Recent Trends in Community-Based Participatory Research
One trend evident from this book is the extension of CBPR into new communities and population subgroups. For example, although many early community- engaged studies of HIV/AIDS focused on gay and bisexual men in major urban centers such as Los Angeles, San Francisco, and New York, a growing number of CBPR studies have addressed HIV prevention and referral for treatment among African Americans and Hispanic men and women, and other important population subgroups.4 As an additional example, CBPR and participatory action research on infant mortality have primarily been conducted in the United States and in Asian countries such as Nepal and India.5-12 More recent studies are addressing infant mortality in countries in sub-Saharan Africa and other parts of the world.13-15 As a further example, faith-based CBPR studies (which have sometimes been referred to as church-based studies) are no longer limited to those that engage members of church congregations; an increasing number of CBPR studies involve members of mosques, temples, and synagogues.16-19
Another trend has been continued innovation and creativity in CBPR. Creative approaches for engaging and empowering community members are hallmarks of CBPR.20 As discussed in chapter 1, “photovoice” methods, a means of telling personal stories and community stories through photographs, have been used in CBPR as an approach for health needs assessment.20-24 Community arts events have also been incorporated into CBPR projects.25 For example, as part of a CBPR project involving African American youth in two urban neighborhoods, Yonas et al.26 used the creative arts (writing, drawing, and painting activities) to obtain information about the participants’ perspectives about community safety and violence. Recent studies have used CBPR approaches to develop smartphone applications for promoting pregnancy and interconception health among African American women at risk for adverse birth outcomes27 and for enhancing dietary intake and physical activity among African American breast cancer survivors.28
As detailed by Oyana in chapter 4, Geographic Information System/Global Positioning System (GIS/GPS) technologies are being used to collect and analyze environmental (geospatial) datasets, which offer new scientific knowledge and insights into health problems. Robust and unbiased geospatial data and knowledge about communities is being used to deepen our understanding of public health problems, target interventions to reduce health disparities, and achieve health equity. Participatory GIS methods and analytical techniques are enhancing community-engaged health research. As discussed by Kim and Haynes in chapter 13, CBPR studies are being enhanced using novel technology for environmental and biological sampling. These new technologies are combining GPS with air monitoring and health outcome data. Community residents are being equipped with new tools to engage with researchers and collect their own data (i.e., citizen’s science).
Another trend has been the incorporation of CBPR approaches into dissemination and implementation research as discussed by Coughlin and Yoo in chapter 2 and by Smith et al. in chapter 11. This is an important development as the dissemination, implementation, and adaptation of well-packaged CBPR interventions into new communities greatly extend their reach and potential benefits. Dissemination refers to the active promotion or support of a health program to encourage its widespread adoption.29 This includes the adaptation, evaluation, implementation, and maintenance of an intervention that has been shown to be effective. The dissemination and translation of CBPR findings to address public health problems helps to ensure that the research has pragmatic results that lead to the greatest possible benefits. In addition to dissemination and implementation research, CBPR approaches have been integrated into informatics health research30 and the clinical and translational sciences.31
A further trend has been the adaptation of accepted principles of CBPR prin- ciples32,33 to specific cultural groups and into language that is understandable to a wide range of people. For example, as part of a community-engaged study of intimate partner violence, Burke et al.34 conducted a workshop in which 18 participants were introduced to CBPR and accepted principles of CBPR were dis- cussed.32-33 The participants were critical of the language used to illustrate the principles and felt strongly that CBPR principles should be revised using more common words so that there would be less ambiguity about how the research would proceed. Smith et al.35 noted that several sets of principles have been developed to guide the conduct of CBPR. They tend to be written in language that is most appropriate for academics and other research professionals and may not help lay people from the community understand CBPR. As part of a large- scale dissemination and implementation research (the Educational Program to Increase Colorectal Cancer Screening Study), Smith et al.35 engaged community members of the National Black Leadership Initiative on Cancer in developing culturally specific principles for conducting academic-community collaborative research. A set of CBPR principles was developed that was intended to resonate with African American community members.35