International participatory research framework: triangulating procedures to build health research capacity in Brazil

Abstract

SUMMARYThis study advances Community-based Participatory Research (CBPR) by presenting a set of triangulated procedures (steps and actions) that can facilitate participatory research in myriad international settings. By using procedural triangulation-the combination of specific steps and actions as the basis for the International Participatory Research Framework (IPRF)-our approach can improve the abilities of researchers and practitioners worldwide to systematize the development of research partnerships. The IPRF comprises four recursive steps: (i) contextualizing the host country; (ii) identifying collaborators in the host country; (iii) seeking advice and endorsement from gatekeepers and (iv) matching partners' expertise, needs and interests. IPRF includes the following sets of recursive participatory actions: (A 1 ) becoming familiar with local languages and culture; (A 2 ) sharing power, ideas, influence and resources; (A 3 ) gathering oral and written information about partners; (A 4 ) establishing realistic expectations and (A 5 ) resolving personal and professional differences. We show how these steps and actions were used recursively to build a partnership to study the roles of community health workers (CHWs) in Brazil's Family Health Program (PSF). The research conducted using IPRF focused on HIV prevention, and it included nearly 200 CHWs. By using the IPRF, our partnership achieved several participatory outcomes: communitydefined research aims, capacity for future research and creation of new policies and programs. We engaged CHWs who requested that we study their training needs, and we engaged CHWs' supervisors who used the data collected to modify CHW training. Data collected from CHWs will form the basis for a grant to test CHW training curricula. Researchers and community partners can now use the IPRF to build partnerships in different international contexts. By triangulating steps and actions, the IPRF advances knowledge about the use of CBPR methods/procedures for international health research.

Acceptability and feasibility of a community based participatory research project comparing cytology and urine HPV DNA testing for cervical cancer screening in Yap, Federated States of Micronesia

“…Wallerstein et al’s CBPR conceptual model suggests that if structural and relational partnership processes are effective within their dynamic contexts, then these partnership decisions will have an impact on and change intervention design, and the research [16]. Furthermore prior successful international collaboration steps including those operationalized in this current research project aligned with Pinto et al’s IPRF [14]. …”

“…Pinto et al’s IPRF comprises four recursive steps: (i) contextualizing the host country; (ii) identifying collaborators in the host country; (iii) seeking advice and endorsement from gatekeepers, and (iv) matching partners’ expertise, needs and interests [14]. Using this CBPR framework, these steps were operationalized in the current HPV CBPR trial.…”

“…This collaboration has the potential to be transformative for all those involved wherein partners (e.g. researchers, community residents and service providers) participate in multiple aspects of research, from determining goals to developing methods and procedures to disseminating results [14]. …”

“…The IPRF presents steps and actions to improve the abilities of researchers and practitioners worldwide to systematize the development of research partnerships and which can facilitate participatory research in myriad international settings. The CBPR literature lacks specificity regarding how to initiate, employ and sustain participation when working with partners internationally in developing countries [14]. The IPRF serves as a relevant CBPR project framework because the IPRF describes the international participatory processes that the collaborative team demonstrated, contextualized to the host country, Yap State, FSM.…”

Systematizing Planning and Formative Phases of HIV Prevention Research: Case Studies from Brazil, Mongolia, and Kazakhstan

“…Researchers worldwide have begun to develop frameworks to facilitate such work (Bellamy, Bledsoe, Mullen, Fang, & Manuel, 2008; Griffin Jr. & Floyd, 2006; Lasker, Weiss, & Miller, 2001). For example, a framework for participatory international research showing how procedural triangulation may achieve the following outcomes: (1) community-defined research goals; (2) capacity for further research; and (3) policies and programs was published (Pinto, da Silva, Penido, & Spector, 2012). This unifying interpretation views community as its central concept; research as being long-term and involving community members focused on local issues and ecological determinants of health/social outcomes; and methods as being iterative (Wright et al, 2010).…”