Since the 1990s, the emphasis on engaging communities, patients, and other stakeholders in clinical, public health, and translational sciences research has grown tremendously. While this emphasis on engaged research began primarily in public health, the number and type of biomedical and clinical researchers implementing engaged research are increasing spurred by research-funding initiatives from agencies such as the Patient Centered Outcomes Research Initiative (PCORI),1 the National Institutes of Health (NIH),2 and the Centers for Disease Control and Prevention (CDC).3
Community-engaged research (CEnR) has been referred to by many different names [e.g., community-based participatory research (CBPR),4,5 tribal participatory research,6 participatory action research or action research,7 community-participatory partnered research,8 community-owned and -managed research9], which reflect variations in approaches and level of involvement in the research. Recently, researchers have begun to use CEnR as an inclusive term to describe any type of engaged research focused on health improvement, regardless of the degree or type of engagement.10,11
HISTORICAL ROOTS OF CENR RESEARCH
Engaging the intended beneficiaries of research in the research process is not new; it has existed for many years in different disciplines. Wallerstein and colleagues note two traditions, the Northern and Southern, which contribute to today’s CBP approach. Named for their origins in the northern and southern hemispheres, respectively, both traditions reject a (post) positivist view of reality.12 Rather than presuming a single underlying truth that scientists could discover with the correct tools, these traditions hold that knowledge is socially constructed. Thus, any truth is created through interactions and is specific to a time and a place. To understand a phenomenon, you must engage and interact with the persons who experience that phenomenon as partners in the research exploration.
The northern tradition involved a utilization-focused research approach, such as the work of psychologist Kurt Lewin and his action research involving a cycle of planning, action and investigating the results of the action.12 The southern tradition arose in the early 1970s from Marxist critiques of underdevelopment, Catholic liberation theology, and the drive to improve the practice of adult education and development among populations vulnerable to the impact of globalization. This tradition is perhaps best represented by Paulo Freire, whose approach to research was to engage community members as participants in the inquiry instead of as subjects of the research study.12
An additional influence for health sciences research is the southern tradition, with roots in the work of Drs. Sidney and Emily Kark and colleagues at the Institute of Family and Community Health and the Department of Social, Preventive and Family Medicine in the Natal Medical School in Durban, South Africa.13 The Karks are recognized for their contribution to the development of the community-oriented primary care (COPC) movement as well as other innovations, which have influenced current-day preventive medicine and public health in this country. ...