In order to address the social, physical and economic determinants of urban health, researchers, public health practitioners, and community members have turned to more comprehensive and participatory approaches to research and interventions. One such approach, community-based participatory research (CBPR) in public health, has received considerable attention over the past decade, and numerous publications have described theoretical underpinnings, values, principles and practice. Issues related to the long-term sustainability of partnerships and activities have received limited attention. The purpose of this article is to examine the experiences and lessons learned from three Urban Research Centers (URCs) in Detroit, New York City, and Seattle, which were initially established in 1995 with core support from the Centers for Disease Control and Prevention (CDC). The experience of these Centers after core funding ceased in 2003 provides a case study to identify the challenges and facilitating factors for sustaining partnerships. We examine three broad dimensions of CBPR partnerships that we consider important for sustainability: (1) sustaining relationships and commitments among the partners involved; (2) sustaining the knowledge, capacity and values generated from the partnership; and (3) sustaining funding, staff, programs, policy changes and the partnership itself. We discuss the challenges faced by the URCs in sustaining these dimensions and the strategies used to overcome these challenges. Based on these experiences, we offer recommendations for: strategies that partnerships may find useful in sustaining their CBPR efforts; ways in which a Center mechanism can be useful for promoting sustainability; and considerations for funders of CBPR to increase sustainability.Israel, Lichtenstein, and McGranaghan are with the

Pediatric asthma is a growing public health issue, disproportionately affecting low-income people and people of color. Exposure to indoor asthma triggers plays an important role in the development and exacerbation of asthma. We describe the implementation of the Seattle-King County Healthy Homes Project, a randomized, controlled trial of an outreach/education intervention to improve asthma-related health status by reducing exposure to allergens and irritants in the home. We randomly assigned 274 low-income children with asthma ages 4-12 to either a high- or a low-intensity group. In the high-intensity group, community health workers called Community Home Environmental Specialists (CHES) conducted initial home environmental assessments, provided individualized action plans, and made additional visits over a 12-month period to provide education and social support, encouragement of participant actions, provision of materials to reduce exposures (including bedding encasements), assistance with roach and rodent eradication, and advocacy for improved housing conditions. Members of the low-intensity group received the initial assessment, home action plan, limited education during the assessment visit, and bedding encasements. We describe the recruitment and training of CHES and challenges they faced and explain the assessment and exposure reduction protocols addressing dust mites, mold, tobacco smoke, pets, cockroaches, rodents, dust, moisture, and toxic or hazardous chemicals. We also discuss the gap between the practices recommended in the literature and what is feasible in the home. We accomplished home interventions and participants found the project very useful. The project was limited in resolving structural housing quality issues that contributed to exposure to indoor triggers.

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Objectives-We implemented and evaluated multiple interventions to increase walking activity at a multicultural public housing site.Methods-A community-based participatory research partnership and community action teams assessed assets and barriers related to walking and developed multiple interventions to promote walking activity. Interventions included sponsoring walking groups, improving walking routes, providing information about walking options, and advocating for pedestrian safety. A pre-post study design was used to assess the changes in walking activity.Results-Self-reported walking activity increased among walking group participants from 65 to 108 minutes per day (P=.001). The proportion that reported being at least moderately active for at least 150 minutes per week increased from 62% to 81% (P=.018).Conclusions-A multicomponent intervention developed through participatory research methods that emphasized walking groups and included additional strategies to change the built and social environments increased walking activity at a public housing site in Seattle.Obesity and diabetes are major contributors to health inequities. 1 The excess burden of these diseases in low-income and minority populations is in part caused by adverse conditions in the Correspondence should be sent to James Krieger, Chronic Disease and Injury Prevention Section, Public Health-Seattle and King County, Chinook Building, Suite 900, 401 5th Ave, Seattle, WA 98104 james. krieger@kingcounty.gov). Reprints can be ordered at http://www.ajph.org by clicking on the "Reprints/Eprints" link. Contributors J. Krieger and D. Sharify originated the study and oversaw all aspects of its implementation and evaluation. J. Krieger had primary responsibility for preparing the article, assisted by J. Rabkin. J. Rabkin assisted with implementation and led the evaluation. L. Song conducted the statistical analyses. All authors helped to conceptualize ideas, interpret findings, and review drafts of the article. Human Participant ProtectionThe study was approved by the Human Subjects Division institutional review board of the University of Washington. NIH Public Access Author ManuscriptAm J Public Health. Author manuscript; available in PMC 2010 November 1. NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript built and social environments. These conditions in turn affect behaviors that lead to obesity and diabetes such as physical inactivity and unhealthy eating. The built environment influences opportunities for physical activity through access to trails, parks, recreation centers, and walkable streets. [2][3][4][5] The social environment affects physical activity through perceptions of community and pedestrian safety, social support, and access to recreation and activity programs. 6 The growing awareness of the impact of built and social environments on health inequities has led to a more inclusive concept of the environment in the context of environmental justice. 7,8 The environmental justice movement originated as a re...