Community-based participatory research (CBPR) has been identified as a useful approach to increasing community involvement in research. Developing rigorous methods in conducting CBPR is an important step in gaining more support for this approach. The current article argues that concept mapping, a structured mixed methods approach, is useful in the initial development of a rigorous CBPR program of research aiming to develop culturally tailored and community-based health interventions for vulnerable populations. A research project examining social dynamics and consequences of alcohol and substance use in Newark, New Jersey, is described to illustrate the use of concept mapping methodology in CBPR. A total of 75 individuals participated in the study.
Cognitive behavioral therapy (CBT) is an effective intervention for reducing substance use. However, because CBT trials have included predominantly White samples caution must be used when generalizing these effects to Blacks and Hispanics. This meta-analysis compared the impact of CBT in reducing substance use between studies with a predominantly non-Hispanic White sample (hereafter NHW studies) and studies with a predominantly Black and/or Hispanic sample (hereafter BH studies). From 322 manuscripts identified in the literature, 17 met criteria for inclusion. Effect sizes between CBT and comparison group at posttest had similar effects on substance abuse across NHW and BH studies. However, when comparing pre-posttest effect sizes from groups receiving CBT between NHW and BH studies, CBT’s impact was significantly stronger in NHW studies. T-test comparisons indicated reduced retention/engagement in BH studies, albeit failing to reach statistical significance. Results highlight the need for further research testing CBT’s impact on substance use among Blacks and Hispanics.
Theoretical approaches traditionally applied in mental health and criminal justice interventions fail to address the historical and structural context that partially explains health disparities. Community Wise was developed to address this gap. It is a 12 week group intervention informed by Critical Consciousness Theory and designed to prevent substance abuse, related health risk behaviors, psychological distress, and reoffending among individuals with a history of incarceration and substance abuse. This paper reports findings from the first implementation and pilot evaluation of Community Wise in two community-based organizations. This pre-posttest evaluation pilot-tested Community Wise and used findings to improve the intervention. Twenty-six participants completed a phone and clinical screening, baseline, 6- and 12-week follow-ups, and a focus group at the end of the intervention. Measures assessed participants’ demographic information, psychological distress, substance use, criminal offending, HIV risk behaviors, community cohesion, community support, civic engagement, critical consciousness, ethnic identification, group cohesion, client satisfaction, and acquired treatment skills. Research methods were found to be feasible and useful in assessing the intervention. Results indicated that while Community Wise is a promising intervention, several changes need to be made in order to enhance the intervention. Community Wise is a new approach where oppressed individuals join in critical dialogue, tap into existing community resources, and devise, implement and evaluate their own community solutions to structural barriers.
Communities with histories of oppression have shown great resilience. Yet few health interventions focus on structural oppression as a contributor to health problems in these communities. This paper describes the development and active ingredients of Community Wise, a unique behavioral-health intervention designed to reduce substance use frequency, related health risk behaviors, and recidivism among individuals with a history of incarceration and substance abuse residing in distressed and predominantly African American communities. Community Wise, developed through the collaborative efforts of a board of service providers, researchers, consumers, and government officials, is a 12-week group intervention that aims to address behavioral-health problems by raising critical consciousness in distressed communities.
Engagement of high-risk adolescents and their families in treatment is a considerable challenge for service providers and agencies. Despite its importance, little research has been conducted that explores this important treatment process. To address this gap, a test of an innovative method to improve engagement in family therapy was undertaken. Findings of this study of 42 intervention group families and 41 comparison group families (N=83) suggest that augmenting in-home family therapy with short and creative experiential activities can significantly increase engagement and retention in treatment. Further research of engagement as a mechanism of change in family-based treatment is needed.
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