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By the same token, your effort should occur at the best time for it to have the desired effect. This may mean coordinating it with regular legislative procedures the issuing of a state budget, for instance , with a particular season timing a fundraising effort for homeless families to coincide with the winter holidays , with a similar national or international effort e. Community intervention should be replicable and sustainable. The basic elements of the intervention should be effective — perhaps with some adaptation to a different community or population — anywhere, and you should be able to explain exactly how it works, so that someone else can set it up and run it in another situation.

For an intervention to be sustainable, you have to be able to continue to operate it for the long term. Community work is never done.

Scientific evidence: what is it and how can we trust it?

To really bring about change in a community, you have to keep at it indefinitely. Sometimes, it might seem that altering your purpose will make it more palatable and less controversial, and will make your life easier. If these need to change because of changes in circumstances or community needs, then they should. The integrity of your cause and your organization is worth far more, and will contribute far more to your effort, than any short-term financial or public relations gain. The real goal of community work is positive social change. The ideal, in most cases, is to improve the quality of life for a particular group, or for everyone, in the community.

This often means changing some fundamental aspects of the way the community thinks or functions — its attitude toward domestic violence, for instance, its commitment to education or to environmental preservation, its consumption of alcohol or unhealthy food, or its concept of social justice.

If you can help the community change its attitudes and behaviors in positive ways, it will become a better place for everyone to live. If we start with that assumption, it becomes easier to establish common ground, and to begin to work together. Demonizing those we disagree with is easy and often satisfying, but it leads nowhere. Assuming instead that others want many of the same things we do can lead to cooperation on some issues, and can at least start a dialogue on others. In the quest for equity in a community, we often come up against attitudes that seem mean and unfeeling.

In many cases, however, these attitudes are the result of people in different circumstances having little contact with one another. If people are treated with respect, they usually respond the same way. The Golden Rule is generally a good guideline, not only morally and ethically, but practically. Coalitions, partnerships, and collaborations are built one relationship at a time. It may be relatively easy to bring a number of people and groups together around an issue, but getting them to stay and work together is another matter.

The relationships that they build with one another are the glue that can make that happen. House of Representatives, used to say that all politics was local. What he really meant was that all politics was personal, that alliances are built relationship by relationship. This is the reason that a shared vision is so important in community work, but it also hold true on the individual level.

An individual or community has to be able to imagine the future in order to make it happen. People working together are better off and more successful than people working alone. Underlying every section of the Community Tool Box are the values, principles, and assumptions that the Tool Box team uses to guide its work.

Historical Context of CBPR

These have to do largely with the fundamental dignity and worth of all people; the ability of — and necessity for — communities to solve their own problems and produce their own leaders; the ethical and practical necessities of health and community work; and the need for positive social change. Journal of Applied Behavior Analysis, 24, no. Skip to main content. Chapter 1 Sections Section 1.

Our Model of Practice: Evaluating Comprehensive Community Initiatives Section 6. Working Together for Healthier Communities: The Tool Box needs your help to remain available. Toggle navigation Chapter Sections. Willingness to collaborate by sharing authority, responsibility, and credit for success means adopting an attitude that will allow this to happen, even when decisions are made that the researcher may deem unusual.

This does not mean that the researcher suspends judgment, rather that the researcher joins in a collaborative discussion with all opinions being given respectful consideration. This process established a norm of equality for all members of the research team. We also were aware that any other means of decision making, most likely, would have been unworkable because each of the team members held unique spheres of power within the group. This recognition, in tandem with an understanding of common goals, including belief in the worthiness of the project; dedication to conduct the research in a scientifically rigorous and ethical manner while maintaining cultural congruence; and a sense of altruism, kept the project moving through various stages of both stress and accomplishment.

This project was grounded in a commitment to social justice. Being mindful of the ethical implications of the research project involves issues related to informed consent, confidentiality, and ownership of intellectual property. In action research there may be difficulty gaining true informed consent. Because it is the nature of action research to allow the project to evolve as the research progresses, it is not easy to specify explicitly what involvement in the research will mean for the participants.

First, the Native research team member approached the tribal chief and the director of senior services. Both of these individuals supported the idea of the project and wrote 2 separate letters indicating their support. Because the first project was so small and there was no certainty that it would come to fruition, the Native research team member did not wish to give it the publicity it would have received if a community advisory board had been developed. Rather, she opted to let people know about the project via the interviewing process and the FCC intervention conducted during the pilot project.

By the time the pilot study was completed, people had become familiar with the idea. When funding for the second, expanded project was secured, the Native research team member recruited a group of tribal people who were most willing to serve as a planning committee for the next stage of the project's development. The second manner in which informed consent was addressed was through the conventional IRB process.

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Approval of the project with the attendant informed consent forms was provided via the completion of a detailed application process. We were fortunate to have a review board that was sensitive to cultural concerns and therefore allowed us the necessary flexibility to conduct this project. Other review boards, however, may be less flexible. In addition to requiring that all written materials, such as advertising fliers, letters of invitation, and examples of thank-you notes, receive a physical stamp of approval, IRBs may mandate that prospective phone calls have written scripts.

The issue of confidentiality also is of concern. The collaborative nature of the research may often endanger confidentiality. Thus, participants active in the project, with dual roles of community member and research collaborator, may be privileged to generally inaccessible information. We addressed this issue in a couple of ways. As professionals, we held to principles of confidentiality. We also discussed what confidentiality meant for this project. During the course of the project, we decided that because of the sensitive nature of the topic of elder mistreatment, we would use a pseudonym when referring to the reservation.

This spawned other discussion with regard to when to use the pseudonym. We decided to use it in all cases when referring to the study, and not simply when discussing the results of the project. Additionally, by having all team members read through reports, we were able to provide a system of checks with regard to what might constitute identifying information. Another ethical issue related to CBPR is how to handle information that might cast the community in a negative light. Reporting this type of information may well be damaging to the community, or could weaken the community's trust in the research process.

Furthermore, there is the possibility, when working across cultures, that the interpretation or cultural misinterpretation of the data could depict the community in a negative manner. To address this issue, we developed a Memorandum of Understanding that clearly delineates how we will handle reports and publications resulting from the research project.

If any of us wish to publish or present results or submit a subsequent grant related to the project, we will present a 1-page concept paper to the other members of the research team for review and consensus. All of us will be listed as coauthors. As an additional safeguard, and in an effort to reduce the Native research team member's stress of being the only spokesperson for the Native American community, the Memorandum of Understanding provides the option of recruiting another tribal member to serve as a cultural reader or reviewer of manuscripts.

Another ethical issue concerns ownership of the collected data. This issue needs to be contextualized in terms of instances of exploitation that have occurred as a result of past research in which traditional knowledge has been taken and used for profit with no compensation to the people who owned the knowledge in the first place. Additionally, some knowledge is sacred and central to a community's cultural identity.

Sharing this knowledge with outsiders who are unable to understand the context may erode the cultural identity. We addressed this issue as described above via the Memorandum of Understanding. In addition, we agreed to request exemption from the norm of data sharing for secondary analysis by other investigators in National Institutes of Health NIH -sponsored projects. The final guideline, application of the concept of culture in everyday working relationships, at first glance seems logical and straightforward.

However, it is complex. Although it is important to understand differences across cultures, it is equally important not to assume that every person within a culture will exhibit characteristic cultural beliefs and behaviors. Caution is needed when trying to use culture as a framework for understanding individual behavior. Equally important is the need for awareness of one's own cultural thinking and behavioral patterns.

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Working with culturally diverse groups requires a multicultural orientation on many levels and brings a degree of complexity to the project that first demands our awareness and secondly requires skillful navigation. In our situation, we used traditional ethnographic field methods for collecting data.

Originally, the plan had included a period of orientation for the non-Native research team members to become familiar with the community. When the time came to implement this part, there was considerable discomfort among the research team members. The Native research team member had experienced previous research that, in an attempt to describe the culture, had done so in a manner deemed inappropriate by the community in which it had taken place.

Concern grew, among the research team members, that this period of orientation would be an exercise in futility and may even sabotage the success of the project. The Native research team member contended that it really was impossible to know the culture without living among the people for many years and even then there is danger that one may think she understands the culture but really does not.

Finally, since the Native research team member knew the culture intimately, there was less need for the non-Native research team members to become familiar with it. Rather, with the Native research team member as guide, we were able to enter the community in a culturally appropriate manner. Relying on the Native research team member's understanding of the community allowed the non-Native research team members to meet, in a genuine manner, with the people as people, while recognizing the cultural differences between us.

This marked a departure from the conventional wisdom of the traditional ethnographic approach to research. Additional concerns relevant to CBPR included the fact that it is a very time-consuming process and requires a long-term commitment on the parts of the research team members. During this time, it was important to recognize and acknowledge the altruistic motives for social justice that underlay our ultimate goal to use research to help improve the lives of the elders and their families with whom we would be working.

Finally, other concerns related to CBPR may be associated with the political process Of change, which, at times, can be threatening to communities or groups within a community. First, we learned what community leaders, elders, and service providers thought about the issue of elder mistreatment. Was it present on the reservation? What forms did it take? What factors contributed to elder mistreatment. What were the current means of addressing elder mistreatment?

Community-based Participatory Research

If so, why, and if not, why not? We also asked their opinions of the feasibility of using the FCC as an intervention to enhance family unity and Improve the lives of elders.


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We asked whether, or in what situations, elders should be included in the FCC and what qualities FCC facilitator should have. Once we had arrived at an understanding of this nature, the second phase of the pilot study began. The Native research team member set about finding referrals of a family who would be willing to participate in an FCC.

For the pilot FCC, it was important to choose a family very carefully. Although many families could have benefited from participation, the Native research team member screened referrals to find a family without problems so complex that a successful outcome would be tenuous. If the FCC was well received by the family, it would provide a positive foundation from which to build a more extensive program. The steps are as follows: The spiral continues until the planned change demonstrates that it is practical and functioning within the context in which it was begun.

Israel et al 24 included another aspect that could be considered the endpoint of the action research spiral. In order for the project to become sustainable, the community must desire its continuation. In our case, the Native research team member kept in touch with the service providers and leaders in the community. They expressed desire to help in any way they could to see the project take hold. At the same time, once we had gained sufficient information from the pilot project, the research team set about writing a proposal for an expansion of the project. One of the key components of this project was the training and hiring of indigenous natural helpers to facilitate FCCs over the course of 1 year.

The project was funded and we are one step closer to helping ensure the sustainability of the FCC project on this reservation. When conducting research, there is always a question of the trustworthiness or soundness of the results. How do we know if the findings of qualitative or naturalistic research have substance beyond the investigator's mental processes? Finding a means of evaluating the trustworthiness of an investigation's findings confers some level of certainty or safety when using the knowledge that has been derived from the investigation.

As naturalistic, or qualitative, research has become more of an accepted approach to conducting research, the issue of ensuring rigor has grown as a topic of discussion. Bruyn, 26 in a treatise on participant observation, identified 6 indices that could be used to determine subjective adequacy. Explicating the use of these criteria or indices in a qualitative study can help to increase the study's credibility. Guba and Lincoln 28 also addressed the issue of trustworthiness or soundness of qualitative research.

The 4 evaluative criteria Guba and Lincoln 28 identified for naturalistic research include credibility, transferability, dependability, and confirmability. Credibility refers to the assessment of fit between constructed realities of the informants and the reconstruction attributed to them.


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  8. Useful procedures for ascertaining adherence to this criterion include prolonged engagement, persistent observation, peer debriefing, member checks, negative case analysis, and progressive subjectivity. For example, are the findings reported in such a manner that can render them useful to the reader who may wish to apply them in another related context? Although the burden of proof rests with the reader, transferability judgments on the part of the reader may be enhanced when the reporter of the results uses thick description including careful detailing of the time, place, and context in which the data has been collected.

    Dependability refers to the stability of the analytic process over time that might occur because of inquirer exhaustion, boredom, or psychological stress. To adhere to this criterion, it is important to establish the process of analysis in a manner that makes it a trackable and documentable process. Confirmability refers to whether the data, interpretations, and outcomes are rooted in contexts and persons apart from the analytical processes of the investigator s.

    To achieve this criterion, it is important to ensure that all data, facts, figures, and constructions can be traced back to the original sources. There are similarities and differences between Bruyn's work 26 and Guba and Lincoln's work. Sample sizes in qualitative research are typically small. Emerging from grounded theory, where filling theoretical categories is considered essential to the robustness of the developing theory, data saturation has been expanded to describe a situation where data tend towards repetition or where data cease to offer new directions and raise new questions Charmaz, However, the legitimacy of saturation as a generic marker of sampling adequacy has been questioned O'Reilly and Parker, Increasingly, it is expected that researchers will report the kind of saturation they have applied and their criteria for recognising its achievement; an assessor will need to judge whether the choice is appropriate and consistent with the theoretical context within which the research has been conducted.

    Sampling strategies are usually purposive, convenient, theoretical or snowballed. Maximum variation sampling may be used to seek representation of diverse perspectives on the topic.

    Objective and unbiased

    Homogeneous sampling may be used to recruit a group of participants with specified criteria. The threat of bias is irrelevant; participants are recruited and selected specifically because they can illuminate the phenomenon being studied. Rather than being predetermined by statistical power analysis, qualitative study samples are dependent on the nature of the data, the availability of participants and where those data take the investigator.

    Multiple data collections may also take place to obtain maximum insight into sensitive topics. For instance, the question of how decisions are made for embryo disposition may involve sampling within the patient group as well as from scientists, clinicians, counsellors and clinic administrators.

    Consistency, or dependability of the results, is the criterion for assessing reliability. This does not mean that the same result would necessarily be found in other contexts but that, given the same data, other researchers would find similar patterns. Researchers often seek maximum variation in the experience of a phenomenon, not only to illuminate it but also to discourage fulfilment of limited researcher expectations for example, negative cases or instances that do not fit the emerging interpretation or theory should be actively sought and explored. Qualitative researchers sometimes describe the processes by which verification of the theoretical findings by another team member takes place Morse and Richards, Research that uses qualitative methods is not, as it seems sometimes to be represented, the easy option, nor is it a collation of anecdotes.

    It usually involves a complex theoretical or philosophical framework. Rigorous analysis is conducted without the aid of straightforward mathematical rules. Researchers must demonstrate the validity of their analysis and conclusions, resulting in longer papers and occasional frustration with the word limits of appropriate journals. Nevertheless, we need the different kinds of evidence that is generated by qualitative methods.

    The experience of health, illness and medical intervention cannot always be counted and measured; researchers need to understand what they mean to individuals and groups. Knowledge gained from qualitative research methods can inform clinical practice, indicate how to support people living with chronic conditions and contribute to community education and awareness about people who are for example experiencing infertility or using assisted conception. Each author drafted a section of the manuscript and the manuscript as a whole was reviewed and revised by all authors in consultation.

    Oxford University Press is a department of the University of Oxford. It furthers the University's objective of excellence in research, scholarship, and education by publishing worldwide.


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    Sign In or Create an Account. Close mobile search navigation Article navigation. When to use qualitative research. How to judge qualitative research. How to judge qualitative research Qualitative research is gaining increased momentum in the clinical setting and carries different criteria for evaluating its rigour or quality. Trustworthiness A report of a qualitative study should contain the same robust procedural description as any other study. Applicability Applicability, or transferability of the research findings, is the criterion for evaluating external validity.

    Consistency Consistency, or dependability of the results, is the criterion for assessing reliability. Conclusions Research that uses qualitative methods is not, as it seems sometimes to be represented, the easy option, nor is it a collation of anecdotes. Authors' roles Each author drafted a section of the manuscript and the manuscript as a whole was reviewed and revised by all authors in consultation. Funding No external funding was either sought or obtained for this study. Conflict of interest The authors have no conflicts of interest to declare. Offspring searching for their sperm donors: Grounded Theory in the 21st century; applications for advancing social justice studies.

    Evaluative criteria for qualitative research in health care: