Presentation on evaluating the community and research partnership in a lay health worker intervention

1. Healthy Research Partnerships Promote Healthy
Communities: Evaluating the Process of Community
Participation in Lay Health Worker
Intervention Research
American Public Health Association 139TH Annual Meeting and Exposition
Washington, DC
October 31, 2011
Mary C. B. Nacionales, MPH, MBA 1
Ngoc Bui-Tong, MHSA 4
Alene L. Pham 1
Khanh Q. Le, MD, MPH 1
Gem M. Le, PhD 1, 3
Tung T. Nguyen, MD 3
Susan L. Stewart, PhD 3
Mai T. Tran, MPA 1
Bang H. Nguyen, DrPH 1, 2
1 Cancer Prevention Institute of California, Fremont, California
2 Stanford University, Stanford, California
3 University of California, San Francisco, California
4 Valley Health and Hospital Systems, San Jose, California
National Cancer Institute RO1CA132660

2. PRESENTER DISCLOSURE
Mary C. B. Nacionales, MPH, MBA
(1) The following personal financial relationships with
commercial interests relevant to this presentation existed
during the past 12 months:
No relationships to disclose

3. LEARNING OBJECTIVES
By the end of the session, participants will be able to:
1. Understand the methods of evaluating the process of
community participation in a lay health worker
intervention research project.
2. Describe initial lessons learned from evaluating the
process of community participation in a lay health worker
intervention research project

4. OUTLINE
• Background
• Methods
• Preliminary Results
• Discussion
• Acknowledgement

5. BACKGROUND: Purpose of the Live
Healthy and Live Long Project
Reduce disparities in colorectal cancer among
Vietnamese Americans through:
• Lay Health Worker (LHW) intervention research
project designed to improve colorectal cancer
screening, nutrition, and physical activities
• Evaluation of the community participation process

6. BACKGROUND: Community Participation
Project Partners
• Vietnamese Reach for Health Coalition (VRHC)
• Community Advisory Board (CAB) of UCSF Vietnamese
Community Health Promotion Project SÙc KhÕe Là Vàng
Agencies Providing LHW Services
• Asian Americans for Community Involvement
• Catholic Charities John XXIII Multi-Service Center
• Immigrant Resettlement & Cultural Center
• Vietnamese Voluntary Foundation

7. BACKGROUND: Research Questions of
Community Participation Interviews
• What are the qualities of partnership between
researcher and community?
• How does the Community Based Participatory
Research (CBPR) process creates equitable research-
community partnerships and community benefits?

8. METHODS: Eligibility and Setting
1. Eligibility
• LHW providers
• Community leaders: VRHC & CAB
• Researchers
2. Setting
• San Francisco Bay Area: Contra Costa, San
Francisco, and Santa Clara counties

9. METHODS: Qualitative Interview Using
Topic Guide
I. Context & History of Participation in LHW Project
• Role and motivation for working in the Vietnamese
American community
• Decision process for participation
II. Expected Benefits of Partnership

10. METHODS: Qualitative Interview Using
Topic Guide
III. Partnership Dynamics
• Extent of involvement in the LHW project
 Research design
 Implementation
 Dissemination of results
• Opportunity to provide feedback
• Perception of how suggestions were received

11. METHODS: Qualitative Interview Using
Topic Guide
IV. Assessment of Partnership Effectiveness & Benefits
• Satisfaction with LHW project participation
• Observed organizational changes
• Participation in LHW project influences agency’s
relationship with community
V. Impact for Potential Partnerships in the Community
• Vietnamese American community perception of health
research and researchers
• LHW model influence community perception

12. METHODS: Interview
1. Conduct interview at participant’s choice of location
2. Procedure for interviews
• Introduction and Overview
• Informed Consent Administration
• Open-Ended Questions Using Topic Guides
• Self-Administered Demographic Questionnaire
• Closing and Thank You
3. Interviews were digitally recorded

13. METHODS: Timeframe and Activities
TIMEFRAME ACTIVITIES
March 2010 – May 2011 • Conduct Qualitative Interviews
July – October 2011 • Review Demographic Data
• Transcribe and QA Interviews
September 2011 • Initiate Coding
October – December 2011 • Complete Coding
• Identify Key Themes
October 2012 • Report Findings at Community
Health Forum

14. METHODS: Data Analysis
Theoretical Framework: Grounded Theory (Glaser &
Strauss, 1967)
• Consist of “systematic, yet flexible guidelines for
collecting and analyzing qualitative data”
• Construct theories “grounded in the data”
• Data form the “foundation of theory and analysis of
the data generates constructed concepts”
*Glaser, BG & Strauss, AL. (1967). The discovery of grounded theory: Strategies for qualitative research.
New Brunswick, NJ: Aldine Transaction.

15. METHODS: Data Analysis
1. Transcription
• Verbatim
• Quality review
2. Coding (Initial and Focused): separate, sort, and synthesize
3. Memo-Writing: what is happening when data is coded
4. Theory Development
*Charmaz, K. (2006). Constructing grounded theory: A practical guide through qualitative analysis. Great
Britain: Sage Publications.

16. PRELIMINARY RESULTS: Demographic
Profile - Stakeholders
N = 13
Researchers
15%, n=2
LHW Service
Providers
54%, n=7
Community
Leaders
31%, n=4

17. PRELIMINARY RESULTS: Demographic
Profile - Language Speaking Proficiency
N=13
9
8
7
6
5
4
3
2
1
0
Fluent Well Fair Not Very Good Not At All
Vietnamese English

18. PRELIMINARY RESULTS: Impressions
• Different perspective of LHW project as stakeholder or
job role
 Understanding of LHW project goal
 Prioritizing objectives
 Accessing information about LHW project
• Power dynamics between LHW providers and
researchers
• Prevalence of humility among Vietnamese American
respondents

19. DISCUSSION: Themes To Explore
THEMES TO EXPLORE
• Knowledge: What are the stakeholders’ understanding of
the LHW project goals, including the partnership roles?
• Power: What are the levels of control and influence
within the LHW project and partnerships by the
stakeholders?
• Decision: To what extent do stakeholders have the
ability to impact decision processes made related to the
LHW project?
• Ownership: What are the stakeholders’ perception of
their accountability to the LHW project?

20. ACKNOWLEDGEMENT
• Similoluwa Sowunmi for entering demographic data and
transcribing interviews
• Loan Dao, PhD for developing interview guides and
consent form; conducting interviews
• The Interview Participants for sharing their wisdom and
generously volunteering their time

21. THANK YOU
What happens to you does not matter; what you
become through those experiences is all that is
significant. This is the true meaning of life.
~Zen Meditation
For more information contact:
Mary C. B. Nacionales, MPH, MBA
Community Research Associate
(510) 608-5102; mary.nacionales@CPIC.org
Cancer Prevention Institute of California
2201 Walnut Avenue, Suite 300
Fremont, CA 94538
www.cpic.org