Method Acting

Like many brilliant concepts, Community-Based Participatory Research, or CBPR, is both revolutionary and simple. Just ask Chris Burke, assistant professor of psychology and one of the faculty leads of Lehigh’s new Community Health Cluster, which will rely heavily on the fast-growing research methodology.

“What got me really excited was hearing about CBPR for the first time,” says Burke, a social psychologist by training who also has a background in quantitative psychology. “It was one of those things where it was surprising, but it was also surprising that it was surprising.”

The key word is “participatory.” The idea is to involve members of the community in every step of the research: from defining the problem, to developing the questions to ask, to collecting and analyzing the data, to deciding on the appropriate intervention to solve the problem. It’s a bottom-up approach, compared to the typical top-down model of most research projects.

“At first I thought, that’s revolutionary. Nobody does that,” Burke recalls. “But at the same time, it was like, of course, that’s how it would work best.”

As Judith Lasker, the NEH Distinguished Professor of Sociology and another member of the faculty core, puts it, “It’s meant to be a two-way street. It’s not just the community buying into what we want. It’s our buying into what they want and need and making it a collaborative venture.”

The commitment to CBPR is one of the distinguishing features of Lehigh’s latest interdisciplinary faculty “cluster,” which will add three new faculty members to a “nucleus” of five current scholars. As part of its commitment to address complex issues with broad-based interdisciplinary approaches, Lehigh is funding small groups of faculty “clustered” around an intellectual theme, interest or problem.

Donald E. Hall, the Herbert J. and Ann L. Siegel Dean of the College of Arts and Sciences, serves as lead dean for the new cluster, as four of the core faculty members are in the College of Arts and Sciences. In addition to Burke and Lasker, the group also includes Breena Holland, associate professor of political science and the Environmental Initiative, and Kelly Austin, assistant professor of sociology. The core group is rounded out by George White, professor in the College of Education’s educational leadership program and director of the Center for Developing Urban Educational Leaders (CDUEL).

Searches began in the fall 2013 semester for two new faculty hires to start work this coming fall: an epidemiologist in the department of sociology and anthropology, who brings expertise in designing studies to determine how and why disease is distributed throughout a community, and a psychologist focused on health with expertise in quantitative methods.

Lasker says the epidemiology position is “a core piece of any kind of public health program” that “has been on our wish list for a long time.” And Burke says bringing in a psychologist with a “sophisticated understanding of quantitative methods” will help the cluster “ask sophisticated questions.”

“I always say that quantitative methods are like keys to opening doors,” Burke says.

Following the initial two faculty hires this year, a search will commence in the fall for an experienced researcher with expertise in CBPR who will be brought into the College of Education at an associate or full professor level starting in the fall of 2015.

The cluster approach builds on areas where Lehigh has existing expertise, and that is certainly the case with the Community Health Cluster. While Lehigh offered a health and human development minor, the university’s focus on health received a major boost when it was designated as one of the three strategic areas of investment in the university’s strategic plan under President Alice P. Gast.

It gained momentum with the creation of the Health Medicine and Society (HMS) minor in 2008, under the direction of Beth Dolan, and the hiring of Dena Davis in 2011 as Lehigh’s first Presidential Endowed Chair in Health in the social sciences and humanities. At the same time, student interest in public health showed a noticeable increase, mirroring a national trend.

Internal discussions, aided by outside experts, on how to meet the growing demand for public health training led to the focus on community health and CBPR. The process, says Holland, “was very organic, which is promising.”

The diverse interests of the core faculty members provide an intriguing glimpse into what the future of the cluster may hold as it works hand in hand with members of the community to identify and tackle public health issues.

“I think the expertise that our team brings will help shape the kind of issues that we can address,” says Burke, whose research has focused primarily on stress, looking at how people cope with it and the impact of social support systems. “But they also have to be things the community finds to be important. So it’s finding that intersection that will really determine what we focus on.”

Lasker has taught the Medicine and Society course at Lehigh for three decades. It was one of the few health courses offered at Lehigh when she arrived on campus in 1981 and today is a core course in the Health Medicine and Society program. For years, Lasker incorporated a service component into the course, including having students help with a local flu clinic and conduct surveys for New Bethany Ministries. She also has helped community health agencies with research needs, particularly through the Social Science Research Center.

Austin’s research has primarily focused on global health issues, particularly communicable diseases—HIV, tuberculosis and malaria—and how the health system addresses them in sub-Saharan Africa.

“A lot of my research prior to the work I’m starting to do through the cluster has been macro-comparative, large-scale, using large data sets from organizations such as the World Health Organization or the World Bank,” says Austin, who came to Lehigh in 2012. “So I’m really excited to be able to work with the cluster to help me develop more community health-based skills.”

Holland, meanwhile, has been conducting research focused on the link between outdoor air pollution and asthma among school children in the local community. Holland sees the CBPR approach as being essential to reversing the high rates of asthma.

“If people don’t feel comfortable with us, if we can’t even go into the home and identify the asthma triggers, we’re never going to get to a point where we figure out what the right solution is that solves the problem,” she says.

Her asthma research project wound up being a central part of the Community Health Cluster proposal.

“It was an area where there was a clear need for additional faculty expertise and promising research that could be carried out, which fit precisely what we were looking for,” Holland says. “We wanted to use air pollution problems as an existing area of faculty research that exemplifies why we needed the cluster, and it worked out especially well for that purpose.”

In recent years, White and CDUEL have partnered with the Bethlehem Area School District and the United Way of the Greater Lehigh Valley to create a University Assisted Community School at Broughal Middle School on the south side. CDUEL manages and evaluates the after-school programs that focus on improving academic preparation of the students. The program is also dedicated to improving the quality of parent education and mentoring for students as they progress through their middle school years.

Holland also credits the South Side Initiative—which brings together Lehigh faculty, students and staff and members of the South Side community to share knowledge, foster democracy and make the city a better place to live—with laying some of the groundwork for the community-based and participatory focus of the cluster by doing positive work in the community and helping to spur her research there.

And Lasker cites the long-running Community Fellows program, which pairs master’s degree students with community agencies, as another example of the good work on which the cluster can build.

“A lot of the driving force behind this cluster, as I understand it, is to really try to shift the focus to making sure the kinds of things our faculty and students do are driven by the needs of the community and serve the community in a way that people who are not at Lehigh find valuable,” Lasker says.

Adds Holland: “Everybody in the cluster is deeply committed to the CBPR methodology. Everybody’s committed to getting the community involved in defining the problems we’re doing research on, participating in actual data collection and the interpretation of results.”

As a researcher who has worked with data a lot, Austin says the CBPR methodology is a win-win for the community and the university.

“You give the community skills,” Austin says. “When you train people to collect data, when you train community members to analyze data or to promote and carry out the interventions—you’re teaching real people real skills that will hopefully go beyond the research project and perhaps propel that individual or that community into a better social status than they would have had if they hadn’t had the opportunity to learn those skills.”

At the same time, Austin says, “When you’re able to work with community members to help you gather the data, you actually can get much, much more reliable answers and results from the people you are studying, as they are often more comfortable talking to a member of their community, rather than an outside researcher.”

And as an added benefit, she says, interventions developed as a result of CBPR “tend to be much more self-sustaining, with much better success rates over the long term. And I think that’s really important for health, that long-term thinking.”

The success of the Community Health Cluster will largely depend on how successful it is in building trust in a community where tensions still exist with the affluent university in its midst.

“It’s definitely an uphill battle,” Burke acknowledges. “From everybody we’ve talked to about engaging in this kind of research, building that trust relationship is probably the hardest aspect of the research process. A lot of our efforts over the beginning stages in this process are really going to be about building that kind of trust.

“Even just getting in the door is going to be a real challenge, but one we’re prepared to make because we realize that this is something that’s really important to do because not only do we live in a community that really could benefit from this kind of endeavor, but Lehigh can benefit a lot from it, too.”

And there are other potential benefits and partnerships. The Affordable Care Act requires nonprofit hospitals to perform community health needs assessments every three years while also shifting the emphasis—and payment structure—for health care providers to prevention.

“Some of these issues are very salient to the health and hospital industry in our region, and having partners nearby who can collaborate on the kinds of projects they want to do, that’s a plus for everybody,” Lasker says.

Holland, who brings a public policy perspective to the team, says the cluster’s work will offer excellent opportunities for students to get hands-on experience and gain some understanding of what it takes to make change happen.

“To me, it’s creating opportunities for students to really be engaged in institutional change, right here, and get some experience doing that,” Holland says. “And it’s my hope that will help them get jobs and give them the experience they need to do really well in those jobs.”

Burke agrees: “I think getting students out there, really seeing the kinds of experiences people have and working with people to make things better, I think those are really invaluable experiences that they can then carry forward to wherever life takes them after Lehigh.”