The Art and Science of Integrating Undoing Racism with CBPR: Challenges of Pursuing NIH Funding to Investigate Cancer Care and Racial Equity
- First Online:
In this nation, the unequal burden of disease among People of Color has been well documented. One starting point to eliminating health disparities is recognizing the existence of inequities in health care delivery and identifying the complexities of how institutional racism may operate within the health care system. In this paper, we explore the integration of community-based participatory research (CBPR) principles with an Undoing Racism process to conceptualize, design, apply for, and secure National Institutes of Health (NIH) funding to investigate the complexities of racial equity in the system of breast cancer care. Additionally, we describe the sequence of activities and “necessary conflicts” managed by our Health Disparities Collaborative to design and submit an application for NIH funding. This process of integrating CBPR principles with anti-racist community organizing presented unique challenges that were negotiated only by creating a strong foundation of trusting relationships that viewed conflict as being necessary. The process of developing a successful NIH grant proposal illustrated a variety of important lessons associated with the concepts of cultural humility and cultural safety. For successfully conducting CBPR, major challenges have included: assembling and mobilizing a partnership; the difficulty of establishing a shared vision and purpose for the group; the problem of maintaining trust; and the willingness to address differences in institutional cultures. Expectation, acceptance and negotiation of conflict were essential in the process of developing, preparing and submitting our NIH application. Central to negotiating these and other challenges has been the utilization of a CBPR approach.
KeywordsBreast cancer Community-based participatory research Health disparities Institutional racism.
- 1.Geiger HJ. Health disparities: What do we know? What do we need to know? What should we do? In: Schulz A, Mullings L, eds. Gender, Race, Class, and Health: Intersectional Approaches. San Francisco, CA: Jossey-Bass; 2006:261–288.Google Scholar
- 2.Smedley BD, Stith AY, Nelson R. Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care. Washington, D.C.: National Academies; 2003.Google Scholar
- 5.Griffith DM, Childs EL, Eng E, Jeffries V. Racism in organizations: the case of a county public health department. J Commun Psychol. In press.Google Scholar
- 8.People’s Institute for Survival and Beyond. Dedicated to training and organizing with intelligence and integrity-with values and vision. (2006) Available at http://www.pisab.org. Accessed on October 2, 2006.
- 10.Ramsden I. Cultural safety: Implementing the concept. The social force of nursing and midwifery. In: Te Whaiti P, McCarthy M, Durie A, eds. Mai i Rangiatea: Maori wellbeing and development. Auckland, New Zealand: Auckland University Press and Bridget Williams Books; 1997:113–125.Google Scholar