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Text for Figures and Slides in TB Behavioral and Social Science Research Forum Proceedings


Shawna Mercer, M.Sc., Ph.D.
Health Scientist,
Public Health Practice Program Office, Office of the Director
Centers for Disease Control and Prevention

Slide #1: This slide shows the logos for the Department of Health and Human Services and Centers for Disease Control and Prevention

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Slide #2: Sharpening the Focus on Turning Research into Practice: The Promise of Participatory Research Approaches

Shawna L. Mercer, PhD, MSc
Office of Science and Extramural Research
Public Health Practice Program Office
Centers for Disease Control & Prevention

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Slide #3: Bottleneck in Translating Public Health Research into Practice

  • There is insufficient recognition of the complexities inherent in putting public health research findings into practice across diverse communities, settings, and situations
    • To be relevant for practice, research must meet diverse practice needs

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Slide #4: Challenges for Taking Research Results to Practice

1. Internal vs. external validity (generalizability):

  • Internal:
    • Are we measuring what we purport to measure?
  • External:
    • How applicable is this to real-world rural settings and situations?

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Slide #5: Challenges for Taking Research Results to Practice

2. Best practices vs. locally appropriate and affordable practices

  • For special populations
    • e.g., minority populations in rural areas
  • In underserved areas
  • For those of lower socioeconomic status, lower education
  • Behavioral vs. medical interventions

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Slide #6: Best Practice Application Gaps

  • Accessibility gap
    • Do I have the same resources as the experimenters?
  • Credibility gap
    • How different is their situation of practice from mine?
  • Expectations gap
    • Is it really necessary for me to strive for such lofty goals in my practice?
      • Lancaster B. Closing the gap between research and practice. Health Educ Q 1992;19:408-411

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Slide #7: A Solution for Taking Research Results to Practice

  • An upstream approach
    • By actively engaging practitioners, policy makers, community members in the research process, it is more likely the results will be relevant to their needs

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Slide #8: Participatory Research is…

  • “Systematic inquiry
  • With the collaboration of those affected by the issue being studied
  • For the purposes of education and taking action or effecting social change”

    Green, et al., 1995
    Study of Participatory Research in Health Promotion.

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Slide #9: What is Participatory Research?

  • It is not a method
  • It is an approach
    • Involves engaging potential users and beneficiaries of the research in the research process
    • A wide range of study designs and research methods can be used
      • Selection depends on the research questions and feasibility issues

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Slide #10: Whose Participation Should be Sought?

  • Who is to be affected by the research results?
    • Geographic communities
    • Other groups sharing common characteristics
      • Ethnic groups, practitioners, policy makers, health departments
      • Minority or special populations living in rural settings

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Slide #11: This slide includes a cartoon drawing with the quotation, “Mom, Dad’s been doing participatory research again.”

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Slide #12: How Much Participation is Needed?

  • At a minimum:
    • helping to formulate research questions
    • interpreting and applying the research findings
  • Possibly also:
    • Selecting and using methods
    • Analyzing data
  • Rule of thumb:
    • Dependent on complexity and labor-intensiveness of methods and analyses

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Slide #13: Considerations in Developing OSER’s Extramural Prevention Research Grant Program (EPRP)

  • Tenets of participatory research:
    • Grass-roots initiative
    • Local control and autonomy
  • What are the implications for funding, supporting, judging (not threatening or undermining) participatory research?

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Slide #14: Needs and Preferences of Researchers and Practitioners

  • A vision for participatory research
  • Adequate time for true participation
  • Investigator-initiated research
  • External peer-review
  • Infrastructure capacity, methodology, and other cross-cutting issues
  • Multiple levels of intervention
  • Take research results to scale and sustain effects

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Slide #15: OSER Grant Funding FY2003-2005: Community-Based Participatory Prevention Research

  • To stimulate investigator-initiated participatory research on community-based approaches to prevention
    • Multi-disciplinary
    • Multi-level research
    • Community
    • Cross-cutting
      • Caveat: guided by community needs

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Slide #16: This slide includes a map of the United States indicating the number of community-based participatory prevention research grants (n=435).

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Slide #17: EPRP’s Second Round of Grants: Response and Funding

  • Response:
    • 570 letters of intent (LOI)
    • 311 full applications
  • Funding:
    • 40+ projects approved for funding
    • ~$11.4 million
    • ~25 projects funded
    • Each project: ~$450,000 per year for 3 years

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Slide #18: Range of Projects Funded

  • Cross-cutting research such as:
    • Diabetes, asthma, obesity
    • physical activity, nutrition, tobacco prevention, drug prevention, violence/injury prevention
    • youth and school-based health
    • workforce development
    • reduction of health disparities
    • Increasing access to care

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Slide #19: Diabetes in Hispanic Appalachians

  • Issue:
    • Growing numbers of Hispanics moving into rural Appalachia (migrant and permanent)
    • High levels of diabetes; low access to care
  • Research team:
    • East Tennessee State University Researchers
    • Hispanic community and provider partners
  • Site:
    • Southern Appalachia
  • Intervention:
    • Development of tailored interventions to enhance detection, management, and prevention of diabetes
    • Education to increase the capacity of Hispanic community to identify and solve its other health problems

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Slide #20: References

  • Green LW & Mercer SL. Can public health researchers and agencies reconcile the push from funding bodies and the pull from communities? American Journal of Public Health. 2001;91:1926-1929.
  • Minkler M & Wallerstein N (Eds.). Community-Based Participatory Research for Health. San Francisco: Jossey-Bass, 2003.

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