Rethinking, Reimagining, and Reigniting Community-Engaged Research to Promote Cardiovascular Health Equity.
Rethinking, Reimagining, and Reigniting Community-Engaged Research to Promote Cardiovascular Health Equity.
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DOI：
10.1161/circoutcomes.122.009519
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发表时间：
2022-11
影响因子：
6.9
通讯作者：
Cooper, Lisa A.
中科院分区：
文献类型：
--
作者：
Commodore-Mensah, Yvonne;Metlock, Faith E.;Cooper, Lisa A.
在美国，与非西班牙裔白色人相比，黑人、拉丁裔和美洲印第安人/阿拉斯加原住民的心血管疾病和相关危险因素存在差异。1健康的社会决定因素;人们出生、生活、学习、工作、娱乐、崇拜、年龄的背景;以及结构性因素被认为是这些群体中心血管疾病差异的根本原因。尽管越来越多的研究确定了有效解决CVD中这些长期存在的种族/民族和社会经济差异的干预措施，但仍然存在许多问题，我们所知道的大部分内容仍然没有用于改变实践和政策。越来越多的知识也支持这样一种观点，即社区参与的研究是促进心血管健康公平的一种有前途的方法。社区参与研究是缓解这一挑战的典范，因为它超越了传统科学研究和医疗模式的局限性。2通过整合整体方法，社区参与研究旨在通过社会，环境和文化透镜了解个人。2在整个研究的设计和实施过程中让社区参与，可以更好地了解他们的独特背景或影响他们健康的社会决定因素。2社区参与的研究沿着一个连续体发生，从社区外展，（例如，一次性的交易性活动，如健康博览会）和社区咨询（例如，定期要求输入或反馈），以社区为基础的参与式研究（CBPR），其中涉及互惠的真实关系，并最终，社区驱动的研究，其中包括与研究人员共享领导，社区层面的决策和双向信任。3.科学家和临床医生必须停止从社区成员那里拿走时间而不回馈的常见做法，而是努力设计研究，通过早期包容，纳入想法和共同领导积极参与成员，并改善社区健康。CBPR是一种杰出的社区参与研究形式，致力于通过在整个研究设计，实施和传播结果中整合社区合作伙伴来实现共同学习的原则。尽管数十年来的证据支持CBPR的价值，但科学界对这些原则和实践的吸收仍然有限。在整个研究过程中参与利益相关者的CBPR框架有助于为社区和卫生政策变化提供可持续的解决方案，以解决健康差距。4 CBPR的基本原则源自以制度变革为中心的合作研究的北方传统实践和旨在扩大研究准入和所有权的解放研究的南方传统实践。这种合作研究方法可以包括各种研究设计，包括实验，非实验，案例研究，纵向，生态和实施科学设计。CBPR通过一个框架利用学术和社区合作伙伴的独特优势，（1）在所有研究阶段促进合作和公平的伙伴关系，
States, disparities in CVD and associated risk factors exist among Black, Latino, and American Indian/Alaska Native individuals when compared with nonHispanic White individuals. 1 Social determinants of health; the context in which people are born, live, learn, work, play, worship, age; and structural factors are regarded as the root causes of CVD disparities seen in these groups. Although there is a growing body of research identifying interventions that effectively address these longstanding racial/ethnic and socioeconomic disparities in CVD, many questions remain, and much of what we know is still not being used to change practice and policy. A growing body of knowledge also supports the notion that community-engaged research is a promising approach to promote cardiovascular health equity. Community-engaged research is an exemplary model to mitigate this challenge because it transcends limitations associated with traditional scientific research and medical care models. 2 By integrating a holistic approach, community-engaged research aims to understand individuals through a social, environmental, and cultural lens. 2 Engaging communities throughout the design and implementation of studies allows for a greater understanding of their unique context or the social determinants that influence their health. 2 Community-engaged research occurs along a continuum that can range from community outreach (eg, one-off, transactional events such as health fairs) and community consultation (eg, periodic requests for input or feedback) to communitybased participatory research (CBPR), which involves authentic relationships with reciprocity, and ultimately, to community-driven research, which includes shared leadership with researchers, decision-making at the community level, and bidirectional trust. 3 It is imperative that scientists and clinicians discontinue the common practice of taking time away from community members without giving back and rather strive to design studies that actively engage members through early inclusion, incorporation of ideas, and shared leadership, and that improve community health. 4 CBPR, an illustrious form of community-engaged research, commits to the principles of co-learning by integrating community partners throughout the research study design, implementation, and dissemination of findings. 4, 5 Despite decades of evidence supporting the value of CBPR, uptake of these priniciples and practices across the scientific community remains limited. The CBPR framework of engaging stakeholders throughout the entire research process lends to sustainable solutions for the community and health policy changes that address health disparities. 4 The foundational principles of CBPR are derived from the Northern Tradition practice of collaborative research centered on system changes and the Southern Tradition practice of emancipatory research that aims to expand research access and ownership. 5 This collaborative research approach can encompass various research designs, including experimental, nonexperimental, case studies, longitudinal, ecological, and implementation science designs. 5, 6 CBPR leverages the unique strengths of academic and community partners through a framework that (1) promotes collaborative and equitable partnerships in all research phases and