prepare for 15 minutes exclude Q&AEmphasize story-telling
Today’s learning objectives slightly changed from original posted abstract.
*point out LHW still in progress of collecting data, so will jump into describing evaluation process
Community Leaders: CAB & VRHC
II. Pertains to agency’s strategic direction
Also asked:Opinion how other interview constituencies would respondInput regarding other perspectives of community participation
Overall time = 2 hoursworksite, coffee shop2 recordersInterviews range 60-75 minutes
Provides structure and parameters rather than impose strict rulesGlaser & Strauss – Sociologist in 1960s collaborated study of dying process in various hospital settings. Health professionals and patient perspective
1 hour of interview, approximately 8-10 hrs transcriptionRefer to Ch 3 of Grounded Theory to clarify trend of initial coding.
Aimed for 10, completed 132 Researchers4 Community Leaders7 LHW Service Providers >50%
>50% advance degrees
Primarily bilingual/bicultural participants. Fair Self-assessment indicative of humility when reality is that language proficiency was well
Healthy Research Partnerships Promote Healthy Communities
Healthy Research Partnerships Promote Healthy Communities: Evaluating the Process of Community Participation in Lay Health Worker Intervention ResearchAmerican Public Health Association 139TH Annual Meeting and Exposition Washington, DC October 31, 2011 Mary C. B. Nacionales, MPH, MBA 1 Ngoc Bui-Tong, MHSA 4 Alene L. Pham 1 Khanh Q. Le, MD, MPH 1 Gem M. Le, PhD 1, 3 Tung T. Nguyen, MD 3 Susan L. Stewart, PhD 3 Mai T. Tran, MPA 1 Bang H. Nguyen, DrPH 1, 2 1 Cancer Prevention Institute of California, Fremont, California 2 Stanford University, Stanford, California 3 University of California, San Francisco, California 4 Valley Health and Hospital Systems, San Jose, California National Cancer Institute RO1CA132660
PRESENTER DISCLOSURE Mary C. B. Nacionales, MPH, MBA(1) The following personal financial relationships with commercial interests relevant to this presentation existed during the past 12 months: No relationships to disclose
LEARNING OBJECTIVESBy the end of the session, participants will be able to:1. Understand the methods of evaluating the process of community participation in a lay health worker intervention research project.2. Describe initial lessons learned from evaluating the process of community participation in a lay health worker intervention research project
BACKGROUND: Purpose of the LiveHealthy and Live Long Project Reduce disparities in colorectal cancer among Vietnamese Americans through: • Lay Health Worker (LHW) intervention research project designed to improve colorectal cancer screening, nutrition, and physical activities • Evaluation of the community participation process
BACKGROUND: Community ParticipationProject Partners• Vietnamese Reach for Health Coalition (VRHC)• Community Advisory Board (CAB) of UCSF Vietnamese Community Health Promotion Project SÙc KhÕe Là VàngAgencies Providing LHW Services• Asian Americans for Community Involvement• Catholic Charities John XXIII Multi-Service Center• Immigrant Resettlement & Cultural Center• Vietnamese Voluntary Foundation
BACKGROUND: Research Questions ofCommunity Participation Interviews• What are the qualities of partnership between researcher and community?• How does the Community Based Participatory Research (CBPR) process creates equitable research- community partnerships and community benefits?
METHODS: Eligibility and Setting1. Eligibility • LHW providers • Community leaders: VRHC & CAB • Researchers2. Setting • San Francisco Bay Area: Contra Costa, San Francisco, and Santa Clara counties
METHODS: Qualitative Interview UsingTopic GuideI. Context & History of Participation in LHW Project • Role and motivation for working in the Vietnamese American community • Decision process for participationII. Expected Benefits of Partnership
METHODS: Qualitative Interview UsingTopic GuideIII. Partnership Dynamics • Extent of involvement in the LHW project Research design Implementation Dissemination of results • Opportunity to provide feedback • Perception of how suggestions were received
METHODS: Qualitative Interview UsingTopic GuideIV. Assessment of Partnership Effectiveness & Benefits• Satisfaction with LHW project participation• Observed organizational changes• Participation in LHW project influences agency’s relationship with communityV. Impact for Potential Partnerships in the Community• Vietnamese American community perception of health research and researchers• LHW model influence community perception
METHODS: Interview1. Conduct interview at participant’s choice of location2. Procedure for interviews • Introduction and Overview • Informed Consent Administration • Open-Ended Questions Using Topic Guides • Self-Administered Demographic Questionnaire • Closing and Thank You3. Interviews were digitally recorded
METHODS: Timeframe and Activities TIMEFRAME ACTIVITIESMarch 2010 – May 2011 • Conduct Qualitative InterviewsJuly – October 2011 • Review Demographic Data • Transcribe and QA InterviewsSeptember 2011 • Initiate CodingOctober – December 2011 • Complete Coding • Identify Key ThemesOctober 2012 • Report Findings at Community Health Forum
METHODS: Data Analysis Theoretical Framework: Grounded Theory (Glaser & Strauss, 1967) • Consist of “systematic, yet flexible guidelines for collecting and analyzing qualitative data” • Construct theories “grounded in the data” • Data form the “foundation of theory and analysis of the data generates constructed concepts”*Glaser, BG & Strauss, AL. (1967). The discovery of grounded theory: Strategies for qualitative research.New Brunswick, NJ: Aldine Transaction.
METHODS: Data Analysis1. Transcription • Verbatim • Quality review2. Coding (Initial and Focused): separate, sort, and synthesize3. Memo-Writing: what is happening when data is coded4. Theory Development*Charmaz, K. (2006). Constructing grounded theory: A practical guide through qualitative analysis. GreatBritain: Sage Publications.
PRELIMINARY RESULTS: DemographicProfile - Stakeholders N = 13 Researchers 15%, n=2 LHW Service Providers 54%, n=7 Community Leaders 31%, n=4
PRELIMINARY RESULTS: Demographic Profile - Language Speaking Proficiency N=139876543210 Fluent Well Fair Not Very Good Not At All Vietnamese English
PRELIMINARY RESULTS: Impressions• Different perspective of LHW project as stakeholder or job role Understanding of LHW project goal Prioritizing objectives Accessing information about LHW project• Power dynamics between LHW providers and researchers• Prevalence of humility among Vietnamese American respondents
DISCUSSION: Themes To Explore THEMES TO EXPLORE• Knowledge: What are the stakeholders’ understanding of the LHW project goals, including the partnership roles?• Power: What are the levels of control and influence within the LHW project and partnerships by the stakeholders?• Decision: To what extent do stakeholders have the ability to impact decision processes made related to the LHW project?• Ownership: What are the stakeholders’ perception of their accountability to the LHW project?
ACKNOWLEDGEMENT• Similoluwa Sowunmi for entering demographic data and transcribing interviews• Loan Dao, PhD for developing interview guides and consent form; conducting interviews• The Interview Participants for sharing their wisdom and generously volunteering their time
THANK YOU What happens to you does not matter; what you become through those experiences is all that is significant. This is the true meaning of life. ~Zen MeditationFor more information contact: Mary C. B. Nacionales, MPH, MBA Community Research Associate (510) 608-5102; mary.nacionales@CPIC.org Cancer Prevention Institute of California 2201 Walnut Avenue, Suite 300 Fremont, CA 94538 www.cpic.org