Cultures, Collaboratives, and Capabilities: The Richness of Asian American, Native Hawaiian, and Pacific Islander CBPR

In 2010, I joined Public Health—Seattle & King County, as the Chief of Assessment, Policy Development, and Evaluation unit. One of my major responsibilities is to work with our epidemiologists and social scientists in providing the population- and community-level data that identify health needs, provide the basis for the allocation of resources for health programs and services, and catalyze policy and systems changes. Despite my previous advocacy work on Asian-American, Native Hawaiian, and Pacific Islander (AA and NHPI) health with the Asian & Pacific Islander American Health Forum (APIAHF), which included the constant voicing of the need to collect racial and ethnic data and to disaggregate racial and ethnic data when possible and shaping a national AA and NHPI health agenda on data and research, I was still taken aback at the lack of available data pertaining to AA and NHPI communities at our health department and other health departments across the country.

Over the past year, state and local health departments and community-based organizations have continued to tighten their belts. In many cases, these entities have had to make wrenching decisions over which programs to fund and which to let go of. These decisions are not made in a vacuum, but are a result of negotiations among policymakers, health departments, health systems, and community leaders and advocates. During these types of negotiations, data and research on what works, for whom, and why are critical. However, population-level health data, whether collected nationally or locally, generally are not designed to capture sufficient data on small and/or emerging populations, such as AAs and NHPIs, particularly in a timely fashion. Hence, the importance of community-based participatory research (CBPR) and for dedicated space to focus on specific issues facing AA and NHPI populations in peer-reviewed journals, such as Progress in Community Health Partnerships (PCHP).

This special issue of PCHP brings to light foundational contexts for engaging communities in research, supporting evidence-based research–policy partnerships, and building research infrastructure in AA and NHPI communities. First is the importance of culture. Ma and colleagues in developing a successful hepatitis B intervention acknowledged and addressed the cultural context in their outreach to the Korean community and the design of their intervention. They respected the role of the Korean church (i.e., the cultural institution) as an equal partner in their CBPR project, thus creating the necessary buy-in and support for the project and for the project’s expansion. In a striking example of how to develop culturally congruent interventions, Look and colleagues used hula dancing, an ancient Hawaiian dance, as the basis for a cardiac rehabilitation program. Look and colleagues discuss how they overcame the challenges of meshing an indigenous cultural practice with scientific and clinical standards through inclusive and thorough discussion between their research team and cultural advisors. Culture, in these examples, is an asset that is leveraged for the benefit of the research.

Second is the role of collaboratives in building the evidence base for catalyzing policy and systems changes. Quach and colleagues describe the catalytic research work of the California Healthy Nail Salon Collaborative that resulted in the nation’s first nail salon ordinance that incentivizes nail salons to use nontoxic compounds. Russ and colleagues highlight three health research partnership models that explicitly involve community members, researchers, and legislators, focusing in depth on the researcher–policymaker relationship. The formation of these partnerships is, in part, a response to the increasing emphasis on evidence-based policymaking. So, whether the research is proactive as in the nail salon example or more reactive in terms of addressing legislative proposals, CBPR can ensure data and information from the perspective of AA and NHPI communities are injected into policymaking and decision making.

Third is the continued need to strengthen the research capabilities and infrastructure within AA and NHPI communities. As Hirono points out, there are many unanswered and critical questions about AA and NHPI health. He also points out that the work of AA and NHPI serving community-based organizations can be significantly enhanced and improved by CBPR. Rideout and colleagues...