Session
Lessons Learned from Community-Based Participatory Research Projects: Roundtable Discussion
APHA 2022 Annual Meeting and Expo
Abstract
Whereâs our place in this?: Lessons Learned regarding Stakeholder Engagement in a Community-Centered Violence Prevention Community Partnership
APHA 2022 Annual Meeting and Expo
The pervasiveness of violence in our communities is overwhelming and daunting. Violence is a multi-layered public health issue that requires multi-institutional engagement and stakeholders. It is unconscionable to think that one institution alone can solve this issue. To mitigate this pervasiveness, a group of individuals, agencies, and scholar practitioners joined efforts with a community-based non-profit to collaboratively address the spike in violence impacting so many youth and families. This Pittsburgh-based initiative, Violence Prevention Community Partnership, leans on the expertise of current and former law enforcement personnel to build relationships between law enforcement and the community, particularly young residents. These partnerships began with the creation of on-the-ground, 24-hour community liaisons who work in and around communities. These liaisons identify potential safety threats and serve as a communication connector between youth and law enforcement. The coordinated efforts throughout the city are a promising sign of success. This research project reports on the process for developing multi-dimensional partnerships and the lessons learned throughout partnership securement. Data from focus groups suggest the importance of the community and a need for a more concerted effort to address violence.
Abstract
Substance Use Disorder (SUD) in East Texas: Community-Driven Needs and Assessment of Response Capacity
APHA 2022 Annual Meeting and Expo
The project aimed to assess perceived challenges regarding substance use disorder (SUD) in East Texas and develop a community-driven research agenda to address them.
Data were gathered through nine focus-group discussions (FGDs) with stakeholder groups; people living with SUD, families, medical providers, counselors, community-based organizations representatives, and law-enforcement officers. We asked participants how SUD was manifested in their communities, which challenges they confronted in coping with SUD, and in which order their needs should be prioritized. Findings were reported at four community forums to confirm the list of SUD-related challenges and prioritize the needs.
Five themes emerged from FGDs as major challenges related to SUD prevention, treatment, and recovery in East Texas. These include (a) access to SUD treatment and recovery resources, (b) mental health and resiliency, (c) education, training, and professional development to facilitate SUD treatments, (d) care and service coordination, and (e) community/social support for people living with SUD and their families.
Discussions with stakeholders and subsequent community forums helped identify SUD challenges and concerns in East Texas. With this information, we can prioritize needs and work collaboratively to serve communities to address the manifestation of substance use and misuse. Significant resources such as financing, collaboration across silos and community education will be required to effectively curb this public health problem. Our findings can inform research and outreach to help East Texans develop interventions, research programs, and educational opportunities for clinicians, community-based organizations, law enforcement officers, and counsellors to build their capacity in SUD prevention, treatment, and recovery.
Abstract
El SEl Sazón: Tailoring CBPR principles to a Latino community project.
APHA 2022 Annual Meeting and Expo
Issue
Community-based participatory research (CBPR) advances health equity. CBPR principles guide working with the community, building community capacity, and fostering co-learning and sustainability. However, CBPR principles are often not culturally tailored to the community served. Tailoring is a key determinant in an intervention/policy being adopted and successful.
Description
This project describes the CBPR adaptation process undertaken by a grassroots Heroin/Opioid Work Group that is part of our communityâs Latino Health Coalition. Our five tailored principles, framed as âEl Sazón include: No más; Los menos entre nosotros; La voz de la gente; ¡Respetame!; Planta la semilla, mírala crecer. El Sazón, a Latino seasoning that brings ingredientes to maturity, captured our collaborative process in adapting CBPR principles.
Lessons Learned
Principles must be developed organically over time. This iterative process took 2 years and repetition was important. Many principles guided weekly meetings, keeping the team grounded. In fact, La voz de la gente became the title of the teamâs first White Paper. Using Spanish words to describe principles helped us co-learn and connect to the Latino culture. This was an important nuance as the community of interest is primarily Latino and Spanish speaking, but not all members of the CBPR team are. The team member responsible for leading meetings, âEl Cocinero, was key in coalescing all the principles of El Sazón.
Recommendations
CBPR principles must be tailored to particular communities by use of local terminology, meeting regularly to support co-learning, and a focus on the values that drive the collaborative work. This is the addition of El Sazón.
Abstract
Understanding rural familiesâ needs for returning to in-person learning
APHA 2022 Annual Meeting and Expo
Background: The COVID-19 pandemic has disproportionately impacted rural communities. While school closures helped reduce COVID-19 transmission, they have exacerbated the learning gaps for children in rural communities. We aimed to identify resources and needs for students to return to in-person learning in a rural community where 50% of their population are Latino/Hispanic.
Methods: We conducted 4 focus groups with 26 parents in total and 19 interviews with children grades K-8, who attend school in the Yakima Valley in central Washington. Bilingual and bicultural staff collected all data. The interview guide included questions about needs for returning to in-person learning, concerns about regular testing and vaccines. Transcripts were analyzed by two coders using an inductive approach.
Results: Parentsâ mean age was 43.5 years (SD 6.8), 96% were female, and 85% identified as Latino. Childrenâs mean age was 12.9 years (SD 0.9), 53% were female, and 100% identified as Latino. Four major themes emerged: 1) perceptions of virtual versus in-person learning, 2) concerns about COVID-19 vaccines, 3) concerns about COVID-19 regular testing and 4) childrenâs mental health. Participants discussed challenges with virtual learning and how this impacted childrenâs educational learning, physical and mental health. Participants mentioned vaccine concerns including infertility, side effects and microchip in the vaccine. Most parents were concerned about overburdening children with weekly testing, while others recognized it can keep children safe.
Conclusions: Understanding familiesâ concerns about the COVID-19 pandemic and specifically to in-person learning can help inform strategies for future pandemics that can influence school closure policies.
Abstract
Community Leadership to Advance Public Health: Three Perspectives from Academic Partners
APHA 2022 Annual Meeting and Expo
This presentation synthesizes reflections from three unique research and evaluation projects using community-based participatory methods to improve public health impact. Presenters will share insights and lessons learned regarding infusion of community leadership into diverse projects on the path towards equity. Each session will include a combination of presentation, discussion, and audience Q&A.
The first session will present a collaboration between LGBTQ+ and Indigenous Health research teams which leveraged Two-Spirit and LGBTQ+ Indigenous knowledge to adapt an existing colorectal cancer screening intervention. Talking circles were used for data collection; Native American students were engaged to lead qualitative analyses informed by research expertise, lived experience, and cultural knowledge. Presenters will discuss partnership development and synthesis of diverse community knowledges.
The second session will present experiences from a population health-focused secondary data project, utilizing the CDC's Youth Risk Behavior Survey. Researchers at Northwestern University created a novel community-engaged research method - Youth Research Workshops (YRW). Presenters will discuss YRW creation, goals, and findings. Presenters will share considerations researchers should make when working with LGBTQ+ youth in the currently tumultuous political climate of anti-LGBTQ+ legislation.
The final session will reflect on Training and Technical Assistance offerings within a multi-site evaluation of 50+ agencies specializing in HIV service delivery. This unique project has implemented a community-engaged approach informed by critical pedagogy. Led by efforts to maximize accessibility and impact of Adult Education, presenters will discuss the use of participatory Think Tanks that invited agencies to work alongside Evaluators to determine training themes and learning objectives.
Abstract
Hybrid Evaluation Approaches for Promoting Equity in Rural Obesity Interventions
APHA 2022 Annual Meeting and Expo
Equitable evaluation methods are needed for examining diet-related chronic disease in rural communities where disparities exist among risk factors and resources for disease prevention. Two evaluation approaches, appreciative inquiry (AI) and culturally-responsive evaluation (CRE), can capitalize on momentum in community-based work and orient projects around a communityâs values. AI focuses on program successes to allocate resources to what a program does well. Evaluators collaborate with community members to discover program successes, envision new and ideal possibilities, and deploy program changes in a sustainable manner. CRE focuses on issues of race, power, and privilege to determine the needs of the most vulnerable community members. Using collaborative engagement with community members to enhance responsiveness to community needs, evaluators can promote equitable program development. Using the two evaluation approaches incorporates an explicit focus on equity, attunement to cultural nuance, and an appreciation for program successes to help empower community members and fuel culturally-responsive project progress. Authors will describe lessons learned from using the CRE-AI approach to evaluate a multidisciplinary, community-based, and participatory obesity intervention in five rural [state] communities, a partnership between [funding agency], the University of [state], Cooperative Extension, and community members. Results include descriptions of community visioning, sociocultural barriers to program progress, and cultural causes of non-engagement with the project. As a case study, this project demonstrates benefits of using this approach when partnerships include rural and non-rural stakeholders. Next steps include incorporating evaluation results into final year program plans and developing a summative evaluation plan utilizing the hybrid approach.
Abstract
Partnerships to increase dementia care in rural Georgia
APHA 2022 Annual Meeting and Expo
1 Issues:
Alzheimerâs disease and related dementias (ADRD) result in extensive economic and societal burdens for Georgia communities and incidence is predicted to increase by 35% by 2025. Diagnosing ADRD generally requires specialty care, such as consultation by geriatricians, neurologists, and neuropsychologists. Of the 159 counties in Georgia, 118 are designated rural. Residents of rural counties often face limited access to specialty care practitioners, less than 8% of whom practice in rural counties. As a result, many people living with ADRD in rural communities do not receive a diagnosis. Early detection and diagnosis are key to accessing the services and support that can help people live healthy and engaged lives with ADRD.
2 Description:
This presentation will describe the impact of the unique collaboration between four geographically and demographically diverse rural Georgia communities (Grady County, Hart County, McDuffie County and Washington County) and three University of Georgia (UGA) entities: the Cognitive Aging, Research, and Education (CARE) Center, the Archway Partnership, and Cooperative Extension. Together, these communities and their UGA collaborators have created dementia resource hubs tailored to the needs of each community.
3 Lessons Learned:
Lessons learned in building sustainable partnerships with community input, as well as plans to expand partnerships throughout rural Georgia will be discussed.
4 Recommendations:
This interdisciplinary collaboration will help to form the basis for a state-wide program that will continue to support healthy aging and access to resources that empower people to age well across Georgia.
Abstract
The Flint Center for Health Equity Solutions (FCHES): Evaluating a Transdisciplinary Collaborative Center Using a Comprehensive Framework
APHA 2022 Annual Meeting and Expo
Over the past few decades there has been a growing focus on evaluating large-scale research initiatives that are conducted by a collaborative team of scientists in partnership with community-based organizations. These large-scale initiatives are designed to impact complex, multifaceted health issues. Considering this new focus, there is growing need to develop and implement comprehensive evaluation models that can be used to define and assess the key processes and outcomes of these large initiatives and the effectiveness of these centersâ interventions, their social and community impact, cost utility and scientific benefit.
The Flint Center for Health Equity Solutions (FCHES)is a National Institutes of Minority Health and Health Disparities (NIMHD)- funded Transdisciplinary Collaborative Center (TCC) for health disparities research. The overall aim of FCHES is to serve as a regional focal point that creates, nurtures and sustains productive cross-disciplinary partnerships that provide health equity solutions for the elimination of health disparities. The major goal of the Center is to eliminate disparities in physical and behavioral health through developing, implementing, and disseminating community-based multilevel interventions and creating sustainable health equity solutions. To evaluate the extent to which the aims and goals were being realized, a comprehensive conceptual framework was created and implemented to guide the center evaluation. A major consideration that shaped the development and implementation of this evaluation was to the ability to assess the implementation of the Centerâs initiatives and understand the reach, impact, and overall efficacy of the Center.
The purpose of this presentation is to describe how this FCHES framework was used to evaluate the major goals and outcomes of FCHES and provide participants with lessons learned for the application of this novel and comprehensive framework. We begin with an overview of the development of this framework and provide and an overview of the overarching FCHES evaluation framework. Next, we describe the various theoretical models the comprise this framework, which include organizational optimization, economic evaluation and cost-effectiveness, academic and community partnerships and dissemination and implementation science. Next, we will discuss how this framework was used to guide the collection and analysis of relevant data to assess the effectiveness to of the center and the extent to which is met its major aims and goals. We will end with a discussion of how this framework can be applied to evaluate other large-scale initiatives and lessons learned from our implementation of this comprehensive approach to evaluating large transdisciplinary initiatives.
Abstract
Impact and Effectiveness of Flintâs Community Ethics Review Board (CERB): A pilot study
APHA 2022 Annual Meeting and Expo
Background: Community Advisory Boards (CABs) have emerged as an important entity to increase trust, community engagement, and community benefit in public health research taking place in communities. At the same time, few CABs have conducted evaluations of their value added to the community or to the investigators who they claim to connect or seeking feedback in ways they can optimize their impact. This pilot, led by an academic partner (Cargill) and a community partner from Flint (Spencer developed and implemented an evaluation of a particular CAB, the Community Ethics Review Board (CERB) in Flint, Michigan with the cooperation and support of its leadership.
Methods: In order to evaluate the role of the CERB in their geographic area, we conducted six focus groups with diverse members of the Flint community to elicit their views about how research in their community can best be responsive to their needs and concerns, as well as their views of how the CERB functions, and should function, to promote these needs and concerns. In order to evaluate the impact of the CERB with researchers, we conducted an anonymous Qualtrics survey with investigators who had utilized the CERB to elicit feedback on the perceived quality of its process and contribution to their research.
Results: We held six focus groups with a total of 41 participants who were diverse in as many ways possible (age, race, vocation, etc.). We are currently qualitatively analyzing the data from these focus groups. 25 investigators who had utilized the CERB responded to our survey. The CERB process was generally positively received, and we received interesting qualitative feedback on strategies for improvement. The CERB was perceived as impacting the research in the ways they intended in some domains (helping align research with community values (87%), and recognize and mitigate effects on vulnerable populations (76%), and less in others such as recruitment and retention (30% and 35% respectively). Ultimately, 91% said they were likely or very likely to engage with the CERB for their future projects and 95% said they would recommend working with the CERB to their peers. We will present this and other results from the survey.
Discussion: These two evaluative endeavors can serve as a model of approaches for the evaluation for CABs, as well as findings that can indicate ways that CABs can best serve research and their local communities to the optimal benefit to both.
Abstract
Vieques, Ambiente, Salud, y Acción Comunitaria - A CBPR approach to addressing health and environmental risks in Vieques, Puerto Rico
APHA 2022 Annual Meeting and Expo
Issues: From 1941 to 2003, the U.S. Navy used Vieques, Puerto Rico (P.R.), for weapons testing and training exercises. Disease morbidity and mortality assessments point to elevated disease risks compared to those on P.R.'s main island, including higher cancer rates.
Description: In January 2021, a transdisciplinary group of researchers partnered with Vieques' residents and community-based organizations to establish a multi-year collaboration called Vieques, Ambiente, Salud y Acción Comunitaria ([VASAC] Vieques, Environment, Health, and Community Action). VASAC's primary aim is to examine the multiple pathways and interactions by which the U.S. Navy's presence in Vieques and related contaminants have shaped Vieques' public health. The project hinges on close, transparent collaborations between community members and the scientific team.
Lessons Learned: The VASAC partnership process is particularly sensitive given distrust of past contaminant assessments, fatigue and disillusionment with past research, and broader political factors in Vieques and Puerto Rico. This process has been complicated by the COVID-19 pandemic, which primarily moved partnership-building activities online. Within this context, we will discuss our experience in establishing a new, long-distance CBPR-partnership, including the steps to establish the Community-Academic Steering Committee and determining the health focus of VASAC. The years-long process forms the foundation for data collection activities to assess human and ecological risk, including a citizen science monitoring program to empower community members to access information about contaminants in their environment.
Recommendations: We will conclude with recommendations for productively navigating complex logistical, social, and political dynamics in CBPR public health research in vulnerable communities.