tag:blogger.com,1999:blog-6436224560193948046.post5803896931206190004..comments2007-12-25T10:21:10.140-05:00Neilhttp://www.blogger.com/profile/08797714666842395812noreply@blogger.comBlogger1125tag:blogger.com,1999:blog-6436224560193948046.post-2845353430144530662007-12-24T23:59:00.000-05:002007-12-24T23:59:00.000-05:00Dr Calman, Community based participatory research as you have outlined is arguably the best method to engage communities of color in trying to improve their health. However, before engaging the community as research participants we must first engage them as patients. The most difficult part of this effort will be engaging the patient and gaining trust that participation is in their best interest for improving themselves and communities. Skepticism runs deep and a long memory of past injustices, be it factual or perceived remains. This mistrust plays a role in poor communication between patients and clinicians.<BR/><BR/> Therefore, I would argue that before becoming participants in the research activities, communities need information on being participating patients. <BR/>The first step in engaging the community entails teaching the community how to participate in the healthcare system when they do engage it. In the report "Racial and ethnic disparities in the use of health services ," by Dr. Ashton, Paul Haidet (1), the researchers identified poor communication between patients of color with their physicians as a significant contributor to racial and ethnic disparities in health care and health outcomes. The reports four recommendations: teaching patients how to provide a health narrative, how to ask important questions about their health and treatment options, how to discuss their concerns and how to be assertive in participating in their health management, are first steps in engaging patients in the healthcare system. <BR/><BR/>I agree with your thoughts and ideas on community based participatory research, and believe it to be the best in engaging a community. But if patients within the community do not know how to communicate with their physicians, then they will not communicate or participate in research activities.<BR/><BR/>Thus learning first to communicate with physicians with whom they engage, may lead to better understanding of research activities be it community based or otherwise.<BR/>E.G. Gayle, MD<BR/>Citation:<BR/>Ashton, Paul Haidet, M.D., M.P.H., Debora A. Paterniti, Ph.D., and others, in the February 2003 Journal of General Internal Medicine 18, pp. 146-152.E.G.Gayle, MDnoreply@blogger.com