By way of introduction: What comes to your mind as the health problem that most concerns your own community of origin?
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- Candice Gibbs
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1 By way of introduction: What comes to your mind as the health problem that most concerns your own community of origin?
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4 Deconstructing Research Dysfunctionality Across Cultural and Inter/Intra-Disciplinary Boundaries (it s a two way street)
5 Communities Engaged In Research Communities can be should be want to be Engaged In Research Why?
6 Outsiders have researched us to death, and the research doesn t even benefit us. -Former Councilman Eddie Tullis Poarch Band of Creek Indians Wallerstein & Duran Research for Change, NCMHD Grantees Meeting Philadelphia November 8, 2009
7 Communities Engaged In Research The problem of perception
8 Communities Engaged In Research Gown (in this case, Boston University School of Medicine)
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11 Communities Engaged In Research Town (in this case, Somerville, MA)
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17 Immigrant Service Providers Group Health
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19 Department of Psychiatry
20 Why, in this case, Communities Engaged In Research instead of Community Based Participatory Research? Because, in reality, there are two different communities engaged in research.
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24 Obligatory Bullet Point Slide Contexts Relational Dynamics (cont.): Social-economic, cultural, geographic, politicalhistorical, environmental factors Self & collective reflection Participatory decision-making & negotiation Policies/Trends: National/local governance & political climate Integration of local beliefs to group process Historic degree of collaboration and trust between Task roles and communication university & community Intervention Community: capacity, readiness & experience Intervention adapted or created within local culture University: capacity, readiness & reputation Intervention informed by local settings and Perceived severity of health issues organizations Group Dynamics Shared learning between academic and community knowledge Structural Dynamics: Research and evaluation design reflects partnership Diversity input Complexity Bidirectional translation, implementation & Formal Agreements dissemination Real power/resource sharing Outcomes Alignment with CBPR principles CBPR System & Capacity Changes: Length of time in partnership Changes in policies /practices Individual Dynamics: -In universities and communities Core values Culturally-based & sustainable Motivations for participating interventions Personal relationships Changes in power relations Cultural identities/humility Empowerment: Bridge people on research team -Community voices heard Individual beliefs, spirituality & meaning -Capacities of advisory councils Community reputation of PI -Critical thinking Relational Dynamics: Cultural revitalization & renewal Safety Health Outcomes: Dialogue, listening & mutual learning Transformed social /econ conditions Leadership & stewardship Reduced health disparities Influence & power dynamics Flexibility
25 Obligatory Bullet Point Slide Contexts Social-economic, cultural, geographic, politicalhistorical, environmental factors Policies/Trends: National/local governance & political climate Historic degree of collaboration and trust between university & community Community: capacity, readiness & experience University: capacity, readiness & reputation Perceived severity of health issues Group Dynamics Structural Dynamics: Diversity Complexity Formal Agreements Real power/resource sharing Alignment with CBPR principles Length of time in partnership Individual Dynamics: Core values Motivations for participating Personal relationships Cultural identities/humility Bridge people on research team Individual beliefs, spirituality & meaning Community reputation of PI Relational Dynamics: Safety Dialogue, listening & mutual learning Leadership & stewardship Influence & power dynamics Flexibility Relational Dynamics (cont.): Self & collective reflection Participatory decision-making & negotiation Integration of local beliefs to group process Task roles and communication Intervention Intervention adapted or created within local culture Intervention informed by local settings and organizations Shared learning between academic and community knowledge Research and evaluation design reflects partnership input Bidirectional translation, implementation & dissemination Outcomes CBPR System & Capacity Changes: Changes in policies /practices -In universities and communities Culturally-based & sustainable interventions Changes in power relations Empowerment: -Community voices heard -Capacities of advisory councils -Critical thinking Cultural revitalization & renewal Health Outcomes: Transformed social /econ conditions Reduced health disparities
26 Preview of Coming Attractions!
27 Engaging a specific community - in this case, the Somerville, MA immigrant communities of faith. A meeting of Priests and Pastors was convened to discuss and gain support for the recruitment goals of an NIHCD CTR/CBPR study: Assessing and Preventing Obesity in New Immigrants.
28 Somerville Immigrant Communities Interfaith Meeting - Health August 18, 2009
29 Number of Immigrants to the United States Data provided by Division of Research & Epidemiology, Bureau of Health Statistics, MDPH
30 As a percent of the total U.S. population, there are less than ½ as many new immigrants arriving today as there were 80 years ago.
31 Medical Science & Religion Hildegarde of Bingen Maimonides Abū Alī Sīnā Ibn Sina Thomas Bayes Gregor Mendel
32 Daniel 1:8 1:15 8 But Daniel resolved not to defile himself with the royal food and wine, and he asked the chief official for permission not to defile himself this way. Now God had caused the official to show favor and sympathy to Daniel, but the official told Daniel, "I am afraid of my lord the king, who has assigned your food and drink. Why should he see you looking worse than the other young men your age? The king would then have my head because of you." 11 Daniel then said to the guard whom the chief official had appointed over Daniel, Hananiah, Mishael and Azariah, "Please test your servants for ten days: Give us nothing but vegetables to eat and water to drink. Then compare our appearance with that of the young men who eat the royal food, and treat your servants in accordance with what you see." So he agreed to this and tested them for ten days. 15 At the end of the ten days they looked healthier and better nourished than any of the young men who ate the royal food. So the guard took away their choice food and the wine they were to drink and gave them vegetables instead. (New International Version)
33 Daniel the clinical trial [The problem: Daniel and his fellow Jews cannot eat Nebuchadnezzar s food.] 8 But Daniel resolved not to defile himself with the royal food and wine, and he asked the chief official for permission not to defile himself this way. Now God had caused the official to show favor and sympathy to Daniel, but the official told Daniel, "I am afraid of my lord the king, who has assigned your food and drink. Why should he see you looking worse than the other young men your age? The king would then have my head because of you." [Daniel proposes an experiment - a kind of clinical trial.] 11 Daniel then said to the guard whom the chief official had appointed over Daniel, Hananiah, Mishael and Azariah, [length of trial] "Please test your servants for ten days: [the intervention group] Give us nothing but vegetables to eat and water to drink. [the control group] Then compare our appearance with that of the young men who eat the royal food], and treat your servants in accordance with what you see." So he agreed to this and tested them for ten days. [The results of the two groups are compared] 15 At the end of the ten days they looked healthier and better nourished than any of the young men who ate the royal food. So the guard took away their choice food and the wine they were to drink and gave them vegetables instead.
34 Why go to all this trouble?
35 Health Disparities in Washington, D.C.
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38 Today s learning objectives: 1) List strategies for meaningful community engagement in the adoption of community health interventions. 2) Develop tools that encourage learning and relationship building between academic researchers and community partners. 3) Identify challenges, and corresponding corrective strategies, in community-based recruitment plans. Thanks for your attention!
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