There have been increasing calls for community-academic partnerships to enhance the capacity of partners to engage in policy advocacy aimed at eliminating health disparities. Community-based participatory research (CBPR) is a partnership approach that can facilitate capacity building and policy change through equitable engagement of diverse partners. Toward this end, the Detroit Community-Academic Urban Research Center, a long-standing CBPR partnership, has conducted a policy training project. We describe CBPR and its relevance to health disparities; the interface between CBPR, policy advocacy, and health disparities; the rationale for capacity building to foster policy advocacy; and the process and outcomes of our policy advocacy training. We discuss lessons learned and implications for CBPR and policy advocacy to eliminate health disparities.
The study of urban populations must be grounded in the realities of local communities. Much as many insights of urban health are generalizable to the health of cities worldwide, local knowledge both can and is necessary to guide action that can improve the health of urban populations. Community-based participatory research is an approach to research that has a particular role in both the study of urban communities and in developing interventions and policies that can improve the health of these populations. This chapter discusses the principles and strategies of community-based participatory research and how their applications can guide the study and practice of urban health towards achieving health equity.
Residents of distressed urban areas suffer early aging-related disease and excess mortality. Using a community-based participatory research approach in a collaboration between social researchers and cellular biologists, we collected a unique data set of 239 black, white, or Mexican adults from a stratified, multi-stage probability sample of three Detroit neighborhoods. We drew venous blood and measured Telomere Length (TL), an indicator of stress-mediated biological aging, linking respondents’ TL to their community survey responses. We regressed TL on socioeconomic, psychosocial, neighborhood, and behavioral stressors, hypothesizing and finding an interaction between poverty and racial/ethnic group. Poor whites had shorter TL than nonpoor whites; poor and nonpoor blacks had equivalent TL; poor Mexicans had longer TL than nonpoor Mexicans. Findings suggest unobserved heterogeneity bias is an important threat to the validity of estimates of TL differences by race/ethnicity. They point to health impacts of social identity as contingent, the products of structurally-rooted biopsychosocial processes.
In this article, we community partners provide our assessment of the benefits and challenges in using a CBPR approach at the personal, organizational, and community levels; the factors that facilitate effective partnerships; and our lessons learned through engagement in CBPR. We also present specific recommendations from a community perspective to researchers and institutions interested in conducting CBPR.
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