkLay the groundwork

• Jointly develop and agree on ground Jointly develop and agree on ground rulesrules

Working backwardsWorking backwards

• ““Start where the people are” Start where the people are” (Nyswander, 1956)(Nyswander, 1956)

• Listen to “hidden transcripts” of the Listen to “hidden transcripts” of the communitycommunity

• Recognize and begin with Recognize and begin with community strengthscommunity strengths

The journey from The journey from cervical cancer to cervical cancer to

cervical healthcervical health

• Walking and “windshield” toursWalking and “windshield” tours

• Key formal and informal interviewsKey formal and informal interviews

• Frame question within lived contextFrame question within lived context

Designing the researchDesigning the research

• Community Advisory BoardCommunity Advisory Board

• Jointly decided on the methodologyJointly decided on the methodology

• Developed focus group questions with teamDeveloped focus group questions with team

• Conducted focus groups with key Conducted focus groups with key stakeholders (girls, boys, educators, school stakeholders (girls, boys, educators, school staff, mothers, service providers) staff, mothers, service providers)

Implementing the research Implementing the research designdesign

• Focused on capacity buildingFocused on capacity building

• Hired, trained community Hired, trained community membersmembers

• Develops ownership of projectDevelops ownership of project

• Informal “research ambassadors”Informal “research ambassadors”

Analyzing the research Analyzing the research datadata

• Trained researchers in South Africa Trained researchers in South Africa to analyze data to analyze data

• Trained researchers in US to analyze Trained researchers in US to analyze datadata

Reporting the research Reporting the research resultsresults

• Data disseminationData dissemination

• Returned to stakeholdersReturned to stakeholders

• WorkshopsWorkshops

• Reports/Co-authorshipReports/Co-authorship

Acting on the research Acting on the research resultsresults

•Action that benefits the Action that benefits the communitycommunity

•Policy implicationsPolicy implications

•SustainabilitySustainability

CPBR in ClevelandCPBR in Cleveland

•The research questionThe research question

•Research DesignResearch Design

•Data CollectionData Collection

Data AnalysisData Analysis

•Research AssistantsResearch Assistants

•Community Research TeamCommunity Research Team

Research in ActionResearch in Action

•Data DisseminationData Dissemination

•Mother-daughter health Mother-daughter health communication daycommunication day

PBRN and CBPR¹PBRN and CBPR¹• Bottom-up not top-downBottom-up not top-down

• Recognizes the importance of the lived Recognizes the importance of the lived experienceexperience

• Recognize the assets of peopleRecognize the assets of people

• Driven by local needsDriven by local needs

Minkler,M. (Minkler,M. ( 2000) Public Health Reports 2000) Public Health Reports

ChallengesChallenges

• Deciding who the relevant Deciding who the relevant stakeholders are and how to engage stakeholders are and how to engage them in a meaningful processthem in a meaningful process

• Will community voices truly be Will community voices truly be heard or is it just camouflage?heard or is it just camouflage?

• Meeting the needs of researchers, Meeting the needs of researchers, clinicians, and community membersclinicians, and community members

• Time consumingTime consuming

Contact InfoContact Info

mxm5@case.edumxm5@case.edu

778-8475778-8475