Community‐Driven Research Agenda to Reduce Health Disparities

Abstract

This article describes how a new regional campus of an academic health center engaged in a community-based participatory research (CBPR) process to set a community-driven research agenda to address health disparities. The campus is situated among growing Marshallese and Hispanic populations that face significant health disparities. In 2013, with support from the Translational Research Institute, the University of Arkansas for Medical Sciences Northwest began building its research capacity in the region with the goal of developing a community-driven research agenda for the campus. While many researchers engage in some form of community-engaged research, using a CBPR process to set the research agenda for an entire campus is unique. Utilizing multiple levels of engagement, three research areas were chosen by the community: 1) chronic disease management and prevention; 2) obesity and physical activity; and 3) access to culturally appropriate healthcare. In only 18 months, the CBPR collaboration had dramatic results. Ten grants and five scholarly articles were collaboratively written and 25 community publications and presentations were disseminated. Nine research projects and health programs were initiated. In addition, many interprofessional educational and service learning objectives were aligned with the community-driven agenda resulting in practical action to address the needs identified.

Diabetes and Hypertension in Marshallese Adults: Results from Faith-Based Health Screenings

“…The CBPR collaborative in northwest Arkansas began with a series of qualitative studies that indicated diabetes, obesity, and other cardiometabolic diseases were the primary health concern of the Marshallese [20, 23–27, 30], but there was a lack of data on the prevalence and severity of non-communicable diseases within the northwest Arkansas Marshallese community. As the CBPR team sought to fill this gap in information, community collaborators explained Pacific Islanders’ health beliefs and behaviors reflect a collectivistic orientation in which church plays a crucial role [50, 51].…”

Engagement practices that join scientific methods with community wisdom: designing a patient‐centered, randomized control trial with a Pacific Islander community

“…This needs assessment process took 18 months and used a mixed-methods design of qualitative interviews and a broad quantitative survey of the community. This mixed-methods needs assessment process is described in a separate article (McElfish, Kohler, et al, 2015). The top priority identified by the Marshallese community was type 2 diabetes (Center for Disease Control and Prevention, 2009; Hallgren, McElfish, & Rubon-Chutaro, 2015; McElfish, Kohler, et al, 2015).…”

“…This mixed-methods needs assessment process is described in a separate article (McElfish, Kohler, et al, 2015). The top priority identified by the Marshallese community was type 2 diabetes (Center for Disease Control and Prevention, 2009; Hallgren, McElfish, & Rubon-Chutaro, 2015; McElfish, Kohler, et al, 2015). In order to address type 2 diabetes, the lead investigator brought together a diverse interprofessional research team and engaged 31 community stakeholders, including patients, family members, and health care providers (hereafter referred to as “stakeholders”) to begin planning an appropriate intervention with community support.…”

“…Furthermore, the Marshallese have been skeptical of participating in research because of the historical trauma originating from the nuclear testing in their islands and subsequent medical experiments (Barker, 2012). The University of Arkansas for Medical Sciences Northwest is committed to a CBPR approach that engages Marshallese stakeholders to overcome these challenges to research, and collaboratively addresses the health disparities identified and prioritized by the Marshallese community (McElfish, Kohler, et al, 2015). …”

Lessons learned through a partnership with Marshallese faith-based organizations to screen for hypertension and diabetes

“…UAMS used a community-based participatory approach to work with the Marshallese community in Arkansas to identify and address community health concerns. (6,24,(27)(28)(29) Marshallese community members identified faith-based organizations (FBOs) as important to their culture and recommended that we work closely with FBOs. Stakeholders stated that virtually all Marshallese attend at least one FBO on a regular basis.…”