"We'll do it together": The CBPR process with a sex workers' collective in Kolkata, India

Background: While CBPR is often cited as the approach used in the development, implementation, and evaluation of community-based interventions, few studies actually identify the ways in which the CBPR process unfolds in international settings. This study examined the CBPR process for the development and implementation of a family-based sexual health communication intervention (FSHCI) for sex worker mothers (SWM) in Kolkata, India. 

Methods: Community stakeholders’ feedback regarding the CBPR process was obtained through: in-depth semi-structured interviews with SWM who participated in the intervention (n=10) and intervention facilitators and community partners (n=10). Thematic analysis was employed

Results: The CBPR process involved 1) Establishing partnerships with FSW peer educators and young adult children of sex workers to create a community board 2) Understanding the community’s need through a postcolonial lens 3) Identifying methods to address the need of increasing mother-child sexual health communication 4) Creating a culturally-tailored FSHCI that address SWM specific needs. Particularly we found that  1) surface structures, observable materials such as intervention activities and pamphlets, and 2) deep structures, such as contextual factors of the environment, psychological and social realities, impact intervention feasibility and outcomes. Surface structures included using familiar activities, recognizable HIV knowledge pamphlets, and common language in the intervention. Deep structures included using facilitators that were SWM.

Conclusion: A better understanding of the CBPR process ensures that relevant information to serve community and family needs will be generated, and is proving to be a critical component of impactful international public health research.