Community Based Participatory Research (CBPR) Model:Nina Wallerstein, DrPHProfessor, Public Health
Director, Center for Participatory ResearchCollege of Population Health
University of New Mexico
CBPR Conceptual Model• Developed over a long process: 2006 – 2016• Key Question:
• What is the added value of partnering for improved health outcomes and health equity?
• Useful for assessing the links and pathways between promising practices and outcomes
• Validated by community partnerships and by national survey of 200 federally-funded partnerships (450 partners)
• Developed in consultation with Think TankFunding:
NIMHD Pilot (2006-2009)
Research for Improved Health NARCH Funding: (2009-2013)I.H.S./NIGMS, NIDA, NCRR, OBSSR, NCI, NIMHD
Engage for Equity: Advancing Community Engaged Partnerships (2015-20200National Institute of Nursing Research
Visual from amoshealth.org 2016
CBPR Conceptual Model
Partnership
Structures
RelationshipsIndividual
Characteristics
Health Care
Agency
Government
Intervention
& Research Outcomes
Long-term
Intermediate
• Policy Environment
• Sustained Partnership
• Empowerment
• Shared Power Relations
in Research
• Cultural Reinforcement
• Individual Partner /
Agency Capacities
Adapted from Wallerstein et al, 2008 & Wallerstein and Duran, 2010
Community
CBOs
Contexts
Capacity
&
Readiness
Collaboration
Trust &
Mistrust
Political
&
Policy
Social
&
Structural
• Community
Transformation
• Social Justice
• Health / Health Equity
Health
Issue
Importance
Funders
Integrate
Cultural
Knowledge
Cultural-
Centered
Interventions
Co-LearningPartnership
Synergy
Appropriate
Research
Design
Community
Involved in
Research
Academic
Partnership Processes
Processes Outputs
Capacity
&
Readiness
Collaboration
Trust &
Mistrust
Political
&
Policy
Social
&
Structural
Health
Issue
Importance
Context
Social-Economic Status,
Place, History,
Environment, Community
Safety, Institutional
Racism, Culture, Role of
Education and Research
Institutions
National/ Local
Governance/Approvals
of Research; Policy &
Funding Trends
Community/Academic,
Partnership Capacity
Perceived Severity by
Partners
Historic Trust /
Mistrust between
Partners
Partnership Processes
Partnership
Structures
RelationshipsIndividual
Characteristics
Health Care
Agency
Government
Community
CBO
s
Funders Academic
•Motivation to
Participate
•Cultural Identities /
Humility
•Personal Beliefs
/Values
•Spirituality
•Reputation of P.I.
How we interact
•Safety: Respect for
Community
Voice/Trust
•Flexibility
•Dialogue, Listening &
Mutual Learning
•Conflict Management
•Leadership/Influence
•Power
Shared/Stewardship
•Self & Collective
Reflection
•Participatory Decision-
making
•Resource
Management
•Task Roles/Group
Communication•Formal Agreements
•Partnership Values
•Bridging Social
Capital
•Time in Partnership
•Diversity: Who is involved
•Complexity
•Shared Resources
•% Dollars to Community
•Aligned CBPR Principles
Intervention & Research
Integrate
Cultural
Knowledge
Cultural-
Centered
Interventions
Co-LearningPartnership
Synergy
Appropriate
Research
Design
Community
Involved in
Research
Processes Outputs
Co-Learning Processes lead to
Partnership Synergy & Trust
Cultural Processes that honor cultural
knowledge, local settings and
organizations; and use both academic &
community language lead to culturally-
centered Interventions
Community Members Involved in Research
Activities leads to Research/Evaluation
Design that Reflects Community Priorities
Bidirectional Translation,
Implementation & Dissemination
Outcomes
Long-term
Intermediate
•Policy Environment
•Sustained Partnership
•Empowerment
•Shared Power Relations in
Research
•Cultural Reinforcement
•Individual Partner / Agency
Capacities
•Community Transformation
•Social Justice
•Health / Health Equity
Policies / Programs / Conditions
Both in Universities & Communities
Sustained Partnership and Interventions
Multi-Level
Knowledge Democracy, Productivity
Measures, i.e. Papers, Grant Applications &
Awards with Partners
Revitalization
Growth
Partnership Structures:
• Diversity: Who is involved
• Complexity
• Formal Agreements
• Shared Resources
• % Dollars to Community
• Aligned CBPR Principles
• Partnership Values
• Bridging Social Capital
• Time in Partnership
• Social-Structural: Social-Economic
Status, Place, History,
Environment, Community Safety,
Institutional Racism, Culture, Role
of Education and Research
Institutions
• Political Policy: National/ Local
Governance/Approvals of
Research; Policy & Funding
Trends
• Health Issue: Perceived Severity
by Partners
• Collaboration: Historic
Trust/Mistrust between Partners
• Capacity: Community/ Academic,
Partnership Capacity
Partnership DynamicsContexts OutcomesIntervention &
ResearchRelationships: How we interact
• Safety: Respect for
Community Voice/Trust
• Flexibility
• Dialogue, Listening & Mutual
Learning
• Conflict Management
• Leadership/Influence
• Power Shared/Stewardship
• Self & Collective Reflection
• Participatory Decision-
making
• Resource Management
• Task Roles/Group
Communication
Individual Characteristics:
• Motivation to Participate
• Cultural Identities/Humility
• Personal Beliefs/Values
• Spirituality
• Reputation of P.I.
• Cultural Processes that honor
cultural knowledge, local settings
and organizations; and use both
academic & community language
lead to culturally-centered
Interventions
• Co-Learning Processes lead to
Partnership Synergy & Trust
• Community Members Involved in
Research Activities leads to
Research/Evaluation Design that
Reflects Community Priorities
• Bidirectional Translation,
Implementation & Dissemination
Intermediate System & Capacity Outcomes
• Policy Environment Changes: both in Universities
& Communities
• Sustainable Partnerships and Interventions
• Empowerment – Multi-Level
• Equalized Power Relations in Research
• Productivity Measures, i.e. Papers, Grant
Applications & Awards with Partners
• Cultural Reinforcement/Revitalization
• Growth in Individuals & Agencies Capacities
• Knowledge Democracy
Long-Term Outcomes: Social Justice
• Community Transformation: Policies / Programs /
Conditions
• Improved Health / Health Equity
Visual from amoshealth.org 2016
CBPR Conceptual Model
Partnership
Structures
RelationshipsIndividual
Characteristics
Health Care
Agency
Government
Intervention
& Research Outcomes
Long-term
Intermediate
• Policy Environment
• Sustained Partnership
• Empowerment
• Shared Power Relations
in Research
• Cultural Reinforcement
• Individual Partner /
Agency Capacities
Adapted from Wallerstein et al, 2008 & Wallerstein and Duran, 2010
Community
CBOs
Contexts
Capacity
&
Readiness
Collaboration
Trust &
Mistrust
Political
&
Policy
Social
&
Structural
• Community
Transformation
• Social Justice
• Health / Health Equity
Health
Issue
Importance
Funders
Integrate
Cultural
Knowledge
Cultural-
Centered
Interventions
Co-LearningPartnership
Synergy
Appropriate
Research
Design
Community
Involved in
Research
Academic
Partnership Processes
Processes Outputs
Partnership Structures:
Partnership DynamicsContexts OutcomesIntervention &
ResearchRelationships: How we interact
Individual Characteristics:
• \
Intermediate System & Capacity Outcomes
Long-Term Outcomes: Social Justice
Visual from amoshealth.org 2016
CBPR Conceptual Model
Partnership
Structures
RelationshipsIndividual
Characteristics
Health Care
Agency
Government
Intervention
& Research Outcomes
Long-term
Intermediate
• Policy Environment
• Sustained Partnership
• Empowerment
• Shared Power Relations
in Research
• Cultural Reinforcement
• Individual Partner /
Agency Capacities
Adapted from Wallerstein et al, 2008 & Wallerstein and Duran, 2010
Community
CBOs
Contexts
Capacity
&
Readiness
Collaboration
Trust &
Mistrust
Political
&
Policy
Social
&
Structural
• Community
Transformation
• Social Justice
• Health / Health Equity
Health
Issue
Importance
Funders
Integrate
Cultural
Knowledge
Cultural-
Centered
Interventions
Co-LearningPartnership
Synergy
Appropriate
Research
Design
Community
Involved in
Research
Academic
Partnership Processes
Processes Outputs
Partnership Structures:
• Diversity: Who is involved
• Complexity
• Formal Agreements
• Shared Resources
• % Dollars to Community
• Aligned CBPR Principles
• Partnership Values
• Bridging Social Capital
• Time in Partnership
• Social-Structural: Social-Economic
Status, Place, History,
Environment, Community Safety,
Institutional Racism, Culture, Role
of Education and Research
Institutions
• Political Policy: National/ Local
Governance/Approvals of
Research; Policy & Funding
Trends
• Health Issue: Perceived Severity
by Partners
• Collaboration: Historic
Trust/Mistrust between Partners
• Capacity: Community/ Academic,
Partnership Capacity
Partnership DynamicsContexts OutcomesIntervention &
ResearchRelationships: How we interact
• Safety: Respect for
Community Voice/Trust
• Flexibility
• Dialogue, Listening & Mutual
Learning
• Conflict Management
• Leadership/Influence
• Power Shared/Stewardship
• Self & Collective Reflection
• Participatory Decision-
making
• Resource Management
• Task Roles/Group
Communication
Individual Characteristics:
• Motivation to Participate
• Cultural Identities/Humility
• Personal Beliefs/Values
• Spirituality
• Reputation of P.I.
• Cultural Processes that honor
cultural knowledge, local settings
and organizations; and use both
academic & community language
lead to culturally-centered
Interventions
• Co-Learning Processes lead to
Partnership Synergy & Trust
• Community Members Involved in
Research Activities leads to
Research/Evaluation Design that
Reflects Community Priorities
• Bidirectional Translation,
Implementation & Dissemination
Intermediate System & Capacity Outcomes
• Policy Environment Changes: both in Universities
& Communities
• Sustainable Partnerships and Interventions
• Empowerment – Multi-Level
• Equalized Power Relations in Research
• Productivity Measures, i.e. Papers, Grant
Applications & Awards
• Cultural Reinforcement/Revitalization
• Growth in Individuals & Agencies Capacities
• Knowledge Democracy
Long-Term Outcomes: Social Justice
• Community Transformation: Policies / Programs /
Conditions
• Improved Health / Health Equity
Visual from amoshealth.org 2016
CBPR Conceptual Model
Partnership
Structures
RelationshipsIndividual
Characteristics
Health Care
Agency
Government
Intervention
& Research Outcomes
Long-term
Intermediate
• Policy Environment
• Sustained Partnership
• Empowerment
• Equal Power Relations
in Research
• Cultural Reinforcement
• Individual Partner /
Agency Capacities
Adapted from Wallerstein et al, 2008 & Wallerstein and Duran, 2010
Community
CBOs
Contexts
Capacity
&
Readiness
Collaboration
Trust &
Mistrust
Political
&
Policy
Social
&
Structural
• Community
Transformation
• Social Justice
• Health / Health Equity
Health
Issue
Importance
Funders
Integrate
Cultural
Knowledge
Cultural-
Centered
Interventions
Co-LearningPartnership
Synergy
Appropriate
Research
Design
Community
Involved in
Research
Academic
Partnership Processes
Processes Outputs