Noel J. Chrisman

Researcher and Researched-Community Perspectives: Toward Bridging the Gap

In the process of initiating a new community-based research project, the authors wanted to understand the experiences of community members and researchers in community-based research projects and to develop guidelines to improve future projects. They conducted qualitative, key informant interviews with 41 people involved at all levels of community-based research projects in Seattle. Respondents were identified using a snowball sampling technique. More problems than successes were discussed by informants, including dissatisfaction with the focus of research, which some said is marked by a lack of cultural appropriateness and relevance. Power imbalances, lack of trust, and communication difficulties impeded collaboration. According to respondents, many problems could be avoided if the community were involved from the beginning in setting research priorities and developing and implementing interventions. Meaningful collaboration between communities and researchers is characterized by early involvement of communities, power sharing, mutual respect, community benefit, and cultural sensitivity.

Extending cultural competence through systems change: academic, hospital, and community partnerships.

Work on cultural competence has a long history in nursing, yet we have not successfully institutionalized these attitudes and skills throughout education and practice. An effective approach to promoting widespread cultural competence is to work at the system level in which coalitions of community agencies partner with academic and health care organizations. A systems approach includes all health practitioners, reducing current discrepancies across disciplines, and establishes cultural competence as the standard. Work in and with communities places students and practitioners more consistently in cross-cultural circumstances. Implementing this vision will require national as well as local leadership across public and private sectors.

Qualitative Process Evaluation of Urban Community Work: A Preliminary View

Community-based and participatory research have become significant activities during the past 15 years as public health practitioners and researchers have sought new ways to provide effective disease prevention and health promotion programs. It is also important that more examples of evaluation schemes be contributed for field testing. The process evaluation model offered here was based on an eclectic literature search because the evaluators did not know what directions this Centers for Disease Control and Prevention (CDC)-funded Urban Research Center would take and wanted to be thorough. Participatory action research using predominantly qualitative methods provided a research approach congruent with the capacity-building and power-sharing principles of the center. Seattle Partners for Healthy Communities is not a traditional community project, acting primarily as a broker for expertise and community needs. However, it has been successful in supporting and evaluating community health projects.

The effects of an educational training workshop for community leaders on self‐efficacy of program planning skills and partnerships

AIM This aim of this study was to evaluate the effects of a 6-month educational workshop for community leaders designed to improve their confidence in health promotion programmes and to develop partnerships among the participants. BACKGROUND It is important for public health nurses to work with community leaders to provide community-orientated services. However, only a few existing studies have reported the content and effects of training programmes aimed at enhancing the capabilities of community leaders. METHODS A participatory action research design with pre- and post-test methods was applied in this study. Fifteen community leaders completed a 6-month educational workshop that was held in Tamsui, Taipei and Taiwan. It was designed to enable community leaders to improve their confidence in planning health programmes and developing group partnerships. Data were collected from April 2009 to October 2009, and descriptive statistics and Wilcoxon signed-rank test analyses were carried out. RESULTS Participants demonstrated improvements in their self-efficacies of planning health programmes by completing a structured questionnaire after attending a 6-month educational workshop (Z =-2·90, P = 0·004). Their confidence in data collection, needs assessment and diagnosis, programme planning, and programme evaluation were significantly improved (Z = -3·1, P = 0·002; Z = -2·42, P = 0·016, Z = -2·84, P = 0·004, and Z = -2·68, P = 0·007, respectively). CONCLUSIONS Providing training workshops for community leaders is a useful strategy for increasing their capabilities and confidence in planning health programmes. Nurses have a responsibility to advocate and provide training programmes for community leaders.

Partnering with REACH to Create a "Diabetes-Friendly" Restaurant: A Restaurant Owner's Experience

We describe a Latino restaurateur’s perspectives and partnership with Seattle-King County REACH to improve the healthfulness of his restaurant as a step toward tackling diabetes in his community. We interviewed the owner and reviewed other documentation to capture his perspectives and identify key elements in this restaurant intervention. The impact of diabetes in the owner’s family and Latino community motivated him to make changes at his restaurant. If changes were successful, he hoped this would motivate other Latino restaurateurs to make similar changes. At his request, REACH gathered consumer feedback, provided diabetes education and nutritional guidance, and worked with him to develop simple, economically feasible, healthier items. Positive consumer response and media coverage motivated the owner to explore additional changes at his restaurant and encourage other restaurateurs to make healthful changes. This intervention illustrates the potential for local businesses to collaborate with community partners, like REACH, to promote healthy food environments.

Cultural Shock in the Operating Room: Cultural Analysis in Transcultural Nursing

Another version of this paper was published in Transcultural Nursing: A Futuristic Field of Health Care, Michael Carter, (Ed.), Memphis: The Transcultural Nursing Society, 1986. Would like to thank Mary Sweeney, R.N., M.N. who suggested this topic to me, arranged for me to observe her operating room and provided comments on an earlier draft, and Madeleine Leininger and anonymous reviewers for the Journal of Transcultural Nursing for their helpful revision suggestions. Variations of this paper have been presented at the Annual Meeting of the Transcultural Nursing Society and the Annual Meeting of the American Anthropological Association in 1985.

The Culture of Research: "no I'm not gonna be no guinea pig for all of that"

Agencies such as the World Health Organization, the Commission on Social Determinants of Health, and the Robert Wood Johnson Foundation are challenging researchers to focus attention on social determinants of health at the community level. Community-based research can be time intensive because establishing and sustaining partnerships is an essential element of the work. Trust is a critical component of community-based work (Israel, Eng, Schulz, & Parker, 2013); yet, historically mismanaged research has created mistrust of researchers and contributed to multicultural historical trauma. Historical trauma has been defined as the “cumulative emotional and psychological wounding, over the lifespan and across generations, emanating from massive group trauma experiences” (Brave Heart, 2003, p. 7). In previous issues of this journal, authors have addressed racial/minority mistrust and the historic events that have contributed to researcher stigma. Flaskerud (2008) explored the question of ethnic/racial matching of researcher to participants; Tullmann and Flaskerud (2009) addressed barriers to recruitment; and DeLilly (2012) discussed how multiple levels of racism continue to create health disparities and contribute to poor health outcomes. Despite access to programs and literature designed to educate researchers on ethical conduct, historical trauma, and cultural awareness/sensitivity, the recruitment of racial/minority participants can be complicated. As a doctoral nursing student, I was introduced to research ethics, racism, and white privilege in the classroom environment