Community-Based Participatory Research: A Capacity-Building Approach for Policy Advocacy Aimed at Eliminating Health Disparities

摘要

There have been increasing calls for community–academic partnerships to enhance the capacity of partners to engage in policy advocacy aimed at eliminating health disparities. Community-based participatory research (CBPR) is a partnership approach that can facilitate capacity building and policy change through equitable engagement of diverse partners. Toward this end, the Detroit Community–Academic Urban Research Center, a long-standing CBPR partnership, has conducted a policy training project. We describe CBPR and its relevance to health disparities; the interface between CBPR, policy advocacy, and health disparities; the rationale for capacity building to foster policy advocacy; and the process and outcomes of our policy advocacy training. We discuss lessons learned and implications for CBPR and policy advocacy to eliminate health disparities. Stressors in the social and physical environment are associated with poor health outcomes and contribute to the gaps in health status between rich and poor and between Whites and non-Whites. 1 – 7 There is growing recognition that community-based participatory research (CBPR) is a viable approach for addressing these health disparities, 8 – 11 and that such community–academic–practice partnerships can engage the participation of community members in public health advocacy to effect structural change in communities aimed at eliminating health disparities. 12 – 16 To have a broader and more sustained effect on health, models for influencing policy need to enhance the capacity of community residents and organizations to engage in the policy change process. 11 , 17 , 18 By equitably engaging diverse partners in all aspects of the policy process, CBPR can be particularly effective at facilitating capacity building for policy change among community residents. 9 , 13 , 14 However, there are limited examples in the literature of CBPR efforts involving capacity-building strategies aimed at enhancing the knowledge and skills of community members to successfully engage in the policy process. The Detroit Community–Academic Urban Research Center (URC), a long-standing CBPR partnership, 19 – 21 has conducted the Neighborhoods Working in Partnership (NWP) project aimed at strengthening policy advocacy skills within local neighborhoods, extending community voices in policymaking, and affecting policies aimed at creating healthy neighborhoods. We describe CBPR and its relevance to addressing health disparities, discuss the interface between CBPR and policy advocacy, provide a rationale for why capacity building for policy advocacy is needed at the community level, describe the process and outcomes of the NWP, and discuss lessons learned and implications for CBPR and policy advocacy aimed at eliminating health disparities.