Skip to main content
Top
Published in: BMC Public Health 1/2015

Open Access 01-12-2015 | Research article

A realist evaluation of community-based participatory research: partnership synergy, trust building and related ripple effects

Authors: Justin Jagosh, Paula L. Bush, Jon Salsberg, Ann C. Macaulay, Trish Greenhalgh, Geoff Wong, Margaret Cargo, Lawrence W. Green, Carol P. Herbert, Pierre Pluye

Published in: BMC Public Health | Issue 1/2015

Login to get access

Abstract

Background

Community-Based Participatory Research (CBPR) is an approach in which researchers and community stakeholders form equitable partnerships to tackle issues related to community health improvement and knowledge production. Our 2012 realist review of CBPR outcomes reported long-term effects that were touched upon but not fully explained in the retained literature. To further explore such effects, interviews were conducted with academic and community partners of partnerships retained in the review. Realist methodology was used to increase the understanding of what supports partnership synergy in successful long-term CBPR partnerships, and to further document how equitable partnerships can result in numerous benefits including the sustainability of relationships, research and solutions.

Methods

Building on our previous realist review of CBPR, we contacted the authors of longitudinal studies of academic-community partnerships retained in the review. Twenty-four participants (community members and researchers) from 11 partnerships were interviewed. Realist logic of analysis was used, involving middle-range theory, context-mechanism-outcome configuration (CMOcs) and the concept of the ‘ripple effect’.

Results

The analysis supports the central importance of developing and strengthening partnership synergy through trust. The ripple effect concept in conjunction with CMOcs showed that a sense of trust amongst CBPR members was a prominent mechanism leading to partnership sustainability. This in turn resulted in population-level outcomes including: (a) sustaining collaborative efforts toward health improvement; (b) generating spin-off projects; and (c) achieving systemic transformations.

Conclusion

These results add to other studies on improving the science of CBPR in partnerships with a high level of power-sharing and co-governance. Our results suggest sustaining CBPR and achieving unanticipated benefits likely depend on trust-related mechanisms and a continuing commitment to power-sharing. These findings have implications for building successful CBPR partnerships to address challenging public health problems and the complex assessment of outcomes.
Appendix
Available only for authorised users
Literature
1.
go back to reference Cargo M, Mercer SL. The Value and Challenges of Participatory Research: Strengthening Its Practice. Annu Rev Public Health. 2008;29(1):325–50.CrossRefPubMed Cargo M, Mercer SL. The Value and Challenges of Participatory Research: Strengthening Its Practice. Annu Rev Public Health. 2008;29(1):325–50.CrossRefPubMed
2.
go back to reference Macaulay AC et al. Participatory research maximises community and lay involvement. Br Med J. 1999;319(7212):774–8.CrossRef Macaulay AC et al. Participatory research maximises community and lay involvement. Br Med J. 1999;319(7212):774–8.CrossRef
3.
go back to reference Minkler M, Wallerstein N, editors. Community-Based Participatory Research for Health. 2nd ed. San Francisco: Jossey-Bass; 2008. Minkler M, Wallerstein N, editors. Community-Based Participatory Research for Health. 2nd ed. San Francisco: Jossey-Bass; 2008.
4.
go back to reference Wallerstein N, Duran B. The Theoretical, Historical, and Practice Roots of CBPR. In: Minkler M, Wallerstein N, editors. Community-Based Participatory Research for Health: From Process to Outcomes. San Francisco: Wiley & Sons; 2008. p. 25–39. Wallerstein N, Duran B. The Theoretical, Historical, and Practice Roots of CBPR. In: Minkler M, Wallerstein N, editors. Community-Based Participatory Research for Health: From Process to Outcomes. San Francisco: Wiley & Sons; 2008. p. 25–39.
5.
go back to reference Ismail S. Participatory Health Research in International Observatory on Health Research Systems. Cambridge: RAND Report: UK Department of Health; 2009. Ismail S. Participatory Health Research in International Observatory on Health Research Systems. Cambridge: RAND Report: UK Department of Health; 2009.
6.
go back to reference Minkler M, Wallerstein N. Introduction to Community-Based Participatory Research. In: Minkler M, Wallerstein N, editors. Community-Based Paticipatory Research for Health: From Process to Outcomes. San Fransisco: Wiley & Sons; 2008. p. 1–23. Minkler M, Wallerstein N. Introduction to Community-Based Participatory Research. In: Minkler M, Wallerstein N, editors. Community-Based Paticipatory Research for Health: From Process to Outcomes. San Fransisco: Wiley & Sons; 2008. p. 1–23.
7.
go back to reference Wallerstein N, Duran B. Community-Based Participatory Research Contribution to Intervention Research: The Intersection of Science and Practice to Improve Health Equity. Am J Public Health. 2010;100(S1):S40–6.CrossRefPubMedPubMedCentral Wallerstein N, Duran B. Community-Based Participatory Research Contribution to Intervention Research: The Intersection of Science and Practice to Improve Health Equity. Am J Public Health. 2010;100(S1):S40–6.CrossRefPubMedPubMedCentral
8.
go back to reference Hicks S et al. Evaluating community-based participatory research to improve community-partnered science and community health. Prog Community Health Partnersh. 2012;6(3):289–99.CrossRefPubMedPubMedCentral Hicks S et al. Evaluating community-based participatory research to improve community-partnered science and community health. Prog Community Health Partnersh. 2012;6(3):289–99.CrossRefPubMedPubMedCentral
9.
go back to reference Oetzel J, Zhou C, Duran B, Pearson C, Magarati M, Lucero J, et al. Establishing the psychometric properties of constructs in a community-based participatory research conceptual model. Am J Health Promot 2015 29(5):e188-202. Oetzel J, Zhou C, Duran B, Pearson C, Magarati M, Lucero J, et al. Establishing the psychometric properties of constructs in a community-based participatory research conceptual model. Am J Health Promot 2015 29(5):e188-202.
10.
go back to reference Marent B, Forster R, Nowak P. Theorizing participation in health promotion: A literature review. Soc Theory Health. 2012;10(2):188–207.CrossRef Marent B, Forster R, Nowak P. Theorizing participation in health promotion: A literature review. Soc Theory Health. 2012;10(2):188–207.CrossRef
11.
go back to reference Mercer SL, Green LW, Cargo M, Potter MA, Daniel M, Scott Olds R, et al. Appendix C: Reliabilitytested guidelines for assessing PR projects. In: Community-Based Participatory Research for Health: from practice to outcomes, 2nd edition. edn. Edited by Minkler M, Wallerstein N. San Francisco: Jossey-Bass; 2008. Mercer SL, Green LW, Cargo M, Potter MA, Daniel M, Scott Olds R, et al. Appendix C: Reliabilitytested guidelines for assessing PR projects. In: Community-Based Participatory Research for Health: from practice to outcomes, 2nd edition. edn. Edited by Minkler M, Wallerstein N. San Francisco: Jossey-Bass; 2008.
12.
go back to reference Wallerstein N, Oetzel J, Duran B, Tafoya G, Belone L, Rae R. What predicts outcomes in CBPR? In: Community-based participatory research for health: From process to outcomes. 2nd edn. Edited by Minkler M, Wallerstein N. San Francisco, CA: Jossey-Bass; 2008:371-92. Wallerstein N, Oetzel J, Duran B, Tafoya G, Belone L, Rae R. What predicts outcomes in CBPR? In: Community-based participatory research for health: From process to outcomes. 2nd edn. Edited by Minkler M, Wallerstein N. San Francisco, CA: Jossey-Bass; 2008:371-92.
14.
go back to reference Cacari-Stone L et al. The Promise of Community-Based Participatory Research for Health Equity: A Conceptual Model for Bridging Evidence with Policy. Am J Public Health. 2014;104(9):1615–23.CrossRefPubMedPubMedCentral Cacari-Stone L et al. The Promise of Community-Based Participatory Research for Health Equity: A Conceptual Model for Bridging Evidence with Policy. Am J Public Health. 2014;104(9):1615–23.CrossRefPubMedPubMedCentral
15.
go back to reference Berkowitz B. Studying the Outcomes of Community-Based Coalitions. Am J Community Psychol. 2001;29(2):213–27.CrossRefPubMed Berkowitz B. Studying the Outcomes of Community-Based Coalitions. Am J Community Psychol. 2001;29(2):213–27.CrossRefPubMed
16.
go back to reference Khodyakov D et al. An Exploration of the Effect of Community Engagement in Research on Perceived Outcomes of Partnered Mental Health Services Projects(). Society and mental health. 2011;1(3):185–99.CrossRefPubMedPubMedCentral Khodyakov D et al. An Exploration of the Effect of Community Engagement in Research on Perceived Outcomes of Partnered Mental Health Services Projects(). Society and mental health. 2011;1(3):185–99.CrossRefPubMedPubMedCentral
17.
go back to reference Sandoval JA et al. Process and outcome constructs for evaluating community-based participatory research projects: a matrix of existing measures. Health Educ Res. 2012;27(4):680–90.CrossRefPubMed Sandoval JA et al. Process and outcome constructs for evaluating community-based participatory research projects: a matrix of existing measures. Health Educ Res. 2012;27(4):680–90.CrossRefPubMed
18.
go back to reference Khodyakov D et al. On Measuring Community Participation in Research. Health Educ Behav. 2013;40(3):346–54.CrossRefPubMed Khodyakov D et al. On Measuring Community Participation in Research. Health Educ Behav. 2013;40(3):346–54.CrossRefPubMed
19.
go back to reference Macaulay A et al. Assessing the benefits of participatory research: a rationale for a realist review. Glob Health Promot. 2011;18(2):45–8.CrossRefPubMed Macaulay A et al. Assessing the benefits of participatory research: a rationale for a realist review. Glob Health Promot. 2011;18(2):45–8.CrossRefPubMed
20.
go back to reference Jagosh J, Pluye P, Macaulay AC, Salsberg J, Henderson J, Sirett E, et al. Assessing the outcomes of participatory research: protocol for identifying, selecting, appraising and synthesizing the literature for realist review. Implementation Science. 2011;6(1):24. Jagosh J, Pluye P, Macaulay AC, Salsberg J, Henderson J, Sirett E, et al. Assessing the outcomes of participatory research: protocol for identifying, selecting, appraising and synthesizing the literature for realist review. Implementation Science. 2011;6(1):24.
21.
go back to reference Jagosh J et al. Uncovering the Benefits of Participatory Research: Implications of a Realist Review for Health Research and Practice. Milbank Q. 2012;90(2):311–46.CrossRefPubMedPubMedCentral Jagosh J et al. Uncovering the Benefits of Participatory Research: Implications of a Realist Review for Health Research and Practice. Milbank Q. 2012;90(2):311–46.CrossRefPubMedPubMedCentral
22.
go back to reference Macaulay A et al. Quantitative Methods in Participatory Research: Being sensitive to issues of scientific validity, community safety, and the academic-community relationship. Nouvelles pratiques sociales. 2014;25(2):159–72.CrossRef Macaulay A et al. Quantitative Methods in Participatory Research: Being sensitive to issues of scientific validity, community safety, and the academic-community relationship. Nouvelles pratiques sociales. 2014;25(2):159–72.CrossRef
23.
go back to reference Jagosh J et al. Critical Reflections on Realist Review: insights from customizing the methodology to the needs of participatory research assessment. Res Synth Methods. 2013;5(2):131–14. Jagosh J et al. Critical Reflections on Realist Review: insights from customizing the methodology to the needs of participatory research assessment. Res Synth Methods. 2013;5(2):131–14.
24.
go back to reference Pawson R, Tilley N. Realistic Evaluation. London: Sage; 1997. Pawson R, Tilley N. Realistic Evaluation. London: Sage; 1997.
25.
go back to reference Pawson R. Evidence-based Policy: A Realist Perspective. London: SAGE publications; 2006.CrossRef Pawson R. Evidence-based Policy: A Realist Perspective. London: SAGE publications; 2006.CrossRef
26.
go back to reference Green J, Thorogood N. Qualitative Methods for Health Research. 2nd ed. London: Sage; 2009. Green J, Thorogood N. Qualitative Methods for Health Research. 2nd ed. London: Sage; 2009.
27.
go back to reference Pawson R et al. Realist review: a new method of systematic review designed for complex policy interventions. J Health Serv Res Policy. 2005;10:21–34.CrossRefPubMed Pawson R et al. Realist review: a new method of systematic review designed for complex policy interventions. J Health Serv Res Policy. 2005;10:21–34.CrossRefPubMed
28.
go back to reference Pawson R. The Science of Evaluation: A realist manifesto. London: Sage Publications; 2013.CrossRef Pawson R. The Science of Evaluation: A realist manifesto. London: Sage Publications; 2013.CrossRef
29.
go back to reference Merton RK. Social theory and social structure. New York, NY: The Free Press; 1968. Merton RK. Social theory and social structure. New York, NY: The Free Press; 1968.
30.
go back to reference Lasker R, Weiss E, Miller R. Partnership Synergy: A Practical Framework for Studying and Strengthening the Collaborative Advantage. Milbank Q. 2001;79(2):179–205.CrossRefPubMedPubMedCentral Lasker R, Weiss E, Miller R. Partnership Synergy: A Practical Framework for Studying and Strengthening the Collaborative Advantage. Milbank Q. 2001;79(2):179–205.CrossRefPubMedPubMedCentral
31.
go back to reference Trickett E. The Ecology of Multilevel Interventions to Reduce Social Inequalities in Health. Am Behav Sci. 2013;57(8):1227–46.CrossRef Trickett E. The Ecology of Multilevel Interventions to Reduce Social Inequalities in Health. Am Behav Sci. 2013;57(8):1227–46.CrossRef
32.
go back to reference Hawe P, Shiell A, Riley T. Theorising interventions as events in systems. Am J Community Psychol. 2009;43(3-4):267–76.CrossRefPubMed Hawe P, Shiell A, Riley T. Theorising interventions as events in systems. Am J Community Psychol. 2009;43(3-4):267–76.CrossRefPubMed
33.
go back to reference Cargo M et al. Community governance of the Kahnawake Schools Diabetes Prevention Project, Kahnawake Territory, Mohawk Nation, Canada. Health Promot Int. 2003;18(3):177–87.CrossRefPubMed Cargo M et al. Community governance of the Kahnawake Schools Diabetes Prevention Project, Kahnawake Territory, Mohawk Nation, Canada. Health Promot Int. 2003;18(3):177–87.CrossRefPubMed
34.
go back to reference Jones L & Wells K. Strategies for Academic and Clinician Engagement in Community-Participatory Partnered Research. Journal of the American Medical Association 2007, 297(4):407-410. Jones L & Wells K. Strategies for Academic and Clinician Engagement in Community-Participatory Partnered Research. Journal of the American Medical Association 2007, 297(4):407-410.
35.
go back to reference Chung B, Corbett C, Boulet B, Cummings J, Paxton K, McDaniel S, et al. Talking Wellness: a description of a community-academic partnered project to engage an African-American community around depression through the use of poetry, film, and photography. Ethn Dis 2006;16(1Suppl 1):S67-78. Chung B, Corbett C, Boulet B, Cummings J, Paxton K, McDaniel S, et al. Talking Wellness: a description of a community-academic partnered project to engage an African-American community around depression through the use of poetry, film, and photography. Ethn Dis 2006;16(1Suppl 1):S67-78.
37.
39.
go back to reference Greener I. Patient choice in the NHS: the view from economic sociology. Social Theory and Health. 2003;1:72–89.CrossRef Greener I. Patient choice in the NHS: the view from economic sociology. Social Theory and Health. 2003;1:72–89.CrossRef
40.
go back to reference Robb N, Greenhalgh T. ‘You have to cover up the words of the doctor’. The mediation of trust in interpreted consultations in primary care. Social Science in Medicine. 2005;20:434–55. Robb N, Greenhalgh T. ‘You have to cover up the words of the doctor’. The mediation of trust in interpreted consultations in primary care. Social Science in Medicine. 2005;20:434–55.
41.
go back to reference Moynihan D. Maximum Feasible Misunderstanding: Community action in the war on poverty. New York: Free Press; 1969. Moynihan D. Maximum Feasible Misunderstanding: Community action in the war on poverty. New York: Free Press; 1969.
42.
go back to reference Trickett E et al. Advancing the Science of Community-Level Interventions. Am J Public Health. 2011;101(8):9. Trickett E et al. Advancing the Science of Community-Level Interventions. Am J Public Health. 2011;101(8):9.
Metadata
Title
A realist evaluation of community-based participatory research: partnership synergy, trust building and related ripple effects
Authors
Justin Jagosh
Paula L. Bush
Jon Salsberg
Ann C. Macaulay
Trish Greenhalgh
Geoff Wong
Margaret Cargo
Lawrence W. Green
Carol P. Herbert
Pierre Pluye
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2015
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-015-1949-1

Other articles of this Issue 1/2015

BMC Public Health 1/2015 Go to the issue