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Obesity is a critical modifiable risk factor in cancer prevention, control, and survivorship. Comprehensive weight loss interventions (e.g., Diabetes Prevention Program (DPP)) have been recommended by governmental agencies to treat obesity. However, their high implementation costs limit their reach, especially in underserved African American (AA) communities. Community health workers (CHWs) or trusted community members can help increase access to obesity interventions in underserved regions facing provider shortages. CHW-led interventions have increased weight loss. However, in-person CHW training can be costly to deliver and often requires extensive travel to implement. Web-based trainings have become common to increase reach at reduced cost. However, the feasibility of an online CHW training to deliver the DPP in AAs is unknown. The feasibility of an online CHW training to deliver the DPP adapted for AAs was assessed. The online training was compared to an in-person DPP training with established effectiveness. CHW effectiveness and satisfaction were assessed at baseline and 6 weeks. Nineteen participants (in-person n = 10; online n = 9) were recruited. At post-training, all scored higher than the 80% on a knowledge test required to deliver the intervention. All participants reported high levels of training satisfaction (88.9% of online participants and 90% of in-person participants rated the training as at least 6 on a 1-7 scale) and comfort to complete intervention tasks (78% of online participants and 60% of in-person participants scored at least 6 on a 1-7 scale). There were no significant differences in outcomes by arm. An online CHW training to deliver the DPP adapted for AAs faith communities produced comparable effectiveness and satisfaction to an evidence-based in-person CHW training. Further research is needed to assess the cost-effectiveness of different CHW training modalities to reduce obesity.
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Negro ou Afro-Americano , Agentes Comunitários de Saúde , Estudos de Viabilidade , Humanos , População Rural , Redução de PesoRESUMO
Community advisory boards (CABs) are a valuable strategy for engaging and partnering with communities in research. Eighty-nine percent of Clinical and Translational Science Awardees (CTSA) responding to a 2011 survey reported having a CAB. CTSAs' experiences with CABs are valuable for informing future practice. This study was conducted to describe common CAB implementation practices among CTSAs; document perceived benefits, challenges, and contributions; and examine their progress toward desirable outcomes. A cross-CTSA collaborative team collected survey data from respondents representing academic and/or community members affiliated with CTSAs with CABs. Data representing 44 CTSAs with CABs were analyzed using descriptive statistics. A majority of respondents reported practices reflecting respect for CAB members' expertise and input such as compensation (75%), advisory purview beyond their CTSA's Community Engagement program (88%), and influence over CAB operations. Three-quarters provide members with orientation and training on roles and responsibilities and 89% reported evaluating their CAB. Almost all respondents indicated their CTSA incorporates the feedback of their CABs to some degree; over half do so a lot or completely. This study profiles practices that inform CTSAs implementing a CAB and provide an evaluative benchmark for those with existing CABs.
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INTRODUCTION: Effective translational research requires engagement and collaboration between communities, researchers, and practitioners. We describe a community scientist academy (CSA) developed at the suggestion of our CTSA's community advisory board to engage and capacitate community members by 1) increasing community members' and patients' understanding about the research process and 2) increasing their access to opportunities to influence and participate in research. A joint CTSA/community planning committee developed this 8-hour workshop including sessions on: 1) research definitions and processes; 2) study design; 3) study implementation; and 4) ways to get involved in research. The workshop format includes interactive exercises, content slides and videos, and researcher and community presenters. METHODS: Community-based information sessions allowed assessment of community interest before piloting. Two pilots of the CSA were conducted with community members and patients. Participant data and a pre/post knowledge and feedback survey provides evaluation data. RESULTS: The pilot included 24 diverse participants, over half of whom had not previously participated in research. Evaluation data suggest knowledge gains. Post- CSA, one third have reviewed CTSA pilot grants and over 80% want to attend further training. CONCLUSIONS: The CSA can demystify the research process for those underrepresented in research and facilitate their engagement and influence within CTSAs.
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BACKGROUND: Community subcontracts are an essential component of community-engaged research, particularly community-based participatory research (CBPR). However, several barriers have limited community-based organizations' (CBOs) ability to serve as subcontractors on research grants. This article describes the barriers and strategies to implementing community subcontracts through a case study of the implementation of one federal grant. LESSONS LEARNED: Specific lessons learned at the CBO level, budget-creation level, and university-level are described to overcome barriers in executing community subcontracts in community-engaged research. CONCLUSIONS: We call for institutional changes to facilitate equitable resource sharing in community-engaged research.
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Pesquisa Participativa Baseada na Comunidade/organização & administração , Alocação de Recursos/métodos , Pesquisa Participativa Baseada na Comunidade/métodos , Relações Comunidade-Instituição , Serviços Contratados/métodos , Serviços Contratados/organização & administração , Humanos , Desenvolvimento de Programas/métodos , Alocação de Recursos/organização & administração , Estados Unidos , Universidades/organização & administraçãoRESUMO
BACKGROUND: Although community-engaged research (CEnR) is increasingly promoted in the literature, academic programs often fail to prepare researchers for the critical, ethical, and power issues involved in CEnR. This article documents a community-created and led workshop for CEnR researchers. OBJECTIVES: The workshop's main objective is to increase researchers' knowledge and felt experience of the "dos and don'ts" of CEnR in three research domains: entering the community, accommodating the realities and constraints of community-based organizations, and dissemination. METHODS: The Dos and Don'ts of Community Engagement workshop was developed and implemented by the Arkansas Prevention Research Center's (PRC) Community Advisory Board (CAB) in partnership with faculty and staff from the Fay W. Boozman College of Public Health (COPH) at the University of Arkansas for Medical Sciences (UAMS). The CAB developed the workshop using a collaborative, iterative process grounded in popular education. Teaching approaches include video testimonials, reverse role-play scenarios, and group reflections and debriefings. Implementation included dry runs with CAB members, a pilot, and five workshops with UAMS faculty, dissemination to an out-of-state university, and post-assessment surveys of participants. CONCLUSIONS: Participants' written evaluations suggest the workshop was engaging and successfully motivated researchers to adopt new perspectives, acknowledge power imbalances across the domains, self-reflect about their role as researchers, and consider solutions to these problems. Other reported outcomes included the development of relationships leading to new CEnR projects, unanticipated learning experienced by community member participants, requests for additional workshops through UAMS' Translational Research Institute, and development of a train-the-trainer manual and accompanying video guide.