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ABSTRACT: As a professor of Public Health in the United States, the author presents her perspective of violence as a public health issue in Colombia, based on her experiences over a relatively short period of time as a Fulbright scholar in Bogota. Though not claiming to be definitive, the article presents the far-ranging complexity of the violence, from its epidemiology, to its social-economic-political origins, and its devastating psychological, social and life threatening consequences over multiple generations. The article is both narrative of experiences with scholars, people in communities, fellow parents, activists, and professionals, as well as a scholarly treatise to illustrate that the violence is not chaotic and indecipherable, but has systematic roots and therefore systematic opportunities for amelioration. Hope for Colombia is uncovered through the dedication of professionals engaged in community development efforts; through existing, though fragile, political negotiations; and through popular demonstrations for peace. ; RESUMEN: Como profesora de salud pública en Estados unidos y habiendo tenido la oportunidad de estar en Santafé de Bogotá por un corto periodo de tiempo la autora presenta su perspectiva de ?a violencia en Colombia como asunto que atañe a la salud pública. Aunque no intenta sentar conclusiones, este articulo presenta la gran complejidad de la violencia desde verla como epidemia, hasta sus orígenes socioeconómicos y políticos, y sus devastadoras consecuencias psicológicas, sociales y de amenaza a la vida desde hace varias generaciones. Este artículo es tanto una narración de experiencias con académicos, gente de la comunidad, familiares, activistas, y profesionales, como también un intento académico por mostrar que la violencia no es caótica e indescifrable sino que tiene raíces sistemáticas y, por ende, oportunidades sistemáticas de mejoramiento. Esperemos que Colombia salga adelante gracias al trabajo de profesionales dedicados al desarrollo de los esfuerzos de la comunidad; gracias a las negociaciones políticas, que aun son débiles; y gracias a las manifestaciones populares por la paz.

Purpose and Scope. This article reviews the health and social science research relevant to both the role of powerlessness as a risk factor for disease, and the role of empowerment as a health-enhancing strategy. The research literature surveyed includes studies that address these key concepts from the fields of social epidemiology, occupational health, stress research, social psychology, community psychology, social support and networks, community competence and community organizing. Definitions are provided to operationalize these sometimes loosely-applied terms. Important Findings. Powerlessness, or lack of control over destiny, emerges as a broad-based risk factor for disease. Empowerment, though more difficult to evaluate, can also be demonstrated as an important promoter of health. Major Conclusions. Given the importance and currency of these concepts of powerlessness and empowerment, a model of empowerment education is proposed for health-promotion practitioners. Measurement of empowerment raises issues for researchers on how to test the multiple personal and community changes that may result from an empowering education intervention.

Minkler and Wallerstein have pulled together a fantastic set of contributions from the leading researchers in the field. In addition to a fine collection of case studies, this book puts the key issues for researchers and practitioners in a historical, philosophical, and applied, practical context

Health promotion programs are commonly viewed as value-free initiatives which seek to improve health, often through behavior change. An opposing view has begun to emerge that health promotion efforts, especially ones seeking to impact health policy and social determinants of health, are vulnerable to political contexts and may depend on who is in power at the time. This community-based participatory research study attempts to understand these interactions by applying a conceptual model focused on the power context, diverse stakeholder roles within this context, and the relationship of political levers and other change strategies to the sustainability of health promotion interventions aimed at health policy change. We present a case study of a health promotion coalition, New Mexico for Responsible Sex Education (NMRSE), as an example of power dynamics and change processes. Formed in 2005 in response to federal policies mandating abstinence-only education, NMRSE includes community activists, health promotion staff from the New Mexico Department of Health, and policy-maker allies. Applying an adapted Mayer's power analysis' instrument, we conducted semi-structured stakeholder interviews and triangulated political-context analyses from the perspective of the stakeholders. We identified multiple understandings of sustainability and health promotion policy change, including: the importance of diverse stakeholders working together in coalition and social networks; their distinct positions of power within their political contexts; the role of science versus advocacy in change processes; the particular challenges for public sector health promotion professionals; and other facilitators versus barriers to action. One problem that emerged consisted of the challenges for state employees to engage in health promotion advocacy due to limitations imposed on their activities by state and federal policies. This investigation's results include a refined conceptual model, a power-analysis instrument, and new understandings of the intersection of power and stakeholder strategies in the sustainability of health promotion and health in all policies. ; Univ Fed Sao Paulo, Campus Baixada Santista, Sao Paulo, Brazil ; Univ New Mexico, Albuquerque, NM 87131 USA ; Univ New Mexico, Publ Hlth Program, MSC 09 5060, Albuquerque, NM 87131 USA ; Univ Fed Sao Paulo, Campus Baixada Santista, Sao Paulo, Brazil ; Web of Science

Purpose.To analyze the organizational development and implementation of an interdisciplinary health promotion project at the University of New Mexico. The effort involved three academic units in a 3-year externally funded project to institutionalize health promotion curricula in the respective schools and to develop a wellness-oriented service for students, faculty, and staff.Methods.The open systems theory was used as a framework to analyze the organizational and role issues that emerged from the data collected through interviews, staff surveys, and document review. The analysis is summarized by five thematic questions: (1) How did the project's vision affect its development? (2) How was leadership enacted, and with what effect? (3) What were the organizational issues for the staff? (4) What were the interdisciplinary dilemmas? (5) What was instituted or changed as a result of the project?Results.The analysis uncovered a series of interpersonal and organizational dilemmas involving the nature of the organizational environment, the character of interdisciplinary work, leadership, boundaries of group membership, and the structuring of a unified vision.Conclusions.Future projects should consider the strength and stability of the boundary spanners, the resource context, and the role of a unified vision for new and organizationally linked units as key issues in facilitating and sustaining change.

Since the Ottawa Charter 25 years ago, community participation has been adopted worldwide by nation states and communities as a core health promotion strategy. Rising inequities since that time, however, have been largely unchecked in the Americas and globally, and have presented us with an acutely paradoxical time for community participation and action. On the one hand, transnational globalized markets and accompanying economic and environmental devastation have challenged the effectiveness of community action to create health. On the other hand, hopeful signs of local through national and international activism and of new mechanisms for community engagement continue to surface as meaningful and effective democratic acts. This article presents a dialogue on these issues between colleagues in the United States and Brazil, and considers the broader applicability to Latin America and worldwide. We begin by discussing how community participation and community organizing grew out of our respective histories. We consider the catalytic role of the Ottawa Charter in spurring a reorientation of health promotion and the genesis of healthy city and community initiatives, as well as other current community organizing strategies and the growth of participatory research/CBPR. We unpack the potential for co-optation of both community and social participation and end with recommendations for what we can do to maintain our integrity of belief in democratic social participation to promote improved health and health equity. ; Univ New Mexico, Publ Hlth Program, Dept Family & Community Med, Albuquerque, NM 87131 USA ; Universidade Federal de São Paulo UNIFESP, CEPEDOC Cidades Saudaveis, Santos, Brazil ; Univ Calif Berkeley, Sch Publ Hlth, Berkeley, CA 94720 USA ; Saude Colet Fac Med ABC, São Paulo, Brazil ; Universidade Federal de São Paulo UNIFESP, CEPEDOC Cidades Saudaveis, Santos, Brazil ; Web of Science

Insufficient attention has been paid to how research can be leveraged to promote health policy or how locality-based research strategies, in particular community-based participatory research (CBPR), influences health policy to eliminate racial and ethnic health inequities. To address this gap, we highlighted the efforts of 2 CBPR partnerships in California to explore how these initiatives made substantial contributions to policymaking for health equity. We presented a new conceptual model and 2 case studies to illustrate the connections among CBPR contexts and processes, policymaking processes and strategies, and outcomes. We extended the critical role of civic engagement by those communities that were most burdened by health inequities by focusing on their political participation as research brokers in bridging evidence and policymaking.

Insufficient attention has been paid to how research can be leveraged to promote health policy or how locality-based research strategies, in particular community-based participatory research (CBPR), influences health policy to eliminate racial and ethnic health inequities. To address this gap, we highlighted the efforts of 2 CBPR partnerships in California to explore how these initiatives made substantial contributions to policymaking for health equity. We presented a new conceptual model and 2 case studies to illustrate the connections among CBPR contexts and processes, policymaking processes and strategies, and outcomes. We extended the critical role of civic engagement by those communities that were most burdened by health inequities by focusing on their political participation as research brokers in bridging evidence and policymaking.

The practice of community based participatory research (CBPR) has evolved over the past 20 years with the recognition that health equity is best achieved when academic researchers form collaborative partnerships with communities. This article theorizes the possibility that core principles of CBPR cannot be realistically applied unless unequal power relations are identified and addressed. It provides theoretical and empirical perspectives for understanding power, privilege, researcher identity and academic research team composition, and their effects on partnering processes and health disparity outcomes. The team's processes of conducting seven case studies of diverse partnerships in a national cross-site CBPR study are analyzed; the multi-disciplinary research team's self-reflections on identity and positionality are analyzed, privileging its combined racial, ethnic, and gendered life experiences, and integrating feminist and post-colonial theory into these reflections. Findings from the inquiry are shared, and incorporating academic researcher team identity is recommended as a core component of equalizing power distribution within CBPR.

Objectives. We explored the relationship of community-engaged research final approval type (tribal government, health board, or public health office (TG/HB); agency staff or advisory board; or individual or no community approval) with governance processes, productivity, and perceived outcomes.

Purpose. The purpose of this study is to establish the psychometric properties of 22 measures from a community-based participatory research (CBPR) conceptual model. Design. The design of this study was an online, cross-sectional survey of academic and community partners involved in a CPBR project. Setting. CPBR projects (294) in the United States with federal funding in 2009. Subjects. Of the 404 academic and community partners invited, 312 (77.2%) participated. Of the 200 principal investigators/project directors invited, 138 (69.0%) participated. Measures. Twenty-two measures of CBPR context, group dynamics, methods, and health-related outcomes were examined. Analysis. Confirmatory factor analysis to establish factorial validity and Pearson correlations to establish convergent and divergent validity were used. Results. Confirmatory factor analysis demonstrated strong factorial validity for the 22 constructs. Pearson correlations (p < .001) supported the convergent and divergent validity of the measures. Internal consistency was strong, with 18 of 22 measures achieving at least a .78 Cronbach α. Conclusion. CBPR is a key approach for health promotion in underserved communities and/or communities of color, yet the basic psychometric properties of CBPR constructs have not been well established. This study provides evidence of the factorial, convergent, and discriminant validity and the internal consistency of 22 measures related to the CBPR conceptual model. Thus, these measures can be used with confidence by both CBPR practitioners and researchers to evaluate their own CBPR partnerships and to advance the science of CBPR.