Community-based Participatory Research Is Needed to Address Pulmonary Health Disparities

Abstract

Socioeconomic and racial disparities in the outcomes of medical management remain common across pulmonary diseases in the United States and worldwide. Acknowledging this, the American Thoracic Society recently put forth recommendations to advance respiratory health equity. Through engagement of vulnerable communities in search of collaborative solutions to improve health disparities, community-based participatory research embodies concepts essential to the American Thoracic Society mission for respiratory health equity. The purpose of this commentary is to provide an overview of the principles of community-based participatory research and the application of this approach to addressing inequity in the outcomes of treatment for lung disease. Community-based participatory research aims to decrease health disparities by recognizing the social and ecological paradigms of health care and by partnering community members with academic researchers in all aspects of the research process. Community partners are uniquely poised to offer insight into local culture, circumstances that guide health behaviors, and other challenges to improve their own community's health. Sustainable interventions, either through strengthening existing community assets or through community empowerment and local capacity building throughout the research process, are essential to the success of community-based participatory research. The National Institutes of Health and other funding agencies offer funding opportunities to support specific interventions aimed at engaging community members in the research process. In pulmonary medicine, community-based initiatives have focused primarily on improving pediatric asthma outcomes. Using a community-based approach in adult asthma and other pulmonary diseases could be an ideal manner in which to decrease pulmonary health disparities.

Metal air pollution partnership solutions: building an academic-government-community-industry collaboration to improve air quality and health in environmental justice communities in Houston

“…CBPR is challenging because of the substantial investment in time that is required to engage community partners [35,36]. In our study, engagement took place at multiple levels, involving interactions between academics, government and community groups as research partners, as well as interactions between research partners and CAB members, i.e., residents and metal recyclers.…”

Addressing the Needs of Abused Chinese Women Through a Community‐Based Participatory Approach

“…Application of the CBPA (Barnack‐Tavlaris, Garcini, Sanchez, Hernandez, & Navarro, 2013; Harris, Pensa, Redlich, Pisani, & Rosenthal, 2016; Kalokhe et al, 2019; Leff et al, 2010; Lincoln et al, 2016; Smith et al, 2016;) has yielded promising positive outcomes in violence‐related or disease‐related programs. It was apparent that interventions or programs that were developed through the CBPA had demonstrated several benefits for abused Chinese women—the abused women had actively participated and were fully engaged in the development of the intervention by providing ideas and input, and they were involved in the whole implementation process.…”

The High Obesity Program: Overview of the Centers for Disease Control and Prevention and Cooperative Extension Services Efforts to Address Obesity

“…Given the growing evidence that community-based participatory approaches are effective in addressing health concerns in communities characterized by health disparities, particularly rural communities (11)(12)(13), HOP required CES to work with key stakeholders by engaging existing or developing new community coalitions to identify and support implementation of PSE approaches.…”

“…Implement and promote Safe Routes to School or other walk/bike-to-school programs 4 Promote Complete Streets or other safe streets/community design initiatives 3 a Beginning in 2014, the Centers for Disease Control and Prevention's Division of Nutrition, Physical Activity, and Obesity awarded funding to 11 LGUs through the High Obesity Program. The program implemented evidence-and practice-based strategies with a goal to increase access to nutritious foods and places to be physically active in counties in which the prevalence of obesity among adults is greater than 40%.…”

“…LGUs and CES offices aligned with the US Department of Agriculture's 2014 report, Cooperative Extension's National Framework for Health and Wellness, which encouraged cooperative extensions to move beyond direct education efforts to increase knowledge and awareness and to focus on policy, systems, and environmental (PSE) strategies to prevent obesity (10). This redirection by CES resulted from growing evidence that social, econom-ic, and environmental factors influence an individual's health behaviors and outcomes (11,12). Consistent with the CES framework, through HOP, LGUs and CES were asked to expand their approach beyond direct education efforts to also focus on implementing evidence-based obesity prevention strategies with a focus on PSE approaches that facilitate healthy choices related to nutrition and physical activity in these high-risk, primarily rural communities.…”