Mary Frances Oneha

Finding solutions to challenges faced in community-based participatory research between academic and community organizations.

Summary Partnerships between communities and academic institutions have been vital in addressing complex health and psychosocial issues faced by culturally diverse and hard-to-reach populations. Community-based participatory research (CBPR) has been suggested as a strategy to develop trust and build on the strengths of partners from various settings to address significant health issues, particularly those persistent health issues that reveal disparities among minority populations. There have been many challenges to developing these partnerships in the United States. The purpose of this paper is to discuss approaches and solutions used by this research team in response to the challenges they have faced in using CBPR. The team uses CBPR to understand and support the process of disclosure of intimate partner violence (IPV) within the context of the community health centers that provide services for multicultural and multi-lingual populations. While CBPR provides a route to develop trust and build on the strengths of partners from various settings, there are multiple challenges that arise when partnering organizations present with different infrastructures, missions, resources and populations served. Examples of common challenges and solutions from the literature and from the teams experience will be discussed. Implications for partners, partnerships, practice and research will be explored.

Community Partnerships: Redirecting the Education of Undergraduate Nursing Students

Consistent with the goal of reforming nursing education to support nursings agenda for health care reform, a community-based, multiprofessional initiative supported by the W.K. Kellogg Foundation began in Hawaii in 1991. This initiative created a partnership among the University of Hawaii Schools of Medicine, Nursing, Social Work, and Public Health, three community health centers, and their communities to provide a community-based, integrated system of health care, education, and research. In response to this initiative, the School of Nursing developed an integrated undergraduate curriculum consisting of: a discipline-specific tutorial using an inquiry-based learning strategy; a multiprofessional tutorial; and a 1-year clinical experience providing culturally competent primary care. Community-based education has stimulated changes in the philosophy, mission, and curriculum of the School of Nursing. The outcomes achieved as a result of this initiative have had a favorable impact on clients using the community health centers, the communities, the School of Nursing, and the students.

Ensuring quality nursing education in community-based settings.

With the shift to more nursing practice occurring in community settings, nurse educators are seeking ways to guarantee a quality education in community settings. The authors describe one nursing students activities at a community health center, reflecting the movement toward a community-based curriculum at the University of Hawaii School of Nursing.

When does abuse become abuse

Reported rates of intimate partner violence (IPV) have a wide range of variation from one cultural group to another (Magnussen et al., 2004). There is little data available regarding the incidence and prevalence of IPV in women who are of a variety of cultural or other hard to reach populations (Samuel, 2003; Senturia, et al., 2000). Differences between cultural perspectives related to IPV may lead to barriers that prevent women from receiving effective care. Campbell and Campbell (1996) suggest that clinical interventions for abused women should be based on principles, which include cultural competence and empowerment. Women of various cultural groups perceive their experiences differently and may not identify their experience as abuse. So, when does abuse become abuse? In Hawaii, between 2000 and 2008, there were 45 murders of women related to IPV (Hawaii Coalition Against Domestic Violence; HCADV, 2008), nine within the first nine months of 2008 (Hawaii Public Radio, 2008). Greater than 70% were Filipino or Native Hawaiian. In a 2003 retrospective review of records in four primary care settings (Magnussen et al., 2004), 32.3% of the total reports of IPV were among Native Hawaiian women, while Native Hawaiians represent only 20% of the population. Pacific Islanders represent 4.5% of the total population, but comprised 16.1% of reported IPV. Filipinos make up 14% of the total population, and 16% of reported IPV. Although these data are based on a small sample (pilot data), they provide an indication of the scope of this problem in these cultural groups.