Moving from Rhetoric to Evidence‐based Action in Health Care

Do you know how many meetings I've attended in the last year on CBPR? And do you know what has resulted from those meetings? Nothing. This was the sentiment of a researcher when he was initially contacted about taking part in a meeting on Community-based Participatory Research (CBPR). This statement succinctly captures the frustrations of many who have been involved with CBPR. Yet, they also raise questions as to the place CBPR should take among more traditional research approaches and what can be done about that. This issue of the Journal of General Internal Medicine examines these questions, presents a number of examples of CBPR, and identifies strategies that may help the field move from rhetoric to having a more defined and central role in health services research. This special issue is the outgrowth of that meeting of stakeholders Ð community leaders, researchers, funding organizations, and journal editors Ð convened in November 2001 by the Agency for Healthcare Research and Quality (AHRQ) in conjunction with the W. 1 Participatory approaches to research are well established in environmental and public health and other non± health-related fields. Their role in understanding and improving health care, however, has been quite limited. CBPR practitioners note that calls to expand opportunities for CBPR result in little change, a consequence of challenges faced by funding organizations, academic researchers , and community organizations. While there is some skepticism about the value and validity of participant/ subject involvement in research, there is the growing consensus that strategies that aim to make change should include the active involvement of stakeholders, including communities and patients. Policy makers, researchers and communities are taking active steps to expand opportunities for CBPR. This editorial presents a brief overview of CBPR and its role in improving health and health care, discusses why CBPR has failed to attract more support, and finally outlines action needed to advance CBPR. Community-based participatory research is an approach to research that emphasizes the equitable involvement of community members, representatives of community organizations, and researchers in all aspects of the research process. 2 CBPR also has been defined as systematic inquiry that involves collaboration of those who are affected by the issue under study to generate new knowledge, educate, act, and effect social change. 3 While experts may differ in how they operationalize CBPR, they agree that in CBPR, community representatives are substantively involved in the research process; this involvement …