This case study of community and university research partnerships utilizes previously developed principles for conducting research in the context of Native American communities to consider how partners understand and apply the principles in developing community-based participatory research partnerships to reduce health disparities. The 7 partnership projects are coordinated through a National Institutes of Health-funded center and involve a variety of tribal members, including both health care professionals and lay persons and native and nonnative university researchers. This article provides detailed examples of how these principles are applied to the projects and discusses the overarching and interrelated emergent themes of sharing power and building trust.
We present the ethical challenges and lessons learned over the course of a four-year community-based participatory research (CBPR) project conducted on sexually transmitted infections (STIs) in Greenland. Specifically discussed is Inuulluataarneq-the "Having the Good Life" study. Inuulluataarneq is an interdisciplinary international, collaborative CBPR study involving the University of Toronto in Canada, the Greenlandic Medical Research Council, the Centre for Primary Care in Nuuk, the University of Greenland, local health partners and communities in Greenland, the Statens Serum Institut in Denmark, and Montana State University in the United States. Inuulluataarneq is the first CBPR project implemented in Greenland. Ethical issues discussed are: (1) the complexity of working with multiple institutional review boards on an international health research project using a CBPR framework; (2) unexpected influences on health policy; and (3) the dynamic of balancing community decision making and practices with academic research requirements and expectations. Inuulluataarneq's primary contribution to understanding ethical issues when conducting research in the Arctic involves an acceptance of the time, patience, and dedication of researchers and community partners it takes to discuss, understand, and process differing ethical viewpoints and procedures.
HIV/AIDS prevention projects utilizing indigenous outreach workers often rely on the life experiences and skills of the staff to structure the intervention, without grounding in theory. However, to be most effective, community outreach projects which target harder-to-reach high-risk populations should both utilize and enhance the natural strengths of indigenous field workers' experience and style of interaction, while guiding intervention content with theoretical rigor. In this paper we demonstrate that the challenge of successfully integrating a theoretically guided program design with field staff's credibility with, and sensitivity toward, drug-using clients can be practically and satisfactorily met through appropriate training. This training is an important investment for better utilizing valued and scarce prevention resources. The Philadelphia site of the AIDS Evaluation of Street Outreach Project (AESOP), a cooperative agreement of the Centers for Disease Control and Prevention, designed and implemented staff trainings to reflect the enhancement of the outreach program by the Stages of Change model. Through these trainings, the outreach workers have learned to integrate their natural street and intervention skills into the structure of a theoretical framework. This paper presents specific training components, relevant issues within these components, and areas for evaluation and feedback.
Cites: AIDS Educ Prev. 1989 Summer;1(2):105-182641228
Increasingly, community-based participatory research (CBPR), with its emphasis on engaging communities as full and equal partners in all phases of the research process is being promoted to address the health needs of peoples living in the North American Arctic. However, the CBPR approach is not without its challenges in Arctic countries such as Greenland, where research capacity, different languages, distance, time and cost become barriers to remaining true to the purest form of CBPR. In this paper, we describe the practical application of CBPR principles and methodologies to a sexual health project investigating sexually transmitted infections in Greenland. We present the initial challenges encountered in the early stages of the pilot CBPR sexual health study, and solutions to these challenges. We also provide recommendations for expanding the capacity in Greenland to conduct CBPR projects.