Since these prepubescent girls spent so much time on their mobile phones researchers wound up modifying their interaction around mobile technology. A health center was referring a large number of women for mammograms, but many were not showing up for their appointments. Once this health center saw how they compared to other health centers in the area, they took action by assigning a language-appropriate nurse to contact the referred w omen and make sure they knew when their appointment was, how to get there, and essentially guide them through the process.
By making these changes, the clinic had the highest mammography rate in the entire system. The panelists noted that measuring the impact of a CBPR program presents a challenge since the outcomes, such as reducing the incidence of breast cancer, of any research study may take time to unfold. The group that Della had recruited had become a community-based participatory research team. Working with Della and others at the hospital, they helped to determine what kind of information would be useful, and then learned how to gather it.
This section is about participatory action research: what it is, why it can be effective, who might use it, and how to set up and conduct it. In other words, community-based participatory research adds to or replaces academic and other professional research with research done by community members, so that research results both come from and go directly back to the people who need them most and can make the best use of them. There are several levels of participatory research.
At one end of the spectrum is academic or government research that nonetheless gathers information directly from community members. The community members are those most directly affected by the issue at hand, and they may or may not be asked for their opinions about what they need and what they think will help, as well as for specific information.
At the same time, this type of participatory research is still a long step from research that is done at second or third hand, where all the information about a group of people is gathered from statistics, census data, and the reports of observers or of human service or health professionals. At another level, academic or other researchers recruit or hire members of an affected group — often because they are familiar with and known by the community — to collect data.
In this case, the collectors may or may not also help to analyze the information that they have gathered. A third level of participatory research has academic, government, or other professional researchers recruiting members of an affected group as partners in a research project. The community members work with the researchers as colleagues, participating in the conception and design of the project, data collection, and data analysis. They may participate as well in reporting the results of the project or study.
At this level, there is usually — though not always — an assumption that the research group is planning to use its research to take action on an issue that needs to be resolved.
The opposite end of the participatory research continuum from the first level described involves community members creating their own research group — although they might seldom think of it as such — to find out about and take action on a community issue that affects them directly. This is what is often defined as community-based participatory research. Employing CBPR for purposes of either evaluation or long-term change can be a good idea for reasons of practicality, personal development, and politics.
And that, of course, is the true goal of community research — to identify and resolve an issue or problem, and to improve the quality of life for the community as a whole. By engaging in research, they not only learn new skills, but see themselves in a position of competence, obtain valuable knowledge and information about a subject important to them, and gain the power and the confidence to exercise control over this aspect of their lives. Community-based participatory research has much in common with the work of the Brazilian political and educational theoretician and activist, Paulo Freire.
Freire believes that with the right tools — knowledge and critical thinking ability, a concept of their own power, and the motivation to act — they can undo that oppression. Action research is often used to consider social problems — welfare reform or homelessness, for example — but can be turned to any number of areas with positive results. Just as it can be used for different purposes, CBPR can be structured in different ways. The differences have largely to do with who comes up with the idea in the first place, and with who controls, or makes the decisions about, the research.
Any of these possibilities might involve a collaboration or partnership, and a community group might well hire or recruit as a volunteer someone with research skills to help guide their work. Action research yields better and more nearly complete and accurate information from the community. Action research makes a reasonable resolution or accurate evaluation more probable in two ways. Second, it encourages community buy-in and support for whatever plans or interventions are developed. Action research, by involving community members, creates more visibility for the effort in the community.
Community members are more likely to accept the legitimacy of the research and buy into its findings if they know it was conducted by people like themselves, perhaps even people they know. Citizens are more apt to trust both the truthfulness and the motives of their friends and neighbors than those of outsiders. Action research trains citizen researchers who can turn their skills to other problems as well.
They often become community activists, who work to change the conditions that create difficulty for them and others.
An action research project can have profound effects on community researchers who are disadvantaged economically, educationally, or in other ways. Such an expanded vision leads to an increased willingness to take action, and to an increase in their control over their lives. A participatory action research process can help to break down racial, ethnic, and class barriers.
CBPR can remove barriers in two ways. First, action research teams are often diverse, crossing racial, ethnic, and class lines. As people of different backgrounds work together, this encourages tolerance and friendships, and often removes the fear and distrust. In addition, as integral contributors to a research or evaluation effort, community researchers interact with professionals, academics, and community leaders on equal footing.
Once again, familiarity breaks down barriers, and allows all groups to see how much the others have to offer. I walked into the first meeting thinking I was the greatest thing to hit the pike and found that I, too, had some prejudices that I was not aware of. Action research helps people better understand the forces that influence their lives. Just as Paulo Freire found in his work in Latin America, community researchers, sometimes as a direct result of their research, and sometimes as a side benefit, begin to analyze and understand how larger economic, political, and social forces affect their own lives.
This understanding helps them to use and control the effects of those forces, and to gain more control over their own destinies. Community based action research can move communities toward positive social change. All of the above rationales described reasons for employing CBPR act to restructure the relationships and the lines of power in a community.
They contribute to the mutual respect and understanding among community members and the deep understanding of issues that in turn lead to significant and positive social change. A businessman from the Portuguese community in a small city was an invaluable member of an action research team examining the need for services in that community. He was quite successful, had graduated from college in the US, and needed no services himself, but his fluency in Portuguese, his credentials as a trusted member of the community, and his understanding of both the culture of the Portuguese residents and the culture of health and human service workers brought a crucial dimension to data gathering, analysis, and general information about the community.
Everyone on a team has to view other members as colleagues, not as superiors or inferiors, or as more or less competent or authoritative.
This can be difficult on both sides — i. Both the quality of the research and the long-term learning by team members will benefit greatly from the effort. There are some circumstances where actual equality among all team members is not entirely possible.
When community members are hired as researchers, for instance, the academic or other researcher who pays the bills has to exercise some control over the process. One criterion is the amount of time you have to do the research on the issue or intervention. Action research may take longer than traditional methods, because of the need for training, and because of the time it often takes for community researchers to adjust to the situation i.
If your time is limited, CBPR may not be the right option. Action research lends itself particularly well to qualitative research. The results of qualitative research are usually expressed as a narrative or set of conclusions, with the analysis backed up by quotes, observation notes, and other non-numerical data.
Almost anything can be expressed in terms of numbers in some way. Interviewers, for instance, can count the number of references to a particular issue, or even record the number of times that an interviewee squirmed in his chair. The number of squirms may say something about how nervous an interviewee is, or it may indicate that he has to go to the bathroom. Depends on numbers — the number of people served by an intervention, for instance, the number that completed the program, the number that achieved some predetermined outcome lowered blood pressure, employment for a certain period, citizenship , scores on academic or psychological or physical tests, etc.
These numbers are usually then processed through one or more statistical operations to tell researchers exactly what they mean. Some statistics may, for instance, help researchers determine precisely what part of an intervention was responsible for a particular behavior change.
The Changes Project was looking at the possible effects of a change in the welfare system on adult learners. The project was conducted very early in the change process, in order to try to head off the worst consequences of the new system. There was very little quantitative information available at that point, and most of the project involved collecting information about the personal experiences of learners on welfare.
Often, a mix of the two will yield the richest and most accurate information. What follows assumes an ideal action research project with a structure, perhaps one initiated by a health or human service organization.
The nature of your group will help you determine how — or whether — you follow each of the steps below. How you recruit a team will depend on the purpose of the project as well as on who might be most effective in gaining and analyzing information. Policy — Politicizing health care. P Conrad, R Kern, pp. New York, NY: St. All Rights Reserved Worldwide. Privacy Policy Information Disclaimer. Unite For Sight. The Importance of Community-Based Research Historically, the fields of medicine and public health have examined the environmental and social determinants of health 1 , 2 and involved the public itself in identifying and addressing public health problems.
Understanding Local Realities Community-based research can make important contributions toward understanding how local environments impact the health status of a population. The Role of Student Researchers in Community-Based Health Research Health is a broad concept; it is not simply a biological phenomenon but is also influenced by various social, economic and political determinants.
Footnotes 1 Frenk J. The new public health. Contact Us Unite For Sight is a c 3 nonprofit organization. Join Our E-Newsletter. Skip to main content. About Overview. Director's Corner. Legislative Information. Strategic Plan. Advisory Council. Employment Opportunities. Extramural Research. Intramural Research.
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