The Long-Term Public Health Impact of a Community-Based Participatory Research Project for Health Promotion Among Socially Disadvantaged Women—A Case Study Protocol

Abstract

Introduction: Community-based participatory research (CBPR) is considered to be of high potential for health promotion among socially disadvantaged groups. However, the long-term implementation and transfer of these approaches remain challenging, and the public health impact they achieve is difficult to study. This also pertains to the potential health effects and cost-effectiveness of CBPR. This study protocol describes the follow-up case study (NU-BIG) after 15 years of the BIG project (“movement as investment in health”), a project to promote physical activity among socially disadvantaged women. Through a participatory approach, BIG empowers the addressed women to plan and implement low-threshold physical activity offers. Since the project started in 2005, it was transferred to 17 communities in Germany.Materials and Analysis: NU-BIG intends to examine the long-term effects, including economic aspects, of the BIG project on individual and structural levels at all project sites, as well as its long-term implementation and transfer. NU-BIG is a cross-sectional and longitudinal study using a mixed method approach. For the longitudinal section, we re-analyze existing data from former BIG evaluations. For cross-sectional data collection, we use questionnaires and conduct qualitative interviews and focus groups. Women who take part in BIG program offers are part of the research team and will use the photo-voice approach to report on the effects of BIG. The study population consists of about 800 women who participate in BIG project offers and 50 persons involved in the implementation of the BIG project at local sites.Discussion: The expected results from NU-BIG are highly relevant for studying the long-term public health impact of CBPR. In particular, this project intends to answer questions on how the transfer of such projects can succeed and which factors determine if a CBPR project can be sustained at the community level. Eventually, these results can contribute to the further development of participatory approaches to provide effective health promotion among socially disadvantaged groups.Conclusion: Although CBPR is seen of having the potential to reduce health disparities, there is still a lack of research on its long-term effects and public health impact. NU-BIG aims at generating knowledge about the economic effects, reach, efficacy, adoption, implementation, and maintenance of a CBPR project. The expected results could be of high interest for BIG and other CBPR-projects.

“For me, it's just a piece of freedom”—Increased empowerment through physical activity promotion among socially disadvantaged women

“…The present study was conducted as part of a federally funded follow-up for the BIG project, termed NU-BIG, with the goal of assessing the long-term effects of BIG projects across all sites. The detailed study design of the NU-BIG is described elsewhere ( 24 ).…”

“…In this study, we examined the effects of the BIG ( Bewegung als Investition in Gesundheit , i.e., movement as an investment in health) project, a long-standing German community-based participatory research (CBPR) project ( 24 ). Using a participatory approach, BIG aims to empower women in difficult life situations to increase control over the determinants of their health and reduce social inequalities ( 25 ).…”

Preferences of women in difficult life situations for a physical activity programme: protocol of a discrete choice experiment in the German NU-BIG project

“…The present DCE is part of a general effort to evaluate the impact of the BIG programme, called the NU-BIG study (‘Nachuntersuchung des BIG-Projekts’), funded by the German Federal Ministry of Education and Research. The evaluation will follow the RE-AIM framework and was described in detail in the study protocol for the NU-BIG project 32. The evaluation focuses on investigating the long-term effects of BIG on health behaviour, inclusion and social participation, as well as factors facilitating long-term implementation and transfer.…”

“…The BIG project is carried out using a ‘cooperative planning approach’,19 where women from the target group are involved in the planning and implementation of physical activity courses. Furthermore, in the NU-BIG project, as a comprehensive evaluation of BIG, the point of view of women from the target group was always taken into account by regularly involving the group of ‘BIG experts’ in every step of the project for targeted feedback 21 32…”

Scaling Up Physical Activity Promotion Projects on the Community Level for Women in Difficult Life Situations and Older People: BIG-5 and GET-10—A Study Protocol

“…These women include low-income earners, ethnic minority members, the unemployed, those unable to work, and single mothers. BIG has been implemented in 17 communities, and its effects, efficiency, and long-term implementation have been evaluated regularly among the different settings ( 22 ). The project created low-barrier PA programs by adopting a participatory research method.…”