Marilyn Metzler

Implementing community-based participatory research centers in diverse urban settings

This issue of the Journal of Urban Health contains descriptions of the implementation of community-based participatory research (CBPR) activities at three Urban Research Centers (URCs) funded through an initiative of the Centers for Disease Control and Prevention (CDC). Now in their sixth year, the URCs have each formed research partnerships among community-based organizations (CBOs), universities, private organizations, and public health agencies. The articles presented here, describing the first 4 years of the development of the URCs, focus on the process of conducting participatory research and include an overview of the urban health issues that are being addressed. Health outcomes will be reported in the future as the URCs analyze findings from their multiple research activities. Here, we document the processes that have become the cornerstones of the activities of the URCs so we can link these processes to health outcomes down the road. The URC-specific reports presented here describe the implementation of CBPR partnerships in the context of urban settings, demonstrating that this approach can be used both to establish new participatory research centers and to guide the transition of traditional research centers to more participatory entities. Our goal is to provide community representatives, public health researchers, and funding agencies with information about how research can be done with equitable opportunities for all partners to contribute. Drawing on the expertise of all partners increases understanding of the factors and processes leading to poor health outcomes and informs the development of interventions to improve community health. We begin by exploring the background of the URCs.

The Association Between Adverse Childhood Experiences and Risk of Cancer in Adulthood: A Systematic Review of the Literature

CONTEXT: Adverse childhood experiences (ACEs) can affect health and well-being across the life course. OBJECTIVE: This systematic review summarizes the literature on associations between ACEs and risk of cancer in adulthood. DATA SOURCES: We searched PubMed to identify relevant publications published on or before May 31, 2015. STUDY SELECTION: We included original research quantifying the association between ACEs and adult cancer incidence. Case reports and reviews were excluded. DATA ABSTRACTION: Two reviewers independently abstracted and summarized key information (eg, ACE type, cancer type, risk estimates) from included studies and resolved all discrepancies. RESULTS: Twelve studies were included in the review. In studies in which ACE summary scores were calculated, significant associations were observed between the scores and an increased risk of cancer in adulthood. Of the different types of ACEs examined, physical and psychological abuse victimization were associated with risk of any cancer in 3 and 2 studies, respectively. Two studies also reported significant associations with regard to sexual abuse victimization (1 for cervical cancer and 1 for any cancer). However, 2 other studies reported no significant associations between childhood sexual or physical abuse and incidence of cervical or breast cancer. LIMITATIONS: Because of heterogeneity across studies, we were unable to compute a summary effect estimate. CONCLUSIONS: These findings suggest that childhood adversity in various forms may increase a person’s cancer risk. Further research is needed to understand the mechanisms driving this relationship and to identify opportunities to prevent and mitigate the deleterious effects of early adversity on long-term health.