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Objectives: Black women face disparities in maternal morbidity and mortality when compared to White women. Multiple factors contribute to these disparities. This study examines the perspectives of Black women who have given birth in the last 5 years, to understand their pregnancy and birth experiences as a means of ascertaining factors that may be contributing to these disparities. Methods: The Consortium to End Black Maternal Mortality was established as a collaborative table of cross-sector stakeholders and Black mothers to effectively conduct community-based participatory research focused on Black maternal health. Between January and March 2020, Black mothers who had given birth in the last 5 years facilitated Listening Sessions (LS) with other Black mothers in Rochester, NY. Participants reported on details of their pregnancy and delivery, including interaction with providers, personal relationships and their individual experience. The qualitative data captured during these sessions were coded to draw out key themes which were validated with LS participants and the Consortium. Results: The key themes that emerged clustered into four groups, including: (1) Mother-Provider Communication; (2) Social Support; (3) Systemic factors and (4) Maternal Emotional & Mental Health. Mother-provider communication was the most salient factor affecting the maternal experience and was found to be influenced primarily by maternal health literacy and provider discriminatory attitudes and behaviors. Conclusions for Practice: As a result of the Listening Sessions conducted with Black women, we identified mother-provider communication as the most important factor influencing the maternal experience. [ABSTRACT FROM AUTHOR]

This article discusses how Co-Principal Investigators that designed and executed the Estate Little Princess Archaeology Project (ELPAP) came together as a community, to demonstrate how such a formation within the discipline, with all its ups and downs, facilitates the skills needed to conduct community archaeology. By using the ELPAP as a case study, this article provides a multiscale examination of the ELPAP, expanding the discourse on community archaeology to include community building practices among archaeologists, between organizations, and with communities impacted by archaeological work. [ABSTRACT FROM AUTHOR]

The perspectives of Alaska Native (AN) peoples are rarely represented in quality of life (QOL) research. AN representation and voice is imperative to mitigating health disparities and in health promotion for AN peoples. To address these gaps, a sample of 15 AN people (six male, nine female) was recruited to participate in stakeholder QOL research. Five focus groups participated in activities that led participants to identify 28 themes; qualitative data analyses led researchers to identify seven additional themes. All 35 themes were integrated and reduced to the following nine culturally-grounded QOL themes: family, subsistence, access to resources, health and happiness, traditional knowledge and values, acts of self, providing, sobriety, and healing. These themes reflect the values of the participants and are exemplars of a culturally relevant, community based participatory research approach. Future research and health service implications – such as future development of a measure of AN QOL to improve wellness in healthcare settings and beyond – are discussed. [ABSTRACT FROM AUTHOR]

Native Americans make up less than 2% of the population of the USA, but suffer from some of the highest rates of food insecurity, poverty, diet-related diseases, and other socioeconomic challenges. This study examined unique attributes of food security in Native American communities in the Klamath River Basin of southern Oregon and northern California to generate a more comprehensive and culturally relevant understanding of Native American food insecurity. Through an in-depth case study among the Karuk, Yurok, Hoopa and Klamath Tribes, in which access to native foods was a central focus, our study examined the experience of food insecurity among tribal members, as well as barriers to and opportunities for building a more healthy, affordable and culturally appropriate food system. We found extremely high rates of food insecurity in participant households, greater than that documented in previous studies of food insecurity in tribal and non-tribal communities in the USA. Additionally, we found that the majority of study participants lacked access to desired native foods, due to reduced availability from restrictive laws and habitat degradation under settler colonialism, and that limited access to native foods is a strong predictor of food insecurity. There is a strong demand for increased access to and consumption of native foods and Native communities are actively engaged in eco-cultural restoration activities to enhance their cultural foodways. To understand contributions and solutions to food insecurity in Native communities, we examined predictors of food security and native foods security and provide new insights into the relationship between these two categories. Results from our study suggest the need to expand the way in which food security is defined and measured in Native American communities, and in indigenous communities more broadly, incorporating more culturally relevant measures, while simultaneously calling for policy change to address the historical underpinnings of contemporary food insecurity among indigenous peoples. Our findings contribute to the growing literature on the value and importance of Native food systems in revitalizing culture and restoring community health and well-being among Native American communities, as well as sovereignty over their food systems. [ABSTRACT FROM AUTHOR]

How we engage the community within our institutions, from higher education to social services, requires consistent reconceptualization. Many fields benefit from engaging the community; yet research around practical methods for engagement is limited. This study describes the process of using nominal group technique as a practical method for both community and academic members to discuss Community Based Participatory Research. Participants included faculty, staff, students, and community member stakeholders of a medical institution during a community engagement themed conference. The goal of this study was to assess the effectiveness of using the nominal group technique for community and academic members to discuss the principles of Community Based Participatory Research. Through this discussion a significant change in the research paradigm was addressed by focusing on the importance of dialogue in order to have an impact on health disparities. This study serves to illustrate a method for bringing community and academic members together around discussion of a complex topic, while simultaneously identifying general perceptions around Community Based Participatory Research. [ABSTRACT FROM AUTHOR]

Grassroots community efforts intuitively understand the physics of relationships—that you cannot interact with something or someone, even if that interaction is simply observation, without having an impact. Research shapes the way our lives are imagined. There’s no way around it. But developing relationships with researchers or others who can help document and disseminate ‘by and for’ information can be challenging for grassroots and community led initiatives. When institutions seek to include marginalized community priorities into pre-existing frameworks or study initiatives, or when researchers come from the outside, extract information from our community organizations and grassroots efforts, and then leave to analyze and make meaning of it elsewhere, the result is never accurate and our own community led trajectories of learning are disrupted and undermined. From significant changes to how research collaborations are conceived and funded, to simple fixes to approaches used in the field, researchers can be better partners to community led efforts to document and understand our own lives. [ABSTRACT FROM AUTHOR]

In the absence of ongoing involvement in the communities that are the subjects of research, even well-intentioned researchers can develop questions that are not relevant to community needs, employ methods that hurt community members, or disseminate findings in ways that are inaccessible to those most affected. Recognizing these harms, a growing number of domestic violence (DV) researchers have embraced community-based participatory research (CBPR), an approach in which researchers and community members share power at every level of the research process, co-creating knowledge that can be applied to enhance community well-being. Despite growing interest in this approach, however, there are insufficient opportunities for interested researchers to learn how to actually engage in it, especially in the DV context. To remedy this gap, the authors of this paper collaborated to develop an online toolkit for emerging researchers interested in CPBR. This brief report frames the need for CBPR in DV research using short vignettes that come from our own research experience; introduces Power Through Partnerships: A CBPR Toolkit for Domestic Violence Researchers; and presents recommendations for developing, promoting, and disseminating future CBPR research. We chose to announce the development and availability of this toolkit in an academic journal in order to highlight its scholarly and practical relevance for researcher audiences who might be less familiar with the CBPR approach. [ABSTRACT FROM AUTHOR]

Overweight and obesity are associated with significant health problems and rates of obesity are high among Latino men. This paper describes the design, rationale and participant characteristics of the key demographic variables assessed in an NIH-funded study (R21-CA143636) addressing culture and several obesity-related variables (diet, physical activity, and body image) among Mexican and Puerto Rican men using a community-based participatory research framework. Participants completed objective measures (height, weight, body fat, hip, waist), a health and culture interview, a diet questionnaire, and used an accelerometer to measure their level of physical activity. A total of 203 participants completed the measures and the health and culture interview and 193 completed all study components. Puerto Ricans were older than Mexicans ( p < .0001) and there were significant differences in marital status ( p < .05), country of birth ( p < .05), smoking ( p < .05) and work status ( p < .001). There were no significant differences in religion, education, health insurance, Body Mass Index, body fat, hip and waist measurements, and the language preference of the interview. Results have implications for the development of a future intervention that incorporates the role of cultural factors into a community participatory obesity intervention for Latino men. [ABSTRACT FROM AUTHOR]

Persons from Somalia constitute the largest group of immigrants and refugees from Africa among whom diabetes-related health disparities are well documented. As one of the first steps toward developing a behavioral intervention to address diabetes among Somali immigrants and refugees, we administered a face to face interview-based survey to Somali and Latino adults with diabetes in a single community to assess diabetes knowledge, attitudes and behaviors. Respondents (N = 78) reported several barriers to optimal diabetes management for physical activity and glucose self-monitoring, as well as a high burden of disease and negative perceptions of diabetes. High participant engagement in disease management, self-efficacy, and social support were important assets. Similarities suggest that the shared experiences of immigration and related systemic socioeconomic and linguistic factors play a significant role in the understanding and self-management of diabetes in these populations. Together with previously collected qualitative work, the survey findings will inform development of a behavioral intervention to improve outcomes and reduce diabetes-related health disparities among immigrant and refugee groups to the U.S. [ABSTRACT FROM AUTHOR]

Psychiatric emergency services (PES) remain a critical and under-examined component of the community mental health system. We describe how a unique community-academic partnership came together to examine repeat use of PES through the design and conduct of a qualitative study using a CBPR approach. The goals of the project were to: (1) develop a model of research which promoted the inclusion of people who use mental health services in the research process; and (2) design and conduct a study to examine the repeat use of PES through the inclusion of the perspectives and experiences of people who use these services. [ABSTRACT FROM AUTHOR]

Critical systems thinking (CST) and community based participatory research (CBPR) are distinct approaches to inquiry which share a primary commitment to holism and human emancipation, as well as common grounding in critical theory and emancipatory and pragmatic philosophy. This paper explores their intersections and complements on a historical, philosophical, and theoretical level, and then proposes a hybrid approach achieved by applying CBPR's principles and considerations for operationalizing emancipatory practice to traditional systems thinking frameworks and practices. This hybrid approach is illustrated in practice with examples drawn from of the implementation of the learning organization model in an action research setting with the Autistic community. Our experience of being able to actively attend to, and continuously equalize, power relations within an organizational framework that otherwise has great potential for reinforcing power inequity suggests CBPR's principles and considerations for operationalizing emancipatory practice could be useful in CST settings, and CST's vocabulary, methods, and clarity around systems thinking concepts could be valuable to CBPR practitioners. [ABSTRACT FROM AUTHOR]

This paper presents the findings of a study that used an innovative mixed methods community based participatory research approach that included participatory photo mapping, which combines photography, youth-led neighborhood tours, and advocacy (n=10); in-depth interviews with youth (n=21); and spatial analysis of neighborhood factors using Geographic Information Systems (GIS). The focus is on youths' descriptions of the meaning and implications of abandoned housing for their own and their community's well-being. Youth in this study indicated that abandoned properties signify that no one cares about the neighborhood. A youth-authored version of broken windows theory is presented that can be used to better understand the built environment as an indicator of child and neighborhood well-being. This multi-step cycle, reminiscent of broken windows theory, is as follows: 1) unrepaired signs of incivility signal that no one cares; 2) residents withdraw, become more fearful; 3) untended property becomes "fair game" leading to more crime and incivilities; and finally, 4) a breakdown of community control and individual and community vulnerability. The youths' narratives are used to highlight research and practice implications and suggest the need for future youth-engaged, community-partnered intervention research to address the effects of housing abandonment. [ABSTRACT FROM AUTHOR]

Youth from immigrant communities may experience barriers to connecting with schools and teachers, potentially undermining academic achievement and healthy youth development. This qualitative study aimed to understand how educators serving Somali, Latino, and Hmong (SLH) youth can best promote educator-student connectedness and positive youth development, by exploring the perspectives of teachers, youth workers, and SLH youth, using a community based participatory research approach. We conducted four focus groups with teachers, 18 key informant interviews with adults working with SLH youth, and nine focus groups with SLH middle and high school students. Four themes emerged regarding facilitators to educators promoting positive youth development in schools: (1) an authoritative teaching approach where teachers hold high expectations for student behavior and achievement, (2) building trusting educator-student relationships, (3) conveying respect for students as individuals, and (4) a school infrastructure characterized by a supportive and inclusive environment. Findings suggest a set of skills and educator-student interactions that may promote positive youth development and increase student-educator connectedness for SLH youth in public schools. [ABSTRACT FROM AUTHOR]

Intake of fruits and vegetables (F&V) continues to be low in children in the United States. The purpose of this study was to conduct a pilot feasibility evaluation of Brighter Bites, a school-based food co-op to provide access to fresh F&V and nutrition education to low-income children and their families. Brighter Bites is a 16-week school-based food co-op consisting of: (1) Weekly distribution of 50-60 servings of fresh F&V; (2) Weekly bilingual parent handouts and recipe demonstrations; and (3) implementing CATCH, a coordinated school health program in schools. Brighter Bites was pilot tested using a pre-post evaluation design in one charter school in Houston, TX, USA ( n = 57 3rd grade parent-child dyads; 94.1 % Hispanic, 91 % low-income). Evaluation, at baseline, midpoint, and post-intervention, included self-reported child and parent surveys on psychosocial factors, dietary habits and mealtime practices. Pearson's Chi square test, Fisher's exact-test or paired t test were used to determine changes pre- to post-intervention (at p < 0.05). Process data using parent surveys, teacher surveys, attendance logs, and produce cost data were used to determine feasibility and acceptability of program. Participants received on average 61 servings of F&V weekly for 16 weeks at the cost of $4.31/family/week. Results showed significant increases in child reported self-efficacy, outcome expectations and attitudes towards consuming F&V ( p < 0.05). We found significant increases in child exposure to F&V and child preference of various F&V from baseline to post-intervention ( p < 0.05). Parent surveys showed significant improvements in mealtime practices at home: decrease in children eating while watching TV, increase in eating dinner with the family, less fast food, less sugary drinks with meals, more children asking for F&V as snacks. Process data showed 98 % retention rate and high parent acceptability of program components. Brighter Bites is a promising strategy to increase F&V access and education in low-income populations using existing infrastructure of schools and food banks. [ABSTRACT FROM AUTHOR]

Use of community-based participatory research (CBPR) approaches is increasing with the goal of making more meaningful and impactful advances in eliminating cancer-related health disparities. While many reports have espoused its advantages, few investigations have focused on comparing CBPR-oriented recruitment and retention. Consequently, the purpose of this analysis was to report and compare two different CBPR approaches in two cancer prevention studies. We utilized frequencies and Chi-squared tests to compare and contrast subject recruitment and retention for two studies that incorporated a randomized, controlled intervention design of a dietary and physical activity intervention among African Americans (AA). One study utilized a de-centralized approach to recruitment in which primary responsibility for recruitment was assigned to the general AA community of various church partners whereas the other incorporated a centralized approach to recruitment in which a single lay community individual was hired as research personnel to lead recruitment and intervention delivery. Both studies performed equally well for both recruitment and retention (75 and 88 % recruitment rates and 71 and 66 % retention rates) far exceeding those rates traditionally cited for cancer clinical trials (~5 %). The de-centralized approach to retention appeared to result in statistically greater retention for the control participants compared to the centralized approach (77 vs. 51 %, p < 0.01). Consequently, both CBPR approaches appeared to greatly enhance recruitment and retention rates of AA populations. We further note lessons learned and challenges to consider for future research opportunities. [ABSTRACT FROM AUTHOR]

Emerging evidence supports the theoretical and clinical importance of the preconception period in influencing pregnancy outcomes and child health. Collectively, this evidence affirms the need for a novel, integrative theoretical framework to design future investigations, integrate new findings, and identify promising, evidence-informed interventions to improve intergenerational health and reduce disparities. This article presents a transdisciplinary framework developed by the NIH Community Child Health Network (CCHN) through community-based participatory research processes. CCHN developed a Preconception Stress and Resiliency Pathways (PSRP) model by building local and multi-site community-academic participatory partnerships that established guidelines for research planning and decision-making; reviewed relevant findings diverse disciplinary and community perspectives; and identified the major themes of stress and resilience within the context of families and communities. The PSRP model focuses on inter-relating the multiple, complex, and dynamic biosocial influences theoretically linked to family health disparities. The PSRP model borrowed from and then added original constructs relating to developmental origins of lifelong health, epigenetics, and neighborhood and community influences on pregnancy outcome and family functioning (cf. MCHJ 2014). Novel elements include centrality of the preconception/inter-conception period, role of fathers and the parental relationship, maternal allostatic load (a composite biomarker index of cumulative wear-and-tear of stress), resilience resources of parents, and local neighborhood and community level influences (e.g., employment, housing, education, health care, and stability of basic necessities). CCHN's integrative framework embraces new ways of thinking about how to improve outcomes for future generations, by starting before conception, by including all family members, and by engaging the community vigorously at multiple levels to promote resiliency, reduce chronic and acute stressors, and expand individualized health care that integrates promotive and prevention strategies. If widely adopted, the PSRP model may help realize the goal of sustaining engagement of communities, health and social services providers, and scientists to overcome the siloes, inefficiencies, and lack of innovation in efforts to reduce family health disparities. Model limitations include tremendous breadth and difficulty measuring all elements with precision and sensitivity. [ABSTRACT FROM AUTHOR]

Homelessness is a primary concern for community health. Scientific literature on homelessness is wide ranging and diverse. One opportunity to add to existing literature is the development and testing of affordable, easily implemented methods for measuring the impact of homeless on the healthcare system. Such methodological approaches rely on the strengths in a multidisciplinary approach, including providers, both healthcare and homeless services and applied clinical researchers. This paper is a proof of concept for a methodology which is easily adaptable nationwide, given the mandated implementation of homeless management information systems in the United States and other countries; medical billing systems by hospitals; and research methods of researchers. Adaptation is independent of geographic region, budget restraints, specific agency skill sets, and many other factors that impact the application of a consistent methodological science based approach to assess and address homelessness. We conducted a secondary data analysis merging data from homeless utilization and hospital case based data. These data detailed care utilization among homeless persons in a small, Appalachian city in the United States. In our sample of 269 persons who received at least one hospital based service and one homeless service between July 1, 2012 and June 30, 2013, the total billed costs were $5,979,463 with 10 people costing more than one-third ($1,957,469) of the total. Those persons were primarily men, living in an emergency shelter, with pre-existing disabling conditions. We theorize that targeted services, including Housing First, would be an effective intervention. This is proposed in a future study. [ABSTRACT FROM AUTHOR]

Native Navigators and the Cancer Continuum (NNACC) was a community based participatory research study among Native American Cancer Research Corporation, CO; Inter-Tribal Council of Michigan, MI; Rapid City Regional Hospital's Walking Forward, SD; Great Plains Tribal Chairman's' Health Board, SD; and Muscogee (Creek) Nation, OK. The project goal was to collaborate, refine, expand, and adapt navigator/community education programs to address American Indian communities' and patients' needs across the continuum of cancer care (prevention through end-of-life). The intervention consisted of four to six site-specific education workshop series at all five sites. Each series encompassed 24 h of community education. The Social Ecology Theory guided intervention development; community members from each site helped refine education materials. Following extensive education, Native Patient Navigators (NPNs) implemented the workshops, referred participants to cancer screenings, helped participants access local programs and resources, and assisted those with cancer to access quality cancer care in a timely manner. The intervention was highly successful; 1,964 community participants took part. Participants were primarily American Indians (83 %), female (70 %) and between 18 and 95 years of age. The education programs increased community knowledge by 28 %, facilitated referral to local services, and, through site-specific navigation services, improved access to care for 77 participants diagnosed with cancer during the intervention. Approximately, 90 % of participants evaluated workshop content as useful and 92.3 % said they would recommend the workshop to others. The intervention successfully increased community members' knowledge and raised the visibility of the NPNs in all five sites. [ABSTRACT FROM AUTHOR]

BACKGROUND: Filipino Americans have high rates of hypertension, yet little research has examined hypertension awareness, treatment, and control in this group. OBJECTIVE: In a community-based sample of hypertensive Filipino American immigrants, we identify 1) rates of hypertension awareness, treatment, and control; and 2) factors associated with awareness, treatment, and control. DESIGN: Cross-sectional analysis of survey data from health screenings collected from 2006 to 2010. PARTICIPANTS: A total of 566 hypertensive Filipino immigrants in New York City, New York and Jersey City, New Jersey. MAIN MEASURES: Hypertension awareness, treatment, and control. Participants were included in analysis if they were hypertensive, based on: a past physician diagnosis, antihypertensive medication use, and/or high blood pressure (BP) screening measurements. Demographic variables included sex, age, time in the United States, location of residence, and English spoken language fluency. Health-related variables included self-reported health, insurance status, diabetes diagnosis, high cholesterol diagnosis, clinical measures (body mass index [BMI], glucose, and cholesterol), exercise frequency, smoking status, cardiac event history, family history of cardiac event, and family history of hypertension. RESULTS: Among the hypertensive individuals, awareness, treatment, and control rates were suboptimal; 72.1 % were aware of their status, 56.5 % were on medication, and only 21.7 % had controlled BP. Factors related to awareness included older age, worse self-reported health, family history of hypertension, and a diagnosis of high cholesterol or diabetes; factors related to treatment included older age, longer time lived in the United States, and being a non-smoker; having health insurance was found to be the main predictor of hypertension control. Many individuals had other cardiovascular disease (CVD) risk factors; 60.4 % had a BMI ≥25, 12.0 % had at-risk glucose measurements and 12.8 % had cholesterol ≥ 240. CONCLUSIONS: Hypertensive Filipinos exhibit poor hypertension management, warranting increased efforts to improve awareness, treatment and control. Culturally tailored public health strategies must be prioritized to reduce CVD risk factors among at-risk minority populations. [ABSTRACT FROM AUTHOR]

In response to the H1N1 epidemic, we used community health workers to design and implement a randomized controlled trial to test the efficacy of a new automated call-monitoring system for second and third trimester predominantly Medicaid-eligible pregnant women in an urban free standing birth center to promptly detect symptoms of influenza and assure rapid treatment to prevent adverse outcomes from influenza. Daily automated telephone call to second and third trimester pregnant women asking if the woman experienced flu-like symptoms. Calls continued daily until 38 weeks gestation. A community health worker's voice was used for the automated call recording. Positive responses triggered an immediate referral to a nurse-midwife for prompt treatment with anti-viral medication. Fifty pregnant participants were randomized into daily-automated call group ( n = 26) or health information group ( n = 24). The automated call group participants ranged in age from 14 to 36 (mean = 23.5, SD = 6.3), 84.7 % identified their race/ethnicity as African-American Non-Hispanic, and 80.7 % were Medicaid-Eligible. In the automated call group, 11.5 % chose to be immunized against H1N1. The mean percent of patients reached daily was 45.1 % (SD = 3.2 %) and at least once every 3 days was 65.1 % (SD = 3.1 %). One pregnant woman in the automated call group contracted H1N1 influenza and received prompt anti-viral treatment without any serious outcomes. Participation in daily-automated telephone calls did not differ significantly between patients younger than 18 years old versus patients 18 years or older. There was also no difference in participation between patients with parity of 0 versus patients with parity ≥1. Participation in daily telephone calls significantly (alpha ≤0.05) increased when a community health worker provided personal follow-up of non-responsive participants. 93.3 % of surveyed pregnant women, who received automated daily calls, recommended to use a similar daily call system in response to a future health crisis. Automated daily phone calls, designed and produced by community health workers, is a feasible, well received strategy to provide urgent health information to an urban, Medicaid-eligible group of pregnant women, regardless of age or parity. [ABSTRACT FROM AUTHOR]

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Participatory health research involves a wide spectrum of participation from the population of study. We describe the participatory research processes of a large mixed method study on the psychosocial impact of dragon boating in individuals with breast cancer. In particular, we discuss the involvement of a Community Advisory Group (consisting of five breast cancer patients/survivors) in the development of the research study, data collection and analysis, and dissemination of the study results. We also outline the elements of a research workshop, in which 13 breast cancer patients/survivors were involved in the development of a provincial survey for the study. The purpose of this article is to share our experience of engaging cancer patients/survivors in a participatory research study. We discuss the value-based elements of participatory research (power sharing, voice and respect, reciprocity, and mutual benefit), and provide a case-based example of how these participatory elements were employed to potentially increase the validity of the survey instrument, to enhance the ethics of working with a cancer population, and ultimately contributed to a high survey response rate. [ABSTRACT FROM AUTHOR]

Prevention of childhood obesity is a national priority. Parents influence young children's healthy lifestyles, so it is paradoxical that obesity interventions focus primarily on children. Evidence and theory suggest that including parents in interventions offers promise for effective childhood obesity prevention. This case study engaged parents' as co-researchers in the design, implementation and evaluation of an intervention for low-income families with a child enrolled in Head Start. Parent engagement mechanisms include: (1) targeted partnership development (2) operationalizing a Community Advisory Board (CAB) that was the key decision making body; (3) a majority of CAB members were parents who were positioned as experts, and (4) addressing structural barriers to parent participation. Lessons learned are provided for future research, and practice. [ABSTRACT FROM AUTHOR]

With the increased understanding of the relationship between stress and disease, the role of stress in explaining persistent disparities in health outcomes has received growing attention. One body of research has focused on allostatic load-the 'wear and tear' that results from chronic or excessive activation of the stress response. Other research has looked at the link between stress and health behaviors. In this study, we conducted 7 focus groups with a total of 56 people to understand how people living in Highbridge, South Bronx, New York, a low income community with poor health outcomes, perceive stress and its relationship to health. Focus group participants described a direct causal pathway between stress and poor health as well as an indirect pathway through health behaviors, including uncontrolled eating, sleep deprivation, substance abuse, smoking, violence and aggression, and withdrawal and inactivity. Participants articulated a number of theories about why stress leads to these unhealthy behaviors, including self-medication, adaptive behavior, discounting the future, depletion of willpower, and competing priorities. Their nuanced understanding of the link between stress and health elucidates the mechanisms and pathways by which stress may result in disparities in health outcomes and create challenges in changing health behaviors in poor communities like the South Bronx. [ABSTRACT FROM AUTHOR]

Adult and childhood obesity and related adverse outcomes are most common among racial/ethnic minorities and socio-economically disadvantaged populations in the United States . Research approaches to obesity developed in mainstream populations and deploying new information technologies may exacerbate existing disparities in obesity. Current obesity management and prevention research priorities will not maximally impact this critical problem unless investigators explicitly focus on discovering innovative strategies for preventing and managing obesity in the disadvantaged populations that are most affected. On the basis of our research experience, four key research approaches are needed: (1) elucidating the underlying social forces that lead to disparities; (2) directly involving community members in the development of research questions and research methods; (3) developing flexible strategies that allow tailoring to multiple disadvantaged populations; and (4) building culturally and socio-economically tailored strategies specifically for populations most affected by obesity. Our experience with a community-based longitudinal cohort study and two health center-based clinical trials illustrate these principles as a contrast to traditional research priorities that can inadvertently worsen existing social inequities. If obesity research does not directly address healthcare and health-outcome disparities, it will contribute to their perpetuation. [ABSTRACT FROM AUTHOR]

The article discusses a study which examined the costs and benefits of joining a nascent health information exchange (HIE) from the perspective of potential provider organization participants. Topics covered include the concerns about HIE increasing the risk of data security breaches, the need for state and federal governments to consider subsidies to sustain HIE and the importance of coordinating HIE policies with those of founding organizations.

This manuscript presents the evaluation of a 3 year community-based participatory research (CBPR) approach involving the testing of a psychosocial intervention to improve reproductive and mental health of married women in a disadvantaged community in Beirut, Lebanon. The community-based participatory approach involved a community advisory committee (CAC), a local women committee (LWC), and university researchers. The evaluation of the CBPR approach followed qualitative assessment which included: analysis of compiled field notes and minutes of meetings of CAC and LWC throughout the 3 years of the intervention, and focus group discussions and individual interviews conducted with the CAC and the LWC members following completion of the trial. The CBPR approach confirmed feasibility, cultural adequacy, as well as representation of community needs. Five main emerging themes came out of the FGD and interviews with CAC and LWC. The community and women involved viewed that the CBPR approach allowed for a good understanding of the community, they felt ownership of the study, acknowledged that participation gave the women voices, and established trust, and acknowledged the challenges faced. This manuscript describes how the community was involved, reports on their evaluation of the CBPR process, and discusses challenges to CBPR in this particular context. [ABSTRACT FROM AUTHOR]

To describe the participatory approach used to develop 'Good For The Neighborhood' (GFTN), a community program to improve the health of four underserved communities. A core program was developed involving a 'park and stay' approach to impact four underserved predominately minority communities (two predominately African American, 1 predominately Latino, and the Seneca Nation of Indians). The core program includes health screenings, risk assessments, health education, and exposure to health services. An extensive tracking and evaluation system was developed to determine participation and impact on the community. Multi-methods (key informant interviews, focus groups, surveys) were implemented to gain feedback from community partners and participants as to how to adopt the program to meet the needs of the community. GFTN has been sustained for over 3 years and has reached over 3,500 predominately minority individuals in four communities with 1/3 of participants engaging regularly in the program. The program has evolved in the four communities to meet specific needs. A 'park and stay' approach in partnership with the community has led to a strong program that community partners and residents embrace. Community ownership and social networking, including word-of-mouth from residents is essential to establishing a successful program. [ABSTRACT FROM AUTHOR]

The principal goal of this article is to contribute to the field of prevention science by providing a sequential description of how Community Based Participatory Research (CBPR) was used to develop a parent education curriculum aimed at preventing and decreasing adolescent drug use and risky sexual behaviors. CBPR principles are outlined, and information is provided on the unique contributions of researchers and community members who came together to develop this parent education program. Focus group information is presented as an exemplar to illustrate how thematic content from focus groups was used to inform the development of this parent education curriculum. A step by step description is given to facilitate replication of this process by other prevention researchers who are interested in applying this CBPR approach to develop a culturally responsive parent education intervention. [ABSTRACT FROM AUTHOR]

One of the most attractive aspects of food and agricultural studies for scholars is the level of public interest in the subjects of our research. Such interest means that food and agriculture scholars often become public scholars, asked to comment on issues of great interest to the public. In addition, food and agriculture scholars often have the opportunity to partner more directly with community organizations to perform community-based research. Such studies take many forms, but community members often take a lead role, helping plan the study as well as participate in data collection and analysis. Community based research may be very rewarding, but scholars involved in such research need to deal with a lack of control that inevitably goes along with it. This article gives examples of such research and discusses the public role of food and agriculture studies in general, in particular highlighting what can be learned from public responses to a 2009 shortage of Eggo waffles. [ABSTRACT FROM AUTHOR]

A key tenet of community-based participatory research is that communities be involved in all facets of research, from defining the problem to identifying solutions, to assisting in the research, and to participating in the publication of results. In this study, we instituted a small grants program for community participation. A Request for Applications (RFA) was developed and circulated widely throughout the Valley. The RFA sought proposals to address health disparities in cancer education, prevention, and treatment among Hispanics living in the Valley. Funds available were $2,500.00–3,500.00 for 1 year’s worth of work. To help evaluate the progress of the RFA community projects according to the perspectives of the Community Advisory Board (CAB), an open-ended, semi-structured interview was created and administered by a former staff member to CAB members. In 4 years, ten small grants proposed by community members were funded. Funds allocated totaled approximately $25,000. Interviews with CAB members indicated that the RFA program was perceived positively, but there were concerns about sustainability. Our community grants program resulted in the implementation of several novel cancer prevention programs conducted by a variety of community organizations in the Lower Yakima Valley. [ABSTRACT FROM AUTHOR]

The purpose of this study was to examine cultural perceptions, awareness, responses, and actions recommended about IPV by Samoan women served by a Community Health Center (CHC). Theoretical Foundation This investigation is a part of a series of exploratory community based participatory research (CBPR) studies based on critical social theory. Research Design and Methods This qualitative study was conducted using focus groups with Samoan women served by a health center. Analysis of qualitative data was accomplished using content analysis. Demographic data were analyzed using descriptive methods. Participants Eight Samoan women, 18 years and older participated in the focus groups. Procedure The instruments were translated from English to Samoan and back translated into English. The facilitators conducted an initial focus group and a validation group with the same participants. Sessions were taped and transcribed in Samoan and back translated into English. Results The women clearly identified IPV and were aware that it occurs in their cultural group. They identified multiple responses of individual women, families, and communities to IPV. In Samoa there was a formalized process for addressing this problem that has been changed in Hawai’i. The CHCs are viewed as an important resource for the families and can be a source of interventions. Implications Health care providers should be aware of differences between Western notions of independence and the ideals of interdependence held by specific cultural groups. The CHC personnel have raised questions about the appropriateness of using tools that were developed for use with Western women with immigrant women. [ABSTRACT FROM AUTHOR]

Background: Social support is associated with better diabetes self-management behavior (SMB), yet interventions to increase family and friend support (FF support) have had inconsistent effects on SMB.Objective: To test whether FF support differentially affects specific SMBs and compare the influence of support from health professionals and psychological factors on specific SMBs to that of FF support.Design: Cross-sectional survey of people with diabetes recruited for a self-management interventionParticipants and Setting: One hundred sixty-four African-American and Latino adults with diabetes living in inner-city DetroitMeasurements and Main Results: For every unit increase in FF support for glucose monitoring, the adjusted odds ratio (AOR) of completing testing as recommended was 1.77 (95% CI 1.21-2.58). FF support was not associated with four other SMBs (taking medicines, following a meal plan, physical activity, checking feet). Support from non-physician health professionals was associated with checking feet [AOR 1.72 (1.07-2.78)] and meal plan adherence [AOR = 1.61 (1.11-2.34)]. Diabetes self-efficacy was associated with testing sugar, meal plan adherence, and checking feet. Additional analyses suggested that self-efficacy was mediating the effect of FF support on diet and checking feet, but not the FF support effect on glucose monitoring.Conclusions: The association between FF support and SMB performance was stronger for glucose monitoring than for other SMBs. Professional support and diabetes self-efficacy were each independently associated with performance of different SMBs. SMB interventions may need to differentially emphasize FF support, self-efficacy, or professional support depending on the SMB targeted for improvement. [ABSTRACT FROM AUTHOR]

African American women in the U.S. have the highest breast cancer mortality though not the highest breast cancer incidence. This high mortality rate has been attributed in part to discrepancies in screening between African American and White women. Although this gap in mammography utilization is closing, little is known about what has been and is driving the screening practices of African American women, in particular age at first mammogram. This study examined the rates of breast cancer screening in an African American community sample from eight churches in greater Baltimore, Maryland and investigated the association between various factors and age at first mammogram. Participants were 213 women ages 22-89 years. About 77% of women had ever had a mammogram. Over 40% had their first mammogram before age 40. Women who first screened before age 40 had greater odds than women who had never screened of being knowledgeable about screening guidelines, of having received a physician recommendation to screen, and of having three or more female relatives who had been screened. Women who first screened at or after age 40 were more likely to have stronger religious beliefs of health than women who never had screened. These findings suggest the importance of reinforcing factors in screening behavior for African American women and have implications for physician training and public health education about breast cancer screening. A better understanding of African American women's mammography practice including early screening is needed to reduce this population's disproportionate breast cancer mortality risk. [ABSTRACT FROM AUTHOR]

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Background: A patient-centered approach to research development is important to the creation of research evidence that is meaningful and beneficial to patients. Collaboration between patients, stakeholders, and researchers, where patients serve an integral role in all aspects of the research development process, is integral to achieving these twin objectives. Results: This paper presents a unique approach to engaging patients and stakeholders in research by describing a conference series focused on meaningfully integrating patients in each phase of the project. Through three meeting phases, patients were not only introduced to patient-centered research (PCR) concepts, but they also led discussions about diabetes self-management and developed PCR questions. A total of 17 questions were developed represented by four main themes: communication, patient knowledge and perceptions, diabetes prevention, and diabetes management. Through patient feedback, three research questions were each identified as immediate priorities for development into research project proposals. Conclusion: To our knowledge, the use of a conference series designed to teach patients about research, encourage collaboration across stakeholder groups, and write research questions has not been described in the literature. Moreover, this approach has proven successful in recruiting and retaining patient participation through the life of the project. This project has also identified a number of issues for consideration by future researchers looking to meaningfully engage patients in the development of research proposals. [ABSTRACT FROM AUTHOR]