Exploring theoretical mechanisms of community-engaged research: a multilevel cross-sectional national study of structural and relational practices in community-academic partnerships

• Published in: International journal for equity in health Vol. 21; no. 1; p. 59
• Main Authors: Oetzel, John G, Boursaw, Blake, Magarati, Maya, Dickson, Elizabeth, Sanchez-Youngman, Shannon, Morales, Leo, Kastelic, Sarah, Eder, Milton Mickey, Wallerstein, Nina
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 02.05.2022; BioMed Central; BMC
• Subjects: CBPR conceptual model; Collaboration; Collective empowerment; Community involvement; Community participation; Community research; Community-Based Participatory Research; Community-based participatory research (CBPR); Community-based research; Community-engaged research; Community-Institutional Relations; Context; Cross-Sectional Studies; Demographic aspects; Discrimination; Economic aspects; Empowerment; Fairness; Fuzzy sets; Governance; Health care disparities; Health disparities; Health Equity; Humans; Inequality; Institutional racism; Methods; Multivariate statistical analysis; Organizations; Pandemics; Participatory health research; Participatory research; Partnerships; Power; Prevention; Public health; Qualitative analysis; Racism; Research centers; Research projects; Social aspects; Structural equation modeling; Systemic racism; United States; United States > US; Participatory health research; Community-engaged research; Community-based participatory research (CBPR); Collective empowerment; CBPR conceptual model
• DOI: 10.1186/s12939-022-01663-y
• ISSN: 1475-9276

Community-Based Participatory Research (CBPR) is often used to address health inequities due to structural racism. However, much of the existing literature emphasizes relationships and synergy rather than structural components of CBPR. This study introduces and tests new theoretical mechanisms of the CBPR Conceptual Model to address this limitation. Three-stage online cross-sectional survey administered from 2016 to 2018 with 165 community-engaged research projects identified through federal databases or training grants. Participants (N = 453) were principal investigators and project team members (both academic and community partners) who provided project-level details and perceived contexts, processes, and outcomes. Data were analyzed through structural equation modeling and fuzzy-set qualitative comparison analysis. Commitment to Collective Empowerment was a key mediating variable between context and intervention activities. Synergy and Community Engagement in Research Actions were mediating variables between context/partnership process and outcomes. Collective Empowerment was most strongly aligned with Synergy, while higher levels of Structural Governance and lower levels of Relationships were most consistent with higher Community Engagement in Research Actions. The CBPR Conceptual Model identifies key theoretical mechanisms for explaining health equity and health outcomes in community-academic partnerships. The scholarly literature's preoccupation with synergy and relationships overlooks two promising practices-Structural Governance and Collective Empowerment-that interact from contexts through mechanisms to influence outcomes. These results also expand expectations beyond a "one size fits all" for reliably producing positive outcomes.