Challenges of conducting community-based participatory research in Boston's neighborhoods to reduce disparities in asthma
Challenges of conducting community-based participatory research in Boston's neighborhoods to reduce disparities in asthma
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DOI：
10.1007/s11524-006-9111-0
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发表时间：
2006-11-01
影响因子：
6.6
通讯作者：
Carrasco, Edna Rivera
中科院分区：
文献类型：
--
作者：
Freeman, Elmer R.;Brugge, Doug;Carrasco, Edna Rivera
波士顿是世界上最杰出的医疗保健和研究中心之一，但对于其城市核心的大部分地区来说，这些资源在很大程度上是遥不可及的。基于社区的参与性研究（CBPR）提供了一种模式，有可能弥合其研究突出性与居民健康之间的差距。我们在这里报告两个主要研究项目的案例研究，这些项目是波士顿大学与社区组织和城市机构之间的伙伴关系。健康公共住房倡议（HPHI）和社区环境和社会压力哮喘病中心（ACCESS）等项目提供了许多关于开展CBPR的潜力和挑战的经验教训。确保项目是真正的伙伴关系成为这两个项目的关键问题，特别是在筹资机制和资源分配方面，尽管这两个项目面临的挑战性质有很大不同。我们注意到，学术合作伙伴和社区合作伙伴都可能对对方抱有成见，对广泛人群、学者或社区成员的概括可能不适用于所有人。调整目标和期望是另一个重要的教训。在HPHI中，服务提供和研究之间的紧张关系既是冲突的根源，也是创造性发展的源泉，导致了不同但有趣的结果。在ACCESS项目中，紧张局势更多地围绕着社区能力建设，同时试图建立和维持一个大型流行病学调查队列。我们的结论是，关于项目方向、财务、期望和其他方面的公开和坦率的讨论和透明的过程是必要的，但不足以解决CBPR的内在挑战，即使如此，在这种需要在整个项目过程中进行诚实谈判的伙伴关系中，观点可能存在差异。
Boston is one of the preeminent health care and research centers in the world, but for much of its urban core, these resources are largely out of reach. Community Based Participatory Research (CBPR) provides a model with the potential to bridge the gaps between its research prominence and the health of its residents. We report here two case studies of major research projects that were partnerships between universities in Boston and community based organizations and city agencies. The Healthy Public Housing Initiative (HPHI) and the Asthma Center on Community Environment and Social Stress (ACCESS) are projects that provide numerous lessons about the potential and challenges of conducting CBPR. Ensuring that the projects were true partnerships emerged as key issues in both, especially with respect to funding mechanisms and distribution of resources, although the nature of the challenges differed substantially in the two projects. We note that both academic and community partners may harbor stereotypes about the other and that generalizations about broad populations, academics or community members, may not apply well to everyone. Aligning objectives and expectations emerged as another key lesson. In HPHI, tension between service delivery and research was both a source of conflict and a source of creative development that led to divergent but interesting outcomes. In ACCESS, the tensions revolved more around community capacity building while attempting to build and maintain a large cohort for epidemiological investigations. We conclude that open and frank discussion and a transparent process upfront about project direction, finances, expectations, and other dimensions are necessary but not sufficient to address the inherent challenges in CBPR, and that even so, there are likely to be differences in perspective in such partnerships that require honest negotiation throughout the process of the project.