How to Access & Collaborate with Migrant Communities Using Community-Based Participatory Research
Deanna Perez Williams, PhD, CHES Howard University, School of Medicine
Community-Based Participatory Research (CBPR)
A collaborative process of research that: Involves researchers and community representatives in all phases of research Based on a partnership model of participation Applicable across applied methodologies and study designs Entrée to difficult to reach populations Facilitates enhanced participation and completion of protocols Effective strategy for addressing health disparities
Key principles of CBPR – cont’d
Recognizes community as a unit of identity Builds on strengths and resources within the community Facilitates collaborative, equitable involvement of all partners in all phases Integrates knowledge and action for mutual benefit of all partners
Key principles of CBPR – cont’d
Involves a cyclical and iterative process Promotes co-learning and empowering process that attends to social inequities Addresses health from both positive and ecological perspectives Disseminates findings and knowledge gained to all partners Involves long-term commitment by all partners
Introduction Marshallese in NW Arkansas
4,000 immigrants (approx.) 34% families live below poverty line in 2001
(U.S. Pilot Census Survey, 2001)
Paucity of health & ethnographic data
Introduction
Marshallese In Arkansas Medical community & social services inadequately prepared to provide
Culturally competent health care
Culturally sensitive services
Current health attributed to premigration health status
Purpose of Research
To conduct a preliminary health & social needs assessment of underserved Marshallese immigrants to improve health care delivery
Research Aims
Understand health & social needs Determine barriers to health care Address viable methods of ameliorating these needs
Barriers to Accessing Migrant Populations
Power/Control
Communication
Trust
Community
Migrant
Culture
Geography Representation
How to Access Community Using CBPR Methodology
Become knowledgeable Engage & partner with community Establish trust
Knowledge of community
Demographics Health issues Culture Strengths, resources, needs Barriers to health care Community & social organizations, churches Leaders and gate keepers
Engagement process
Allow community to voice concerns in their own terms Actively build relationships Value, identify, & build on partnerships, knowledge & strengths Share in decision making Attend organizational meetings Create stakeholders
Establish Trust
Establish credibility & realistic goals Engage community in research process
Create or access community advisory committee
Build collaboration on mutual respect & colearning Understand how their health issues impact daily lives Maintain confidentiality Disseminate knowledge
Community Assets Map
Businesses Churches Schools Associations
Youth Elderly Community activists Cultural groups Community clinics
Advantages of Using Advisory Committees
Fosters mutual trust Enhances credibility Provides ownership Empowers advisory members Facilitates research process
Methodology - Community Based Participatory Research
Marshallese advisory group (N=20) Survey constructed by Advisory group Health community members Survey submitted (N=75)
Qualitative Analysis/Results
Examined textual data Patterns Domains Validated by community Results:
Multiple Health Issues Social & Systemic Issues
Recommendations
Home visits for health & social issues Workshops in community Use team approach-Marshallese & member from health community Information for new arrivals Access to medical & social services Driver’s license Medicaid Community newsletter Website
Successes in Partnering
Gained trust
Willingness to cooperate and participate in research process & focus groups Readily collaborated with research team
Focus groups successful within timeframe Diversity of participants Obtained culturally relevant data
Developed partnerships
Recruited focus group participants
Summary
Community partnership
Minimizes access barriers Allows access to migrant communities Facilitates and expedites research process Promotes positive research collaboration experience Enhances credibility of university Enables researchers to obtain culturally relevant data
Community Based Participatory Research - * Outcomes
Marshallese community mobilized Marshallese recognized importance of capacity building to address important issues Marshallese community and health providers learned to collaborate
Realties
Establishing a rapport parallels the building of reciprocal trust Active engagement optimizes partnership Accessing the strengths of the community is an art acquired through learning and utilizing CPPR principles Success of intervention is reflective of the strengths of the community
Thank you!
Thank you for inviting me to share my work with you.