Earlier in this chapter, we discussed Israel et al.’s2 core components of CBPR. In this concluding section, we examine these components and phases and offer insight into potential challenges of their implementation. We also offer suggestions for overcoming these challenges, drawing on multiple CBPR projects that we have been involved with.
There are many levels of partnership, ranging from networking, cooperating, coordinating, to collaborating.21 Networking involves low levels of time and trust. Cooperating requires moderate levels of time and trust, as well as some sharing of turf. Coordinating requires high levels of time and trust and moderate sharing of turf. Collaborating requires maximum levels of time, trust, and turf sharing. Transcendent partnership involves partners working together on endeavors of mutual interest irrespective of a person’s community and/or academic background. Transcendent partnership involves working WITH each other, not doing TO or doing FOR one another.
Community-academic partnerships are most likely to succeed when partners have (1) a clear understanding of the strengths and limitations each organization brings to the partnership; (2) a strong belief in and commitment to compromise and equality as essential components of partnership; and (3) clearly established guidelines or a memorandum of understanding to guide the partnership process. For example, one author of this chapter has had a collaborative community partnership with the lesbian, gay, bisexual, and transgendered (LGBT) community in a Midwestern city for almost two decades. The partnership includes both programmatic and scientific health promotion projects, as well as shared service on advisory groups, in support of improving the health and wellness of LGBT persons. This collaboration builds on their respective scientific and programmatic strengths. Well-defined and time-tested guidelines for decision-making and communication developed and refined over time in their lengthy history enables their investigative team to quickly initiate project activities if funded. Such strategies include (1) a written agreement outlining individual and shared responsibilities, decision-making processes, and budget allocations and (2) regular team meetings, phone conversations, and e-mail correspondence. Budgets are equally distributed, and often the majority of funds are allocated to the community partners.
Although each partner has specific tasks related to their areas of expertise within any given project, our partnership plan ensures that project decisions are made through consensus agreement between community and academic leadership in close consultation with our auxiliary partners. The executive director of the lead community partner and the lead investigator of the academic team frequently serve as co-principal investigators on their collaborative project. For multisite projects, both individuals have an equal role in the representation of the investigative team at national meetings, and they jointly share project oversight. All project decisions are made through consensus, and both individuals have complete veto power on any decision. When rare differences do arise, they are resolved through discussion and compromise. Their collaboration, which synthesizes unique scientific and programmatic expertise, increases the likelihood of developing programs and interventions that are (1) scientifically efficacious, (2) programmatically appropriate, and (3) responsive to community needs, values, and priorities.