A fish consumption study of anglers in an at-risk community: a community-based participatory approach to risk reduction

ABSTRACT Objective: To determine the effectiveness of a community-partnered risk communication intervention tailored for subsistence anglers in a public housing community.
Design and sample: A one group, pretest, posttest design was used to test the effectiveness of the intervention in a sample ( n =23, age range 18–75 years, 100% African American) of subsistence anglers residing in a public housing community in close proximity to a Superfund clean-up site. Face-to-face surveys were conducted at baseline and 3 months post the intervention to assess changes in knowledge and behaviors.
Intervention: A socioculturally appropriate risk communication intervention was developed, implemented, and evaluated in the targeted community. The risk communication included an interactive power point presentation, visual demonstration by a role model, and distribution of low literacy written materials, followed by a booster mailing of materials 1 month past the initial intervention. Evaluation measures included survey instruments on knowledge and self-reported fishing behaviors.
Results: Participants showed improved knowledge and behavior change related to trimming fish, consumption by pregnant women and children, and consumption of large fish.
Conclusions: The sociocultured tailored risk communication intervention demonstrated promising outcomes in this community and should be evaluated in a larger population of subsistence anglers.     

Funding community-based participatory research: lessons learned

The California Breast Cancer Research Program (CBCRP) was created to fund innovative breast cancer research specifically addressing the needs of women in California. Beginning in 1997, the Program launched the Community Research Collaboration (CRC) Program, a Community-Based Participatory Research (CBPR) program intended to foster community-researcher collaboration on all aspects of the research process, essentially placing the community in the center of the research paradigm. The CBCRP conducted a process evaluation of the CRC Program to assess success and identify areas for improvement. The evaluation included community-researcher collaborations and the award process. The evaluation identified successes that speak to the effectiveness of the collaboration concept: empowering women to formulate and initiate research; involving underserved and hard-to-reach populations; addressing important and useful research questions; increasing communities' skills and expertise, and enabling lasting collaborations. The greatest weakness identified was the involvement of the broader community (beyond the group/organization involved) in these projects. The evaluation identified strengths in CBCRP's award process, including technical assistance and feedback, the emphasis on collaboration in the review process, and awarding funds directly to community groups. Barriers included: power imbalances due to the community's lack of experience in the dominant research funding culture; funding limits and award delays; and the increased service demand beyond the funding limits of the award that is created. The CBCRP has been able to incorporate many of the evaluation findings to improve the CRC Program.     

The impact of lay health advisors on cardiovascular health promotion: using a community-based participatory approach

Overweight and obesity, lack of exercise, and exposure to tobacco smoke are clearly identified behavioral risk factors for cardiovascular disease. These problems disproportionately affect some communities. To address these problems within one community of underserved Latinos, participatory research methods were used to design an outreach program through a collaborative partnership between UCLA School of Nursing, Los Angeles County Department of Health Services, and members of the target community. Latina lay health advisors (LHAs) (n = 12) from the community were recruited and trained to teach 3 classes on healthy nutrition, physical activity, and maintaining smoke-free environments. Classes were offered in Spanish to adult Latinos recruited through the LHAs' social networks. A questionnaire on lifestyle behaviors was completed at baseline and 1 month following the last class. Exploratory open-ended questions on successes and challenges of applying new knowledge were also asked at follow-up. Results of paired t-tests on 256 participants showed significant increases in scores from baseline to follow-up in overall lifestyle behaviors and all 3 behavioral subsets (nutrition, physical activity, smoke-free behavior). Qualitative findings are also presented. Findings support utilizing LHAs as a feasible and effective healthcare delivery strategy for cardiovascular community health promotion, especially among immigrant populations.     

Funding community-based participatory research: lessons learned

The California Breast Cancer Research Program (CBCRP) was created to fund innovative breast cancer research specifically addressing the needs of women in California. Beginning in 1997, the Program launched the Community Research Collaboration (CRC) Program, a Community-Based Participatory Research (CBPR) program intended to foster community-researcher collaboration on all aspects of the research process, essentially placing the community in the center of the research paradigm. The CBCRP conducted a process evaluation of the CRC Program to assess success and identify areas for improvement. The evaluation included community-researcher collaborations and the award process. The evaluation identified successes that speak to the effectiveness of the collaboration concept: empowering women to formulate and initiate research; involving underserved and hard-to-reach populations; addressing important and useful research questions; increasing communities' skills and expertise, and enabling lasting collaborations. The greatest weakness identified was the involvement of the broader community (beyond the group/organization involved) in these projects. The evaluation identified strengths in CBCRP's award process, including technical assistance and feedback, the emphasis on collaboration in the review process, and awarding funds directly to community groups. Barriers included: power imbalances due to the community's lack of experience in the dominant research funding culture; funding limits and award delays; and the increased service demand beyond the funding limits of the award that is created. The CBCRP has been able to incorporate many of the evaluation findings to improve the CRC Program.     

Patient-centered evaluation of home-based rehabilitation developed using community-based participatory research approach for people with disabilities: a case series

Purpose: The purpose of this study was to evaluate the effectiveness of the locally tailored and individualized home-based rehabilitation (HBR) program developed using the community-based participatory research (CBPR) approach, in terms of perceived health in patients with different levels of social engagement, and to explore the perceived facilitators and barriers to rehabilitation.

Method: A concurrent mixed-method design was employed. Four patients participated in the combined therapist- and self-delivered HBR program for 5 months. The perceived health outcomes were quantitatively assessed at baseline, after the therapist-delivered intervention period, and at 1 and 3 months after the self-delivered intervention period. Then, in-depth individual interviews were conducted to explore the facilitators and barriers to rehabilitation.

Results: The perceived health of patients who were fully or partially engaged in society was increased during the therapist-delivered intervention period, and maintained the increased level during the self-delivered intervention period, whereas that of patients who were rarely or not engaged dropped again to lower than the baseline. These results were caused by differentiated facilitators and barriers to rehabilitation depending on the level of social engagement.

Conclusions: Applying tailored strategies to patients with differing levels of social engagement is recommended to further optimize the local relevance of the HBR program.

• Implications for rehabilitation

• A community-based participatory research approach can provide an opportunity to enhance local relevance through community-academic partnerships, in developing a home-based rehabilitation (HBR) program for the people with disabilities.

• For community therapists, enhancing the local relevance of the HBR program, applying tailored strategies to patients with differing levels of social engagement is recommended because the perceived health of the HBR program can be different owing to differing perceived facilitators and barriers to rehabilitation, depending on the level of social engagement.

• For patients with rare or no engagement in society, satisfying their need for interaction with the therapists and helping them cope with their wrong belief about the possibility of their recovery is important to encourage behavioral change and perceived physical improvements.

     

Mental health service needs of a Latino population: a community-based participatory research project

Community-based participatory research bridges the gap between academic researchers and the real-life issues of communities and offers promise for addressing racial and ethnic disparities in mental health care. The purpose of this community-based participatory research was to identify factors that affect access, use, and perception of mental health services by a Latino population at individual, organizational, and community levels. Individual level factors included health beliefs about mental illness and care, suspicions of providers, financial concerns, and culturally determined gender roles. Organizational factors included problems with access to care related to cost, lack of bilingual providers, and culturally competent care; and community level factors included distance between resources and the need for services to be provided in community sites. Immigration status and acculturation were identified as factors at all levels.     

Management of lymphoedema: a community-based approach.

Lymphoedema causes considerable physical, emotional and social problems. This article describes the establishment of a community lymphoedema service in one district health authority. The proposal won the Queen's Nursing Institute Innovation Award in 1991. A second article will review the first year of the clinical service.     

A community-based approach to sexual assault

The community-based Athens-Clarke County Sexual Assault Nurse Examiners (ACC-SANE) program was developed to respond to the needs of sexual assault victims. Although this type of SANE model allows for a strong nurse-managed program, there are frustrations and pitfalls that differ from most hospital-based programs. At this time, the majority (71%) of SANE programs are based in hospitals, and few (15%) function in outpatient/community facilities. In the ACC-SANE program, many community agencies interact to provide a seamless approach to postassault health care, counseling, and criminal prosecution. SANE nurses are well equipped to provide forensic examinations in a caring, out-of-hospital environment. The program is housed in a remodeled cottage that rests on property owned by the Athens-Clarke County government and that is adjacent to the local police department. ACC-SANE is governed by a nonprofit board of directors. This management model has allowed the original organizing groups to remain active in the development of the program. As these agencies continue in the governance of the program, they remain committed to the success of ACC-SANE. The impact of program growth and published program guidelines is examined.     

Enhancing lives through the development of a community-based participatory action research programme

A community-based participatory action research (PAR) programme that has spanned 5 years is discussed in this article. A primary healthcare philosophy requires research in this practice setting and supports the way healthcare is ideally organized within an integrated team and supported by a community network that includes not only the healthcare workers and service providers but also the community as partners. The principles driving three PAR inquiries are described: the development of a model for prevention of workplace violence; working with clinicians towards improving wound management practice; and management of continence for community-dwelling women living with multiple sclerosis. Participatory action research is a potentially democratic process that is equitable and liberating as participants construct meaning in the process of group discussions. We conclude that the cyclical processes inherent in PAR promote reflection and reconstruction of experiences that can lead to the enhancement of people's lives, either at an individual or community level, or both.     

A preventive approach to stroke

There is reason to believe that continued attention to and modification of stroke risk factors will yield major dividends in disease prevention. It will be through the united efforts of health professionals that we can extend the continued success demonstrated in the current decline seen in stroke occurrence and disability. Nursing professionals contribute to preventive interventions by promoting positive health attitudes and applying prevention strategies in their personal lives and clinical practice.     

Community-based participatory research: an approach to intervention research with a Native American community

Community-based participatory research (CBPR), with its emphasis on joining with the community as full and equal partners in all phases of the research process, makes it an appealing model for research with vulnerable populations. However, the CBPR approach is not without special challenges relating to ethical, cultural, and scientific issues. In this article, we describe how we managed the challenges we encountered while conducting a CBPR project with a Native American community. We also suggest criteria that will enable evaluation of the project.