Reflections on CBR Principles: Partnerships, Mentorship and Equity

“Partnerships, Mentorship and Equity: The best CBR is done when community members work closely with researchers who have strong training in methodologies, and when academics work closely with community members who understand the needs/concerns of populations most affected by HIV as well as the challenges of delivering programs and services. Through this process, communities learn more about research while researchers learn more about community. Experts in each context mentor one another. Within this structure, it is essential that power imbalances are actively recognized and addressed between a diverse set of partners.” hands-1939895_1280

On a Tuesday not that long ago, I had the privilege of attending a meeting on next steps for a community-based research (CBR) project led collaboratively by people with lived experience, academic researchers, community-based organization staff, and other key stakeholders. On the same night, I attended a dialogue on community-university engagement that focused on what the organizers described as “co-creating and/or mobilizing knowledge for a complicated world.” Attending both of these events on the same day (!) raised ideas about applying the CBR principle of partnerships, mentorship and equity, as defined above.

The working group meeting was an example of partnerships, mentorship and equity in action, as the group was actively brainstorming next steps for the research project based on their different sets of expertise. This group was coming together before launching the next phase of the project, in order to pool their skills and experience to collectively determine how they should proceed with the project in order to best meet the next set of research objectives. While there is always room to self-reflect and challenge the power imbalances that we bring to these encounters, this meeting was an example of what it can look like to co-create knowledge through research.

The more theoretical discussion that same evening revealed the power of language in framing these relationships. A participant asked the facilitator at our table of four participants to define knowledge mobilization, and she replied with “moving research from labs into community, for example.” The co-creation of knowledge, the other key term in the discussion question, went largely untouched; instead, the dialogue focused on knowledge mobilization as a tool to build more active community-university partnerships. This approach to knowledge mobilization, as the table was discussing it, seemed more oriented on sharing research findings with community after the fact and less so on involving community members throughout the process as equitable partners with potential interest in both mentoring and being mentored. Knowing that this group was committed and excited enough about community-university engagement to be meeting on a warm summer evening, I left the dialogue thinking how far we have to go in promoting the CBR principle of partnership, mentorship and equity as something to consider throughout the research process.

How can we decenter the concept of knowledge as being something that is mostly created by researchers and then shared back into community? Even with the best of intentions, it seems that the relationship between researchers and the communities involved in the production and application of research findings can leave much to be desired in terms of who is considered to know and who is considered as needing knowledge. Can changing our language about research partnerships shift our research practices, so that we reshape power-laden encounters between researchers and community members?

At an ancillary event for the 2017 Canadian Association of HIV Research, I heard the term ‘capacity-bridging’ for the first time and was deeply influenced by its meaning. Originally proposed by the Aboriginal HIV & AIDS Community-Based Research Collaborative Centre (AHA Centre), this term is an alternative to ‘capacity-building,’ in that it refocuses on the need to train all partners engaging in CBR projects, not just community members. While the term ‘capacity-building’ implies that community member involvement in research is a one-way mentorship of community members by researchers, the term ‘capacity-bridging’ reframes our understanding of the research (or evaluation!) encounter as being one that occurs between individuals who each bring a set of skills, knowledge and experience to the table. Superbly, the event captured the value of adopting a participatory, capacity-bridging approach even in bio-medical research projects where most of the research takes place in laboratory settings.

Reframing our understanding of community-academic partnerships as presenting the opportunity for mutual capacity-bridging raises our awareness of the extent to which projects are strengthened when we all come to the table ready, willing and enthused about bringing together diverse sets of experience and applying these learnings to the research process. In turn, this awareness facilitates projects that promote the principle of partnerships, mentorship and equity. While we have a way to go in seeing this principle applied as a widespread standard of research, REACH and the CBR Collaborative Centres are modelling the process and its valuable impact on research outcomes.

Read our CBR principles here.

Permalink

PAN at CAHR 2017: PLPH Shares Findings on Housing Services and the Importance of Stable Housing for Health

This post is our last of three in our series about Pacific AIDS Network’s (PAN) poster and oral presentations at this year’s Canadian Association for HIV Research (CAHR) Conference in Montreal, QC. The first post in the series focused on our impact evaluation of the Positive Leadership Development Institute and can be found here, and the second post discussed Jaydee Cossar’s oral presentation of the BC People Living with HIV Stigma Index’s research methodology and can be found here.Screen Shot 2017-06-15 at 10.00.30 AM

Co-led by Pacific AIDS Network and the University of Victoria, the Positive Living, Positive Homes (PLPH) study was invited to present two posters at CAHR 2017.

Darren Lauscher, a PLPH community consultant who has been involved with the study since its early days, presented a poster titled “A Critical Examination of Housing Services for People Living with HIV and Recommendations for Action.” This poster focused on study participants’ access and use of housing programs and services in the three PLPH research sites (Greater Vancouver, Kamloops, and Prince George). It also listed the recommendations that PLPH community partners suggested in response to issues that participants identified with some of these services, the foremost being confusion and frustration with navigating the subsidized and rental markets.

Screen Shot 2017-06-15 at 10.02.10 AMDevyn Flesher, PLPH’s Prince George Site Coordinator, presented a poster titled “HIV and Housing Histories: Using Timelines to Trace Connections between Housing and Health.” Devyn and the other site coordinators played a crucial role in honing the PLPH interview schedule to facilitate the creation of timelines to trace participant housing history. The site coordinators mapped the many housing transitions that study participants described in their interviews onto a simple linear timeline and added information about the points in time at which participants experienced illness episodes and/or periods of very good health. The timelines showed that unstable, unaffordable or inappropriate housing contributed to illness for study participants, while safe, affordable, appropriate housing contributed to better physical and mental health.

For more information on Positive Living, Positive Homes, please email Heather Picotte, the PLPH Study Manager who designed the posters, at plph@pacificaidsnetwork.org.

Permalink

A New Evaluation Resource: Peer Evaluator Training Manual

PAN is excited to introduce a new comprehensive resource on evaluation – the Peer Evaluator Training Manual! We hope this will be a good resource for PAN, REACH and other teams doing participatory evaluation work around the country. This resource will particularly be useful to those seeking to build evaluation capacity including teams that are working with people with lived experience and/or community-based organizations who haven’t done a lot of evaluation work to date. It was developed and piloted as a manual to train a team of peer evaluators at PAN for the PLDI program impact evaluation. Screen Shot 2017-05-08 at 1.15.39 PM

The Positive Leadership Development Institute (PLDI) is a well-recognized program in BC to support people living with HIV and AIDS (PLWHA) to realize their leadership potential and to increase their capacity to meaningfully participate in the community. PLDI is an exemplary model of implementing GIPA and MIPA principles, as the program is run by a team of PLWHA for their peers. Thus, an evaluation project to measure the impact of PLDI program also followed the GIPA and MIPA approach by hiring and training peer evaluators.

Using the Peer Evaluator Training Manual, the peer evaluators learned about  evaluation and different types, approaches, and methods used in evaluation. Peer evaluators also gained skills on how to: build an evaluation plan, develop and execute data collection tools; conduct data analysis; and share evaluation findings.

For those who are interested in engaging deeper into and learning more about any of the topics, the References and Resources document provides additional resources, broken down into the same chapters as the manual.

Permalink

PAN at CAHR 2017: The power of inclusive research methodologies, as presented by the BC People Living with HIV Stigma Index

This post is one of three in our series about Pacific AIDS Network’s (PAN) poster and oral presentations at this year’s Canadian Association for HIV Research (CAHR) Conference in Montreal, QC. The first post in the series focused on our impact evaluation of the Positive Leadership Development Institute aPAN CAHR Stigma Post Imagend can be found here.

PAN’s BC People Living with HIV Stigma Index Research Steering Committee was excited to give an oral presentation titled Emancipatory Participation: Active Change Agents in the Fight Against Stigma in the multidisciplinary session focused on community-based research and participatory approaches. The Research Steering Committee thought it apt to expound the methodological virtues of integrating GIPA/MEPIA vertically and horizontally across all aspects of the research design and implementation. As such, the presentation by Jaydee Cossar, PAN’s Stigma Index Project manager, highlighted the role PLHIV in conceptualizing the Stigma Index methodology and research schema, a level of involvement that adds a new twist to a core principle of community based research. The presentation stressed how the Stigma Index went one step further in the GIPA/MEIPA process by not only consulting PLHIV but by centring those living with HIV as active participants engaged meaningfully in all research activities: as research team members, core staff, interviewers, interviewees, and as drivers of the data collection, analysis, and dissemination. The main crux of the presentation postulated, vis-à-vis the Stigma Index research process of meaningful inclusion, that when efforts are made to embrace the unique and specific needs of PLHIV, individuals can break the layered and intersectional bonds of HIV stigma, becoming active change agents for their communities and themselves.

Keep your eyes out for our next post, which will focus on the Positive Living, Positive Homes study’s poster presentations at CAHR!

 

Permalink

PAN presents the PLDI Impact Evaluation and more at CAHR 2017

PLDI Impact Eval Poster imageThe Pacific AIDS Network (PAN) had the good fortune of presenting several research and evaluation projects at the recent Canadian Association for HIV Research (CAHR) Conference in Montreal, QC. It was a wonderful opportunity to meet, reconnect, and learn from a diverse group of researchers, people with lived experiences, funders, partners, advocates from across Canada (and we even met a few people from the United States!). Over the next several weeks, we’ll be providing a short series of blog posts describing PAN’s posters and presentation offerings at CAHR 2017. 
One of the three posters PAN presented at CAHR focused the peer-led impact evaluation of the Positive Leadership Development Institute (PLDI). This poster included preliminary findings from the survey, interview, and focus group data collected from PLDI participants, people living with HIV, and key stakeholders at PAN and partner agencies, as well as information about the participatory evaluation approach that guided the project. Thanks to funding from REACH 2.0 and the CBR Collaborative Centre, Paul Kerber and Heather Holroyd were able to travel to Montreal to present the poster. Poster visitors were especially interested to learn more about the PLDI program and its objectives, the impacts revealed by the evaluation, and about the method of participatory evaluation. Many visitors recognized the value of a leadership training program by and for people living with HIV (PLHIV) and commented that such a training program would be well-received in their region. Several visitors also expressed interest in accessing the ‘just-in-time’ training manual produced by the community based research and evaluation team at PAN to train the peer evaluators hired for this project. The training manual has been posted in English on the PAN website and will be posted on the Evaluation Toolkit on the REACH website. The training manual can be translated into French upon request. Please email Janice Duddy, PAN’s Director of Evaluation and Community-Based Research, with any questions or comments about the training manual.

 

Permalink

New Resource: Introduction to Realist Evaluation

The BC team is beginning to implement the Making It Work study funded through a CIHR CBR Catalyst Grant. The team has decided to use a Realist Evaluation approach to this work and as part of the team’s capacity building PAN has pulled together an introductory primer on Realist Evaluation.

What is Realist Evaluation?

Realist Evaluation is a theory-based approach that asks “How or why does this work, for whom and in what circumstances?” rather than just “what works?” The goal is to develop a detailed theory on how a program works and unpack the processes that are normally non-observable.

Realist-Eval-Figure-1

 

When to Use Realist Evaluation

  • New initiatives or pilot programs (or programs that seem to work, but for whom and how is not yet understood)
  • Programs for scale-up (to understand how to adapt the intervention to new contexts)
  • Programs that have previously demonstrated mixed patterns of outcomes (to understand how and why this is).

Visit PAN’s website to learn more.

Permalink

Responding to the Overdose Crisis in BC: A Rapid Assessment of Frontline and Advocacy Organizations’ Capacity- and Skills-Building Needs

Report coverOn April 14, 2016, Dr. Perry Kendall, the Provincial Health Officer, declared a public health emergency under the Public Health Act as a result of a dramatic increase in the number of opioid-related overdose deaths across British Columbia (BC) since the beginning of 2016. Because PAN’s member agencies and partners have been on the frontlines of responding to, reversing, and managing grief and loss related to overdoses, substantial time was spent discussing the opioid crisis and national drug policy at the PAN Fall Conference in October 2016. After the conference, PAN staff put together a Drug Policy Report summarizing these conversations.

Building on momentum from the conference and a strong desire to support the work already happening in community-based organizations (CBOs) across the province, PAN and the BC Centre for Disease Control (BCCDC) started a conversation about how PAN can best support progress on this issue. The discussion put into motion a rapid assessment to determine key capacity- and skills-building activities that would support frontline organizations responding to BC’s overdose crisis.

Key stakeholders from across the province, including people with lived experience, CBO staff, outreach nurses, and Regional Harm Reduction Coordinators, were invited to participate in the rapid assessment. Most invitees were eager to make time to schedule these 20- to 30-minute phone calls despite their stretched resources, commenting that they had prioritized this invitation as an opportunity to report on what they were experiencing in their organizations and to voice the needs of their staff, members and clients. This high level of stakeholder engagement in the rapid assessment speaks to a province-wide need for capacity- and skills-building activities, as well as other forms of sustained support, in response to this crisis.

The responses provided by the key stakeholders were analyzed and summarized in a report that will guide PAN’s next steps. If you are interested in reading the results of the rapid assessment, please click here to download the report.

Permalink

Population Size Estimate Case Studies and Resources

Population Size Estimates (PSEs) for key populations most affected by HIV and HCV, namely gay, bi and other MSM and for people who inject drugs, have been developed. This project has been led by the BCCDC and supported by the Pacific AIDS Network, with consulting work provided by the University of Manitoba. In addition to the PSEs, the team also developed a summary document for the project.

During this work the team was able to develop some reference resources that describe why PSEs are important and that highlight case studies or examples from around the world of places that have used PSEs for program planning. These may be useful resources for teams who want to learn more information about how to develop and use population size estimates in their work.

Please take a look at these documents:Why PSE IMportant

Permalink

PAN Supporting Peer Evaluators to Conduct Impact Evaluation of BC’s PLDI Program

The Positive Leadership Development Institute (PLDI), a three-module leadership training program led by and for people living with HIV (PLHIV), has delivered 20 sessions of leadership training to over 167 participants in BC since 2009, when PAN’s partnership with the Ontario AIDS Network was established.

The purpose of this highly-valued series of three- and four-day training programs is to support people living with HIV/AIDS to realize their leadership potential and meaningful participation in community life. Each PLDI training includes an evaluation process and the feedback collected after each session been very positive. But what are the larger impacts of the training? What leadership activities do PLDI participants participate in after they complete any or all three of the PLDI modules? After all these years, PAN and the PLDI Leadership decided it is time for a comprehensive evaluation of the training program – we know that PLDI participants are accomplishing great things in the community and it is time to gather the information needed to tell that story!

In keeping with the PLDI’s mandate to deliver training by and for PLHIV, four Peer Evaluators – Paul Kerber, Darcy McFadden, Martin Morberg and Candice Norris – were hired in June 2016 to drive this evaluation project. PAN, through support from REACH, has been working to train and support this team of Peer Evalutors. The team has just launched data collection through an online survey and will be doing interviews as well and analysis on past evaluations. If you live in BC and want to participate please see this blog post on PAN’s website. We hope to be able to share findings from this evaluation in the spring!

Permalink

REACH Welcomes New CBR and Evaluation Associate in BC: Heather Holroyd

heather-h-photo-for-pan-post-170x300We are excited to welcome Heather Holroyd who was hired in October 2016 at the Pacific AIDS Network (PAN) in British Columbia to support PAN’s Evaluation and Community Based Research Programs, thanks to support from the CBR Collaborative Centre and REACH. Collaborating with PAN staff and the Peer Evaluators on the Positive Leadership Development Institute’s impact evaluation will be a major component of Heather’s work over the coming months. Heather recently completed a PhD in sociology at the University of British Columbia and has been a board member at Positive Women’s Network since 2012.

To learn more about Heather please see her 5 Questions with Heather Holroyd, PAN’s Evaluation & Community Based Research Programs Contractor blog post on the PAN website.

Permalink