1. Community-Based Participatory Research Planning and Design Noel Chrisman, PhD, MPH NURS 557/HSERV 576, Jan. 28, 2006

2. Community Partnership Research Community Assessment Involve Community, Set Priorities Implement Program Evaluation, Feedback Loop Sustain Culture, Involvement, Capacity Building, Shared Power Noel Chrisman, University of Washington, 1996

3. HSERV 576/NURS 557, Chrisman, Jan 28, 06

4. Educational and Organizational n Predisposing-antecedents to behavior that provide the rationale or motivation for the behavior (low income, decreased access) n Enabling-antecedents to behavior that enable a motivation to be realized (health resource availability, accessibility, commitment to health) n Reinforcing-factors subsequent to a behavior that provide the continuing reward or incentive for the behavior and contribute to its persistence/repetition (better health, feel better, lower obesity) HSERV 576/NURS 557, Chrisman, Jan 28, 06

6. Designs Gold l Gold standard is the Randomized Controlled Trial (RCT). l Randomly selected intervention and control groups. l Tightly designed, rigorously applied, theoretically justified intervention. l Quantitative data gathering and analysis evaluation design. HSERV 576/NURS 557, Chrisman, Jan 28, 06

7. Designs l Other quasi-experimental designs approach the rigor of the RCT. l Naturally occurring samples, but still a control group. l Range of interventions, only some of which have a theoretical rationale. l Quantitative evaluation. HSERV 576/NURS 557, Chrisman, Jan 28, 06

8. Designs l Community-Based Participatory Research l Naturally occurring samples; may include a control group. l Range of interventions, only some of which have a theoretical rationale. l Quantitative and qualitative evaluation. l Most important: power sharing, etc. HSERV 576/NURS 557, Chrisman, Jan 28, 06

9. Designs Examples of Interventions Local Health Advisors; peer educators. Small groups: education, support. Grocery store, barbershop, church. Clinics, clinicians. Media: radio, TV, video, web. Community/system change. Policy, legislation. HSERV 576/NURS 557, Chrisman, Jan 28, 06

11. REACH 2010 Coalition Agencies Public Health Managed Care University/HMCClinics Diverse Partnership at the Table: Average attendance is 25. HSERV 576/NURS 557, Chrisman, Jan 28, 06

12. REACH 2010 Coalition Registry/Case Management African American Asian/Pacific Islander Latino HSERV 576/NURS 557, Chrisman, Jan 28, 06

13. REACH Community Summits (Samoan, Filipino, Latino, Chinese, Korean, African American) l Community and Family Awareness and Knowledge of Diabetes. l Need to Reveal Oneself as Different and Still be Accepted. l Need for an Acceptable Form of Revealing Issues. l General Need for Information about Diabetes. l Giving and Receiving Information in the Medical Environment. HSERV 576/NURS 557, Chrisman, Jan 28, 06

14. REACH Community Summits (Samoan, Filipino, Latino, Chinese, Korean, African American) l Need for Clear and Consistent Messages about Self-Management. l Need for Family Support. l Need for Group Support. l Summit Event as Example of Community Awareness-Raising. l Need for Financial Assistance. l Other. HSERV 576/NURS 557, Chrisman, Jan 28, 06

15. Joint Planning as Power Sharing n University/HMC: literature search for evidence, Coalition evaluation. n Community Clinics: agree to register participants in the electronic data base. n Multiethnic Agencies: conduct community summits. n Quality Assurance: statewide data base on Medicare. n Public Health: epidemiological data, coordination, grant writing, fiscal agent. HSERV 576/NURS 557, Chrisman, Jan 28, 06

16. REACH 2010 Coalition Registry/Case Management African American Asian/Pacific Islander Latino Clinic/Health Provider Change DEMS Registry Case Management Provider Training Patient Education Individual Behavior Change Support Groups Peer Educators Education Classes Self Management Training Classes Community Systems Change Make community environment more favorable to diabetics Community Capacity Building REACH Coalition Organizational Networking Provider/Patient Training Environment & Systems Change Interventions HSERV 576/NURS 557, Chrisman, Jan 28, 06

18. Logic Model: South Park Partnership Short-term OutcomesActivitiesInputsLong-term Outcomes Reduction in Obesity Competent Community Increase in concern about fruit, juice & vegetable consumption Increase in concern about obesity Increase in fruits and vegetables use in the home Stronger, more integrated coalition Heightened ability of coalition members to apply for and win grants. Women’s groups evolve toward natural helpers Primary care intervention at Sea Mar 5 a day intervention at Concord 5 a day intervention at the Community Center Women’s support groups: diet and nutrition. Natural helper training if desired. Regular coalition meetings, joint grant proposals and other activities. Community assessment Resources  Funding  History of trust  Competent community organizations Collaboration  FHCRC  UW Nursing, Dentistry, and Public Health  Seattle Partners Planning  Evaluation  Evidence based interventions  Health Department data  Assessment HSERV 576/NURS 557, Chrisman, Jan 28, 06

19. South Park Community Partnership SPARC: Garden Coalition Sea Mar: Primary Care Clinic SW Youth and Family: Women’s Groups Concord Elementary: Curriculum & Family Nights Community Center: Youth and Family Activities SAMPLE OF SOUTH PARK FAMILIES PARTICIPANTS IN AGENCY PROGRAM WHO BECOME PART OF SOUTH PARK SAMPLE HSERV 576/NURS 557, Chrisman, Jan 28, 06