Principles of practice for academic/

practice/community research partnerships

Elizabeth A. Baker PhD, MPHa, , Sharon Homan PhDa, Sr. Rita Schonhoffb and Matthew
Kreuter PhD, MPHa

a
Saint Louis University, Department of Community Health, St. Louis, MO, USA

b
Whole Health Outreach, Ellington, MO, USA

Available online 24 March 1999.

Abstract

Context: Researchers and practitioners are increasingly realizing that improvements in public
health require changes in individual, social, and economic factors. Concurrent with this renewed
awareness there has been a growing interest in working with communities to create healthful
changes through academic/practice/community research partnerships. However, this type of
research presents different challenges and requires different skills than traditional research
projects. The development of a set of principles of practice for these types of research projects
can assist researchers in developing, implementing, and evaluating their partnerships and their
project activities.

Objective: This paper describes the different ways in which academics and community groups
may work together, including academic/practice/community partnerships. Several principles of
practice for engaging in these research partnerships are presented followed by a description of
how these principles have been put into operation in a family violence prevention program.

Conclusions: The principles presented are: (1) identify the best processes/model to be used based
on the nature of the issue and the intended outcome; (2) acknowledge the difference between
community input and active community involvement; (3) develop relationships based on mutual
trust and respect; (4) acknowledge and honor different partner’s “agendas”; (5) consider multi-
disciplinary approaches; (6) use evaluation strategies that are consistent with the overall
approach taken in the academic/practice/community partnership; and (7) be aware of partnership
maturation and associated transition periods. The limitations of these principles and their
application in various settings are discussed.

Author Keywords: Medical Subject Headings: research(collaborative); community

participation; program evaluation

Article Outline

• Introduction
• Child abuse prevention
• Whole Health Outreach
• Principles of practice
• Identify the best processes/ model to be used based on the nature of the issue and the intended
outcome
• Description of principle
• Example: Whole Health Outreach/Resource Mothers Program
• Acknowledge the difference between community input and active community involvement
• Description of principle
• Example: Whole Health Outreach/Resource Mothers Program
• Develop relationships based on mutual trust and respect
• Description of principle
• Example: Whole Health Outreach/Resource Mothers Program
• Acknowledge and honor different partner’s “agendas”
• Description of principle
• Example: Whole Health Outreach/Resource Mothers Program
• Consider multidisciplinary approaches
• Description of principle
• Example: Whole Health Outreach/Resource Mothers Program
• Use evaluation strategies that are consistent with the overall approach taken in the
academic/practice/community partnership
• Description of principle
• Example: Whole Health Outreach/Resource Mothers Program
• Be aware of partnership maturation and associated transition periods
• Description of principle
• Example: Whole Health Outreach/Resource Mothers Program
• Summary and conclusions
• Acknowledgements
• References
Introduction

A n increasing number of researchers and practitioners are realizing that to truly affect health
they must address individual, social, and economic factors. Along with this realization there has
been a growing interest in working with communities to create healthful changes through
academic/practice/community research partnerships. As stated in the recent Institute of Medicine
report,[1] to work with communities it is important to understand research as an evolving
process. The report suggests that three types of research characterize this process: “(1) current
proactive practice of academically driven research initiatives, (2) a more reactive practice for
designing research in response to the needs and input of community agencies, and (3) the
development of interactive research practices that involve both academic researchers and the
community as equal partners in all phases of a research project.” [1] The first type of research,
which will hereafter be called Type 1 research, typically involves the academician as the sole
inquirer. The academician determines the questions to be asked and defines the range of
acceptable answers. In the second type of research, hereafter called Type 2 research, non-
academicians assist in defining the question, but academicians still define the methods of inquiry
and the range of answers. Using the third type of research, hereafter called Type 3 or
community-based research, the community and academicians jointly define the questions to ask,
determine how to gather the answers, and decide what to do with the information that is gathered
(i.e., dissemination of information or action).

These different types of research are not simply a continuum, but rather are based on different
underlying assumptions or paradigms.[2] Therefore, using the first type of research process even
when seeking input from the members of the target community is not the same as engaging in the
latter types of research. Rather, to engage in community-based research (or Type 3 research) it is
necessary to create and maintain true partnerships among academicians, practitioners, and
community members.

While public health practitioners and community organizers have long realized the importance of
working with communities,[2] the development of research projects with community partners
utilizing Type 3 research methods is comparatively new. Type 3 research presents different
challenges and requires different skills than either Type 1 or Type 2 research. The development
of a set of principles of practice for engaging in Type 3 research projects can assist researchers in
developing, implementing, and evaluating their partnerships and their project activities.

This paper will examine one such academic/practice/community partnership, a family violence-
prevention project presently being conducted in rural Missouri. The paper will focus on the child
abuse– prevention component of this project, the Resource Mothers Program. The paper will
present an overview of the project and the principles of practice that guide the Resource Mothers
program activities. Specific examples of how these principles have been put into operation will
also be discussed.

Child abuse prevention

While it is difficult to get exact figures, available data suggest approximately one million
children were victims of abuse and neglect in 1994.[3] In Missouri alone, 17,105 children were
found to be victims of abuse and neglect during 1997. [4] National data indicate that parents are
the most frequent perpetrators of child abuse. [3] However, no single factor can be said to
account for child maltreatment and abuse. [5] As a result, the most effective prevention programs
are those that use an ecologic framework, e.g., attempting to create changes in some combination
of individual, family, community, societal, and cultural factors. [5]

Family support programs, particularly home visiting programs, attempt to prevent child
maltreatment and abuse by changing both individual and social factors. Studies have found that
these programs are most effective when they “empower families to develop skills and knowledge
necessary to recognize their strengths and weaknesses, and to seek and effectively utilize
services.”[5] One recent study found that home visits during and for one year after pregnancy
resulted in a significant decrease in reports of child abuse and neglect. [6]

Whole Health Outreach

Whole Health Outreach (WHO) was formed in 1989 in rural Missouri as a collaborative effort
between local churches and the local health department. The project began when a group of local
residents became aware that they and their neighbors did not have access to a number of different
health and social services. The community decided to focus on what they had identified as one of
the most significant community concerns, family violence. WHO sought to decrease family
violence in rural Missouri through community outreach and support. WHO members include
individuals from local churches and religious organizations, a lawyer who has worked with
survivors of domestic violence, social service workers, an accountant, teachers, law enforcement
officials, and interested community members. The organization uses an ecologic framework,
addressing individual, social, community, organizational, and policy factors that influence family
violence. The efforts to create changes in local organizations and community-level factors
include working with social service agencies, law enforcement agencies, local health
departments, hospitals, child care centers, churches, and schools. The efforts to create changes in
individual and social factors include a residential shelter for individuals and families who need to
remove themselves from abusive situations, support groups and educational classes, and a
Resource Mothers program that provides pre- and post-natal home visits.

The collaboration between WHO and Saint Louis University School of Public Health began in
1993. The remainder of this paper will describe the principles of practice on which this
collaboration was based, and the challenges of putting these principles into operation in one
component of WHO programming, the Resource Mothers Program.

Principles of practice

Identify the best processes/ model to be used based on the nature of the issue and the
intended outcome

Description of principle

More often than not academicians and practitioners choose their method of conducting research
based on their familiarity with, and comfort with, various methodologies.[7] Most academic
degree programs focus on, and provide skills for, engaging in Type 1 rather than Type 3
research. In fact, many training programs may inadvertently convey a lack of respect for one
type of research or another. Therefore, one of the first challenges we face in conducting
academic/practice/community research or intervention projects is to determine the appropriate
model to be used based on the nature of the health concern and the intended outcome. For
example, one health concern may be the high rate of diabetes within a given population or
community. One outcome of interest may be to educate individuals who have just been
diagnosed with diabetes in the proper use of insulin. Alternately, one may wish to change dietary
habits and norms in a community so that there is a decreased risk of Type II diabetes. The first is
focused primarily on creating individual behavior change (with some potential need for changes
in social and community factors). Alternately, individual, social, community, economic, and
cultural factors influence eating habits. The optimal intervention for the first may be an
individualized approach, not a collaborative approach. While it may be beneficial to obtain input
from those with diabetes to effectively plan and implement the program, this input could be
incorporated into an effective proactive, academically driven approach. In contrast, changing
dietary habits involves addressing numerous factors that may more effectively be influenced by a
partnership approach (i.e., community-based research).

Example: Whole Health Outreach/Resource Mothers Program

As described earlier, Whole Health Outreach identified a need and desire to decrease family
violence in rural Missouri. The literature in the field and the experience of the individuals and
organizations initially involved indicated that the etiology of family violence is multi-factorial
(including individual, social, and community factors). Members of WHO realized that
individuals with various expertise, from local and statewide organizations, needed to be included
in all aspects of the program to address these multiple factors. These individuals from different
organizations assisted in the planning and implementation of various interventions. Some of
these interventions were started simultaneously at the outset of the project (e.g., the shelter and
counseling programs) while others were added later (e.g., educational programs in the schools).

Acknowledge the difference between community input and active community involvement

Description of principle

One of the assumptions of research involving partnerships is that community involvement is

beneficial. This benefit is derived from a process of gathering local beliefs and experiences and
using these to develop, implement and evaluate programs.[2] Community members provide more
accurate information, knowledge, and understanding of their own communities than outside
academicians have. This can lead to more precise development of theory, or local theory. [2, 8, 9
and 10] Local theory (theory grounded in the beliefs and experiences of community members) is
likely to lead to programs that are more effective than programs that are based on acontextual
theory. [2 and 8] This process of community involvement enhances the likelihood that research
and intervention activities will be socially and contextually appropriate and specific. [11]

Simply recognizing that community involvement is “good” does not, however, inform practice in
a meaningful way. The amount and nature of this involvement can vary significantly.[11] For
instance, a researcher may ask for community input to ensure that community members
understand the questions they are being asked. Or, an academician may ask community members
to determine whether media messages and the format of educational materials is appropriate for
the community. This type of involvement is more of a request for input than real community
involvement. As such, it is less likely to impact program effectiveness than more complete
involvement in research activities because it does not take advantage of the process described
above. Input can enhance an academically driven program (Type 1 research), but it is not the
same as making full use of the partnership in creating a community-based research project (Type
3).

Example: Whole Health Outreach/Resource Mothers Program

Whole Health Outreach programs were initiated by the community and the community continues
to be actively involved in the on-going development of program activities. The approach taken is
one in which all partners share in the various research and intervention activities including:
generating ideas for new projects, assisting in the development of these projects and grant
writing activities, assisting in reviewing assessment and programmatic materials, implementing
program activities, evaluating programs, and disseminating results through both written
publications and oral presentations.

This active involvement of all partners in the research and intervention activities requires
significant changes in the way each partner typically conducts his/her work. For example,
academic partners need to relinquish some of the control usually associated with research
projects.[12] Community and practice partners need to be willing to share ideas and resources
with each other and academicians. Lastly, all partners need to allot more time to finish tasks, and
be willing to spend time assisting other partners in tasks that may not be of primary importance
to them. For example, community members may need to take time to share in the tasks
associated with writing papers, and academicians may need to take time to share in the tasks
associated with organizational planning.

Develop relationships based on mutual trust and respect

Description of principle

The capacity to engage in this type of community-based research partnership is based, to a large
extent, on each individual’s capacity to develop relationships based on mutual trust and respect.
[2] Building this type of relationship requires a significant time commitment at the beginning of
the project (often before grant money is available) as well as during the grant period. Researchers
and community members must make this time commitment even when this time is not fully
compensated. Regular communication and information sharing is also critical to relationship
building and maintenance. If individuals within the academic, community, or practice arena feel
that decisions are being made without their consultation, or if they do not know about the
decisions at all, then the relationship, and the overall success of the research project, is
threatened.

Lastly, to build trusting and respectful relationships it is necessary to acknowledge that previous
projects may have been conducted in a way that was disrespectful of one of the partners.[2, 13
and 14] This history should not eliminate the possibility of future research and programs. Rather,
each partner is responsible for discussing both positive and negative experiences with previous
projects. More importantly, the partners need to work together to develop specific strategies to
avoid repeating previous mistakes, and regularly assess and address these issues. [2]

Example: Whole Health Outreach/Resource Mothers Program

The relationships among the Whole Health Outreach academic, community, and practice
partners are based on mutual trust and respect. This is in part because the initial grant created a
true friendship between two individuals. This created patterns of communication that were able
to enhance the research project in spite of the long distances between the two sites
(approximately 150 miles). This friendship created an opening for relationships among the other
members within the academic and practice organizations.

Partners communicate frequently about project-related activities through the use of phones,
faxes, and regular site visits. In addition, these relationships are enhanced through: quarterly
partnership retreats that include social time as well as program planning and continuing
education; joint participation and inclusion in board meetings and workshops; and feedback
opportunities for the evaluation of program components, tools and program adjustments.

One of the challenges that the partnership now faces is that new project staff have been added to
all of the participating agencies. These new project staff need to create their own relationships
and communication patterns across organizations. Moreover, individuals withineach organization
need to establish their own relationships. These new relationships within and between
organizations have been difficult because the new members did not experience the initial stages
of the partnership. In addition, these new individuals were added because they offer something
new to the partnership. By definition they bring new perspectives and approaches to the project
that may or may not be consistent with those already created and agreed on by previous
partnership members. The partners all agree that the best way to use these resources is to see
each individual as bringing certain gifts. The challenge is to add these gifts to the existing “mix”
in a way that honors and integrates the gifts, but does not violate the basic assumptions of the
program.

Acknowledge and honor different partner’s “agendas”

Description of principle

While each partner may be very willing to engage in an academic/practice/community

partnership, they may have very different “agendas” or reasons for their involvement. For
example, community members and practitioners may want to see increased access to training and
resources (including money and outside expertise). In addition, community members and
practitioners will likely want to see increased intervention activities. Academicians, on the other
hand, want to see that their contributions enhance their teaching, lead to grant opportunities and
publications, and improve community health. It is important to acknowledge and see some value
in each partner’s perspectives and priorities. It is also important for each partner to feel
comfortable articulating these needs. Once articulated, everyone involved should make an effort
to meet the differing needs of the various partners.

Example: Whole Health Outreach/Resource Mothers Program

The Whole Health Outreach/Resource Mothers Program reflects the importance acknowledging
the different priorities and agendas of each of the partners. The initial grant provided for
programs that were jointly developed by several community members and one faculty member.
As the project developed, the community group needed additional resources (financial
contributions and alternative skills and expertise) and the initial faculty member needed to focus
on other areas of her research agenda. New faculty and resources were sought in a way that
ensured that the academic and community partners would benefit from the expanded research
project. To maximize this benefit the new faculty members and the community jointly defined
the parameters of the expanded research project. These expanded parameters include a renewed
commitment to the intervention program in a way that has the potential to add new knowledge to
the field, and hence enhance both intervention activities and the potential for future publication.

Consider multidisciplinary approaches

Description of principle

If the issue or problem to be addressed is influenced by a number of different factors (e.g.,

individual, social, and community), then it is important that partnerships draw on expertise from
each of these different areas.[15] Because of the nature of most academic programs, this requires
bringing together individuals from multiple disciplines and perspectives, and often requires
multi-agency collaboration. [12 and 16] Working in these multidisciplinary teams can create
tension in part because one discipline’s ideal practices and approaches may be not be valued by
other disciplines. In addition, each discipline has its own set of assumptions regarding the nature
of complex public health problems. To truly address problems that have multifactorial etiology,
academicians, practitioners, and community members are challenged to broaden their
perspectives, and see skills other than their own as complementary rather than competitive.

Example: Whole Health Outreach/Resource Mothers Program

The Whole Health Outreach/Resource Mothers Program has included individuals with training in
statistics, education, health education, community organizing, social work, nursing, dentistry,
law, accounting, and spirituality. The interdisciplinary and multi-organizational partnership has
highlighted similarities and differences in the way we approach specific issues. The partnership
has also created an innovative, multi-faceted approach to addressing family violence.

For example, some partners focus on the problem of domestic violence and seek solutions to
specific problems (e.g., by providing health education information, medical care, or legal
services). For these partners, the central activity or purpose is to provide specific information and
services. Alternately, other partners engage in the project to enhance the community’s capacity
to address its own needs. These partners focus on engaging individuals and the community as a
whole in problem solving activities.

Partners have not only different perceptions of the priority and intent of program activities, but
also different discipline-based ethics and expectations. For example, a nurse is bound by certain
licensing agreements that mandate reporting of drug use as it relates to suspected child abuse,
while a religious sister or clergy member may be obligated to maintain confidentiality.

Perhaps most critical for the success of the project is the recognition that each agency and
individual brings complementary, welcomed skills and perspectives to the project. Utilization of
these multiple skills and perspectives has led to changes in the legal system, programs in the
schools, and family and individual support services. One of the most exciting aspects of the
current project is the opportunity to assess the efficacy and appropriateness of using health
education tools designed to create changes in individual behavior (tailored messages and a self-
management manual) within a lay health advisor approach. In other words, the project formally
bridges the gap that often exists between individual-directed interventions and community-based
or -directed efforts.

Pregnant women who enroll in the Resource Mother Program receive prenatal home visits from a
lay health advisor (resource mother). The visits can continue for up to one year after the birth.
The women visited learn about child development, diet, exercise, anger management, and
maternal role attainment. The new adaptation of the program will compare the outcomes of
women who received one of three different levels of the intervention: (1) Resource Mothers
visits alone; (2) visits combined with computer-generated print materials tailored for each
pregnant woman based on an assessment of her unique needs and interests; or (3) visits,
computer-tailored materials, plus education in self-management techniques. Each of these
additions brings in the expertise of different project partners.

Use evaluation strategies that are consistent with the overall approach taken in the
academic/practice/community partnership

Description of principle

A number of excellent articles and books review the key components of program evaluation in
general, and specifically with regard to community-based programs (such as
academic/practice/community partnerships).[17 and 18] These books and articles suggest that
one of the most important considerations is keeping evaluation consistent with the other aspects
of the partnership. In particular, all of the partners should be included not only in program design
and implementation, but also in evaluation activities. Community, practice and academic
partners may be involved in designing the evaluation approach and tools, analyzing the results,
and disseminating the information to the appropriate audiences. [17] It is also important to
choose methods and tools appropriate for the questions asked rather than merely using the
particular expertise available. [7 and 17] In addition, it is important to conduct process, impact,
and outcome evaluation and to include both qualitative and quantitative measures. [17 and 18] In
this vein, it is important to assess not only the research questions and intervention activities but
also the qualities of the partnership. [17]

Example: Whole Health Outreach/Resource Mothers Program

The two broad goals of this project were to implement the specific intervention activities and to
establish and maintain the partnership. The evaluation activities therefore addressed the
partnership itself, the changes occurring in the academic arena, and the intervention activities
within the community.
The evaluation of the partnership itself involved documentation of specific activities and
interactions. These data were reviewed with attention paid to unmet or changing needs and how
current partners could address these needs by the addition of new partnership organizations, or
additional individuals within the existing organizations. This resulted in the training of additional
Resource Mothers, efforts to gain additional funding for particular programs or training, and the
addition of more faculty to the research project. The review of these data also highlighted where
linkages in the partnership were operating most and least effectively. For example, the
relationship between the Department of Health and the Resource Mothers in some communities
was excellent and in others the relationship was not as smooth. These relationships are
particularly critical to allow the Resource Mothers to recruit women into the programs.

The evaluation of the activities and changes in the academic arena included documenting the
number and quality of presentations in classrooms, the number of interns in placements, and the
quality of the internships. The methods of documentation included written and verbal feedback.
Academic and community advisors also met to assess the quality of the placement and
suggestions for future internships.

The evaluation of the Resource Mothers program provides a good example of the types of
evaluation that can be conducted to evaluate community interventions. The initial program
activities were evaluated by systematically collecting residential, demographic, and
programmatic (e.g., number of visits and information covered in each visit) data for all women
enrolled in the Resource Mothers program. At the end of each year, these records were matched
to state birth and death certificate data obtained from the State Department of Health. The
preliminary analysis of these data indicated that women enrolled in the Resource Mothers
program had a fourfold reduction in low birthweight babies (<.05) controlling for known risk
factors, than women in the same region who did not take part in the Resource Mothers Program.
[19]

The evaluation of the Resource Mothers program also included qualitative interviews with
Resource Mothers and program participants. These interviews were conducted to assess the types
of support provided by the Resource Mothers and how this support affected the larger social
networks of the pregnant women. Initial analysis of this data indicated that Resource Mothers
provided emotional, instrumental, informational, and appraisal support during the pregnancy and
after delivery of the child. The data also indicated that the provision of the multiple forms of
support was particularly important for first-time and younger mothers whose views differed from
those of their extended family in terms of how they wanted to deliver and raise their children.
The provision of social support by the Resource Mother was not intended to replace or
negatively affect other social ties. The interview data suggested that in general the social support
provided was not perceived as threatening by the participant, her partner, or her extended family.
In fact, most of the participants interviewed indicated that the Resource Mother’s support
enhanced rather than took away from their primary relationships.[20]

The current intervention activities will require additional data collection. Women enrolled in the
Resource Mothers program in each county will be asked to complete pre- and post-intervention
assessments, including an instrument designed to provide tailored messages to the women. These
instruments will be pretested with pregnant women in these communities. Once the instruments
have been modified as needed they will be administered to women enrolled in the Resource
Mothers Program. These data will be analyzed to determine the extent to which participants
changed knowledge, attitudes, beliefs, and behaviors. The assessment will also include measures
of social support, self-esteem, and control (e.g., mastery and self-efficacy). The primary analysis
will compare three levels of intervention: (1) the current Resource Mothers program (information
and home visits); (2) the Resource Mothers program plus computer-tailored preventive health
information given to each woman; and (3) the Resource Mothers program plus computer-
tailored preventive health information, and self-management and problem-solving skills. A
subsample of women in each of the counties will also be interviewed to evaluate program
activities (the benefits of participating and any suggestions they have for a change in future
programs).

Be aware of partnership maturation and associated transition periods

Description of principle

Academic/practice/community research partnerships change and mature over time. These

partnerships can be considered a type of coalition, and thus previous work in the field describing
the various stages of coalition development can be helpful in understanding the partnership
maturation process.a

Coalitions are said to go from initial formation, to planning, implementation, maintenance, and
institutionalization.[21 and 22] Each of these different stages may require attention to different
tasks and different aspects of the relationships within the partnership. For example, the formation
period may require an identification of decision-making processes while the implementation
phase may require more attention to the specific roles and responsibilities of each partner. [22]

After a partnership has been established and programs are initiated, the organizations in the
partnership may experience changes in staffing or organizational priorities. This may require
adjustments in partnership commitments and responsibilities.

Example: Whole Health Outreach/Resource Mothers Program

The academic/practice/community partnership has matured over time. The partnership went
through initial phases of formation. As a first step in the formation of Whole Health Outreach,
individuals within the community came together and stated a joint commitment to developing
family violence-prevention programs. These individuals then joined with formal organizations
within (e.g., Department of Health, police, schools) and outside of the community (e.g., Saint
Louis University School of Public Health). This partnership then developed, implemented, and
refined various programs.

The stages delineated in previous work do not adequately reflect the partnership’s evolutionary
process. Previous work indicates prerequisites to moving effectively from one stage of coalition
function to the next. For example, it is important to have decision-making processes in place
before designing and implementing specific program activities. While some of the initial
activities of WHO could be seen as linear (as previous literature suggests), later coalition
development and maturation could more accurately be described as a metamorphosis. The
change from a grassroots group interested in making some changes in its community to an
organization that has an annual budget, tax-exempt status, several properties, and permanent staff
was experienced not merely as development but as a significant change in structure and function.
This metamorphosis occurred consciously at some levels, and unconsciously at others. This
change influences the programs that are offered, and has forced the organization to determine if
the current staffing is adequate to address the changing needs. Perhaps more importantly this
dramatic change has caused initial group members to question how much change can occur
without losing the initial mission and vision of the organization.

Lastly, the metamorphosis has caused some in the organization to wonder about the utility and
appropriateness of sustainability and growth. Although efforts are being made to increase stable
funding streams, sustainability still requires grant money. As the organization grows there are,
therefore, a growing number of community members who rely on soft money for their
livelihood. Some have questioned if creating this dependence on soft money is appropriate and if
not, if it is appropriate for the organization to continue to grow.

The members of the partnership are struggling with what to do in this transitional stage. Should
the organization become a more formal structure, gathering additional resources to meet the
needs it has identified to date? Or, should there be two organizations: one with a focus on
grassroots involvement and responsiveness to the community and the other a more formally
organized, structured organization to address the needs that have been defined to date. The
community continues to drive these decisions; outside partners assist the community as they can
and offer resources where and when it seems appropriate.

Summary and conclusions

While there are no blueprints to direct researchers and practitioners who wish to engage in
academic/practice/community research partnerships, the principles of practice presented in this
paper provide some general guidance. In summary, these principles are:

Identify the best processes/model to be used based on the nature of the issue and the intended
outcome.

Acknowledge the difference between community input and active community involvement.

Develop relationships based on mutual trust and respect.

Acknowledge and honor different partner’s “agendas.”

Consider multi-disciplinary approaches.

Use evaluation strategies that are consistent with the overall approach taken in the
academic/practice/community partnership.

Be aware of partnership maturation and associated transition periods.

Although these principles were derived from previous literature in the field of community-based
research and the experiences of individuals who have been involved in a research partnership,
three issues should be considered prior to applying these principles in future partnerships. First, it
is not sufficient to simply adopt one or more of these principles. These principles represent an
attempt to put into operation a processof engaging in community-based research. These
principles are interrelated, and work synergistically to improve research outcomes. For example,
a partnership based on mutual respect is likely to provide the basis for honoring each partner’s
agenda. It is difficult to have one without the other. Therefore, while an academically driven
research or intervention project (Type 1) may be enhanced by adopting one or more of these
strategies, doing so does not necessarily make the project community-based research (Type 3).

A second consideration is that this list of principles is not exhaustive. Moreover, some principles
may be more important than other principles depending on the stage of the partnership, and the
stage of development of the organizations within the partnership.

Lastly, this list of principles is derived from previous literature and experiences in conducting
Type 3 research. However, the very nature of this type of research suggests that it is essential to
respond to the specific context in which one is working. Hence, while these principles may be
useful in guiding one’s work they may not be appropriate in every setting.

Academic/practice/community research partnerships are gaining popularity. To be effective, it is

important to move toward using these partnerships to engage in community-based or Type 3
research.[15] However, as we begin to use these approaches it is important to examine not only
the outcomes of these research and intervention projects, but also to increase our understanding
of partnerships and how they affect our ability, to create more healthful communities.

Acknowledgements
The partnership described within this paper was funded by the Health Resources and Services
Administration. We thank Stephanie Starkloff Morgan and Fran Daniel for their comments on an
earlier draft.

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Address correspondence to: Elizabeth A. Baker, PhD, MPH, Saint Louis University,
Department of Community Health, 3663 Lindell Blvd., 63108

a
Parker, Eng, Laraia, et al.[23] defined coalitions as “alliances among different sectors,
organizations, or constituencies for a common purpose.”