Introduction

Community-based participatory research

(CBPR) is an approach to health and

environmental research meant to increase the

value of studies for both researchers and the

community being studied. This approach is

particularly attractive for academics and public

health professionals struggling to address the

persistent problems of health care disparities in a

variety of populations (identified by factors such

as social or economic status, lack of health

insurance, or membership in various racial and

ethnic groups).1-6 Few guidelines exist for

evaluating CBPR grant proposals and

determining what resources are required to

promote successful community-based research

efforts. Still less is known about the degree to

which CBPR has been effective in sustaining

long-term university–community partnerships

and generating high-quality data to guide further

research. Experts are becoming impatient with the

gap between knowledge produced through

conventional research and the translation of this

research into interventions and policies to

improve the health of various groups, especially

minority communities and other disadvantaged

populations.2,7-12

Done properly, CBPR benefits community

participants, health care practitioners, and

researchers alike. CBPR creates bridges between

scientists and communities, through the use of

shared knowledge and valuable experiences.13-17

This collaboration further lends itself to the

development of culturally appropriate

measurement instruments, thus making projects

more effective and efficient.18,19 Finally, CBPR

establishes a mutual trust that enhances both the

quantity and the quality of data collected.13,20-22

The ultimate benefit to emerge from such

collaborations is a deeper understanding of a

community’s unique circumstances, and a more

accurate framework for testing and adapting best

practices to the community’s needs.2,13,15,18,23-29

In 2001, the Agency for Healthcare Research

and Quality (AHRQ), in collaboration with

several Federal agencies and the W.K. Kellogg

Foundation, convened a 2-day conference “to

promote and support the use of CBPR, to

develop strategies to advance CBPR, and to

explore the use of CBPR as a resource for

policymakers to help guide their program

development.”30 AHRQ organized the meeting

specifically to address three key barriers to CBPR:

(1) insufficient community incentives (staffing

and resources) to play a partnership role in CBPR

projects; (2) insufficient academic incentives

(staffing and resources) for researchers to play a

partnership role in CBPR projects; and (3)

inadequate funding and insensitive funding

mechanisms.*

The conference membership recommended an

AHRQ-commissioned study of the existing

evidence on the conduct and evaluation of

CBPR, performed by one of the Agency’s

Evidence-based Practice Centers (EPCs).

Accordingly, the Agency commissioned the RTI

International–University of North Carolina (RTIUNC) EPC to produce a systematic review and

synthesis of the scientific literature regarding

CBPR and its role in improving community

health. Specifically, the EPC investigators were

asked to consider four Key Questions (KQs):

KQ 1: What defines community-based

participatory research?

KQ 2: How has CBPR been implemented to date,

with regard to the quality of research

methodology and community involvement?

Evidence Report/Technology Assessment

Number 99

Community-Based Participatory Research:

Assessing the Evidence

Summary

Agency for Healthcare Research and Quality

Advancing Excellence in Health Care • www.ahrq.gov

Agency for Healthcare Research and Quality Evidence-Based

Practice

* Drawing on this conference, AHRQ prepared a guide to

community-based participatory research for community

groups and the general public, The Role of CommunityBased Participatory Research: Creating Partnerships,

Improving Health (AHRQ Publication No. 03-0037, June

2003).
2

KQ 3: What is the evidence that CBPR efforts have resulted in

the intended outcomes? 

KQ 4: What criteria and processes should be used for review of

CBPR in grant proposals?

Methods

In 2002, the EPC convened a group of experts to provide

early guidance for the investigation. The meeting participants

included community research partners, academic researchers,

and CBPR research financiers, bringing a diverse range of

perspectives to the review. Feedback from the expert meeting

substantially altered the researchers’ search terms and their

research questions.

Search Criteria

Articles considered for the EPC review included peerreviewed reports of human studies, across all ages and both

genders, conducted in English-speaking North America (U.S.

and Canada), and published in the English language. The

source language was limited to exclude from consideration

international studies conducted in vastly different sociocultural

and political climates. However, international publications that

described the history and definition of CBPR were included.

Editorials, letters, and commentaries were excluded from the

analysis, as were articles in which information related to the key

questions was not reported. The EPC staff limited its review to

studies that included at least one community as a research

collaborator and, therefore, excluded studies that involved only

health agencies or other professional institutions in the research

process.

Relevant Data Sources

For KQs 1 through 3, the EPC first searched standard

electronic databases—e.g., MEDLINE®, Cochrane

Collaboration resources, PsycINFO, and Sociofile—using

search terms based on the inclusion/exclusion criteria and

additional key terms identified in the expert group meeting.

The EPC researchers then consulted their Technical Expert

Advisory Group (TEAG), regarding in-progress studies that

had not been published. Key among the sources of information

identified was a special CBPR issue of the Journal of General

Internal Medicine (July 2003). The third level of the

investigative process required EPC reviewers to perform hand

searches of the reference lists of relevant articles, for the purpose

of identifying additional articles to gain full information on

particular studies. Unlike many research areas, searching the

CBPR literature is labor- rather than computer-intensive.

For KQ 4, very few peer-reviewed articles directly addressed

CBPR funding issues per se.

31 Rather, the culled materials had a

tendency to describe agency or foundation funding

mechanisms used to support CBPR.32,33 Accordingly, the EPC

researchers reviewed the Web sites of several organizations

funding CBPR research and spoke with funding agency

representatives involved in the development of CBPR-related

grants programs or their agencies’ grant review process. 

Data Collection and Analysis 

Data was collected for KQs 1, 2, and 3 through the

abstraction of relevant information from eligible articles and the

creation of summary evidence tables presenting the key details

and findings for the articles. The EPC paired trained

abstractors with a senior reviewer, who used an analytic

framework to guide development of abstraction tables. The

EPC researchers used the same framework to rate the quality of

both the primary research and primary community-based

participation elements. They rated the quality of only those

studies (often represented by a set of published articles)

representative of a completed intervention study evaluation, or

an observational study designed to permit extrapolation beyond

the study population.

Results

The EPC researchers identified a total of 1408 abstracts with

relevance to the four key questions. Of these, they retained and

pulled 297 articles for complete review. Another 112 articles

were excluded from this subset—typically because the study

could not be considered CBPR. Ultimately, the EPC

investigators reviewed 55 of the 185 retained articles for KQ 1

and 123 articles comprising 60 studies for KQs 2 and 3. [Full

names and publications lists for the identified studies can be

found in Table 4 of the complete Report.] The researchers

reviewed 7 articles for KQ 4. A key limitation of using

secondary and tertiary sources to identify CBPR studies is that

the studies often do not identify themselves as CBPR.

KQ 1: Definition of Community-based Participatory

Research

The EPC researchers sought to answer three important

questions in their exploration of this topic: 

• What are the essential elements of CBPR?

• What are the “best practices” of CBPR, including the

characteristics of successful investigator-community

partnerships?

• What major outcomes are anticipated from both the research

and community perspectives?

The EPC researchers analyzed 55 conceptual articles (i.e.,

synthesizing the evolution of, values for, or lessons learned from

collaborative research), in the process of writing a deliberately

short working definition for CBPR. These articles each used

terms common to, or similar to, CBPR. They originated with a

variety of fields in the social and health sciences. Using these

articles, the researchers were able to arrive at a definition they

feel confident will serve the purposes of AHRQ, other Federal

agencies supporting CBPR, and other interested parties and

agencies:
Community-based participatory research is a collaborative

research approach that is designed to ensure and establish structures

for participation by communities affected by the issue being studied,

representatives of organizations, and researchers in all aspects of the

research process to improve health and well-being through taking

action, including social change.

To expand upon this definition, the authors further suggest

that CBPR involves: (1) co-learning and reciprocal transfer of

expertise, by all research partners, with particular emphasis on

the issues that can be studied with CBPR methods; (2) shared

decisionmaking power; and (3) mutual ownership of the processes

and products of the research enterprise.

KQs 2 and 3: Intervention Studies and

Outcomes 

The EPC researchers found a striking degree of variability in

the study designs, substantive concerns, and the extent of

community involvement in CBPR studies. Thirty of the 60

studies relevant to these KQs included interventions, while the

other 30 were noninterventional studies. For the purposes of

this review, researchers defined an intervention as an organized

and planned effort to change individual behavior, community

norms or practices, organizational structure or policies, or

environmental conditions.

KQ 2: Implementation of Community-based Participatory

Research 

Each of the 60 studies identified as CBPR resulted in an

average of two publications. Thirty-five studies produced one

published article each; not counting the East Baltimore Health

Promotion Study—which lasted 17 years between the first

publication and the last—the 24 studies with more than one

publication each produced, on average, 3.5 articles over a

period of about 2.5 years. The majority (63.6 percent) of the

55 studies giving information on their funding reported a

single funding source, while a significant minority (32.7

percent) mentioned two funding sources, and a handful (3.7

percent) report more than two sources.

Quality of Research Methodology. Of the 60 CBPR

studies, 30 included ongoing or completed interventions; of

these, 12 evaluated the intervention and 18 either had not

completed the intervention, or had not evaluated it fully. The

remaining 30 studies did not have an intervention or did not

report one.

Four of the 12 studies that implemented and evaluated

interventions14,34–44 were randomized controlled trials (RCTs),

and five were quasi-experimental studies. The three remaining

studies had nonexperimental designs.

Of the 30 studies classified as noninterventional because they

were neither designed with an explicit intervention nor did they

undertake an evaluation of any intervention that might have

resulted from their findings, 10 studies moved beyond problem

identification to risk factor assessments, 45–50 examining

prevalence, 51,52 and examining the impact of environmental or

policy change.53,54 Increasing community capacity or

engendering empowerment as a byproduct of the collaboration,

was the major objective in four of the projects.55–58 

Community involvement in the research process. Sixteen

studies documented the involvement of the community in

making measurement instruments more culturally relevant, or

mentioned field-testing their instruments to improve their

reliability. Fourteen studies described the effort to build

community partnerships through the use of baseline data,

general findings, or process evaluation results. Many of the

studies provided rich qualitative and quantitative data regarding

the lengthy process of building partnerships between

institutions and communities–although formal evaluation of

this process was rare.

Regarding evidence in the published literature of the level of

community involvement in the research process, 28 of 60

studies (47 percent) involved the community in helping to set

priorities and generate hypotheses. The extent of community

involvement, however, varied greatly among the studies.

Community input was used in some studies to direct change or

expand priorities while others used community involvement

mainly to confirm their priorities.

Researchers many times took a lead role in proposal

development, often applying for grants before the actual

community involvement began. Fourteen studies mentioned

community involvement in proposal development.

Community involvement took place mainly in the form of

advisory committees, but there were also examples of

partnership steering committees in which community partners

were involved as equal partners. In one turn of events, the

community approached the researchers to initiate the proposal

on the basis of the community’s priorities and desired research.

Nineteen studies reported shared funding. Communities

used funds mainly to pay for staffing. In one study, the

community contributed some of the direct funding (taken from

union funds) to maintain the research. 

Twenty-eight studies described the active participation of the

community in the study design and implementation. Fifty

studies reported community involvement with respect to

recruiting and participant retention. Contact with community

members generally raised participation rates. Local staff helped

to administer surveys and conduct interviews, and as survey

helpers fluent in the languages of the target group. 

Of 30 studies with a planned or implemented intervention,

more than 90 percent (28 in all) reported community

participation in the intervention design and implementation.

Among the 30 studies without a planned intervention, 30

percent (10 studies) reported that community members had

participated in the design of future interventions for the

community, based on the study results. 

Articles reviewed by the EPC investigators made little

mention of the involvement of community partners in the data

interpretation or manuscript preparation processes. Although

3
4

some papers included authors without academic degrees, the

researchers could not draw firm conclusions about the level of

participation by community partners.

The EPC researchers also identified those studies in which

communities were involved in translating research findings into

policy change. Three of the 60 studies reported demonstrable

policy change in civic bodies, as a result of the intervention

through the efforts of the community collaborators. Five

studies brought about change in private institutions or at local

levels through the efforts of community collaborators. 

Thirteen studies reported on the sustainability of programs

or interventions. An additional 28 studies detailed the

integration or application of findings to achieve changes in

health or other aspects of daily life. Some projects achieved

temporary sustainability of programs through the acquisition of

additional grants for further research or by attracting local

funding. 

KQ 3: Outcomes of Community-based

Participatory Research

Improved Research Quality Outcomes. The investigators

rated the 12 studies with completed interventions for research

quality and for adherence to the principles of community

participation. On a scale of 1 to 3, higher scores reflected better

quality. The research quality scores reflected study design rigor,

with experimental studies rating highest overall. Community

participation scores, however, appeared less closely associated

with study design. And while the scores on these two

performance dimensions are not directly comparable, the

average research quality scores ranged from 1.5 to 2.8 with a

mean of 2.3, while the community participation quality scores

ranged from 1.6 to 3.0 with a mean of 2.2.

When the EPC researchers looked at the influence of

community involvement on the quality of interventional

studies, they discovered 11 of the 12 completed intervention

studies had reported enhanced intervention quality. Just two

studies reported improved outcomes, while eight noted

enhanced recruitment efforts, four reported improved research

methods and dissemination, and three described improved

descriptive measures. Very little evidence of diminished research

quality resulting from CBPR was reported.

Community and Research Capacity. Of the 60 studies

reviewed, 47 reported improved community involvement,

including additional grant funding and job creation, as an

outcome associated with the study. The authors—typically

academics—generally focused on the increased capacity of the

participant community, rather than that of the research

community.

Health Outcomes. Among the 12 studies evaluating

completed interventions that play a role in health outcomes,

two dealt with physiologic health outcomes, three with cancer

screening behavior, and four addressed other behavioral changes

(including alcohol consumption, immunization rates, and safer

sex behavior). Finally, three studies measured the impact of the

intervention on emotional support, empowerment, and

employee well-being. 

Given the highly varied health outcomes, measurement

strategies, and intervention approaches used, the EPC

researchers were unable to perform a direct comparison of

studies and their relative impact on health outcomes. Moreover,

an absence of cost-effectiveness data precluded any comparison

of outcomes from CBPR studies and those of more traditional

research studies. 

KQ 4: Funding Criteria for Community-based

Participatory Research

AHRQ asked the EPC investigators to address several

specific questions about CBPR funding, drawing on the lessons

learned through the synthesis of the literature on the first three

key questions. Specifically:

1. What current approaches are being used by funders in their

efforts to solicit and review CBPR grant proposals?

2. What criteria should high quality grant applications possess?

3. What guidance can be offered to funding organizations and

CBPR applicants?

4. Who should be involved in the review process? What should be

the role of the community? 

Current Approaches by Funders. The Centers for Disease

Control and Prevention and the National Institute of

Environmental Health Sciences have been at the forefront of

Federal CBPR funding to date. Specific initiatives by these

agencies include many of the EPC-reviewed studies. Interest in

funding CBPR at the Federal level is growing, given the recent

creation of an Interagency Working Group for Communitybased Participatory Research. This group has begun assembling

information on existing funding mechanisms for CBPR.

Discussions with individuals from the NIH and CDC tasked

with generating requests for research proposals on specific

topics (Requests for Applications, or RFAs) and administering

the review process underscored the need for brief guidance

materials (fact sheets) about CBPR for reviewers less familiar

with this approach. Guidelines for individuals writing RFAs

designed to encourage CBPR submissions and documents

providing guidance for researchers submitting CBPR proposals

also were recommended.

Criteria for Applications. According to the details of

conversations between researchers and funders, the process of

obtaining funding for CBPR projects through conventional

review mechanisms can be a difficult one. This is often because

reviewers are less familiar with (and perhaps even skeptical

about) the possibility of integrating high-quality conventional

research within the framework of a CBPR collaboration. The

EPC researchers identified relatively few high-quality completed

interventions or observational studies, relative to what appears

to be many excellent collaborations based on CBPR principles.
Guidance for Funding Organizations and Applicants.

The researchers created three concise documents providing

guidance to funding organizations, reviewers, and applicants,

based on the EPC’s review, discussions with Federal funding

sources, reviews of funding agency Web sites, and the funding

criteria outlined above. The EPC elected to employ the same

review criteria often used by agencies within the U.S.

Department of Health and Human Services in the

development of these prototype guideline documents; these

criteria are both standardized and rigorous. These documents

(CBPR Exhibits 1, 2, and 3) are available on the RTI Web site

(http://www.rti.org).

Involvement in the Review Process. Discussions with

funding providers and their review of the literature led EPC

investigators to recommend the inclusion of academic experts

for the content area, and for CBPR methods, on project

application review panels. Moreover, they recommended

involving individuals with expertise in both arenas. The

researchers further suggested the potential value of including

community representatives, but emphasized the need to orient

and structure the review panels to immediately and effectively

tap into the expertise of the community representatives. 

Discussion

Implementing CBPR

Research Quality. Authors of interventional studies

(whether traditional or CBPR) often must publish their

findings and study methodology in separate articles. The nature

of CBPR further compounds this fragmentation when years of

partnership development and collaboration must be distilled to

few words in a small number of journals willing to publish this

more descriptive science. This may be why information

regarding the implementation of CBPR, both in terms of

community participation and the research, often was missing in

the EPC-reviewed articles.

A limited number of studies representing a complete and

fully evaluated intervention—an observational study or an

epidemiologic study that can be generalized beyond the

participants involved—have been published to date. Limiting

factors appear to be the categorical nature of most Federal

funding, funding period length and flexibility, and the page

limitations of journals.

There was little evidence to indicate that high-quality scores

in community collaboration are associated with low-quality

research scores. Recent special journal issues focusing on CBPR

have led a number of publications to implement high-quality

research methods. CBPR funding initiatives originating with

Federal agencies have the potential to do the same.

Level of Community Involvement. Community

involvement varied in different stages of the research. There was

strong involvement in recruiting study participants, designing

and implementing the intervention, and interpreting findings.

Many authors argued that community involvement (especially

in theses areas) leads to greater participation rates, increased

external validity, decreased loss of follow-up, and increased

individual and community capacity. The disadvantages of

community involvement were not frequently reported, but they

may include the introduction of selection bias (bias in

recruitment), decreased (and sometimes an absence of)

randomization, and the potential selection of highly motivated

intervention groups not representative of the broader

population.

Achieving Intended Outcomes

Improving Research Quality. In CBPR, researchers must

work with the community to select and justify the strongest

possible research methods, while balancing research rigor with

their responsiveness to the community. The researchers must

credit community members with the ability to understand

complex research challenges, if presented clearly and

thoughtfully. One of the many benefits of making research

partners of community members is that they begin to see the

long-term gains associated with research, in comparison to the

relatively short-term nuisance of data collection activities.

Enhancing Community Capacity. Enhanced community

capacity was rarely mentioned in the EPC’s review of the

literature as an explicit goal of CBPR projects. Rather, it was

mentioned in descriptions of the collaborative process and was

clearly considered to be a critical component. Studies were

much more likely to report capacity building in the

community, than in the cadre of researchers or their

institutions. Perhaps a true indicator of investigator

appreciation for CBPR might be published study results that

include a discussion of capacity-building efforts on the part of

the researchers.

Improving Health Outcomes. Among the limited number

of fully evaluated, complete interventions that were identified,

the stronger or more consistently positive health outcomes

generally were found in the higher quality research designs.

This should convince CBPR research partnerships to pay

adequate attention to the “R” component of CBPR. 

Given the long-term nature of true CBPR efforts, individual

and community capacity-building efforts ultimately may result

in positive health outcomes that have little or nothing to do

with those targeted in the initial study. None of the studies

reviewed could accurately predict such long-term and indirect

potential benefits of CBPR. 

Funding Issues

Because CBPR is a potential approach to translational

research, the EPC researchers have suggested using peer review

groups with a background in translational research or research

dissemination to consider the merits of grant proposals for this

type of research. Conversely, peer review by conventional

mechanisms rather than special emphasis panels has the

potential to expand the options for funding CBPR efforts,

while at the same time educating other scientists on the

potential rigor and “added value” of CBPR. A proposal based

5
6

on CBPR should not simply describe CBPR criteria–it should

also discuss the potential benefits for the research quality and

for the community.

Future Research

In many areas of health promotion and disease prevention,

researchers and community advocates alike are beginning to

focus their efforts further “upstream” in the socio-ecologic

model, encouraging a greater emphasis on policy and

environmental changes that facilitate proactive health choices at

the individual level. CBPR is well positioned to address such

approaches to health promotion through its ability to mobilize

community action. Continued efforts aimed at achieving the

best possible balance between research methodologies and

community collaboration are critical to advancing the field.

The EPC investigators anticipate a significant increase in

high-quality CBPR coverage in the near future, due in part to a

number of recent Federal initiatives funding CBPR projects

and a willingness on the part of respected journals to publish

the findings. Along with proposed CBPR proposal-writing and

peer-review guidelines, the investigators also have suggested that

recommendations may be needed to improve the quality of

CBPR study reports. These guidelines would reflect the

increasing rigor required of authors in the evidence-based

practice field, while at the same time acknowledging the unique

situation facing those researchers who are balancing research

rigor with a commitment to community collaboration.

Availability of the Full Report

The full evidence report used to create this summary was

prepared for the Agency for Healthcare Research and Quality

by the RTI–University of North Carolina Evidence-based

Practice Center under Contract No. 290-02-0016. It is

expected to be available late in the summer of 2004. At that

time, printed copies may be obtained free of charge from the

AHRQ Publications Clearinghouse by calling (800)-358-9295.

Inquiries should include a request for Evidence

Report/Technology Assessment No. 99, Community-based

Participatory Research: Assessing the Evidence. In addition,

Internet users will be able to access the report and this

summary online through AHRQ’s Website at www.ahrq.gov. 

Suggested Citation

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. Summary, 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-E022-1. Rockville, MD: Agency

for Healthcare Research and Quality. August 2004. 

References

1. Institute of Medicine, Committee for the Study of the Future of

Public Health, Division of Health Care Services. The Future of Public

Health. Washington, D.C.: National Academy Press, 1988.

2. Green LW, Mercer SL. Can public health researchers and agencies

reconcile the push from funding bodies and the pull from

communities? Am J Public Health 2001; 91(12):1926-9.

3. Olden K, Guthrie J, Newton S. A bold new direction for

environmental health research. Am J Public Health 2001;

91(12):1964-7.

4. O’Neill EH. Health Professions education in the Future: Schools in

Service to the Nation. San Francisco, Ca: Pew Health Professions

Commission, 1993. 

5. Cassel JC. The contribution of social environment to host resistance.

Am J Epidemiol 1976; 104:107-23.

6. Satel S. The indoctrinologists are coming. Atlantic Monthly 2001; 59-

64.

7. Kaplan CD. What works in drug abuse epidemiology in Europe. J

Addict Dis 1991; 11(1):47-59.

8. Berg A. Sliding toward nutrition malpractice: time to reconsider and

redeploy. Am J Clin Nutr 1993; 57(1):3-7.

9. Mittelmark MB, Hunt MK, Heath GW, et al. Realistic outcomes:

lessons from community-based research and demonstration programs

for the prevention of cardiovascular diseases. J Public Health Policy

1993; 14(4):437-62.

10. Aguirre-Molina M, Gorman DM. Community-based approaches for

the prevention of alcohol, tobacco, and other drug use. Annu Rev

Public Health 1996; 17:337-58.

11. Israel BA, Schulz AJ, Parker EA, et al. Review of community-based

research: assessing partnership approaches to improve public health.

Annu Rev Public Health 1998; 19:173-202.

12. Davis SM, Reid R. Practicing participatory research in American

Indian communities. Am J Clin Nutr 1999; 69(4 Suppl):755S-9S.

13. Schensul SL. Science, theory and application in anthropology. Am

Behav Scient 1985; 29:164-85.

14. Israel BA, Schurman SJ, House JS. Action research on occupational

stress: involving workers as researchers. Int J Health Serv 1989;

19(1):135-55.

15. Hall BL. From margins to center? The development and purpose of

participatory research. Am Sociol 1992; 23(15-28).

16. Himmelman AT . Communities Working Collaboratively for a

Change. Minneapolis, MN: Humphrey Institute for Public Affiars:

University of Minnesota, 1992. 

17. Butterfoss FD, Goodman RM, Wandersman A. Community

coalitions for prevention and health promotion. Health Educ Res

1993; 8(3):315-30.

18. Altman DG. Sustaining interventions in community systems: on the

relationship between researchers and communities. Health Psychol

1995; 14(6):526-36.

19. Schensul JJ, Denelli-Hess D, Borreo MG, et al. Urban comadronas:

Maternal and child health research and policy formulation in a Puerto

Rican community. In: Stull DD, Schensul JJ, eds. Collaborative

Research and Social Changes: Applied Anthrology in Action. Boulder,

Col: Westview Press, 1987.
20. Brown P. The role of the evaluator in comprehensive community

initiatives. In: Connel JP, Kubisch AC, Schorr LB, Weiss CH, eds.

New Approaches to Evaluating Community Initiatives. Washington,

DC: Aspen, 1995.

21. Cousins JB, Earl LM, eds. Participatory Evaluation: Studies in

Evaluation Use and Organizational Learning. London: Falmer, 1995. 

22. Schulz AJ, Parker EA, Israel BA, et al. Conducting a participatory

community-based survey: Collecting and interpreting data from a

community health intervention on Detroit’s East Side. J Public Health

Manag Pract 1997; 4(2):10-24.

23. Vega WA. Theoretical and pragmatic implications of cultural diversity

for community research. Am J Comm Psychol 1992; 20:375-91.

24. Dressler WW. Commentary on “Community research: Partnership in

Black communities”. J Prev Med 1993; 9:31-4.

25. Gaventa J. The powerful, the powerless, and the experts: Knowledge

struggles in an information age. In: Park P, Brydon-Miller M, Hall B,

Jackson T, eds. Voices of Change: Participatory Research in the

United States and Canada. Westport, CT: Bergin, Garvey, 1993.

26. Elden M, Levin M. Natural Helper Models to Enhance a

Community’s Competence. In: Whyte WF, ed. Participatory Action

Research. Newbury Park, CA: Sage, 1994.

27. Bishop R. Addressing issues of self-determination and legitimation in

Kaupapa Maori research. In: Webber B, ed. Research Perspectives in

Maori Education. Wellington, New Zealand: Council on Education

Research, 1996.

28. deKoning K, Martin M. Participatory research in health: Setting the

context. In: deKoning K, Martin M, eds. Participatory Research in

Health: Issues and Experiences. London: Zed Books, 1996.

29. Maguire P. Considering more feminist participatory research: What’s

congruency got to do with it? Qual Inq 1996; 2:106-18.

30. Conference on Community-based Participatory Research —

Conference Minutes [Web Page]. Available at

http://www.ahcpr.gov/about/cpcr/cbpr/. 

31. Israel BA, Lichtenstein R, Lantz P et al. The Detroit CommunityAcademic Urban Research Center: development, implementation, and

evaluation. J Pub Health Manag Pract 2001; 7(5):1-19.

32. Higgins DL, Maciak B, Metzler M, CDC Urban Research C. CDC

Urban Research Centers: community-based participatory research to

improve the health of urban communities. J Womens Health Gend

Based Med 2001; 10(1):9-15.

33. Higgins DL, Metzler M. Implementing community-based

participatory research centers in diverse urban settings. J Urban Health

2001; 78(3):488-94.

34. Wagenaar AC, Murray DM, Wolfson M, et al. Communities

Mobilizing for Change on Alcohol: Design of a Randomized

Community Trial. J Comm Psychol 1994; Special Issue:79-101.

35. Green LW, Levine DM, Deeds S. Clinical Trials of Health Education

for Hypertensive Outpatients: Design and Baseline Data. Prev Med

1975; 4:417-25.

36. Lam TK, McPhee SJ, Mock J, et al. Encouraging VietnameseAmerican women to obtain Pap tests through lay health worker

outreach and media education. J Gen Intern Med 2003; 18(7):516-

24.

37. Angell KL, Kreshka MA, McCoy R, et al. Psychosocial intervention

for rural women with breast cancer. J Gen Intern Med 2003;

18(7):499-507.

38. Flaskerud JH, Nyamathi AM, Uman GC. Longitudinal effects of an

HIV testing and counseling programme for low-income Latina

women. Ethn Health 1997; 2(1-2):89-103.

39. Masi CM, Suarez-Balcazar Y, Cassey MZ, et al. Internet access and

empowerment: a community-based health initiative. J Gen Intern

Med 2003; 18(7):525-30.

40. Wismer BA, Moskowitz JM, Min K, et al. Interim assessment of a

community intervention to improve breast and cervical cancer

screening among Korean American women. J Public Health Manag

Pract 2001; 7(2):61-70.

41. Daniel M, Green LW, Marion SA, et al. Effectiveness of communitydirected diabetes prevention and control in a rural Aboriginal

population in British Columbia, Canada. Soc Sci Med 1999;

48(6):815-32.

42. Matsunaga DS, Enos R, Gotay CC, et al. Participatory research in a

Native Hawaiian community. The Wai’anae Cancer Research Project.

Cancer 1996; 78(7 Suppl):1582-6.

43. Rosenberg Z, Findley S, McPhillips S, et al. Community-based

strategies for immunizing the “hard-to-reach” child: the New York

State immunization and primary health care initiative. Am J Prev Med

1995; 11(3 Suppl):14-20.

44. Stevens PE, Hall JM. Participatory action research for sustaining

individual and community change: a model of HIV prevention

education. AIDS Educ Prevent 1998; 10(5):387-402.

45. McCauley LA, Lasarev MR, Higgins G, et al. Work characteristics and

pesticide exposures among migrant agricultural families: a

community-based research approach. Environ Health Perspect 2001;

109(5):533-8.

46. Lauderdale DS, Kuohung V, Chang SL, et al. Identifying older

Chinese immigrants at high risk for osteoporosis. J Gen Intern Med

2003; 18(7):508-15.

47. Ledogar RJ, Acosta LG, Penchaszadeh A. Building international

public health vision through local community research: the El PuenteCIET partnership. Am J Public Health 1999; 89(12):1795-7.

48. Adrien A, Godin G, Cappon P, et al. Overview of the Canadian study

on the determinants of ethnoculturally specific behaviours related to

HIV/AIDS. Can J Public Health 1996; 87 Suppl 1:S4-10.

49. Mullings L, Wali A, McLean D et al. Qualitative methodologies and

community participation in examining reproductive experiences: the

Harlem Birth Right Project. Matern Child Health J 2001; 5(2):85-93.

50. Parsons ML, Warner-Robbins C. Factors that support women’s

successful transition to the community following jail/prison. Health

Care Women Int 2002; 23(1):6-18.

51. Stratford D, Chamblee S, Ellerbrock TV, et al. Integration of a

participatory research strategy into a rural health survey. J Gen Intern

Med 2003; 18(7):586-8.

52. Stratford D, Chamblee S, Ellerbrock TV, et al. Integration of a

participatory research strategy into a rural health survey. J Gen Intern

Med 2003; 18(7):586-8.

53. Wing S, Wolf S. Intensive livestock operations, health, and quality of

life among eastern North Carolina residents. Environ Health Perspect

2000; 108(3):233-8.

54. Vander Stoep A, Williams M, Jones R, Green L, Trupin E. Families as

full research partners: what’s in it for us? J Behav Health Serv Res

1999; 26(3):329-44.

55. Sloane DC, Diamant AL, Lewis LB, et al. Improving the nutritional

resource environment for healthy living through community-based

participatory research. J Gen Intern Med 2003; 18(7):568-75.

7
56. el-Askari G, Freestone J, Irizarry C, et al. The Healthy Neighborhoods

Project: a local health department’s role in catalyzing community

development. Health Educ Behav 1998; 25(2):146-59.

57. Yoshihama M , Carr ES. Community Participation Reconsidered:

Feminist Participatory Action Research With Hmong Women . J

Comm Pract 2002; 10(4 ):85-103.

58. Choudhry UK , Jandu S, Mahal J, Singh R, Sohi Pabla H, Mutta B.

Health promotion and participatory action research with South Asian

women. J Nurs Scholarsh 2002; 34(1):75-81.

8

www.ahrq.gov

AHRQ Pub. No. 04-E022-1

August 2004

ISSN 1530-440X