Learning Objectives for Community Engaged Research (CEnR) - Core Competencies 1-5

Core Competencies 1-5, October 25, 2010

Education, Scholarship and Engagement Workgroup of the CTSA CE KFC
Mary Anne McDonald and Linda Ziegahn

Working definitions of Foundational and Applied

The Foundational level learning objectives include the ideas and concepts of community engaged research (CEnR). Foundational objectives  include understanding theories, practices, principles and examples of CEnR at an introductory level. Foundational activities include listening, discussing, viewing and conceptualizing. This level corresponds to Bloom's knowledge and comprehension categories.

The Applied level includes practice of the principles introduced at the foundational level. Applied objectives include the ability to think critically about issues regarding each competency and use this understanding of CEnR practice within community settings. Applied activities include creating/designing, conceptualizing, implementing, analyzing, , leading, and disseminating.  The applied level encompasses Bloom's applied, analytical, synthesis and evaluative categories.

Competency #1:  Examine the characteristics that bind people together as a community, including social ties, common perspectives or interests and geography.

Foundational Level:

  1. Discuss the term “community” as it is used in CEnR: include elements beyond geography such as social ties and shared values and norms. 
  2. Describe different formal and informal centers, sources and dimensions of power in communities and organizations.  
  3. Discuss issues concerning who may represent “the community” in CEnR.

Applied Level:

  1. Develop and apply an asset inventory to illustrate community resources that contribute to social capital and capacity.
  2. Identify sub-groups within a given geographic community, e.g. a town, and describe the elements of each that could affect a project with a CEnR approach.
  3. Evaluate the elements of a community organization that contribute to its ability to form partnerships with researchers.

Competency #2:  Summarize the principles and practices of the spectrum of community-engaged research (using the CDC list of “Principles and Practices of Community Engagement” as a guide), and how they can contribute to the creation of community-academic partnerships.

Foundational Level

  1.  Discuss the principles and practices of the CEnR approach that support fairness, equity and social justice.   
  2. Explain the CEnR principles that support the identification of the strengths and resources of the community (e.g. economic conditions, political structures, organizational structures, social capital, or experience with engagement efforts).
  3. Describe  the range of collaborative processes that can be used to facilitate community-academic partnerships such as: shared decision making; respect for the resources of all partners; open communication, and equitable resolution of conflicts.

Applied Level

  1. Analyze the principles and practices of the CEnR approach that support effective recruitment, retention, and dissemination.
  2. Analyze the principles of fairness and equity and explain the roles they play in effective recruitment, retention, and dissemination in CEnR projects.
  3. Evaluate the different components of community-academic partnerships using the CDC list of “Principles and Practices of Community Engagement” as a guide.
  4. Use  the CEnR principles to evaluate both academic-community partnerships and collaborative research processes

Competency #3:  Analyze the role of community engagement as a strategy for identifying community health issues, translating health research to communities and reducing health disparities.

Foundational Level:

  1. Describe the differences between a CEnR approach and conventional health research approaches and discuss the potential benefits of a CEnR approach when working on community health issues and translating findings to communities.
  2. Describe how the process of using a CEnR approach can address health disparities and explain why this approach is important in disparities work

Applied Level:

  1.  Analyze the major elements of a relationship between a community and an academic institution that would influence the success of a CEnR approach in translating health research findings.  Include political and economic context, local history, type of problem, community partner capacity and previous partnerships.
  2. Develop a plan to translate and disseminate health research findings with communities in culturally relevant ways.
  3.  Design an example which demonstrates how a CEnR approach could  address health disparities through changes in the local health care delivery system, policy and/or environmental changes.

Competency #4:  Analyze the ethical complexities of conducting community-engaged research.

Foundational Level:

  1. Describe the ethical challenges commonly encountered in CEnR such as just distribution of resources and incorporation of community values.
  2. Discuss the risks and benefits of CEnR at the individual and community levels.
  3. Describe historical examples of biomedical and health research and the positive and negative effects on identified communities.

Applied Level:

  1. Evaluate the informed consent processes for CEnR projects at both the individual and community levels and identify how they can be made more responsive to the CEnR approach.
  2. Assess the ethical issues for community-academic partnerships involved in data ownership, financial responsibility, decision making, concepts of risks and benefits, and other concerns.

Competency 5:  Specify how cultural and linguistic competence and health literacy influence the conduct of community engaged research. (1)

Foundational Level

  1. Explain the relationships among health literacy (2) , cultural competency (3) and cultural humility (4).
  2. Discuss how CEnR principles of equity, collaboration, and mutual communication can inform health literacy.
  3. Discuss how researchers and others who are not members of the community under study may have health literacy gaps that need to be addressed. 

Applied Level

  1.  Compare and contrast the strengths & weaknesses of existing health literacy tools and their utility in CEnR projects”
  2. Examine health literacy as a continuous dynamic process and the community spaces where these processes take place and the effects of market and media.
  3. Analyze examples and mechanisms of how improved health literacy may be related to potential improved health outcomes.

References for Competency #5

  1. U.S. Department of Health and Human Services. Office of Minority Health web site.  Washington, DC; 2005.
  2. Zorn M, Allen MP, Horowitz AM. Understanding Health Literacy and its Barriers (CBM 2004-1). Washington DC: U.S. Department of Health and Human Services, 2004.
  3. Tervalon M. Components of culture in health for medical students' education. Academic Medicine 2003;78(6):570-6.
  4. Hunt LM. Beyond Cultural Competence: Applying humility to clinical settings. Park Ridge Center 2001;24:3-4.

[1] The common understanding of Health Literacy in 2010 focuses on methods to enable people to understand health information and follow medical orders or advice.  This is very important, yet health literacy from a CEnR perspective is broader.  We define health literacy through the lens of the principles of community engaged research: collaboration; equity among partners; mutual communication; respect; recognizing strengths and building capacity of all partners. Researchers are part of this process and need to acknowledge their own gaps in health literacy in terms of the community’s terminology, understanding and causal models of health, illness and prevention.

[2] “Health Literacy is the capacity to obtain, process and understand basic health information and services needed to make appropriate health decisions.” (1)

[3] “Cultural and linguistic competence in health are a set of congruent behaviors, attitudes, and policies that come together in a system, agency, or among professionals that enables effective work in cross-cultural situations.”  (2)

[4] Cultural Humility incorporates a lifelong commitment to self-evaluation and self-critique, to redressing the power imbalances in the patient-physician [or other relational] dynamic, and to developing mutually beneficial and non-paternalistic clinical and advocacy partnerships with communities on behalf of individuals and defined populations.(3, 4)

 

 

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