Title

Culture-centeredness in community-based participatory research: contributions to health education intervention research

Document Type

Article

Publication Date

6-25-2019

Abstract

Health education research emphasizes the importance of cultural understanding and fit to achieve meaningful psycho-social research outcomes, community responsiveness and external validity to enhance health equity. However, many interventions address cultural fit through cultural competence and sensitivity approaches that are often superficial. The purpose of this study was to better situate culture within health education by operationalizing and testing new measures of the deeply grounded culture-centered approach (CCA) within the context of community-based participatory research (CBPR). A nation-wide mixed method sample of 200 CBPR partnerships included a survey questionnaire and in-depth case studies. The questionnaire enabled the development of a CCA scale using concepts of community voice/agency, reflexivity and structural transformation. Higher-order confirmatory factor analysis demonstrated factorial validity of the scale. Correlations supported convergent validity with positive associations between the CCA and partnership processes and capacity and health outcomes. Qualitative data from two CBPR case studies provided complementary socio-cultural historic background and cultural knowledge, grounding health education interventions and research design in specific contexts and communities. The CCA scale and case study analysis demonstrate key tools that community–academic research partnerships can use to assess deeper levels of culture centeredness for health education research.

Comments

‘Research for Improved Health’ was a National Institutes of Health-funded Native American Research Centers for Health (NARCH) V study, supported by the National Institute of General Medical Sciences in partnership with the Indian Health Service (U26IHS300009 and U26IHS300293), with additional funding from the National Institute on Drug Abuse, the Office of Behavioral and Social Science Research, the National Cancer Institute and the National Institute of Minority Health and Health Disparities. Bronx Health REACH was supported, in part, by the National Institute of Minority Health and Health Disparities (5R24 MD001644) and Centers for Disease Control and Prevention (5U58DP000943); Health Resources Services Administration. The University of Rochester National Center for Deaf Health Research was supported, in part, by the Centers for Disease Control and Prevention (U48DP001910 and U48DP005026). The contents of this manuscript are solely the responsibility of the authors and do not necessarily represent the official views of the funders.

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