Research and Programsto Eliminate Cancer Disparities

April 19, 2007Marriott New Orleans at the Convention Center

New Orleans, Louisiana

BRIDGING THE GAP

NBLIC’s Seven Guiding Principles of Community-Based Participatory Research

(CBPR)

Selina A. Smith, Ph.D., M.Div., Joyce Q. Sheats, R.N., M.P.H., Jackson Smith, III, LaDonna Carter,

Sandra J. Hamilton, R.N., F.N.P., MEd.

National Black Leadership Initiative on Cancer III: Community Networks Program (NBLIC III)

A program of the National Cancer Institute

Community-Based Community-Based Participatory Research Participatory Research

(CBPR)(CBPR)

A collaborative research approach that is A collaborative research approach that is designed to endure and establish designed to endure and establish structures for participation by structures for participation by communities affected by the issue being communities affected by the issue being studied. Representatives of organizations studied. Representatives of organizations and researchers are involved in all and researchers are involved in all aspects of the research process to aspects of the research process to improve health and well-being through improve health and well-being through taking action, including social changetaking action, including social change

CBPRCBPR

• Co-learning and reciprocal transfer of Co-learning and reciprocal transfer of expertise, by all research partners expertise, by all research partners with particular emphasis on the with particular emphasis on the issues that can be studied with BRPR issues that can be studied with BRPR methods;methods;

• Shared decision-making power;Shared decision-making power;• Mutual ownership of the processes Mutual ownership of the processes

and products of the research and products of the research enterprise.enterprise.

Community-Based Community-Based Participatory ResearchParticipatory Research

• Kurt Lewin - active involvement or Kurt Lewin - active involvement or participationparticipation

• Paulo Freire - mutual learning and Paulo Freire - mutual learning and action-reflectionaction-reflection

• Barbara Israel – nine principlesBarbara Israel – nine principles

CBPRCBPRPrinciples*Principles*

1.1. Recognizes community as a unit of Recognizes community as a unit of identity.identity.

2.2. Builds on strengths and resources within Builds on strengths and resources within the community.the community.

3.3. Facilitates collaborative, equitable Facilitates collaborative, equitable involvement of all partners in all phases of involvement of all partners in all phases of the researchthe research

4.4. Integrates knowledge and action for the Integrates knowledge and action for the mutual benefit of all partners.mutual benefit of all partners.

5.5. Promotes a co-learning and empowering Promotes a co-learning and empowering process that attends to social inequalities.process that attends to social inequalities.

CBPRCBPRPrinciples*Principles*

6.6. Involves a cyclical and iterative Involves a cyclical and iterative process.process.

7.7. Addresses health from both positive Addresses health from both positive and ecological perspectives.and ecological perspectives.

8.8. Disseminates findings and knowledge Disseminates findings and knowledge gained to all partners.gained to all partners.

9.9. Involves a long-term commitment by Involves a long-term commitment by all partners all partners

*Israel, B. A., Schulz, A.J., Parker, E.A., (1998). Review of community-*Israel, B. A., Schulz, A.J., Parker, E.A., (1998). Review of community-based research; Assessing partnership approaches to improve based research; Assessing partnership approaches to improve public health. Annual Review of Public Health, 19, 173-202.public health. Annual Review of Public Health, 19, 173-202.

National Black Leadership Initiative National Black Leadership Initiative on Cancer’s (NBLIC III)on Cancer’s (NBLIC III)

Seven Guiding Principles of Seven Guiding Principles of Community-Based Participatory Community-Based Participatory

Research (CBPR)Research (CBPR)

Seven Guiding PrinciplesSeven Guiding Principles

• We are FamilyWe are Family• Just StandJust Stand• It Takes a VillageIt Takes a Village• Come as You AreCome as You Are• Health, Wholeness & HealingHealth, Wholeness & Healing• Go Tell it on the MountainGo Tell it on the Mountain• We Shall Overcome, SomedayWe Shall Overcome, Someday

We are FamilyWe are Family

• Describes Community-based (not Describes Community-based (not community-placed) methodcommunity-placed) method

• Define community-based participatory Define community-based participatory research within historical contextresearch within historical context

• Nationwide network of community Nationwide network of community stakeholdersstakeholders

• Initiative arising out of the Initiative arising out of the community, for the communitycommunity, for the community

It Takes a VillageIt Takes a Village

• Community Partnerships with Community Partnerships with mutual trust and respectmutual trust and respect

• Community coalitions Community coalitions • Community “Gatekeepers”Community “Gatekeepers”• Community ResourceCommunity Resource

Come as You AreCome as You Are

• Shared learning processShared learning process• Community enhancement through Community enhancement through

empowermentempowerment• Academic and community training Academic and community training • Better prepared community Better prepared community

leadershipleadership• Diverse scientific poolDiverse scientific pool

Just StandJust Stand

• Current research grounded in past Current research grounded in past researchresearch

• Reduce cancer incidence and Reduce cancer incidence and mortalitymortality

• Understand processes facilitating Understand processes facilitating positive outcomespositive outcomes

• Dual pursuit of action and researchDual pursuit of action and research

Just StandJust Stand

• Engage community through Engage community through community coalitionscommunity coalitions

• Cyclic approachCyclic approach• Pursues change and understanding Pursues change and understanding • Refine and replicate Refine and replicate

Best PracticesBest Practices

• Stay Beautiful, Stay Alive – Breast & Stay Beautiful, Stay Alive – Breast & Cervical CancerCervical Cancer

• Down Home Healthy Living – Down Home Healthy Living – Colorectal CancerColorectal Cancer

• For Men Only – Prostate Health & For Men Only – Prostate Health & Co-morbidityCo-morbidity

• Clearing the Air – Tobacco Use & Clearing the Air – Tobacco Use & Lung CancerLung Cancer

Health, Wholeness & Health, Wholeness & HealingHealing

• Holistic approach to community-based Holistic approach to community-based researchresearch

• Individual knowledge, attitude and skillsIndividual knowledge, attitude and skills• Community involvement with planning Community involvement with planning

and implementation for sustainabilityand implementation for sustainability• Integration of cancer control Integration of cancer control • Educational program focused on co-Educational program focused on co-

morbiditymorbidity• Recognizes community diversityRecognizes community diversity

Go Tell it on the MountainGo Tell it on the Mountain

• Extensive process and outcome Extensive process and outcome evaluationsevaluations

• Scientific meritScientific merit• Public awarenessPublic awareness• Community advocacyCommunity advocacy• Affecting policy changeAffecting policy change

We Shall Overcome, We Shall Overcome, SomedaySomeday

• Sustained effortSustained effort• Program sustainability Program sustainability • Long-range effectsLong-range effects

• 10 – 15 Item Pre-Knowledge 10 – 15 Item Pre-Knowledge QuestionnaireQuestionnaire

• Overview of individual principlesOverview of individual principles

• 10 – 15 Item Post-Knowledge 10 – 15 Item Post-Knowledge QuestionnaireQuestionnaire

Online Module Session

ImplicationsImplications

Greater stakeholder buy-in into the Greater stakeholder buy-in into the CBPR process may result through CBPR process may result through self-identification with these self-identification with these principlesprinciples

SustainabilitySustainability

This training tool ensures that This training tool ensures that NBLIC’s nationwide network of NBLIC’s nationwide network of community stakeholders, in community stakeholders, in conversation with state-of-the-art conversation with state-of-the-art cancer screening and treatment cancer screening and treatment partners, will continue to combat partners, will continue to combat cancer health disparities among cancer health disparities among African Americans.African Americans.

Thank YouThank You

Morehouse School of Medicine

720 Westview Drive, SW

Atlanta, Georgia 30310

404-756-5205/1-800-724-1185