Community-Based Participatory Research: Summary

Community-based participatory research (CBPR) is an approach to health and environmental research meant to increase the value of studies for both researchers and the community being studied. This approach is particularly attractive for academics and public health professionals struggling to address the persistent problems of health care disparities in a variety of populations (identified by factors such as social or economic status, lack of health insurance, or membership in various racial and ethnic groups). Few guidelines exist for evaluating CBPR grant proposals and determining what resources are required to promote successful community-based research efforts. Still less is known about the degree to which CBPR has been effective in sustaining long-term university–community partnerships and generating high-quality data to guide further research. Experts are becoming impatient with the gap between knowledge produced through conventional research and the translation of this research into interventions and policies to improve the health of various groups, especially minority communities and other disadvantaged populations. Done properly, CBPR benefits community participants, health care practitioners, and researchers alike. CBPR creates bridges between scientists and communities, through the use of shared knowledge and valuable experiences. This collaboration further lends itself to the development of culturally appropriate measurement instruments, thus making projects more effective and efficient. Finally, CBPR establishes a mutual trust that enhances both the quantity and the quality of data collected. The ultimate benefit to emerge from such collaborations is a deeper understanding of a community’s unique circumstances, and a more accurate framework for testing and adapting best practices to the community’s needs. In 2001, the Agency for Healthcare Research and Quality (AHRQ), in collaboration with several Federal agencies and the W.K. Kellogg Foundation, convened a 2-day conference “to promote and support the use of CBPR, to develop strategies to advance CBPR, and to explore the use of CBPR as a resource for policymakers to help guide their program development.” AHRQ organized the meeting specifically to address three key barriers to CBPR: (1) insufficient community incentives (staffing and resources) to play a partnership role in CBPR projects; (2) insufficient academic incentives (staffing and resources) for researchers to play a partnership role in CBPR projects; and (3) inadequate funding and insensitive funding mechanisms. The conference membership recommended an AHRQ-commissioned study of the existing evidence on the conduct and evaluation of CBPR, performed by one of the Agency’s Evidence-based Practice Centers (EPCs). Accordingly, the Agency commissioned the RTI International–University of North Carolina (RTIUNC) EPC to produce a systematic review and synthesis of the scientific literature regarding CBPR and its role in improving community health. Specifically, the EPC investigators were asked to consider four Key Questions (KQs):