Community-based participatory research (CBPR) is a collaborative approach to research that equitably involves all partners in the research process and recognizes the unique strengths that each brings. CBPR begins with a research topic of importance to the community, has the aim of combining knowledge with action and achieving social change to improve health outcomes and eliminate health disparities.
WK Kellogg Foundation Community Health Scholars Program
All too often, community health concerns can be overlooked in public health research projects leading to a disconnect between research and the community the research is designed to inform; scientists tend to focus on their own research questions and report back to the public only when the analysis is complete. Many researchers and communities are working to change this outdated methodology by adopting the CBPR approach to more appropriately address community environmental health concerns. SRP Researcher, Laurel Schaider, has been leading a CBPR project evaluating sources and concentrations of mercury in fish in Tar Creek since 2009. The project reaches completion in the next three months and Laurel shared with us some of her experiences from working with this unique community.
Laurel first began working in the Tar Creek community back in 2005 as part of an interdisciplinary effort exploring the fate and transformation of metals from mining waste in the environment that is now a part of Project 5. She spent most of her time in the field, collecting and analyzing samples and getting to know the area. Through this work, Laurel met Tar Creek community advocates, Rebecca Jim and Earl Hatley from the Local Environmental Action Demanded (LEAD) Agency, and together they formed a partnership to collaboratively explore community health concerns.
By speaking with their neighbors and citizens in surrounding communities, Rebecca and Earl were able to identify mercury exposure from eating fish caught in nearby Grand Lake as the biggest community health concern. Grand Lake is a popular fishing destination that is sourced by Tar Creek and many people were concerned about the risk of mercury contamination from direct deposition from the six coal fired power plants nearby. With the support of a generous grant from the National Institute of Environmental Health Sciences (NIEHS), SRP researchers and the Tar Creek community were able to embark on a four year CBPR project entitled “The Grand Lake Watershed Mercury Study.” From the beginning of the project, the community has played a key role on the study team in designing the research approach and implementing the findings.
The community worked together to define the following project goals:
- Measure the mercury exposure among people who eat fish from Grand Lake
- Understand how much fish people are eating
- Measure the mercury levels in commonly consumed fish from Grand Lake
- Correlate species-specific fish consumption with biomarkers of mercury exposure
- Assist in designing strategies for reducing exposure
The good news is that for the most part, researchers are not finding elevated levels of mercury in fish. However, this presents a communication challenge for the team in that the expectation was that mercury was a significant issue in this community. Although the team learned that most fish are safe to eat, there are some species that do show elevated levels with implications for fish consumption. Communicating the risks of mercury exposure in specific species, while promoting the consumption of local fish overall as a healthy source of protein proved to be challenging. Many community members focused exclusively on the news of elevated levels and wanted specific recommendations for daily fish consumption. This was difficult, because researchers wanted to explain their findings, while also being clear about what they didn’t know, including the ability to make very specific recommendations. In the end, Laurel recommended the team be as honest as possible about the uncertainties and help provide general guidelines for fish consumption.
Conducting a CBPR project has better informed the way Laurel approaches research in many ways. She’s found that it has challenged her to communicate findings of direct relevance to communities, while still emphasizing the importance of the work for the broader scientific community. She’s learned that she enjoys developing creative explanations of research findings in intuitive ways. She relies on analogies and appealing graphics in an effort to convey complex data and information in an easily understandable way. The CBPR process has been very rewarding for Laurel and she plans to implement it in the design of her future studies.
Perhaps the most valuable lesson Laurel has learned through this CBPR process is the value of relationships with community partners. Living far away from Tar Creek can be difficult, but the community partners have made it much easier by bridging the gap between researchers and the community. They have helped plan, brainstorm and execute many ideas in addition to spending countless hours visiting, surveying, sampling and following up with over 100 study participants in order to help achieve the goals of the study. Building these relationships has required investing time and establishing the trust that only comes with time. Laurel has found that her visits to Tar Creek have been far more informative than any amount of email communication and these visits have led to lasting friendships with the people of the Tar Creek community. Working so closely with community partners, Rebecca and Earl, has been an inspiration to Laurel; she deeply admires the decades of work they have put in to build awareness around the environmental problems in their community. The passion they have for their community is contagious, and Laurel is forever grateful for their friendship and commitment.