The rise of the community-based participatory research initiative at the National Institute for Environmental Health Sciences: an historical analysis using the policy streams model.

BACKGROUND Community-based participatory research (CBPR) is an approach to research that seeks equitable and collaborative involvement of community members and researchers in all aspects of the research process. It has moved slowly into the areas of health and public health research. In 1995, the National Institute for Environmental Health Sciences (NIEHS) launched the first research initiative at NIH specifying the use of the CBPR approach. OBJECTIVES The purpose of this paper is to provide the historical record and to identify factors and events that led to the development of the policy creating the CBPR initiative at NIEHS. METHODS The study used Kingdon's policy streams model as an analysis framework. The policy streams model explains that policies are developed when three "streams" (problem, policy and political) come together at a point called the policy window. Information collected from key informant interviews and document analyses were coded to the components of the policy streams model. RESULTS The study documented factors and events in each of the three streams of the model. All these occurred about the same time to bring together the three streams, causing the opening of a policy window. This analysis demonstrates an importance of problem awareness and changes in leadership positions or ideology/mood to bring a policy option to the attention of policymakers, and the importance of a policy entrepreneur to advocate for a particular policy when the opportunity arises. CONCLUSIONS Policy entrepreneurs should be alert for opportunities to take advantage of the open policy windows when they emerge, thereby achieving success in moving policy ideas forward.