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Building Capacity for Productive Indigenous Community-University Partnerships.

ABSTRACT: This paper describes capacity development as a key aspect of community-based research with indigenous communities. University research engagement with indigenous communities includes extensive, and often negative, historical antecedents. We discuss strategies for developing effective, egalitarian, and balanced indigenous community-university relationships to build research capacity of these communities, and to create sustainable partnerships to improve health and wellness, and to reduce health disparities. We draw on the experience of eight investigators conducting research with indigenous communities to assess effective strategies for building and enhancing partnerships, including (1) supporting indigenous investigator development; (2) developing university policies and practices sensitive and responsive to Indigenous community settings and resources, and training for research; (3) developing community and scientifically acceptable research designs and practices; (4) aligning indigenous community and university review boards to enhance community as well as individual protection (e.g., new human subjects training for Indigenous research, joint research oversight, adaptation of shorter consent forms, appropriate incentives, etc.); (5) determining appropriate forms of dissemination (i.e., Indian Health Services provider presentation, community reports, digital stories, etc.); (6) best practices for sharing credit; and (7) reducing systematic discrimination in promotion and tenure of indigenous investigators and allies working in indigenous communities.

SUBMITTER: Gittelsohn J

PROVIDER: S-EPMC6447474 | biostudies-literature | 2020 Jan

REPOSITORIES: biostudies-literature

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Building Capacity for Productive Indigenous Community-University Partnerships.

Gittelsohn Joel J Belcourt Annie A Magarati Maya M Booth-LaForce Cathryn C Duran Bonnie B Mishra Shiraz I SI Belone Lorenda L Jernigan Valarie Blue Bird VBB

Prevention science : the official journal of the Society for Prevention Research 20200101 Suppl 1

This paper describes capacity development as a key aspect of community-based research with indigenous communities. University research engagement with indigenous communities includes extensive, and often negative, historical antecedents. We discuss strategies for developing effective, egalitarian, and balanced indigenous community-university relationships to build research capacity of these communities, and to create sustainable partnerships to improve health and wellness, and to reduce health d ...[more]

PMID: 30284683

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Project description:To achieve sustained reductions in child mortality in low- and middle-income countries, increased local capacity is necessary. One approach to capacity building is support offered via partnerships with institutions in high-income countries. However, lack of cooperation between institutions can create barriers to successful implementation of programs and may inadvertently weaken the health system they are striving to improve. A coordinated approach is necessary.Three U.S.-based institutions have separately supported various aspects of pediatric care at Kamuzu Central Hospital (KCH), the main government referral hospital in the central region of Malawi, for several years. Within each institution's experience, common themes were recognized, which required attention in order to sustain improvements in care. Each recognized that support of clinical care is a necessary cornerstone before initiating educational or training efforts. In particular, the support of emergency and acute care is paramount in order to decrease in-hospital mortality. Through the combined efforts of Malawian partners and the US-based institutions, the pediatric mortality rate has decreased from >10 to <4% since 2011, yet critical gaps remain. To achieve further improvements, representatives with expertise in pediatric emergency medicine (PEM) from each US-based institution hypothesized that coordinated efforts would be most effective, decrease duplication, improve communication, and ensure that investments in education and training are aligned with local priorities.Together with local stakeholders, the three US-based partners created a multi-institutional partnership, Pediatric Alliance for Child Health Improvement in Malawi at Kamuzu Central Hospital and Environs (PACHIMAKE). Representatives from each institution gathered in Malawi late 2016 and sought input and support from local partners at all levels to prioritize interventions, which could be collectively undertaken by this consortium. Long- and short-term goals were identified and approved by local partners and will be implemented through a phased approach.The development of a novel partnership between relevant stakeholders in Malawi and US-based partners with expertise in PEM should help to further decrease pediatric mortality through the coordinated provision of acute care expertise and training as well as investment in the development of educational, research, and clinical efforts in PEM at KCH.

Project description:BackgroundNeurological disorders are a common cause of morbidity and mortality in sub-Saharan African, but resources for their management are scarce. Collaborations between training institutions in developed and resource-limited countries can be a successful model for supporting specialty medical education and increasing clinical and research capacity.Case reportThis report describes a US National Institutes of Health (NIH) funded Medical Education Partnership Initiative (MEPI) to enhance expertise in neurology, developed between Makerere University College of Health Sciences in Kampala, Uganda, and Case Western Reserve University School of Medicine in Cleveland, OH, USA. This collaborative model is based on a successful medical education and research model that has been developed over the past two decades. The Ugandan and US teams have accumulated knowledge and 'lessons learned' that facilitate specialty expertise in neurological conditions, which are widespread and associated with substantial disability in resource-limited countries. Strengths of the model include a focus on community health care settings and a strong research component. Key elements include strong local leadership; use of remote technology, templates to standardize performance; shared exchanges; mechanisms to optimize sustainability and of dissemination activities that expand impact of the original initiative. Efficient collaborations are further enhanced by external and institutional support, and can be sequentially refined.ConclusionModels such as the Makerere University College of Health Sciences - Case Western Reserve University partnership may help other groups initiate collaborative education programmes and establish successful partnerships that may provide the opportunity to expand to other chronic diseases. A benefit of collaboration is that learning is two-directional, and interaction with other international medical education collaborators is likely to be of benefit to the larger global health community.

Project description:BackgroundThe issue of food security is complex and requires capacity for often-unrelated groups to work together. We sought to assess the relevance and meaning of a commonly used set of community capacity development constructs in the context of remote Indigenous Australia and through this propose a model to support capacity.MethodsThe assessment was conducted with four communities and took place over five steps that involved: (i) test of clarity of construct meaning; (ii) inductive derivation of community capacity constructs; (iii) application of these constructs to the capacity of community multi-sector food-interest groups; (iv) a cross-check of these constructs and their meanings to literature-derived constructs, and; (v) achieving consensus on tool constructs. Data were collected over a three-year period (2010-2012) that involved two on-site visits to one community, and two urban-based workshops. These data were augmented by food-interest group meeting minutes and reports.ResultsEleven community capacity development constructs were included in the proposed model: community ownership, building on strengths, strong leadership and voice, making decisions together, strong partnerships, opportunities for learning and skill development, way of working, getting together the things you need, good strong communication, sharing the true story, and continuing the process and passing on to the next generation. The constructs derived from the literature and commonly used to appraise community capacity development were well accepted and could be used to identify areas needing strengthening. The specifics of each construct however differed from those derived from the literature yet were similar across the four communities and had particular meaning for those involved. The involvement of elders and communication with the wider community seemed paramount to forming a solid foundation on which capacity could be further developed.ConclusionThis study explored an approach for ascribing context specific meanings to a set of capacity development constructs and an effective visual appraisal tool. An approach to tackling food security in the remote Indigenous context where community capacity goals are considered in parallel with outcome goals, or at least as incremental goals along the way, may well help to lay a more solid foundation for improved service practice and program sustainability.

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Building Capacity for Productive Indigenous Community-University Partnerships.

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Building Capacity for Productive Indigenous Community-University Partnerships.

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