Exploring the effects of longstanding academic-community partnerships on study outcomes: A case study

Annette E Maxwell, Catherine M Crespi, Anthony A Arce, Roshan Bastani, Annette E Maxwell, Catherine M Crespi, Anthony A Arce, Roshan Bastani

Abstract

While sustained academic and community partnerships can improve relationships between research partners, they could also influence study outcomes. Research on this issue is limited. We conducted a trial (2010-15) to test two implementation strategies for an evidence-based intervention to promote colorectal cancer (CRC) screening at community organizations in Los Angeles (N = 17). For both strategies, trained community health advisors (CHAs) recruited Filipino Americans (N = 673) who were non-adherent to CRC screening guidelines. The main study outcome was CRC screening status of participants at 6-month follow-up. This case study compares outcomes among organizations that had participated in our prior effectiveness trial and new organizations with which we had no prior relationship. Using multilevel logistic regression with multiple imputation for missing outcomes, we compared CRC screening rates among previous versus new partners controlling for study condition and organizational, CHA and participant characteristics. Screening rates were substantially higher among participants of previous versus new partner organizations in unadjusted analysis (77% versus 55%, OR 2.8, p = 0.12), after adjusting for organization-level variables (81% versus 42%, OR 7.5, 95% CI [2.0-28.7], p = 0.003) and after additionally adding CHA and participant level factors to the model (79% versus 47%, OR 5.9, CI [1.3-27.3], p = 0.02). Analyses using complete cases and assuming not-screened for missing outcomes indicated similar differences in screening rates (30 and 33 percentage points, respectively). Study outcomes that are achieved with long-term community partners may not be generalizable to new partners. However, inclusion of new community partners is important for external validity of dissemination efforts in community settings. NCT01351220 (ClinicalTrials.gov).

References

    1. Beydoun H.A., Beydoun M.A. Predictors of colorectal cancer screening behaviors among average-risk older adults in the United States. Cancer Causes Control. 2008;19:339–359.
    1. Christy S.M., Perkins S.M., Tong Y. Promoting colorectal cancer screening discussion: a randomized controlled trial. Am. J. Prev. Med. 2013;44:325–329.
    1. Damschroder L.J., Aron D.C., Keith R.E., Kirsh S.R., Alexander J.A., Lowery J.C. Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science. Implement. Sci. 2009;4:50.
    1. Hayes R.J., Moulton L.H. Chapman & Hall/CRC; Boca Raton, FL: 2009. Cluster Randomised Trials.
    1. Holt C.L., Tagai E.K., Scheirer M.A. Translating evidence-based interventions for implementation: experiences from project HEAL in African American churches. Implement. Sci. 2014;9:66.
    1. Israel B.A., Schulz A.J., Parker E.A., Becker A.B. Community-based participatory research: policy recommendations for promoting a partnership approach in health research. Educ. Health (Abingdon) 2001;14:182–197.
    1. Israel B.A., Krieger J., Vlahov D. Challenges and facilitating factors in sustaining community-based participatory research partnerships: lessons learned from the Detroit, New York City and Seattle Urban Research Centers. J. Urban Health. 2006;83:1022–1040.
    1. Israel B.A., Coombe C.M., Cheezum R.R. Community-based participatory research: a capacity-building approach for policy advocacy aimed at eliminating health disparities. Am. J. Public Health. 2010;100:2094–2102.
    1. Larkey L.K., McClain D., Roe D.J. Randomized controlled trial of storytelling compared to a personal risk tool intervention on colorectal cancer screening in low-income patients. Am. J. Health Promot. 2015;30:e59–70.
    1. Ma G.X., Shive S., Tan Y. Community-based colorectal cancer intervention in underserved Korean Americans. Cancer Epidemiol. 2009;33:381–386.
    1. Manne S., Steinberg M.B., Delnevo C., Ulpe R., Sorice K. Colorectal cancer screening among foreign-born South Asians in the Metropolitan New York/New Jersey Region. J. Community Health. 2015;40:1075–1083.
    1. Maxwell A.E., Bastani R., Danao L.L., Antonio C., Garcia G.M., Crespi C.M. Results of a community-based randomized trial to increase colorectal cancer screening among Filipino Americans. Am. J. Public Health. 2010;100:2228–2234.
    1. Maxwell A.E., Danao L.L., Cayetano R.T., Crespi C.M., Bastani R. Implementation of an evidence-based intervention to promote colorectal cancer screening in community organizations: a cluster randomized trial. Transl. Behav. Med. 2016;6:295–305.
    1. Plested B.A., Edwards R.W., Jumper-Thurman P. 2006. Community Readiness: A Handbook for Successful Change. Tri-Ethnic Center for Prevention Research.
    1. Raghunathan T.E., Lepkowski J.M., Van Hoewyk J., Solenberger P. A multivariate technique for multiply imputing missing values using a sequence of regression models. Surv. Methodol. 2001;27:85–95.
    1. Santos S.L., Tagai E.K., Wang M.Q., Scheirer M.A., Slade J.L., Holt C.L. Feasibility of a web-based training system for peer community health advisors in cancer early detection among African Americans. Am. J. Public Health. 2014;104:2282–2289.
    1. Savas L.S., Vernon S.W., Atkinson J.S., Fernandez M.E. Effect of acculturation and access to care on colorectal cancer screening in low-income Latinos. J. Immigr. Minor. Health/Cent. Minor. Publ. Health. 2015;17:696–703.
    1. Scarinci I.C., Moore A., Wynn-Wallace T., Cherrington A., Fouad M., Li Y. A community-based, culturally relevant intervention to promote healthy eating and physical activity among middle-aged African American women in rural Alabama: findings from a group randomized controlled trial. Prev. Med. 2014;69:13–20.
    1. Shelton R.C., Dunston S.K., Leoce N. Predictors of activity level and retention among African American lay health advisors (LHAs) from the National Witness Project: implications for the implementation and sustainability of community-based LHA programs from a longitudinal study. Implement. Sci. 2016;11:41.
    1. Wang J.H., Schwartz M.D., Brown R.L. Results of a randomized controlled trial testing the efficacy of a culturally-targeted and a generic video on mammography screening among Chinese-American immigrants. Cancer Epidemiol. Biomark. Prev. 2012

Source: PubMed

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