Partnership

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					Understanding Investigator-
Community Partnerships to Improve
CBPR Research:
CITRA’s Partnership Study

           Risa Breckman, LCSW
          Elaine Wethington, PhD
             Karl Pillemer, PhD
            Rhoda Meador, MA
              Myra Sabir, PhD
        M. Carrington Reid, MD, PhD
Establishing and Maintaining Successful
Investigator-Community Partnerships
                          Active and on-
                          going processes
                          Fundamental to
                          CBPR success
                          Fundamental to
                          other community-
                          researcher
                          partnerships on
                          continuum
Introduction: Importance of
Partnerships



 “CBPR is dependent on partnerships….”
   -Wallerstein, et al., (2005). Developing and maintaining partnerships with
   communities. Israel, B. et al., (Eds.), Methods in CBPR research for health;
   (p.31). San Francisco: Jossey-Bass.
Partnership Relationship Can
Influence
 Priorities
    E.g., Community buy-in
 Aims of study
 Tasks of study
    Recruitment
    Retention
 Analysis
 Interpretation of results
 Dissemination efforts
   Intermediate Measures of
   Partnership Effectiveness
                                                          Examples of
  Intermediate Measures of                                intermediate
  Partnership Effectiveness
                                                          measures:
                                                                Perceived effectiveness
                                                                in achieving goals
                                                                Perceived benefits and
  Outcome Measures of                                           costs of participating
  Partnership Effectiveness                                     Shared ownership and
                                                                cohesiveness or
  (i.e., achievements)                                          commitment to
                                                                collaborative efforts
                                                                Future expectations of
                                                                effectiveness
-Schulz, A, et al. (2003). Instrument for evaluating dimensions of group dynamics within
community-based research partnerships. Eval and Program Planning, 26 (3), 249-262.
Background: CITRA’s Role in
Partnership Development
 CITRA has funded 14 pilot studies
 All pilots utilize as partners
   Cornell researchers (Weill, Ithaca,
   Westchester)
     Senior and junior investigators
     From Medicine, Psychology, Sociology,
     Psychiatry, etc.
   NYC elder service agencies and health
   organizations
     Senior centers, ambulatory care, case
     management, social services
Background: CITRA’s Role in
Partnership Development
 CITRA utilized a Community Advisory
 Board to:
   Develop agreement on values, priorities for
   pilot funding
   Develop RFA for pilot studies
Background: CITRA’s Role in Partnership
Development (Continued)
  From the RFA:
  “Researcher-Community Partnerships can take
  many forms and proposals should include one or
  more of the possible types of collaborations:
    Mutual development of a research idea;
    The collaboration between agency and researcher in all
    stages of the research including initial planning,
    implementation, and utilization;
    Interpreting results together;
    The agency providing research subjects in return for the
    researcher writing a research-based review or another
    acceptable product.”
CITRA’s Role in Partnership
Development
 CITRA staff
   Assisted with partnership matching, if
   needed
Background: CITRA’s Role in
Partnership Development
(Continued)
 CITRA provides mentorship and technical
 assistance to funded pilots
   Partners present to a formal group of researchers
   and receive feedback on study (as per RFA)
   CITRA’s Director of Partnerships provides
   assistance on process concerns (by request)
CITRA Partnership Survey:
Purpose

  CITRA conducted pre and post partnership
  survey of our 2005-2007 funded pilot
  projects (IRB approved) to:
    Evaluate intermediate measures of partnership
    effectiveness
      Identify partnerships experiencing difficulties
      Identify elements of partnerships in which
      discrepancies are frequently found
CITRA’s Partnership Survey:
Methods
 Pilot Study Survey Development
   Initial survey drafted by CITRA staff
   Draft reviewed by CITRA’ NAC and CAC
     In-person, phone and email feedback
 Feedback incorporated into final version
Methods (Continued)
 Survey Design--25 questions
  General information
  Perceptions of communications
  Extent of involvement in research
  project
  Perceptions of benefits/costs of
  participating
  Future expectations
Methods (Continued)
 Survey Participants
   Researchers and their community partner(s)
 Survey Administration
   Survey self-administered
      After funding awarded and IRB approved; at conclusion of
      study as defined by researcher
   Paper and pencil or electronic
   Confidential
   20-30 minutes
   Requirement of funding as per RFA for last round pilots
Analysis
 Descriptive
 Qualitative
   Results: Total Number Surveys in
   Dataset (2005-2007)

                                Partners
    N=5 Studies
                            N=5          N=6
  (6 partnerships)
                         Researchers   Agencies

            Pre-Study    5 surveys     5 surveys
             Surveys     completed     completed
 Surveys
Completed   Post-Study   3 surveys     3 surveys
             Surveys     completed     completed
Purpose of CITRA Survey:


 In which elements of partnerships are
   discrepancies frequently found?
      Agency/Researcher Comparisons: Are
      Communications with Partner Satisfactory?


  N=5 Studies
(6 Partnerships)         Pre               Post
                   Research Agency Research Agency
                      2        4       3       2
   Satisfactory
                    (40%)    (80%)  (100%)   (66%)
                      3        1
 Unsatisfactory                        0       0
                    (60%)    (20%)
                                               1
   No Answer          0        0       0
                                             (33%)
      Agency/Researcher Comparisons: Perceptions of
      Partnership Agreements

   N=5 Studies                  Pre                    Post
 (6 Partnerships)        Research     Agency    Research Agency

  Written/acceptable     3 (60%)      4 (80%)      0       2 (66%)

 Unwritten/acceptable       0         1 (20%)   3 (100%)      0

 Written/unacceptable       0           0          0          0
Unwritten/unacceptable      0           0          0          0
    No agreement         2 (40%)        0          0          0
     Don’t know              0          0          0          0
     No Answer              0           0          0       1 (33%)
           Agency/Researcher Comparisons: What Tasks
           are Agency Staff Doing for Study?
             Tasks               Pre: 5 Studies      Post: 3 Studies
                                 Research   Agency   Research Agency
Identify research participants   5 (100%) 4 (80%) 2 (66%)      3 (100%)
Contact/Schedule participants 2 (40%)       2 (40%) 0          2 (66%)
Provide intro material for part 1 (20%)     1 (20%) 0          2 (66%)
Provide space for work           3 (60%)    3 (60%) 1 (33%)    2 (66%)
Co-design study questions        2 (40%)    1 (20%) 0          0

Provide space for researcher     1 (20%)    3 (60%) 1 (33%)    2 (66%)
Provide storage for materials    1 (20%)    2 (40%) 0          0
Interview participants           1 (20%)    1 (20%) 0          2 (66%)
Other: Solicit client interest   0          1 (20%) 0          0
Other: Obtain permissions        2 (40%)    1 (20%) 2 (66%)    0
            Agency/Researcher Comparisons: What percentage of
            agency staff time is devoted to study activities?

                     Pre- Study (5 Studies)                  Post-Study (3 Studies)
% Staff Time         Research: 12 Staff   Agency: 22 Staff   Research: 14 Staff   Agency: 8 Staff

Few min./month       7                    --                 --                   --
1-2 hours/week       --                   5                  --                   --
1-2%                 --                   --                 10                   --
3%                   --                   5                  2                    --
5%                   1                    3                  2                    --
10%                  --                   --                 --                   2
10-15%               --                   --                 --                   2
15%                  1                    --                 --                   --
20%                  --                   --                 --                   1
25%                  2                    1                  --                   2
30%                  --                   1                  --                   1
40%                  --                   1                  --                   --
50%                  1                    1                  --                   --
Unable to estimate   --                   5                  --                   --
No Answer            --                   --                 --                   1
           Agency/Researcher Comparisons: How Do You
           View the Benefits of the Study for the Agency?
                                  Pre N=5 Studies     Post N=2 Studies
                                  (6 partnerships)    (3 partnerships)
Benefits                          Research Agency     Research   Agency
Services provided for agency      2 (40%)   3 (60%)   1 (33%)    2 (66%)
Support for agency activities     2 (40%)   4 (80%)   3 (100%) 3 (100%)
Activities/benefits for clients   4 (80%)   4 (80%)   1 (33%)    3 (100%)
Proposal activity                 2 (40%)   3 (60%)   0          1 (33%)
New info about org                0         2 (40%)   0          2 (66%)
Improve org ability research      1 (20%)   4 (80%)   1 (33%)    2 (66%)
Eval of current programs          0         2 (40%)   0          2 (66%)
Assist w/ planning/fund raise     1 (20%)   3 (60%)   1 (33%)    1 (33%)
Other: Understand needs of        0         0         1 (33%)    0
pop agency wants to serve
            Agency/Researcher Comparisons: How Do You
            View the Partnering Agency as Professionally
            Beneficial to the Researcher?
                                      Pre                   Post
Benefits                              Research   Agency     Research   Agency
Providing research participants       5 (100%)   3 (60%)    2 (66%)    2 (66%)
Providing hands-on exp w/             2 (40%)    5 (100%)   3 (100%)   2 (66%)
community
Use of agency network for research-   3 (60%)    5 (100%)   3 (100%)   2 (66%)
related activities
Help w/ analysis and interpretation   0          3 (60%)    0          1 (33%)
Understanding real life problems      2 (40%)    3 (60%)    3 (100%)   2 (66%)
Learning how to do applied research   2 (4%)     4 (80%)    2 (66%)    1 (33%)

Research will help w/ promotion or    1 (20%)    3 (60%)    2 (66%)    1 (33%)
tenure
Other                                 0          0          0          0
Not Applicable                        0          0          0          1 (33%)
     Agency/Researcher Comparisons: How Likely is
     Long-Term Relationship with Partner?


                    Pre-survey       Post-survey
                   (N=5 surveys     (N=3 surveys)
                  Research Agency Research Agency
  Very Likely     4 (40%)   3 (60%)   3 (100%)   1 (33%)

Somewhat Likely   1 (20%)   2 (40%)      0       1 (33%)

   Unlikely          0        0          0       1 (33%)
Senior Investigator’s
Reflections on Partnership
  Researcher:

“This unique project needed a unique partnership and we
  had/have one with XX. This includes being able—on both
  sides—to ask questions, provide boundaries, and work
  together to reach out to the community. ….It was a real
  boon to partner with an agency that understands the
  importance of serious research…and that will use our
  results to serve the constituency we are serving.”
Junior Investigator’s Reflections on
Partnership
“…I found this project an amazing learning experience.
  Although my project was not strictly speaking a 50-50
  ownership…it still required substantial partnering and
  communication with agencies and staff…CITRA staff
  helped by facilitating the researcher/agency relationship,
  advising on how to strengthen the relationship and improve
  communication….The project also taught me the realities
  of working in the community, what agency staff face day-
  to-day, advantages and limitations, which will inform
  future community-based projects….”
Agencies’ Reflections on
Partnership
“It is important for social service agencies to gather
   research data and statistical information in
   addition to the anecdotal, in order to influence
   positive change in public policy.” (Partnered with
  the Sr. Investigator)
“My staff and I enjoyed working with XX…. We
  learned a great deal from her regarding the
  research process. We would enjoy collaborating
  with her again in the near future.” (Partnered with
  the Jr. Investigator)
Limitations
 Limitations:
   Small dataset
   Biased responses
     CITRA provided money--are people giving
     honest answers?
Conclusions
 Many significant elements of partnership
 relationships remain unexplored
 Surveying partners viable method to
    identify agreements/differences
    explore elements of partnerships
 Providing timely technical assistance can
 strengthen partnerships
 Impact of partnership relationship on study
 outcomes is complex
Implications

 Partners could utilize a survey to identify
 agreement/differences in partnership relationships
   Problem-solving
   Strengthen partnerships
 Future research:
   Which partnership relationship elements impact on study
   outcomes?
   Which study outcomes are influenced?
Implications (continued)
 Step up efforts regarding educating partners about
 importance of partnership agreement
    Educate each other about topics for content
    Partners should sign and receive a copy
 Educate researchers about the potential time
 involved for agencies to do work for studies
 Educate partners about having a post research
 discussion regarding future possibilities (e.g., vision,
 priorities, needs)
CITRA’s Next Steps
 Distribute remaining post-study surveys
 Enroll more studies
   Future CITRA pilots in survey
   3 Rand/Harford projects
 Continue utilizing survey to help pilot
 projects
   Encourage partners to use survey to
   understand each other and problem-solve
Acknowledgements
 Thank you to:
   CITRA’s NAC and CAC
   CITRA’s pilot studies
   CITRA’s faculty and staff

				
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posted:12/2/2011
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