Process and outcome constructs for evaluating community-based participatory research projects: a matrix of existing measures

Electronic health record reveals community-level cardiometabolic health benefits associated with 10 years of community-based participatory research

BACKGROUND

While a major goal of community-based participatory research (CBPR) is to improve community health; it is unclear how to measure longstanding success of CBPR.

OBJECTIVE

We sought to determine the impact of ongoing CBPR on cardiometabolic health of participating communities, including in people not directly participating in research.

METHODS

We used linear mixed-effects modelling with electronic medical records from 2002 to 2012 from the Yukon-Kuskokwim Health Corporation, which provides health care to all Alaska Native people in southwestern Alaska, to compare rates of change in cardiometabolic risk factors between communities that did and did not participate in ongoing CBPR beginning in 2003.

RESULTS

We analysed 1,262,035 medical records from 12,402 individuals from 10 study and 38 control communities. Blood pressure declined faster in study than in control communities: systolic blood pressure (0.04 mmHg/year; 95% confidence interval [CI]: 0.01, 0.08); diastolic blood pressure (DBP) (0.07 mmHg/year; 95% CI: 0.04, 0.09). Body mass index increased 0.04 units/year faster in study communities than in control communities (95% CI: 0.03, 0.05). More study visits were associated with faster reduction of DBP and triglyceride levels in study communities.

CONCLUSIONS

Ongoing CBPR may improve overall cardiometabolic health in communities, perhaps by increasing engagement in health and advocacy.

Increased community engagement of Indigenous Peoples in dementia research leads to higher context relevance of results

INTRODUCTION

Health research that focuses on Indigenous Peoples must ensure that the community in question is actively engaged, and that the results have context relevance for Indigenous Peoples. Context relevance is "the benefits, usability, and respectful conduct of research from the perspective of Indigenous communities." The purpose of this study was to apply two tools within an already-published scoping review of 76 articles featuring research on cognitive impairment and dementia among Indigenous Peoples worldwide. One tool assessed levels of community engagement reported in the corpus, and the other tool assessed the context relevance of recommendations in the corpus. We hypothesized that research with higher levels of reported community engagement would produce recommendations with greater context relevance for Indigenous Peoples.

METHODS

We employed semi-structured deductive coding using two novel tools assessing levels of reported community engagement and context relevance of recommendations based on studies included in the existing scoping review.

RESULTS

Application of the two tools revealed a positive relationship between increasing community engagement and greater context relevance. Community engagement primarily occurred in studies conducted with First Nations, Inuit, and Métis populations in Canada and with Australian Aboriginal and/or Torres Strait Islander Peoples. Research with Alaska Native, American Indian, and Native Hawaiian Peoples in the USA stood out for its comparative lack of meaningful community engagement.

DISCUSSION

There is opportunity to utilize these tools, and the results of this assessment, to enhance training and mentorship for researchers who work with Indigenous populations. There is a need to increase investigator capacity to involve communities throughout all phases of research, particularly in the pre-research stages.

Validation of the Measurement Approaches to Partnership Success (MAPS) Questionnaire

Conceptualizing and testing factors that contribute to the success of community-academic partnerships are critical to understanding their contributions to the health and well-being of communities. Most measures to date focus on factors that contribute to the development of new partnerships, and only a few have been adequately tested and validated. Methods. The Measurement Approaches to Partnership Success (MAPS) study followed a community-based participatory research (CBPR) approach and a multiphase process that included the construction and pilot testing of a questionnaire, and a national survey to validate the psychometric properties of the questionnaire in long-standing CBPR partnerships (existing ≥ six years). All members within partnerships were recruited to complete the survey (55 partnerships with 563 partners). We used confirmatory factor analysis (CFA), Cronbach's alpha statistics, and a pairwise correlations approach to assess discriminant and convergent validity, and assessed internal consistency, and test-retest reliability. Results. All MAPS Questionnaire dimensions demonstrated strong validity and reliability and demonstrated agreement over time. Conclusion. The MAPS Questionnaire includes seven dimensions and 81 items related to the MAPS conceptual model and provides a scientific, in-depth measurement tool that allows long-standing CBPR partnerships to evaluate their work toward achieving health equity.

Whose Signals Are Being Amplified? Toward a More Equitable Clinical Psychophysiology

Research using psychophysiological methods holds great promise for refining clinical assessment, identifying risk factors, and informing treatment. Unfortunately, unique methodological features of existing approaches limit inclusive research participation and, consequently, generalizability. This brief overview and commentary provides a snapshot of the current state of representation in clinical psychophysiology, with a focus on the forms and consequences of ongoing exclusion of Black participants. We illustrate issues of inequity and exclusion that are unique to clinical psychophysiology, considering intersections among social constructions of Blackness and biased design of current technology used to measure electroencephalography, skin conductance, and other signals. We then highlight work by groups dedicated to quantifying and addressing these limitations. We discuss the need for reflection and input from a wider variety of stakeholders to develop and refine new technologies, given the risk of further widening disparities. Finally, we provide broad recommendations for clinical psychophysiology research.

#4Corners4Health Social Media Cancer Prevention Campaign for Emerging Adults: Protocol for a Randomized Stepped-Wedge Trial

BACKGROUND

Many emerging adults (EAs) are prone to making unhealthy choices, which increase their risk of premature cancer morbidity and mortality. In the era of social media, rigorous research on interventions to promote health behaviors for cancer risk reduction among EAs delivered over social media is limited. Cancer prevention information and recommendations may reach EAs more effectively over social media than in settings such as health care, schools, and workplaces, particularly for EAs residing in rural areas.

OBJECTIVE

This pragmatic randomized trial aims to evaluate a multirisk factor intervention using a social media campaign designed with community advisers aimed at decreasing cancer risk factors among EAs. The trial will target EAs from diverse backgrounds living in rural counties in the Four Corners states of Arizona, Colorado, New Mexico, and Utah.

METHODS

We will recruit a sample of EAs (n=1000) aged 18 to 26 years residing in rural counties (Rural-Urban Continuum Codes 4 to 9) in the Four Corners states from the Qualtrics' research panel and enroll them in a randomized stepped-wedge, quasi-experimental design. The inclusion criteria include English proficiency and regular social media engagement. A social media intervention will promote guideline-related goals for increased physical activity, healthy eating, and human papillomavirus vaccination and reduced nicotine product use, alcohol intake, and solar UV radiation exposure. Campaign posts will cover digital and media literacy skills, responses to misinformation, communication with family and friends, and referral to community resources. The intervention will be delivered over 12 months in Facebook private groups and will be guided by advisory groups of community stakeholders and EAs and focus groups with EAs. The EAs will complete assessments at baseline and at 12, 26, 39, 52, and 104 weeks after randomization. Assessments will measure 6 cancer risk behaviors, theoretical mediators, and participants' engagement with the social media campaign.

RESULTS

The trial is in its start-up phase. It is being led by a steering committee. Team members are working in 3 subcommittees to optimize community engagement, the social media intervention, and the measures to be used. The Stakeholder Organization Advisory Board and Emerging Adult Advisory Board were formed and provided initial input on the priority of cancer risk factors to target, social media use by EAs, and community resources available. A framework for the social media campaign with topics, format, and theoretical mediators has been created, along with protocols for campaign management.

CONCLUSIONS

Social media can be used as a platform to counter misinformation and improve reliable health information to promote health behaviors that reduce cancer risks among EAs. Because of the popularity of web-based information sources among EAs, an innovative, multirisk factor intervention using a social media campaign has the potential to reduce their cancer risk behaviors.

TRIAL REGISTRATION

ClinicalTrials.gov NCT05618158; https://classic.clinicaltrials.gov/ct2/show/NCT05618158.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

PRR1-10.2196/50392.

A scoping review of the globally available tools for assessing health research partnership outcomes and impacts

BACKGROUND

Health research partnership approaches have grown in popularity over the past decade, but the systematic evaluation of their outcomes and impacts has not kept equal pace. Identifying partnership assessment tools and key partnership characteristics is needed to advance partnerships, partnership measurement, and the assessment of their outcomes and impacts through systematic study.

OBJECTIVE

To locate and identify globally available tools for assessing the outcomes and impacts of health research partnerships.

METHODS

We searched four electronic databases (Ovid MEDLINE, Embase, CINAHL + , PsychINFO) with an a priori strategy from inception to June 2021, without limits. We screened studies independently and in duplicate, keeping only those involving a health research partnership and the development, use and/or assessment of tools to evaluate partnership outcomes and impacts. Reviewer disagreements were resolved by consensus. Study, tool and partnership characteristics, and emerging research questions, gaps and key recommendations were synthesized using descriptive statistics and thematic analysis.

RESULTS

We screened 36 027 de-duplicated citations, reviewed 2784 papers in full text, and kept 166 studies and three companion reports. Most studies originated in North America and were published in English after 2015. Most of the 205 tools we identified were questionnaires and surveys targeting researchers, patients and public/community members. While tools were comprehensive and usable, most were designed for single use and lacked validity or reliability evidence. Challenges associated with the interchange and definition of terms (i.e., outcomes, impacts, tool type) were common and may obscure partnership measurement and comparison. Very few of the tools identified in this study overlapped with tools identified by other, similar reviews. Partnership tool development, refinement and evaluation, including tool measurement and optimization, are key areas for future tools-related research.

CONCLUSION

This large scoping review identified numerous, single-use tools that require further development and testing to improve their psychometric and scientific qualities. The review also confirmed that the health partnership research domain and its measurement tools are still nascent and actively evolving. Dedicated efforts and resources are required to better understand health research partnerships, partnership optimization and partnership measurement and evaluation using valid, reliable and practical tools that meet partners' needs.

Advancing community-academic partnerships to achieve breast health equity: Applying the community-based participatory model to build capacity for sustained impact

BACKGROUND

This formative study leveraged a community-academic partnership to identify barriers to care that are potential sources of breast cancer disparities in Black women. Through this partnership and using a community-based participatory research approach, the objective was to develop a community task force to inform future interventions aimed at addressing breast cancer disparities and increasing health equity.

METHODS

The authors assessed gaps in care related to breast cancer in Buffalo, New York, by collecting and analyzing qualitative data from focus groups and interviews with breast cancer survivors and breast navigation groups assessing barriers and facilitators across the cancer care continuum. Then, community-based participatory research approaches were used to build a task force to develop an action plan addressing gaps in care.

RESULTS

The authors conducted a thematic analysis of qualitative findings to understand barriers and facilitators to cancer care. Three main domains of themes emerged, including medical mistrust, fear, and stigma; the importance of patient navigation as a form of social support; and the importance of faith and faith-based community. Finally, the findings were presented to a newly formed community task force to validate the data collected and set future priorities to address breast cancer disparities and increase breast health equity in the region.

CONCLUSIONS

The authors observed that health equity is a critically important issue in cancer care and that developing culturally tailored interventions has the potential to improve care delivery and reduce breast cancer disparities. Learning from and working with community members helps set the future agenda related to health equity.

PLAIN LANGUAGE SUMMARY

Our overall goal was to assess gaps in breast cancer care in Buffalo, New York, and to use community-based participatory approaches to build a task force to work toward breast health equity. Recent and historical data indicate that the Western New York community is facing a continued wide gap in breast cancer mortality trends between Black and White patients. We collected qualitative data to understand potential sources of inequity related to breast cancer and presented findings to a community task force to set future priorities for addressing breast cancer disparities and increasing breast health equity in our region.

Community capacity for prevention and health promotion: a scoping review on underlying domains and assessment methods

BACKGROUND

Building community capacity is an essential health promotion approach, which refers to the characteristics of communities that affect their ability to identify and address social and public health problems. Despite general agreement about certain capacity domains and frameworks, there is no comprehensive and consistent assessment of community capacity. Therefore, the aim of this scoping review is to identify the domains and methods used to assess community capacity related to community-based prevention and health promotion.

METHODS

A scoping search was performed on 06/02/2022 via PubMed, Web of Science, and Science Direct, with supplemental searches via Google Scholar. The review included studies published in English from 1990 to 2022 that explicitly described how community capacity was assessed in health promotion and prevention interventions. Furthermore, studies had to meet at least two of the three following criteria for capacity assessment: a theoretical foundation, a participatory approach, or a field test of the assessment tool.

RESULTS

From 4779 records, 38 studies were included after applying exclusion criteria. Nineteen studies used mixed, eleven qualitative and eight quantitative methods to assess community capacity. The various domains used to assess community capacity were identified and reassembled into nine comprehensive domains: community participation, knowledge and skills, resources, leadership, community power, sense of community, collaboration, critical awareness and problem-solving, and community structure. The review also identified four sub-domains, which include commitment, communication, shared values and goals, and sustainability.

DISCUSSION

This scoping review provides an overview of the domains and methods used to assess community capacity, which can facilitate the development of a comprehensive approach to capacity assessment in future research.

Participatory Design Application in Youth Sexual Violence and Abuse Prevention: A Mixed-Methods Systematic Review

Youth sexual violence and abuse (SVA) are leading public health and human rights issues around the world. Prevention is key to reducing SVA rates and minimising resultant harms. Despite advocacy for more collaborative approaches, knowledge of how to effectively engage young people and key stakeholders in the design, implementation, and evaluation of SVA prevention programs is limited. This mixed-methods systematic review aimed to synthesise available evidence on participatory design (PD) application in primary and secondary SVA prevention targeting young people. A systematic search was executed across seven electronic databases. Eligible studies were peer-reviewed, published in English, reported primary or secondary SVA prevention, described application of PD or a related approach, and targeted young people aged 12-25 years. Quality was assessed using the Mixed Methods Appraisal Tool. Overall, 20 articles reporting 15 studies were included. Most (55%; n = 11) employed a qualitative design. Descriptions, methods, and scope of PD application varied across included studies. A lack of empirical evaluations prevented conclusions regarding the utility of PD application in terms of measured outcomes. The methodology, agent of change, training, and engagement (MATE) taxonomy was subsequently developed to describe and classify PD application. As illustrated in the MATE taxonomy, PD methods promoting agency, encouraging input, and facilitating empowerment are likely to facilitate more meaningful engagement of participants. Integration of participant and expert views, community consultation, and appropriate socio-cultural adaption appear to be critical determinants of program acceptability and feasibility. Empirical evaluations are needed to assess the relative utility of PD methods in line with SVA prevention objectives.

Community engagement group model in basic and biomedical research: lessons learned from the BEAT-HIV Delaney Collaboratory towards an HIV-1 cure

INTRODUCTION

Achieving effective community engagement has been an objective of U.S. National Institutes of Health-funded HIV research efforts, including participation of persons with HIV. Community Advisory Boards (CABs) have remained the predominant model for community engagement since their creation in 1989. As HIV cure-directed research efforts have grown into larger academic-industry partnerships directing resources toward both basic and clinical research under the Martin Delaney Collaboratories (MDC), community input models have also evolved. The BEAT-HIV MDC Collaboratory, based at The Wistar Institute in Philadelphia, United States, implemented a three-part model for community engagement that has shown success in providing greater impact for community engagement across basic, biomedical, and social sciences research efforts.

DISCUSSION

In this paper, we review the case study of the formation of the BEAT-HIV Community Engagement Group (CEG) model, starting with the historical partnership between The Wistar Institute as a basic research center and Philadelphia FIGHT as a not-for-profit community-based organization (CBO), and culminating with the growth of community engagement under the BEAT-HIV MDC. Second, we present the impact of a cooperative structure including a Community Advisory Board (CAB), CBO, and researchers through the BEAT-HIV CEG model, and highlight collaborative projects that demonstrate the potential strengths, challenges, and opportunities of this model. We also describe challenges and future opportunities for the use of the CEG model.

CONCLUSIONS

Our CEG model integrating a CBO, CAB and scientists could help move us towards the goal of effective, equitable and ethical engagement in HIV cure-directed research. In sharing our lessons learned, challenges and growing pains, we contribute to the science of community engagement into biomedical research efforts with an emphasis on HIV cure-directed research. Our documented experience with implementing the CEG supports greater discussion and independent implementation efforts for this model to engage communities into working teams in a way we find a meaningful, ethical, and sustainable model in support of basic, clinical/biomedical, social sciences and ethics research.

Rochester Healthy Community Partnership: Then and now

Community-engaged research partnerships promote health equity through incorporation of regional contexts to inform partnership dynamics that shape research and interventions that reflect community voice and priorities. Long-term partnerships build trusted relationships and promote capacity building among community and academic partners, but there are many structural barriers to sustaining long-term partnerships. Here we describe lessons learned from sustaining Rochester Healthy Community Partnership (RHCP), an 18-year community-based participatory research (CBPR) partnership in Southeast Minnesota. RHCP collaborates with immigrant and refugee populations to co-create interventions that promote health equity for community health priorities. Challenges to sustainability include a tension between project-based funding and the needs of long-term community-based research infrastructure. These challenges can be met with a focus on shared CBPR principles, operating norms, partnership dynamics, and governance. RHCP began in 2004 through identification of a community health priority, defining the community, and establishment of CBPR principles. It grew through identification of broader community health priorities, capacity building for community and academic partners, and integration of diverse learners. We describe the capacity for RHCP to respond to new societal contexts, the importance of partnership dynamics as a barometer for partnership health, and lessons learned about sustainability of the CBPR partnership.

Tools for assessing health research partnership outcomes and impacts: a systematic review

OBJECTIVE

To identify and assess the globally available valid, reliable and acceptable tools for assessing health research partnership outcomes and impacts.

METHODS

We searched Ovid MEDLINE, Embase, CINAHL Plus and PsycINFO from origin to 2 June 2021, without limits, using an a priori strategy and registered protocol. We screened citations independently and in duplicate, resolving discrepancies by consensus and retaining studies involving health research partnerships, the development, use and/or assessment of tools to evaluate partnership outcomes and impacts, and reporting empirical psychometric evidence. Study, tool, psychometric and pragmatic characteristics were abstracted using a hybrid approach, then synthesized using descriptive statistics and thematic analysis. Study quality was assessed using the quality of survey studies in psychology (Q-SSP) checklist.

RESULTS

From 56 123 total citations, we screened 36 027 citations, assessed 2784 full-text papers, abstracted data from 48 studies and one companion report, and identified 58 tools. Most tools comprised surveys, questionnaires and scales. Studies used cross-sectional or mixed-method/embedded survey designs and employed quantitative and mixed methods. Both studies and tools were conceptually well grounded, focusing mainly on outcomes, then process, and less frequently on impact measurement. Multiple forms of empirical validity and reliability evidence was present for most tools; however, psychometric characteristics were inconsistently assessed and reported. We identified a subset of studies (22) and accompanying tools distinguished by their empirical psychometric, pragmatic and study quality characteristics. While our review demonstrated psychometric and pragmatic improvements over previous reviews, challenges related to health research partnership assessment and the nascency of partnership science persist.

CONCLUSION

This systematic review identified multiple tools demonstrating empirical psychometric evidence, pragmatic strength and moderate study quality. Increased attention to psychometric and pragmatic requirements in tool development, testing and reporting is key to advancing health research partnership assessment and partnership science. PROSPERO CRD42021137932.

Community engagement in health services research on elimination of lymphatic filariasis: A systematic review

This study aimed to contextualize the extent, nature, and quality of community engagement in health services research on eliminating lymphatic filariasis in low-and middle-income countries of Southeast Asia and Pacific Region. We performed a systematic review, and the results were reported according to the PRISMA-S checklist. Relevant studies were searched in health-related electronic databases, and selected according to the inclusion criteria. Sixteen studies with various study designs were identified. The majority (68%) were conducted in India. Lay people, community leaders, and volunteers were the most common groups of community members (12/16,75%). Overall, the majority (13/16, 81%) were at the 'moderate level' of engagement in research context mainly by 'collaboration' in 'developing methodology' 'collaboration' in data collection and 'collaboration' for 'dissemination of findings. The common barriers to the community engagement were lack of involvement of participating bodies and technology-related issues. In conclusion, the insufficient description of the community engagement process in the studies limits a deeper understanding and analysis of the issue. Future well-designed prospective studies with attention to the description of mechanisms of engagement, facilitating the whole process and reporting the community level outcome are recommended.

How are health research partnerships assessed? A systematic review of outcomes, impacts, terminology and the use of theories, models and frameworks

Background

Accurate, consistent assessment of outcomes and impacts is challenging in the health research partnerships domain. Increased focus on tool quality, including conceptual, psychometric and pragmatic characteristics, could improve the quantification, measurement and reporting partnership outcomes and impacts. This cascading review was undertaken as part of a coordinated, multicentre effort to identify, synthesize and assess a vast body of health research partnership literature.

Objective

To systematically assess the outcomes and impacts of health research partnerships, relevant terminology and the type/use of theories, models and frameworks (TMF) arising from studies using partnership assessment tools with known conceptual, psychometric and pragmatic characteristics.

Methods

Four electronic databases were searched (MEDLINE, Embase, CINAHL Plus and PsycINFO) from inception to 2 June 2021. We retained studies containing partnership evaluation tools with (1) conceptual foundations (reference to TMF), (2) empirical, quantitative psychometric evidence (evidence of validity and reliability, at minimum) and (3) one or more pragmatic characteristics. Outcomes, impacts, terminology, definitions and TMF type/use were abstracted verbatim from eligible studies using a hybrid (independent abstraction–validation) approach and synthesized using summary statistics (quantitative), inductive thematic analysis and deductive categories (qualitative). Methodological quality was assessed using the Quality Assessment Tool for Studies with Diverse Designs (QATSDD).

Results

Application of inclusion criteria yielded 37 eligible studies. Study quality scores were high (mean 80%, standard deviation 0.11%) but revealed needed improvements (i.e. methodological, reporting, user involvement in research design). Only 14 (38%) studies reported 48 partnership outcomes and 55 impacts; most were positive effects (43, 90% and 47, 89%, respectively). Most outcomes were positive personal, functional, structural and contextual effects; most impacts were personal, functional and contextual in nature. Most terms described outcomes (39, 89%), and 30 of 44 outcomes/impacts terms were unique, but few were explicitly defined (9, 20%). Terms were complex and mixed on one or more dimensions (e.g. type, temporality, stage, perspective). Most studies made explicit use of study-related TMF (34, 92%). There were 138 unique TMF sources, and these informed tool construct type/choice and hypothesis testing in almost all cases (36, 97%).

Conclusion

This study synthesized partnership outcomes and impacts, deconstructed term complexities and evolved our understanding of TMF use in tool development, testing and refinement studies. Renewed attention to basic concepts is necessary to advance partnership measurement and research innovation in the field.

Systematic review protocol registration: PROSPERO protocol registration: CRD42021137932 https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=137932.

Building capacity in quantitative research and data storytelling to enhance knowledge translation: a training curriculum for peer researchers

BACKGROUND

Many community-based HIV research studies incorporate principles of greater involvement and meaningful engagement of people living with HIV (GIPA/MEPA) by training people with HIV as peer researchers. Unfortunately, there are still some aspects of research (e.g., quantitative data analysis and interpretation) where many projects fall short in realizing GIPA/MEPA principles. To address these gaps, we developed an eight-week training course that aimed to build the capacity of peer researchers around the understanding and interpretation of quantitative data and incorporating lived experience to increase the impact of the knowledge transfer and exchange phase of a study.

METHODS

Peer researchers (n = 8) participated from British Columbia, Alberta, and Ontario and lessons learned from the training were implemented throughout the dissemination of research findings from the People Living with HIV Stigma Index study. This paper presents the curriculum and main training components, course evaluation results, and challenges and lessons learned. The manuscript was created in collaboration with and includes the perspectives of both the peer researchers involved in the training, as well the course facilitators.

RESULTS

Throughout the course, peer researchers' self-assessed knowledge and understanding of quantitative research and data storytelling improved and, through interactive activities and practice, they gained the confidence to deliver a full research presentation. This improved their understanding of research findings, which was beneficial for discussing results with community partners and study participants. The peer researchers also agreed that learning about integrating lived experience with quantitative data has helped them to make research findings more relatable and convey key messages in a more meaningful way.

CONCLUSIONS

Our training curriculum provides a template for research teams to build capacity in areas of research where peer researchers and community members are less often engaged. In doing so, we continue to uphold the principles of GIPA/MEPA and enhance the translation of research knowledge in communities most greatly affected.

Establishing a Framework for Sustainable Community Action Research

Community-based participatory research/community-partnered participatory research (CBPR/CPRR) is viewed as a critical approach for improving health and addressing inequities found in under-resourced communities by pairing community partners and academic partners to address health and environmental concerns. This article aims to amplify the potential of the current CBPR/CPPR models through insights learned from the underserved community of Watts in south central Los Angeles. We discuss our framework that shifts the primary academic focus in the community-academia partnership from individual investigators and/or research groups to the academic institution to generate sustainable partnerships. We summarize the Community Action Research Engagement (CARE) Framework as a new set of recommended tenets to expand CBPR/CPPR. This framework can provide guidance for how universities can catalyze: 1) building trust; 2) facilitating knowledge; 3) advancing solutions; and 4) fostering mentorship in the context of leveraging a university's position to address the root causes of community inequities and thus create more sustained partnerships that achieve greater impact within their surrounding communities.

Methodologies to Advance a "Science of How": Identifying and Engaging Intervention Targets and Outcomes

OBJECTIVE

Although implementation science has taken hold in many areas of psychiatric services research, a need remains for developing effective, low-cost interventions for specific subpopulations with mental health conditions. The experimental therapeutics approach has gained momentum as a framework for developing effective interventions. However, few studies have taken steps to rigorously apply experimental therapeutics. This article provides a blueprint for applying this approach.

METHODS

A focused literature review was conducted to document the frequency of the application of experimental therapeutics among articles published between 2011 and 2021 in some of the American Psychiatric Association's journals. Independently of the review, the authors delineated a four-component approach for applying experimental therapeutics in research and present practical, innovative strategies to advance psychiatric services research.

RESULTS

The four-component approach includes outlining prerequisites, identifying target mechanisms, proposing intervention strategies to address target mechanisms, and using advanced analytic methods. The strategies described for each component are not exhaustive; rather, they suggest promising avenues for research that can lead to more effective interventions and deeper understanding of how, and for whom, an intervention works.

CONCLUSIONS

The application of experimental therapeutics in psychiatric services research can lead to increased development, refinement, and implementation of effective interventions for specific populations or conditions.

Personalized Medicine for the Critically Ill Patient: A Narrative Review

Personalized Medicine (PM) is rapidly advancing in everyday medical practice. Technological advances allow researchers to reach patients more than ever with their discoveries. The critically ill patient is probably the most complex of all, and personalized medicine must make serious efforts to fulfill the desire to “treat the individual, not the disease”. The complexity of critically ill pathologies arises from the severe state these patients and from the deranged pathways of their diseases. PM constitutes the integration of basic research into clinical practice; however, to make this possible complex and voluminous data require processing through even more complex mathematical models. The result of processing biodata is a digitized individual, from which fragments of information can be extracted for specific purposes. With this review, we aim to describe the current state of PM technologies and methods and explore its application in critically ill patients, as well as some of the challenges associated with PM in intensive care from the perspective of economic, approval, and ethical issues. This review can help in understanding the complexity of, P.M.; the complex processes needed for its application in critically ill patients, the benefits that make the effort of implementation worthwhile, and the current challenges of PM.

Evaluating the Impacts of Patient Engagement on Health Services Research Teams: Lessons from the Veteran Consulting Network

BACKGROUND

Despite increasing commitment to patient engagement in research, evaluation of the impact of these efforts on research processes, products, and teams is limited.

OBJECTIVE

To explore the impacts of engaging patients as consultants to research studies by examining the experiences, impacts, and lessons learned from a program facilitating patient engagement at a Veterans Health Administration research center.

DESIGN

We developed a logic model to articulate the activities being implemented to support patient engagement and their anticipated outcomes. Then, we conducted qualitative, semi-structured interviews with participants in the local Veteran Consulting Network to qualitatively explore these outcomes.

PARTICIPANTS

Twelve researchers and eleven Veteran patients with experience working on at least one grant or funded study.

APPROACH

Interview transcripts were inductively coded using a consensus-based approach. Findings were synthesized using framework analysis and mapped back onto our logic model of expected patient engagement impacts.

KEY RESULTS

Patient engagement improved the perceived quality and relevance of research studies as patient consultants challenged researchers' assumptions about patient populations and clinical contexts and gave feedback that helped improve the feasibility of proposed grants, readability of study materials, comprehensiveness of study assessments, and cultural sensitivity and relevance of interventions. Patient engagement also had personal benefits to researchers and patients. Researchers reported improved communication skills and higher job satisfaction. Patients reported a sense of purpose and satisfaction from their work with greater awareness of and appreciation for research.

CONCLUSIONS

Engaging patients in research can have multiple benefits to the people and work involved. Our evaluation process can serve as a template for other organizations to plan for and assess the impact of their own patient engagement programs. Creating logic models and updating them based on feedback from program users make engagement goals explicit, help verify expected mechanisms to achieve impact, and facilitate organizational learning.

Community Based Participatory Research (CBPR): An Underutilized Approach to Address Surgical Disparities

Disparities are well-documented across the continuum of surgical care. Counteracting such disparities requires new multidisciplinary approaches that utilize the expertise of affected individuals, such as community-based participatory research (CBPR). CBPR is an approach to research that is anchored in equitable, sustainable community-academic partnerships, and has been shown to improve intervention implementation and outcomes. In this article, community stakeholders and researchers outline the principles and benefits of CBPR, examples of CBPR in trauma and transplant, and future directions for CBPR within surgery.

Use of a community advisory board to build equitable algorithms for participation in clinical trials: a protocol paper for HoPeNET

Introduction

Participation from racial and ethnic minorities in clinical trials has been burdened by issues surrounding mistrust and access to healthcare. There is emerging use of machine learning (ML) in clinical trial recruitment and evaluation. However, for individuals from groups who are recipients of societal biases, utilisation of ML can lead to the creation and use of biased algorithms. To minimise bias, the design of equitable ML tools that advance health equity could be guided by community engagement processes. The Howard University Partnership with the National Institutes of Health for Equitable Clinical Trial Participation for Racial/Ethnic Communities Underrepresented in Research (HoPeNET) seeks to create an ML-based infrastructure from community advisory board (CAB) experiences to enhance participation of African-Americans/Blacks in clinical trials.

Methods and analysis

This triphased cross-sectional study (24 months, n=56) will create a CAB of community members and research investigators. The three phases of the study include: (1) identification of perceived barriers/facilitators to clinical trial engagement through qualitative/quantitative methods and systems-based model building participation; (2) operation of CAB meetings and (3) development of a predictive ML tool and outcome evaluation. Identified predictors from the participant-derived systems-based map will be used for the ML tool development.

Ethics and dissemination

We anticipate minimum risk for participants. Institutional review board approval and informed consent has been obtained and patient confidentiality ensured.

Promoting informed prostate cancer screening decision-making for African American men in a community-based setting

PURPOSE

Current screening guidelines for prostate cancer (PCa) encourage men to make individual screening decisions after consulting with their primary care provider to weigh the risks and benefits of undergoing prostate specific antigen (PSA) testing, but many men at high risk of PCa diagnosis (notably African American men) are more likely to be uninsured and lack a primary care provider. An academic-community partnership redesigned its community-based screening program to ensure access to services for African American men, incorporating a session with a trained clinical educator in community settings, designed to increase knowledge and promote informed decision-making regarding PSA testing. This study evaluated effects of the intervention on decision-making outcomes.

METHODS

To evaluate program efficacy, 88 men completed pre- and post-test surveys assessing outcomes of interest.

RESULTS

Participants' knowledge, beliefs, attitudes, anxiety levels, and self-efficacy all improved from pre- to post-test at a statistically significant level. Most notably participants' awareness that PCa is often not life-threatening, and watchful waiting is a reasonable treatment option increased after the encounter. More than half of the study sample felt they had received enough knowledge to make an informed decision about whether the PSA test was right for them.

CONCLUSION

Our findings show the program had positive effects on men's ability to make informed decisions about PCa screening and demonstrate that educational outreach programs with an emphasis on informed decision-making can effectively balance screening guidelines with the needs of underserved populations in community settings to improve outcomes.

Community engagement in the development and implementation of a rural road safety campaign: Steps and lessons learned

INTRODUCTION

Rural crashes result in fatality rates twice as high as urban, after accounting for vehicle miles traveled, and those involving farm vehicles tend to be the most severe. Farm vehicle crash interventions have focused on the farm equipment (e.g., lighting and marking) or the farm vehicle operator (e.g., training), despite crashes being most frequently caused by other vehicle driver actions. Community-based campaigns focused on rural drivers have potential to influence driver behavior. The objective of this study was to describe the role, formation, and lessons learned from a community advisory board (CAB) in the development and dissemination of a community-based rural roadway safety campaign.

METHODS

The CAB provided campaign input through quarterly meetings and email. The campaign had three main CAB and crash data-informed messages: 1) Slow Down, 2) Leave More Space, and 3) Avoid Passing. The CAB led campaign activities to publicize the message, distribute swag, and organize event logistics. To evaluate CAB effectiveness and inform future community engagement efforts, we conducted in-depth, semi-structured telephone interviews with CAB members in July 2020. Interviews were transcribed, coded, and codes were categorized into five main themes.

RESULTS

Overall, CAB membership was described as an overwhelmingly positive experience in terms of the CAB structure, culture fostered among the group, responsibilities, and time commitment. Board members reported successful campaign implementation, gave positive feedback regarding the research team's engagement efforts, and provided valuable recommendations for future campaigns (e.g., adding social media components, expansion of CAB age and industry diversity, and increasing group bonding activities).

CONCLUSIONS

Results from this study demonstrate the instrumental role and logistics involved in engagement of community advisors for the development and implementation of a rural roadway safety campaign. Steps and lessons from this study can be applied to other community-level injury and violence prevention topics, with a particular focus on rural communities.

Health Benefits of Social Participation Interventions among Community-Dwelling Older Persons: A Review Article

BACKGROUND

Social disengagement among older persons may result from accumulated physical impact and social stressors experienced throughout life. Conversely, interventions that enhance social participation addresses social isolation with positive influences on health. This article, therefore, aimed to review the range of published studies that evaluated the health benefits of interventions on social participation among community-dwelling older persons.

METHOD

We conducted a search using the databases CINAHL, MEDLINE, EBSCOhost, PubMed, ProQuest, SAGE, ScienceDirect, SpringerLink, Web of Science, and Open repository/archive.

RESULTS

Twenty-five studies from Asia, Europe and America were selected. Included articles described randomized controlled trials (9), quasi-experimental studies (9), mixed-methods studies (2), participatory action research (3), and community-based intervention research (2). Social interventions described are group or cultural activities, personal/group monitoring and discussion, and communications devices. Intervention designed utilized theories, models, concepts, principles, and evidence from published literature.

CONCLUSION

Most social intervention studies evaluating health outcomes have been conducted in North America and Western Europe. Group-based activities were most commonly employed, but personal/group discussions, home visits and technology-based interactions have also been used. While social isolation is now a widely accepted risk factor for ill-health, research evidence for improvement of health through reduction of social isolation remains limited.

Conducting a Community "Street Survey" to Inform an Obesity Intervention: The WE Project

Using a community-based participatory research approach, a citywide survey was conducted to explore perceptions of obesity and interventions to reduce obesity within an African American urban community. More than 1300 surveys were collected within 3 months; 92.9% of respondents agreed or strongly agreed that obesity was an important health issue in the community and the majority indicated that family-based interventions were the preferred pathway for improving physical activity (86.0%) and nutrition (85.2%). Engaging community members in survey development and implementation was an effective approach to build local research capacity and establish a shared agenda of reaching a diverse sample of community residents.

Advancing engagement and capacity for rural cancer control: a mixed-methods case study of a Community-Academic Advisory Board in the Appalachia region of Southwest Virginia

BACKGROUND

The objectives are to: 1) describe engagement processes used to prioritize and address regional comprehensive cancer control needs among a Community-Academic Advisory Board (CAB) in the medically-underserved, rural Appalachian region, and 2) detail longitudinal CAB evaluation findings.

METHODS

This three-year case study (2017-2020) used a convergent parallel, mixed-methods design. The approach was guided by community-based participatory research (CBPR) principles, the Comprehensive Participatory Planning and Evaluation process, and Nine Habits of Successful Comprehensive Cancer Control Coalitions. Meeting artifacts were tracked and evaluated. CAB members completed quantitative surveys at three time points and semi-structured interviews at two time points. Quantitative data were analyzed using analysis of variance tests. Interviews were audio recorded, transcribed, and analyzed via an inductive-deductive process.

RESULTS

Through 13 meetings, Prevention and Early Detection Action Teams created causal models and prioritized four cancer control needs: human papillomavirus vaccination, tobacco control, colorectal cancer screening, and lung cancer screening. These sub-groups also began advancing into planning and intervention proposal development phases. As rated by 49 involved CAB members, all habits significantly improved from Time 1 to Time 2 (i.e., communication, priority work plans, roles/accountability, shared decision making, value-added collaboration, empowered leadership, diversified funding, trust, satisfaction; all p < .05), and most remained significantly higher at Time 3. CAB members also identified specific challenges (e.g., fully utilizing member expertise), strengths (e.g., diverse membership), and recommendations across habits.

CONCLUSION

This project's equity-based CBPR approach used a CPPE process in conjunction with internal evaluation of cancer coalition best practices to advance CAB efforts to address cancer disparities in rural Appalachia. This approach encouraged CAB buy-in and identified key strengths, weaknesses, and opportunities that will lay the foundation for continued involvement in cancer control projects. These engagement processes may serve as a template for similar coalitions in rural, underserved areas.

The Underutilization of Community-based Participatory Research in Psychology: A Systematic Review

Traditional non-participatory research methodologies have struggled to address the needs of multicultural populations in the United States (U.S.). Community-based participatory research (CBPR) is a research paradigm offering a unique opportunity for culturally appropriate research and improving health equity. CBPR is an equitable, strength-based approach involving all stakeholders throughout the research process. We investigate the field of psychology's utilization of CBPR as an approach for working with multicultural populations to collaboratively address relevant and impactful research questions. A total of 1912 CBPR-related articles, from 2004 to 2014, were identified using PsycINFO, PubMed, and CINAHL Complete databases. Of these, approximately 16% (n = 311) met our criteria for psychology-related CBPR articles accounting for a negligible amount (<1%) of peer-reviewed publications in mainstream psychological journals during the same time period. Among U.S. psychology-related CBPR articles, 86% focused on multicultural and marginalized populations. Prominent topics of investigation included physical health, mental and behavioral health, and theoretical or methodological articles. Features of publications, including authors' training, types of journals, study populations, and topics under investigation, were explored for all 1912 publications. Findings highlight an opportunity for further utilization of CBPR within psychology, with key implications for health equity. Recommendations for increasing CBPR uptake within the discipline are also offered.

Scales of Practices and Outcomes for Community-Engaged Research

Despite the growth of research on community-engaged research (CEnR), recent reviews suggest there has been limited development of validated scales to measure key contexts, mechanisms, and outcomes, impairing testing and refinement of theoretical models. The purpose of this study is to present the psychometric properties of scales from the Engage for Equity (E2) project, stemming from a long-term research partnership examining community-engaged research projects. This study used a three-stage, cross-sectional format: (a) a sampling frame of 413 CEnR projects was identified; (b) 210 principal investigators completed a project-level survey and nominated partners for another survey; (c) 457 investigators and partners completed a survey about project contexts, processes, interventions, and outcomes. Factorial validity was established through confirmatory factor analysis supporting seven scales: contextual capacity, commitment to collective empowerment, relationships, community engagement in research actions, synergy, partner and partnership transformation, and projected outcomes. Convergent validity was established through examining covariances among the scales. This study largely yielded results consistent with a previous psychometric study of related measures, while demonstrating improved ceiling effects of the items and refined conceptualization of core theoretical constructs.

A Contribution to Measure Partnership Trust in Community-Based Participatory Research and Interventions With Latinx Communities in the United States

Given the growing diversity in the United States, responsiveness to the needs of diverse communities is paramount. Latinx communities in the United States often state mistrust in outside institutions because of adverse experiences. Community-based participatory research (CBPR) is considered a trust-building process and is one approach to understand disparities. However, the conceptualization and evaluation of trust as a CBPR outcome are understudied. This article summarizes a community-engaged research process conducted for the cultural and linguistic refinement of a partnership trust survey tool to assess partnership trust as an outcome of CBPR (CBPR-PTS), by using Perinatal Awareness for Successful Outcomes (PASOs) as a case study and cross-cultural cognitive interviewing (CCCI) methodology. The participants were 21 diverse stakeholders of PASOs, a community-based health organization that serves the Latinx population in South Carolina. A modified version of the multidimensional measure of trust model informed instrument development. The team analyzed the CCCI data using compiling informal analysis to identify which survey items' wordings must be changed or adapted based on the participants' accounts. Sixteen of 28 questions subjected to CCCI required modifications due to translation errors, culturally specific errors, or general cognitive problems. The new survey instrument has 19 scales and 195 items categorized into nine dimensions of the modified multidimensional measure of trust model. CCCI was a useful tool to address the cross-cultural understanding issues of the CBPR-PTS. Measurement instruments should be able to capture the socioeconomic, cultural, and geographic/environmental variability of community stakeholders to help understand the diversity of the comprehension and views of the communities involved in disparities' reduction efforts.

In pursuit of equity: partnering to improve breast and prostate cancer outcomes among African Americans

PURPOSE

Community-based participatory research (CBPR) is a collaborative partnership approach that leverages the strengths of academic-community groups to address local problems. CBPR emphasizes equity (e.g., co-learning, power-sharing, participatory decision-making) among groups to achieve goals and promote sustainability. This study examines group dynamics, and their influence on achieving shared goals, within a CBPR-guided partnership established to improve breast and prostate cancer outcomes among underserved African American communities in St. Louis, Missouri.

METHODS

We conducted in-person, semi-structured interviews with key academic and community informants and surveyed via email community collaborators involved in outreach activities. Interviews were audiotaped, transcribed, and independently coded by two authors using an iterative, open-coding process to identify major themes. Surveys were summarized using similar coding criteria for open-ended responses and descriptive statistics for discrete responses. Using a grounded theory approach, we summarized and compared themes from each data source to identify similarities and differences and triangulated results to generate overarching thematic findings.

RESULTS

Participants described benefits from the partnership (funding; clinical, public health and evaluation expertise; training and networking opportunities) and found beneficial ways to leverage the partners' strengths in collaborating Participants expressed long-term commitment to sustaining the partnership and building capacity to address cancer disparities, but faced challenges related to power-sharing and participatory decision-making.

CONCLUSIONS

Using CBPR to address cancer disparities is an effective approach to capacity-building and achieving shared goals. By evaluating the structures and processes within CBPR collaborations through the lens of equity, partners may identify and address challenges that threaten long-term partnership sustainability.

Coordinator Perceptions When Assessing the Impact of Citizen Science towards Sustainable Development Goals

Tracking progress towards the United Nations’ Sustainable Development Goals (SDGs) requires high-quality, timely, and accessible data, often in areas where data are rarely available. Problems exist due to socioeconomic variations between countries and the qualitative nature of certain indicators in their definition. Citizen science has the potential to contribute to several SDGs. However, whilst citizen science’s potential to contribute towards SDGs is well documented, limitations exist when measuring the impact that citizen science has made toward SDG progress. To better understand the issues and prospective solutions surrounding impact assessment towards SDG progress, this work presents the outcomes of semi-structured interviews with citizen science project coordinators. They reveal the complex nature of impact assessment within a citizen science context. Coordinators demonstrate greater confidence when the project is easier to relate to the SDGs, and the project methodology can objectively measure indicators. Issues exist, however, when considering SDGs with a broader, global context, those more difficult to link to project goals and when the project’s impact on them happens at timescales beyond the funding period. If the full potential of citizen-science contributions to the SDGs is to be realised, approaches are needed to fully consider practitioners’ needs and motivations.

Measurement Approaches to Partnership Success: Theory and Methods for Measuring Success in Long-Standing Community-Based Participatory Research Partnerships

BACKGROUND

Numerous conceptual frameworks have been developed to understand how community-based participatory research (CBPR) partnerships function, and multiple measurement approaches have been designed to evaluate them. However, most measures are not validated, and have focused on new partnerships. To define and assess the meaning of success in long-standing CBPR partnerships, we are conducting a CBPR study, Measurement Approaches to Partnership Success (MAPS). In this article we describe the theoretical underpinnings and methodological approaches used.

OBJECTIVES

The objectives of this study are to 1) develop a questionnaire to evaluate success in long-standing CBPR partnerships, 2) test the psychometric qualities of the questionnaire, 3) assess the relationships between key variables and refine the questionnaire and theoretical model, and 4) develop mechanisms and a feedback tool to apply partnership evaluation findings.

METHODS

Methodological approaches have included: engaged a community-academic national Expert Panel; conducted key informant interviews with Expert Panel; conducted a scoping literature review; conducted a Delphi process with the Expert Panel; and revised the measurement instrument. Additional methods include: conduct cognitive interviews and pilot testing; revise and test final version of the questionnaire with long-standing CBPR partnerships; examine the reliability and validity; analyze the relationship among variables in the framework; revise the framework; and develop a feedback mechanism for sharing partnership evaluation results.

CONCLUSIONS

Through the application of a theoretical model and multiple methodological approaches, the MAPS study will result in a validated measurement instrument and will develop procedures for effectively feeding back evaluation findings in order to strengthen authentic partnerships to achieve health equity.

Using attendance data for social network analysis of a community-engaged research partnership

BACKGROUND

The Rockefeller University Center for Clinical and Translational Science (RU-CCTS) and Clinical Directors Network (CDN), a Practice-Based Research Network (PBRN), fostered a community-academic research partnership involving Community Health Center (CHCs) clinicians, laboratory scientists, clinical researchers, community, and patient partners. From 2011 to 2018, the partnership designed and completed Community-Associated Methicillin-Resistant Staphylococcus Aureus Project (CAMP1), an observational study funded by the National Center for Advancing Translational Sciences (NCATS), and CAMP2, a Comparative Effectiveness Research Study funded by the Patient-Centered Outcomes Research Institute (PCORI). We conducted a social network analysis (SNA) to characterize this Community-Engaged Research (CEnR) partnership.

METHODS

Projects incorporated principles of Community-Based Participatory Research (CAMP1/2) and PCORI engagement rubrics (CAMP2). Meetings were designed to be highly interactive, facilitate co-learning, share governance, and incentivize ongoing engagement. Meeting attendance formed the raw dataset enriched by stakeholder roles and affiliations. We used SNA software (Gephi) to form networks for four project periods, characterize network attributes (density, degree, centrality, vulnerability), and create sociograms. Polynomial regression models were used to study stakeholder interactions.

RESULTS

Forty-seven progress meetings engaged 141 stakeholders, fulfilling 7 roles, and affiliated with 28 organizations (6 types). Network size, density, and interactions across organizations increased over time. Interactions between Community Members or Recruiters/Community Health Workers and almost every other role increased significantly across CAMP2 (P < 0.005); Community Members' centrality to the network increased over time.

CONCLUSIONS

In a partnership with a highly interactive meeting model, SNA using operational attendance data afforded a view of stakeholder interactions that realized the engagement goals of the partnership.

A Systematic Review of Community Engagement Outcomes Research in School-Based Health Interventions

BACKGROUND

Involving communities in school health has been purported as a practice integral to supporting a Whole School, Whole Community, Whole Child (WSCC) approach. Although community collaboration is often included in school-based health initiatives, there is little research considering methods for increasing community engagement. The purpose of this study was to identify effective school-based health interventions documenting changes in community engagement.

METHODS

Academic experts and school stakeholders guided procedures for a systematic review of studies published from 1987-2017 and gray literature (ie, best practice documents; policy documents, etc.) on comprehensive school health interventions including community engagement as a targeted outcome.

RESULTS

The search identified 9 studies addressing community as an outcome of school-based health interventions; types of partnership mechanisms and partners' roles were classified.

CONCLUSIONS

Although involving communities is a WSCC component and commonly recommended as a strategy fundamental to school health, there is little empirical research examining effective strategies for engaging communities and engagement is often not measured as part of intervention studies. Further measurement and research in engaging communities in school health is warranted.

Advancing the pragmatic measurement of sustainment: a narrative review of measures

BACKGROUND

Sustainment, an outcome indicating an intervention continues to be implemented over time, has been comparatively less studied than other phases of the implementation process. This may be because of methodological difficulties, funding cycles, and minimal attention to theories and measurement of sustainment. This review synthesizes the literature on sustainment measures, evaluates the qualities of each measure, and highlights the strengths and gaps in existing sustainment measures. Results of the review will inform recommendations for the development of a pragmatic, valid, and reliable measure of sustainment.

METHODS

A narrative review of published sustainment outcome and sustainability measures (i.e., factors that influence sustainment) was conducted, including appraising measures in the Society of Implementation Research Collaboration (SIRC) instrument review project (IRP) and the Dissemination and Implementation Grid-Enabled Measures database initiative (GEM-D&I). The narrative review used a snowballing strategy by searching the reference sections of literature reviews and definitions of sustainability and sustainment. Measures used frequently and judged to be comprehensive and/or validated by a team of implementation scientists were extracted for analysis.

RESULTS

Eleven measures were evaluated. Three of the included measures were found in the SIRC-IRP, three in the GEM-D&I database, (one measure was in both databases) and six were identified in our additional searches. Thirteen constructs relating to sustainment were coded from selected measures. Measures covered a range of determinants for sustainment (i.e., construct of sustainability) as well as constructs of sustainment as an outcome. Strengths of the measures included, development by expert panels knowledgeable about particular interventions, fields or contexts, and utility in specific scenarios. A number of limitations were found in the measures analyzed including inadequate assessment of psychometric characteristics, being overly intervention or context specific, being lengthy and/or complex, and focusing on outer context factors.

CONCLUSION

There is a lack of pragmatic and psychometrically sound measures of sustainment that can be completed by implementation stakeholders within inner context settings (e.g., frontline providers, supervisors).

Development of a novel social incubator for health promoting initiatives in a disadvantaged region

Background

Bottom-up approaches to disparity reduction present a departure from traditional service models where health services are traditionally delivered top-down. Raphael, a novel bottom-up social incubator, was developed in a disadvantaged region with the aim of ‘hatching’ innovative health improvement interventions through academia-community partnership.

Methods

Community organizations were invited to submit proposals for incubation. Selection was made using the criteria of innovation, population neediness and potential for health impact and sustainability. Raphael partnered with organizations to pilot and evaluate their intervention with $5000 seed-funding. The evaluation was guided by the conceptual framework of technological incubators. Outcomes and sustainability were ascertained through qualitative and quantitative analysis of records and interviews at 12 months and 3–5 years, and the Community Impact of Research Oriented Partnerships (CIROP) questionnaire was administered to community partners.

Results

Ninety proposals were submitted between 2013 and 2015 principally from non-governmental organizations (NGOs). Thirteen interventions were selected for ‘incubation’. Twelve successfully ‘hatched’: three demonstrated sustainability with extension locally or nationally through acquiring external competitive funding; six continued to have influence within their organizations; three failed to continue beyond the pilot. Benefits to the organisations included acquisition of skills including advocacy, teaching and health promotion, evaluation skills and ability to utilize acquired knowledge for implementation. CIROP demonstrated that individuals’ research skills were reported to improve (mean ± sd) 4.80 ± 2.49 along with confidence in being able to use knowledge acquired in everyday practice (5.50 ± 1.38) and new connections were facilitated (5.33 ± 2.25).

Conclusions

Raphael, devised as a ‘social incubator’, succeeded in nurturing novel ideas engendered by community organizations that aimed to impact on health disparities. Judging by success rates of technological incubators its goals were realized to a considerable degree.

Partnerships, Processes, and Outcomes: A Health Equity-Focused Scoping Meta-Review of Community-Engaged Scholarship

In recent decades, there has been remarkable growth in scholarship examining the usefulness of community-engaged research (CEnR) and community-based participatory research (CBPR) for eliminating health inequities.This article seeks to synthesize the extant literature of systematic reviews, scoping reviews, and other related reviews regarding the context, processes, and research designs and interventions underlying CEnR that optimize its effectiveness. Through a scoping review, we have utilized an empirically derived framework of CBPR to map this literature and identify key findings and priorities for future research. Our study found 100 reviews of CEnR that largely support the CBPR conceptual framework.

The Community-Academic Aging Research Network: A Pipeline for Dissemination

BACKGROUND/OBJECTIVES

The Community-Academic Aging Research Network (CAARN) was created to increase the capacity and effectiveness of Wisconsin's Aging Network and the University of Wisconsin to conduct community-based research related to aging. The purpose of this article is to describe CAARN's infrastructure, outcomes, and lessons learned.

DESIGN

Using principles of community-based participatory research, CAARN engages stakeholders to participate in the design, development, and testing of older adult health interventions that address community needs, are sustainable, and improve health equity.

SETTING

Academic healthcare and community organizations.

PARTICIPANTS

Researchers, community members, and community organizations.

INTERVENTION

CAARN matches academic and community partners to develop and test evidence-based programs to be distributed by a dissemination partner.

MEASUREMENTS

Number of partnerships and funding received.

RESULTS

CAARN has facilitated 33 projects since its inception in 2010 (30 including rural populations), involving 46 academic investigators, 52 Wisconsin counties, and 1 tribe. These projects have garnered 52 grants totaling $20 million in extramural and $3 million in intramural funding. Four proven interventions are being prepared for national dissemination by the Wisconsin Institute for Healthy Aging: one to improve physical activity; one to reduce bowel and bladder incontinence; one to reduce sedentary behavior; and one to reduce falls risk among Latinx older adults. Additionally, one intervention to improve balance using a modified tai chi program is being disseminated by another organization.

CONCLUSION

CAARN's innovative structure creates a pipeline to dissemination by designing for real-world settings through inclusion of stakeholders in the early stages of design and by packaging community-based health interventions for older adults so they can be disseminated after the research has been completed. These interventions provide opportunities for clinicians to engage with community organizations to improve the health of their patients through self-management. J Am Geriatr Soc 68:1325-1333, 2020.

Collaboration and Context in the Design of Community-Engaged Research Training

Collaboration between academic researchers and community members, clinicians, and organizations is valued at all levels of the program development process in community-engaged health research (CEnR). This descriptive study examined a convenience sample of 30 projects addressing training in CEnR methods and strategies within the Clinical and Translational Science Awards (CTSA) consortium. Projects were selected from among posters presented at an annual community engagement conference over a 3-year period. Study goals were to learn more about how community participation in the design process affected selection of training topics, how distinct community settings influenced the selection of training formats, and the role of evaluation in preparing training participants to pursue future health research programming. Results indicated (1) a modest increase in training topics that reflected community health priorities as a result of community (as well as academic) participation at the program design stage, (2) a wide range of community-based settings for CEnR training programs, and (3) the majority of respondents conducted evaluations, which led in turn to revisions in the curricula for future training sessions. Practice and research implications are that the collaboration displayed by academic community teams around CEnR training should be traced to see if this participatory practice transfers to the design of health promotion programs. Second, collaborative training design tenets, community formats and settings, and evaluation strategies should be disseminated throughout the CTSA network and beyond. Third, common evaluative metrics and indicators of success for CEnR training programs should be identified across CTSA institutions.

Development of Guidelines to Improve the Effectiveness of Community Advisory Boards in Health Research

BACKGROUND

Community advisory boards (CABs) are a common community engagement strategy. Tools for developing CABs that are accessible to academic-community partnerships are limited. This article describes the process and partnership with the Hopi Tribe to develop CAB guidelines as a tool for research funded by the Center for Indigenous Environmental Health Research (CIEHR) and nonaffiliated projects.

METHODS

The CAB guidelines consist of three sections: formation, operation, and sustainability and evaluation. Each section includes best practices and interactive worksheets. The CAB guidelines were piloted with the Hopi Tribe to determine feasibility and relevance.

RESULTS

The CAB guidelines were well-received by the tribal CAB. Some of the worksheets were difficult to complete because they did not represent their perspectives or introduced potential tension in CAB interactions. Revisions were made accordingly.

CONCLUSIONS

Future evaluation and broad dissemination of the CAB guidelines will promote the use and effectiveness of CABs in health research.

Success in Long-Standing Community-Based Participatory Research (CBPR) Partnerships: A Scoping Literature Review

Background. Community-based participatory research (CBPR) is increasingly used by community and academic partners to examine health inequities and promote health equity in communities. Despite increasing numbers of CBPR partnerships, there is a lack of consensus in the field regarding what defines partnership success and how to measure factors contributing to success in long-standing CBPR partnerships. Aims. To identify indicators and measures of success in long-standing CBPR partnerships as part of a larger study whose aim is to develop and validate an instrument measuring success across CBPR partnerships. Methods. The Joanna Briggs Institute framework and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guided searches of three databases (PubMed, CINAHL, Scopus) for articles published between 2007 and 2017 and evaluating success in CBPR partnerships existing longer than 4 years. Results. Twenty-six articles met search criteria. We identified 3 key domains and 7 subdomains with 28 underlying indicators of success. Six partnerships developed or used instruments to measure their success; only one included reliability or validity data. Discussion. CBPR partnerships reported numerous intersecting partner, partnership, and outcome indicators important for success. These results, along with data from key informant interviews with community and academic partners and advisement from a national panel of CBPR experts, will inform development of items for an instrument measuring CBPR partnership success. Conclusion. The development of a validated instrument measuring indicators of success will allow long-standing CBPR partnerships to evaluate their work toward achieving health equity and provide a tool for newly forming CBPR partnerships aiming to achieve long-term success.

Measuring quality and outcomes of research collaborations: An integrative review

INTRODUCTION

Although the science of team science is no longer a new field, the measurement of team science and its standardization remain in relatively early stages of development. To describe the current state of team science assessment, we conducted an integrative review of measures of research collaboration quality and outcomes.

METHODS

Collaboration measures were identified using both a literature review based on specific keywords and an environmental scan. Raters abstracted details about the measures using a standard tool. Measures related to collaborations with clinical care, education, and program delivery were excluded from this review.

RESULTS

We identified 44 measures of research collaboration quality, which included 35 measures with reliability and some form of statistical validity reported. Most scales focused on group dynamics. We identified 89 measures of research collaboration outcomes; 16 had reliability and 15 had a validity statistic. Outcome measures often only included simple counts of products; publications rarely defined how counts were delimited, obtained, or assessed for reliability. Most measures were tested in only one venue.

CONCLUSIONS

Although models of collaboration have been developed, in general, strong, reliable, and valid measurements of such collaborations have not been conducted or accepted into practice. This limitation makes it difficult to compare the characteristics and impacts of research teams across studies or to identify the most important areas for intervention. To advance the science of team science, we provide recommendations regarding the development and psychometric testing of measures of collaboration quality and outcomes that can be replicated and broadly applied across studies.

Capacity Development and Evaluation of a Parent Advisory Team Engaged in Childhood Obesity Research

Guided by community-based participatory research principles, this mixed-methods process evaluation explored the experience and capacity of a newly formed Parental Advisory Team (PAT) engaged in childhood obesity research in a medically underserved region. Following the successful completion of a 3-month evidence-based childhood obesity treatment program (iChoose), 13 parents/caregivers who completed iChoose consented to participate in the PAT. Between June 2015 and March 2016, the PAT had nine monthly meetings and completed mixed-methods capacity assessments. They engaged in activities related to understanding iChoose outcomes, defining their role and purpose as a partnership, initiating content development, and pilot testing maintenance intervention components for future iChoose efforts. Assessments included a quantitative survey administered at baseline and 9 months, and a qualitative interview completed at 9 months. Results indicated that PAT members' perceptions of the identified capacity dimensions were positive at baseline (3.8-4.3 on a 5-point scale) and remained positive at follow-up (3.9-4.4 on a 5-point scale); changes were not statistically significant. Qualitative data revealed that PAT members were satisfied with group participation and desired to enhance their role in subsequent iChoose research. Understanding and promoting parental engagement in the research process fills an important gap in childhood obesity literature.

NIH-Funded CBPR: Self-Reported Community Partner and Investigator Perspectives

The community-based participatory research (CBPR) approach across health contexts has matured greatly over the last 20 years. Though contributions to the literature on the development and effectiveness of CBPR interventions have grown, the number of publications on the function and evaluation of actual community-research partnerships has not kept pace. To help address that gap, we searched National Institutes of Health archival data and identified a set of 489 CBPR projects including collaboration-building, exploratory/pilot, research, and program project grants. We found community partner contact information commonly was absent from grant records and contacted principal investigators (PIs) for community-partner contact information. Subsequently, we built upon established measures to ask principal investigators and community partners for their perceptions of participation in NIH-funded CBPR projects. Many principal investigators and community partners reported existing collaborations-between academicians and community organizations as well as among community organizations. Partners tended to agree on the appropriateness of funding levels to accomplish projects and on the community partners' ability to recruit and retain participants, collect data, and implement interventions. Partners differed in perceptions of participation in research design, data analyses, manuscript and presentation production, and dissemination of findings. Suggestions include collection of lead community partner information without undue burden and increased standard education and involvement of community organizations in research vocabulary and practices.

Development and Psychometric Evaluation of a Community Program Capacity Scale for a Rural American Indian Tribe

BACKGROUND AND PURPOSE

Community-based participatory research (CBPR) is often preferred in partnerships between universities and American Indian tribes. Central to CBPR is a strong impetus for capacity building. Community capacity includes capabilities and infrastructures to provide a service(s).

METHODS

An American Indian community advisory board developed and tested an 11-item community capacity scale. A total of 128 tribal members or those who lived on the reservation completed the survey. Exploratory factor analysis assessed the factor structure and Cronbach's alpha estimated internal consistency.

RESULTS

A one-factor model demonstrated adequate model fit (comparative fit index [CFI] = .92, root mean square error of approximation [RMSEA] = .06, standardized root mean square residual [SRMR] = .07), and items were internally consistent (alpha = .79).

CONCLUSIONS

Survey development with academic and tribal partners was iterative, with time spent on partnership and consensus building, resulting in a psychometrically sound and culturally relevant community program capacity scale.

A comparative effectiveness trial of two family-based childhood obesity treatment programs in a medically underserved region: Rationale, design & methods

While there is a large body of literature documenting the efficacy of family-based childhood obesity (FBCO) treatment interventions, there is little evidence that these interventions have been systematically translated into regular practice - particularly in health disparate regions. To address this research-practice gap, this project was guided by a community advisory board (CAB) and the RE-AIM planning and evaluation framework within a systems-based and community-based participatory research approach. Families with overweight or obese children between 5 and 12 years old, in the medically-underserved Dan River Region, were randomly assigned to one of two FBCO treatment programs (iChoose vs. Family Connections) delivered by local Parks & Recreation staff. Both programs have previously demonstrated clinically meaningful child BMI z-score reductions, but vary in intensity, structure, and implementation demands. Two clinical CAB partners embedded recruitment methods into their regional healthcare organization, using procedures representative to what could be used if either program was taken to scale. The primary effectiveness outcome is child BMI z-scores at 6-months, with additional assessments at 3-months and at 12-months. Secondary goals are to determine: (1) reach into the intended audience; (2) effectiveness on secondary child and parent outcomes; (3) intervention adoption by organizations and staff; (4) fidelity, cost, and capacity for intervention implementation; and (5) maintenance of individual-level changes and organizational-level sustainability. This research addresses literature gaps related to the features within clinical and community settings that could improve both child weight status and the translation of FBCO interventions into typical practice in medically-underserved communities. IDENTIFIERS: Clincialtrials.gov: NCT03245775.