Nothing can be more important to a state than its public health. Health care scientists increasingly recognize of the impact of race, culture, gender, socioeconomic status, living conditions, and geography on the health of individuals and communities. Many communities which may include minority, low-income, rural, or non-English-speaking groups, as well as others such as the disabled or the homebound, are considered medically underserved. Barriers resulting from language, isolation, and cultural differences often limit access to health care.
Prev Chronic Dis ; PEER REVIEWED Abstract The call for community-based participatory research approaches to address cancer health disparities is increasing as concern grows for the limited effectiveness of existing public health practice and research in communities that experience a disparate burden of disease.
A national study of participatory research projects, Research for Improved Health, funded by the National Institutes of Health —identified 64 of projects focused on cancer and demonstrated the potential impact participatory approaches can have in reducing cancer disparities.
Several projects highlight the success of participatory approaches to cancer prevention and intervention in addressing many of the challenges of traditional practice and research.
Best practices include adapting interventions within local contexts, alleviating mistrust, supporting integration of local cultural knowledge, and training investigators from communities that experience cancer disparities.
The national study has implications for expanding our understanding of the impact of participatory approaches on alleviating health disparities and aims to enhance our understanding of the barriers and facilitators to effective community-based participatory research.
This disparity exists for cancers that can be detected early through screening, such as colorectal cancer, breast cancer, and cervical cancer. Disparities in mortality are likely related to lack of prevention and detection efforts 2.
Challenges to reducing cancer health disparities through public health practice and applied prevention research are vast and include multilevel intersecting factors. Community-based participatory research CBPR has been identified as an approach in creating interventions and prevention strategies to reduce health disparities 5,6 and was highlighted as a core strategy in the first national NIH Summit to Eliminate Disparities 7.
CBPR incorporates values and strategies to promote collaborative inquiry based on community-identified issues, equitable partnerships, and structures for participation; it also seeks to apply research to practice and policy for social change and reduced disparities 5.
Within cancer and chronic disease prevention, CBPR provides strategies for contextualizing interventions to promote external validity across diverse communities and incorporates culturally centered indigenous knowledge with evidence-based sociobehavioral theory for comprehensive interventions 8.
CBPR addresses mistrust between academia, public health agencies, and communities through reciprocal learning and the challenges of translating and sustaining interventions within specific community contexts to improve health 9.
This article presents the extent of the use of CBPR within cancer prevention and control research, uses examples of CBPR cancer research to highlight emerging best practices, and showcases the potential for uncovering further best practices through a national cross-site CBPR study.
The NCI strategic plan states the importance of community-based research for addressing health disparities and working with communities to address their needs From throughNCI funded 25 CNPs to support community-based participatory education, training, and research.
A survey, conducted in with responses by 22 of 25 CNPs showed high operationalization of many CBPR principles, the most notable being building on community identity and strengths, co-learning, capacity development, and balance between research and practice Resource and power sharing were more of a challenge, as was intervention sustainability, though the commitment to CBPR was reaffirmed.
Top of Page Research for Improved Health: We excluded smaller pilot grants, training grants, and R03 and R21 mechanisms Table because we wanted to focus on long-term projects that would allow us to collect data to answer our research questions about the added value of the partnership processes to promoting CBPR and health outcomes.
The RIH study had a final sample of CBPR projects, which then became the denominator for the Internet survey of partnerships that was administered during — Most of these studies focused on developing or implementing interventions; others identified cultural and other barriers to cancer prevention and screening.
Topics included smoking cessation, screening, early detection, and vaccinations; use of different practice modalities and settings, such as lay health workers, patient navigators, workplace, clinic, school, and community settings; and targeted messaging and interactive technologies.
It also led to RIH decisions to include 2 cancer-focused case studies as part of the mixed-methods design. Data collection was completed at the end ofand analyses are under way; accomplishments so far include the creation of the CBPR logic model http: The current state of cancer projects, however, does provide insight into emerging best practices, which we discuss below.
These include adapting interventions within local contexts; developing trust; supporting integration of local cultural knowledge; and training investigators from communities that experience cancer disparities with combined goals of enhanced cultural legitimacy, community capacity, and sustainability of practices and programs.Community-based participatory research is a "collaborative approach to research that equitably involves all partners in the research process and recognizes the unique strengths that each brings.
CBPR begins with a research topic of importance to the community, has the aim of combining knowledge with action and achieving social change to improve. The call for community-based participatory research approaches to address cancer health disparities is increasing as concern grows for the limited effectiveness of existing public health practice and research in communities that experience a disparate burden of disease.
A national study of. respect from academics and community-based organizations alike, as an approach that equitably engages community residents as part of the research process -- making it accessible and relevant-- with a focus on action-oriented solutions to community identified problems of greatest importance.
Focused Community-based Research for Eliminating CVD Risk Disparities in a Rural Underserved Population Cardiovascular disease (CVD) is the leading cause of death and chronic illness in the.
respect from academics and community-based organizations alike, as an approach that equitably engages community residents as part of the research process -- making it accessible and relevant-- with a focus on action-oriented solutions to community identified problems of greatest importance.
In , the Bureau of Justice Assistance (BJA) funded Michigan State University (MSU) to train a cohort of seven jurisdictions to implement a community-based strategy that uses focused deterrence, community engagement, and incapacitation to reduce the crime and disorder associated with overt drug markets.