Unit 2 Section 2.2: Setting Priorities

Because there are always a multitude of important issues that all seem to be pressing at one time on any given community, it is important to set priorities for what issues the partners will work on at the very beginning of a partnership. Without this road map, it will be very difficult to make any progress on any particular issue at all. A lack of progress and impact will not only be detrimental to the morale of those involved in the partnership, but cause each partner to question if their time and energy invested in the partnership is going to good use.

Minkler and Hancock suggest using the following questions when discussing issue selection:

  • Is the issue consistent with the long-range goals or agenda of the community?

  • Will the issue be unifying or divisive?

  • Will the issue contribute to community capacity building?

  • Will the process of CBPR on this issue provide a good educational experience for leaders and community members, developing their consciousness, independence, and skills?

  • Will the community receive credit for a victory?

  • Will working on this issue result in new partnerships or alliances?

  • Will CBPR on this issue lead to an improved health or social outcome for the community?

  • Is the issue important enough to people that they are willing to work on it?

Other questions that should be considered in issue selection are:

  • Does the issue build upon or leverage community strengths?

  • Is the issue consistent with the priorities and current programs of partner organizations?

  • Does the issue address common themes of interest or concern across the partnership?

  • Does the issue allow for different levels of partner affiliation and participation?

  • Is the issue able to attract external funding? (This may influence, but should not drive, the selection process)

Exercises 2.2.1 and 2.2.2 below demonstrate how different partnerships have approached the prioritization process.

Exercise 2.2.1: Choosing Priorities

In the early years of our partnership, we made no attempt to set priorities for community problems. If it was a reality for the community at that time, then we made every effort to address it. As we have matured, we have relied not only on the community's definition of the problem but also community-based participatory action research principles to guide our work.  Through a dialogue process we also applied the following criteria:

  • Existing efforts – Will addressing this issue build upon existing efforts in the community?  For example, when request for proposals around health disparities was released, it made sense to tackle issues of disparities in infant mortality because of existing infant mortality work in the community.

  • Relationship to other problems – Will addressing this particular issue also have a positive effect on another issue of concern?  For example, when we decided to address disparities in infant mortality rates, we knew that the response to issues affecting infant mortality (i.e. focusing on diet) would address other issues like diabetes.

  • Local expertise – Do we have expertise within our partnership to assist in the efforts?  For example, one of the factors in our decision to address lead contamination was the support we received from an expert in the area of lead poisoning and air pollution at a local academic institution.

  • Capacity – Does capacity exist within organizations to address this problem?  For example, we asked if the Health Department had personnel and services to address the issue and if community-based organizations had connections with the community being impacted by the problem.

  • Feasibility – Are there funds available to address this problem (with particular attention given to funding resources within the community)?

  • Policy impact – Will addressing this problem have the potential of making a significant impact on policy?  In this way, our efforts could be more far-reaching.

  • Synergy – Is this an issue that everyone can rally around so that our combined efforts will have more of an impact than if individual partners focused separately on the problems?

Adapted from Flint PRC proposal

Discussion Question:

Has your CBPR partnership established criteria for choosing priorities?  If so, what are the criteria?  If not, what criteria would you establish and why?

 

Exercise 2.2.2: Choosing Priorities

The East Side Village Health Worker Partnership – A Project of the Detroit Community-Academic Urban Research Center (Schultz)

Composed of representatives from the local health department, hospitals, community-based organizations, and academic institutions, the East Side Village Health Worker Partnership chose their priorities using two methods: (1) working with a steering committee (composed of neighborhood residents) to develop a model that encompassed the various factors creating and impacting stress among women and children residents, and (2) developing and implementing a community-based participatory survey that tested this model, and using the results to determine areas of greatest concern among residents, and set priorities.

Discussion Question:

Has your CBPR partnership established criteria for choosing priorities?  If so, what are the criteria?  If not, what criteria would you establish and why?