Towards the successful use of local partnerships to reduce health disparity: Lessons learned from a preliminary evaluation of rural Hispanic Health Advisory Committees

The success of community-based participatory research approaches to reduce health disparities largely depends upon the successful formation and sustainability of community partnerships. However, little is known regarding the factors that contribute to, or lessen these partnerships' ability to work more effectively. Project EXPORT Center of Excellence in Rural Health formed 10 local partnerships in rural communities of Illinois between 2003 and 2006 with the objective of investigating Hispanic health disparity issues. Using a Community Based Participatory Action Research approach (CBPAR), partnerships have been actively involved in community assessments of health needs, implementation of mini projects to address those needs, and evaluation of numerous components of the process. Results from a structure-process-outcomes evaluation of eight EXPORT-formed local Hispanic Health Advisory Committees (HHACs) are presented using survey data that was collected from active HHAC members six months after they started the mini projects implementation. Evaluation results suggest that HHACs have a good representation of academic and public health sectors but could benefit from increased participation of Safety Net Providers and Hispanic community members. There were high levels of satisfaction among participants related to decision-making, communication, technical assistance and, to a lesser extent, financial resources. Partnership members perceived positive impacts of their work with regard to awareness building and the development of culturally appropriate communication and health promotion strategies for Hispanic community residents. Associations between specific structural/process indicators and successful outcomes are discussed highlighting ideal partnerships' characteristics to effectively address health disparity in rural areas of the Midwest.