Community-Level
Community
Level
Interventions to Prevent or
Manage Chronic Disease
Community Engagement in
Analysis and Intervention
Development
Goal 1: Understand Community Health Issues
Strategy
gy 1D: Community
y Forums & Communityy
Partnered-Participatory Research
1 Town Hall
1.
Status
Identify Public Health problem

Complete

Convene Conference for
Knowledge Exchange Data and
Collection

Complete

Analyses: Pile Sorting, Multidimensional Scaling and Cluster
Analysis

Complete
Feedback


and Dissemination:
Forums, publications and
presentations
2nd Town Hall July 2010
 Summer/Fall 2010
Translational Research in the 21st Century
y
Interdisciplinary
Research
Public-Private Partnerships
Bench
Building Blocks and Pathways
Molecular Libraries
Bi i f
Bioinformatics
ti and
d
Computational
Biology
Structural Biology
N
Nanomedicine
di i
Bedside
Community &
Public Health
Practice
Clinical Research/Trials & Training
“Practical” Trials
Bio-behavioral/Cultural
Bio
behavioral/Cultural
Community Partnered Participatory Research
System Level Clinical Outcomes Assessment
Geographic Systems Modeling
H lth Advocacy
Health
Ad
&P
Policy
li
Norris KC, Ethnicity & Disease, 2005
Fi di
Finding
Answers
A
to
t Disparities
Di
iti
Document
Disparities
and Causes
Develop
l andd Test
Interventions
Intervention design
Practical trials
Implement
Solutions
Efficiently
Di
Disparities
iti IIntervention
t
ti D
Design
i
Conceptual Model
 Use culturally and linguistically appropriate
media,
di settings,
tti
and
d agents
t
 Incorporate patient and community input at all
stages
t
off research
h
 Use multifaceted, intensive, and interactive
approaches
h
Cooper LA, J Gen Intern Med, 2002
Community-Based Participatory
Research

Community-Based
Community
Based Participatory Research
(CBPR) model “a collaborative approach to
research that equitably involves all partners
in the research process and recognizes the
unique strengths that each brings”
brings
Wallerstein N, Ethn Dis 2006
Community “Partnered” Participatory
Research

Community-“Partnered”
Community
Partnered Participatory
Research (CPPR) to maintain an equitable
and highly engaged partnership that
recognizes and respects each partner, yet
clearly distinguished from CBPR to minimize
false expectations and potential conflicts
Wells K, Ethn Dis, 2006
Community-“Partnered” Participatory
Research

“Many
Many components of Community
Community-Partnered
Partnered
Participatory Research (CPPR) are partly
based on Community-Based Participatory
Research (CBPR) models but are organized
into a particular approach”
approach
Jones L, JAMA, 2007
Community- Partnered Participatory
Research
1
1.
2.
3
3.
4.
Identify a health issue that fits community priorities
and academic capacity to respond
Developing a coalition of community, policy and
academic stakeholders that informs supports,
shares and uses the products
Engaging the community through conferences and
workshops that provide information, determine
readiness to proceed and obtain input
Initiate work groups that develop, implement, and
evaluate action plans
Jones L, JAMA, 2007
Community- Partnered Participatory
Research
1
1.
2.
3
3.
4.
Identify a health issue that fits community priorities
and academic capacity to respond
Developing a coalition of community, policy and
academic stakeholders that informs supports,
shares and uses the products
Engaging the community through conferences and
workshops that provide information, determine
readiness to proceed and obtain input
Initiate work groups that develop, implement, and
evaluate action plans
Jones L, JAMA, 2007
Aims
Ai

Use CPPR to reduce to Health Disparities in
South Los Angeles


Short term
term-Create
Create Los Angeles health
collaborative that can have an impact on
disparities
p
locally
y and nationally
y
Long Term-Carry out CPPR project including
community members at every stage of project and
disseminate approach and findings
M th d
Methods


Community Town Hall Discussions
 56 Community members who responded to fliers at
LA Urban League community events within 70 block
area
 Eight Roundtables, two conducted in Spanish
 Four
F
collaboratively
ll b ti l d
developed
l
d questions
ti
posed
d
Partnered Analysis
 3 Academics
Academics, 3 Urban League staff and 3 Community
members
 Four meetings: Pile sorting and Cluster Interpretation
Goal 1: Understand community health
issues Strategy 1D: Community forums
Community Partnered-Participatory Research
Responses
Themes
1.What is the main
challenge to better health
in your community?
124
40
2.Community strengths or
assets that can be used to
address these challenges?
150
35
3.What can we do working
together to improve the
health of the community?
169
60
77
29
Question
4. What should our
message be?
M th d
Methods

Qualitative and Quantitative Analyses

Theme identification



Pile Sorting
g #1- Conference responses
p
Group discussion and consensus building
Theme sorting


Pile Sorting #2- How are themes related?
Multi-Dimensional Scaling (MDS)


Borgatti,
g , Visual AnthroPac 2003© Natick MA
Interpretation of MDS cluster results
M th d
Methods


Multidimensional Scaling (MDS) and Stress
Evaluation
How similar or dissimilar are themes to each other?


How many times they were put into same pile?
Spatial description of how similar answers are?

AnthroPac © Natick MA

If the stress score is too high it will be hard to make a
good picture, and there will be a lot of “Stress” (more
th .2
than
2 iis ttoo much)
h)

If the stress is greater than .2 then the picture is not doing
a very good job at telling the story of the answers.
Sturrock and Rocha, Field Methods, 2000
Goal 1: Understand community health
issues Strategy 1D: Community forums
Community Partnered-Participatory Research
Responses
Themes
Multi-Dimensional
Scaling & Cluster
Interpretation
1.What is the main
challenge to better health
in your community?
124
40
5
2.Community strengths or
assets that can be used to
address these challenges?
150
35
4
3.What can we do working
together to improve the
health of the community?
169
60
5
77
29
5
Question
4. What should our
message be?
Neighborhood
and Built
Environment
Deprivation
Lack of collective
awareness and trust
Barriers to
healthy
behavior
changes
Poor access to and
quality of health care
Perceived
P
i d and
d
realized lack of
access to healthy
foods
1: From your perspective, what is the main
challenge
h ll
tto b
better
tt h
health
lth iin your community?
it ?

Neighborhood and Built Environment Deprivation


Lack of collective awareness and trust


Cost of Medical Care, Profit Motive in Health Care
Perceived and realized lack of access to healthyy foods


Sense of Community, Mistrust of Politicians/ Community
Leaders/ Systems
P
Poor
access to
t and
d quality
lit off h
health
lth care


Health Prevention Resources/Availability of Healthy
Resources, Drug Dealing/ Addicts / Drugs in Community
High cost of healthy food, Poor Access to Healthy Food
Barriers to healthy behavior changes

Community Health Beliefs; Self
Self-empowerment;
empowerment; Lack of
Knowledge; Stress
Summary





Incorporate community input at every level
Objective/open inclusion process
Continuous feedback & dissemination
Develop partnered interventions and
programs
Implementation and evaluation
Goal 2: Engage L.A. community
Strategy 2B: Identify & develop
community-partnered interventions
Interventions
Status
1.
Existing Urban League
Interventions
1.
Deputy Neighborhood office
initiated programs
2.
Health Collaborative
Ideas/Comments
2.
Collaborative meetings and
feedback sessions
3.
Community Ideas and
Comments
3.
Findings from CommunityPartnered Participatory
Research and Focus Groups