Transcript Acknowledgements - University of Massachusetts Boston

POPULATION RESEARCH SEMINAR SERIES
Sponsored by the Statistics and Survey Methods Core of the U54 Partnership
Participatory Research to Support Change
in Communities:
Assessing Networks as an Example
Shoba Ramanadhan, ScD, MPH
Center for Community-based Research
Dana-Farber Cancer Institute
December 3, 2014
ACKNOWLEDGEMENTS
 Community
Project Advisory Committees for
MassCONECT, PLANET MassCONECT, and
Project IMPACT
 Staff of the Viswanath Lab
 Funding
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from the National Cancer Institute
MassCONECT (5 U01 CA114644, Viswanath, PI)
PLANET MassCONECT (1R01 CA132651,
Viswanath, PI)
IMPACT (5 P50-CA148596, Viswanath, PI for
Project 1)
KNOWLEDGE TRANSLATION IN
COMMUNITY SETTINGS
Focusing on modifiable behaviors
 Gap: What we know vs. what we do
 Community-based organizations (CBOs)
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Trusted channels
 Cancer disparities
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Pull
Participatory
Approach
Closing
the gap
Push
Capacity
COMMUNITY-BASED PARTICIPATORY RESEARCH (CBPR)
Collaborative approach to research that equitably
involves all partners in the research process and
recognizes the unique strengths that each brings.
CBPR begins with a research topic of importance
to the community with the aim of combining
knowledge and action for social change to
improve community health and eliminate health
disparities.
W.K. Kellogg Community Scholar’s Program (2001)
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KEY PRINCIPLES
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Community as a unit of identity
Builds on community strengths and resources
Promotes collaboration across all phases of
research
Knowledge + action for mutual benefit
Co-learning / empowering
Ecological perspectives
Disseminates findings in a usable manner
Israel, B. A., et.al. (1998). Review of community-based research: Assessing
partnership approaches to improve public health. . Annu Rev Public Health, 19,
173-201.
THE PARTICIPATORY KNOWLEDGE TRANSLATION (PAKT)
FRAMEWORK
Ramanadhan, S., & Viswanath, K. (in press). Engaging Communities to
Improve Health: The Participatory Knowledge Translation (PaKT)
Framework. In E. B. Fisher (Ed.), Principles and Concepts of Behavioral
Medicine: A Global Handbook: Springer Science & Business Medial.
SOCIAL NETWORK ANALYSIS
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Studying relationships among actors of interest
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Individuals
Organizations
Communities
Countries
Etc.
Interested in
Structure of networks
 Resources “flowing” across connections
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SOCIAL NETWORK ANALYSIS TO
QUANTIFY INFRASTRUCTURE
DEVELOPMENT: MASSCONECT
MASSACHUSETTS COMMUNITY NETWORKS TO ELIMINATE
CANCER DISPARITIES THROUGH EDUCATION, RESEARCH AND
TRAINING (MASSCONECT)
Boston
NCI (# 5U01 CA114644)
PI: K. Viswanath
Lawrence
Worcester
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PARTNER COMMUNITIES
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STUDYING INFRASTRUCTURE
DEVELOPMENT
Community partner prompt to use SNA
 Working group comprised of investigators,
community partners, students, staff
 Whole-network (sociometric)
 Diverse outcomes for diverse partners
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Cancer prevention programming
Capacity-building
Mobilization around cancer disparities
Program grants
Publications
Research grants
DEFINING THE NETWORK
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Time-intensive deliberation over definitions of
network members  reflects realities of practice
Network members: individuals, groups (e.g. labs),
organizations
 Members active some time in Years 1-4 (n=55)
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Participated in or planned events
 Received funding
 Regularly attended meetings and / or
 Supported a project or initiative directly related to
MassCONECT
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38 MEMBERS RESPONDED
Attribute
Number (Percent)
Sector
CBO / Coalition
11 (29)
Researcher
14 (37)
Philanthropic
1 (3)
Policymaker
2 (5)
Provider
4 (11)
Public
6 (16)
City of Origin
Boston
26 (68)
Lawrence
5 (13)
Worcester
7 (18)
CONNECTIONS
AMONG 38 Network
MASSCONECT
Connections
among 38 MassCONECT
Members, at Network
Inception
and YearM
4 EMBERS, AT NETWORK INCEPTION
NETWORK
AND
YEAR 4
Exemplar statistics
•Density: 16  35 %
•Reciprocity: 19  54%
•Avg. out-degree: 6.08  12.76
INTERSECTORAL CONNECTIONS
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Greater connection density within and between
most sectors at Year 4
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Exception: those already at 100%
Greater average reciprocity of connections within
and between sectors for almost most sectors at
Year 4
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Main gaps related to sectors with small numbers of
members, e.g. 1 philanthropic member, 2
policymakers
IMPACT OF INTERSECTORAL
CONNECTIONS
Ramanadhan, S., et. al. (2012). Addressing cancer
disparities via community network mobilization and
intersectoral partnerships: A social network analysis.
PLoS ONE, 7(2), e32130.
BENEFITS AND CHALLENGES TO A CBPR
APPROACH
SNA was new to the majority of partners
(methods and / or concepts)
 Benefits
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Defining network in a way that reflected practice
 Capturing a range of outcomes
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Challenges
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Additional questions vs. respondent burden
Tying back to practice
 Strong relationships to “make the ask”
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Capacity for engaging in analysis
 Requests for primary data vs. IRB and privacy
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DISSEMINATION - ROADSHOWS
Boston-specific data
DISSEMINATION BRIEF
CAPACITY-BUILDING: WORKSHOP AND TOOL
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LINKS TO ADDITIONAL RESOURCES
NETWORK ANALYSIS TO
UNDERSTAND POWER
STRUCTURES
PROJECT IMPACT (INFLUENCING MEDIA AND
PUBLIC AGENDA ON CANCER AND TOBACCO
DISPARITIES)
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Northeast Center for
Healthy Communities
STUDY IMPETUS
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Community health assessments
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health status, risk factors, disease outcomes, and
overall needs of local residents
?? Assessment of power ??
 New combination of methods  Action-oriented
findings
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McCauley, M., Ramanadhan, S., Viswanath, K. (under review).
METHODS OVERVIEW
Community reconnaissance methods
 Snowball sampling
 33 in-depth interviews
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~ 1 hour long
 Focused on
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Current needs of Lawrence
 Public health and health inequalities
 Possible solutions
 Role of local media
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Transcripts  network maps + qualitative
analysis
EXEMPLAR RESULTS: FACTIONS IN THE
NETWORK OF 33 LEADERS
EXEMPLAR RESULTS: CONNECTIONS
BETWEEN SECTORS
SUMMARY OF STUDY
Powerful method for assessing community
leadership
 Highlights opportunities to build support and
create change related to health inequalities
 Challenges
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How to share the data?
 How to enable communities to utilize this tool?
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NON-PARTICIPATORY NETWORK ANALYSIS:
AN EXAMPLE
Greater Boston YMCA
Afterschool Childcare
 Informal teaching
among staff
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Formal analysis
demonstrated impact of
staff connections and
resource flow across
those connections
Ramanadhan, S., et. al. (2010). Informal training in staff networks to support dissemination of health promotion
programs. American Journal of Health Promotion, 25(1), 12-18.
BENEFITS AND CHALLENGES
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Engaged leadership
Resources, support
 Planned and executed quickly and cheaply
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Challenges
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Study findings shared, but limited impact on practice
Top-down / external approach
Contextual assessment not built in to process
Little inclusion of non-leadership staff, mid-level
leaders in research process
Capacity-building was not a focus
WORKS-IN-PROGRESS
Assessment of trainee social networks in a CBPR
intervention focused on building capacity for
evidence-based programs in CBOs
 Pilot-testing a simple set of questions to support
community mapping of key players
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SUMMARY
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Commitments and challenges
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Engaging across the research project / across
multiple projects
Capacity-building and disseminating results
Who gets to participate?
Tension with academic requirements
Business of knowledge translation
Increases likelihood of producing acceptable,
practical solutions
 Leverages rich expertise of non-academic
stakeholders
 Builds capacity to address current / future problems
 Supports sustainable system-focused change
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POPULATION RESEARCH SEMINAR SERIES
Sponsored by the Statistics and Survey Methods Core of the U54 Partnership
Thank you!
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