Community Based Research

Goal

To facilitate the development of community derived and directed research through the Boston Community Practice Research Collaborative (BCPRC), a practice based research network of "academic community health centers " engaged in participatory health services and clinical research focused on eliminating continuing health disparities among racial/ethnic populations.

Assumptions

A. Partnerships between academia and community based service organizations working
collaboratively, offer the greatest potential for conducting community relevant research and
evaluation of clinical interventions and health services programs aimed at achieving the
Surgeon General's goal of eliminating racial/ethnic health disparities by the year 2010.

B. Community health centers are the locus of the intersection and interaction of social and
economic conditions, public health concerns and the manifestation of medical conditions in
the community with the commitment and capability to engage community members as equal stakeholders in research.

C. Community health practitioners recognize the interrelationship of psychosocial, economic, and environmental factors of urban life as determinants of the health status of minority populations. They recognize the need for interdisciplinary approaches to practice, and research that informs practice.

D. The cultural divide that often exists between traditional academic researchers and underserved communities must be bridged to benefit from relevant investigation into health disparities. Interested researchers in community health centers generally lack the track records as established researchers to secure national research finding. Community health centers lack the infrastructure for conducting research that is inherent in academia. Academic researchers are distant from the locus of practice and often lack the sensitivity to community needs, issues and process.

Accomplishments

* CCHERS, partnership has successfully facilitated the development of the research capacity of community health centers through program evaluation efforts and other selected research projects. Health centers are strategically positioned to incorporate research into their community practices.

* CCHERS health centers are participating in the National Heart, Lung and Blood Institute's clinical trial, "Antihypertensive and Lipid Lowering Treatment to Prevent Heart Attack " (ALLHAT). A seven year national clinical study, initiated in 1994 that focuses on reducing coronary heart disease.

* CCHERS facilitated and funded collaborations between university faculty and community health providers that resulted in published research in areas of community health.

* CCHERS collaboration with the Domestic Violence Institute of Northeastern University School of Law, resulted in a $2.4 million grant for cooperative agreement with the Centers for Disease Control and Prevention (CDC), "Coordinated Community Responses to Prevent Intimate Partner Violence ". Evaluation of legal, social and health systems for provision of services to victims of domestic violence.

* CCHERS participated as a beta test site in the research and development of the Strategic Management and Resources Tool, developed by the Center for Health Economics in Policy at the University of Texas Health Sciences Center at San Antonio with funding from the Kellogg Foundation. SMART is an interactive software package designed to address the planning, monitoring, and reporting needs of community based health programs and organizations.

* CCHERS has assisted in the field testing of a diagnostic instrument, designed by a Northeastern University Physics Professor that measures the balance and sway in elders to assess their potential risk of accidents and falls. CCHERS worked with the university professor and the physical therapy department to translate the relevance of his work to a community audience and recruited several community organizations, with significant elder populations, to participate in the study.

* CCHERS convened the Boston Community Practice Research Collaborative to develop and submit a one year planning grant to the Agency for Health Care Quality and Research to support its early stages of development.

Policy Objectives

Develop stronger incentives for community and practice based research with underserved populations.

* Creating greater funding opportunities for planning and multi-year, community based research efforts.
* Developing increased visibility and credibility for community based research within academic institutions.
* Encouraging national and state funding sources to promote integration of service and research funding opportunities between universities and community health centers.

Design approaches for engaging community members as full partners in research efforts.

* Exploring current approaches being used with in existing community based collaborative research efforts.
* Developing principles and models for engaging the community and curricula for introducing the principles of research to community members; and the principles of community engagement to academic researchers and students.
* Seeking out opportunities for co-presentation and co- publication. by academic/community partners.

Support the establishment of a network of "bridge builders "for community based researchers.

* Developing vehicles and technical assistance for introducing health researchers and students to the principles of community involvement (e.g. group process, communication, cultural competence, conflict resolution and power dynamics).
* Introducing the principles and language of research to community health personnel and interested community members and providing capacity building opportunities (e.g., skills in evaluation, grant writing, research design, survey administration and fiscal management).