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1.  NAPCRG! My, How You've Grown! 
Canadian Family Physician  1988;34:245-249.
PMCID: PMC2218752  PMID: 21253039
3.  A realist evaluation of community-based participatory research: partnership synergy, trust building and related ripple effects 
BMC Public Health  2015;15:725.
Community-Based Participatory Research (CBPR) is an approach in which researchers and community stakeholders form equitable partnerships to tackle issues related to community health improvement and knowledge production. Our 2012 realist review of CBPR outcomes reported long-term effects that were touched upon but not fully explained in the retained literature. To further explore such effects, interviews were conducted with academic and community partners of partnerships retained in the review. Realist methodology was used to increase the understanding of what supports partnership synergy in successful long-term CBPR partnerships, and to further document how equitable partnerships can result in numerous benefits including the sustainability of relationships, research and solutions.
Building on our previous realist review of CBPR, we contacted the authors of longitudinal studies of academic-community partnerships retained in the review. Twenty-four participants (community members and researchers) from 11 partnerships were interviewed. Realist logic of analysis was used, involving middle-range theory, context-mechanism-outcome configuration (CMOcs) and the concept of the ‘ripple effect’.
The analysis supports the central importance of developing and strengthening partnership synergy through trust. The ripple effect concept in conjunction with CMOcs showed that a sense of trust amongst CBPR members was a prominent mechanism leading to partnership sustainability. This in turn resulted in population-level outcomes including: (a) sustaining collaborative efforts toward health improvement; (b) generating spin-off projects; and (c) achieving systemic transformations.
These results add to other studies on improving the science of CBPR in partnerships with a high level of power-sharing and co-governance. Our results suggest sustaining CBPR and achieving unanticipated benefits likely depend on trust-related mechanisms and a continuing commitment to power-sharing. These findings have implications for building successful CBPR partnerships to address challenging public health problems and the complex assessment of outcomes.
Electronic supplementary material
The online version of this article (doi:10.1186/s12889-015-1949-1) contains supplementary material, which is available to authorized users.
PMCID: PMC4520009
Community-based participatory research; Public health; Realist synthesis; Realist analysis; Sustainability; Partnership synergy; Trust; Spin-off projects; Systemic transformations; Ripple effect
4.  Successful Strategies to Engage Research Partners for Translating Evidence into Action in Community Health: A Critical Review 
Objectives. To undertake a critical review describing key strategies supporting development of participatory research (PR) teams to engage partners for creation and translation of action-oriented knowledge. Methods. Sources are four leading PR practitioners identified via bibliometric analysis. Authors' publications were identified in January 1995–October 2009 in PubMed, Embase, ISI Web of Science and CAB databases, and books. Works were limited to those with a process description describing a research project and practitioners were first, second, third, or last author. Results. Adapting and applying the “Reliability Tested Guidelines for Assessing Participatory Research Projects” to retained records identified five key strategies: developing advisory committees of researchers and intended research users; developing research agreements; using formal and informal group facilitation techniques; hiring co-researchers/partners from community; and ensuring frequent communication. Other less frequently mentioned strategies were also identified. Conclusion. This review is the first time these guidelines were used to identify key strategies supporting PR projects. They proved effective at identifying and evaluating engagement strategies as reported by completed research projects. Adapting these guidelines identified gaps where the tool was unable to assess fundamental PR elements of power dynamics, equity of resources, and member turnover. Our resulting template serves as a new tool to measure partnerships.
PMCID: PMC4359847  PMID: 25815016
5.  Physicians and advocacy 
PMCID: PMC1197145  PMID: 16157713
14.  Studying family practice 
PMCID: PMC1269485  PMID: 2766161
15.  Refusing to Keep the Secret 
PMCID: PMC2280395  PMID: 21248962
21.  A Study of Health Maintenance Protocols in Family Practice 
Canadian Family Physician  1985;31:47-54.
A series of color-coded health maintenance protocols for four age groupings were introduced into a community health centre. In a pilot study of the 16-49 year age range, levels of recording before introduction of the protocols were below 50% in all categories, except “blood pressure” “coping skills” and “sexuality/contraception”. After one year, it was not possible to assess changes in recording of screening maneuvers reliably due to the short study period and major changes in staffing that coincidentally occurred during the study period. Further studies should use stable solo practices and a much longer follow up period.
PMCID: PMC2327337  PMID: 21279143
Health maintenance; screening; prevention
22.  Author Has Something to Add 
PMCID: PMC2153570  PMID: 21278958
23.  Follow up of Stress Management Groups in Family Practice 
Canadian Family Physician  1983;29:473-480.
Ninety-six registrants (70 females, 26 males, mean age 36.4) were trained in seven standard autogenic training groups for management of stress-related disorders by a family physician in a community health centre. Comparisons were made before and after six training weeks, using the State-Trait Anxiety Inventory and a questionnaire about physical and psychological symptoms, drug, tobacco and alcohol use. As in a previous study, state and trait anxiety scores and symptoms related to stress were decreased in a majority of subjects. Effects were maintained in a subgroup followed for 12 months. Problems of data collection over time in clinical settings and of establishing the impact of health education measures are discussed.
PMCID: PMC2153791  PMID: 21283343
24.  Uncovering the Benefits of Participatory Research: Implications of a Realist Review for Health Research and Practice 
The Milbank Quarterly  2012;90(2):311-346.
Participatory research (PR) is the co-construction of research through partnerships between researchers and people affected by and/or responsible for action on the issues under study. Evaluating the benefits of PR is challenging for a number of reasons: the research topics, methods, and study designs are heterogeneous; the extent of collaborative involvement may vary over the duration of a project and from one project to the next; and partnership activities may generate a complex array of both short- and long-term outcomes.
Our review team consisted of a collaboration among researchers and decision makers in public health, research funding, ethics review, and community-engaged scholarship. We identified, selected, and appraised a large-variety sample of primary studies describing PR partnerships, and in each stage, two team members independently reviewed and coded the literature. We used key realist review concepts (middle-range theory, demi-regularity, and context-mechanism-outcome configurations [CMO]) to analyze and synthesize the data, using the PR partnership as the main unit of analysis.
From 7,167 abstracts and 591 full-text papers, we distilled for synthesis a final sample of twenty-three PR partnerships described in 276 publications. The link between process and outcome in these partnerships was best explained using the middle-range theory of partnership synergy, which demonstrates how PR can (1) ensure culturally and logistically appropriate research, (2) enhance recruitment capacity, (3) generate professional capacity and competence in stakeholder groups, (4) result in productive conflicts followed by useful negotiation, (5) increase the quality of outputs and outcomes over time, (6) increase the sustainability of project goals beyond funded time frames and during gaps in external funding, and (7) create system changes and new unanticipated projects and activities. Negative examples illustrated why these outcomes were not a guaranteed product of PR partnerships but were contingent on key aspects of context.
We used a realist approach to embrace the heterogeneity and complexity of the PR literature. This theory-driven synthesis identified mechanisms by which PR may add value to the research process. Using the middle-range theory of partnership synergy, our review confirmed findings from previous PR reviews, documented and explained some negative outcomes, and generated new insights into the benefits of PR regarding conflicts and negotiation between stakeholders, program sustainability and advancement, unanticipated project activity, and the generation of systemic change.
PMCID: PMC3460206  PMID: 22709390
Participatory research; action research; realist review; systematic review; partnership synergy theory; community-based participatory research
25.  Family doctor as scholar 
Canadian Family Physician  2012;58(8):829.
PMCID: PMC3418975  PMID: 22893329

Results 1-25 (42)