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

SHARPENING THE FOCUS ON TURNING RESEARCH INTO PRACTICE: THE PROMISE OF PARTICIPATORY RESEARCH APPROACHES

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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