Background

Community-based participatory research (CBPR) is ideally a collaborative approach to research that equitably involves all partners in the research process and recognizes the unique strengths that each brings.

Methods

We reviewed the processes, strategies, and activities around the interface of community-academic partnerships using a CBPR model focused on addressing healthcare issues for minority elders.

Results

Key challenges for the community side include understanding: (1) the needs of the academic partner; (2) how to assess whether there are shared values, goals, and research priorities; (3) the limits of one's organization and competing demands; (4) how to use the partnership to build community capacity to conduct research; and (5) the value added for the community from involvement in research versus the risks inherent in participation. Key challenges for the academic side of the partnership include understanding: (1) what community is; (2) the value added by a true partnership; (3) how to build effective relationships; (4) what a balanced collaboration with equal power sharing entails; (5) that community partner goals may not mirror academic goals; (6) the capabilities and limits of community partners; and (7) how to effectively use a community advisory board (CAB). Building relationships and effective collaboration require time, patience, physical presence, respect, and commitment-elements frequently in short supply in a busy academic environment. A memorandum of understanding (MOU) can be an important tool to document roles and responsibilities. The community advisory board (CAB) is an important liaison between the community and academic settings but is not sufficient to constitute a partnership in and of itself. Members should be carefully selected so that the CAB can assist in: (1) creating a partnership roadmap; (2) providing contacts and strategies; (3) helping to broker competing agendas; (4) helping provide a balance in articulating the community health priorities; (5) giving additional perspectives and balance for the partnerships; and (6) participating as a critical component of the mentor pool.

Conclusion

Our evolving perspective on CBPR has reinforced the importance of a MOU to document the roles and expectations of each partner and a carefully selected CAB to develop and enhance true collaboration with community partners. We cannot overemphasize the importance of educating academia to truly value the role of community and resident experts as equitable and necessary partners to most effectively perform quality research and ultimately bring evidenced-based care for diverse elderly communities into a real-life setting.

Objective

To make cultural and age-specific modifications to a self-care empowerment intervention.

Design

Focus groups with self-administered surveys.

Setting

Two public health diabetes and geriatrics clinic and two senior centers in and around South Los Angeles.

Participants

African Americans and Latinos aged > or = 55 years with diabetes (N=79), and two groups of health educators (N=16).

Main outcome measures

After describing the proposed intervention, the focus group facilitators asked participants: 1) whether the community of interest would be interested in the proposed empowerment intervention; 2) why or why not; and 3) how the intervention could be modified to better address the concerns of the study community of interest. All groups were audiotaped, transcribed, and (when appropriate) translated into English. Three independent investigators read all transcripts and completed standardized coding forms for each transcript. In addition, at the end of each focus group, all participants completed a self-administered written survey asking them to rate aspects of the proposed intervention.

Results

Older African Americans and Latinos endorsed the intervention but desired an expanded dietary educational component and identified disability as an important missing content area. Participants rejected the use of an audio learning tool and did not believe that matching group-facilitator sociodemographic characteristics was important as long as facilitators demonstrated cultural competency.

Conclusions

These findings illustrate a model of participatory research in which researchers and community members work together to develop an empowerment intervention that will meet community needs and will have greater cultural appropriateness. Modifying the intervention in accordance with these findings should enhance the relevance and impact of the self-care intervention.

Objectives

We evaluated whether ethnicity and language are associated with diabetes care for Latinos in managed care.

Methods

Using data from 4685 individuals in the Translating Research Into Action for Diabetes (TRIAD) Study, a multicenter study of diabetes care in managed care, we constructed multivariate regression models to compare health behaviors, processes of care, and intermediate outcomes for Whites and English- and Spanish-speaking Latinos.

Results

Latinos had lower rates of self-monitoring of blood glucose and worse glycemic control than did Whites, higher rates of foot self-care and dilated-eye examinations, and comparable rates of other processes and intermediate outcomes of care.

Conclusions

Although self-management and quality of care are comparable for Latinos and Whites with diabetes, important ethnic disparities persist in the managed care settings studied.