Are the potential benefits of a community-based participatory approach to public health research worth the potential cost?

Much of public health research is conducted in a community setting or is designed to target particular population groups. Community-based participatory research (CBPR) is gaining recognition as good practice in studies of this type(Flicker et al 2007). Its merit is based on the inclusion of the community as active participants at all stages of the research process (Goodman 2006). The focus on justice and equity in this approach is seen to contribute to a range of additional potential research benefits including increased relevance and sustainability of interventions arising from the research ( Blumenthal 2004; Wallestein 2006) However, it is widely acknowledged that adoption of a consciously CBPR approach requires additional expertise. time and resources from researchers and from communities (Tanjasiri et al 2002; Massaro & Claiborne 2001; Israel et al 1998). Adoption of CBPR is also limited by existing infrastructures which are supportive of more· traditional models of research. Changes to professional development programs, funding guidelines and criteria. grant review processes and ethics requirements are needed to support increased application of this approach (Israel et al 2001). As all research resources are limited, the potential additional benefits offered by CBPR over and above a more traditional research approach need to be weighed against the potential additional costs involved. Changes to research infrastructure are unlikely to occur until the costs and
benefits of a consciously CBPR approach as compared to a more traditional research approach can be demonstrated.

This is an exploratory paper that summarises the arguments put forward to date in relation to CBPR. A research case study and an evaluation framework are then used for a conceptual analysis of differences in the potential costs and benefits of the two approaches. Firstly, the paper describes the differences between traditional and consciously CBPR approaches. The reported benefits of CBPR are then outlined, followed by a discussion of the potential costs. Finally, the potential costs are compared to the potential benefits of using a CBPR approach, using a case study of existing research.

"Tell us something new!" : the response of planning and transport professionals to public health guidance on the built environment and physical activity

A large proportion of non-communicable disease can be attributed to modifiable risk factors such as poor nutrition and physical inactivity. We present data on planning and transport practitioners' perceptions and responses to government public health guidance aimed at modifying environmental factors to promote physical activity. This study was informed by questions on the role of evidence-based guidance, the views of professionals towards the guidance, the links between guidance and existing legislation and policy and the practicality of guidelines. A key informant 'snowball' sampling technique was used to recruit participants from the main professional planning organisations across England. Seventy-six people were interviewed in eight focus groups. We found that evidence-based public health guidance is a new voice in urban and town planning, although much of the advice is already reflected by the 'accepted wisdom' of these professions. Evidence-based health guidance could be a powerful driver affecting planning practice, but other legislated planning guidance may take priority for planning and transport professionals.

Building global alliances for public health nutrition training

The purpose of this paper is to present a review of opportunities and challenges for future progress in building intercountry, regional, and global alliances for public health nutrition training. Drawing on experiences from developing, implementing, and evaluating public health nutrition training in Australasia, Europe, and the Middle East, suggestions are provided for building a network of global training activities. Opportunities are described in areas such as standardization of course competencies and registration schemes, resource sharing, student and trainer exchange programs, and professional development. Challenges are identified and options presented for building global alliances in public health nutrition training into the future.

Do food regulatory systems protect public health?

The purpose of this commentary is to consider the extent to which food regulatory systems protect public health, and how a better job could be done. There are fundamental questions about the role of food regulations in responding to changes in food systems and to food-related public health issues. What is meant by the objective ‘to protect public health and safety’ in the context of food regulation? Are current systems well balanced between promoting trade and protecting health? What is the role of nutrition in food regulation? Should food regulation be used to promote as well as to protect public health? Should laws and regulations be used to intervene in the formulation and marketing of foods, or should ‘the market’ merely provide more choices and information for shoppers and consumers to select healthy diets?

Moving towards increased cultural competency in public health research

There has been a renewed focus in recent decades on collaborative approaches in community-based public health research and interventions. This is an important grounding for addressing the needs of culturally and linguistically diverse (CALD) communities. But how well do we as researchers prepare for the complexities of working with CALD communities? And what sort of support do we need to meet the challenges of the task? Cultural competence refers to the extent to which researchers, practitioners and organisations have the necessary skills, knowledge, attitudes and policies to work effectively in cross-cultural situations. The shift towards cultural competence in public health is evidenced by the development of policies and guidelines by government bodies and leading research institutions in countries such as Canada, the United States, Australia and New Zealand. This chapter will draw on these guidelines, on models of cultural competency used in welfare and health service delivery, and on collaborative research approaches. A framework for moving towards cultural competence in public health research and health promotion interventions will be discussed, drawing case study examples from the co-authors' community-based experiences. This will highlight the complexities but also the importance of adopting culturally competent strategies in public health research and health promotion interventions. The need for supporting government and funding structures will also be proposed .