Community-Based Participatory Research Contributions to Intervention Research: The Intersection of Science and Practice to Improve Health Equity

摘要

Community-based participatory research (CBPR) has emerged in the last decades as a transformative research paradigm that bridges the gap between science and practice through community engagement and social action to increase health equity. CBPR expands the potential for the translational sciences to develop, implement, and disseminate effective interventions across diverse communities through strategies to redress power imbalances; facilitate mutual benefit among community and academic partners; and promote reciprocal knowledge translation, incorporating community theories into the research. We identify the barriers and challenges within the intervention and implementation sciences, discuss how CBPR can address these challenges, provide an illustrative research example, and discuss next steps to advance the translational science of CBPR. ALTHOUGH MUCH EVIDENCE exists of health and social disparities within populations of color and other marginalized groups, the real challenge lies ahead—to develop, implement, and sustain effective strategies to eliminate disparities in clinical and public health systems and population health status. Community-based participatory research (CBPR) represents a transformative research opportunity to unite the growing interest of health professionals, academics, and communities in giving underserved communities a genuine voice in research, and therefore to increase the likelihood of an intervention's success. 1 In this article, we add to the literature on intervention and implementation sciences by identifying barriers and challenges to building bridges between science and community-based practice and policy. We illustrate ways to address these challenges through an example of successful CBPR work done among American Indians in the Southwest, and through presenting CBPR as an overall translational strategy for diverse communities to improve health equity. Several definitions of CBPR circulate widely. In their 1995 study of participatory research in Canada, Green et al. defined CBPR as an “inquiry with the participation of those affected by an issue for the purpose of education and action for effecting change.” 2 In the definition offered by the Agency for Healthcare Research and Quality in 2004, CBPR is an approach that incorporates formalized structures to ensure community participation. 3 Focusing on disparities, the Kellogg Foundation Community Health Scholars Program states that CBPR equitably involves all partners … with a research topic of importance to the community with the aim of combining knowledge and action for social change to improve community health and eliminate health disparities. 1 (p6) These definitions set the stage for CBPR to be able to address core challenges in intervention research.