Using community-based participatory research to reduce health disparities in East and Central Harlem

It is important to teach community members about the causes, magnitude and effects of health disparities that affect them, and to partner with them to develop, test and disseminate programs that they can sustain to improve health. East and Central Harlem are two underserved, predominantly minority, inner-city communities whose residents have disproportionately high morbidity and mortality from chronic conditions. We developed an approach to educate and work together with Harlem residents to study health disparities, and to use peer-led classes to improve chronic disease management and outcomes.

Researchers and community leaders formed a community-based research core ("Core") with funds from a large health disparities grant. We then assembled a community advisory board and partnered with them to start a community newsletter to explain the causes of local health disparities and suggest ways to eliminate them. Together, we also began to create a self-sustaining cadre of community-based peer educators to teach culturally acceptable chronic disease self-management skills.

The recruited board consists of 33 leaders of community-based health and social service organizations, religious institutions, and tenant organizations, as well as local activists. We produced and distributed our first educational newsletter to more than 4,000 community leaders, members and community-based organizations. We also adapted an existing chronic disease self-management program for the Harlem population and developed strategies to recruit peer educators and sustain their efforts in the future. To help them attain expertise in teaching chronic disease self-management, the board selected four individuals to become master peer-education trainers. The board then helped recruit more than 60 community members and leaders for our first two peer-education courses.

Researchers, clinicians and community leaders worked together to disseminate knowledge about health disparities and a peer-organized education program to address these disparities. This approach provides a foundation to attain a cadre of community-based experts to inform the community about ways to reduce health disparities. By pooling local and academic expertise and resources, we hope to develop programs that are workable, effective and sustainable without outside control or funding.