Transferring a Community-Based Participatory Research Project to Promote Physical Activity Among Socially Disadvantaged Women—Experiences From 15 Years of BIG

Abstract

Introduction: Community-based participatory research (CBPR) is an effective approach to health promotion, especially in relation to socially disadvantaged groups. However, the long-term implementation of CPBR-based projects on a broad scale is often challenging, and research regarding the sustainable transfer of participatory research is lacking. This limits the scaling-up and public health impact of CBPR. Therefore, this study examines the mechanisms utilized to transfer and sustain the BIG project, a multifaceted CBPR project aimed at promoting physical activity among women in difficult life situations. Materials and Methods: Borrowing from the RE-AIM framework, we analyzed project documentation and conducted a reflection workshop to investigate methods of transferring BIG to new sites as well as strategies from researchers to support project implementation and the maintenance of program activities at those sites. Moreover, we analyzed the reasons for discontinuing program activities at some former BIG sites and the costs involved in transferring BIG. Results: Since its establishment in 2005, BIG was transferred to and implemented at 17 sites. As of the winter of 2019, the program activities were maintained at eight sites. The average duration of sites that continue to offer program activities was more than 9 years. Discontinued sites maintained project activities for an average of 4 years. According to the study findings, the extent of scientific support, the provision of seed funding, and the local project coordinator, the person managing the project at the site, all have a significant impact on the sustainability of the transfer. A patchwork of funding agencies was needed to finance scientific support and seed funding in BIG. The transfer of BIG projects accrued annual costs of approximately EUR20,000 per site; however, long-term project implementation resulted in a decline in the annual transfer costs of BIG. Discussion and Conclusion: The sustainable transfer of CBPR is challenging but possible, and increased support of research and seed funding can facilitate long-term transfer. Nevertheless, other factors in the implementation setting are beyond scientific

Scaling Up a Community-Based Exercise Program for Women in Difficult Life Situations in Germany—The BIG Project as a Case-Study

“…The BIG project was developed in 2005 by researchers of the Friedrich-Alexander-University Erlangen-Nuremberg (FAU) and has, since then, been transferred to 17 communities [ 28 , 31 ]. In total, more than 800 women regularly take part in around 60 different BIG exercise offers [ 28 ]. The average project duration across all communities is approximately six years [ 28 ].…”

“…BIG aims at engaging the addressed women, and city administrations, to develop, implement, and scale-up low-barrier exercise offers in the community setting (low-barrier means that, e.g., there are minimal or no participation fees, no membership is required, childcare is offered, all instructors are female, and the offers take place close to where participating women live) [ 27 ]. Due to the long project duration and the implementation at several locations [ 28 ], the BIG project is particularly suitable as a case study for investigating the scale-up of CBPR. Applying the five different scaling up dimensions described by Kohl and Cooley [ 29 ], this article investigates the scaling up of the BIG project at four communities to answer the following research question: how and under which conditions do CBPR projects to promote exercise among socially disadvantaged groups scale-up on the local level?…”

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

“…Additionally, cooperative planning results in a support network of stakeholders to ensure long-term implementation and sustainability at the community level. This includes assigning a person in the city administration the role of coordinating project activities and serving as a point of contact for all partners and interested persons (20).…”

“…Since 2005, the BIG project, which originated in Erlangen (Germany), has been transferred to 16 additional sites in Germany. In the first years, the German federal ministry of education and research funded the BIG project; later on, a variety of different funders financed BIG and provided seed funding for new BIG sites (20). To date, BIG has been successfully sustained in seven communities, and in total around 800 women take part in BIG program offers.…”

“…Nine other communities were able to implement BIG (for an average of about 4 years), but the project could not be sustained. One additional community is currently preparing to implement BIG (20).…”