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Volume 1:
No. 1, January 2004
BOOK REVIEW
Community-Based Health
Research: Issues and Methods
Editors: Daniel S. Blumenthal, MD, MPH, Ralph J. DiClemente, PhD
New York
Springer Publishing Company
Publication Date: 27 Oct 2003
240 pages
Price: $39.95 (domestic), $44.80 (foreign)
ISBN: 0-8261-2025-3
Suggested citation for this article: Horn I, Mullan
F. Community-based health research: issues and methods. Prev Chronic
Dis [serial online] 2004 Jan [date cited]. Available from: URL: http://www.cdc.gov/pcd/issues/2004/
jan/03_0031.htm
When a book on community-based research opens with comments about Imhotep,
Hippocrates, and Aesculapius, it certainly catches the reader's attention.
Such is the case with Community-Based Health Research: Issues and Methods,
a new book edited by Daniel S. Blumenthal and Ralph J. DiClemente.
Community-Based Health Research: Issues and Methods is an important text for future
public health researchers. As the authors note, public health prevention has
moved from treating infectious diseases to preventing chronic diseases such
as diabetes and heart disease. This evolution argues that our approaches
must change as well. The Blumenthal and DiClemente volume provides 3 key
perspectives on how to conduct community-based health research and its
application to public health.
First, the text successfully places community-based health research on
equal standing with clinical, basic science, and health services research as
the "fourth" estate. The authors make a strong and logical
argument that community-based health research is essential for addressing
the new public health problems posed by chronic diseases. As they point out,
community-based health research "guides public health workers who are
engaged in improving the health of populations just as traditional clinical
research guides the actions of clinicians in caring for individual
patients."
In line with the authors' view of their field's importance, the book
argues that community-based health researchers should be held to the same
level of scientific rigor as their counterparts in bench or clinical
research: "As public health leaders and decision makers, we need to
have confidence in our practices, programs, and services. Yet, all too often
there are little or no data sufficient to evaluate the effectiveness of our
community-based interventions. There is a paucity of reliable information
that enables informed decisions to be made concerning competing options for
program design, or comparing one program approach to another. There is too
little information to guide decisions about program content, structure, or
application based upon documented evidence of the effectiveness of those
options or programs, when assessed by valid scientific methods and reported
in the scientific literature." It is time for this lack of reporting to
change, and this text provides the conceptual basis for that change.
Second, the strength of this text is in the experience of its authors,
who move beyond providing theory and anecdotes and instead give the reader
clear examples of community-based research in action. In Chapter 7,
"Qualitative Methods in Community-Based Research," the reader is
given a clear understanding of the variety of qualitative research methods
used in community-based work. Then in Chapter 8, "HIV/AIDS Prevention:
A Case Study in Qualitative Research," the authors provide a compelling
example of the stepwise application of those methodologies.
Third and finally, the authors make a clear distinction between
conducting research on or in a community rather than with a community in a
"partnership arrangement." In line with the authors' theme of
treating the community as an equal partner, community members write the
chapter, "The View from the Community," which reads,
"Community-owned health programs focus on the community and cultural
capacity of local citizens working as partners with health and academic
professions. These programs should be inclusive in nature and be based on
community and cultural assets, which shifts the mindset of all involved from
one of service-providing to that of capacity-building (true
empowerment)." This is the essence of community-based health research.
The authors' perspectives will resonate with practitioners of both
community-oriented primary care (COPC) and community-based participatory
research (CPBR), whose principles are reinforced in each chapter. Community-Based Health Research: Issues and Methods will prove an essential text
for students of these important fields.
One suggested improvement to the book would be to include a chapter on
the use of community-based health research to address and eliminate health
disparities. The benefit of community-based research is the ability to reach
people where they are and identify the root cause of disease.
"The community-level approach to disease prevention is based not on
a medical model but on a public health model. That is, it seeks to change
not simply individuals or groups of individuals but the distribution of
disease in the population as a whole." To use the metaphor put forth so
eloquently in the text, individual-level interventions and research, working
"downstream," pull people who are drowning from the river, but
community-level interventions and research seek to find out what is
"upstream," initially pushing people into the water. It is time
for us to move upstream as a field, and this text provides a detailed map to
help get us there.
Ivor Horn, MD, MPH
Assistant Professor of Pediatrics
Children's National Medical Center
George Washington University School Of Medicine
Washington, DC
Fitzhugh Mullan, MD
Clinical Professor of Pediatrics and Public Health
George Washington University
Washington, DC |
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