With an increased emphasis on the use of the community-based participatory research approach to actively involve the targeted community groups in addressing health disparities, the CGP model served as an important mechanism for ensuring that CBPR principles such as the equitable distribution of resources, capacity building, recognition of community strengths and resources, and the community as a unit of identity were adhered to.12
In implementing the CGP model, we were able to meet our goal to increase the number of community-based organizations as partners in the CNP. As a result of these partnerships, we were also able to expand our efforts in promoting cancer education and outreach activities and implementing evidence-based intervention programs and strategies. In achieving these successes, we also encountered challenges that have resulted in several lessons learned.
In trying to ensure an equitable distribution of resources whereby research dollars are provided directly to the community, we had to address the financial structure at an academic institution and the implicit imbalance of power created by the academic institution distributing grants to community organizations. Based on feedback from our initial community partners, we decided to allow organizations to choose the type of project (i.e., education, implementation of an intervention, research), use their own strategies, and to develop their own budgets. We also learned that it was important to provide the funded community-based organizations with information on how the academic financial structure works. This strategy reflected value in the community’s ideas on how best to approach their community to address cancer health disparities.
A second lesson learned was that, in addition to the provision of monetary resources through the grants mechanism, access to other resources within the CNP needed to be shared. For example, community partners were able to request technical assistance from the COS or other services in the network (e.g., access to expert speakers, development of materials). The COSs were accessible to the community by meeting individually with prospective community-based organizations to offer guidance in developing the proposal and suggesting resources that could be leveraged for the project. As a result, the scores received by year two applicants were higher than those given in the first year. Improvements in the methods/processes for project implementation and the inclusion of evaluation measures contributed to the improved scores.
A third lesson learned was experienced during the grant review process. To ensure a balanced review process, we paired reviewers—an academic reviewer and a community reviewer—to review each application. Although we initially felt this strategy would allow for an equal voice, the review criteria based on the five point National Institutes of Health process did not work for the community reviewers. We modified the review process so that each reviewer could review the proposal based on the criteria, but through their own lens. The two different perspectives enriched the review discussion by ensuring that the community viewpoint and proposed strategies were understood by the entire review committee.
A fourth lesson learned was the need to build an organization’s research capacity to become a community research partner. The community grants were available to all community organizations regardless of their level of organizational capacity. Hence, some of the community grantees were closer in readiness to becoming a research partner than those with limited to no experience in working with academia. It will be important to develop strategies for supporting the transition of organizations from education and outreach activities to research projects. For example, the transition may start by including community partners as advisors in research grants or training them to conduct aspects of the research process. In using the CGP as a platform for developing community research partners, the number of external CBPR grant applications will increase whereby needed resources to sustain efforts in the community can be leveraged. Another approach to building community research capacity may be to provide workshops tailored for the community on research topics such as human subjects, grant writing, evaluation, identifying and adopting an evidence-based intervention program, and so on.
We also learned that the time frame for completing the project needed to be lengthened from the required 12-month period. Many organizations were challenged to complete the project in time owing to delays in hiring staff, unexpected staff turnover, and the need for more upfront technical assistance around general project management issues. Extending the project period to 2 years would provide time needed for project implementation as well as the identification of subsequent funding to sustain the activity.
Last, we learned that building partnerships with a diverse group of organizations require diverse approaches to fostering partnerships and careful consideration should be given when deciding which groups are the best fit with the small grants structure. Health agencies are bound by their organization’s mission and objectives, and their agenda often is based on the structural and operational needs of the institution. In contrast, grassroots organizations are less restricted by existing guidelines and are more flexible in terms of tailoring programs to the needs of the community and goals of the grantor (CCN). Although health agencies are often able to meet the needs of the community to some degree by providing trainings and technical assistance to community-based organizations, the likelihood of melding to the mission of a research initiative can be challenging.
By adhering to the CBPR principles, the CGP approach to developing community research partners can naturally stand to build research capacity in the community, develop resources in the community, and provide communities with an awareness of the academic research culture. The CGP may be a useful mechanism for other CNPs or research initiatives that require the use of the CBPR approach and need a viable platform for engaging members of the community in various stages of organizational capacity in the research process. Based on 2 years of using the CGP, the model has served not only as a platform for developing partners in the community that did not exist before, but it also generated interest among the organizations to form partnerships among themselves and with academia, fostered the development of CBPR research projects and, last, increased the community’s understanding of the academic research enterprise.