Developing and Sustaining Community-Based Participatory Research Partnerships: A Skill Building Curriculum

Unit 1 Section 1.2: Benefits of CBPR

Successful CBPR partnerships demonstrate tangible benefits to all of the partners involved. All partners enhance their capacity and learn from their involvement.

Examples of tangible benefits for all partners include the following:

Knowledge and skills of partners to work collaboratively and in more participatory ways
Ability to gain a more complex understanding of each other’s strengths and limitations
Relationships and support for each other’s work as well as the establishment of new collaborative efforts through increased networking and collaboration among the partners
Ability of community partners and researchers to learn from and influence one another
Ability and willingness to serve as primary resources for one another
Learn new ways of thinking about their own work
Reconsidering the appropriateness of their measures and techniques in light of new perspectives
Opportunities for enhanced professional development to enable all partners to gain or enhance needed competencies

Examples of tangible benefits for institutional partners include the following:

Learn more about local resources and services
Gain understanding of community history, culture and dynamics and how interventions in other communities may or may not apply to local circumstances
See evidence of how community experiences can improve the research process

Examples of tangible benefits for community partners include the following:

Gain understanding of institutional history, culture and dynamics and how certain decisions about research design could impact the credibility of the results
See evidence of how their experiences can improve the research process
Obtain data that validates their concerns to the “outside world” and provides “proof” that policymakers, the media, and other high-level decision makers require before they believe that the issue deserves their attention
See resulting benefits in the community

Table 1.2.1 below displays some of the potential benefits and challenges of CBPR to participating communities and researchers.

Table 1.2.1 : Critical Elements in CBPR
Source: Viswanathan M. et. al.

CBPR Implementation and Potential Impact
Research Element	CBPR Application	Community Benefits	Research Benefits	Research Challenges
Assembling a research team of collaborators with the potential for forming a research partnership	Identifying collaborators who are decision makers that can move the research project forward	Resources can be used more efficiently	Increases the probability of completing the research project as intended	Time to identify the right collaborators and convincing them that they play an important role in the research project
A structure for collaboration to guide decision-making	Consensus on ethics and operating principles for the research partnership to follow, including protection of study participants	The beginning of building trust and the likelihood that procedures governing protection of study participants will be understood and acceptable	An opportunity to understand each collaborator’s agenda, which may enhance recruitment and retention of study participants	An ongoing process throughout the life of research partnerships that requires skills in group facilitation, building consensus, and conflict accommodation
Defining the research question	Full participation of community in identifying issues of greatest importance; focus on community strengths as well as problems	Problems addressed are highly relevant to the study participants and other community members	Increased investment and commitment to the research process by participants	Time consuming; community may identify issues that differ from those identified by standard assessment procedures or for which funding is available
Grant proposal and funding	Community leaders/members involved as a part of the proposal writing process	Proposal is more likely to address issues of concern in a manner acceptable to comm. unity residents	Funding likelihood increases if community participation results in tangible indicators of support for recruitment and retention efforts, such as writing letters of support, serving on steering committee or as fiscal agents or co-investigators	Seeking input from the community may slow the process and complicate the proposal development effort when time constraints are often present
Research Element	CBPR Application	Community Benefits	Research Benefits	Research Challenges
Research design	Researchers communicate the need for specific study design approaches and work with community to design more acceptable approaches, such as a delayed intervention for the control group	Participants feel as if they are contributing to the advancement of knowledge vs. as if they are passive research “subjects,” and that a genuine benefit will be gained by their community	Community is less resentful of research process and more likely to participate	Design may be more expensive and/or take longer to implement; possible threats to scientific rigor
Participant recruitment and retention	Community representatives guide researchers to the most effective way to reach the intended study participants and keep them involved in the study	Those who may benefit most from the research are identified and recruited in dignified manner rather than made to feel like research subjects	Facilitated participant recruitment and retention, which are among the major challenges in health research	Recruitment and retention approaches may be more complex, expensive, or time consuming
Formative data collection	Community members provide input to intervention design, barriers to recruitment and retention, etc. via focus groups, structured interviews, narratives, or other qualitative method	Interventions and research approach are likely to be more acceptable to participants and thus of greater benefit to them and the broader population	Service-based and community-based interventions are likely to be more effective than if they are designed without prior formative data collection	Findings may indicate needed changes to proposed study design, intervention, and timeline, which may delay progress
Measures, instrument design and data collection	Community representatives involved in extensive cognitive response and pilot testing of measurement instruments before beginning formal research	Measurement instruments less likely to be offensive or confusing to participants	Quality of data is likely to be superior in terms of reliability and validity	Time consuming; possible threats to scientific rigor
Research Element	CBPR Application	Community Benefits	Research Benefits	Research Challenges
Intervention design and implementation	Community representatives involved with selecting the most appropriate intervention approach, given cultural and social factors and strengths of the community	Participants feel the intervention is designed for their needs and offers benefits while avoiding insult; provides resources for communities involved	Intervention design is more likely to be appropriate for the study population, thus increasing the likelihood of a positive study	Time consuming; hiring local staff; may be less efficient than using study staff hired for the project
Data analysis and interpretation	Community members involved regarding their interpretation of the findings within the local social and cultural context	Community members who hear the results of the study are more likely to feel that the conclusions are accurate and sensitive	Researchers are less likely to be criticized for limited insight or cultural insensitivity	Interpretations of data by non-scientists may differ from those of scientists, calling for thoughtful negotiation
Manuscript preparation and research translation	Community members are included as coauthors of the manuscripts, presentations, newspaper articles, etc., following previously agreed-upon guidelines	Pride in accomplishment, experience with scientific writing, and potential for career advancement; findings are more likely to reach the larger community and increase potential for implementing or sustaining recommendations	The manuscript is more likely to reflect an accurate picture of the community environment of the study	Time consuming; requires extra mutual learning and negotiation

Exercise 1.2.2: Understanding Critical Elements in CBPR

Find an article on CBPR describing its research design and outcomes and ask all participants to read it in advance (see Appendix C and Appendix D for suggestions). Depending on the size of the group, do this exercise as a full group or divide into groups of 4-6. Give each group an article with a different research design (e.g., quantitative, qualitative, mixed methods). Ask each group to read the paper and answer the following questions:

Describe the overall research design (rationale, objectives, methods, time frame, population, partners).

Identify the key areas in the research design that distinguish this as CBPR.

Who are the partners?

Who is the community?

What is the issue being addressed? What are the anticipated health outcomes to be achieved?

How will progress towards objectives be measured?
How will the results be evaluated?

How will the results be disseminated?

Identify parts of the design where you have concerns about rigor, objectivity or bias. Explain.
Identify parts of the design where you have concerns about the partnership and/or involvement of the community. Explain.

Identify areas of the design where you have ethical concerns. Explain.
What would you have done differently?

Ask each group to report back to the whole group on common issues of concern as differences in the CBPR designs presented. Ask the whole group problem solve on how to address the various concerns raised in future and current work being done by their partnership(s).