Community-based participatory research (CBPR) is one of the crucial tools used for engaging particular communities and social groups in health care research, as well as making sure that they are not merely passive participants. Two basic principles of CPBR suggest that such research should be, firstly, participatory and, secondly, cooperative and co-learning process (Leung, Yen, & Minkler, 2004, p. 501). In many ways, the Just Move program that was designed to promote efficient health care among Native American communities attempts to surpass the medium of theoretical models developed at the state level and to address local issues directly. From the point of view of community-based participatory research, in such a way, it is possible to increase the understanding of the data collected through paying specific attention to the problems that a certain community faces. Therefore, if members of the community participate in defining the health care problems that they face, they engage with medical research professionals in working on the solutions. With the help of the community members, it will be possible to find more effective solutions, because the community will participate in deciding what solutions are the most appropriate. However, there are still some issues to attend and recommendations to grasp for the Just Move it paradigm.
It is important to point out the fact that the Just Move it Web site became “a virtual gathering place for partners in the national movement to reclaim the legacy of wellness for American Indian and Alaska Native people” (Minkler, & Wallerstein, 2008, p. 174). Among the principles of CBPR, the important role belongs to taking into account the social environment. In other words, “some have argued that health and disease must be studied at a population level within a social context” (Leung, Yen, & Minkler, 2004, p. 499). The principle is that CBPR research requires cooperation and equal engagement of all members of the community in order for everyone to make an equal contribution (Leung, Yen, & Minkler, 2004, p. 501). The idea of using a website as a media of cooperation, in this context, can be interpreted two-fold. On one hand, those members of the community who are enthusiastic about reforming health care and resolving the issues of the current system of medical care have quite a lot of access to participate. On the other hand, it is less effective in terms of engaging people who are less familiar with the initiatives in the research and decision-making process.
Other principles important for the community-based participatory research are that it is supposed to involve “systems development and local capacity building” and to be “an empowering process through which participants can increase control over their lives” (Leung, Yen, & Minkler, 2004, p. 501). Although in some ways, the fact that Just Move it uses support from national partners in the corporate world and various large-scale organizations is helpful for its goals, it also restricts the capacity for the local system’s development. The reason for that is the fact that any external sources that provide help for a particular community also have their share in the process of making decisions and finding solutions for the problems of this community. In such a way, similar practices hinder the very process of empowerment via participation because of the fact that they restrict their power to resist the solutions that are imposed on their communities (Schwab, 1997). Therefore, the fact that Just Move actively engages corporate organizations, in a certain way, distorts the idea that American Indian and Alaska Native people should have more rights in finding solutions for their communities themselves as partners.
One of the basic principles of community-based research is that if all the members of a given community contribute equally to the process of developing health care solutions for this community, the results will be more effective than if merely the researchers develop such solutions (Minkler, & Wallerstein, 2008). The article supports the idea that Healthy Native Communities Fellowship misinterprets the concept of how the communities undergo the process of learning its needs and gaining awareness about the health care issues. It is reasonable to suggest that some principles used by Healthy Native Communities Fellowship do not exactly correspond to the idea that each community is unique in its needs and required solutions. Nevertheless, on the other hand, in terms of spreading awareness about health care practices, it is likely that communities with similar social backgrounds can find some common patterns of implementing the research initiatives (Minkler, 2005).
Thus, on one hand, the opinion suggested in the article underlines the necessity to treat each community as unique in terms of CBPR. However, on the other hand, it exaggerates the standardized nature of the Healthy Native Communities Fellowship approaches. In my experience, the approach based on the fact that each community is unique is a way out of oppression and the key to empowerment of these communities.
In the context of modern community-based participatory research, it would be useful to develop universal mechanisms for engaging more members of the community. However, how would it affect the fact that each community should be approached in a unique way?
References
Leung, M. W., Yen, I. H., & Minkler, M. (2004). Community-Based Participatory Research: A Promising Approach for Increasing Epidemiology’s Relevance in the 21st Century. International Journal of Epidemiology, 33(3), 499–506.
Minkler, M. (2005). Community-Based Research Partnerships: Challenges and Opportunities. Journal of Urban Health, 82(2), 3-12.
Minkler, M., & Wallerstein, N. (2008). Community-Based Participatory Research for Health: From Process to Outcomes (2nd ed.). San Francisco, CA: Jossey-Bass.
Schwab, M. (1997). Sharing Power: Participatory Public Health Research with California Teens. Social Justice, 24(3), 11–22.