Community-Based Participatory Research

Community-based participatory research (CBPR) in public health is a collaborative approach to research that equitably involves diverse partners, including community members, organizational representatives, and academic researchers, in all aspects of the research process. All partners contribute their expertise and share responsibility and ownership to enhance understanding of a topic of importance to the community, and to translate the knowledge gained into action to improve community health and well-being. Through research findings that can guide interventions and policy change, CBPR can contribute substantially to epidemiology's key functions of identifying and understanding the distribution and determinants of health and disease, and applying this knowledge to improve the public's health.

CBPR is an established approach to inquiry rooted in several research traditions across multiple disciplines, including participatory research and participatory action research. Common to these approaches is an emphasis on engaging community and academic partners in understanding and improving community well-being. CBPR is increasingly applied in epidemiological research and is well suited for investigating complex relationships between the social, economic, physical, and biological environments, and how they interact to influence health across multiple levels. Because CBPR is grounded in equitable collaboration between community members and academic researchers, CBPR is particularly relevant to the investigation of health disparities rooted in racial, economic, and social inequality.

As an approach to research rather than a particular research design or method, CBPR can be applied to a wide range of research efforts, including observational research, exposure assessment, risk assessment, intervention research and evaluation, and as a guide to policy development. CBPR draws on the full range of study designs, including cross-sectional, longitudinal, [Page 210]experimental, and quasi-experimental, and may include both quantitative and qualitative methods of data collection and analysis.

CBPR can also form the foundation for comprehensive etiologic research and intervention research investigation of a particular health issue over time. For example, an ongoing community-academic partnership effort to examine and address exposure to environmental triggers of childhood asthma in Detroit, Michigan, as described by Parker et al. (2003), included prioritizing the health issue, successful competition for multiyear federal funding, a laboratory study of allergens and asthma, an epidemiological study of air quality and health indicators, and an intervention to reduce environmental triggers for childhood asthma at the household, neighborhood, and policy levels.

What distinguishes CBPR methodologically from other approaches to research is the engagement of the community as coinvestigator in determining what is being studied, how, by whom, and for what purpose. CBPR provides a framework for applying traditional and innovative research methods in ways that involve partners equitably, address power and cultural differences, maximize strengths and resources of partners, and build individual, organizational, and community capacity. Participatory approaches can enhance research quality and applicability and contribute to innovation in research methods. See Viswanathan et al. (2004) for a systematic review of existing evidence on the conduct and evaluation of CBPR, commissioned by the Agency for Healthcare Research and Quality.