[Federal Register: June 21, 2002 (Volume 67, Number 120)]
[Notices]
[Page 42262-42264]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID: fr21jn02-71]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Agency for Healthcare Research and Quality
Request for Suggestions on Community-Based Participatory Research
AGENCY: Agency for Healthcare Research and Quality (AHRQ), HHS.
ACTION: Notice of request for suggestions.
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SUMMARY: AHRQ is soliciting input from its user-groups and stakeholders
on its implementation of Community-Based Participatory Research (CBPR)
to meet the requirements of the Minority Health and Health Disparities
Research and Education Act of 2000. CBPR is a methodology that promotes
active community involvement in the processes that shape research, as
well as, products and translation of research. CBPR offers
opportunities to overcome the barriers faced by conventional approaches
to research in low-income and minority communities, which lack this
kind of collaboration and communication. As a result, CBPR has been
gaining increasing acceptance within the larger biomedical and
behavioral research community, and is especially relevant to many
research subjects of mutual interest to Federal agencies, including
health disparities. The Minority Health and Health Disparities Research
and Education Act of 2000 mandates that AHRQ use methods characteristic
of CBPR in conducting its research on health disparities. The Act
states that "the Director shall implement research strategies and
mechanisms that will enhance the involvement of individuals who are
members of minority health disparity populations, health services
researchers who are such individuals, institutions that train such
individuals as researchers, members of minority health disparities
populations or other health disparity populations for whom the Agency
is attempting to improve the quality and outcomes of care, and
representatives of appropriate tribal or other community-based
organizations with respect to health disparities." Research strategies
may include the use of centers of excellence that have a "demonstrated
capacity to involve members and communities of health disparity
populations, including minority health disparity populations, in the
planning, conduct, dissemination, and translation of research."
Section 903(b)(2), 42 U.S.C. 299a-1(b)(2) and see Title II of the
Minority Health and Health Disparities Research and Education Act of
2000.
Nature of Recommendations
AHRQ encourages written suggestions from its customers and
stakeholders on how AHRQ can implement CBPR in its research portfolio
and in the field of health services research. In particular, AHRQ
requests comments on the following:
1. Please offer possible definitions of community that are
appropriate for health services research.
2. Please describe collaborative opportunities to foster the
development or use of CBPR.
3. Please describe strategies that AHRQ could use to increase the
capacity for health services researchers and community-based
organizations to conduct CBPR.
4. Please describe the strategies that AHRQ could use to support
relationships between researchers and community-based organizations.
5. Please describe the accountability mechanisms that AHRQ could
institute to ensure the development and
[[Page 42263]]
maturation of these partnership relationships.
6. Please describe strategies that AHRQ could use to support
partnerships with patients and community-based organizations to improve
safety and quality in health care.
In preparing your response, please consider ideas put forth at a
conference on CPBR last fall which are listed under section titled,
"Report of November 2001 Meeting on CBPR."
DATES: Responses to this request will be accepted within 60 days from
publication date. AHRQ will not respond to individual responses, but
will consider all suggestions.
Arrangement for public inspection: All responses will be available
for public inspection on weekdays between 8:30 a.m. and 5 p.m., from
Kaytura Felix Aaron, M.D., Center for Primary Care Research, Agency for
Healthcare Research and Quality.
Arrangements for reviewing the submissions may be made by calling
Phone: (301) 594-6198; Fax: (301) 594-3721; E-mail: KFaaron@ahrq.gov.
Responses may also be accessed through AHRQ's Electronic FOIA Reading
Room on AHRQ's Web site at http://www.ahrq.gov/news/foia.htm
ADDRESSES: Submissions should be brief (no more than three pages for
each submission) and may be in the form of a letter or e-mail,
preferable with an electronic file in a standard word processing
format. Please present your suggestions in bullets or outline format.
Responses to this request should be submitted to Kaytura Felix Aaron,
M.D., Center for Primary Care Research, Agency for Healthcare Research
and Quality, 6010 Executive Blvd., Suite 201, Rockville, MD 20852;
Phone: (301) 594-6198; Fax: (301) 594-3721; E-mail: KFaaron@ahrq.gov.
FOR FURTHER INFORMATION CONTACT: Kaytura Felix Aaron, M.D., Center for
Primary Care Research, Agency for Healthcare Research and Quality, 6010
Executive Blvd., Suite 201, Rockville, MD 20852; Phone (301) 594-6198;
Fax: (301) 594-3721; E-mail: KFaaron@ahrq.gov.
SUPPLEMENTARY INFORMATION:
Background on Community-Based Participatory Research
There is increased interest in research that aims to improve the
health of disadvantaged populations. However, conventional research in
these communities has a contentious history and offers limited
opportunities to improve the health and well being of these
communities. Policy makers are interested in increasing investments in
participatory research because participatory research addresses several
of the barriers to and limitations of conventional research. First,
partnerships with representatives of the study population ensure that
research addresses the priorities of the population under study.
Second, community partners bring local knowledge to the research
process, thereby increasing the understanding of the complex
interactions among economic, social, and behavioral factors that
contribute to health problems. Third, partnerships with the population
under study increase the efficiency of the research process by
improving recruitment and retention of subjects. Finally, the
involvement of stakeholders and groups affected by the problem under
study increases the opportunity for adoption of new knowledge and the
translation of research into practice.
Community-based participatory research (CBPR) is a promising model
of research collaboration between researchers and community-based,
including faith-based and other non-profit organizations. Researchers
and community representatives are actively engaged throughout the
research process, from the conception of the research problem to the
analysis, dissemination and translation of findings. CBPR engages
community members, employs local knowledge in the understanding of
health problems and the design of interventions, and invests community
members in the processes and products of research. In addition,
community members are more likely to be invested in the dissemination
and use of research findings and ultimately in the reduction of health
disparities.
Report on November 2001 Meeting on CBPR
The Agency for Healthcare Research and Quality convened a meeting
on CBPR on November 27-28, 2001 to increase awareness and support for
CBPR and to develop an action plan. Participants at this meeting re-
affirmed that CBPR is an important model of research for AHRQ and other
federal agencies because CBPR can potentially broaden the understanding
of complex health issues and increase the relevance of research.
Participants at that meeting developed a broad, national research
agenda for CBPR.
The recommendations were aimed at the diverse sectors represented
at the meeting: Public and private funding organizations, academic
institutions, and community organizations. The recommendations that
were specific to AHRQ included:
1. Fund CBPR projects and centers;
2. Develop funding mechanisms that facilitate the development of
research capacity in community-based organizations;
3. Build a national repository for CBPR methods, tools, and
resources;
4. Evaluate CBPR as a strategy to improve health and health care;
5. Develop a balanced portfolio that supports early and mature
partnerships;
6. Convene a group to develop standards for CBPR; and
7. Identify and address institutional policies that deter community
participation in grant making process.
CPBR is Consistent With AHRQ's Mission and Programs
AHRQ was reauthorized on December 6, 1999 to support research
designed to improve the outcomes and quality of health care, reduce its
costs, address patient safety and medical errors, and broaden access to
effective services. AHRQ accomplishes these goals through the
establishment of a broad base of scientific research on the
organization, financing, and delivery of health care services, and
through the promotion of improvements in clinical practice. The
research sponsored, conducted, and disseminated by AHRQ provides
information that helps people make better decisions about health care.
Since its reauthorization, the Agency's is also required to produce
information that improves the outcomes, quality, cost, and
accessibility of health care for the following priority populations:
Inner city; rural; low income; minority; women; children; elderly; and
those with special health care needs, including those who have
disabilities, need chronic care, or need end of life health care. CBPR
represents an important strategy to meet these objectives.
AHRQ uses mechanisms of grants, cooperative agreements, and
contracts to carry out research projects, demonstrations, evaluations,
and dissemination activities. AHRQ also supports small grants,
conference grants, and training (http://www.ahrq.gov/fund/training/trainix.htm)
through dissertation grants (http://grants.nih.gov/grants/guide/pa-
files/par-00-076.html) and national research service awards to
institutions and individuals. The vast majority of AHRQ grants and
cooperative agreements are investigator-initiated.
AHRQ uses the following processes to meet its policy and program
objectives to conduct its ongoing activities in order
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to make the most productive use of its resources:
1. Needs Assessment. AHRQ conducts needs assessments through a
variety of mechanisms including expert meetings, conferences, and
consultations with stakeholders and customers of its research,
publishing notices for comment in the Federal Register, as well as
regular meetings with its National Advisory Council and government
leaders. The results of these assessments are used to determine and
prioritize information needs.
2. Knowledge Creation. AHRQ supports and conducts research to
produce the next generation of knowledge needed to improve the health
care system.
3. Translation and Dissemination. AHRQ's commitment to research
extends beyond knowledge generation. AHRQ believes that findings must
be useful and made widely available in accessible formats to
practitioners, patients, and other decisionmakers. In addition, AHRQ
synthesizes and translates knowledge into products and tools in order
to support its customers in problem solving and decision making. AHRQ
actively disseminates the knowledge, products, and tools to appropriate
audiences. Effective dissemination involves forming partnerships with
other organizations and leveraging resources.
4. Evaluation. In order to assess the ultimate outcomes of AHRQ
research, the Agency is placing increased emphasis on the evaluation of
the impact and usefulness of Agency-supported work in health care
settings and policymaking.
Dated: June 18, 2002.
Carolyn M. Clancy,
Acting Director.
[FR Doc. 02-15865 Filed 6-20-02; 8:45 am]
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