Understanding community-based participatory research through a social movement framework: a case study of the Kahnawake Schools Diabetes Prevention Project.

BACKGROUND: A longstanding challenge of community-based participatory research (CBPR) has been to anchor evaluation and practice in a relevant theoretical framework of community change, which articulates specific and concrete evaluative benchmarks. Social movement theories provide a broad range of theoretical tools to understand and facilitate social change processes, such as those involved in CBPR. Social movement theories have the potential to provide a coherent representation of how mobilization and collective action is gradually developed and leads to systemic change in the context of CBPR. The current study builds on a social movement perspective to assess the processes and intermediate outcomes of a longstanding health promotion CBPR project with an Indigenous community, the Kahnawake Schools Diabetes Prevention Project (KDSPP). METHODS: This research uses a case study design layered on a movement-building evaluation framework, which allows progress to be tracked over time. Data collection strategies included document (scientific and organizational) review (n = 51) and talking circles with four important community stakeholder groups (n = 24). RESULTS: Findings provide an innovative and chronological perspective of the evolution of KSDPP as seen through a social movement lens, and identify intermediate outcomes associated with different dimensions of movement building achieved by the project over time (mobilization, leadership, vision and frames, alliance and partnerships, as well as advocacy and action strategies). It also points to areas of improvement for KSDPP in building its potential for action. CONCLUSION: While this study's results are directly relevant and applicable to the local context of KSDPP, they also highlight useful lessons and conclusions for the planning and evaluation of other long-standing and sustainable CBPR initiatives. The conceptual framework provides meaningful benchmarks to track evidence of progress in the context of CBPR. Findings from the study offer new ways of thinking about the evaluation of CBPR projects and their progress by drawing on frameworks that guide other forms of collective action.

Community-based participatory research: lessons from sharing results with the community: Kahnawake Schools Diabetes Prevention Project.

BACKGROUND: Kahnawake Schools Diabetes Prevention Project (KSDPP) is an ongoing, community-based participatory research project with an Aboriginal community in Canada, promoting healthy lifestyles to prevent type 2 diabetes. OBJECTIVES: To document lessons learned from sharing results with the community, and analyzing feedback from attendees. METHODS: In 2004, a researcher-community team delivered 16 sessions of a contextualized presentation of data collected from 1994 to 2002. The team documented the resulting questions and discussions, attendees completed anonymous questionnaires including open-ended questions, and presenters summarized their impressions. RESULTS: One hundred eighty-one people attended the presentations and question/discussion periods were summarized. One hundred sixty-two (82%) of attendees (87% female), completed the questionnaires; 99% understood the presentations and 142 (88%) stated they intended to improve their lifestyles. Qualitative analysis of discussions and open-ended comments categorized attendees' comments about KSDPP, the 1994 through 2002 results, the community, and lifestyle habits. Lessons learned included the time needed to develop and make the presentations, the importance of using community knowledge to guide the experience, ways of attracting an audience, difficulty of reaching men, use of feedback from those attending the presentations, and the need to plan prospectively for analyzing attendee feedback. CONCLUSIONS: Community feedback was used to improve interventions and finalize interpretation of the results.