Cross-community community-based participatory research: A scoping review

In the United States (US), communities that share the reality of relatively poor health are often on differing sides of a growing political divide. Might community-based participatory research (CBPR) promote inter-community understanding and mutual support? We conducted a scoping review of English-language literature on CBPR in the United States that utilized what we term "purposeful diversity." By purposeful diversity, we mean studies that intentionally involved partnerships with communities of differing race/ethnicity, socioeconomic status, geographic regions, gender/sexual orientation, religions or age in order to achieve a specific result. Only 41 partnerships (described in 65 papers) met our review criteria. Purposeful diversity in ethnicity/race was most common. Community advisory boards, community co-investigators, and community membership on steering committees were prevalent forms of community participation. Frequently, reasons for involving diverse partners were not given; those offered most often were the disproportionate burden of poor health on the communities participating. While many partnerships reported benefits of diversity, the only benefit frequently mentioned was success in recruiting diverse participants. Fewer than 40% of partnerships addressed challenges from working with diverse communities; barriers to communication and understanding were the most common. Fewer than 20% of partnerships reported strategies to address these challenges. Even fewer documented results of such strategies or methods they used to explore the influence of community diversity. Despite the focus of CBPR on structural disadvantage and the possibility of structural change, the potential of this approach for addressing inter-community conflict is virtually unexplored.