标题：The Role for Community-Based Participatory Research in Formulating Policy Initiatives: Promoting Safety and Health for In-Home Care Workers and Their Consumers
摘要：Although community-based participatory research (CBPR) can be effective in influencing policy, the process of formulating policy initiatives through CBPR is understudied. We describe a case study to illustrate how alliances among various community partners could be united to formulate policy directions. In collaboration with partners, the National Institute for Occupational Safety and Health initiated a project aimed at improving health and safety for low-income elderly and disabled persons and their in-home care workers. Community partners and stakeholders participated in focus groups, stakeholder interviews, and meetings; they played multiple roles including identifying organizational policy changes the partners could initiate immediately, as well as broader public policy goals. Results indicated that a strong community partnership, participation, and shared values contributed to successful formulation of policy initiatives. COMMUNITY-BASED PARTICI- patory research (CBPR) has gained support as an effective approach to addressing environmental justice issues. 1 – 3 It emphasizes community involvement in applying scientific knowledge to reduce adverse health outcomes, sometimes through changes in health policy. To date, the process of developing and implementing policy change through CBPR is understudied. 4 An evaluation of policy initiatives in four environmental justice projects underscored the importance of strong community leadership, participation, organizational skills, and shared values among partners. 1 Themba and Minkler proposed a multistage process for implementing policy change through CBPR beginning with careful formulation of policy directions. When community partnerships identify and refine common policy objectives, advocating those strategies may be more successful. 3 We describe a case study of the policy formulation process in a unique intervention project targeting the intersection of the home and work environment for two economically marginalized populations—low-income elderly and disabled persons and the low-wage in-home care workers who help them live independently. The on-going study, Partnership for Safety: Making Homecare Safe for All, aims to identify health risks and develop intervention programs to improve health and safety through partnerships between in-home care workers and their clients (consumers) in Alameda County, California. This project demonstrates how alliances among various (and sometimes conflicting) partners within the community could be used to formulate policy directions to improve this challenging home or work environment.
