The promise of community-based participatory research for health equity: a conceptual model for bridging evidence with policy.

Insufficient attention has been paid to how research can be leveraged to promote health policy or how locality-based research strategies, in particular community-based participatory research (CBPR), influences health policy to eliminate racial and ethnic health inequities. To address this gap, we highlighted the efforts of 2 CBPR partnerships in California to explore how these initiatives made substantial contributions to policymaking for health equity. We presented a new conceptual model and 2 case studies to illustrate the connections among CBPR contexts and processes, policymaking processes and strategies, and outcomes. We extended the critical role of civic engagement by those communities that were most burdened by health inequities by focusing on their political participation as research brokers in bridging evidence and policymaking

Sustainability and power in health promotion: community-based participatory research in a reproductive health policy case study in New Mexico

Health promotion programs are commonly viewed as value-free initiatives which seek to improve health, often through behavior change. An opposing view has begun to emerge that health promotion efforts, especially ones seeking to impact health policy and social determinants of health, are vulnerable to political contexts and may depend on who is in power at the time. This community-based participatory research study attempts to understand these interactions by applying a conceptual model focused on the power context, diverse stakeholder roles within this context, and the relationship of political levers and other change strategies to the sustainability of health promotion interventions aimed at health policy change. We present a case study of a health promotion coalition, New Mexico for Responsible Sex Education (NMRSE), as an example of power dynamics and change processes. Formed in 2005 in response to federal policies mandating abstinence-only education, NMRSE includes community activists, health promotion staff from the New Mexico Department of Health, and policy-maker allies. Applying an adapted Mayer's power analysis' instrument, we conducted semi-structured stakeholder interviews and triangulated political-context analyses from the perspective of the stakeholders. We identified multiple understandings of sustainability and health promotion policy change, including: the importance of diverse stakeholders working together in coalition and social networks; their distinct positions of power within their political contexts; the role of science versus advocacy in change processes; the particular challenges for public sector health promotion professionals; and other facilitators versus barriers to action. One problem that emerged consisted of the challenges for state employees to engage in health promotion advocacy due to limitations imposed on their activities by state and federal policies. This investigation's results include a refined conceptual model, a power-analysis instrument, and new understandings of the intersection of power and stakeholder strategies in the sustainability of health promotion and health in all policies.Univ Fed Sao Paulo, Campus Baixada Santista, Sao Paulo, BrazilUniv New Mexico, Albuquerque, NM 87131 USAUniv New Mexico, Publ Hlth Program, MSC 09 5060, Albuquerque, NM 87131 USAUniv Fed Sao Paulo, Campus Baixada Santista, Sao Paulo, BrazilWeb of Scienc

Violencia en Colombia: reflexiones de una profesora visitante

ABSTRACT: As a professor of Public Health in the United States, the author presents her perspective of violence as a public health issue in Colombia, based on her experiences over a relatively short period of time as a Fulbright scholar in Bogota. Though not claiming to be definitive, the article presents the far-ranging complexity of the violence, from its epidemiology, to its social-economic-political origins, and its devastating psychological, social and life threatening consequences over multiple generations. The article is both narrative of experiences with scholars, people in communities, fellow parents, activists, and professionals, as well as a scholarly treatise to illustrate that the violence is not chaotic and indecipherable, but has systematic roots and therefore systematic opportunities for amelioration. Hope for Colombia is uncovered through the dedication of professionals engaged in community development efforts; through existing, though fragile, political negotiations; and through popular demonstrations for peace.RESUMEN: Como profesora de salud pública en Estados unidos y habiendo tenido la oportunidad de estar en Santafé de Bogotá por un corto periodo de tiempo la autora presenta su perspectiva de ?a violencia en Colombia como asunto que atañe a la salud pública. Aunque no intenta sentar conclusiones, este articulo presenta la gran complejidad de la violencia desde verla como epidemia, hasta sus orígenes socioeconómicos y políticos, y sus devastadoras consecuencias psicológicas, sociales y de amenaza a la vida desde hace varias generaciones. Este artículo es tanto una narración de experiencias con académicos, gente de la comunidad, familiares, activistas, y profesionales, como también un intento académico por mostrar que la violencia no es caótica e indescifrable sino que tiene raíces sistemáticas y, por ende, oportunidades sistemáticas de mejoramiento. Esperemos que Colombia salga adelante gracias al trabajo de profesionales dedicados al desarrollo de los esfuerzos de la comunidad; gracias a las negociaciones políticas, que aun son débiles; y gracias a las manifestaciones populares por la paz

RezRIDERS: A Tribally-Driven, Extreme Sport Intervention & Outcomes

Reducing Risk through Interpersonal Development, Empowerment, Resiliency, and Self-Determination (RezRIDERS) is a tribally-driven youth empowerment program designed to deter substance abuse and depression symptomology among high-risk American Indian youth while increasing hope/optimism, self-efficacy, and pro-social bonding. The quasi-experimental intervention took place between 2012-2015 in the Pueblo of Jemez (New Mexico, USA). The community-based program served fifty-five total youth. RezRIDERS has four major curricular components: 1) Extreme Sport activity clusters paired with; 2) Indigenized behavioral-cognitive lessons; 3) Tribal Research Team providing program oversight and cultural mentoring; and 4) Community action projects addressing youth-identified community issues. This unique program is a modern version of challenge and journeying that Indigenous people historically experienced as norms. Using qualitative and quantitative data, intervention pilot-testing assessed feasibility and efficacy of the program

Identifying and Defining the Dimensions of Community Capacity to Provide a Basis for Measurement

Although community capacity is a central concern of community development experts, the concept requires clarification. Because of the potential importance of community capacity to health promotion, the Division of Chronic Disease Control and Community Intervention, Centers for Disease Control and Prevention (CDC), convened a symposium in December 1995 with the hope that a consensus might emerge regarding the dimensions that are integral to community capacity. This article describes the dimensions that the symposium participants suggested as central to the construct, including participation and leadership, skills, resources, social and interorganizational networks, sense of community, understanding of community history, community power, community values, and critical reflection. The dimensions are not exhaustive but may serve as a point of departure to extend and refine the construct and to operationalize ways to assess capacity in communities.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/67070/2/10.1177_109019819802500303.pd

An Adaptive CBPR Approach to Create Weight Management Materials for a School-Based Health Center Intervention

Purpose. From our previous clinical work with overweight/obese youth, we identified the need for research to create an effective weight management intervention to address the growing prevalence of adolescent metabolic syndrome. Formative assessment through an adaptive community-based participatory research (CBPR) approach was conducted toward the development of a nutritional and physical activity (DVD) and clinician toolkit for a school-based health center (SBHC) weight management intervention. Methods. We first conducted parent and adolescent interviews on views and experiences about obesity while convening a community advisory council (CAC) recruited from two participating urban New Mexico high schools. Thematic findings from the interviews were analyzed with the CAC to develop culturally and developmentally appropriate intervention materials. Results. Themes from the parent and adolescent interviews included general barriers/challenges, factors influencing motivation, and change facilitators. The CAC and university-based research team reached consensus on the final content of nutrition and physical activity topics to produce a DVD and clinician toolkit through six monthly sessions. These materials used in the SBHC intervention resulted in a greater reduction of body mass index when compared to adolescents receiving standard care. Conclusions. Formative assessment using an adaptive CBPR approach resulted in the creation of culturally and age appropriate weight reduction materials that were acceptable to study participants. This trial is registered with ClinicalTrials.gov NCT00841334

Clinical Study An Adaptive CBPR Approach to Create Weight Management Materials for a School-Based Health Center Intervention

properly cited. Purpose. From our previous clinical work with overweight/obese youth, we identified the need for research to create an effective weight management intervention to address the growing prevalence of adolescent metabolic syndrome. Formative assessment through an adaptive community-based participatory research (CBPR) approach was conducted toward the development of a nutritional and physical activity (DVD) and clinician toolkit for a school-based health center (SBHC) weight management intervention. Methods. We first conducted parent and adolescent interviews on views and experiences about obesity while convening a community advisory council (CAC) recruited from two participating urban New Mexico high schools. Thematic findings from the interviews were analyzed with the CAC to develop culturally and developmentally appropriate intervention materials. Results. Themes from the parent and adolescent interviews included general barriers/challenges, factors influencing motivation, and change facilitators. The CAC and university-based research team reached consensus on the final content of nutrition and physical activity topics to produce a DVD and clinician toolkit through six monthly sessions. These materials used in the SBHC intervention resulted in a greater reduction of body mass index when compared to adolescents receiving standard care. Conclusions. Formative assessment using an adaptive CBPR approach resulted in the creation of culturally and age appropriate weight reduction materials that were acceptable to study participants. This trial is registered with ClinicalTrials.gov NCT00841334

Transforming the field: the role of academic health centers in promoting and sustaining equity based community engaged research

Community-based participatory research (CBPR) and community engaged research (CEnR) are key to promoting community and patient engagement in actionable evidence-based strategies to improve research for health equity. Rapid growth of CBPR/CEnR research projects have led to the broad adoption of partnering principles in community-academic partnerships and among some health and academic organizations. Yet, transformation of principles into best practices that foster trust, shared power, and equity outcomes still remain fragmented, are dependent on individuals with long term projects, or are non-existent. This paper describes how we designed our Engage for Equity PLUS intervention that leverages the leadership and membership of champion teams (including community-engaged faculty, community partners and patient advocates) to improve organizational policies and practices to support equity based CBPR/CEnR

The human right to adequate food and sustainable development goals: collective interferences with children in vulnerable urban peripheries

Este artigo teve como objetivo analisar as relações entre o Direito Humano à Alimentação Adequada (DHAA) e os Objetivos do Desenvolvimento Sustentável (ODS) que emergem de ações dialógicas com crianças e adolescentes em periferias urbanas vulnerabilizadas de São Vicente, SP. Utilizando referencial metodológico das pesquisas participativas, a observação e registros de assembleias comunitárias e da parceria entre universidade pública e movimento social apontam para espaços de acolhimento às crianças e adolescentes que viabilizam leituras diagnósticas coletivas sobre a alimentação. Esses processos dialógicos permitem problematizar as dimensões do DHAA a partir da cadeia de produção, comercialização e consumo de alimentos, além da instabilidade a que essas crianças e adolescentes estão submetidos, em uma complexa rede de determinantes que produzem má-nutrição nos territórios onde vivem. Os resultados apontam que estas dimensões dialogam com todos os ODS, na medida em que demandam a sustentabilidade cultural, econômica, social e ambiental da alimentação. A parceria e a integração entre universidade e sociedade fortalece e potencializa os espaços de controle social e formação dos atores para a luta pelo DHAA,  e pode também produzir efeitos de transformação nas desigualdades nos territórios e reconhecer a criança como sujeito de direitos com profundo rigor ético na construção de escutas inclusivas e de práticas qualificadas.This study aimed to analyze the relation between the Human Right to Adequate Food (HRAF) and Sustainable Development Goals (SDG) resulting from a dialogic experience with children and adolescents in the periphery of São Vicente, São Paulo. Using the methodological framework of participatory research, community assemblies observation, and the partnership between the university and social movements point to a caring place for children/adolescents that enable collective diagnostic readings on food. Dialogical processes enable us to problematize HRAF dimensions based on the chain of food production, trading and consumption, and the instability to which those children/adolescents are subjected in a complex network of determinants that produce hunger and malnutrition in the territories in which they live. Results show that these dimensions dialogue with all the SDGs, as they demand cultural, economic, social, and environmental sustainability of food. The partnership and integration between university and society strengthens and enhances the spaces of social control and training of actors to advocate for the HRAF. It can also change inequalities in the territories and acknowledge children as subjects of rights with deep ethical commitment in the construction of inclusive listening and qualified practices