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[Federal Register: June 21, 2002 (Volume 67, Number 120)]
[Notices]               
[Page 42262-42264]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID: fr21jn02-71]                         

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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Agency for Healthcare Research and Quality

 
Request for Suggestions on Community-Based Participatory Research

AGENCY: Agency for Healthcare Research and Quality (AHRQ), HHS.

ACTION: Notice of request for suggestions.

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SUMMARY: AHRQ is soliciting input from its user-groups and stakeholders 
on its implementation of Community-Based Participatory Research (CBPR) 
to meet the requirements of the Minority Health and Health Disparities 
Research and Education Act of 2000. CBPR is a methodology that promotes 
active community involvement in the processes that shape research, as 
well as, products and translation of research. CBPR offers 
opportunities to overcome the barriers faced by conventional approaches 
to research in low-income and minority communities, which lack this 
kind of collaboration and communication. As a result, CBPR has been 
gaining increasing acceptance within the larger biomedical and 
behavioral research community, and is especially relevant to many 
research subjects of mutual interest to Federal agencies, including 
health disparities. The Minority Health and Health Disparities Research 
and Education Act of 2000 mandates that AHRQ use methods characteristic 
of CBPR in conducting its research on health disparities. The Act 
states that "the Director shall implement research strategies and 
mechanisms that will enhance the involvement of individuals who are 
members of minority health disparity populations, health services 
researchers who are such individuals, institutions that train such 
individuals as researchers, members of minority health disparities 
populations or other health disparity populations for whom the Agency 
is attempting to improve the quality and outcomes of care, and 
representatives of appropriate tribal or other community-based 
organizations with respect to health disparities." Research strategies 
may include the use of centers of excellence that have a "demonstrated 
capacity to involve members and communities of health disparity 
populations, including minority health disparity populations, in the 
planning, conduct, dissemination, and translation of research." 
Section 903(b)(2), 42 U.S.C. 299a-1(b)(2) and see Title II of the 
Minority Health and Health Disparities Research and Education Act of 
2000.

Nature of Recommendations

    AHRQ encourages written suggestions from its customers and 
stakeholders on how AHRQ can implement CBPR in its research portfolio 
and in the field of health services research. In particular, AHRQ 
requests comments on the following:
    1. Please offer possible definitions of community that are 
appropriate for health services research.
    2. Please describe collaborative opportunities to foster the 
development or use of CBPR.
    3. Please describe strategies that AHRQ could use to increase the 
capacity for health services researchers and community-based 
organizations to conduct CBPR.
    4. Please describe the strategies that AHRQ could use to support 
relationships between researchers and community-based organizations.
    5. Please describe the accountability mechanisms that AHRQ could 
institute to ensure the development and

[[Page 42263]]

maturation of these partnership relationships.
    6. Please describe strategies that AHRQ could use to support 
partnerships with patients and community-based organizations to improve 
safety and quality in health care.
    In preparing your response, please consider ideas put forth at a 
conference on CPBR last fall which are listed under section titled, 
"Report of November 2001 Meeting on CBPR."

DATES: Responses to this request will be accepted within 60 days from 
publication date. AHRQ will not respond to individual responses, but 
will consider all suggestions.
    Arrangement for public inspection: All responses will be available 
for public inspection on weekdays between 8:30 a.m. and 5 p.m., from 
Kaytura Felix Aaron, M.D., Center for Primary Care Research, Agency for 
Healthcare Research and Quality.
    Arrangements for reviewing the submissions may be made by calling 
Phone: (301) 594-6198; Fax: (301) 594-3721; E-mail: KFaaron@ahrq.gov. 
Responses may also be accessed through AHRQ's Electronic FOIA Reading 
Room on AHRQ's Web site at http://www.ahrq.gov/foia/ 

ADDRESSES: Submissions should be brief (no more than three pages for 
each submission) and may be in the form of a letter or e-mail, 
preferable with an electronic file in a standard word processing 
format. Please present your suggestions in bullets or outline format. 
Responses to this request should be submitted to Kaytura Felix Aaron, 
M.D., Center for Primary Care Research, Agency for Healthcare Research 
and Quality, 6010 Executive Blvd., Suite 201, Rockville, MD 20852; 
Phone: (301) 594-6198; Fax: (301) 594-3721; E-mail: KFaaron@ahrq.gov.

FOR FURTHER INFORMATION CONTACT: Kaytura Felix Aaron, M.D., Center for 
Primary Care Research, Agency for Healthcare Research and Quality, 6010 
Executive Blvd., Suite 201, Rockville, MD 20852; Phone (301) 594-6198; 
Fax: (301) 594-3721; E-mail: KFaaron@ahrq.gov.

SUPPLEMENTARY INFORMATION:

Background on Community-Based Participatory Research

    There is increased interest in research that aims to improve the 
health of disadvantaged populations. However, conventional research in 
these communities has a contentious history and offers limited 
opportunities to improve the health and well being of these 
communities. Policy makers are interested in increasing investments in 
participatory research because participatory research addresses several 
of the barriers to and limitations of conventional research. First, 
partnerships with representatives of the study population ensure that 
research addresses the priorities of the population under study. 
Second, community partners bring local knowledge to the research 
process, thereby increasing the understanding of the complex 
interactions among economic, social, and behavioral factors that 
contribute to health problems. Third, partnerships with the population 
under study increase the efficiency of the research process by 
improving recruitment and retention of subjects. Finally, the 
involvement of stakeholders and groups affected by the problem under 
study increases the opportunity for adoption of new knowledge and the 
translation of research into practice.
    Community-based participatory research (CBPR) is a promising model 
of research collaboration between researchers and community-based, 
including faith-based and other non-profit organizations. Researchers 
and community representatives are actively engaged throughout the 
research process, from the conception of the research problem to the 
analysis, dissemination and translation of findings. CBPR engages 
community members, employs local knowledge in the understanding of 
health problems and the design of interventions, and invests community 
members in the processes and products of research. In addition, 
community members are more likely to be invested in the dissemination 
and use of research findings and ultimately in the reduction of health 
disparities.

Report on November 2001 Meeting on CBPR

    The Agency for Healthcare Research and Quality convened a meeting 
on CBPR on November 27-28, 2001 to increase awareness and support for 
CBPR and to develop an action plan. Participants at this meeting re-
affirmed that CBPR is an important model of research for AHRQ and other 
federal agencies because CBPR can potentially broaden the understanding 
of complex health issues and increase the relevance of research. 
Participants at that meeting developed a broad, national research 
agenda for CBPR.
    The recommendations were aimed at the diverse sectors represented 
at the meeting: Public and private funding organizations, academic 
institutions, and community organizations. The recommendations that 
were specific to AHRQ included:
    1. Fund CBPR projects and centers;
    2. Develop funding mechanisms that facilitate the development of 
research capacity in community-based organizations;
    3. Build a national repository for CBPR methods, tools, and 
resources;
    4. Evaluate CBPR as a strategy to improve health and health care;
    5. Develop a balanced portfolio that supports early and mature 
partnerships;
    6. Convene a group to develop standards for CBPR; and
    7. Identify and address institutional policies that deter community 
participation in grant making process.

CPBR is Consistent With AHRQ's Mission and Programs

    AHRQ was reauthorized on December 6, 1999 to support research 
designed to improve the outcomes and quality of health care, reduce its 
costs, address patient safety and medical errors, and broaden access to 
effective services. AHRQ accomplishes these goals through the 
establishment of a broad base of scientific research on the 
organization, financing, and delivery of health care services, and 
through the promotion of improvements in clinical practice. The 
research sponsored, conducted, and disseminated by AHRQ provides 
information that helps people make better decisions about health care. 
Since its reauthorization, the Agency's is also required to produce 
information that improves the outcomes, quality, cost, and 
accessibility of health care for the following priority populations: 
Inner city; rural; low income; minority; women; children; elderly; and 
those with special health care needs, including those who have 
disabilities, need chronic care, or need end of life health care. CBPR 
represents an important strategy to meet these objectives.
    AHRQ uses mechanisms of grants, cooperative agreements, and 
contracts to carry out research projects, demonstrations, evaluations, 
and dissemination activities. AHRQ also supports small grants, 
conference grants, and training (http://www.ahrq.gov/fund/training/trainix.htm) 
through dissertation grants (http://grants.nih.gov/grants/guide/pa-
files/par-00-076.html) and national research service awards to 
institutions and individuals. The vast majority of AHRQ grants and 
cooperative agreements are investigator-initiated.
    AHRQ uses the following processes to meet its policy and program 
objectives to conduct its ongoing activities in order

[[Page 42264]]

to make the most productive use of its resources:
    1. Needs Assessment. AHRQ conducts needs assessments through a 
variety of mechanisms including expert meetings, conferences, and 
consultations with stakeholders and customers of its research, 
publishing notices for comment in the Federal Register, as well as 
regular meetings with its National Advisory Council and government 
leaders. The results of these assessments are used to determine and 
prioritize information needs.
    2. Knowledge Creation. AHRQ supports and conducts research to 
produce the next generation of knowledge needed to improve the health 
care system.
    3. Translation and Dissemination. AHRQ's commitment to research 
extends beyond knowledge generation. AHRQ believes that findings must 
be useful and made widely available in accessible formats to 
practitioners, patients, and other decisionmakers. In addition, AHRQ 
synthesizes and translates knowledge into products and tools in order 
to support its customers in problem solving and decision making. AHRQ 
actively disseminates the knowledge, products, and tools to appropriate 
audiences. Effective dissemination involves forming partnerships with 
other organizations and leveraging resources.
    4. Evaluation. In order to assess the ultimate outcomes of AHRQ 
research, the Agency is placing increased emphasis on the evaluation of 
the impact and usefulness of Agency-supported work in health care 
settings and policymaking.

    Dated: June 18, 2002.
Carolyn M. Clancy,
Acting Director.
[FR Doc. 02-15865 Filed 6-20-02; 8:45 am]
BILLING CODE 4160-90-M


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