Community contexts and “participatory starting points”: Adapting CBPR to improve the health and working conditions of immigrant workers

Community-based participatory research (CBPR) has increasingly been used by health educators to better understand and improve the health of diverse communities. A key strength of CBPR is its adaptability to community contexts and characteristics. Few studies, however, have explicitly explored contextual variables such as patterns of civic and political participation, or the “participatory starting points,” of a community and the corresponding adaptations made by partnerships to CBPR principles and processes to facilitate equitable participation. The concept of “participatory starting points,” may be of special importance to immigrant communities whose members have historically had lower rates of civic participation in the United States. Using qualitative and quantitative evaluation data collected by the San Francisco Chinatown Restaurant Worker Health Project, this presentation examines the links between the contexts of a Chinese immigrant worker community, adaptations made by its CBPR partnership to facilitate engagement, and project outcomes. Health educators analyzed data from multiple sources, including in-depth interviews, a closed-ended partnership survey, and participant observation. Models of CBPR “processes to outcomes” (Wallerstein et al., 2008) and literature on immigrant civic and political incorporation (Bloemraad, 2006; Verba, Schlozman, & Brady, 1995) guided the analysis and interpretation. Findings to be shared include accounts of language barriers, economic and social marginalization, civic skills, and participation. Subsequent partnership adaptations, such as creating safe spaces for participation through training, skills development, consciousness-raising, and negotiation of meeting structures will also be discussed as strategies for promoting equitable participation and capacity building in health education and CBPR work.