Setting the Stage for CBPR:
Theories and Principles
Julie A. Baldwin, Ph.D.
Department of Community and Family
Health
College of Public Health, USF Health

• Describe the background of communitybased participatory research (CBPR)
• Describe and critically discuss key concepts and principles of CBPR
• Discuss some of the challenges of CBPR, as well as the benefits to public health research

• Numerous definitions
• As place - traditional notion
• As social interaction - network of relationships
• As social & political responsibility shared concerns

• Shared sense of belonging and connectedness
• “Manifested in common symbols, language and emotional connections” (Israel et al., 1994, p.151).
• Best Definition: a group of people sharing a sense of collective identity, common values, goals, and institutions

• Community participation
• Community ownership
• Community competence and empowerment
• Recognition and use of community assets
• Participatory research

• People affected by problem should:
• Set goals
• Plan steps to resolve problem
• Implement changes
• Establish structures to sustain changes
• Outside experts may assist by providing data, models for selecting goals

• Closely-related to participation
• Local people select issue to address
• Local people have sense of responsibility for and control over programs
• Contributes to likelihood of success, esp. Ability to sustain change

• Participants motivated change
• Activities reinforce commitment
• Opportunities to make public commitment
• Program designers gain participant’s views
• Stronger program design
• Participants gain information

• Community’s ability to set goals and solve its problems
• Outside experts may assist with process
• Help community set goals
• Assist them as they solve problems

• Process of gaining mastery and power over oneself/community to change
• Implications:
• Individuals and communities gain tools and take responsibility for making decisions that affect them

Community-Based Participatory
Research (CBPR)
• Term used widely in health research
• In order for research to be participatory, must meet three goals:
– Research, Action, and Education (which are interconnected)

Participation
&
Education
Research Action

“a collaborative process that equitably involves all partners in the research process and recognizes the unique strengths that each brings. CBPR begins with a research topic of importance to the community with the aim of combining knowledge and action for social change to improve community health and eliminate health disparities.”
Israel et al, 1998

• Community-Driven Issue Selection
– Involves commitment, time, and skills from the community members (issue: may have other commitments, jobs, family obligations)
– Can true CBPR take place when the research questions come from an outsider to the community?
– Can an outsider with diverse background, ethnicity, and education play a role in the community?
– Community may internally be divided on issues

Ethical Challenges in CBPR
• Participation and its limitations
– Challenge: who truly represents “the community” – constant negotiations to define community
– Community wants different research design than outside researchers;
• Sharing findings and taking action
– Findings may be thought as harmful by the community members; how do you balance researchers’ feelings of obligations to make all findings public?
– Many CBPR programs now have formal or informal research protocols and MOU’s

Ethical Challenges in CBPR
• Researchers may not share the similar community culture
• Cultural misunderstandings, and real or perceived racism, may occur
– Institutionalized racism
– Personally mediated racism based on stereotypic race-based assumptions and judgments
– Internalized racism (reflected in people’s own acceptance of negative messages concerning their own race or ethnic group)

• “None of us can truly become ‘competent’ in another culture. We can approach crosscultural situations with “cultural humility.”
• Cultural humility is “a lifelong commitment to self evaluation and self-critique,” to redress power imbalances and “develop and maintain mutually respectful and dynamic partnerships with communities.”
Tervalon and
Murray-Garcia, 1998

Changing the Vision of Community
Deficit Mentality
Bundle of
Pathologies
Epidemiology of
Strengths
Community Assets
&
Strengths
Source: H. Jack Geiger

• Individuals
• Leaders
• Regular citizens
• Marginalized members
• Groups and associations
• Local institutions
• Physical assets

Identifying Natural
Community Leaders
 When you have a problem, who do you go to for advice?
 Who do others go to?
 When people in the neighborhood have come together around a problem in the past, did a particular individual or group play a key role?
 What things do people tell you you’re good at?
Eng et al, 1990; Israel, 1985; Sharpe, 2000

Community-Campus Partnerships for Health
Available from: http://depts.washington.edu/ccph/commbas.html#Conf

Community Based
Participatory Research in
Health (CBPR)
Research topic
/problem of importance to the community
Combination of knowledge and action for social change
Impact health disparities

Anonymous