Development and Evaluation of a Training Program for Community-Based Participatory Research in Breast Cancer.

This paper describes the development and feasibility of the Community Based Research Infrastructure to Better Science (CRIBS) training. The goal of this training program was to help new or existing community-academic teams to build strong partnerships and successfully develop together fundable research projects focused on breast cancer environmental causes and disparities. A comprehensive mixed-methods participatory approach was utilized to assess the training. Twenty-two community-academic teams applied for the training program; twelve teams were enrolled. All teams completed the training and subsequently submitted research applications for funding. All components of the training received high ratings and positive qualitative comments. Self-rated competency in all of the learning domains increased during the training. Four (33%) of teams were successful in their first attempt to garner research funding, and six (50%) were eventually successful. The evaluation of CRIBS found it to have successfully achieved all four goals of the training: (1) Twelve new CBPR (community-based participatory research) teams, (2) improved knowledge about CBPR and science, (3) twelve submitted grant proposals in the first year, and (4) six (50%) successfully funded research projects.

Re-examining religiosity as a protective factor: comparing alcohol use by self-identified religious, spiritual, and secular college students.

Religiosity has been found to be associated with lower alcohol use by college students. The majority of studies on this topic, however, fail to differentiate religiosity and spirituality. This is potentially problematic due to the changing face of religion in America today. A study was conducted to explore similarities and differences between self-identified religious and spiritual college students. A modified version of the Core Alcohol and Drug Survey was administered online with a sample of 2,312 students. As hypothesized, self-identified religious and spiritual students differed significantly on key variables related to religious practices, alcohol consumption, and postmodern social values.

Nowhere to go: how stigma limits the options of female drug users after release from jail.

BACKGROUND: Drug and alcohol using women leaving prison or jail face many challenges to successful re-integration in the community and are severely hampered in their efforts by the stigma of drug or alcohol use compounded by the stigma of incarceration. METHODS: This qualitative study is based on individual semi-structured interviews and focus groups with 17 women who had recently left jail about the challenges they faced on reentry. RESULTS: Our analysis identified three major themes, which are related by the overarching influence of stigma: survival (jobs and housing), access to treatment services, and family and community reintegration. CONCLUSION: Stigma based on drug use and incarceration works to increase the needs of women for health and social services and at the same time, restricts their access to these services. These specific forms of stigma may amplify gender and race-based stigma. Punitive drug and social policies related to employment, housing, education, welfare, and mental health and substance abuse treatment make it extremely difficult for women to succeed.

Evaluation of a partnership approach to translating research on breast cancer and the environment.

BACKGROUND: The growing literature on community-based participatory research (CBPR) suggests that a participatory approach benefits science in important ways. However there have been few formal evaluations of a CBPR approach itself, and few standards developed to assist in such efforts. OBJECTIVES: This evaluation used CBPR guidelines developed by Green and colleagues to evaluate the participatory approach of the Community Outreach and Translation Core (COTC) of the Bay Area Breast Cancer and the Environment Research Center (BABCERC) in translating scientific findings from two key projects to the public. METHOD: To assess key stakeholders' perceptions of alignment between the projects and the guidelines, four COTC members, four researchers, and four community members rated the projects on each of the 26 guidelines. These data were triangulated with transcripts from interviews with the same participants and a focus group with a subset of the participants. RESULTS: The participatory approach by the COTC resulted in many important benefits including improved relationships among diverse stakeholders, knowledge generation, increased sensitivity and propriety of the research, and increased community support of research. However, several atypical features of this collaboration-for example, the basic and etiological nature of the science being undertaken, and the multiple communities (lay and activist/advocate) involved-resulted in different levels and qualities of participation among stakeholders. CONCLUSIONS: Further research should focus on the adaptation of participatory research principles for different kinds of community partners and on the development and refinement of standards and tools to assist in evaluating the process and outcome of participatory research.

Community reentry: perceptions of people with substance use problems returning home from New York City jails.

Each year about 100,000 people return to New York City communities from municipal jails. Although about four-fifths report drug or alcohol problems, few have received any formal drug treatment while in jail. Researchers and practitioners have identified a number of policies related to corrections, income, housing, and drug treatment that may be harmful to the successful reintegration of people leaving jail. In order to explore the challenges to successful community reentry, six focus groups and one in-depth interview were conducted with 37 men and women who had been released from jail or prison in the last 12 months. Participants were asked to describe their experiences prior to and immediately following release from jail. Findings suggest that many people leaving jail are not prepared for release and, upon release, face a myriad of obstacles to becoming healthy, productive members of their communities. We discuss the implications of these findings for programs and policies that promote community reintegration of individuals returning from correctional facilities.

Harlem service providers' perceptions of the impact of municipal policies on their clients with substance use problems.

Substance abuse is a significant health and social problem in many low-income urban communities. Finding appropriate help for drug users has been identified as a significant barrier to reducing the harm from drug abuse. This report presents findings from a survey of service providers in the Central and East Harlem communities, New York City, conducted in 2000 to identify policy obstacles that impeded clients' attempts to overcome substance use and related problems. Policies can affect substance users by making access to drug treatment more difficult or by imposing unrealistic expectations on substance users for eligibility for benefit programs. Respondents to the survey were asked to rate 30 specific policies as harmful or helpful to their clients and to assess how the policies acted as barriers or facilitators to getting services and reducing drug use. Eleven policies in the areas of drug treatment, corrections, and Medicaid were rated as harmful to their clients by more than 50% of the respondents. We discuss the implications of these and other findings for drug users' ability to seek and receive help for their problems.

Religious involvement, social support, and health among African-American women on the east side of Detroit.

BACKGROUND: A significant body of research suggests that religious involvement is related to better mental and physical health. Religion or spirituality was identified as an important health protective factor by women participating in the East Side Village Health Worker Partnership (ESVHWP), a community-based participatory research initiative on Detroit's east side. However, relatively little research to date has examined the mechanisms through which religion may exert a positive effect on health. OBJECTIVE: The research presented here examines the direct effects of different forms of religious involvement on health, and the mediating effects of social support received in the church as a potential mechanism that may account for observed relationships between church attendance and health. DESIGN: This study involved a random sample household survey of 679 African-American women living on the east side of Detroit, conducted as part of the ESVHWP. MAIN RESULTS: Results of multivariate analyses show that respondents who pray less often report a greater number of depressive symptoms, and that faith, as an important source of strength in one's daily life, is positively associated with chronic conditions such as asthma or arthritis. Tests of the mediating effect of social support in the church indicated that social support received from church members mediates the positive relationship between church attendance and specific indicators of health. CONCLUSIONS: These findings are consistent with the hypothesis that one of the major ways religious involvement benefits health is through expanding an individual's social connections. The implications of these findings for research and practice are discussed.

Presenting the female condom to men: a dyadic analysis of effect of the woman's approach.

Although male partner resistance to female condom use has been reported, little is understood about circumstances under which partners will agree to female condom use. This study documents the experiences of couples who have worked together to achieve female condom use. As part of a prospective female condom efficacy study, female participants (age 18-34) received a behavioral intervention and an assortment of take-home items. Selected women and their partners were recruited for a qualitative interview focusing on their experience with the female condom. Interviews were transcribed, double-coded, and verified using a standard retrieval coding system. Twenty-six pairs of linked interviews were analyzed dyadically: 9 couples who used the female condom "consistently," 12 "experimenters," and 5 "non-users." Women who successfully promoted the female condom to their partners used multiple presentation strategies. Initial male partner reaction did not predict continued use beyond the first trial. In conclusion, employment of multiple strategies facilitates successful introduction of the female condom into a sexual partnership.