Reducing Disparities in Cancer Screening and Prevention through Community‐Based Participatory Research Partnerships with Local Libraries: A Comprehensive Dynamic Trial

Reduction of cancer‐related disparities requires strategies that link medically underserved communities to preventive care. In this community‐based participatory research project, a public library system brought together stakeholders to plan and undertake programs to address cancer screening and risk behavior. This study was implemented over 48 months in 20 large urban neighborhoods, selected to reach diverse communities disconnected from care. In each neighborhood, Cancer Action Councils were organized to conduct a comprehensive dynamic trial, an iterative process of program planning, implementation and evaluation. This process was phased into neighborhoods in random, stepped‐wedge sequence. Population‐level outcomes included self‐reported screening adherence and smoking cessation, based on street intercept interviews. Event‐history regressions (n = 9374) demonstrated that adherence outcomes were associated with program implementation, as were mediators such as awareness of screening programs and cancer information seeking. Findings varied by ethnicity, and were strongest among respondents born outside the U.S. or least engaged in care. This intervention impacted health behavior in diverse, underserved and vulnerable neighborhoods. It has been sustained as a routine library system program for several years after conclusion of grant support. In sum, participatory research with the public library system offers a flexible, scalable approach to reduce cancer health disparities.     

Community Data Collection with Children of Mothers Living with HIV: Boundaries of the Researcher Role

The TRACK‐II program is a multi‐site, community‐based randomized controlled trial evaluating an intervention to assist mothers living with HIV (MLH) in disclosing their HIV status to their young children. Many participants—both mothers and children—reported significant depression and/or suicidal ideation, a phenomenon that presented ethical challenges. This article focuses on participants at one site (Atlanta). Through the vignette of “Jordan,” we describe ethical challenges that may arise when faced with the responsibility of maximizing participants’ safety while maintaining the boundaries of the researcher role. Guided by community psychology values, our team has taken measures within our role as researchers to empower and protect children and mothers endorsing suicidal ideation. For example, we have relied on relationships with community‐based organizations and AIDS service organizations to connect HIV‐affected families to mental health services. Furthermore, we have expanded our system of documentation to follow‐up adequately with families at risk, and we track family resources to promote a strengths‐based framework. We have solicited families’ feedback about their supports and needs to understand how we may best serve them by connecting them to the resources they report needing most and empowering them to care for themselves.     

Time‐limited therapy in a Community Mental Health Team setting

This study examines time‐limited therapy in a Community Mental Health Team (CMHT) setting. This work is a key tension for CMHTs who are under pressure to focus on clients with a serious mental illness as a priority as opposed to clients who might be deemed the ‘psychologically distressed’. The development of CMHTs in the UK is described. Limited research on time‐limited therapy in a CMHT setting is identified. Results suggest that time‐limited therapy has a positive impact on the mental health needs of clients referred to a CMHT by GPs. It is concluded that it is appropriate to justify the use of time‐limited therapy in a CMHT‐based setting. Suggestions for further research are made.     

A participatory approach to healing and transformation in South Africa

In this article I describe my personal journey from working as private practitioner to participating in the wider South African society. Post-apartheid South African society struggles with overwhelming problems related to poverty, illness, violence, sexism, and racism. Moreover, in those communities where the trauma is most severe, professional resources are scarce. I propose a participatory approach which invites therapists to respond to these socio-economic and political challenges and the problems that arise from them by thinking and acting outside the constraints of their consultation rooms and of traditional therapeutic conversations, into active participation in ways that might support healing and social transformation. I use two examples to illustrate and discuss the participatory approach with which I have engaged for over 10 years. The illustrative examples show how a participatory approach can create ripples that impact communities in healing and transformative ways.     

Community Gardening: A Parsimonious Path to Individual, Community, and Environmental Resilience

The goal of this paper is to introduce community gardening as a promising method of furthering well-being and resilience on multiple levels: individual, social group, and natural environment. We examine empirical evidence for the benefits of gardening, and we advocate the development and testing of social ecological models of community resilience through examination of the impact of community gardens, especially in urban areas. The definition of community is extended beyond human social ties to include connections with other species and the earth itself, what Berry (1988) has called an Earth community. We discuss the potential contribution of an extensive network of community gardens to easing the global climate change crisis and address the role of community psychologists in community gardening research and policy-oriented action.     

Development of a Biomedical Program of Research in the Blackfeet Community: Challenges and Rewards

American Indian (AI) communities have high levels of stress and trauma and are disproportionately affected by numerous preventable diseases. Here, we describe an academic–community partnership based on a collaboration between Blackfeet Community College students and faculty in Psychology and Immunology at Montana State University (MSU). The collaboration, which has spanned over 5 years, was sparked by community interest in the relationship between stress and disease on the Blackfeet reservation. Specifically, community members wanted to understand how the experience of psychological stress and trauma may affect disease risk in their community and identify factors that promote resilience. In doing so, they hoped to identify pathways through which health could be improved for individual community members. Here, we discuss all stages of the collaborative process, including development of measures and methods and themes of research projects, challenges for community members and non‐indigenous collaborators, future directions for research, and the lessons learned. Finally, we note the ways in which this partnership and experience has advanced the science of community engagement in tribal communities, with the hope that our experiences will positively affect future collaborations between indigenous community members and non‐indigenous scientists.     

Rising in Witness: The Metropolitan Community Church in the Religious Press

This detailed article surveys the literature generated by and about the Metropolitan Community Church from its foundation in 1968 to contemporary times in the mainstream religious press and tracks its use as a research venue.     

Readiness, Functioning, and Perceived Effectiveness in Community Prevention Coalitions: A Study of Communities That Care

This paper examined whether community readiness, prevention knowledge, coalition functioning, and barriers are linked to perceived effectiveness of community prevention coalitions. Interviews were conducted with 203 key leaders in Communities That Care (CTC) prevention boards in 21 Pennsylvania communities. Community-level means for the reliable self-report measures were utilized separately and in combination with research staff ratings, state technical assistant staff ratings, and other data. The results indicated that the strong link between readiness and perceived effectiveness was mediated by internal coalition functioning. The extent of CTC linkage with outside community entities was not linked to perceived effectiveness. The study concludes that community readiness is an important condition for success of a prevention coalition, and exerts effects mainly through the quality of the coalition's internal functioning. Member turnover and infighting appear to be important factors related to internal functioning. Linkage with outside entities may be more important for coalition models where the coalition is more dependent on local institutions for resources.     

Building Leadership,Capacity, and Power to Advance Health Equity and Justice through Community‐Engaged Research in the Midwest

The Health Equity Advancement Lab (HEAL) at the University of Iowa College of Public Health began in 2012 to support students, researchers, and community members interested in tackling persistent health inequities through a community‐based participatory research (CBPR) approach. Using concepts from critical consciousness theory, we developed an approach to building students’, faculty members’, and community partners’ capacity to engage in CBPR to promote health equity that involved immersion in developing CBPR projects. Our paper describes the evolution of HEAL as a facilitating structure that provides a support network and engages diverse stakeholders in critical reflection as they participate in research to advance health equity, and resulting political efficacy and social action. We describe one HEAL‐affiliated research project that employs a CBPR approach and has a strong focus on providing transformative learning experiences for students, faculty, and community members. We highlight challenges, successes, and lessons learned in the application of critical consciousness as a framework that engages diverse academic and community partners seeking to promote health equity. We argue that critical consciousness is a relevant theoretical framework to promote transformative learning among students, faculty, and community partners to promote health equity research in diverse communities.     

Poverty and Serious Mental Illness: Toward Action on a Seemingly Intractable Problem

This paper examines the issue of poverty among people with serious mental illness (SMI), positioning it as a key issue to be confronted by community mental health systems and practitioners. The paper reviews three perspectives on poverty, considering how each sheds light on poverty among people with SMI, and their implications for action: (a) monetary resources, (b) basic needs, and (c) capabilities. The paper argues that community mental health programs and systems are currently unable to address poverty as they are overly focused on individual‐level interventions that, on their own, cannot raise people out of poverty. The paper calls for a social justice value, informed by the concept of citizenship, as a necessary complement to the recovery concept that has informed community mental health practice for almost 25 years. Finally, the paper argues that community psychologists, with their concepts, methods, and values, are well positioned to contribute to this important issue. However, it also contends that addressing poverty requires collaboration from community psychologists with researchers and practitioners from other fields and domains of expertise to begin to make progress.