Journal of Urban Health

, Volume 83, Issue 6, pp 1022–1040 | Cite as

Challenges and Facilitating Factors in Sustaining Community-Based Participatory Research Partnerships: Lessons Learned from the Detroit, New York City and Seattle Urban Research Centers

  • Barbara A. Israel
  • James Krieger
  • David Vlahov
  • Sandra Ciske
  • Mary Foley
  • Princess Fortin
  • J. Ricardo Guzman
  • Richard Lichtenstein
  • Robert McGranaghan
  • Ann-gel Palermo
  • Gary Tang


In order to address the social, physical and economic determinants of urban health, researchers, public health practitioners, and community members have turned to more comprehensive and participatory approaches to research and interventions. One such approach, community-based participatory research (CBPR) in public health, has received considerable attention over the past decade, and numerous publications have described theoretical underpinnings, values, principles and practice. Issues related to the long-term sustainability of partnerships and activities have received limited attention. The purpose of this article is to examine the experiences and lessons learned from three Urban Research Centers (URCs) in Detroit, New York City, and Seattle, which were initially established in 1995 with core support from the Centers for Disease Control and Prevention (CDC). The experience of these Centers after core funding ceased in 2003 provides a case study to identify the challenges and facilitating factors for sustaining partnerships. We examine three broad dimensions of CBPR partnerships that we consider important for sustainability: (1) sustaining relationships and commitments among the partners involved; (2) sustaining the knowledge, capacity and values generated from the partnership; and (3) sustaining funding, staff, programs, policy changes and the partnership itself. We discuss the challenges faced by the URCs in sustaining these dimensions and the strategies used to overcome these challenges. Based on these experiences, we offer recommendations for: strategies that partnerships may find useful in sustaining their CBPR efforts; ways in which a Center mechanism can be useful for promoting sustainability; and considerations for funders of CBPR to increase sustainability.


Community-based participatory research Sustainability Urban  Community partnerships 



The authors appreciate the involvement of all of the partners in the Detroit Community–Academic Urban Research Center, Harlem Community & Academic Partnership, and Seattle Partners who have contributed greatly to the success of the partnerships described in this article and to enhancing the authors’ understanding of CBPR and strategies for sustaining CBPR. Detroit partners: Community Health and Social Services Center, Communities In Schools, Detroit Department of Health and Wellness Promotion, Detroit Hispanic Development Corporation, Detroiters Working for Environmental Justice, Friends of Parkside, Henry Ford Health System, Latino Family Services, Neighborhood Service Organization, Southwest Solutions, University of Michigan Schools of Public Health, Nursing and Social Work, and Warren/Conner Development Coalition. New York City partners: AIDS Institute (State Health Department), Birdsong Program, Mount Sinai Hospital, Boriken Neighborhood Health Center/ East Harlem Council for Health, Services, Inc, Center for Community Problem Solving at NYU Law School, Center for Multicultural and Community Affairs, Mount Sinai School of Medicine, Center for Urban Epidemiologic Studies, The New York Academy of Medicine, Central Harlem HIV CARE Network, Division of General Internal Medicine, Cornell Medical Center, East Harlem Community Health Committee, East Harlem HIV Care Network, East Harlem Interagency Council for Older Adults, Food Change, Harlem Congregations for Community Improvement, Harlem Directors Group (Substance Abuse Treatment), Harlem East Life Plan, Human Service Consortium of East Harlem, Hunter College Center on AIDS, Drugs and Community Health, City University of New York, Latino Organization for Liver Awareness, Legal Aid Community Law Offices, Little Sisters of the Assumption, Mailman School of Public Health, Columbia University, Metropolitan Hospital Center, Mount Sinai Hospital, New York City Department of Health and Mental Hygiene, New York Harm Reduction Educators, New York Organ Donor Network, North General Hospital, Palladia, Inc., STEPS to End Family Violence & Incarcerated Mothers Program, Union Settlement Association, Women’s Information Network. Seattle partners: Asian Counseling and Referral Services, Central Area Senior Center, Cross Cultural Health Care Program, Group Health Cooperative, Horn of Africa Services, Harborview Medical Center, International District Housing Alliance, Public Health–Seattle & King County, Puget Sound Neighborhood Health Centers, Rainier Beach Community Center, Refugee Women’s Alliance, Safe Futures Youth Center, Seattle Housing Authority, University of Washington School of Public Health and Community Medicine. (See,, and for more details.) The authors also thank Sue Andersen for her assistance in preparing the manuscript, and the anonymous reviewers for their helpful comments.


  1. 1.
    Bullard RD, ed. Unequal Protection: Environmental Justice and Communities of Color. San Francisco, CA: Sierra Club Books; 1994.Google Scholar
  2. 2.
    Freudenberg N. Community-based health education for urban populations: An overview. Health Educ Behav. 1998;25:11–23.PubMedGoogle Scholar
  3. 3.
    Galea S, Vlahov D. Urban health: Evidence, challenges, and directions. Annu Rev Public Health. 2005;26:341–365.PubMedCrossRefGoogle Scholar
  4. 4.
    Schulz AJ, Krieger JW, Galea S. [Introduction] Addressing social determinants of health: Community-based participatory approaches to research and practice. Health Educ Behav. 2002;29:287–295.PubMedCrossRefGoogle Scholar
  5. 5.
    Link BG, Phelan J. Social conditions as fundamental causes of disease. J Health Soc Behav. 1995;36(Special issue):80–94.CrossRefGoogle Scholar
  6. 6.
    Adler N, Newman K. Socioeconomic disparities in health: Pathways and policies. Inequality in education, income, and occupation exacerbates the gaps between the health “haves” and “have-nots.” Health Aff. 2002;21:60–76.CrossRefGoogle Scholar
  7. 7.
    House JS, Williams DR. Understanding and reducing socioeconomic and racial/ethnic disparities in health. In: Smedley BD, Syme SL, eds. Promoting Health: Intervention Strategies from Social and Behavioral Research. Washington, DC: National Academy Press; 2000:81–124.Google Scholar
  8. 8.
    Kaplan G. What is the role of the social environment in understanding inequalities in health? Ann NY Acad Sci. 1999;896:116–119.PubMedCrossRefGoogle Scholar
  9. 9.
    Marmot MG. Socio-economic factors in cardiovascular disease. J Hypertens, Suppl. 1996;14:S201–S205.Google Scholar
  10. 10.
    Kawachi I, Berkman LF, eds. Neighborhoods and Health. New York: Oxford University Press; 2003.Google Scholar
  11. 11.
    Vlahov D, Galea S. Urbanization, urbanicity, and health. J Urban Health. 2002;79(suppl 1):S1–S12.PubMedGoogle Scholar
  12. 12.
    Williams DR, Collins C. US socioeconomic and racial differences in health: Patterns and explanations. Annu Rev Sociol. 1995;21:349–386.CrossRefGoogle Scholar
  13. 13.
    Green LW, George MA, Daniel M, et al. Study of Participatory Research in Health Promotion. Vancouver, BC: University of British Columbia, Royal Society of Canada; 1995.Google Scholar
  14. 14.
    Israel BA, Schulz AJ, Parker EA, Becker AB. Review of community-based research: Assessing partnership approaches to improve public health. Annu Rev Public Health. 1998;19:173–202.PubMedCrossRefGoogle Scholar
  15. 15.
    Israel BA, Schulz AJ, Parker EA, Becker AB, Allen AJ, Guzman JR. Critical issues in developing and following community-based participatory research principles. In: Minkler M, Wallerstein N, eds. Community-Based Participatory Research for Health. San Francisco, CA: Jossey-Bass; 2003:56–73.Google Scholar
  16. 16.
    Minkler M, Wallerstein N, eds. Community-Based Participatory Research for Health. 1st ed. San Francisco, CA: Jossey-Bass; 2003.Google Scholar
  17. 17.
    Israel BA, Eng E, Schulz AJ, Parker EA. Introduction. In: Israel BA, Eng E, Schulz AJ, Parker EA, eds. Methods in Community-Based Participatory Research for Health. San Francisco, CA: Jossey-Bass; 2005:3–26.Google Scholar
  18. 18.
    Israel BA, Eng E, Schulz AJ, Parker EA, eds. Methods in Community-Based Participatory Research for Health. San Francisco, CA: Jossey-Bass; 2005.Google Scholar
  19. 19.
    Freudenberg N. Case history of the Center for Urban Epidemiologic Studies in New York City. J Urban Health. 2001;78:508–518.PubMedGoogle Scholar
  20. 20.
    Green LW, Daniel M, Novick LF. Partnerships and coalitions for community-based research. Public Health Rep. 2001;116(suppl 1):20–31.PubMedCrossRefGoogle Scholar
  21. 21.
    Lantz P, Viruell-Fuentes E, Israel BA, Softley D, Guzman JR. Can communities and academia work together on public health research? Evaluation results from a community-based participatory research partnership in Detroit. J Urban Health. 2001;78(3):495–507.PubMedGoogle Scholar
  22. 22.
    Schensul JJ. Organizing community research partnerships in the struggle against AIDS. Health Educ Behav. 1999;26:266–283.PubMedGoogle Scholar
  23. 23.
    Schulz AJ, Israel BA, Selig SM, Bayer IS, Griffin CB. Development and implementation of principles for community-based research in public health. In: MacNair, RH ed. Research Strategies for Community Practice. New York, NY: Haworth Press; 1998:83–110.Google Scholar
  24. 24.
    deKoning K, Martin M, eds. Participatory Research in Health: Issues and Experiences. London: Zed Books Ltd.; 1996.Google Scholar
  25. 25.
    Israel BA, Parker EA, Rowe Z, et al. Community-based participatory research: Lessons learned from the Centers for Children’s Environmental Health and Disease Prevention Research. Environ Health Perspect. 2005;113:1463–1471.PubMedCrossRefGoogle Scholar
  26. 26.
    Galea S, Factor SH, Bonner S, et al. Collaboration among community members, local health service providers, and researchers in an urban research center in Harlem, New York. Public Health Rep. 2001;116:530–539.PubMedGoogle Scholar
  27. 27.
    Eisinger A, Senturia KD. Doing community-driven research: A description of Seattle Partners for Healthy Communities. J Urban Health. 2001;78:519–534.PubMedGoogle Scholar
  28. 28.
    Krieger JW, Allen C, Cheadle A, et al. Using community-based participatory research to address social determinants of health: Lessons learned from Seattle Partners for Healthy Communities. Health Educ Behav. 2002;29:361–382.PubMedCrossRefGoogle Scholar
  29. 29.
    Metzler MM, Higgins DL, Beeker CG, et al. Addressing urban health in Detroit, New York City, and Seattle through community-based participatory research partnerships. Am J Public Health. 2003;93:803–811.PubMedCrossRefGoogle Scholar
  30. 30.
    Alexander JA, Weiner BJ, Metzger ME, et al. Sustainability of collaborative capacity in community health partnerships. Med Care Res Rev. 2003;60:130s–160s.CrossRefPubMedGoogle Scholar
  31. 31.
    Best A, Stokols D, Green LW, Leischow S, Holmes B, Buchholz K. An integrative framework for community partnering to translate theory into effective health promotion strategy. Am J Health Promot. 2003;18:168–176.PubMedGoogle Scholar
  32. 32.
    Gomez BJ, Greenberg MT, Feinberg ME. Sustainability of community coalitions: An evaluation of communities that care. Prev Sci. 2005;6:199–202.PubMedCrossRefGoogle Scholar
  33. 33.
    Williams A, Labonte R, Randall JE, Muhajarine N. Establishing and sustaining community–university partnerships: A case study of quality of life research. Critical Public Health. 2005;15:291–302.CrossRefGoogle Scholar
  34. 34.
    Bracht N, Finnegan JR, Rissel C, et al. Community ownership and program continuation following a health demonstration project. Health Educ Res. 1994;9:243–255.PubMedGoogle Scholar
  35. 35.
    Evashwick C, Ory M. Organizational characteristics of successful innovative health care programs sustained over time. Family and Community Health. 2003;26:177–193.Google Scholar
  36. 36.
    Goodman RM, Steckler AB. A model for the institutionalization of health promotion programs. Family and Community Health. 1989;11:63–78.Google Scholar
  37. 37.
    Jackson C, Fortmann SP, Flora JA, Melton RJ, Snider JP, Littlefield D. The capacity-building approach to intervention maintenance implemented by the Stanford Five-City Project. Health Educ Res. 1994;9:385–396.PubMedGoogle Scholar
  38. 38.
    Shediac-Rizkallah MC, Bone LR. Planning for the sustainability of community-based health programs: Conceptual frameworks and future directions for research, practice and policy. Health Educ Res. 1998;13:87–108.PubMedGoogle Scholar
  39. 39.
    Higgins DL, Metzler M. Implementing community-based participatory research centers in diverse urban settings. J Urban Health. 2001;78 :488–494.PubMedGoogle Scholar
  40. 40.
    Higgins DL, Maciak BJ, Metzler M. CDC Urban Research Centers: Community-based participatory research to improve the health of urban communities. Journal of Women’s Health and Gender-Based Medicine. 2001;10:9–15.PubMedCrossRefGoogle Scholar
  41. 41.
    Israel BA, Lichtenstein R, Lantz P, et al. The Detroit Community–Academic Urban Research Center: Development, implementation and evaluation. J Public Health Manag Pract. 2001;7(5):1–19.PubMedGoogle Scholar
  42. 42.
    Koné A, Sullivan M, Senturia KD, Chrisman NJ, Ciske SJ, Krieger JW. Improving collaboration between researchers and communities. Public Health Rep. 2000;115:243–248.PubMedCrossRefGoogle Scholar
  43. 43.
    Antonucci TC. Social support and social relationships. In: Binstock RH, George LK, eds. Handbook of Aging and the Social Sciences. 3rd ed. San Diego: Academic Press; 1990:205–226.Google Scholar
  44. 44.
    Thomas JM. Redevelopment and Race: Planning a Finer City in Postwar Detroit. Baltimore: Johns Hopkins University Press; 1997.Google Scholar
  45. 45.
    New York City Department of Health and Mental Hygiene. Publications. 2003. Available at: Accessed on May 21, 2006.
  46. 46.
    Wayne State University Center for Urban Studies. 2000 Census Demographic Profile of City of Detroit. Detroit, MI: Wayne State University; 2000.Google Scholar
  47. 47.
    Washington State Department of Social and Health Services. Population Estimates, Washington State Adjusted Population Estimates. Seattle: 1997.Google Scholar
  48. 48.
    Israel BA, Schulz AJ, Parker EA, Becker AB. Community-based participatory research: Policy recommendations for promoting a partnership approach in health research. Educ Health. 2001;14:182–197.CrossRefGoogle Scholar

Copyright information

© The New York Academy of Medicine 2006

Authors and Affiliations

  • Barbara A. Israel
    • 1
  • James Krieger
    • 2
  • David Vlahov
    • 3
  • Sandra Ciske
    • 2
  • Mary Foley
    • 4
  • Princess Fortin
    • 5
  • J. Ricardo Guzman
    • 6
  • Richard Lichtenstein
    • 1
  • Robert McGranaghan
    • 1
  • Ann-gel Palermo
    • 7
  • Gary Tang
    • 8
  1. 1.University of Michigan, School of Public HealthAnn ArborUSA
  2. 2.Epidemiology, Planning and Evaluation UnitPublic Health—Seattle & King CountySeattleUSA
  3. 3.Center for Urban Epidemiologic StudiesNew York Academy of MedicineNew YorkUSA
  4. 4.Department of Community and Preventive MedicineMt. Sinai Medical SchoolNew YorkUSA
  5. 5.City Research ScientistNew York City Department of HealthNew YorkUSA
  6. 6.Community Health and Social Services, Inc.DetroitUSA
  7. 7.Center for Multicultural and Community AffairsMount Sinai School of MedicineNew YorkUSA
  8. 8.Aging and Adult Services Company, Asian Counseling and Referral ServicesSeattleUSA

Personalised recommendations