Community-Based Participatory Research (CBPR): The Nine Principles and How They Work in Practice

Community-based participatory research, or CBPR, is the name most often used in public health and medicine for research carried out as an equal partnership between academic researchers and the communities affected by a health problem. Since the late 1990s it has been defined less by a method than by a set of principles. Here is what those principles say, and what they demand in practice.
A short definition
CBPR is a partnership approach to research that "equitably involves" community members, organisational representatives and academic researchers in all aspects of the research process. The aim is both to increase knowledge and to use it for action that improves health and reduces inequalities. The approach belongs to the wider family of participatory action research, but grew up mainly in North American schools of public health in the 1990s, where researchers working on asthma, diabetes, housing and environmental exposures found that traditional studies often failed to reach, or to benefit, the communities most affected.
A widely cited example is the Detroit Community-Academic Urban Research Center, established in 1995 by the University of Michigan School of Public Health together with community organisations, health departments and service providers in Detroit. Members of that partnership, including Barbara Israel and Amy Schulz, went on to write much of the methodological literature on CBPR.
The nine principles
In their 1998 review, "Review of community-based research: assessing partnership approaches to improve public health", Israel and colleagues set out eight key principles. A ninth, on long-term commitment, was added in later work by Israel and co-authors, including the opening chapter of Methods in Community-Based Participatory Research for Health (2005). The nine principles have since been reproduced, adapted and extended in textbooks and funding guidance. In summary, CBPR:
- Recognises community as a unit of identity. A community is defined by a sense of shared identity, not just by a postcode. Researchers work with groups that people actually belong to.
- Builds on strengths and resources within the community. Projects start from existing skills, networks and organisations rather than from a list of deficits.
- Facilitates collaborative, equitable partnership in all phases of the research. Power and decision-making are shared, with attention to the inequalities between partners.
- Promotes co-learning and capacity building among all partners. Community members learn research skills; academics learn about the community, its history and its priorities.
- Integrates and balances research and action for the mutual benefit of all partners. A study that produces papers but no change, or change without evidence, misses the point.
- Emphasises local relevance and an ecological view of health. Health problems are understood in their social, economic and physical context.
- Involves systems development through a cyclical and iterative process. Partnerships move through repeated rounds of planning, action and reflection.
- Disseminates findings to all partners and involves them in dissemination. Results go back to the community in usable forms, and community partners co-author and co-present.
- Involves a long-term process and commitment to sustainability. Relationships are expected to last beyond a single grant.
Later editions of the main CBPR textbook, Community-Based Participatory Research for Health (edited by Meredith Minkler and Nina Wallerstein, first published in 2003; third edition 2018 with Bonnie Duran and John Oetzel), added further themes, notably cultural humility and explicit attention to racism and historical trauma.
What the principles mean in practice
Principles are easy to sign up to. They become concrete through decisions that partnerships have to take early:
- Governance. Who sits on the steering group, how votes are taken, and what happens when partners disagree. Many partnerships write this into a memorandum of understanding; see our guide to community-university partnership agreements.
- Budget. Whether community organisations receive a real share of the grant, including overheads, and whether community researchers are paid.
- Methods. Choosing tools that partners can use and interpret, for example participatory mapping or photovoice alongside surveys and clinical measures.
- Data. Who holds the data, who can use it for which purposes, and whether the community can veto publications that it considers harmful.
- Authorship. How community partners are credited on papers, reports and presentations.
CBPR versus research that is merely "in" a community
A useful distinction in the literature separates research that is community-placed (the community is a setting where participants are recruited), community-based in a weak sense (the study addresses a community's problem but is designed by outsiders), and community-based participatory (the community shares control). The labels matter less than the questions behind them: who chose the question, who benefits, and who decides what happens to the findings? A quick self-assessment against the nine principles, done honestly by all partners, usually shows where a project sits.
Funding and institutional support
In the United States, the National Institute on Minority Health and Health Disparities, part of the National Institutes of Health, has long run funding programmes for community-based participatory research on health disparities. The Patient-Centered Outcomes Research Institute (PCORI), created under the Patient Protection and Affordable Care Act of 2010, requires meaningful engagement of patients and other stakeholders in the research it funds and publishes an engagement rubric. In the United Kingdom, the National Institute for Health and Care Research (NIHR) expects patient and public involvement in most of its funding streams, which we cover in our article on public involvement in health research.
Funders' requirements are a floor, not a ceiling. A grant application can tick an "engagement" box without meeting the principles above, and a small unfunded partnership can embody them fully.
Common criticisms
- Time. Building trust takes months or years before data collection begins, which fits poorly with grant cycles and academic promotion criteria.
- Representation. The organisations that partner with universities may not represent everyone in a community. Partnerships need ways to hear from people outside the usual groups.
- Generalisability. Findings rooted in one place may be hard to transfer. Careful description of context helps others judge relevance.
- Institutional barriers. University finance systems may struggle to pay community partners quickly, and ethics committees may not know how to review co-researcher roles.
Sources
- Barbara A. Israel, Amy J. Schulz, Edith A. Parker and Adam B. Becker, "Review of community-based research: assessing partnership approaches to improve public health", Annual Review of Public Health, vol. 19, 1998, pp. 173-202.
- Barbara A. Israel, Eugenia Eng, Amy J. Schulz and Edith A. Parker (eds.), Methods in Community-Based Participatory Research for Health, Jossey-Bass, 2005, chapter 1.
- Meredith Minkler and Nina Wallerstein (eds.), Community-Based Participatory Research for Health, Jossey-Bass, 2003; 3rd edition (Wallerstein, Duran, Oetzel and Minkler, eds.), 2018.
- National Institute on Minority Health and Health Disparities, National Institutes of Health: community-based participatory research programme pages.
- Patient-Centered Outcomes Research Institute, engagement rubric and engagement resources.
MethodsParticipatory action research, step by step
From Kurt Lewin and Orlando Fals-Borda to today's community projects: the PAR cycle, team roles and the traps to avoid.
MethodsParticipatory mapping, from sketch maps to GIS
Sketch maps, transect walks, GPS and open mapping: how residents put their own knowledge on the map, and when a map can do harm.
Ethics & partnershipsWriting a community-university partnership agreement
Governance, money, data, authorship and exit: the clauses that keep research partnerships between universities and community groups fair.