Nina Wallerstein, DrPH
University of New Mexico
nwallerstein@salud.unm.edu
Malia Villegas, EdD
National Congress of American Indians Policy Research Center
mvillegas@ncai.org
Community Campus Partnerships for Health
Houston, April 18, 2012
Research for Improved Health:
A National Study of CommunityAcademic Partnerships
 Overall Goal:
 To examine the facilitators and barriers to effective community-
academic partnerships to improve health and health equity in
AI/AN communities and other communities which face
disparities
 Partners: (2009-2013)
 National Congress of American Indians Policy Research Center
 University of New Mexico Center for Participatory Research
 University of Washington Indigenous Wellness Research Institute
 Funding: Native American Research Centers for Health (NARCH V):
NIH/Indian Health Service partnership
History
 Three-Year Pilot: National Center of Minority Health and
Health Disparities (2006-2009) (Wallerstein/Duran: PI)
 National Advisory Board (CBPR Think Tank)
 Literature Review (2003-2008):
 PubMed, Business Premier, Psych Info, SciSearch, Communication and Mass Media;
 Key Words: Community Based Participatory Research, CBPR, participatory research,
action research, participatory action research, participatory evaluation, community
driven research, action science, collaborative inquiry, empowerment evaluation
 From over 2000 articles, 287 reviewed, used to generate model characteristics
 Internet Survey (Appropriateness of Characteristics)
 Development of Model (Wallerstein et al, 2008;
Chapter in CBPR and Health: Process to Outcomes, 2nd
edition)
Research for Improved Health
Examples of items in Matrix
 The political and social climate seem "right" for starting a
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
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collaborative project like this one.
I have a lot of respect for the other people involved in this
collaboration.
I can talk openly and honestly at the Board meetings.
I am comfortable expressing my point of view.
The partnership has been successful at preparing tribal
leadership.
To what extent has your partnership strengthened ATODrelated policies and regulations in the community?‘
The partnership positively influences community health.
Research for Improved Health
Specific aims:
 Describe the variability of CBPR partnerships/projects
 Describe the impact of governance on CBPR
processes and outcomes
 Examine associations among partnering processes
and intermediate system/capacity and health
outcomes
 Identify promising practices, assessment tools, and
future research needs.
Research for Improved Health
Methodology:
 Quantitative:
 Internet survey of 327 federally funded CBPR projects
 Key informant interview surveys (PIs) to enhance
recruitment and validate data
 Community Engagement survey of perceptions
 (Identified in 2009 RePORT data base & NARCH Projects).
 Qualitative:
 At least 6 case studies of partnerships (originally 8)
 Examine similarities and differences across key contexts,
partnering processes, and outcomes
 Deepen interpretations of survey
Research for Improved Health
Select Hypotheses
 The more a CBPR partnership integrates local knowledge into
the research, the greater likelihood the project will result in
intermediate system and capacity outcomes, ie., cultural
renewal, sustainability, community capacity, policy & practice
changes.
 The more a project is aligned with CBPR principles, the better
quality of intermediate system and capacity outcomes.
 The more there is resource-sharing, participatory decisionmaking and reciprocal learning, the better the capacity
outcomes.
 The longer the CBPR partnership has been in operation, the
more the project will result in intermediate outcomes which
lead to improved health outcomes.
Research for Improved Health
Accomplishments since Fall, 2009
 Application of the conceptual model to study design
 Literature review publication: measurement tools and
constructs (Sandoval et al, Health Education Research)
http://hsc.unm.edu/SOM/fcm/cpr/cprmodel/Instruments/CBPRInteractiveModel/CBPRInstruments-Matrix/InstrumentsMatrix--abstract.pdf
Project code of ethics and integrity, protocols for student
involvement, publications, & communications: Study
website: http://narch.ncaiprc.org/
 Variable Matrix (Pearson et al, 2011, CES4Health;
Web availability of Interactive Model linked to instruments
and to variables/measures:

http://hsc.unm.edu/SOM/fcm/cpr/cprmodel.shtml
Research for Improved Health Case Studies
Personal Involvement/Motivation
Context Emphasized:
History of Community: in Research/Social Movements
Partnership/Group Dynamics:
Governance/Approval Processes
Facilitators and Barriers
Power
Trust
Interventions or Policy Emphasis
CBPR Research
Themes in Findings
 Context Matters:
 Historic trust/mistrust readily present
 Urban/rural access
 Governance Matters:
 Tribal Sovereignty and community accountability
 Structural agreements and approvals vary considerably
 Identity of Researcher(s) Matter:
 Shared ethnic/racial identity enable bridging role
 Interventions impacted by cultural embeddedness
 Partnership and Capacity Outcomes:
 Community sustainability of intervention
 University approval policies
Internet Survey Domains
 Context : Community Capacity
 Group Dynamics: Bridging
 Alignment with Principles/Core Values
 Task Roles
 Power Dynamics/Decision-making
 Leadership/Stewardship
 Trust
 Intervention/Research: Partnership Synergy
 Outcomes
 System and Capacity Changes: Policy/Quality/Access
 Changes in Power Relations
 Sustainability
 Cultural Centeredness
Julie Lucero, 2012
Contact Information
Malia Villegas, Principal Investigator
Principal Investigator, NCAI PRC NARCH Project
Email: mvillegas@ncai.org
Nina Wallerstein, Co-Principal Investigator, UNM
Qualitative Data Collection & Analysis
Email: nwallerstein@salud.unm.edu
Bonnie Duran, Co-Principal Investigator, UW
Quantitative Data Collection & Analysis
Email: bonduran@u.washington.edu