Toward Health Equity: A National Study of Promising Practices in Community-Based Participatory Research

What Is the Purpose of this Research?

• • The purpose of this national study of 294 federally funded community-based participatory research (CBPR) projects was to identify partnership practices and outcomes that lead to successful research outcomes.

• • We identified 3 context and 15 relational practices contributing to CBPR success by testing the community-based participatory research conceptual model, developed over a decade by engaged citizens, activists, scholars, policymakers, and others subject to epistemic injustice.

• • The CBPR conceptual model links historic and social contexts to partnership group dynamics, which influences intervention and research designs, which in turn affect research capacity and health outcomes.

What Is the Problem?

• • Groups that have been historically marginalized or experience health disparities are often not at the table when research about them is being planned or conducted. This study identifies the contexts and practices that promote community voice and epistemic justice, and the necessity of having these contexts and practices present in all phases of the research process.

• • Although there is a need for and growing interest in developing metrics for authentic CBPR, until now there has not been an interdisciplinary socioecologic model that integrates the actors, contexts, and relational practices of successful community–academic engagement, and measures those conditions and practices.

What Are the Findings?

• • Context and process correlates accounted for 21% to 67% of the variance in the specific outcomes. Seven categories of research partnership practices were positively associated with successful synergy, capacity and health outcomes: 1) power sharing, 2) partnership capacity, 3) bridging social capital, 4) value alignment, 5) community involvement in all research stages, 6) influence mutuality, and 7) ethical management/resource sharing.

Who Should Care the Most

• • Citizens, activists, scholars, policymakers, community agencies and academics that seek to promote health equity through research partnerships and epistemic justice.

• • Academic researchers who wish to engage with the partnering community for health disparities research

• • To increase the chance of a successful partnership leading to better health outcomes:

  • ⦁ Power should be shared between the community and the academic partners, including a mutual control of resources and participation in all phases of the research.

  • ⦁ Partnerships should engage in periodic evaluation and self-reflection, and the selection of partners should reflect a high level of care for mutuality and values alignment.

  • ⦁ Hiring research staff from partnering populations will educate academic partners and promote healthy interactions across cultural, economics, educational, and other identity differences.

  • ⦁ View CBPR as a social justice orientation rather than as a utilitarian approach to improving “minority” subject participation in research.

  • ⦁ Ensure that the community is fully engaged from the beginning, so that community epistemologies, contexts, assets, and strengths are integrated completely in the partnership.

  • ⦁ Create an environment where trust, dialogue, conflict resolution, and co-learning are encouraged, so that partner reflection enables co-constructed research and outcomes.

  • ⦁ Management must be ethical, strong, and effective, as well as humble, to ensure that resources are deployed appropriately to meet partnership goals.