Creating pathways to participatory research.

Many disciplines, including Public Health, have recognized the importance of participatory research methods in creating change in communities. The ability of participatory research to create changeparticularly in behaviorsis what makes it such a promising area of research in health promotion. Whereas the value of participatory research is recognized, a “disconnect” exists in that the support mechanisms for this research are not in place. In fact, many researchers are encouraged to forgo the use of participatory research methods via the policies or biases of tenure and promotion committees, funding agencies and institutional review boards. These entities may claim to support participatory methods, but the time commitment and level of autonomy given to the community in participatory projects do not align with the current cultures of these entities. Using the frameworks of Komives, Lucas and McMahon’s Relational Leadership Model as well as Kotter’s Process of Creating Major Change, institutional support of participatory research is an achievable goal. Florida Public Health Review, 2009; 6, 23-27. Introduction It is becoming widely accepted that increasing the participation of the community is one way to strengthen research designs and, especially for health educators because it helps to ensure the relevance and sustainability of interventions (Coreil, Bryant, & Henderson 2001). Public Health’s focus on community-based research was solidified by the Institute of Medicine’s call for community collaboration in its guiding text for public health education – Who Will Keep the Public Healthy (2003). Whereas the names of participatory methods differ – from Participatory Action Research (PAR) to Community Based Participatory Research (CBPR) to Participatory Rural Appraisal (PRA) the overarching theme of these methods from various disciplines is the inclusion of ”community” from the design phase of the research through evaluation to create positive changes in these communities (Dick, 2002; Reason & Bradbury, 2001; Chambers, 1994). Whereas the merits of participatory research are accepted across disciplines, many scholars believe that there are too many obstacles to create and complete participatory projects successfully (Hammond et al., 2005). These perceived obstacles include time, money, and the political nature of participatory work among other things. With the proper leadership and support, it would be possible to expand participatory research and create sustainable change from within the communities we research. Significance of the Problem The goal of applied fields such as public health is to conduct research that affects positive change such as reducing the incidence or prevalence of a disease. Unfortunately for health educators, behavior does not take place in a vacuum and the discipline has had to redirect research to account for various confounding factors that affect behavior (McLeroy et al., 1988). The ability to create health education or health promotion interventions that are successful is difficult. To see this phenomenon one only has to examine the failure to meet the plethora of objectives in Healthy People 2010 and the paucity of evidencebased programs in The Guide to Community Preventive Services. When one examines progress towards the Healthy People 2010 leading health indicators such as physical activity, overweight and obesity, tobacco use and responsible sexual behavior, one sees only modest positive gains, and on many indicators (e.g., physical activity and obesity) one sees apparent declines in progress (U.S. DHHS 2005). This difficulty creating positive changes can be seen in The Community Guide’s (a task force of the CDC) review of the literature surrounding many of Healthy People 2010’s leading health indicators. Looking at the example of obesity prevention research, of all the obesity interventions that have been published only one intervention methodworksite multi-component interventionshas been shown to meet the standards of the task force to be listed as an evidence-based intervention (Katz et al., 2005). These same issues can be seen across many health indicators studied by the task force. Although one can argue the reason for lack of “evidence-based” interventions in the community guide are due to its strong reliance on the academy’s gold standard of randomized experimental design and the difficulty (both procedurally and ethically) of using these designs in real world settings, it may be more important to note what the community guide is