Principles of Community Engagement (Second Edition)

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C. How do you engage a community when there are cultural, educational, or socioeconomic differences within the community as well as between the community and the researchers? Seronda A. Robinson, PhD, Wanda A. Boone, RN, Sherman A. James, PhD, Mina Silberberg, PhD, Glenda Small, MBA Challenge Conducting community-engaged research requires overcoming various hierarchies to achieve a common goal Hierarchies may be created by differing economic status, social affiliation, education, or position in the workplace or the community A Pew Research Center survey, described by Kohut et al (2007), suggests that the values of poor and middle-class African Americans have moved farther apart from each other in recent years and that middleclass African Americans’ values have become more like those of whites than of poor African Americans In addition, African Americans are reporting seeing greater differences created by class than by race (Kohut et al 2007) It is widely known that perceived differences in values may influence interactions between groups Approaches to engage the community can be used as bridge builders when working with economically divided groups The African-American Health Improvement Partnership (AAHIP) was launched in October 2005 in Durham, North Carolina, with a grant from the National Center (now Institute) for Minority Health and Health Disparities through a grant program focused on community participation The AAHIP research team consists of African American and white researchers from Duke University with terminal degrees and research experience and health professionals/community advocates from the Community Health Coalition, Inc, a local nonprofit The community advisory board (CAB) is composed of mostly African American community leaders representing diverse sectors of Durham’s African American and health provider communities The first study launched by the AAHIP, which is ongoing, is an intervention designed by the AAHIP CAB and its research team to improve disease management in African American adults with type 2 diabetes Approaches to engage the community can be used as bridge builders when working with economically divided groups. 125
At meetings of the CAB, decisions were to be made by a majority vote of a quorum of its members Members of the research team would serve as facilitators who provided guidance and voiced suggestions The sharing of information was understood to be key to the process However, dissimilarities in educational level and experience between the research team and the CAB and variations in socioeconomic status, positions, and community roles among CAB members created underlying hierarchies within the group (i e , the CAB plus the research team) The research team assumed a leadership role in making recommendations Notably, even within the CAB, differences among its members led to varying levels of comfort with the CAB process with the result that some members did most of the talking while others were hesitant to make contributions Many of the community leaders were widely known for their positions within the community and their accomplishments, and these individuals were accustomed to voicing their opinions, being heard, and then being followed Less influential members were not as assertive Action Steps Faculty from North Carolina Central University, a historically black university in Durham, conduct annual evaluations to assess the functioning of the CAB and the research team, in particular to ensure that it is performing effectively and meeting the principles of CBPR An early survey found that only about 10% of respondents felt that racial differences interfered with productivity, and 19% felt that the research team dominated the meetings However, nearly half felt that the meetings were dominated by just one or a few members Although more than 90% reported feeling comfortable expressing their point of view at the meetings, it was suggested that there was a need to get everyone involved CAB members suggested ways to rectify the issues of perceived dominance, and all parties agreed to the suggestions From then on, the entire CAB membership was asked to contribute to the CAB meeting agendas as a way to offer a larger sense of inclusion At the meetings themselves, the chair made a point of soliciting remarks from all CAB members until they became more comfortable speaking up without being prompted In addition, subcommittees were established to address important business These made active participation easier because of the size of the group 126
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PRINCIPLES OF COMMUNITY ENGAGEMENT
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TABLE OF CONTENTS CTSA Community En
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Editorial and Research Staff Mina S
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For further information on the CTSA
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FOREWORD As Surgeon General, I am p
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Executive Summary
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of Veterans Affairs, and other fede
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REFERENCES Ahmed SM, Palermo AG Com
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Chapter 1 Community Engagement: Def
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clinics, agencies, after-school pro
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The eligibility criteria that scien
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2 Design and delivery—Improvement
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There is no question that culture a
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oot causes of problems while at the
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• Know the community, its constit
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• Coalitions require that each pa
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studies demonstrate that IRBs gener
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action at those levels This approac
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• S o c i e t y : Advocate for th
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According to Rogers, the characteri
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is the added value of CBPR to the r
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• It is important to understand c
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Butterfoss FD, Kegler MC (2002) Tow
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Flicker S, Travers R, Guta A, McDon
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Jones MR, Horner RD, Edwards LJ, Ho
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Minkler M Community organizing and
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Shore N Community-based participato
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Yale Center for Clinical Investigat
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Chapter 2 Principles of Community E
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• Ask community members to specif
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trust for a true partnership Such m
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that affect health and health dispa
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difference in the health of the pop
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Chapter 3 Successful Examples in th
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59 TABLE 3.1. MATRIX OF CASE EXAMPL
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a mission statement written in the
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2. HEALTH-E-AME Background: The Med
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3. PROJECT SUGAR Background: Gullah
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Websites http://academicdepartments
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of the community context, developme
Page 81 and 82: 5. HEALING OF THE CANOE Background:
Page 83 and 84: 6. FORMANDO NUESTRO FUTURO/SHAPING
Page 85 and 86: 7. IMPROVING AMERICAN INDIAN CANCER
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Page 91 and 92: 9. THE DENTAL PRACTICE-BASED RESEAR
Page 93 and 94: 10. DIABETES EDUCATION & PREVENTION
Page 95 and 96: 11. PROJECT DULCE Background: Diabe
Page 97 and 98: References Gilmer TP, Philis-Tsimik
Page 99 and 100: milestones in child development, ch
Page 101 and 102: Chapter 4 Managing Organizational S
Page 103 and 104: engagement is not limited to coalit
Page 105 and 106: Practice Element 1: Know the Commun
Page 107 and 108: each capacity component for this pr
Page 109 and 110: REFERENCES Butterfoss FD. Coalition
Page 111 and 112: Table 4.1. Know the Community, Its
Page 113 and 114: Table 4.3. Build and Sustain Networ
Page 115 and 116: Challenges in Improving Community E
Page 117 and 118: ecommended public health practices
Page 119 and 120: community setting can be just as ri
Page 121 and 122: These challenges do not compare, ho
Page 123 and 124: halted its efforts to collect data
Page 125 and 126: mechanisms for communication, the c
Page 127 and 128: The researchers and the community b
Page 129 and 130: Horn K, McGloin T, Dino G, Manzo K,
Page 131: Take-Home Messages • Be explicit
Page 135 and 136: 3. WORKING WITH NONTRADITIONAL COMM
Page 137 and 138: B. How do you engage a state as a c
Page 139 and 140: to those applying for funds The eva
Page 141 and 142: 4. INITIATING A PROJECT WITH A COMM
Page 143 and 144: B. How do you set up and maintain a
Page 145 and 146: References Blumenthal DS A communit
Page 147 and 148: parties grew frustrated The partner
Page 149 and 150: 5. O VERCOMING COMPETING PRIORITIES
Page 151 and 152: Reference Reifsnider E, Hargraves M
Page 153 and 154: Take-Home Messages • “Splitting
Page 155 and 156: Although the CTSA sites in the Bost
Page 157 and 158: Chapter 6 The Value of Social Netwo
Page 159 and 160: Social networks can also play an im
Page 161 and 162: engagement effort, relationships mu
Page 163 and 164: engagement Furthermore, social medi
Page 165 and 166: REFERENCES Arthur T The role of soc
Page 167 and 168: Program Evaluation and Evaluating C
Page 169 and 170: approaches to evaluation that are p
Page 171 and 172: Several institutions have identifie
Page 173 and 174: Planning Defining and identifying s
Page 175 and 176: Once the positive outcome of a prog
Page 177 and 178: The major goal of empowerment evalu
Page 179 and 180: Table 7.1. Types of Evaluation Ques
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for understanding a community and i
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REFERENCES Anderson RM, Funnell MM,
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Patton MQ Qualitative evaluation an
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Chapter 8 Summary Donna Jo McCloske
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• Know the extent to which the fo
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Appendix A: Acronyms
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CDC Centers for Disease Control and
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NIH Publication No. 11-7782
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