Community-based Participatory Research: Assessing the Evidence
Viswanathan M, Ammerman A, Eng E, Gartlehner G, Lohr KN, Griffith D, Rhodes S, Samuel-Hodge C, Maty S, Lux, L, Webb L, Sutton SF, Swinson T, Jackman A, Whitener L. Community-Based Participatory Research: Assessing the Evidence. Evidence Report/Technology Assessment No. 99 (Prepared by RTI–University of North Carolina Evidence-based Practice Center under Contract No. 290-02-0016). AHRQ Publication 04-E022-2. Rockville, MD: Agency for Healthcare Research and Quality. July 2004.
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Abstract
Context
Community-based participatory research (CBPR) is a collaborative approach to research that combines methods of inquiry with community capacity-building strategies to bridge the gap between knowledge produced through research and what is practiced in communities to improve health. Interest is growing rapidly for academic institutions, health agencies, and communities to form research partnerships; few agreed-upon guidelines describe how to develop or evaluate CBPR proposals or what resources are required to promote successful collaborative research efforts.
Objectives
This systematic review consolidates literature on health-related CBPR. We addressed the following key questions:
Key Question 1: What defines CBPR?
Key Question 2: How has CBPR been implemented to date with regard to the quality of research methodology and community involvement?
Key Question 3: What is the evidence that CBPR efforts have resulted in the intended outcomes?
Key Question 4: What criteria and processes should be used for review of CBPR in grant proposals?
Data Sources
For KQs 1-4, we searched standard electronic databases (MEDLINE®, Cochrane Collaboration resources, Psycinfo, and Sociofile) for all years using specified Medical Subject Headings terms. We identified a forthcoming special journal issue and hand-searched reference lists of relevant articles. For KQ 4, we also reviewed websites for funding agencies and talked with federal agency staff.
Study Selection
For KQ 1, we used peer-reviewed articles that synthesized the evolution of, values for, or lessons learned from collaborative research. For KQ 2 and 3, we included peer-reviewed CBPR studies published in the English language, conducted in the United States and Canada, and with at least one community collaborator.
Data Extraction
To review articles for KQ 1 through 3, we created separate abstraction forms. We entered abstracted data for KQ 1 into a domain matrix and for KQ 2 and 3 into evidence tables. We created quality rating forms to assess each study’s research methods and adherence to CBPR principles of community collaboration.
Data Synthesis
We reviewed a total of 185 articles: 55 for KQ1; 123 for KQs 2 and 3; and 7 for KQ 4. The 123 articles for KQs 2 and 3 pertain to 60 CBPR studies. Of the 30 intervention studies, 12 had been completed and evaluated. Quality ratings for these suggested stronger research scores for the experimental studies than for the others, although nonexperimental studies also showed modest effects on health outcomes. Quality ratings for community participation were strongest for recruitment/retention and intervention design followed by development and pilot testing of measures. Steering committees or advisory boards were the main mechanisms for sharing research decisionmaking, but these formal structures generally did not develop research questions or proposals.
The number of high-quality CBPR publications has increased recently, which may reflect more targeted funding and special journal issues on this theme. Guidelines are still needed to assist funding agencies and grant applicants and reviewers in achieving the best balance of rigorous research and optimal collaboration among communities and institutions.
Conclusions
Many CBPR studies had strong community-institution collaborations; relatively few combined this type of collaboration with solid research methods. Our synthesis of this literature enabled us to produce guidelines to improve the quality of and funding for CBPR.