Abstract
Health is not equally distributed and various neighbourhoods differ from each other in terms of people’s health and other social and economic variables. Numerous efforts are undertaken to develop healthier and more sustainable neighbourhoods, and a key concern in the process is citizen participation. Due to the challenge of conducting research in poor neighbourhood’s complementary research approaches with a more practice-based and democratic knowledge development are needed. Community-based participatory research (CBPR) is a partnership approach that aims to conduct collaborative knowledge production and to use the research findings for public health interventions. This paper sets out to describe and analyse a community-academic partnership and a CBPR process within a poor neighbourhood in Sweden. Two years of fieldwork were conducted at 26 meetings comprising 84 h in a CBPR group including a researcher, and lay and professional stakeholders. Participatory observation and detailed meeting process-notes were used when doing a qualitative thematic analysis. Eight different developmental phases was identified in the implementation of a CBPR process and four key lessons were found to be important. These were that a community-academic partnership should (1) accept different levels of participation in different phases; (2) openly discuss mutual expectations and individual prerequisites; (3) unmask power and authority; and (4) allow the work to take the time it needs. The design, process, and result of the CBPR project are relevant for local community-academic partnerships using a CBPR approach with the goal of increasing participation as a means of improving people’s health and well-being in poor neighbourhoods.
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References
Bell S, Morse S (2010) Triple task method: systemic, reflective action research. Syst Pract Action Res 23(6):443–452. doi:10.1007/s11213-010-9171-7
Biggs SD (1989) Resource-poor farmer participation in research. A synthesis of experiences from nine national agricultural research systems. OFCOR Comparative Study Paper 3 International Service for National Agricultural Research, Hague
Blackman T (2006) Neighbourhood renewal, health improvement and complexity. Policy Press, Bristol
Blasius J, Friedrichs J, Galster G (2009) Introduction. Quantifying neighbourhood effects. In: Blasius J, Friedrichs J, Galster G (eds) Quantifying neighbourhood effects. Frontiers and perspective. Routledge, London, pp 1–10
Braun V, Clarke V (2006) Using thematic analysis in psychology. Qual Res Psychol 3(2):77–101
Burgers J, Vranken J (2004) How to make a successful urban development programme. Experiences from nine European countries. Garant, Antwerpen–Apeldoorn
Cornwall A, Jewkes R (1995) What is participatory research? Soc Sci Med 41(12–12):1667–1676
Dahlgren G, Whitehead M (1991) Policies and strategies to promote social equity in health. Stockholm Institute for future studies
DeWalt KM, DeWalt BR (2002) Participant observation. A guide for fieldworkers. AltaMira Press, Walnut Creek
Eriksson C, Granvik M, Kindblad I, Lindgren G, Nyström L, Rosén M, Wall S (1981) Health problems in a Swedish county. What can we learn from official sources? Soc Sci Med 15C:143–151
Fitzpatrick K, La Gory M (2011) Unhealthy cities: poverty, race, and place in America. Routledge, New York
Freudenberg N, Galea S, Vlahov D (2006) Cities and the health of the public. Vanderbilt University Press, Nashville
Fröding K, Eriksson C, Elander I (2008) Partnership for healthy neighbourhoods: city networking in multilevel context. Eur Urban Reg Stud 15(4):317–331
Fröding K, Larsson L, Wentzel G, Österdahl K (2009) Delaktighet för utveckling av en hälsosam stadsdel. Participatorisk forskning i Baronbackarna [Participation in the development of a healthy neighbourhood. Participatory research in Baronbackarna]. Örebro
Fröding K, Elander I, Eriksson C (2011) Neighbourhood development and public health initiatives: who participates? Health Promot Int. doi:10.1093/heapro/dar024
Fung A (2006) Varieties of participation in complex governance. Public Adm Rev 66(s1):66–75
Galea S, Vlahov D (2005) Urban health. Populations, methods, and practice. In: Galea S, Vlahov D (eds) Handbook of urban health. Polpulations, methods, and practice. Springer, New York, pp 1–15
Galuppo L, Gorli M, Ripamonti S (2011) Playing dissymmetry in action research: the role of power and differences in promoting participative knowledge and change. Syst Pract Action Res 24(2):147–164. doi:10.1007/s11213-010-9181-5
Geidne J, Fröding K, Montin S, Eriksson C (2012) Implementation structure and participation at neighbourhood level. A multiple case study of neighbourhood development in Sweden. Syst Pract Action Res. doi:10.1007/s11213-012-9227-y
Graham H (2007) Unequal lives. Health and socioeconomic inequalities. Open university press, Maidenhead
Green L (2001) From research to “best practise” in other settings and populations. Am J Health Behav 25(3):165–178
Green J, Tones K (2010) Health promotion. Planning and strategies, 2nd edn. SAGE, London
Hughes D (2007) Participant observation in health research. In: Saks M, Allsop J (eds) Researching health. Qualitative, quantitative and mixed methods. SAGE, London, pp 92–111
Huxham C, Barr C (1996) Involving the community: collaboration for community development. In: Huxham C (ed) Creating collaborative advantage. SAGE, London, pp 110–125
Israel BA, Schulz AJ, Parker EA, Becker AB (1998) Review of community-based research: assessing partnership approaches to improve public health. Annu Rev Public Health 19(1):173–202
Israel BA, Lichtenstein R, Lantz P (2001) The Detroit Community-Academic Urban Research Center: development, implementation, and evaluation. J Public Health Manag Pract 7(5):1–20
Israel BA, Shulz AJ, Parker EA, Becker AB (2003) Critical issues in developing and following community based participatory research principles. In: Minkler M, Wallerstein N (eds) Community-based participatory research for health. Jossey-Bass, San Francisco
Israel BA, Eng E, Schulz AJ, Parker EA (2005) Introduction to methods in community-based participatory research for health. In: Israel Barbara A, Eng E, Schulz Amy J, Parker Edith A (eds) Methods in community-based participatory research for health. Josse-Bass, San Francisco
Kawachi I, Berkman LF (eds) (2003) Neighborhoods and health. Oxford University Press, New York
Labonte R (2005) Community, community development, and the forming of authentic partnerships. Some critical reflections. In: Minkler M (ed) Community organizing and community building for health, 2nd edn. Rutgers University Press, New Brunswick, pp 82–96
Lantz PM, Viruell-Fuentes E, Israel BA, Softley D (2001) Can communities and academia work together on public health research? Evaluation results from a community-based participatory research partnership in Detroit. J Urban Health 78(3):495–507
Larsson J (2000) Formal consensus and democracy. Report 48. Örebro University, Centre for Urban and Regional Research Örebro
Linden-Bostrom M, Persson C, Eriksson C (2010) Neighbourhood characteristics, social capital and self-rated health: a population-based survey in Sweden. BMC Public Health 10(1):628
Lindén-Boström M, Persson C (2013) A selective follow-up study on a public health survey. Eur J Public Health 23(1):152–157. doi:10.1093/eurpub/ckr193
Loewenson R, Laurell AC, Hogstedt C (1994) Participatory approaches in occupational health research. Solna: Arbetsmiljöinstitutet, Arbete och hälsa 38:1–61
Lundberg B, Starrin B (2001) Participatory research. Tradition, theory, and practice. Division for Social Sciences, Karlstad University Studies, Karlstad
Mercer SL, MacDonald G, Green LW (2004) Participatory research and evaluation: from best practices for all states to achievable practices within each state in the context of the master settlement agreement. Health Promot Pract 5(3 suppl):167S–178S
Merriam SB (2009) Qualitative research. A guide to design and implementation. Jossey-Bass, San Francisco
Minkler M, Wallerstein N (2003) Introduction to community based participatory research. In: Minkler M, Wallerstein N (eds) Community-based participatory research for health. Jossey-Bass, San Francisco, pp 3–26
Molarius A, Berglund K, Eriksson C, Lambe M, Nordstrom E, Eriksson H, Feldman I (2007) Socioeconomic conditions, lifestyle factors, and self-rated health among men and women in Sweden. Eur J Public Health 17(2):125–133
Molarius A, Berglund K, Eriksson C, Eriksson H, Linden-Bostrom M, Nordstrom E, Persson C, Sahlqvist L, Starrin B, Ydreborg B (2009) Mental health symptoms in relation to socio-economic conditions and lifestyle factors: a population-based study in Sweden. BMC Public Health 9:302
Nutbeam D (1996) Achieving ‘best practice’ in health promotion: improving the fit between research and practice. Health Educ Res 11(3):317–326. doi:10.1093/her/11.3.317
Ottmann G, Laragy C, Damonze G (2009) Consumer participation in designing community based consumer-directed disability care: lessons from a participatory action research-inspired project. Syst Pract Action Res 22(1):31–44. doi:10.1007/s11213-008-9110-z
Parry J, Laburn-Peart K, Orford J, Dalton S (2004) Mechanisms by which area-based regeneration programmes might impact on community health: a case study of the new deal for communities initiative. Public Health 118(7):497–505
Patton MQ (2002) Qualitative research and evaluation methods, 3rd edn. SAGE, London
Schulz AJ, Israel BA, Lantz P (2003) Instrument for evaluating dimensions of group dynamics within community-based participatory research partnerships. Eval Program Plan 26(3):249–262
Scriven A, Hodgins M (2012) Health promotion settings. Principles and practice. SAGE, London
Stewart M (2003) Neighbourhood renewal and regeneration. In: Orme J, Powell J, Taylor P, Harrison T, Grey M (eds) Public health for the 21st century. New perspectives on policy, participation and practice. Open University Press, Maidenhead, pp 177–191
Suarez-Balcazar Y, Harper GW, Lewis R (2005) An interactive and contextual model of community–university collaborations for research and action. Health Educ Behav 32(1):84–101
Svensson L, Aagaard Nielsen K (2006) A framework for the book. In: Aagaard Nielsen K, Svensson L (eds) Action research and interactive research. Shaker, Maastricht, pp 13–44
Svensson L, Ellström P-E, Åberg C (2004) Integrating formal and informal learning at work. J Workplace Learn 16(8):479–491
Svensson L, Eklund J, Randle H, Aronsson G (2007a) Interactive research. An attempt to analyse two change programmes. Int J Action Res 3(3):250–277
Svensson L, Ellström P-E, Brulin G (2007b) Introduction on interactive research. Int J Action Res 3(3):233–249
Svensson L, Bennich M, Randle H (2009) Organising workplace learning. An inter-organisational perspective. J Eur Ind Train 33(8/9):771–786
Swanborn P (2010) Case study research. What, why and how?. SAGE, Los Angeles
Teddlie C, Tashakkori A (2009) Foundations of mixed methods research. Integrating quantitative and qualitative approaches in the social and behavioral sciences. SAGE, Los Angeles
Thomson H, Petticrew M, Morrison D (2001) Health effects of housing improvement. Systematic review of intervention studies. BMJ 323:187–190
Tydén T (2006) Aspects of interactive research in the Nordic countries. A historical perspective. In: Aagaard Nielsen K, Svensson L (eds) Action research and interactive research. Beyond practice and theory. Shaker, Maastricht, pp 143–178
Van Beckhoven E, Van Boxmeer B, Szemző H (2009) Local participation in large housing estates. A comparison of the Netherlands, Spain and Hungary. In: Rowlands R, Musterd S, van Kempen R (eds) Mass housing in Europe multiple faces of development, change and response. Palgrave Macmillian, Basingstoke
Vranken J, De Decker P, Van Nieuwenhuyze I (2003) Social inclusion, urban governance and sustainability: towards a conceptual framework. Garant, Antwerpen–Apeldoorn
Wallerstein N (2006) What is the evidence of effectiveness of empowerment to improve health?. WHO Regional Office for Europe, Copenhagen
Wallerstein N, Duran B (2006) Using community-based participatory research to address health disparities. Health Promot Pract 7(3):312–323
Whitman S, Shah A, Benjamins M (2010) Urbqan health: combating disparities with local data. Oxford University Press, New York
WHO (1978) Alma-Ata 1978. Primary health care. WHO, Geneva
WHO (1986) The Ottawa charter for health promotion. First international conference on health promotion. WHO, Copenhagen
WHO (2008) Closing the gap in a generation. Health equity through action on the social determinants of health. Final report of the commission on social determinants of health. WHO, Geneva
Wilkinson R, Pickett K (2009) The spirit level. Why more equal societies almost always do better. Penguin Books, London
Yassi A, Fernandez N, Fernandez A, Bonet M, Tate RB, Spiegel J (2003) Community participation in a multisectoral intervention to address health determinants in an inner-city community in central Havana. J Urban Health 80(1):61–80
Acknowledgments
We are very grateful to all group members in the CBPR who made this study possible. Thank you for your engagement, enthusiasm, and valuable experience. We would also like to acknowledge the Partnership for Sustainable Welfare Development for initiating this local CBPR process. In addition, thanks to all the residents who willingly participated in the interviews. The Swedish Research Council for Environment, Agricultural Sciences and Spatial Planning supported the study and the research team/program “The Healthy City: Social Inclusion, Urban Governance, and Sustainable Welfare Development”.
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The authors declare that they have no competing or financial interests.
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Fröding, K., Elander, I. & Eriksson, C. A Community-Based Participatory Research Process in a Poor Swedish Neighbourhood. Syst Pract Action Res 28, 19–36 (2015). https://doi.org/10.1007/s11213-014-9319-y
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DOI: https://doi.org/10.1007/s11213-014-9319-y