Last lesson, we considered prevention of serious disease in a population, through the use of screening or diagnostic tests. One example was the changing role of PSA tests in screening for prostate cancer. Although the utility of PSA screening may seem to be a recent concern, questions about prostate cancer screening with PSA tests were summarized in paper in the NEJM as early as 1993 (Kramer et al, 1993). As Green et al (2009) have conceptualized in the figure reproduced below, the transfer of knowledge from research to practice and policy can take considerable time, effort and resources. Policy decisions may require further funds to actually implement the practice. For PSA screening, the questions about its utility have been asked for almost 20 years!
From: Green et al. Diffusion Theory and Knowledge Dissemination, Utilization, and Integration in Public Health. Annu. Rev. Public Health 2009 30:151-74.
Who or what determines the priorities for research funding at the beginning of this pipeline? While the resulting research may be of high quality due to the peer-review process, should the needs of a population be considered at the beginning of the pipeline, when formulating the research questions? What is the responsibility of the researcher to address the needs of the community?
- differentiate community-based participatory research from other community research,
- apply principles of community-based participatory research in developing a proposal for a community-based intervention study, and
- use a reference guide to evaluate community-based health intervention proposals.