Participatory approaches to addressing community health issues: A formative case study approach

The overall purpose of this current project is to conduct a longitudinal community based participatory action research project (CBPAR) in partnership with the Province of San Jose de Ocoa in the Dominican Republic (SJdO-DR) to address community/province-wide health issues of public health importance. A secondary interest is to compare and contrast the SJdO-DR project with similar projects taking place in the United States (in rural Hispanic immigrant communities in the state of Illinois) and in the Colombian Amazon. Community based participatory action research (CBPAR) is based on a partnership model that involves multiple entities in all aspects o f research process with an emphasis on equity throughout the effort and with the goal of improving the health and wellbeing of the community. CBPAR is a process consisting of five phases (partnership formation, assessment, implementation, evaluation, dissemination) which build on each other to achieve sustainability or social transformation. An initial assessment visit to the SJdO-DR was completed with 20 days spent in the field in which a series of windshield tours were conducted in 18 communities and 137 key informant and informal interviews were conducted. The findings can be grouped into three major categories, health concerns, infrastructure issues and community assets. Similar sets of findings have been collected among the contrasting projects in rural Illinois and in the Colombian Amazon. Next steps include focusing on the social determinants of health aspects of these projects as well as comparing and contrasting aspects of rural location that link these three efforts together.