Culturally Responsive Wellness Promotion Project

 

Principal Investigator: Deborah Kaplan, J.D., World Institute on Disability
Researcher: Karyl Eckels
Time Frame: Years 4 - 5

Introduction

The success of efforts to increase healthy behavior is dependent upon whether the public health message and associated promotion activities are developed and implemented in ways that are consistent with the norms of the target group. In general, ethnically and culturally diverse people have been under represented in health promotion research, and culturally specific health beliefs and practices have not been well integrated within health promotion initiatives. This study will investigate the key issues and factors to consider in marketing and implementing health promotion practices for persons with disabilities within Asian, African American, Native American and Hispanic communities, and identify specific recommendations regarding the most important marketing and implementation strategies to use.

Research Questions

  1. How can Rehabilitation Research and Training Centers involve ethnically and culturally diverse persons with disabilities in research and training project planning and recruitment activities?

  2. What are key practices and policies that promote the involvement of ethnically and culturally diverse persons in research and training projects?

  3. What impact does the adoption of these policies and practices have on participant involvement and staff and participant perceptions of the RRTC’s cultural responsiveness?

Objectives

Major Objectives and Activities

  1. Design and pilot the research protocols.

    ~ Develop and pilot protocols for data collection and analysis

    ~ Develop protocols for participatory action consultation.

    ~ Identify specific objectives for improvement in project planning and recruitment of    ethnically and culturally diverse participants.

  2. Evaluate the impact of participatory action planning and consultation on the involvement of ethnically and culturally diverse RRTC participants and RRTC policies, procedures.

    ~ Collect data semi-annually on the involvement of participants in research and training    activities, barriers, information and supports needed by partners.

    ~ Document PAR planning and consultation activities.

    ~ Provide monthly consultation to Investigators.

    ~ Document procedures and policies adopted to achieve objectives.

    ~ Evaluate self-reported perceptions of partners and participants regarding cultural    responsiveness of RRTC and efficacy of policies and practices.

    ~ Conduct semi-annual RRTC team review of improvements made and Center-wide issues,     policies and practices to address.

    ~ Analyze the data and formulate final recommendations.

  3. Disseminate the findings.

    ~ Incorporate the findings into subsequent research and training projects of the RRTC as    well as Center-wide policies and procedures.

    ~ Prepare and disseminate to all RRTCs and NIDRR a Diversity Impact Report that    examines progress in each targeted area, key facilitator and barriers, and describes    recommendations for RRTC enhancement of the involvement of ethnically and culturally    diverse participants.

    ~ Publish at least 1 referred journal article on the findings and recommendations, and    their implications for research and training initiatives.

    ~ Present the findings and recommendations at 3 national conferences and professional    meetings.

    ~ Prepare at least 2 newsletter articles and 1 research brief aimed at disability, minority    and health organizations.

    ~ Communicate the recommendations through the RRTC web pages and dissemination    network.

Methods

Sample: The participants will be the staff and advisors of the RRTC Health and Wellness Consortium. Using a participatory action, case study methodology, RRTC staff from each partner organization will conduct an initial analysis of the participation of ethnically and culturally diverse individuals in their research and training projects, identify barriers and facilitators that influence participation, and select objectives for enhancing participation in planning and recruitment. A member of the RRTC team will provide monthly technical assistance to research and training staff of specific projects with expertise in involving ethnically and culturally diverse persons in research and training activities. Technical assistance will focus on assisting staff to develop an individualized plan for addressing each objective, to identify short-term goals, to develop and implement strategies to address each goal and to problem-solve solutions to barriers that arise. The Consultant may also connect RRTC staff to other national diversity experts who can provide input related to their questions and activities. Twice each year, the RRTC partners will have a comprehensive discussion of improvements made and issues that must be addressed for each priority area. They will also identify policy and practice recommendations that support the achievement of priorities, at the project level and center-wide.

Data Collection and Analysis Methods: A questionnaire will be developed that assesses the level of participation of ethnically and culturally diverse participants in project planning and recruitment, participation barriers and facilitators, project activities and level of achievement related to each improvement objective identified by the partners, and recommendations for policies and practices. Staff will also complete questions related to perceptions of the cultural responsiveness of their projects and the Center as a whole; their satisfaction with, and benefit from, the consultation they are receiving; and recommendations for improvement. A staff leader from each project will complete the questionnaire twice each year for 2.5 years. The RRTC Consultant will maintain a detailed log of consultation sessions conducted, issues discussed, implementation strategies identified and selected, and impacts reported. Consortium Partner discussions will be audio taped and detailed notes will be taken. Descriptive statistics will be used to analyze and track participation rates, achievement of objectives, satisfaction and utility of consultation, and perceptions of cultural responsiveness. Qualitative methodology will be utilized to compile, categorize and analyze themes and recommendations.

Results

Review of the Current Literature: By the year 2050, The Census Bureau estimates that persons from ethnically and culturally diverse backgrounds will represent the majority of young people in the U.S. population (Sue, Bingham, Porche´-Burke, Vasquez, 1999). Federal agencies, researchers, educators and minority leaders have increasingly emphasized the critical importance of including ethnically and culturally participants in research and training efforts aimed at improving the lives of people with disabilities. NIDRR has been in the forefront of inclusion efforts, developing policies related to conducing participatory action research, training and dissemination, and integrating culture and inclusion within it’s long range plan (NIDRR, 1999).

There is general recognition that the capacities of research and training projects to meaningfully include ethnically and culturally diverse participants must be enhanced. Potential areas of focus include staffing and use of advisors and consultants, participant recruitment, relationships with culturally diverse leaders and organizations, and conducting research and training projects with ethnically and culturally accessible formats, procedures and environments. Practices and policies are required that promote sensitivity, responsiveness and inclusion which extends beyond increasing the percentages of ethnically and culturally diverse participants in projects to supporting a full spectrum of involvement and partnership in research and training activities. Organizational-level cultural or philosophical shifts are required as well as structural changes in discrete procedures and policies.

Numerous recommendations have been developed and strategies identified to enhance the participation of ethnically and culturally diverse people in research and training efforts, however less attention has been focused on systematically examining the design and impact of center-wide and project-specific approaches that research and training centers can use to enhance participation.

The purpose of this study is to evaluate the impact of a participatory action consultation approach on facilitating the participation of ethnically and culturally diverse individuals in research and training project planning and participant recruitment activities. The evaluation will document the PAR consultation approach, planning and recruitment strategies used, the level of involvement of ethnically and culturally diverse participants in planning and recruitment activities, and staff and participant perception of RRTC’s cultural responsiveness.

Conclusions

This study will provide critical information regarding the efficacy of a participatory action consultation approach in enhancing the involvement of ethnically and culturally diverse participants in research and training projects. It will identify key practices and policies that are associated with the promotion of participant involvement, and recommendations for RRTC structure and implementation that enhance involvement. Such knowledge will be essential for RRTCs as well as minority organizations and individuals that are partnering with RRTCs to carryout research and training projects. It will also provide the foundation for future research focused on field-testing the participatory action consultation approach and related practices and policies.