CBPR Powerpoint by v1jQ0W3u

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									Community Based Participatory
     Research (CBPR)

         February 28,2008
                       CBPR
• Not simply a strategy, but an ideology

• People should be able to determine what is
  happening to their community
  – They will have to live with it! (compatibility)
  – Research dollars run out, so what will happen
    later on? (sustainability)
  – Not a laboratory in the traditional sense (fidelity)
       “Traditional” Approaches
• Researchers pre-define “problem”
  – Little community involvement / paternalistic
  – Researchers offer solutions, implement, evaluate and leave
  – Programs are typically not feasible “real-world” solutions
• Communities
  – Define problem within context
  – Develop intervention
  – Evaluation / measurement may not be adequate
                Considerations
• Community members
  – What benefit will become of the research for my
    community?
• Researchers
  – What benefit will become of the research for my needs?
  – Papers, grant funding, promotion, etc.
• Funding agencies
  – What benefit will become of the research for our
    organization?
  – Increased evidence-base, quality outcomes, achieving
    organization’s mission
                      Compatibility
• As researchers, we are typically outsiders (and usually viewed
  as such)
• While we bring a technical expertise to the table, community
  members bring a contextual expertise
• Both are CRITICAL
   – Some types of interventions work well,
     others work not so well
       • DARE, Taxation of tobacco
   – Some types of interventions are contextually appropriate, others are
     not
       • VCR Tapes, TV Commercials
• While our interventions may or may not work, we’ll get an
  article or some benefit from the work (at least a lesson
  learned)
• The community will have to live with this intervention
                Sustainability

• “Traditional” research programs involve a
  research team entering community
  – Conducting some form or forms of interventions
  – Observing changes
  – Consider limitations / changes needed for future
    interventions
  – Good process and immediate outcome
    evaluations
  – Funding is over
  – Short time frame (months to a couple of years)
            Sustainability (cont.)
• Community programs (i.e., local health dept)
   – May use pre-fab or “canned” programs
   – May implement due to mandate from supervising agency
   – May be designed due to perceived or measured need
     within community
   – Context specific (probably not generalizable to other
     communities)
   – Can probably be sustained longer in the community (DARE)
   – Evaluation of effect / outcomes may not be adequate
            Principles of CBPR
• CBPR facilitates collaborative, equitable
  partnerships in all phases of the research.

• CBPR integrates and achieves a balance
  between research and action for the mutual
  benefit of all partners.

• CBPR recognizes community as a unit of
  identity
           Principles of CBPR
• CBPR builds on strengths and resources
  within the community

• CBPR promotes
  co-learning and capacity
  building among all
  partners
           Principles of CBPR
• CBPR involves a long-term process and
  commitment

• CBPR emphasizes local relevance of public
  health problems and ecological perspectives
  that recognize and attend to the multiple
  determinants of health and disease
            Principles of CBPR
• CBPR disseminates findings and knowledge
  gained to all partners and involves all partners
  in the dissemination process

• CBPR involves systems development through a
  cyclical and iterative process
            Process is Dynamic
• Nature of the process requires flexibility
  – Communities are different
  – Various time frames (hard to create timelines)
  – Various personalities
     • Communities (Bryan vs. College Station vs. New York
       City)
     • Organizations (Cooperative Extension Agencies in
       various counties)
     • Individuals (county judges, mayors, etc.)
                    Goal Setting
• Good to set a defined ultimate goal
• Also good to define smaller “baby-step” goals
   – Offers group a sense of success early on
   – “We can do this after all”

• Definition of success and failure is important
   – Multiple definitions are important
   – Developed intervention to obesity problem that was not
     very effective, but was able to have the two local
     physicians, the local pharmacist, and a competing health
     system’s representative all collaborate and agree (or
     maybe simply sit at the same table)
          Rules of Engagement
    (or as John likes to call it: CBPR camping rules)

• Always leave the site in better shape than
  when you arrive
• Before jumping into a river/lake, always
  investigate thoroughly (ask locals about
  stumps, overhangs, safe areas to “swim”)
• Not a good idea to leave fires burning when
  you leave with no one left to manage them or
  put them out
Is CBPR always the best approach?
• Not necessarily
• Very popular approach
• Many are conducting research under the title
  of CBPR, but are not
  – Simply forming coalition to inform what is going
    on

								
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