Cover page

Table of Contents

COVER

TITLE PAGE

COPYRIGHT PAGE

FIGURES AND TABLES

FIGURES

TABLES

FOREWORD

DEDICATION

ACKNOWLEDGMENTS

THE EDITORS

THE CONTRIBUTORS

PART ONE: INTRODUCTION TO METHODS FOR COMMUNITY-BASED PARTICIPATORY RESEARCH FOR HEALTH

Chapter 1 INTRODUCTION TO METHODS FOR CBPR FOR HEALTH

BACKGROUND

PRINCIPLES OF CBPR

CBPR AND HEALTH INEQUITIES: CULTURAL, SOCIAL, ECONOMIC, AND ENVIRONMENTAL CONTEXT

PURPOSE AND GOALS OF THIS BOOK

ORGANIZATION OF THIS BOOK

SUMMARY

PART TWO: PARTNERSHIP FORMATION AND MAINTENANCE

Chapter 2 DEVELOPING AND MAINTAINING PARTNERSHIPS WITH COMMUNITIES

HOW DO WE START?

SUMMARY

KEY TERMS

DISCUSSION QUESTIONS

Chapter 3 STRATEGIES AND TECHNIQUES FOR EFFECTIVE GROUP PROCESS IN CBPR PARTNERSHIPS

ELEMENTS OF GROUP DYNAMICS RELEVANT TO CBPR PARTNERSHIPS

SUMMARY

DISCUSSION QUESTIONS

KEY TERMS

Chapter 4 INFRASTRUCTURE FOR EQUITABLE DECISION MAKING IN RESEARCH

BACKGROUND ON THE CBPR PARTNERSHIPS

INFRASTRUCTURE FOR CBPR PARTNERSHIP DEVELOPMENT

INFRASTRUCTURE FOR CONDUCTING RESEARCH

INFRASTRUCTURE FOR DISSEMINATION PHASE

LESSONS LEARNED AND IMPLICATIONS FOR PRACTICE

SUMMARY

DISCUSSION QUESTIONS

KEY TERMS

PART THREE: COMMUNITY ASSESSMENT AND DIAGNOSIS

Chapter 5 INSIDERS AND OUTSIDERS ASSESS WHO IS “THE COMMUNITY”

ORIGINS OF AOCD

CHALLENGES, LESSONS LEARNED, AND IMPLICATIONS FOR CONDUCTING AOCD

SUMMARY

KEY TERMS

DISCUSSION QUESTIONS

Chapter 6 USING ETHNOGRAPHY IN PARTICIPATORY COMMUNITY ASSESSMENT

COMMUNITY-BASED PARTICIPATORY RESEARCH AND COMMUNITY ASSESSMENT

ETHNOGRAPHIC METHODS IN PARTICIPATORY COMMUNITY ASSESSMENT

IMPLEMENTATION CHALLENGES

LESSONS LEARNED

IMPLICATIONS FOR PRACTICE

SUMMARY

KEY TERMS

DISCUSSION QUESTIONS

PART FOUR: DEFINE THE ISSUE, DESIGN AND CONDUCT THE RESEARCH

Chapter 7 COMMUNITY-BASED PARTICIPATION IN SURVEY DESIGN AND IMPLEMENTATION

BACKGROUND AND DESCRIPTION: HEALTHY ENVIRONMENTS PARTNERSHIP

ROLE OF PARTNERS AND COMMUNITY MEMBERS IN THE DEVELOPMENT, IMPLEMENTATION, AND APPLICATION OF FINDINGS FROM THE HEP COMMUNITY SURVEYS

CHALLENGES, LESSONS LEARNED, AND IMPLICATIONS FOR PRACTICE FROM THE HEP COMMUNITY SURVEYS

SUMMARY

KEY TERMS

QUESTIONS FOR DISCUSSION

Chapter 8 USING A CBPR APPROACH TO DEVELOP AN INTERVIEWER TRAINING MANUAL WITH MEMBERS OF THE APSÁALOOKE NATION

COMMUNITY SETTING

CBPR PARTNERSHIP BACKGROUND

DEVELOPMENT OF SURVEY RESEARCH PROCESSES

CHALLENGES

LESSONS LEARNED AND IMPLICATIONS

SUMMARY

KEY TERMS

DISCUSSION QUESTIONS

Chapter 9 THE APPLICATION OF FOCUS GROUP METHODOLOGIES TO CBPR

CBPR AND THE PROJECT BACKGROUND

RESEARCH DESIGN AND FOCUS GROUP METHODS

DATA ANALYSIS

DATA FEEDBACK, USE OF DATA AND PRODUCTS, AND RESULTING CBPR INTERVENTIONS

CHALLENGES AND LIMITATIONS

LESSONS LEARNED AND IMPLICATIONS FOR PRACTICE

SUMMARY

KEY TERMS

DISCUSSION QUESTIONS

Chapter 10 DEVELOPMENT, EVOLUTION, AND IMPLEMENTATION OF A FOOD ENVIRONMENT AUDIT FOR DIVERSE NEIGHBORHOODS

WHAT IS A FOOD AUDIT?

OVERVIEW OF THE HEALTHY ENVIRONMENTS PARTNERSHIP (HEP)

DEVELOPMENT OF FOOD STORE AUDIT

IMPLEMENTATION OF FOOD STORE AUDIT

CHALLENGES AND LIMITATIONS

LESSONS LEARNED AND IMPLICATIONS FOR PRACTICE

SUMMARY

KEY TERMS

DISCUSSION QUESTIONS

Chapter 11 CBPR AND ETHNOGRAPHY

A GENERAL DESCRIPTION OF ETHNOGRAPHY

METHODS WITHIN METHODS

COMMUNITY ETHNOGRAPHERS

THE CBEPR PROCESS EXEMPLIFIED

CHALLENGES AND LIMITATIONS

LESSONS LEARNED

IMPLICATIONS FOR PRACTICE

SUMMARY

KEY TERMS

DISCUSSION QUESTIONS

Chapter 12 WHAT’S WITH THE WHEEZING?

ENVIRONMENTAL EXPOSURE ASSESSMENT METHODS AND ASTHMA

SEATTLE-KING COUNTY ASTHMA PROGRAM

HOME ENVIRONMENTAL ASSESSMENT IN THE HEALTHY HOMES PROJECTS

IMPROVING EXPOSURE ASSESSMENT WITH A CBPR APPROACH

CHALLENGES, LESSONS LEARNED, AND IMPLICATIONS FOR PRACTICE

SUMMARY

KEY TERMS

DISCUSSION QUESTIONS

PART FIVE: DOCUMENTATION AND EVALUATION OF PARTNERSHIPS

Chapter 13 DOCUMENTATION AND EVALUATION OF CBPR PARTNERSHIPS

CONCEPTUAL FRAMEWORK FOR ASSESSING CBPR PARTNERSHIPS

GENERAL DESCRIPTION OF DATA COLLECTION METHODS

APPLICATION OF METHODS TO DETROIT COMMUNITY-ACADEMIC URBAN RESEARCH CENTER

CHALLENGES AND LIMITATIONS

LESSONS LEARNED AND IMPLICATIONS FOR PRACTICE

SUMMARY

KEY TERMS

DISCUSSION QUESTIONS

PART SIX: FEEDBACK, INTERPRETATION, DISSEMINATION, AND APPLICATION OF RESULTS

Chapter 14 DEVELOPING AND IMPLEMENTING GUIDELINES FOR DISSEMINATION

OVERVIEW OF THE COMMUNITY ACTION AGAINST ASTHMA PARTNERSHIP

FORMATION AND FUNCTIONS OF THE CAAA DISSEMINATION COMMITTEE

IMPLEMENTATION OF THE GUIDELINES: EXAMPLES OF DISSEMINATION DECISIONS AND ACTIVITIES

CHALLENGES

LESSONS LEARNED AND IMPLICATIONS FOR PRACTICE

SUMMARY

KEY TERMS

DISCUSSION QUESTIONS

Chapter 15 COLLABORATIVE DATA COLLECTION, INTERPRETATION, AND ACTION PLANNING IN A RURAL AFRICAN AMERICAN COMMUNITY: MEN ON THE MOVE

OVERVIEW OF MEN ON THE MOVE

COMMUNITY-WIDE ASSESSMENT

ECONOMIC ASSESSMENT

SOFT SKILLS CLASS EVALUATION

PHOTO-ELICITATION GROUP INTERVIEWS

CHALLENGES

LESSONS LEARNED AND IMPLICATIONS FOR PRACTICE

SUMMARY

KEY TERMS

DISCUSSION QUESTIONS

Chapter 16 COLLABORATIVE MAPPING FOR HEALTH EQUITY

NEW TECHNOLOGY AND COMMUNITY MAPPING FOR HEALTH

MAPPING AND MOVEMENT BUILDING

MAPPING FOR ENVIRONMENTAL JUSTICE IN EAST OAKLAND

BUILDING LEADERSHIP THROUGH COMMUNITY MAPPING

CONTESTED IMAGES: COMMUNITY AND PROFESSIONAL MAPS

CHALLENGES AND RECOMMENDATIONS

COMMUNITY MAPPING IN CBPR: OPPORTUNITIES AND LESSONS LEARNED

SUMMARY

KEY TERMS

DISCUSSION QUESTIONS

Chapter 17 PHOTOVOICE AS A CBPR METHOD

THE ORIGIN, USE, AND THEORETICAL UNDERPINNINGS OF PHOTOVOICE

APPLICATION OF PHOTOVOICE: THE SURVIVING ANGELS—INSPIRATIONAL IMAGES PROJECT

CHALLENGES

LESSONS LEARNED—IMPLICATIONS FOR PRACTICE

SUMMARY

KEY TERMS

DISCUSSION QUESTIONS

Chapter 18 METHODS FOR COMMUNITY- BASED PARTICIPATORY POLICY WORK TO IMPROVE FOOD ENVIRONMENTS IN NEW YORK CITY

WHAT IS COMMUNITY-BASED PARTICIPATORY POLICY WORK?

FOOD-RELATED HEALTH CONDITIONS AND FOOD POLICY IN NEW YORK CITY

METHODS FOR DATA COLLECTION, ANALYSIS AND PRESENTATION

LIMITATIONS AND CHALLENGES

LESSONS LEARNED AND IMPLICATIONS FOR PRACTICE

SUMMARY

KEY TERMS

DISCUSSION QUESTIONS

Chapter 19 CITIZENS, SCIENCE, AND DATA JUDO

LOS ANGELES COLLABORATIVE FOR ENVIRONMENTAL HEALTH AND JUSTICE: BACKGROUND AND THE PARTNERS INVOLVED

DISSEMINATION OF RESEARCH RESULTS TO ENHANCE COMMUNITY PARTICIPATION IN ENVIRONMENTAL POLICYMAKING AND REGULATION

LEVERAGING RESEARCH TO PROMOTE POLICY CHANGE

LESSONS LEARNED AND LOOKING TOWARD THE FUTURE

SUMMARY

KEY TERMS

DISCUSSION QUESTIONS

APPENDIXES

Appendix A INSTRUCTIONS FOR CONDUCTING A FORCE FIELD ANALYSIS

PROCEDURE

Appendix B FULL VALUE CONTRACT

Appendix C COLLABORATIVE REVISED BYLAWS

ARTICLE I: NAME

ARTICLE II: MISSION, GOAL, AND STRATEGY

ARTICLE III: MEMBERSHIP

ARTICLE IV: MEETINGS OF MEMBERS

ARTICLE V: EXECUTIVE COMMITTEE

ARTICLE VI: COMMITTEES

ARTICLE VII: AMENDMENTS

ARTICLE VIII: GIFTS, BEQUESTS, AND GRANTS

Appendix D COMMUNITY MEMBER KEY INFORMANT INTERVIEW GUIDE

Appendix E SELECTED HEALTHY ENVIRONMENTS PARTNERSHIP MEASURES BY SURVEY CATEGORIES, INDICATING SOURCE OF IDENTIFICATION FOR INCLUSION AND SCALE ITEMS

Appendix F PROMOTING HEALTHY LIFESTYLES AMONG WOMEN

PROMOVIENDO ESTILOS DE VIDA SALUDABLES ENTRE MUJERES

Appendix G FIELD NOTES GUIDE

Appendix H IN-DEPTH, SEMI-STRUCTURED INTERVIEW PROTOCOL

INTERVIEW QUESTIONS ASKED IN 1996

ADDITIONAL INTERVIEW QUESTIONS ASKED IN 1999

ADDITIONAL INTERVIEW QUESTIONS ASKED IN 2002

Appendix I CLOSED-ENDED SURVEY QUESTIONNAIRE

Appendix J PHILOSOPHY AND GUIDING PRINCIPLES FOR DISSEMINATION OF FINDINGS OF COMMUNITY ACTION AGAINST ASTHMA INCLUDING AUTHORSHIP OF PUBLICATIONS AND PRESENTATIONS, POLICIES AND PROCEDURES, ACCESS TO DATA, AND RELATED MATTERS

Appendix K INSPIRATIONAL IMAGES PROJECT

WOULD YOU LIKE TO PARTICIPATE IN THIS RESEARCH PROJECT EXPLORING BREAST CANCER SURVIVORSHIP?

Appendix L INSPIRATIONAL IMAGES PROJECT

MAY I TAKE YOUR PICTURE?

Appendix M SOUTHERN CALIFORNIA ENVIRONMENTAL JUSTICE COLLABORATIVE

INDEX

Title page

FIGURES AND TABLES

FIGURES

Figure 1.1  Core Components/Phases in Conducting CBPR 
Figure 4.1  Ladder of Citizen Participation 
Figure 4.2  Continuum of Community Involvement, Impact, Trust, and Community Flow 
Figure 6.1  Model for Teen Hustling 
Figure 8.1  Cervix Cancer Incidence and Mortality Rates 
Figure 13.1  Conceptual Framework for Understanding and Assessing the Effectiveness of the CBPR Partnership Process 
Figure 15.1  Multi-Method Sequence for the Development of Men on the Move Phases I and II 
Figure 16.1  Hegenberger Corridor Area, East Oakland, California, and CBE-Mapped Sensitive Receptors, Hazards, and Diesel Truck Idling Locations 
Figure 16.2  Hegenberger Corridor, East Oakland, California, and Agency-Identified Hazards and Sensitive Receptors (Squares) & Community-Identified Hazards and Receptors (Circles) 
Figure 16.3  Example of Block-By-Block Watchperson Project Map of Facilities EPA Modeling Was Missing 
Figure 17.1  Photograph of Cans for Recycling Presented by Survivor During a Photo Discussion 
Figure 17.2  African American Breast Cancer Survivorship Quality-of-Life Framework Developed During Photovoice Study 
Figure 17.3  Voting to Prioritize Future Efforts During Interactive Forum with Influential Advocates 
Figure 19.1  Results from Pacoima Ground-Truthing Area 
Figure 19.2    DustTrak Fine Particulate (PM2.5) Monitoring Results 

TABLES

Table 10.1  Items from the Healthy Environments Partnership’s Food Environmental Audit for Diverse Neighborhoods (FEAD-N) 
Table 11.1  Community Ethnographers’ Predictions and Results from the Ethnosexual Survey for Household Division of Labor in Mexico and the United States 
Table 12.1  Healthy Homes I Exposure Assessment Measures 
Table 14.1  CAAA Projects and Dissemination Activities 
Table 15.1  Demographics for African Americans in Pemiscot County, All Residents in Pemiscot County and Missouri (U. S. Census Bureau, 2011) 
Table 15.2  Methods Used to Understand the Social and Environmental Factors That Influence Health in Pemiscot County and to Inform Action Planning 
Table 16.1  Key Considerations for Using Spatial Maps in CBPR 
Table 18.1    Research Methods for Community-Based Participatory Policy Work: Policy Formulation Phase 

FOREWORD

As director of the Centers for Disease Control and Prevention (CDC) in the mid-1990s, I had the opportunity to initiate the Urban Research Centers Program. At that time, we were able to fund three inaugural programs representing partnerships between communities and academic institutions. The original programs were in Detroit, Michigan, Seattle, Washington, and New York, New York. Although we were not able to expand the programs as we had hoped, we learned valuable lessons from them. Many of these lessons were included in the first comprehensive federal programs geared toward the reduction and ultimate elimination of disparities in health: the CDC’s Racial and Ethnic Approaches to Community Health (REACH). More than forty communities have been funded through REACH. These communities have been funded and empowered to contract with academic health centers to conduct community-based participatory research.

Community-based participatory research brings the best and latest technology for design and measurement together with the insights of community members regarding the major issues affecting community health. In communicating the goals, objectives, and strategies of Healthy People 2010, we settled on a design that showed the interaction among determinants of health. The major components included the individual and his or her behavior (downstream), the physical and social environment including health care (midstream), and the various policies that impact this interaction (upstream). We tried to show that the components do not exist in isolation; there is intense interaction among them.

From 2005 to 2008, I served as a member of the World Health Organization (WHO) Commission on Social Determinants of Health (CSDH). We examined the conditions in which people are born, grow, learn, work, and age and their impact on health outcomes. In the process, we visited several countries throughout the world and had one meeting in the United States. We recommended a major focus on these social determinants as a component of our commitment to achieve global health equity in a generation. The report was accepted by the WHO and the Director-General of the WHO launched the report in 2008 with strong support for this focus and goal. This focus has been affirmed and extended in Healthy People 2020, which incorporates a substantial emphasis on social determinants of health. It is increasingly clear that in order to reach the goals of improving quality as well as increasing years of healthy life and eliminating disparities in health among different racial, ethnic, and socioeconomic groups, we must target all of the determinants of health where disparities have their roots. We must close the gaps that exist in access to quality health care, practice of healthy lifestyles, quality of physical and social environments, and policies that impact these areas. For research aimed at understanding and closing these gaps, community-based participatory research is a viable approach.

As more and more programs in community-based participatory research are funded and initiated, it is important that the lessons learned and problems solved in this area over the last thirty or more years are captured and shared. This book, Methods for Community-Based Participatory Research for Health, provides a major contribution to this field. The editors are some of our most outstanding leaders in community-based participatory research. This second edition of the book incorporates experiences engaging the social determinants of health, including the very important “food environments” relative to overweight, obesity, diabetes, and cardiovascular disease. These chapters add tremendously to the value of this book, as well as its currency. The writing of this book represents an unusual partnership among diverse participants whose involvements with communities make them experts in their own right. They bring a broad range of perspectives to this research approach, grounded in extensive community involvement and experience. What brings them together in this book is their respect for the dignity of community and the tremendous challenges and opportunities found in communities for enhancing health. Because they have found each other, and have come together around this common theme from their diverse backgrounds of race, ethnicity, and perspective, we are the beneficiaries of this outstanding text.

Critical to each case example of community-based participatory research discussed in this book is the development of meaningful partnerships. These partnerships must exist in order that when the question “Who is the community?” is asked, the answer can reliably be, “We are the community,” we who have engaged in meaningful partnerships, made the investments, developed the relationships, suffered the pains, and reaped the benefits of the community. These partnerships are entrenched in the community, they are as diverse as the community, and they are devoted to meaningful change and progress in the community. They share knowledge, resources, and control at every level of the community. They are trusted, not because of what they say, but because of who and where they are, and with whom they share information, methodology, and control of the research agenda. They are interested in bringing the best technology and methodology to bear on problems and opportunities within the community. Community-based participatory research deals with all the determinants of health and the dynamic nature of the interactions within the community. This research approach holds the promise of getting to the root cause of health disparities and of strategies for enhancing health as well as the involvement of persons at every level of community. In her book Night Falls Fast, which deals with teenage suicide, Kay Redfield Jamison says, “The gap between what we know and what we do is lethal.” Community-based participatory research holds the promise of removing these tremendous gaps and adding significantly to what we know.

To move our field forward in accomplishing these aims, this volume provides an excellent compendium of chapters on the methods and processes of community-based participatory research.

David Satcher, MD, PhD
Director, Satcher Health Leadership Institute
at the Morehouse School of Medicine
16th U.S. Surgeon General

To Guy W. Steuart

Whose life’s work on the wisdom of communities and the power of partnerships is our touchstone. Thank you, Guy.

To Archie Israel and Adelaide Love Israel

Your passion for creating a sense of community lives on through the spirit and work of all the persons and organizations you touched. You are missed.

To Wah Poy Eng

Who served as the bridge between cultures that spanned an ocean and five generations. He modeled understanding and compassion, which will not be forgotten.

ACKNOWLEDGMENTS

This book would not have been possible without the insightful contributions from the numerous authors, who so graciously shared their time and experiences in writing these chapters. It was important to us that each chapter reflected the principles of community-based participatory research, involving community partners as well as academics and professionals as coauthors. We extend to each writing team, therefore, our deepest appreciation for the privilege of witnessing, and temporarily joining, their collaboration throughout the writing process.

And to those with whom we have collaborated through our CBPR partnerships over the years, we are tremendously indebted. We consider ourselves most fortunate to have worked with, learned from, and been inspired by many partners. To our community and health practitioner partners and staff, we are especially grateful for your wisdom and tireless efforts to effect meaningful change with your communities, and in us. We have also been most fortunate to count among our academic partners fellow faculty members, students, and postdoctoral fellows whose hard work and enthusiastic engagement continue to renew our energy and perspectives on the value of CBPR. Specifically, although too numerous to mention by name, we would like to acknowledge and thank the following community and academic partners, who have been involved with us through the following CBPR partnerships: Bi-Cultural Bi-Lingual Medicaid Managed Care Project, Broome Team in Flint, Carolina-Shaw Partnership to Eliminate Health Disparities, Chatham Communities in Action, Chatham Social Health Council, Community Action Against Asthma, Detroit Community-Academic Urban Research Center, Detroit-Genesee County Community-Based Public Health Consortium, East Side Village Health Worker Partnership, Greensboro Health Disparities Collaborative, Health Literacy Partnership, Healthy Environments Partnership, Men As Navigators for Health, Neighborhoods Working in Partnership, North Carolina Community-Based Public Health Initiative, Partners for Improved Nutrition and Health, Project GRACE, Promoting Healthy Eating in Detroit, REACH Detroit Partnership, Save Our Sisters, Strengthening The Black Family, Inc., Stress and Wellness Project, The Partnership Project of Greensboro, and United Voices of Efland-Cheeks, Inc.

We are also indebted to friends and colleagues who were not involved with these partnerships but who have had important impacts on our thinking and commitment to CBPR. Current and former colleagues and mentors at the University of Michigan include Cleo Caldwell, Barry Checkoway, Mark Chesler, Noreen Clark, Jim Crowfoot, Libby Douvan, Lorraine Gutierrez, Cathy Heaney, Hy and Joyce Kornbluh. Similarly, at the University of North Carolina at Chapel Hill, we are indebted to Alice Ammerman, Marci Campbell, Tim Carey, Leonard Dawson, Paul Godley, John Hatch, Michel Ibrahim, Ethel Jean Jackson, Laura Linnan, Betsy Randall-David, Allan Steckler, Guy Steuart, Jim Thomas, Rosalind Thomas, and Steve Wing.

We also thank the many other academic and practitioner colleagues who have influenced and supported our CBPR endeavors, including Clive Aspin, Heather Danton, Nancy Epstein, Jean Forester, Mark Freedman, Jack Geiger, Myles Horton, Ron Labonté, Mubiana Macwangi, Kathleen Parker, Baba Phillip-Ouattara, Ted Parrish, Jesus Ramirez-Valles, Sarena Seifer, Jackie Smith, Meera Viswanathan, and Tony Whitehead. For Barbara, a special debt is owed to her colleagues in New Zealand at the Department of Public Health and the Eru Px14D_rnmare Center, University of Otago, Wellington, for hosting and supporting her during the two sabbatical years in which much of the work on both editions of the book occurred, including Peter Crampton, Richard Edwards, Philippa Howden-Chapman, Anna Matheson, Bridget Robson, Clare Salmond, Louise Signal, and Alistair Woodward.

We have been most fortunate and appreciative of the funding we have received from a number of federal and foundation sources, which has enabled us to engage in CBPR endeavors. We are especially indebted to the following institutions and individuals, who are presently or were formerly involved in these institutions, for the leadership they have provided in supporting CBPR for us and countless others. These include: the W.K. Kellogg Foundation and Tom Bruce, Barbara Sabol, Steven Uranga-McKane, and Terri Wright; the National Institute of Environmental Health Sciences and Linda Birnbaum, Gwen Coleman, Allen Dearry, Liam O’Fallon, Kim Gray, Ken Olden, Shobha Srinivasan, and Fred Tyson; the Centers for Disease Control and Prevention and Lynda Anderson, Larry Green, Donna Higgins, Shawna Mercer, and David Satcher; the National Institute on Minority Health and Health Disparities and John Ruffin, Khu Rhee, Francisco Sy; the National Cancer Institute and Jon Kerner; and the Agency for Healthcare Research and Quality and Kaytura Felix-Allen.

An edited book such as this involves considerable organizational skills and attention to details. We owe a tremendous thanks to Sue Andersen, whose continuous assistance and ability to anticipate what needed to be done was invaluable for the completion of this volume. A special thanks is also due to Linnea Evans who played a critical role in several aspects of pulling this volume together, including the development of the downloadable supplements that accompany this second edition of the book.

We have been most fortunate to have worked with Andy Pasternak, senior editor at Jossey-Bass. His knowledge of the publishing process, flexibility and sense of humor were instrumental in guiding our efforts. We thank Seth Schwartz, associate editor at Jossey-Bass, for his attention to details and thorough and good-natured help with our questions, and production editor Kelsey McGee and copy editor Donna J. Weinson, for their assistance.

We recognize the importance of social justice as both a core value and guiding principle for this book, and hence, are grateful to have parents and grandparents who instilled this commitment in us and encouraged our work. We would like to specifically acknowledge our parents, Archie and Adelaide Israel, Wah and Alice Eng, Robert and Gail Stegmier, and Jim and Hallie Parker.

To our partners and children, Richard Pipan, Ilana Israel, Daniel Goetz, Mira Eng-Goetz, Gabriel Eng-Goetz, David Schulz, and David Cohen, whose support and love are always given so unconditionally, we could not have completed this book without you.

THE EDITORS

Barbara A. Israel, DrPH, MPH, is a professor of Health Behavior and Health Education at the School of Public Health, University of Michigan, where she joined the faculty in 1982. She received her Masters of Public Health and Doctorate of Public Health degrees from the University of North Carolina at Chapel Hill. She was deputy editor of Health Education & Behavior from 1989 to 2003. Dr. Israel has authored or coauthored more than one hundred and twenty-five journal articles and book chapters on community-based participatory research, social support and stress, social determinants of health and health inequities, and evaluation. She has over thirty years of experience conducting CBPR in collaboration with partners in diverse ethnic communities, and is presently involved in several CBPR partnerships in Detroit addressing: environmental triggers of childhood asthma; social and physical environmental factors and cardiovascular disease; approaches to policy advocacy, and education and health. She is the principal investigator of the Detroit Community-Academic Urban Research Center, funded initially through the Centers for Disease Control and Prevention, and presently funded through the National Institute on Minority Health and Health Disparities, and the University of Michigan; and principal investigator for Neighborhoods Taking Action, with funding from the Robert Wood Johnson Foundation, The Skillman Foundation, and the W. K. Kellogg Foundation.

Eugenia Eng, DrPH, MPH, is a professor of health behavior at the Gillings School of Global Public Health, University of North Carolina at Chapel Hill, where she joined the faculty in 1984. She received her Masters of Public Health and Doctorate of Public Health degrees from the University of North Carolina at Chapel Hill. She directed the MPH degree program from 1987 to 2006 and has directed the Kellogg Health Scholars Postdoctoral Program since 1998. Dr. Eng has authored or coauthored over one hundred fifteen journal articles, book chapters, and monographs on the lay health advisor intervention model, the concepts of community competence and natural helping, and the community assessment procedure, “Action-Oriented Community Diagnosis.” She has over thirty years of CBPR experience including field studies conducted with rural communities of the U.S. South, Sub-Saharan Africa and Southeast Asia to address socially stigmatizing health problems such as pesticide poisoning, cancer, and STI/HIV. Dr. Eng’s CBPR projects include the CDC-funded Men As Navigators for Health, the NCI-funded Cancer Care and Racial Equity Study, the NHLBI-funded CVD and the Black Church: Are We Our Brother’s Keeper?, and the NCI-funded CBPR Training Core for the Carolina Community Network Center to Reduce Cancer Health Disparities.

Edith A. Parker, DrPH, MPH, is professor and chair of the Department of Community and Behavioral Health at the University of Iowa College of Public Health. Before joining the University of Iowa in 2010, she was on the faculty at the University of Michigan, School of Public Health for fifteen years. She received her Masters of Public Health and Doctorate of Public Health degrees from the University of North Carolina at Chapel Hill. Dr. Parker has authored or coauthored more than sixty journal articles and book chapters on community-based participatory research, community capacity, childhood asthma and related areas. Dr. Parker has over twenty years of research experience focusing on the development, implementation, and evaluation of community-based participatory interventions to improve health status. Currently, she serves as the principal investigator (PI) of the Centers for Disease Control and Prevention–funded University of Iowa Prevention Research Center for Rural Health, and as director of the Community Engagement Key Function for the University of Iowa Clinical and Translational Science Award. Previously, she served as PI of the Community Action Against Asthma (CAAA) CBPR household intervention research component of the NIEHS/EPA-funded Michigan Center for the Environment and Children’s Health, the NIEHS-funded CAAA “Community Organizing Network for Environmental Health” and “Community Based Participatory Research (CBPR) Intervention for Childhood Using Air Filters and Air Conditioners” research projects.

Amy J. Schulz, PhD, MPH, is professor, Department of Health Behavior and Health Education, University of Michigan School of Public Health, where she joined the faculty in 1997, and associate director for the Center for Research on Ethnicity, Culture and Health. She received her PhD degree in sociology and MPH in health behavior and health education from the University of Michigan. Her research focuses on social determinants of health in urban communities, with a particular focus on the role of racism, socioeconomic position, and social and physical environments in shaping health and health inequities, and in the design, implementation, and evaluation of interventions to promote health and contribute to the elimination of health inequities. She has over twenty years experience in the field and has authored or coauthored more than seventy journal articles and book chapters on the development, implementation, and evaluation of community-based participatory research partnerships, social determinants of health, and related topics. She serves as principal investigator for the Healthy Environments Partnership, a CBPR partnership that has been active since 2000 with funding from the National Institute for Environmental Health Sciences and the National Institute on Minority Health and Health Disparities. She also serves as a board member for the Detroit Community-Academic Urban Research Center, and served as an active member of the Detroit Eastside Village Health Worker Partnership and Promoting Healthy Eating in Detroit, two other CBPR efforts in Detroit.

THE CONTRIBUTORS

Alex J. Allen III, MSA, is a non-profit consultant who specializes in organi­zational development, project management, grant writing, fundraising, and evaluation. Prior to consulting, Allen was a program officer with the Skillman Foundation, a private grant making organization with three chief aims: to help develop good schools, good neighborhoods, and support good opportunities that accomplish significant results for children. Allen was vice president of the Community Planning and Research division at Isles, Inc., a nonprofit organi­zation in Trenton, NJ, that is committed to fostering self-reliant families in healthy, sustainable communities. He has been involved in various aspects of community development work for the past 25 years. He has collaborated and addressed a broad range of community issues, including his work with the Detroit Community-Academic Urban Research Center and other organizations. He has expertise in CBPR and participatory neighborhood planning.

Carol Allen is a community health education consultant at Public Health Seattle-King County and is skilled in working with diverse populations of low to moderate income. Previously she worked as project coordinator for the Seattle King County Healthy Homes (SKCHH) Project, providing supervision and overall guidance to outreach workers, conducting asthma trainings, monitoring progress, and overseeing quality control of intervention activities, ensuring the proper application of established protocols. She served as a community board member of the Seattle Partners for Healthy Community (SPHC). She is a master home environmentalist (MHE) through the American Lung Association and a certified asthma trainer by the Asthma and Allergies Foundation of America.

Robert Aronson, DrPH, MPH, is an associate professor of the Department of Public Health Education at the University of North Carolina Greensboro. He is a founding member of the Greensboro Health Disparities Collaborative, and is currently serving as cochair. His research has focused on health disparities affecting African American and Latino communities and the development and evaluation of community-based programs. For the past ten years much of his work has been with African American male college students, using CBPR to understand the influence of masculinity ideology on sexuality, and developing culturally and contextually congruent approaches to HIV prevention in this population. He received his MPH in health behavior and health education at UNC-Chapel Hill and his DrPH in international health from Johns Hopkins Bloomberg School of Public Health.

Magdalena Avila, DrPH, is an assistant professor of Health Education, Health Exercise and Sports Science, College of Education at the University of New Mexico. She has been working and partnering with communities of color for over twenty-five years to address environmental health disparities and inequalities. She has been using activism scholarship to develop grassroots and culturally appropriate public health education interventions. For the past ten years she has been involved in two NIEHS-funded research grants in Albuquerque’s South Valley, both of which have incorporated CBPR into the research process with New Mexican Communities. Recently her involvement has included participatory research with New Mexican/Chicano/Immigrant communities to examine the role of CBPR in informing community residents to engage in the land use zoning and planning policy process, health impact assessments, and environmental health literacy.

Elizabeth A. Baker, PhD, MPH, is a professor and chair of the Department of Behavioral Science and Health Education at Saint Louis University School of Public Health. Her research areas include social networks and social support, control, and other social determinants of health (such as race and income) and the ways in which they influence community and individual capacity to create desired changes. She has extensive experience in CBPR in both urban and rural communities. She received her MPH and PhD degrees from the University of Michigan School of Public Health.

Ellen Barnidge, PhD, MPH, is an assistant professor at Saint Louis University School of Public Health and serves as an administrative manager and research coordinator for the Prevention Research Center in St. Louis. She has experience managing the research activities of community-based participatory research projects in urban and rural communities. She has trained community partners to engage in the design, implementation, and evaluation of interventions that address both chronic disease and social determinants of health. Her research interests include CBPR, social determinants of health, and qualitative methodology. She received her MPH and PhD degrees from Saint Louis University School of Public Health.

Stuart Batterman, PhD, MS, is a professor in the Department of Environmental Health Sciences at the University of Michigan, School of Public Health. He is the director of the University of Michigan Education and Research Center funded by the National Institute for Occupational Safety and Health. He is an environmental health scientist and engineer working mostly in human and ecological exposure research with application to risk and epidemiological studies in occupational, indoor, and environmental settings. In the past six years, he has worked with the Community Action Against Asthma, a CBPR partnership in Detroit, as an investigator on four research projects that address the health effects of both indoor and outdoor air pollutants.

Adam B. Becker, PhD, MPH, is executive director of the Consortium to Lower Obesity in Chicago Children (CLOCC), a nationally recognized broadbased network of over 1,300 organizations working to promote healthy eating and physical activity through individual, community, and policy change. He has used CBPR approaches to examine and address the impact of stressful community conditions on the health of women raising children, youth violence, and the impact of the social and physical environment on physical activity. Before becoming the executive director for CLOCC, he was the director of evaluation and research at the Louisiana Public Health Institute and a faculty member at Tulane University’s School of Public Health and Tropical Medicine where he taught courses in community change and CBPR.

Lorenda Belone, PhD, MPH, is an assistant professor in the Health Education Program, Department of Health, Exercise, and Sports Science, University of New Mexico College of Education. She is a member of the Navajo Nation and a Robert Wood Johnson Center for Health Policy Postdoctoral Fellow and has worked on several National Institutes of Health and Centers for Disease Control and Prevention funded research projects with American Indian communities in the Southwest. Currently, Dr. Belone is principal investigator of an intergenerational family prevention program and a coinvestigator to a national study to better understand CBPR projects in American Indian and Alaska Native and other communities facing health disparities.

Marlene J. Berg, MUP, was associate director for training and cofounder of the Institute for Community Research (ICR), Hartford, CT. She was an anthropologist and participatory action research (PAR) methodologist whose work promotes social justice through social science research. She served as project director on federal and state funded action research-based programs and studies involving adults, children, and youth. Since 2002 she managed ICR’s PAR efforts, training youth, youth workers, teachers, community residents, and university students and faculty to conduct PAR to address issues stemming from structural inequities including teen hustling and structural determinants of racism. Throughout her career, she mentored and inspired high school, college, and graduate students and faculty to use PAR for personal, group, and social change. Marlene Berg passed away on May 29, 2012. She was the recipient of the 2012 Hartford Woman of the Year award, awarded posthumously, and ICR’s twenty-fifth anniversary celebration on October 19, 2011 was dedicated to her.

Nicole S. Berry, PhD, was trained as a medical anthropologist and is an assistant professor in the Faculty of Health Sciences at Simon Fraser University, British Columbia. Her research focuses on the study of social change through an examination of reproductive health in a globalizing world. As a post-doctoral Kellogg Health Scholars Fellow, she worked collaboratively with members of the Durham Hispanic Community and El Centro Hispano (ECH) in North Carolina on a CBPR project that developed a curriculum for immigrant parents who had teens or preteens in their household. She is the author of Unsafe Motherhood: Mayan Maternal Mortality and Subjectivity in Post-War Guatemala, and currently holds funding from the Social Science and Humanities Research Council (SSHRC) of Canada for the study “Development from the North: Correspondence Between Concepts of Modernity and Development Practice.”

Wilma Brakefield-Caldwell received her BS in nursing from Wayne State University and worked for twenty-eight years with the Detroit Health Department (DHD). During her time with the DHD, she worked as a public health nurse and supervisor, a project coordinator, a public health nursing administrator, and most recently, as health care administrator. In that capacity, Ms. Brakefield-Caldwell served as the DHD representative to the Detroit Community-Academic Urban Research Center. Ms. Brakefield-Caldwell retired in 1998 but continues to serve as a community representative on the Community Action Against Asthma Steering Committee. She is a frequent speaker and consultant on CBPR, has coauthored several articles on CBPR, and is a member of the External Advisory Committee for the National Children’s Study.

Linda Burhansstipanov, DrPH, MSPH, is a member of the Cherokee Nation of Oklahoma and has worked in public health since 1971, primarily with Native American issues. She taught full-time at California State University Long Beach for eighteen years and part-time for the University of California Los Angeles for five years. She developed and implemented the Native American Cancer Research Program at the National Cancer Institute from 1989 to 1993. She worked with the AMC Cancer Research Center in Denver for five years before founding Native American Cancer Initiatives, Incorporated (1998) a for-profit business, and Native American Cancer Research Corporation (1999), an American Indian–operated nonprofit. She serves on multiple federal advisory boards for NIH and CDC. She currently is the principal investigator and subcontractor for more than five NIH grants. She has over a hundred peer-reviewed publications, most of which address Native American cancer, public health, and data issues.

Milyoung Cho, MPH, MS, was the project coordinator of the New York City Health Equity Project (HEP). In that role, she collaborated on the development of the HEP curriculum, worked closely with young people to conduct research on health disparities and food environments in New York City, and facilitated youth-led policy and action projects stemming from that research. She has an MPH from Hunter College’s School of Urban Public Health and a Masters of Science in Chinese Medicine. She was formerly a community organizer and acupuncturist.

Suzanne Christopher, PhD, is a professor in the Department of Health and Human Development at Montana State University. She received her doctorate in the Department of Health Behavior and Health Education from the University of North Carolina at Chapel Hill, School of Public Health. She is on the Coordinating Committee for the Spirit of 1848 Caucus of the American Public Health Association (the Caucus is devoted to issues of social justice in health). She worked as a health education consultant with the Montana Breast and Cervical Health Program from 1995 to 1997. During this time she began working with Alma Knows His Gun-McCormick and members of the Apsáalooke Nation to develop and implement a community-based cervical health program, Messengers for Health. She does this work because she believes in health equality and that equality will happen with everyone walking and working side by side.

Nettie Coad was a community organizer, advocate, leader, and founding member of the Partnership Project and Greensboro Health Disparities Collaborative. She worked for twenty-two years in various management capacities for the Sears Catalog Distribution Center. She was an experienced trainer for the People’s Institute for Survival and Beyond (PISAB), a nationally recognized antiracist training and consulting organization. She served on a broad array of active community organizational boards, including the Community Foundation of Greater Greensboro and the City of Greensboro Re-Development Commission. Nettie was a trustee for the Wesley Long-Moses Cone Community Health Foundation and steadfast organizer in her Greensboro neighborhood for over twenty-eight years, serving eight terms as president of the board for her neighborhood association. In that capacity, she successfully organized her neighborhood to prevent the widening of Martin Luther King Jr. Boulevard and assumed management of a multifamily housing unit, which was named the Nettie Coad Apartments in her honor. Nettie Coad died on April 10, 2012. Yet, her unwavering commitment to change, beautiful spirit, and sweet memory will continue to inspire each person she touched.

Jason Corburn, PhD, MCP, is an associate professor jointly appointed in the Department of City and Regional Planning and the School of Public Health at the University of California, Berkeley. He has published two award-winning books: Street Science: Community Knowledge and Environmental Health Justice (MIT Press, 2005) and, Toward the Healthy City: People, Places and the Politics of Urban Planning (MIT Press, 2009). His work is focused on engaged scholarship aimed at addressing urban health inequities. He received both a Masters in City Planning (1996) and a PhD in Urban Environmental Planning (2002) from MIT.

Bonnie Duran, DrPH, is an associate professor in the Department of Health Services, University of Washington School of Public Health, and director of the Center for Indigenous Health Research, Indigenous Wellness Research Institute (http://www.iwri.org). She is the principal investigator of two NIH-funded research projects in “Indian Country.” Working with the National Congress of American Indians Policy Research Center, and the University of New Mexico, she is studying the promoters, barriers, and mechanisms of change in CBPR (http://narch.ncaiprc.org/). With the Northwest Indian College and the American Indian Higher Education Consortium, she is conducting a needs and capacity study of behavioral health at 34 tribal colleges (http://iwri.org/tcu-dapss/research-resources/). The overall aims of her research are to work with communities to design public health treatment and prevention efforts that are empowering, culture-centered, sustainable, and that have maximum public health impact.

Katherine K. Edgren, MSW, has held leadership positions in a variety of settings for over thirty years. Most recently, she served as director of the Health Promotion and Community Relations (HPCR) Department at University Health Service at the University of Michigan. She was project manager of Community Action Against Asthma, a CBPR partnership in Detroit, and was based at the University of Michigan School of Public Health. She also served as executive director of two nonprofit organizations working with adults with serious mental illnesses, and as a city council member in Ann Arbor, Michigan. Her interests include CBPR, citizen participation in the political process, college health and wellness, strategic planning, and psychosocial rehabilitation.

Kevin Foley,