Table 1.

Critical Elements in Community-based Participatory Research (from Ammerman A, et al., AHRQ Proposal for CBPR Evidence-based Practice Review)

CBPR Implementation and Impact
Research Element	CBPR Application	Community Benefits	Research Benefits	Research Challenges
Defining the research question	Full participation of community in identifying issues of greatest importance. Focus on community strengths as well as problems	Problems addressed are highly relevant to the study participants and other community members	Increased investment and commitment to the research process by participants	Time-consuming, and community may identify issues different from those identified by standard assessment procedures or for which funding is available
Grant proposal and funding	Community leaders/members consulted as a part of the proposal writing process	Proposal is more likely to address issues of concern in a manner acceptable to community residents	Funding likelihood increases if community participation results in tangible indicators of support for recruitment and retention efforts, such as letters of support	Seeking input from the community may slow the process and complicate the proposal development effort, when time constraints are often present
Research design	Researchers communicate the need for specific study design approaches and work with community to design more acceptable approaches, such as a delayed intervention for the control group	Participants feel like they are contributing to the advancement of knowledge versus as passive research “subjects”	Community is less resentful of research process and more likely to participate	Design may be more expensive and/or take longer to implement. Possible threats to scientific rigor
Participant recruitment and retention	Community representatives guide researchers as to the most effective way to reach the intended study participants and keep them involved in the study	Those who may benefit most from the research are identified and recruited in dignified manner rather than made to feel like research subjects	Facilitated participant recruitment and retention, which are among the major challenges in health disparities research	Recruitment and retention approaches may be more complex, expensive, or time-consuming
Qualitative or formative data collection	Community members provide input as to intervention design, barriers to recruitment and retention, etc. via focus groups or structured interviews	Interventions and research approach are likely to be more acceptable to participants and thus of greater benefit to them and the broader population	Clinical and community-based interventions are likely to be more effective than if they are designed without prior formative data collection	Delays the start of quantitative data collection
Quantitative data instrument design and data collection	Extensive cognitive response and pilot testing of measurement instruments before beginning formal research	Measurement instruments less likely to be offensive or confusing to participants	Quality of data is likely to be superior in terms of reliability and validity	Time-consuming. Possible threats to scientific rigor
Intervention design and implementation	Community representative consulted about the most appropriate intervention approach given cultural and social factors and strengths of the community	Participants feel the intervention is designed for their needs and offers benefits while avoiding insult. Provides resources for communities involved	Intervention design is more likely to be appropriate for the study population, thus increasing the likelihood of a positive study	Time-consuming. Hiring local staff may be less efficient than using study staff hired for the project
Data analysis and interpretation	Community members are consulted regarding their interpretation of the findings within the local social and cultural context	Community members who hear the results of the study are more likely to feel that the conclusions are accurate and sensitive	Researchers are less likely to be criticized for limited insight or cultural insensitivity	Interpretations of data by nonscientists may differ from those of scientists. Thoughtful negotiation is required
Manuscript preparation and research translation	Members of the community are included as authors of the manuscripts following previously agreed upon guidelines	Pride in accomplishment, experience with scientific writing, and potential for career advancement	The manuscript is more likely to reflect an accurate picture of the community environment of the study	Time-consuming. Requires extra teaching and negotiation