Podcast Interview Transcript

In each volume of Progress in Community Health Partnerships: Research, Education, and Action, the editors select one article for our Beyond the Manuscript podcast interview with the authors. Beyond the Manuscript provides authors with the opportunity to tell listeners what they would want to know about the project beyond what went into the final manuscript. Beyond the Manuscript podcasts are available for download on the journal's website ( http://www.press.jhu.edu/journals/progress_in_community_health_partnerships/multimedia.html ). This Beyond the Manuscript podcast is with Professor Marlynn May of the Texas A&M Health Sciences—Department of Social and Behavioral Health, School of Rural Public Health, and Jon Law of the Center for Border Health Research authors of CBPR as Community Health Intervention: Institutionalizing CBPR within Community Based Organizations. Associate Editor David Levine conducted the interview. The following is an edited transcript of the Beyond the Manuscript podcast.

David Levine: I'd like to start off by asking you a question in regard to the manuscript. In that, you indicated the importance of the community-based organization taking the lead from the beginning in initiating the partnership. You also indicated selection of community-based organizations was conducted purposely, presumably, by the School of Public Health. Could you explain further how the initiation is accomplished?

Jon Law; The partnership was initiated by the Center for Border Health Research, which is a 501(c)(3) in El Paso, Texas. We invited Dr. May to engage in the project with us, and he certainly had a number of ideas of how it would look. So it was a community-academic partnership from the very beginning.

We've done this for 2 years. We finished 1 year, and we're in the second half of the second year.

We were looking for organizations that had a strong history and a level of strength that they would be able to start and finish the project because it's a year-long project. We received recommendations from a number of people in the region where we implemented the project, which is the Paso del Norte region on the Texas, New Mexico, and the Chihuahua border, and then invited organizations to engage in the project.

The second time we did it we were a lot more intentional about it, and we actually issued an RFP [request for proposals].

Marlynn May: We were a lot smarter.

Jon Law: Yes, the first time it actually worked out well. Our selection process was very successful, and we got good input as to which organizations would be able to start and finish the whole process. The second time the RFP started with an orientation where groups were told about the project, expectations of them, benefits of participating, and then they submitted a very brief one- to two-page proposal.

Jon Law: The proposals were evaluated by a review panel, including one representative from each year 1 CBO. Selection was based upon the organizations' reasons for wanting to participate in the project, their commitment to and their ability to participate in the year-long process, and their identification of a research topic of their interest that was strongly relevant to their organization's mission and primary activities.

Marlynn May: I might also add to that Jon that the initial mailing of the RFP went out to a mailing list that the Center for Border Health Research maintains. And so what—there were probably 150 organizations?

Is that correct on that list?

Jon Law: At least. It was our broad mailing list. So really we work with some of them—almost all of the nonprofit organizations in the region.

David Levine: I think that will help readers understand that much more in-depth. A second area that we were interested in pursuing a bit more was that you mentioned that important elements of the program include an academic support person from a local or regional university, workshops and conferences for the community-based organizations. How are these initially funded? And how do you maintain support for these elements?

Marlynn May: These are funded through the regular budget that was agreed upon from the initial proposal. So in that budget, there is a specific amount for each of the technical support staff to receive a stipend.

I want to be clear about the technical support staff. We try to select them with the community-based organizations. If at all possible, we'd like to have a university representative on the team that has worked with or knows the community-based organization team as well or members of the time and know the organization. In some cases, they've actually worked with them before in some capacity.

The technical support staff are not from the School of Public Health. They are actually from academic institutions in the region where the community-based organizations are, which we feel is really important, because the technical support staff really serve two very important roles. One is, of course, they bring a certain level of expertise to the research process, to the community-based participatory process that will give ongoing support for the community-based organizations.

But the other is that we really see these technical support staff as regular members of the team. We've had an interesting kind of discussion about this because we believe very strongly in as much equitable relationship in community and university representation as possible. And so we didn't want them to be an add-on or the expert coming in and being there if the help was needed.

They are actually engaged for the entire year. They participate in the initial workshops that we do. We do three 2-day intensive workshops with the community-based organizations. And then they work with them throughout the year. And so we really emphasize that aspect of it.

Jon Law: Just to add a little bit, the funding for the overall project was provided by the Paso del Norte Health Foundation in El Paso, Texas. It's a private foundation. To strengthen what Marlynn just said, the technical support persons, in many of the cases, already had a relationship with the organization but not necessarily from the standpoint of their research expertise or work interest. Some were board members of the organization. Some were volunteers with these organizations.

David Levine: I think that will particularly help other programs who may be getting started. I'd like to ask now regarding the area of sustainability. Your program has been more successful than most in addressing this very important issue, and I congratulate you on it. How are you currently sustaining the programs within the community-based organizations? And how would you advise others to do this?

Jon Law: Well, I think the key thing is to keep in mind that the sustainability we're looking for is that research continues to be part of the overall program of the organization.

One of the things we did with this year-long training curricula is require that each team that participated had four members participate in the project, and preferably four members with different roles or different relationships to the organization. Part of our purpose in doing this was that if one or two members of the team moved away or left the organization for some reason, that some of the capacity would stay with the organization.

The other expectation that was part of the selection process was that the research project developed by the team be core to the organization's mission. And we have found this to be successful because the research is an integral part of what the organization is doing. So sustaining the research or continuing to mine whatever data sources the group has or continuing to engage in the literature related to their study becomes a natural part of what they want to do already and what they're charged to do as part of their mission.

Marlynn May: I want to add an anecdote. One of the “ah-ha” moments for one of the community-based organizations came in an e-mail exchange. We do a lot of communication back and forth using e-mail. And this was at the end, when they were beginning to think about where they were going.

They kept thinking about research as being somehow added on to what they were already doing as far as programming is concerned. And through the course of discussion, what came out was that Jon and I encouraged them to think about research as a part of program, as a part of programming, and it was like a light bulb came on. Because they didn't necessarily see it as an add-on, they began to think more and more about it as a value added intrinsically in the organization. So we really do try to emphasize that aspect of it.

David Levine: The last question I'd like to ask both of you, please, is that you note the importance of ongoing evaluation. Could you please comment further on how this has been incorporated and sustained within the community-based organizations?

Marlynn May: When we talk about evaluation, at this point in the development of this program and the evolution of this program, we primarily focus on evaluating the project. That is to say, we're interested in seeing what kinds of outcomes and what kinds of impacts the project has, not just on the individuals in the research teams, but also in the organization itself. So evaluation is primarily from that point of view at this stage of development.

David Levine: Just to add a little bit further on that, because this is, again, a very sentinel area, would you have any comments on where you see evaluation going in the future in regard to these programs?

Marlynn May: This second year was the year we really began to develop a formal evaluation. We hope that this evaluation now will become more refined so that it can be utilized in other locations. One of the things we haven't mentioned is that we are scaling up this project.

Marlynn May: We are going to be translating it and transferring to Houston, where there is a Center for Excellence in Community-Based Participatory Research. One of the things we will do is to take this evaluation paradigm with it so that we will then have evaluation data from not only our current project but that project as well. Then we hope to do the same in the future as we expand to other locations.

With regard to evaluation internal to each of the community-based organizations, that's a little more difficult to think about at this point. Certainly, we can look at certain indicators as to whether or not the project has had some kind of impact on the organization. There are probably several anecdotes that we could provide that would give some indication of that. But at this point, we haven't designed an evaluation that would be done by the CBO on itself in terms of its own project.

Jon, do you want to add to that?

David Levine: I want to compliment you. I think you've got a really exemplary program, and I think this has allowed us and researchers to get even more insight into it. So thank you very much.

Mark Newgent: Marlynn, Jon, is there anything else you'd like to add that we didn't get to or anything else in the manuscript that you would like listeners or readers of the transcript to know?

Jon Law: I think what's exciting about this project is really that the research is initiated by the community organization and conducted by the community organization. So the Program really just provides support and different access to different types of expertise that they can utilize as they see fit.

Marlynn May: It's probably also part of the evaluation because to the extent that their research has produced results that they can then use within the program in some way is a really good indicator of the impact.