In the PILI ‘Ohana Pilot Project, a co-learning community-academic partnership was instrumental in translating an evidenced-based clinical trial (the DPP-LI) into community practice among a high risk population of NHOPIs. The key elements of this pilot project that adds to the existing literature on CBPR approaches in translational research were: 1) The use of a fully engaged CBPR partnership model that facilitated the completion of the scientific goals; 2) The role of CIs to collect and analyze the qualitative data that informed the cultural and community adaptations by, and for, NHOPI communities. 3) The feasibility of implementing a culturally adapted intervention via community peer educators and 4) Research oversight by community-based researchers to conduct a research protocol that achieved clinically significant improvements in weight loss, the primary outcome of the study.
The accomplishments of the POLI pilot study, however was enabled not merely by community involvement but more importantly by the collective partnership of both academic and community partners. That is, each partner brought resources and skills to the partnership which would not have been possible individually and this strengthened our ability to complete the scientific aims of the pilot study. For example, involvement of the community research teams from study inception facilitated awareness and recruitment of participants. (42
) Delivery of the intervention, in a competent manner, by peer educators helped to breakdown perceived mistrust of research and of researchers. (40
The main outcome of the intervention, mean weight loss was modest (−1.5 kg) compared to other studies in the literature. (9
) However, few studies have used fully engaged CBPR approaches to translate the DPP-LI or were conducted in community settings with high risk populations, such as NHOPIs. Thus, our study adds to the existing literature of approaches to translating research into minority communities through the use of CBPR approaches as a viable option.
In particular, CBPR approaches offer the added benefit of building capacity within these difficult to reach communities for future translational studies. (25
) Forming partnerships that provide direct benefits to racial/ethnic minority populations, such as NHOPIs, also addresses another public health imperative the elimination of health and health care disparities. (46
) Thus, our preliminary results suggests that CBPR may be a promising way of both reducing the development of health disparities but also offers the promise of assisting communities to confront health disparities by becoming actively involved in research. (22
Broad interpretation of our findings however, must remain cautious. Our study was limited by the types of communities who were involved in this study (i.e. NHOPI, Micronesian, etc.) which may not be generalizable to other at risk populations. Also the design of our study (non-randomized, pre-post design) does not allow for comparison with a control group. (18
) However, efficacy of the original DPP-LI is already established. (8
) Moreover, the model of CBPR involvement that was used in this study may not be comparable to all forms of CBPR used in other settings and thus may not be generalizable to other community populations or settings. Finally, the enrolled population was not uniformly pre-diabetic individuals as was the case in the DPP study and thus the effect size of the intervention may not be applicable across a more diverse population. Nonetheless, these preliminary results suggest that CBPR approaches of this type may be a promising option to conducting scientifically rigorous translational research in high risk minority populations. Furthermore, our preliminary study suggests that by engaging communities, we may also be addressing a more urgent public health mandate, the elimination of health disparities and promoting health equity for all.